Burnout in healthcare affects the quality of patient care. In 2020, Mayo Clinic implemented Advanced Care at Home (ACH), a new hospital-at-home program. We aimed to assess burnout levels among ACH providers, analyzing data from quarterly surveys. Physicians and nurse practitioners registered in ACH completed a 16-question anonymous survey distributed via email. Ten questions from the original survey used the Maslach Burnout Inventory to measure the three domains associated with burnout: depersonalization, emotional exhaustion, and personal achievement. We conducted a descriptive analysis using frequency distribution and percentages. A total of 27 providers participated, with response rates of 38%, 23%, and 66% in the first, second, and third quarters. Over 75% of the participants responded satisfactorily to nine of the ten questions associated with the risk of burnout. Moreover, 77% of providers felt joyful at work "always or most of the time." Of the 74% of participants who responded to the question about feeling burned out from work, 48% of the participants "strongly” or “somewhat” disagreed, while only 26% "strongly” or “somewhat” agreed. Mayo Clinic's ACH has demonstrated low levels of burnout among providers, positively impacting the well-being of healthcare workers and contributing to a high standard of patient care.

(1) Background: There is not much research about obesity in nursing homes although knowledge will help us to develop customized treatment plans and prevention strategies, which may help to decrease the burden for all persons involved. The objective of conducting this study was to describe the prevalence of obesity and the association between obesity and care problems in nursing home patients. (2) Methods: This study is a secondary data analysis of data collected in an annually performed cross-sectional study called “Nursing Quality Measurement 2.0”. A standardized and tested questionnaire was used to collect data. (3) Results: 1236 nursing home patients took part and 16.7% of them were obese. The multivariate logistic regression analysis results show that urinary incontinence is significantly associated with the presence of obesity (OR 2.111). The other care problems of pressure injuries, fecal and double incontinence, physical restraints, falls and pain were not associated with obesity. (4) Conclusion: The results indicate that, in the nursing home setting, health care staff should pay special attention to the patients’ nutritional and continence status and help patients maintain a normal, healthy weight. Conducting more studies with larger sample sizes is recommended, as this will allow differentiation among different obesity classes.

Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, doctors, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for Legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint, and 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but stated that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. The home-based care services generate a significant amount of health care risk waste that is mismanaged. However, more attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

The COVID-19 pandemic has been challenging for society, especially for those residing in long-term care facilities (LTCF). This study aimed to describe rates of infection, hospitalization, and death due to COVID-19 among older people and staff of LTCF in a state of Southeastern Brazil and identify strategies to prevent and control the disease spread. This cross-sectional study was conducted with 164 LTCF (6,017 older people). Among the studied LTCF, 48.7% confirmed COVID-19 infection in older people, resulting in 39.6% hospitalization and 32.3% death among infected. Moreover, 68.9% of LTCF confirmed COVID-19 infection in the staff, with 7.3% hospitalization and 1.2% death. Preventive measures were identified and classified as organizational, infrastructure, hygiene items and personal protective equipment, and staff training against COVID-19. These measures showed strategies and barriers experienced in the daily routine of LTCF during the pandemic. LTCF in Brazil experienced challenges similar to observed worldwide.

This pilot randomized controlled trial (RCT) aimed to explore whether depression and anxiety could be reduced by psychiatric home healthcare supporters offering brief cognitive behavioral therapy for psychosis (CBTp) at home using a workbook for patients with schizophrenia. Eighteen patients with schizophrenia treated in a psychiatric home nursing service were randomly assigned to two groups: one group received CBTp in addition to usual care (CBTp + TAU group; n=8) and the other received only usual care (TAU group; n=8); 2 patients were excluded due to hospitalization or withdrawal of consent. Eight weekly CBTp sessions were conducted; anxiety/depression, quality of life, self-esteem, and overall functioning were assessed at baseline, week 9, and week 13. There was no significant difference in the primary evaluation; however, a significant improvement (p=0.014) was observed in the secondary evaluation of quality of life. The effect size was 0.95 for primary evaluation and 1.33 for the secondary evaluation, indicating a large effect. This study showed that nurses and occupational therapists can provide CBTp in psychiatric home care for patients with schizophrenia to potentially alleviate anxiety and depression compared to standard psychiatric home care alone. Therefore, larger RCTs with larger sample sizes are recommended.

Long-term care (LTC) settings are increasingly used for palliative care in Japan. This study aimed to assess the proportion of LTC settings that provide palliative care services for older clients with advanced dementia in Japan and the trends across the types of settings. A nationwide questionnaire survey was conducted between November 2022 and January 2023, targeting 1,000 geriatric hospitals (GHs), 1,000 geriatric health services facilities (GHSFs), and 1,000 home nursing care stations (HNCSs). The palliative care practices for older patients with advanced dementia and their families in the agencies were assessed. Less than half of the GHs supported family participation or the spiritual needs of their older clients with dementia, while many had access to pain and symptom assessments and analgesic prescriptions by physicians. Less than half the GHSFs used pain assessment tools, assessed and supported family caregivers' pain and distress, and supported family participation in palliative care. More than 80% of the HNCSs practiced most of the listed palliative care. Current palliative care practices for older adults with dementia vary among GHs, GHSFs, and HNCSs. This emphasizes the need for targeted approaches to improve the provision of palliative care for patients with dementia across LTC settings in Japan.

Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This cross-sectional report is part of a before/after intervention study using a multifaceted approach based on the normalization process theory to improve healthcare quality provided by nursing staff in 34 NHs in Spain. In this study we present the results of the first audit including 719 UTI cases, with an average age of 85.5 years and 74.5% being women. Cystitis and pyelonephritis presented distinct symptom patterns. Notably, 6% of asymptomatic bacteriuria cases were treated. The prevalence of dipstick usage was 83%, raising concerns about overreliance, including in the 46 asymptomatic cases, leading to potential overdiagnosis and antibiotic overtreatment. Improved diagnostic criteria and personalized strategies are crucial for UTI management in NHs, emphasizing the need for personalized guidelines on management of UTIs, to mitigate indiscriminate antibiotic use in asymptomatic cases.

Home care centers face both an increase in demand and many variations during the execution of routes, compromising the routes initially planned: robust solutions are not effective enough, it is necessary to move on to resilient approaches. We create a close to reality use case supported by interviews of staff at home health care centers, where caregivers are faced with unexpected events that compromise their initial route. We model, analyze and compare three resilient approaches to deal with these disruptions: a baseline approach without any collaboration, a distributed collaborative approach, and a centralized collaborative approach, where we propose a centralization and sharing of information to improve local decision-making. The latter reduces the number of late arrivals by 11% and the total time of late arrival by 21%, and also halves the number of routes exceeding the end of work time (contrary to the distributed collaborative approach, due to the time wasted reaching colleagues). The use of a device, such as a smartphone application, to centralize and share information thus allows better mutual assistance between caregivers. Moreover, we highlight several possible openings like the coupling of simulation and optimization to propose a more resilient approach.

