Search results for: Health care

Authors: B. Stroetmann, A. Aisenbrey

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The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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Authors: Phayong Thepaksorn

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The objective of this study was to assess whether living in proximity to a roofing fiber cement factory in southern Thailand was associated with physical, mental, social, and spiritual health domains measured in a self-reported health risk assessment (HRA) questionnaire. A cross-sectional study was conducted among community members divided into two groups: near population (living within 0-2km of factory) and far population (living within 2-5km of factory) (N=198). A greater proportion of those living far from the factory (65.34%) reported physical health problems than the near group (51.04%) (p =0.032). This study has demonstrated that the near population group had higher proportion of participants with positive ratings on mental assessment (30.34%) and social health impacts (28.42%) than far population group (10.59% and 16.67%, respectively) (p <0.001). The near population group (29.79%) had similar proportion of participants with positive ratings in spiritual health impacts compared with far population group (27.08%). Among females, but not males, this study demonstrated that a higher proportion of the near population had a positive summative score for the self-HRA, which included all four health domain, compared to the far population (p<0.001 for females; p = 0.154 for males). In conclusion, this self-HRA of physical, mental, social, and spiritual health domains reflected the risk perceptions of populations living in the vicinity of the roofing fiber cement factory. This type of tool can bring attention to population concerns and complaints in the factory’s surrounding community. Our findings may contribute to future development of self-HRA for HIA development procedure in Thailand.

Keywords: Cement dust, health impact assessment, risk assessment, walk-though survey.

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Authors: Kerstin Grunden, Ann Svensson, Berit Forsman, Christina Karlsson, Ayman Obeid

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The research question of the article is to explore whether the dialogue meetings method could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in municipalities, or not. A testbed was planned to be implemented in a retirement home in a Swedish municipality, and the practitioners worked with a pre-study of that testbed. In the article, the dialogue between the researchers and the practitioners in the dialogue meetings is described and analyzed. The potential of dialogue meetings as an arena for learning and reflection among researchers and practitioners is discussed. The research methodology approach is participatory action research with mixed methods (dialogue meetings, focus groups, participant observations). The main findings from the dialogue meetings were that the researchers learned more about the use of traditional research methods, and the practitioners learned more about how they could improve their use of the methods to facilitate change processes in their organization. These findings have the potential both for the researchers and the practitioners to result in more relevant use of research methods in change processes in organizations. It is concluded that dialogue meetings could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in a health care organization.

Keywords: Dialogue meetings, implementation, reflection, test bed, welfare technology, participatory action research.

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Authors: K. Turhan, B. Kurt, E. Uzun

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This paper describes Clinical Document Architecture Release Two (CDA R2) standard and a client application for messaging with SAĞLIK-NET project developed by The Ministry of Health of Turkey. CDA R2 , developed by Health Level 7 (HL7) organization and approved by American National Standards Institute (ANSI) in 2004, to standardize medical information to be able to share semantically and syntactically. In this study, a client application compatible with HL7 V3 for a project named SAĞLIKNET, aimed to build a National Health Information System by Turkey. Moreover, CDA conformance of this application will also be evaluated.

Keywords: HL7 V3, CDA, Interoperability, Web Service.

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Authors: Arundhati Devi Maibam, K. Ingocha Singh

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Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: Cervical cancer, Manipuri women, RIIMS, Socio-demographic risk factors.

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Authors: Muhibul H. Bhuyan, Mafujul Hasan

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If a person can monitor his/her heart rate regularly then he/she can detect heart disease early and thus he/she can enjoy longer life span. Therefore, this disease should be taken seriously. Hence, many health care devices and monitoring systems are being designed to keep track of the heart disease. This work reports a design and simulation processes of an Arduino microcontroller based heart rate measurement and monitoring system in Proteus environment. Clipping sensors were utilized to sense the heart rate of an individual from the finger tips. It is a digital device and uses mainly infrared (IR) transmitter (mainly IR LED) and receiver (mainly IR photo-transistor or IR photo-detector). When the heart pumps the blood and circulates it among the blood vessels of the body, the changed blood pressure is detected by the transmitter and then reflected back to the receiver accordingly. The reflected signals are then processed inside the microcontroller through a software written assembly language and appropriate heart rate (HR) is determined by it in beats per minute (bpm) from the detected signal for a duration of 10 seconds and display the same in bpm on the LCD screen in digital format. The designed system was simulated on several persons with varying ages, for example, infants, adult persons and active athletes. Simulation results were found very satisfactory.

