205 research outputs found

    Liability crisis for Montana muncipalities with over 25000 residents

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    ElectroCutscenes: Realistic Haptic Feedback in Cutscenes of Virtual Reality Games Using Electric Muscle Stimulation

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    Cutscenes in Virtual Reality (VR) games enhance story telling by delivering output in the form of visual, auditory, or haptic feedback (e.g., using vibrating handheld controllers). Since they lack interaction in the form of user input, cutscenes would significantly benefit from improved feedback. We introduce the concept and implementation of ElectroCutscenes, a concept in which Electric Muscle Stimulation (EMS) is leveraged to elicit physical user movements to correspond to those of personal avatars in cutscenes of VR games while the user stays passive. Through a user study (N=22) in which users passively received kinesthetic feedback resulting in involuntarily movements, we show that ElectroCutscenes significantly increases perceived presence and realism compared to controller-based vibrotactile and no haptic feedback. Furthermore, we found preliminary evidence that combining visual and EMS feedback can evoke movements that are not actuated by either of them alone. We discuss how to enhance realism and presence of cutscenes in VR games even when EMS can partially rather than completely actuate the desired body movements

    Prioritizing research for integrated implementation of early childhood development and maternal, newborn, child and adolescent health and nutrition platforms

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    Background: Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 timeframe of the Sustainable Development Goals (SDGs).Methods: We applied the Child Health and Nutrition Research Initiative method, and consulted a diverse group of global health experts to develop and score 57 research questions against five criteria: answerability, effectiveness, deliverability, impact, and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question.Findings: The research priority scores ranged from 61.01 to 93.52, with a median of 82.87. The average expert agreement scores ranged from 0.50 to 0.90, with a median of 0.75. The top-ranked research question were: i) How can interventions and packages to reduce neonatal mortality be expanded to include ECD and stimulation interventions? ; ii) How does the integration of ECD and MNCAH&N interventions affect human resource requirements and capacity development in resource-poor settings? ; and iii) How can integrated interventions be tailored to vulnerable refugee and migrant populations to protect against poor ECD and MNCAH&N outcomes? . Most highly-ranked research priorities varied across the life course and highlighted key aspects of scaling up coverage of integrated interventions in resource-limited settings, including: workforce and capacity development, cost-effectiveness and strategies to reduce financial barriers, and quality assessment of programs.Conclusions: Investing in ECD is critical to achieving several of the SDGs, including SDG 2 on ending all forms of malnutrition, SDG 3 on ensuring health and well-being for all, and SDG 4 on ensuring inclusive and equitable quality education and promotion of life-long learning opportunities for all. The generated research agenda is expected to drive action and investment on priority approaches to integrating ECD interventions within existing health and nutrition services

    Critical Factors Influencing Adoption of Blockchain-Enabled Smart Contracts in Construction Projects

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    Construction projects are premised upon contractual arrangements, and contracts constitute the basis of their success. A contract enables execution of work and transfer of payments, tracking of key performance indicators, and facilitation of collaboration among project stakeholders. Historically, construction projects have faced critical challenges due to poor alignment between clients’ expectations, contract terms, and contractor performance. The advent of advanced digital technologies under the concept of Industry 4.0 has the potential to benefit construction projects through application of blockchain-enabled smart contracts. However, the adoption of smart contracts in construction projects is in its early stages, and the factors that will influence its adoption remain unclear. Therefore, this study aimed to explore and establish the critical factors influencing adoption of smart contracts in construction contractual arrangements. This study administered an international questionnaire survey among experienced construction practitioners with involvement in smart contract initiatives and activities. The results obtained from descriptive statistics and fuzzy set-based analysis show that trialability, relative advantage, competitive advantage, and compatibility of smart contracts are the important predictors of the adoption of such contracts. The findings suggest that practitioners share a view that technological characteristics of blockchain-enabled smart contracts are critical to their adoption, regarding the technology’s perceived practicality in improving effectiveness and efficiency of construction projects. This study contributes to technology diffusion research in construction and highlights drivers that require practitioners’ and industry leaders’ attention to ensure successful adoption of smart contracts for cost-effective delivery of construction projects

    Cure or control: complying with biomedical regime of diabetes in Cameroon

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    <p>Abstract</p> <p>Background</p> <p>The objective of the study was to explore the cultural aspect of compliance, its underlying principles and how these cultural aspects can be used to improve patient centred care for diabetes in Cameroon.</p> <p>Methods</p> <p>We used participant observation to collect data from a rural and an urban health district of Cameroon from June 2001 to June 2003. Patients were studied in their natural settings through daily interactions with them. The analysis was inductive and a continuous process from the early stages of fieldwork.</p> <p>Results</p> <p>The ethnography revealed a lack of basic knowledge about diabetes and diabetes risk factors amongst people with diabetes. The issue of compliance was identified as one of the main themes in the process of treating diabetes. Compliance emerged as part of the discourse of healthcare providers in clinics and filtered into the daily discourses of people with diabetes. The clinical encounters offered treatment packages that were socially inappropriate therefore rejected or modified for most of the time by people with diabetes. Compliance to biomedical therapy suffered a setback for four main reasons: dealing with competing regimes of treatment; coming to terms with biomedical treatment of diabetes; the cost of biomedical therapy; and the impact of AIDS on accepting weight loss as a lifestyle measure in prescription packages. People with diabetes had fears about and negative opinions of accepting certain prescriptions that they thought could interfere with their accustomed social image especially that which had to do with bridging their relationship with ancestors and losing weight in the era of HIV/AIDS.</p> <p>Conclusion</p> <p>The cultural pressures on patients are responsible for patients' partial acceptance of and adherence to prescriptions. Understanding the self-image of patients and their background cultures are vital ingredients to improve diabetes care in low-income countries of Sub-Sahara Africa like Cameroon.</p