Introduction: In the marginalised countries most neglected health issue is Newborn mortality. A study was undertaken to assess the influence of factors and newborn care practices influencing newborn health in the rural area of Bareilly district. Methodology: The Descriptive cross-sectional study was organized in the rural areas of Bareilly. Study participants were selected based on the mothers who gave birth to a baby during the last six months. The mothers who delivered in that area within six months were included, and using the semi-structured questionnaire, data was collected. Data analyzed using Microsoft Excel and SPSS 2021 version for windows. Results: Mothers initiating early breastfeeding were more commonly 78 (52.3%) observed in the younger mothers at 24-29 years, followed by 48(32.3%) at 30-35 years, the difference was statistically significant (p<0.05). Delayed bathing was observed in nearly 125 (70.1%) three fourth in the age of 24-29 years, followed by 29 (16.8%) in the age period 30-35 years. It was observed that unsafe cord care practices were observed more among 8(53.4%) nuclear families than 7(46.6%) joint families, and it was found to be statistically insignificant. Conclusion: The practice of essential newborn care still needs to improve in Bareilly; there is a need to create awareness to the mothers and family members on newborn and early neonatal care aspects, such as promoting exclusive and early initiation of breastfeeding and delayed bathing practices.

Abstract: Background: Bangladesh has achieved remarkable progress in reducing maternal mortality, yet postpartum deaths remain a significant issue. Emphasis on quality postnatal care (qPNC) is crucial, as increased coverage alone has not sufficiently reduced maternal morbidity and mortality. Methods: This study included data from the Bangladesh Maternal Mortality Survey of 32,106 mothers who delivered within three years prior to the survey. Descriptive statistics were used to report coverage and components of postnatal care stratified by covariates. Log-linear regression models were used to assess the determinants of quality postnatal care among facility and home births. Results: From 2010 to 2016, postnatal care coverage within 48 hours of delivery by a qualified provider rose from 23% to 47%. 94% of facility births received timely PNC, contrasted with only 6% for home births. Despite the increased coverage, quality of care remained as low as 1% for home births and 13% for facility births. Key factors affecting qPNC utilization included socio-demographic factors, pregnancy complications, delivery method, financial readiness, and mobile ownership. Conclusion: Importantly, deliveries assisted by skilled birth attendants correlated with higher quality postnatal care. The study reveals a significant gap between the coverage and quality of postnatal care in rural Bangladesh, especially for home births. It underscores the need for targeted interventions to enhance qPNC.

Multicomponent training is recommended for people with dementia living in long-term care homes. Nevertheless, evidence is limited and people with severe dementia are often excluded from trials. Hence, the aim of this study was to investigate (1) the feasibility and (2) the requirements regarding a multicomponent training for people with moderate to severe dementia. The study was conducted as an uncontrolled single arm pilot study with a mixed methods approach. 15 nursing home residents with a mean age of 82 years (range: 75-90 years; female: 64%) with moderate to severe dementia received 16 weeks of multicomponent training. Feasibility and requirements of the training were assessed by a standardized observation protocol. Eleven participants regularly attended the intervention. The highest active participation was observed during gait exercises (64%), the lowest during strength exercises (33%). It was supportive if exercises were task-specific or related to everyday life. This study confirms that a multicomponent training for the target group is (1) feasible and well accepted. To enhance active participation (2) individual instructions and the implementation of exercises related to everyday life is required. The effectiveness of the adapted training should be tested in future randomized controlled trials.

In recent years, the management of health systems is a main concern of governments and decision makers. Home health care is one of the newest methods of providing services to patients in developed societies that can respond to the individual lifestyle of modern age and the increase of life expectancy. The home health care routing and scheduling problem is a generalized version of the vehicle routing problem, which is extended to a complex problem by adding special features and constraints of health care problems. In this problem, there are multiple stakeholders such as nurses for which an increase of their satisfaction level is very important. In this study, a mathematical model is developed to expand traditional home health care routing and scheduling models to downgrading cost aspects by adding the objective of minimizing the difference between the actual and potential skills of the nurses. Downgrading can lead to a dissatisfaction of the nurses. In addition, skillful nurses have higher salaries and high-level services increase equipment costs and need more expensive trainings and nursing certificates. Therefore, downgrading can enforce hidden huge costs to the managers of a company. To solve the bi-objective model, an -constraint based approach is suggested and the model applicability and its ability to solve the problem in various sizes are discussed. A sensitivity analysis on the Epsilon parameter is conducted to analyze the effect of this parameter on the problem. Finally, some managerial insights are presented to help the managers in this field, and some directions for future studies are mentioned as well.

Background/Objectives: Home and community care (HCC) nurses experienced increased occupational challenges during the COVID-19 pandemic including increased workloads, job stressors and occupational risks like virus exposure. The objective was to elucidate what factors influenced nurses’ decisions to stay in their role, take a temporary leave, or exit HCC during the COVID-19 pandemic. Methods: A secondary analysis of data collected using a cross-sectional online open survey distributed among HCC Registered Practical Nurses across Ontario between June and September 2022 was conducted. The factors contributing to nurses’ decision to remain in HCC, temporarily leave, or exit the sector were evaluated using multinomial logistic regression (p < 0.05). Results: Of the 664 participants, 54% (n=357) stayed in the HCC sector, 30% (n=199) temporarily left, and 16% (n=108) exited the sector. Nurses with greater years of experience working in HCC and those who avoided infection were more likely to stay in their role in HCC, which may reflect strong relationships with long-term clients, opportunity and accumulated experience to increase income, and maintained good health. Nurses with higher levels of emotional intelligence were more likely to take leaves and exit HCC, suggesting that stepping away may have been a strategy to safeguard themselves. Conclusions: HCC leadership should prioritize the development of solutions to support nurses in the HCC workforce, including those with fewer years’ experience. This may promote nurses’ participation in the sector, particularly during times of heightened occupational challenges and crises like COVID-19.

The EXO+ hip protector was developed to minimize the risk of hip fractures in seniors following falls. This study evaluated its usability in a Singapore nursing home from the perspective of staff, focusing on Learnability, Efficiency, and Satisfaction. A mixed-method design was employed, with nursing home residents wearing the EXO+ daily for 8 weeks. Quantitative data on wear time was collected alongside qualitative insights from four repeated focus group discussions with care staff. In total, 15 residents (including 8 residents with cognitive impairments) and 9 staff participated. The analysis revealed six themes and fourteen subthemes related to EXO+’s usability. Residents wore the device for an average of 1.54 hours per day, with those having cognitive impairments showing increased wear times, especially in the mornings and on weekdays. Findings indicated that the EXO+ was learnable and satisfactory for nursing home use, provided there are adequate supporting features. The efficiency of the EXO+ was not fully measured since no falls were reported during the study period. The study offers valuable insights for potential design modifications and workflow adaptations to enhance the implementation of hip protectors in healthcare settings, highlighting facilitators and barriers to support device uptake.