Keywords: Heart rate measurement, design, simulation, Proteus, Arduino Uno microcontroller.

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Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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Authors: M. M. Mortula

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Bottle water is getting very popular all through the world; especially in the gulf countries as the main source of drinking water. However, concerns over leaching of toxic chemicals are increasing. In this study, a health risk assessment was conducted in accordance with the guidelines indicated by United States Environmental Protection Agency (USEPA). It is conducted based on leaching of Diethyl Phthalate (DEP) from Polyethylene terephthalate (PET). The toxicity and exposure assessment of diethyl phthalate was conducted to characterize its risk on human health. Risk management is also discussed.

Keywords: Toxicity, diethyl phthalate, PET, risk Assessment.

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Authors: Ivy Chumo, Sheillah Simiyu, Hellen Gitau, Isaac Kisiangani, Caroline Kabaria Kanyiva Muindi, Blessing Mberu

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The global sanitation workforce bridges the gap between sanitation infrastructure and the provision of sanitation services through essential public service work. Manual pit emptiers often perform the work at the cost of their dignity, safety, and health as their work requires repeated heavy physical activities such as lifting, carrying, pulling, and pushing. This exposes them to occupational and environmental health hazards and risking illness, injury, and death. The study will extend the studies by presenting occupational health risks and suggestions for improvement in informal settlements of Nairobi, Kenya. This is a qualitative study conducted among sanitation stakeholders in Korogocho, Mukuru and Kibera informal settlements in Nairobi. Data were captured using digital voice recorders, transcribed and thematically analysed. The discussion notes were further supported by observational notes made during the interviews. These formed the basis for a robust picture of occupational health of manual pit emptiers; a lack or inappropriate use of protective clothing, and prolonged duration of working hours were described to contribute to the occupational health hazard. To continue working, manual pit emptiers had devised coping strategies which include working in groups, improvised protective clothing, sharing the available protective clothing, working at night and consuming alcohol drinks while at work. Many of these strategies are detrimental to their health. Occupational health hazards among pit emptiers are key for effective working and is as a result of a lack of collaboration amongst stakeholders linked to health, safety and lack of PPE of pit emptiers. Collaborations amongst sanitation stakeholders is paramount for health, safety, and in ensuring the provision and use of personal protective devices.

Keywords: Sanitation, occupational health, manual emptiers, informal settlements.

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Authors: Mustafa Jahanara

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The purpose of the current study is to examine the relationships between hope, optimism and mental health (psychological well-being and psychological distress) among students. A total of 222 students (132 males and 90 females) at the University of Pune from India completed inventories Revision of the Life Orientation Test (LOT-R), the Trait Hope Scale (THS) and the Mental Health Inventory (MHI) that assessed their optimism, hope and psychological well-being and psychological distress. The results of the study showed that optimism and hope were significantly correlated with each other. Optimism is positively related to psychological well-being and optimism is negatively related to psychological distress. Also, hope was positively related to psychological well-being. However, the findings suggest that optimism and hope could influence on mental health.

Keywords: Hope, optimism, psychological distress, psychological well-being.

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Authors: Mutshinye Manguvhewa, Maria Florence, Mansoo Yu

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Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential elements related with substance use among women of childbearing-age. Factors associated with substance use during pregnancy were explored using qualitative research approach and bio-ecological theoretical framework was utilised to guide the study. Participants were selected using purposive sampling. Participants accessed from the Department of Social Development who met the inclusion criteria of the study were interviewed using semi structured interviews. Participants were referred for psychological intervention during the interview if deemed necessary. Braun and Clarke’s six phases of thematic analysis were used to analyse the data. The study adhered to ethical measures for the participants’ protection. Participants had been knowledgeable about the study earlier than the initiation of the interviews and the important points of their voluntary participation had been explained. The key findings from this study illustrate that social factors, individual area and romantic relationship are the major contributing factors to substance use among pregnant ladies in this sample. Recommendations arising from the study encompass that the stakeholders, rehabilitation centers, Department of Health and future researchers ought to act proactively against substance use all through pregnancy.

Keywords: Bio-ecological factors, pregnancy risk awareness, antenatal care, substance use.