    Advancing newborn health: The Saving Newborn Lives initiative

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    Until recently, newborn health was virtually absent from the global health agenda. Now, assistance agencies, national governments and non-governmental organisations are increasingly addressing this previously neglected issue of close to four million newborns dying every year. The experience of the Saving Newborn Lives initiative documents some of the progress that has been made and the challenges and opportunities that lie ahead. Since the start of the initiative in 2000, targeted research, focused on overcoming the key barriers to improved newborn survival, has demonstrated low-cost, community-based interventions and strategies that can significantly reduce newborn mortality. Building on what has been learned from this and other efforts to date, the challenge now is to reach the millions of newborns still at risk

    Principal component analysis of socioeconomic factors and their association with malaria in children from the Ashanti Region, Ghana

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    <p>Abstract</p> <p>Background</p> <p>The socioeconomic and sociodemographic situation are important components for the design and assessment of malaria control measures. In malaria endemic areas, however, valid classification of socioeconomic factors is difficult due to the lack of standardized tax and income data. The objective of this study was to quantify household socioeconomic levels using principal component analyses (PCA) to a set of indicator variables and to use a classification scheme for the multivariate analysis of children < 15 years of age presented with and without malaria to an outpatient department of a rural hospital.</p> <p>Methods</p> <p>In total, 1,496 children presenting to the hospital were examined for malaria parasites and interviewed with a standardized questionnaire. The information of eleven indicators of the family's housing situation was reduced by PCA to a socioeconomic score, which was then classified into three socioeconomic status (poor, average and rich). Their influence on the malaria occurrence was analysed together with malaria risk co-factors, such as sex, parent's educational and ethnic background, number of children living in a household, applied malaria protection measures, place of residence and age of the child and the mother.</p> <p>Results</p> <p>The multivariate regression analysis demonstrated that the proportion of children with malaria decreased with increasing socioeconomic status as classified by PCA (p < 0.05). Other independent factors for malaria risk were the use of malaria protection measures (p < 0.05), the place of residence (p < 0.05), and the age of the child (p < 0.05).</p> <p>Conclusions</p> <p>The socioeconomic situation is significantly associated with malaria even in holoendemic rural areas where economic differences are not much pronounced. Valid classification of the socioeconomic level is crucial to be considered as confounder in intervention trials and in the planning of malaria control measures.</p

    Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012

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    Iqbal S, Maqsood S, Zakar R, Zakria Zakar M, Fischer F. Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012. BMC Health Services Research. 2017;17(1): 189.Background Pakistan, being a developing country, presents the dismal picture of maternal and neonatal mortality and morbidity. The majority of maternal and neonatal deaths could be avoided if Continuum of Care (CoC) is provided in a structured pathway from pregnancy to birth and to the first week of life of the newborn child. This study aimed to analyse the trends of CoC at all three levels (antenatal care, skilled delivery and postpartum care) and to identify various factors affecting the continuation in receiving CoC in Pakistan during 2006 to 2012. Methods Secondary data analysis was performed on nationally representative data from the last two iterations of Pakistan Demographic and Health Survey (PDHS), conducted during 2006/07 to 2012/13. The analysis is limited to women of the reproductive age group (15–49 years) who gave birth during the last five years preceding both surveys. This leads to a sample size of 5,724 and 7,461 respondents from PDHS 2006/07 and 2012/13 respectively. The association between CoC and several factors, including individual attributes (reproductive status), family influences, community context, as well as cultural and social values was assessed in bivariate analyses in a first step. Furthermore, odds ratios and adjusted odds ratios with 95% confidence intervals using a binary and multivariable logistic regression were calculated. Results Our research presents the trends of a composite measure of CoC including antenatal care, delivery assistance and postpartum care. The largest gap in CoC was observed at antenatal care followed by delivery and postnatal care within 48 h after delivery. Results show that CoC completion rate has increased from 15% to 27% amongst women in Pakistan over time from 2006 to 2012. Women with high age at first birth, having less number of children, with higher education, belonging to richest quintile, living in Sindh province and urban areas, having high autonomy and exposure to mass media were most likely to avail complete CoC. Conclusions The findings show that women in Pakistan still lack the CoC. This calls for attention to develop and implement tailored interventions, focusing on the needs of women in Pakistan to provide CoC in an integrated manner, involving both public and private sectors by appropriately addressing the factors hindering CoC completion rates
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