In Taiwan, remote healthcare was initially limited to telemedicine services, and the systematic development of remote care was relatively delayed. It was not until 2007 that the Department of Health of the Executive Yuan first initiated the 'Remote Care Pilot Program,' followed by the 'Remote Care Service Improvement and Quality Enhancement Plan' in the subsequent year. In 2010, Taiwan officially launched the 'Remote Health Care Services Development Plan' and established a dedicated project office, marking the comprehensive start-up of remote care services. This stage saw significant contributions from artificial intelligence aids and ICT remote transmission technologies, greatly promoting the application of smart healthcare in home care. This study aims to explore the strategic gaps in the application of smart healthcare in home remote care. By analyzing gaps in 'legal regulations,' 'economic factors,' 'user behavior habits,' 'policy and culture,' and 'environment and technology,' this study employs a mixed-methods approach. Particularly, it uses the Analytic Hierarchy Process (AHP) to construct a weighted ranking of these strategic gaps. Through in-depth interviews with doctors and smart healthcare experts and the collection of 16 valid AHP questionnaire samples, which cover both industry and academia with a balanced distribution, the survey results are ensured to be representative and reliable. The findings indicate that 'legal regulations' are considered the most critical strategic gap that needs to be addressed first, followed by 'user behavior habits.' This suggests that when designing smart healthcare applications, greater consideration needs to be given to user acceptance and habits. By systematically analyzing and addressing these strategic gaps, this study not only provides solutions to issues in the application of smart healthcare in home remote care but also offers valuable references for future research and practice, aiming to make home remote care services more comprehensive and efficient.

The understanding of various health-oriented vital sign data generated from body sensor networks (BSN) and discovery of the association between the generated parameters is an important task that may assist and promote important decision making in healthcare. For example, in a smart home scenario where the occupants’ health status is continuously monitored remotely, it is essential to provide required assistance when an unusual or critical situation is detected in their vital sign data. In this paper, we present an efficient approach to mine the incomplete (partial) periodic patterns obtained from BSN data. In addition, we employ a correlation test on the generated patterns and introduce the productive-associated partial periodic frequent patterns as the set of correlated partial periodical frequent items. The combination of these measures has the advantage of empowering healthcare providers and patients for quality of diagnosis, and also for better treatment and smart care, especially for the elderly people at smart home. We developed an efficient algorithm named PPFP-Growth (Productive Periodic Frequent Pattern growth) to discover all productive associated partial periodic patterns using these measures. PPFP-Growth is efficient, and the productiveness measure removes uncorrelated periodic items. An experimental evaluation on synthetic and real datasets shows the efficiency of the proposed PPFP-Growth algorithm, and can filter a huge number of partial periodic patterns to reveal only the correlated ones.

Aim: this scoping review was designed to identify studies that assess the adverse drug reactions (ADRs) for older people in Australian aged-care facilities. This review critically evaluated each published study to identify the risk of, or actual adverse drug events in older people. Inclusion criteria: This review considered any clinical studies that examined the adverse effects of medications in older people who were living in aged-care facilities. This review considered qualitative studies, analytical studies, RCTs, descriptive cross-sectional studies, and analytic observational studies that explored the use of medications and their adverse effects on older people in clinical settings (including aged care facilities). Methods: An initial search of the PubMed, OvidSP, EBSCOHost, MEDLINE, ScienceDirect, Wiley Online, SAGE, and SCOPUS databases, with full text was performed, followed by an analysis of the article’s title and abstract. Additionally, MeSH was used to describe the article. The initial round of the database search was based on inclusion criteria from studies that assessed tools or protocols aiming to identify the adverse effects of medications on the elderly population suffering chronic conditions or multiple co-morbidities. Two reviewers screened the retrieved papers for inclusion. The data presented in this review are in tabular forms and a narrative summary which aligns with the review’s objectives. Results: Seven studies were identified, and the extracted data from these studies were grouped according their characteristics and the auditing results of each study. Conclusion: There was no comprehensive or broadly adverse drug reaction assessment tool derived from Australian data that has been used on the elderly in an Australian healthcare setting.

The COVID-19 pandemic profoundly impacted older people in residential aged care facilities (RACFs), especially those with dementia. This retrospective cohort study investigates the impact of the pandemic on agitation incidents within this population in 40 Australian RACFs. We compared pre-pandemic data (January-October 2019) with during-pandemic data (same months in 2020 and 2021) from electronic health records (EHRs) using Python to extract information from nursing notes. Various statistical analyses, including descriptive statistics to summarize the data, and a chi-square test to examine any significant association between the COVID-19 pandemic and the prevalence of dementia and agitation in dementia. Dementia prevalence dropped by 1.98% in 2021 compared to 2019, and by 4.09% compared to 2020 (p < 0.05). Overall agitation symptoms decreased by 20.1% from 2019 to 2021 (p < 0.05), but six specific symptoms increased: resisting (28.98%), wandering (11.78%), restlessness (3.19%), complaining (10.1%), arguing (2.36%), and outbursts (1.74%) (p < 0.05). Conversely, pacing decreased by 15.88% and speaking loudly de-creased by 10.9% (p < 0.05). Over half of the care recipients experienced agitation symptoms 2-5 times each year, increasing from 50.56% in 2019 to 58.28% in 2021 (p < 0.05). It is important to exercise caution regarding the accuracy of these findings due to the reduced opportunity for busy care staff to record behavioral changes caused by the isolation of individuals in their rooms during the pandemic.

Jabulile Ndlovu1 and Kebogile Mokwena1, 2 1 Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa 2 Research Chair in Substance abuse and population Mental Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa Corresponding author: jabulilendlovu5@gmail.com Abstract An estimated 6% of the world population has serious mental illness, with one in four families having a member with some form of psychiatric disorder, who are mostly cared for by their relatives within a family setting. Although caregiving in a home setting is reported to be associated with significant mental distress, the burden of such distress is rarely measured. The purpose of this study was to quantify the burden of care among family caregivers of relatives with serious mental disorders, as well as to explore possible association between the caregiver burden of care and a range of caregiver and Mental Health Care User (MHCU) variables in a rural district in Kwa-Zulu Natal, South Africa. The Zarit Burden Interview (ZBI) scale was used to collect data from 357 caregivers, and STATA 14 was used to analyze data. The ages of the sample ranged from 18 to 65, with a mean of 50.29, and the majority (86%) were female and unemployed (83%). The ZBI scores ranged from 8 to 85, with a mean of 41.59. The majority (91%) tested positive for caregiver burden of care, which ranged from mild to severe. Using the Pearson Chi-square test of association (p=0.05), variables that were significantly associated with the burden of care were clinically related (caregiver self-reported depression, MHCU diagnosis, recent relapse of the MHCU), socio-economic (caregiver family monthly income, MHCU disability grant status and MHCU employment status) and socio-demographic (MHCU gender and MHCU level of education). The prevalence of burden of care is high and severe, and scarcity of resources in families and communities contribute to the high burden of care in these rural communities.

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

Goals: To use visual logistics for interpreting COVID-19 molecular and rapid antigen test (RAgT) performance, determine prevalence boundaries where risk exceeds expectations, and evaluate benefits of recursive testing along home, community, and emergency spatial care paths. Methods: Mathematica/open access software helped graph relationships, compare performance patterns, and perform recursive computations. Results: Tiered sensitivity/specificity comprise: T1) 90%/95%; T2) 95%/97.5%; and T3) 100%/≥99%, respectively. In emergency medicine, median RAgT performance peaks at 13.2% prevalence, then falls below T1, generating risky prevalence boundaries. RAgTs in pediatric ERs/EDs parallel this pattern with asymptomatic worse than symptomatic performance. In communities, RAgTs display large uncertainty with median prevalence boundary of 14.8% for 1/20 missed diagnoses, and at prevalence >33.3-36.9% risk 10% false omissions for symptomatic subjects. Recursive testing improves home RAgT performance. Home molecular tests elevate performance above T1, but lack adequate validation. Conclusions: Widespread RAgT availability encourages self-testing. Asymptomatic RAgT and PCR-based saliva testing present the highest chance of missed diagnoses. Home testing twice, once just before mingling, and molecular-based self-testing help avoid false omissions. Community and ER/ED RAgTs can identify contagiousness in low prevalence (<22%). Real-world trials of performance, cost-effectiveness, and public health impact could identify home molecular diagnostics as the optimal diagnostic portal.