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Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

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Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as physiological vital signs, images and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful to influence the judgement of clinical sentiment in ICU clinical notes. This paper presents two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of a clinical transformer model that can reliably predict clinical sentiment for notes of COVID patients in ICU. We train the model on clinical notes for COVID-19 patients, ones not previously seen by Bio_ClinicalBERT or Bio_Discharge_Summary_BERT. The model which was based on Bio_ClinicalBERT achieves higher predictive accuracy than the one based on Bio_Discharge_Summary_BERT (Acc 93.33%, AUC 0.98, and Precision 0.96). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and Precision 0.92).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation.

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Authors: Yi-Ting Liu, Pei-Ying Wen

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In order to improve the overall safety of chemotherapy, safety-protecting netwas established for the whole process from prescribing by physicians, transcribing by nurses, dispensing by pharmacists to administering by nurses. The information system was used to check and monitorwhole process of administration and related sheets were computerized to simplify the paperwork.

Keywords: Chemotherapy, Bar Code Medication Administration (BCMA), Medication Safety.

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Authors: Saleh Alumaran, Giampaolo Bella, Feng Chen

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The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified a set of cultural and sub-cultural dimensions in SA health information security and services.

Keywords: Behaviour theory, Culture dimensions, Electronic health records, Information security.

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Authors: Bin Su

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According to the Auckland climate, building passive design more focus on improving winter indoor thermal and health conditions. Based on field study data of indoor air temperature and relative humidity close to ceiling and floor of an insulated Auckland townhouse with and without a whole home mechanical ventilation system, this study is to analysis variation of indoor microclimate data of an Auckland townhouse using or not using the mechanical ventilation system to evaluate winter indoor thermal and health conditions for the future house design with a mechanical ventilation system.

Keywords: House ventilation, indoor thermal condition, indoor health condition, passive design.

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Authors: Michael Ajide Oyinloye

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Generally the natural environment is made up of air, water and soil. The release of emission of industrial waste into anyone of the components of the environment causes pollution. Industrial pollution significantly threatens the inherent right of people, to the enjoyment of a safe and secure environment. The aim of this paper is to assess the effect of environmental pollution and health risks of residents living near Ewekoro cement factory. The research made use of IKONOS imagery for Geographical Information System (GIS) to buffer and extract buildings that are less than 1km to the factory, within 1km to 5km and above 5km to the factory. Also questionnaire was used to elicit information on the socio-economic factors, effect of environmental pollution on residents and measures adopted to control industrial pollution on the residents. Findings show that most buildings that fall between less than 1km and 1km to 5km to the factory have high health risk in the study area. The study recommended total relocation for the residents of the study area to reduce health risk problems.

Keywords: Environmental pollution, Ewekoro, GIS, Health risk, Satellite imagery.

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Authors: Atena Sajedin, Shokoufeh Zakernejad, Soheil Faridi, Mehrdad Javadi, Reza Ebrahimpour

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This paper illustrates the use of a combined neural network model for classification of electrocardiogram (ECG) beats. We present a trainable neural network ensemble approach to develop customized electrocardiogram beat classifier in an effort to further improve the performance of ECG processing and to offer individualized health care. We process a three stage technique for detection of premature ventricular contraction (PVC) from normal beats and other heart diseases. This method includes a denoising, a feature extraction and a classification. At first we investigate the application of stationary wavelet transform (SWT) for noise reduction of the electrocardiogram (ECG) signals. Then feature extraction module extracts 10 ECG morphological features and one timing interval feature. Then a number of multilayer perceptrons (MLPs) neural networks with different topologies are designed. The performance of the different combination methods as well as the efficiency of the whole system is presented. Among them, Stacked Generalization as a proposed trainable combined neural network model possesses the highest recognition rate of around 95%. Therefore, this network proves to be a suitable candidate in ECG signal diagnosis systems. ECG samples attributing to the different ECG beat types were extracted from the MIT-BIH arrhythmia database for the study.

Keywords: ECG beat Classification; Combining Classifiers;Premature Ventricular Contraction (PVC); Multi Layer Perceptrons;Wavelet Transform

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Authors: A. Sherif, H. Sabry, A. Elzafarany, M. Gadelhak, R. Arafa, M. Aly

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This paper addresses the design of hospital Intensive Care Unit windows for the achievement of visual comfort and energy savings. The aim was to identify the window size and shading system configurations that could fulfill daylighting adequacy, avoid glare and reduce energy consumption. The study focused on addressing the effect of utilizing different shading systems in association with a range of Window-to-Wall Ratios (WWR) in different orientations under the desert clear-sky of Cairo, Egypt. The results of this study demonstrated that solar penetration is a critical concern affecting the design of ICU windows in desert locations, as in Cairo, Egypt. Use of shading systems was found to be essential in providing acceptable daylight performance and energy saving. Careful positioning of the ICU window towards a proper orientation can dramatically improve performance. It was observed that ICU windows facing the north direction enjoyed the widest range of successful window configuration possibilities at different WWRs. ICU windows facing south enjoyed a reasonable number of configuration options as well. By contrast, the ICU windows facing the east orientation had a very limited number of options that provide acceptable performance. These require additional local shading measures at certain times due to glare incidence. Moreover, use of horizontal sun breakers and solar screens to protect the ICU windows proved to be more successful than the other alternatives in a wide range of Window to Wall Ratios. By contrast, the use of light shelves and vertical shading devices seemed questionable.

Keywords: Daylighting, Desert, Energy Efficiency, Shading.

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Authors: Frantisek Bozek, Lenka Jesonkova, Jiri Dvorak, Milos Bozek, Eduard Bakos

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The contents of nitrates and nitrites were monitored in 15 ground water resources of a selected region earmarked for the emergency supply of population. The resources have been selected on the basis of previous assessment of natural conditions and the exploitation of territory in the infiltration area as well as the surroundings of water resources. The health risk analysis carried out in relation to nitrates and nitrites, which were found to be the most serious water contaminants, proved, that 14 resources met the health standards in relation to the assessed criterion and could be included in crisis plans. Water quality of ground resources may be assessed in the same way with regard to other contaminants.

Keywords: Drinking water, health risks, methemoglobinemia, nitrates, nitrites, water pollution.

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Authors: Arsalan Jabbar, Wajiha Javed, Nelofer Mehboob, Zahid Memon

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Introduction: There are multiple social, individual and cultural factors that influence an individual’s decision to adopt family planning methods especially among non-users in patriarchal societies like Pakistan. Non-users, if targeted efficiently, can contribute significantly to country’s CPR. A research study showed that nonusers if convinced to adopt lactational amenorrhea method can shift to long term methods in future. Research shows that if non users are targeted efficiently a 59% reduction in unintended pregnancies in Saharan Africa and South-Central and South-East Asia is anticipated. Methods: We did secondary data analysis on Pakistan Demographic Heath Survey (2012-13) dataset. Use of contraception (never-use/ever-use) was the outcome variable. At univariate level Chi-square/Fisher Exact test was used to assess relationship of baseline covariates with contraception use. Then variables to be incorporated in the model were checked for multicollinearity, confounding and interaction. Then binary logistic regression (with an urban-rural stratification) was done to find relationship between contraception use and baseline demographic and social variables. Results: The multivariate analyses of the study showed that younger women (≤ 29 years)were more prone to be never users as compared to those who were >30 years and this trend was seen in urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR 1.809, CI 1.421-2.303). While looking at regional variation, women from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as compared to other urban regions. Women in the rich wealth quintile were more never users and this was seen both in urban and rural localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162, CI .887-1.524)) even though these were not statistically significant. Women idealizing more children (>4) are more never users as compared to those idealizing less children in both urban (AOR 1.854, CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916). Women who never lost a pregnancy were more inclined to be nonusers in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar with only traditional or no method had more never users in rural areas (AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant. Women unaware of Lady Health Worker’s presence in their area were more never users especially in rural areas (AOR 1.276, CI 1.014-1.607). Women who did not visit any care provider were more never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR 7.832, CI 6.243-9.826)). Discussion/Conclusion: This study concluded that government, policy makers and private sector family planning programs should focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more children.). We need to make sure to cover catchment areas where there are less LHWs and less providers as ignorance to modern methods and never been visited by an LHW are important determinants of never use. This all is in sync with previous literate from similar developing countries.

Keywords: Contraception, Demographic and Health Survey, Family Planning, Never users.