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical, geographic variables, and neighborhood socio-economic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to patients who received home health care within the recommended first two days, patients who received delayed services (3-7 days after discharge) had higher odds of rehospitalization (OR 1.28, 95% CI 1.25-1.32). Among patients who received late services (8-14 days after discharge), the odds of rehospitalization were four times greater than for patients receiving services within 2 days (OR 4.12, 95% CI 3.97-4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.

The Dutch PET@home Toolkit was developed to mitigate challenges and foster conversations and planning concerning pets in long-term care at home. This process evaluation study aimed to evaluate the practical application of the toolkit on four topics: 1) satisfaction; 2) relevance; 3) feasibility; and 4) integration of the PET@home Toolkit materials in home care. Outcomes may be used to improve the toolkit materials to better align with the long-term care at home setting. Accounting for data saturation, professional caregivers (N=6), clients (N=2), and family caregivers (N=2) who used toolkit materials participated in semi-structured interviews. Interviews were analysed by two researchers in ATLAS.ti using an inductive-iterative approach. The researchers reached consensus on themes and clustering within interview topics. This led to the identification of the following topics and (themes): satisfaction (general impression, suggestions for improvement), relevance (awareness, planning, pet-related aspects in practice, impact on healthcare quality), feasibility (healthcare practice, competence, quantity), and implementation (digitalisation, task owner, piloting, timing). Several improvements were made to toolkit materials, such as providing clearer instructions for clients in the information booklet. Participants acknowledged the toolkit could lead to better planning while mitigating potential challenges concerning pets which may lead to longer-lasting relationships between clients and their pets.

Home-dwelling older people without health services might develop health issues and challenges. To live longer at home and manage well, it is important to promote health-promotion towards this target group. One approach is through health-promotion dialogues conducted by healthcare professionals in the municipality. The aim of this study is to explore healthcare professionals’ experiences who are conducting health-promotion dialogues to older home-dwellers over 75 years without services. Focus-groups were used to collect data, and a total of nine participants formed three focus groups. Thematic analysis was applied to analyse the material, which resulted in one major theme “The challenging dialogues” comprising three sub-themes, “Mobilise coping skills and health awareness”, “Uncover vulnerability”, and “The ambiguity of the dialogues”. The findings were also discussed by using empowerment as a theoretical lens. The health-promotion conversation uses a resource perspective for elderly to remain independent in old age and can reveal vulnerability and underlying needs. The conversation purpose appears ambiguous for the target group, which leads to unclear service expectations and rejections of the offer. Nevertheless, it seems to be important that this health-promotion service to a larger degree addresses a clear purpose in order to meet the needs of the target group in a broader sense in the aging process.

Agroforestry homegardens are integrated arrangements of common vegetable plants in areas close to residences, which follow a structure similar to that of tropical forests, with the cultivation of multiple species to meet the basic needs of families, such as the provision of food and medicine, as well as ensuring an environment for other family activities. Considering the importance of these environments, this work aimed to address the composition and use of plant species in agroforestry homegardens, in order to support society initiatives and government policies to strengthen the management of natural resources and individual and collective well-being in the region. For this, 119 homegardens were studied in the municipalities of Belterra, Mojuí dos Campos and Santarém, in the state of Pará, in the Brazilian Amazonia, comprising five different zones (peri-urban, urban, floodplain, indigenous land and tourist land), obtaining the data via questionnaires and guided visitation by the residents. A total of 5,323 vegetal individual plants were surveyed, distributed in 188 species and 62 botanical families. The data showed that 80.5% of the individual plants are concentrated in 18.6% of the species, with no significant difference in the average of species per homegarden in the five zones. The predominance of species for food use, primarily fruit-bearing, stands out, showing a possible direction for incentive actions and/or for the ordering of public policies and programs aimed at these spaces. Most homegardens have up to 17 plant species; less than half of homegardens have species intended for medicinal use; and there is percentage parity between native plant species and those of exotic origin, where native plants stand out for shading. Agroforestry homegardens play a crucial role in the conservation and cultivation of species for food purposes, with the cultivation or maintenance of plants based on their various purposes, showing distinct profiles of distribution and choice of species, evidencing their socioeconomic and environmental importance. Thus, it is important that these land use systems are valued, investing financial resources in actions and projects aimed at maintaining and enhancing their benefits for the region.

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

This article describes the use of the PI ProcessBook software tool for visualization and indirect monitoring of occupancy of SHC rooms from the measured operational and technical quantities for monitoring of daily living activities for support of independent life of elderly persons. The proposed method for data processing (predicting the CO₂ course using neural networks from the measured temperature indoor T_i (°C), temperature outdoor T_o (°C) and the relative humidity indoor rHi (%)) was implemented, verified and compared in MATLAB SW tool and IBM SPSS SW tool with IoT platform connectivity. Within the proposed method, the Stationary Wavelet Transform de noising algorithm was used to remove the noise of the resulting predicted course. In order to verify the method, two long-term experiments were performed, (specifically from February 8 to February 15, 2015, from June 8 to June 15, 2015) and two short-term experiments (from February 8, 2015 and from June 8, 2015). For the best results of the trained ANN BRM within the prediction of CO₂, the correlation coefficient R for the proposed method was up to 90%. The verification of the proposed method confirmed the possibility to use the presence of persons of the monitored SHC premises for rooms ADL monitoring.

The Smart Angel connected medical device allows ambulatory surgery patients to monitor their health by taking their own blood pressure and oxygen levels and by answering a health questionnaire from home. This preventive device must necessarily be "usable" by patients with different profiles. The objective of this article is, therefore, to better understand the links between certain characteristics of potential patients and usability. We conducted an experimental study involving thirty-six participants, investigating the effects of four patient characteristics (i.e. age, education, technophilia and health literacy) on usability measured in terms of effectiveness, efficiency, and satisfaction. The results show a moderate correlation between age, health literacy and usability. However, there is a weak correlation between technophilia and usability and no relationship between the level of education and usability. This study provides theoretical insights into the effects of user characteristics by means of personas in usability (ISO 9241-11).