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Authors: Li-Ping Hsiao, Feng-Chuan Pan

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Leave of absence is important in maintaining a good status of human resource quality. Allowing the employees temporarily free from the routine assignments can vitalize the workers- morality and productivity. This is particularly critical to secure a satisfactory service quality for healthcare professionals of which were typically featured with labor intensive and complicated works to perform. As one of the veteran hospitals that were found and operated by the Veteran Department of Taiwan, the nursing staff of the case hospital was squeezed to an extreme minimum level under the pressure of a tight budgeting. Leave of absence on schedule became extremely difficult, especially for the intensive care units (ICU), in which required close monitoring over the cared patients, and that had more easily driven the ICU nurses nervous. Even worse, the deferred leaves were more than 10 days at any time in the ICU because of a fluctuating occupancy. As a result, these had brought a bad setback to this particular nursing team, and consequently defeated the job performance and service quality. To solve this problem and accordingly to strengthen their morality, a project team was organized across different departments specific for this. Sufficient information regarding jobs and positions requirements, labor resources, and actual working hours in detail were collected and analyzed in the team meetings. Several alternatives were finalized. These included job rotating, job combination, leave on impromptu and cross-departmental redeployment. Consequently, the deferred leave days sharply reduced 70% to a level of 3 or less days. This improvement had not only provided good shelter for the ICU nurses that improved their job performance and patient safety but also encouraged the nurses active participating of a project and learned the skills of solving problems with colleagues.

Keywords: Information, job rotating, human resource, intensive care unit.

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Authors: Armin Samarghandi, Amirreza Jafari, Mohamad Ghiasi

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Since individuals spend the majority of their time indoors, this immediately affects their productivity and health. An essential factor in occupational health and public health is the influence of indoor environmental quality (IEQ) in buildings on occupant welfare and productivity. Since then, empirical data have been equivocal, indicating either that the studies are inaccurate or that the research has just scratched the surface of green buildings in offices, accommodation, and hospital settings and not taken the aforementioned holistically. This study compared three green-certified buildings — a residential green building, a green hospital, and a green school — with conventional structures in Tehran, Iran by means of a questionnaire spread among those utilizing these buildings, and assessing their productivity and health rate as opposed to the time they resided, worked in conventional buildings. The results demonstrated higher scores pertaining to productivity, physical and mental wellness as a consequence of better indoor environmental quality (IEQ), natural lighting, design, and sustainability of these building against non-green buildings. In addition, ancillary matters — environmental, financial, intellectual, emotional, social, spiritual dimensions of participants — were indirectly evaluated, and the same results are produced.

Keywords: Green building, Iran, productivity, physical and mental health, Tehran.

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Authors: Haga Elimam

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This paper investigates the connotation, and some of the realistic implications, of the economic reform of health sector in under developed countries. The paper investigates the issues that economic reforms have to address, and the policy targets they are considered to accomplish. The work argues that the development of economic reform is not connected only with understanding the priorities and refining them, furthermore with reformation and restructuring the organizations through which health policies are employed. Considering various organizational values, that are likely to be regular to all economic reform programs, a regulatory approach to institutional reform is unsuitable. The paper further investigates the selection of economic reform that may as well influence via technical suggestions and analysis, but the verdict to continue, and the consequent success of execution, eventually depends on the progressive political sustainability. The paper concludes by giving examples of institutional reforms from various underdeveloped countries and includes recommendation of the responsibility and control of donor organizations.

Keywords: Economic Reform, Health Sector, underdeveloped Countries.

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Authors: S. Impey, D. Berry, S. Furtado, M. Galvin, L. Grogan, O. Hardiman, L. Hederman, M. Heverin, V. Wade, L. Douris, D. O'Sullivan, G. Stephens

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Healthcare is a knowledge-rich environment. This knowledge, while valuable, is not always accessible outside the borders of individual clinics. This research aims to address part of this problem (at a study site) by constructing a maximal data set (knowledge artefact) for motor neurone disease (MND). This data set is proposed as an initial knowledge base for a concurrent project to develop an MND patient data platform. It represents the domain knowledge at the study site for the duration of the research (12 months). A knowledge elicitation method was also developed from the lessons learned during this process - the WICKED method. WICKED is an anagram of the words: eliciting and confirming data, information, knowledge, wisdom. But it is also a reference to the concept of wicked problems, which are complex and challenging, as is eliciting expert knowledge. The method was evaluated at a second site, and benefits and limitations were noted. Benefits include that the method provided a systematic way to manage data, information, knowledge and wisdom (DIKW) from various sources, including healthcare specialists and existing data sets. Limitations surrounded the time required and how the data set produced only represents DIKW known during the research period. Future work is underway to address these limitations.

Keywords: Healthcare, knowledge acquisition, maximal data sets, action design science.

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Authors: Nevena Stolba, A Min Tjoa

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Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.

Keywords: data mining, data warehousing, decision-support systems, evidence-based medicine.