The Supportive and Palliative Indicators Tool (SPICT) was developed for timely identifying patients who may benefit from supportive and palliative care for a better treatment review, care plan discussion, and end-of-life care. Although the SPICT has been validated in different languages and patients living in different settings, it has not been validated in patients receiving home-based medical care (HBMC), or in the context of using traditional Chinese characters. The present study aimed to validate the Taiwan version of SPICT (SPICT-TW) and to measure its ability to predict six-month mortality in patients who received HBMC in Taiwan. Seven HBMC agents (five clinics and two hospitals) participated in this validation study. We recruited 129 patients aged ≥50 years who had been consistently receiving HBMC for &gt; two months. The results revealed that the SPICT-TW demonstrated similar reliability and validity compared to other language versions of SPICT. It may be an appropriate tool for healthcare professionals to timely detect the needs of palliative care in older people who received home healthcare. Furthermore, we found that a combination of four general indicators and one clinical indicator in SPCIT-TW has the best prediction ability at predicting six-month mortality in these HMBC recipients. This multicenter study validated the SPICT-TW among HBMC recipients in Taiwan. SPICT-TW demonstrated high reliability and validity and may be a practical tool for identifying older people at risk of dying within six months who would benefit from palliative care.

Medication adherence is a vexing challenge with nonadherence at 50% or greater among US adults. With most medications self-administered by patients in the home, home medication management practices, especially where patients store medication in the home and receptivity to guidance from healthcare providers, need to be better understood to improve adherence. We designed and deployed a survey to investigate home medication management. The 1,673 survey respondents reported that the most common home storage locations for medications were nightstand drawers (28%) and atop nightstands (27%). Kitchen cabinets and bathroom vanities were significantly associated with increased odds of having ever forgotten to take a medication. Desks, dining room tables, and nightstand drawers were associated with the greatest statistically significant decrease in odds of having ever forgotten to take a medication. Almost all (96%) respondents were receptive to guidance on medication storage from a healthcare provider. Patients are largely on their own to devise home medication management practices, yet some home storage locations are significantly associated with decreased odds of having forgotten to take a medication. Knowing which practices are associated with adherence may lead to better guidance for patients from healthcare providers and to innovation in the design of medication adherence interventions.

Robot-assisted rehabilitation has emerged as a promising approach for enhancing motor function in stroke survivors. However, the feasibility and effectiveness of home-based robotic training in this population are underexplored, especially in low/middle-income countries. This feasibility study aimed to address this gap by examining the feasibility and effectiveness of independent home-based training using PLUTO, a robotic device for hand training. A total of 7 chronic stroke survivors were recruited, with 5 completing the study. The results revealed high engagement and adherence to the home-based training program, with participants averaging 1659.8 minutes of training over 24.8 days. The PLUTO system demonstrated excellent usability and elicited positive user perceptions. Significant improvements were observed in functional outcomes, as evidenced by a noteworthy increase in Fugl-Meyer Assessment scores (mean increase of 6.2 points, exceeding the minimal clinically important difference (MCID) of 5.35 points). Furthermore, participants showed improvements in the ABILHAND measure (mean improvement of 1.24 logits, surpassing the MCID of 0.2 logits) and the Barthel Index (mean increase of 8.8 points). These findings demonstrate the feasibility and effectiveness of home-based robotic rehabilitation for chronic stroke survivors. This has implications for expanding access to rehabilitation services in low- and middle-income countries, enhancing patient engagement and adherence, and improving functional outcomes. Larger controlled studies are warranted to evaluate the effectiveness of home-based robotic rehabilitation programs.

The reef manta ray (Mobula alfredi) is a highly mobile and plankton-feeding species, classified vulnerable to extinction on the IUCN Red List for Threatened Species. Knowledge on their spatial ecology and the extent of their dispersal remain incomplete, especially within island-fragmented habitats as found in New Caledonia. Satellite telemetry was used to investigate the horizontal movement ecology of reef manta rays in New Caledonia. A total of 21 manta rays were tagged with pop-up satellite archival transmitting tags (21 Fastloc and 2 MiniPAT) that remained deployed for a duration ranging from 3 to 180 days (mean ± SE = 76.7 ± 50.3). Rays presented a strong site fidelity and an important affinity for coastal waters. Long-distance migrations (> 300 km) were also observed, mainly through coastal and shallow water paths. Horizontal movements were compared to a home range area and classified into four distinct patterns: Fidelity, Excursion, Fidelity + Relocation and Relocation. The most dominant pattern was Fidelity where manta rays remained within their home range for the whole duration of the tag deployment. Our findings may assist the design of more appropriate management strategies for the species in New Caledonia and other regions worldwide.

The fact that Thailand’s energy policy has set a new renewable energy target of 30% of total final energy consumption by 2036. It also has the potential of solar energy and community demands in remote areas. However, most of the renewable energy technology will still be able to achieve renewable energy goals, similar to the case of the national policy that promotes Solar Home System (SHS) in remote areas, lack of good handling. Therefore, achieving the goal of the renewable energy policy should be in position using the right strategy. This article presents the result of a case study in the Akha upland community, northern Thailand, where we used the mixing method and factor analysis to analyze strategies for SHS related criteria. The key scopes and challenge included bottom-up planning concepts and subsidies from expert persons, while contributions to factors have an impact on developing sustainable SHS, include the creating approval of SHS technologies, developing of SHS management, promoting of SHS technologies, and supporting of SHS policies, respectively. Mainly, social factors provide positive effects, which thus influence the sustainable development of process SHS in terms of the creation of approval. Furthermore, there should be managed appropriately for each community, for the positive imagery of solar power.

(1) Background: The purpose of this study was to assess the external load demands in futsal, con-sidering both home and away matches and their outcomes, in order to plan microcycles throughout the season based on the external load of each match. (2) Methods: The external load of 10 players from a First Division team in the Spanish Futsal League was recorded. The total dura-tion of player involvement with the clock stopped was 18.15 ±7.04 minutes. The players' external load was monitored using OLIVER devices. To analyse the influence of the match outcome and location on the external load, a univariate general linear model (GLM) analysis was conducted. (3) Results: There are no differences between the variables, except for accelerations of 2 to 3 m/s² (m) per minute and the number of accelerations of 2 to 3 m/s² per minute. Despite not showing significant differences, there is a trend indicating a higher demand for external loads in away matches as well as in matches won. (4) Conclusions: These findings are important for planning microcycles and providing the appropriate dosage to each player to achieve optimal performance in matches.

This study aims to spatially analyze the distribution characteristics of vacant homes in Asan-si, Chungcheongnam-do, and understand the differences in factors causing vacant homes by type. We use a variety of statistical methods to examine these factors and identify key influencing factors such as the number of vacant stores, changes in overall population, land use complexity, and physical characteristics of land and buildings. The findings reveal that the factors contributing to the occurrence of vacant homes vary significantly by region and property type, highlighting the need for region-specific policies. For instance, in old town areas, small lot ratios and land use complexity are significant, while in rural village, the average number of floors and land use complexity play a major role. This study underscores the diversity of factors influencing vacant homes, suggesting that policies should be tailored to the unique characteristics of different regions to effectively address this issue.