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Authors: W. Rowan, Y. O’Connor, L. Lynch, C. Heavin

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Situation Awareness can offer the potential for conscious dynamic reflection. In an era of online health data sharing, it is becoming increasingly important that users of health social networks (HSNs) have the information necessary to make informed decisions as part of the registration process and in the provision of eConsent. This research aims to leverage an adapted Situation Awareness (SA) model to explore users’ decision making processes in the provision of eConsent. A HSN platform was used to investigate these behaviours. A mixed methods approach was taken. This involved the observation of registration behaviours followed by a questionnaire and focus group/s. Early results suggest that users are apt to automatically accept eConsent, and only later consider the long-term implications of sharing their personal health information. Further steps are required to continue developing knowledge and understanding of this important eConsent process. The next step in this research will be to develop a set of guidelines for the improved presentation of eConsent on the HSN platform.

Keywords: eConsent, health social network, mixed methods, situation awareness.

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Authors: Sh. Khoshemehry, M. E. Bahram, M. J. Pourvaghar

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Sport has found a special place as an effective phenomenon in all societies of the contemporary world. The relationship between physical activity and exercise with different sciences has provided new fields for human study. The range of issues related to exercise and physical education is such that it requires specialized sciences and special studies. In this article, the psychological and social sections of exercise have been investigated for children and adults. It can be used for anyone in different age groups. Exercise and regular physical movements have a great impact on the mental and social health of the individual in addition to body health. It affects the individual's adaptability in society and his/her personality. Exercise affects the treatment of diseases such as depression, anxiety, stress, body image, and memory. Exercise is a safe haven for young people to achieve the optimum human development in its shelter. The effects of sensorimotor skills on mental actions and mental development are such a way that many psychologists and sports science experts believe these activities should be included in training programs in the first place. Familiarity of students and scholars with different programs and methods of sensorimotor activities not only causes their mental actions; but also increases mental health and vitality, enhances self-confidence and, therefore, mental health.

Keywords: Anxiety, mental health, physical activity, serotonin.

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Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira

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Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Keywords: Absenteeism, health/safety integration, work accommodation management, total worker health.

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Authors: Elżbieta Antczak

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Cities offer important opportunities for economic development and for expanding access to basic services, including health care and education, for large numbers of people. Moreover, green areas (as an integral part of sustainable urban development) present a major opportunity for improving urban environments, quality of lives and livelihoods. This paper examines, using spatial concentration and spatial taxonomic measures, regional diversification of greenery in the cities of Poland. The analysis includes location quotients, Lorenz curve, Locational Gini Index, and the synthetic index of greenery and spatial statistics tools: (1) To verify the occurrence of strong concentration or dispersion of the phenomenon in time and space depending on the variable category, and, (2) To study if the level of greenery depends on the spatial autocorrelation. The data includes the greatest Polish cities, categories of the urban greenery (parks, lawns, street greenery, and green areas on housing estates, cemeteries, and forests) and the time span 2004-2015. According to the obtained estimations, most of cites in Poland are already taking measures to become greener. However, in the country there are still many barriers to well-balanced urban greenery development (e.g. uncontrolled urban sprawl, poor management as well as lack of spatial urban planning systems).

Keywords: Greenery, urban areas, regional spatial diversification and concentration, spatial taxonomic measure.

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Authors: Yosia Mulumba, Klaus Schmidt

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Financial Inclusion is considered a key pillar for development in most countries around the world. Access to affordable financial services in a country’s economy can be a driver to overcome poverty and reduce income inequalities, and thus increase economic growth. Nevertheless, the number of financially excluded populations in developing countries continues to be very high. This paper explores the role of Financial Technology (Fintech) as a key driver for achieving financial inclusion in developing countries post the COVID-19 pandemic with an emphasis on four East African countries: Kenya, Tanzania, Uganda, and Rwanda. The research paper is inspired by the positive disruption caused by the pandemic, which has compelled societies in East Africa to adapt and embrace the use of financial technology innovations, specifically Mobile Money Services (MMS), to access financial services. MMS has been further migrated and integrated with other financial technology innovations such as Mobile Banking, Micro Savings, and Loans, and Insurance, to mention but a few. These innovations have been adopted across key sectors such as commerce, health care, or agriculture. The research paper will highlight the Mobile Network Operators (MNOs) that are behind MMS, along with numerous innovative products and services being offered to the customers. It will also highlight the regulatory framework under which these innovations are being governed to ensure the safety of the customers' funds.

Keywords: Financial inclusion, financial technology, regulatory framework, mobile money services.

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