Objective: To investigate the feasibility and preliminary effects of a 12-week home-based moderate intensity cycling programme in stroke survivors. Design: Single-blinded, parallel group, Randomised Controlled Trial Setting: Home-based Participants: Participants will be survivors of first-ever stroke and randomly assigned to an Active Cycling Group (ACG) or control group. Intervention: The ACG performed a 12-week home-based cycling programme, three sessions per week. Work intervals were executed at 75% of the maximal heart rate (HR_max), recovery intervals at 50% of HR_max. Work interval duration increased from three ten-minute intervals to 30 minutes continuous cycling. The control group completed a 12-week neurocognitive exercise programme. Main outcome measurements: Primary outcome measures are compliance with training, adherence to protocol and safety as measured by adverse events. Secondary outcome measurements included a: simplified modified Rankin Scale questionnaire (stroke severity), Six-Minute Walking Test (walking ability), Ten-meter Walk Test (walking ability), Rivermead Mobility Index (walking ability), graded submaximal cycling test (exercise capacity), Physical Activity for Individuals with Physical Disability questionnaire (physical activity), EQ-5D-5L (quality of life), Stroke Specific Quality of Life questionnaire (quality of life), Montreal Cognitive Assessment (cognition), General Self-Efficacy Scale (self-efficacy), and Exercise Self-Regulation Questionnaire (self-regulation).

Objectives: To analyze cumulative incidence and mortality by COVID-19 in the different types of nursing homes, in the first and second wave.Methods: Data source: Transparency portal of the Generalitat de Catalunya, official COVID-19 register of all Catalan nursing homes (from March to December 10, 2020). Variables: Affectation of disease and mortality by COVID-19 in geriatric centers in Catalonia, stratified by size of center and type of management. Univariate, bivariate and multivariate linear regression analysis, IBM^TMSPSS^® v.20.Results:N = 1,057 residences (63,682 beds, average = 60.48). 52% have <50 beds, 42.8% between 50-150 beds, and 5%> 150 beds. COVID-19: Cumulative incidence: 21,370 (confirmed + suspicious); mortality: 5,010 (confirmed + suspicious).233 residences did not register COVID-19 patients (22%) and 636 did not register COVID-19 deaths (60.2%).According to the type of supplier, the lowest incidence of COVID-19 was in non-accredited (36.2% without cases), then concerted / collaborators (19.3%) and own of the Generalitat de Catalunya (7.9 %, p = 0.000). The centers with the fewest deaths were the non-accredited (78% without deaths), followed by contracted / collaborators (56.8%) and those of the Generalitat de Catalunya (41.3%, p = 0.000).Depending on the size, no COVID-19 patients were registered: 168 centers <50 beds (30.5%); 64 of the 50-150 beds (14.2%); and 1 of the> 150 beds (1.9%) (p = 0.000). 395 of the <50 beds did not register deaths due to COVID-19 (71.8%), 232 of the 50-150 beds (51.3%), and 9 of the> 150 beds (17%) (p = 0.000).Discussion:Of the 1,057 centers analyzed, 22% did not register cases and in 60% there were no deaths from COVID-19.Residences without concert / collaboration with the Generalitat and with fewer beds showed a lower cumulative incidence and mortality due to COVID-19 during the first wave.

Abstract: Background: Stunting is primarily a public health concern in LMIC. The involvement of Integrated Service Post cadres is one of the strategies to combat stunting in Indonesia. Objective: This study aimed to determine the effect of a short course on cadres knowledge. Method: A single group pre-post test design was conducted in Yogyakarta, Indonesia, from March to May 2022. Thirty cadres were selected based on the following criteria: willingness to participate, the number of stunted children in their Integrated Service Post (Posyandu), and full attendance at short course. The knowledge scores were measured by a structured questionnaire after short course (post-test 1) and 4 weeks later (post-test 2). We apply STATA 16 to calculate the mean difference (MD) using a t-test and Generalized Estimated Equation (GEE). Furthermore, the adequacy of the short course was evaluated with in-depth interviews. Result: On post-tests 1 and 2, cadres' knowledge of IYCF, children growth monitoring (CGM) and children development monitoring (CDM) significantly improved. The GEE analysis showed that a short course significantly improves cadres' knowledge after age control, education, occupation, and years of experience. Conclusion: Short course in-creased their affection, self-efficacy, and confidence, hence, they are capable of assisting children through home visits.

Background: In long-term care facilities, there are many residents who do not have the ability to seek shelter by themselves in the case of an emergency. Thus, it is extremely important that the staff of nursing homes are equipped with correct disaster prevention concepts, emergency survival responses, and hazard mitigation measures. Purpose: Discuss the intervention effectiveness of different fire prevention and emergency response trainings at nursing homes and the relationship and predictivity of awareness to self-efficacy. Method: Recruit staff from two nursing homes through purposive sampling, using a two-team pre-and post-test design to collect results from 41 individuals in the experiment group and 40 individuals in the control group. The research tool is the “Nursing Home Fire Prevention and Emergency Response Awareness and Self-Efficacy Scale,” to compare the effectiveness of advanced and general fire safety trainings. Result: After receiving improved advanced fire safety training, the total score and the result of the experiment group on fire prevention and emergency response awareness and self-efficacy had both performed better than the control group who received general fire safety training (p < .001); fire prevention and emergency response awareness has significant and positive correlation with self-efficacy (r=.601, p < .001), and awareness is a significant predictor variable to self-efficacy (p < .001). Conclusion/Practical Application: This study finds that the key to improving learning effectiveness includes adding fire science concept chapter when creating fire safety training material in order to strengthen basic awareness; fire safety training should comprehensively introduce all related duty responsibilities of staff fire defense formation, in turn enabling mutual responsive support for the needs of the site; also, to become familiarized with the knowledge requires appropriate frequency of training and enhancing the staff’s awareness to fire prevention and emergency response, which is the most important key of learning effectiveness.

Severe asthma patients are at increased risk of major exacerbations and they need to be monitored regularly. The COVID-19 pandemic has impressively impacted on the health care resources. The telemedicine approach applied to the follow-up of asthmatic patients has been proved to be effective in monitoring their disease and adherence to the therapy. The aim of our study was to investigate the satisfaction of severe asthma patients, before the activation of a telemedicine management complemented by a standard of care. An ad hoc questionnaire was developed and sent by e-mail to 180 severe asthma patients. Most of subjects (82%) were confident with the idea of doing self-measurements and self-managing their disease; 77% of subjects favoured to carry out virtual visit and telemedicine. 93% of patients considered easy the self-injection therapy. 94% of subjects felt safe and 93% were not worried while self-administering. Only mild adverse events were reported in 22% subjects after self-administration. Our results showed an agreement between what is considered necessary and practicable by healthcare personnel and what is perceived by the severe asthma patients, in terms of treatment and monitoring of the disease with Telehealth. Biologics have a safety profile and can be easily self-administred at home

A brain-computer interface for controlling elements commonly used at home is presented in this paper. It includes the electroencephalography device needed to acquire signals associated to the brain activity, the algorithms for artefact reduction and event classification, and the communication protocol.

The present paper offers a reading of three selected novels by two Anglophone Arab writers Diana Abujaber and Fadia Faqir. Our reading is fundamentally based on a philosophical post-humanist perception of other ethnic minorities as being inferior and un-human. In interpreting the three novels, Arabian Jazz (2003), My Name is Salma (2007) and Willow Trees Don’t Weep (2014), a main concern is to bring to light how Arabs –and Muslims –have been zombified and de-humanized in Western mainstream media and culture based on a biased stigmatization and stereotyping of a large heterogeneous ethnic group wherein religions, traditions, languages and cultures are diverse. Also, a pivotal preoccupation is going to be the exiling journey of the protagonists from their homelands to Western countries, and how these journeys contribute to the post-humanization of the self, the identity and the culture of Arab displaced immigrants.

ObjectivesIn increasingly stressful times, many people are increasingly turning to fast food, neglecting to drink enough fluids and often forgoing regular exercise. The fast tempo of everyday life leaves little room for healthy habits, such as cooking at home, which means that a conscious and balanced diet takes a back seat.MethodsA descriptive pilot study was conducted to investigate the effects of an eight-week intervention program. This program included the daily intake of breakfast, cooking at home, adequate fluid intake and daily physical activity. The aim of the study was to evaluate the effects of these measures on the participants' body weight and general health.Results During the 56-day intervention, there was a steady trend towards weight reduction, and at the end of the intervention phase, a significant weight reduction in the test person could be observed. At the end of the intervention, the participant was still 45 years old, measured a body weight of 73.4 kg, which represents a BMI of 25.1 and is classified as slightly overweight. ConclusionThe results of the pilot study demonstrate clearly that the health mix of regular cooking at home, a daily breakfast, a daily physical activity session and sufficient fluid intake can be an effective booster for weight loss in adults. This combination has not only led to a significant reduction in body weight, but has also shown that simple, everyday measures can have a profound effect on health.

Brain-Computer Interface (BCI) processes and converts brain signals to provide 20 commands to output devices to carry out certain tasks. The main purpose of BCI is to replace or 21 restore missing or damaged functions of disabled people including neuromuscular disorders like 22 Amyotrophic Lateral Sclerosis (ALS), cerebral palsy, stroke, or spinal cord injury. Hence, BCI does 23 not use neuromuscular output pathways. Scientists have used several techniques like 24 Electroencephalography (EEG), intracortical, and Electrocorticographic (ECoG) to collect brain 25 signals which are used to control robotic arms, prosthetics, wheelchairs, and several other devices. 26 The non-invasive method of EEG is used for collecting and monitoring the signals of the brain. 27 Implementing EEG-based BCI technology in home automation systems may facilitate a wide range 28 of tasks for people with disabilities. It is important to assist and empower individuals with paralysis 29 to engage with existing home automation systems and gadgets in this particular situation. This 30 paper proposed a home security system to control a door and a light using EEG-based BCI. The 31 system prototype consists of the EMOTIV Insight™ headset, Raspberry PI 4, servo motor to 32 open/close the door, and LED. The system can be very helpful for disabled people including arm 33 amputees who cannot close/open doors or use remote control to turn on/turn off doors. The system 34 includes an application made in Flutter to receive notifications on the smartphone related to the 35 status of the door and the LEDs. The disabled person can control the door as well as the LED using 36 his/her brain signals detected by the EMOTIV Insight™ headset.

This paper describes a system that is used to gather data from Smart Home sensors measuring energy consumption, analyze and predict future consumption by using machine learning algorithm for prediction. It focuses on the architecture of the system as well as the need for such system to exist in practice – why the consumption should be measured at all and how that measurement can be put to good use for achieving energy efficiency.

Sociality in animal populations is a continuum, and interactions between conspecifics are meaningful for all vertebrates. Ignorance of social structures can lead to misunderstanding their ecology and, consequently, to unsuccessful species management. Here, we combined genetic and spatial data on radio-collated brown bears (Ursus arctos) to investigate kin-related home range overlap and kin-related centroid distance within central and eastern Finland. We found that the extent of overlap of home ranges was positively linked with relatedness among adult females. A similar positive correlation could be detected between home range centroid distance and relatedness among adult females. Moreover, there were significant differences between the two studied regions: female brown bears in central Finland were more closely related to each other, and the sizes of their home ranges were larger than those in eastern Finland. The smaller home ranges and lower degree of relatedness among bears in eastern Finland might be a result of the substantially higher hunting pressure in the area, combined with immigration of new unrelated individuals from Russia.

This paper proposes the localisation of room occupants in home environments using Unobtrusive Sensing Solutions (USSs). The ability to localise room occupants in home environments can help in the objective monitoring of sedentary behaviour. While wearable sensors can provide tangible information on health and wellness, they have battery life issues and the inability to perform prolonged monitoring. This work uses heterogeneous USSs in the form of an Infrared Thermopile Array (ITA-64) thermal sensor and a Multi-Chirp Frequency Modulated Continuous Wave Mono-pulse (MC-FMCW-M) Radar sensor to monitor room occupants. Digital filters and background subtraction algorithms were used to process the thermal images gleaned from the ITA-64 thermal sensors. The MC-FMCW-M Radar sensor used multi-chirp and Doppler shift principles to estimate the exact location of the targeted room occupants. The estimated distances from the Radar Sensor were compared with ground truth values. Experimental results demonstrated the ability to identify thermal blobs of occupants present in the room at any particular time. Data analyses indicated no significant difference (p = 0.975) and a very strong positive correlation (r = 0.998) between the ground truth distance values and those obtained from the Radar Sensor.

Ziziphus tree species offer valuable socio-economic and ecological benefits but experience significant damage from insect pests. In Ethiopia, there is limited knowledge on the insects attacking Ziziphus fruits and a study aimed to identify these pests, assess their impact and understand how different land use types (LUTs), affect them were conducted. Sampling involved collecting fifty fruits and ten leaves from ten randomly chosen Ziziphus trees per LUT within each agroecological zone from August to December in 2022 and 2023. Samples were visually assessed for incidence and infestation levels, and the five morphotypes were identified using molecular techniques through phylogenetic analysis. Fruit pest incidence varied during the season yet a positive correlation (r = 0.84) was observed among the assessment months and years. Most fruits showed low to medium infestation levels (5–50%), while severe infestations (&gt;75%) were predominant in the lowland agroecological zone. The insects attributed to the damage were identified as Carpomya incompleta (Becker), Drosophila hydei Sturtevant, D. simulans Sturtevant and Zaprionus indianus Gupta. Fruits showed higher incidence and infestation levels than leaves, indicating significant yield and income losses. Thus, implementing effective management strategies is vital to minimize these losses and achieve sustainable production in Ethiopia.

The COVID-19 pandemic has significantly altered how people work, with an increasing number transitioning to working-from-home (WFH). This paradigm shift has raised various challenges in adapting living spaces to meet the needs of remote work. Dedicated workspaces or home offices need to be customised for creativity and productivity. Thus, this systematic literature review explores the potential challenges and limitations of implementing modern office design features in residential environments. The study synthesises findings from 108 peer-reviewed articles published within the last decade, focusing on ergonomics, productivity, work-life balance, and spatial constraints. The study found several challenges in translating office design features to home settings. Firstly, spatial limitations in residential areas often restrict the implementation of open-plan layouts and collaborative zones, which are hallmarks of modern office designs. Secondly, the integration of ergonomic furniture and adjustable workstations are limited by budget constraints and the dual-purpose nature of many home spaces. Furthermore, the review highlights the psychological challenges of maintaining work-life boundaries when professional and personal spaces overlap. Noise pollution and distractions emerge as significant factors impacting productivity in home offices, which contrasts controlled modern office environments. The review suggests that the complete replication of modern office design in homes may be impractical, a hybrid approach that adapts key features to residential constraints could enhance home office productivity. Potential solutions could include modular furniture designs, the simulation of collaborative spaces, and the development of noise-cancelling technologies specifically for home environments. This study contributes to the growing body of knowledge on remote work environments and provides valuable insights for enhancing work-life balance, environmental sustainability, and economic growth.

Consumer IoT (CIoT) manufacturers seek customer feedback to enhance their products and services, creating a smart ecosystem like a smart home. Due to security and privacy concerns, Blockchain-based federated learning (BCFL) ecosystems can let CIoT manufacturers update their Machine Learning (ML) model using end-user data. FL uses privacy-preserving ML techniques to forecast customers' needs and consumption habits, and blockchain replaces the centralised aggregator to safeguard the ecosystem. However, Blockchain technology (BCT) struggles with scalability and quick ledger expansion. In BCFL, local model generation and secure aggregation are other issues. This research contributes a novel architecture emphasising Gateway Peer (GWP) in blockchain network to resolve scalability, ledger optimisation and secure model transmission issues. In the architecture we replace the centralised aggregator by the blockchain network, while GWP restricts the number of local transactions to execute in BCN. Considering the security and privacy of FL processes, we have added differential privacy and advanced normalisation techniques to ML processes. The approaches strengthen end-users' cyber security and encourage the adoption of technological innovation standards by service providers. The proposed approach has been tested extensively using a well-respected Stanford Cars dataset. We experimentally demonstrate that the proposed architecture makes the network scalable and optimises the ledger significantly. In addition, the normalisation technique outperforms batch normalisation when features are under DP protection.

The propagation of the coronavirus disease 2019 (COVID-19) reshaped the relationship between income and food-away-from-home (FAFH) expenditure in Mexico during 2020. Although the number of households participating in this market fell across income deciles and regions due to the pandemic, the impact on their budget shares is not uniform. Using data from the Encuesta Nacional de Ingresos y Gastos de los Hogares (ENIGH) 2020, we estimated an Engel curve of the Working-Lesser functional form for FAFH. Among the independent variables are the number of family members 65 years of age and older, and dummies to indicate whether the household experienced food insecurity or received remittances. The estimation was carried out following the Heckman two-step method, suitable for censored-response data. The results suggest that the budget share for FAFH drops as income increases. The number of older adults and food insecurity discourage the decision to participate in FAFH expenditure and increase its budget share, whereas remittances encourage participation and reduce its budget share. The corrected conditional elasticity is 0.4609; the sign and the magnitude indicate that FAFH is a necessity good.

As consequence of COVID-19, millions of households suffered mobility restrictions and changes in their lifestyle during several months. The aim of this study was to evaluate the effects of COVID-19 home confinement in food habits, lifestyle and emotional balance of the Spanish population. This cross-sectional study used data collected via an anonymous online questionnaire during the last month before lockdown finished in Spain in a total of 675 participants. 38.8% of the respondents experienced weight gain while 31.1% lost weight during confinement. The increase in body weight was positively correlated with the age (Rs = 0.14, p &lt;0.05) and BMI (Rs = 0.20, p &lt;0.05). We also identified that 39.7% reported poorer quality sleep, it was positively correlated with BMI (Rs = -0.18, p &lt;0.05) and with age (Rs = -0.21, p &lt;0.05). 44.7% of the participants had not performed physical exercise during confinement with differences by sex (p &lt;0.05), by age (p &lt;0.05), by BMI (p &lt;0.05) and sleep quality (p &lt;0.05). According to emotional-eater questionnaire, 21.8% and 11% were classified as emotional eater and very emotional eater, respectively. We emphasize the importance of adopting a healthy lifestyle, as the COVID-19 pandemic nowadays is ongoing.

Activities of daily living (ADLs) are fundamental routine tasks that the majority of physically and mentally healthy people can independently execute. In this paper, we present a Semantic Framework for detecting problems in ADLs execution, monitored through Smart Home sensors. In the context of this work, we conducted a pilot study, gathering raw data from various sensors and devices installed in a smart home environment. The proposed Framework combines multiple Semantic Web technologies (i.e. ontology, RDF, triplestore) to handle and transform these raw data into meaningful representations forming a Knowledge Graph. Subsequently, SPARQL queries are used to define and construct explicit rules to detect problematic behaviours in ADLs execution, a procedure that leads to generating new implicit knowledge. Finally, all available results are visualized in a clinician dashboard. The proposed framework can monitor the deterioration of ADLs performance for people in the spectrum of dementia, by offering a comprehensive way for clinicians to describe problematic behaviors in the every-day life of an individual.

Better understanding of the quality of life among nursing home residents with dementia is im-portant for developing interventions. The objectives of this cross-sectional study were to examine factors associated with poor health-related quality of life in older adults with dementia living in nursing homes in Hanoi, Vietnam. In-person interviews were conducted with 140 adults 60 years and older with dementia and information about their quality of life was obtained using the Quality of Life in Alzheimer’s Disease scale (QOL-AD). A number of sociodemographic and clinical factors associated with poor health-related quality of life (lowest tertile) were assessed through the results of physical tests, interviews with nursing home staff, and review of medical records. The average age of the study sample was 78.3 years, 65% were women, and their av-erage QOL-AD total score was 27.3 (SD = 4.4). Malnutrition, total dependence in activities of daily living, and urinary incontinence were associated with poor quality of life after controlling for multiple potentially confounding factors. Our findings show that Vietnamese nursing home residents with dementia have a moderate quality of life and interventions based on comprehen-sive geriatric assessment remain needed to modify risk factors associated with poor health-related quality of life.

To examine the association of sleep quality and work from home with physical inactivity (PI) in leisure time during Covid-19 pandemic. A population-based household survey was conducted in two Bra-zilian municipalities from October to December 2020. Leisure-time physical activity (PA) was self-reported, and individuals who practiced less than 150 minutes of moderate PA or 75 minutes of vigorous PA weekly were classified as PI. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). WFH was assessed by: "Currently, how is your work routine regarding location? Associations were investigated using logistic regression and directed acyclic graphs (DAG) for the multivariate models. A total of 1,750 adults were interviewed, 69.1% were PI and 51.9% had poor sleep quality. Furthermore, 79.8% were not in WFH. In multivariate analysis, leisure PI was associated with poor sleep quality (OR:1.59: 95% CI: 1.02-2.48), and not being in WFH (OR:1.62: 95% CI: 1.05-2.50). When performing the combined analysis between these two factors, and who were not in WFH were four times more likely to be PI at leisure (OR=4.22;95%CI:2.05-8.65). The results indicate a high prevalence of PI, with poor quality sleep and non-WFH associated with leisure PI. These combined factors exacer-bated the occurrence of PI.

This study examined the effectiveness of virtual delivery of the Strength at Home (SAH) intervention program for intimate partner violence in a sample of 605 military Veterans across 69 Veterans Affairs (VA) Medical Centers through a national implementation of the program. Outcome measures included physical IPV, psychological IPV, coercive control behaviors, posttraumatic stress disorder (PTSD) symptoms, and alcohol misuse. Significant pre-intervention to post-intervention reductions were found for all outcomes, with similar effect size estimates relative to a prior investigation of in-person delivered SAH through the same national VA implementation. Study findings suggest that virtual delivery of SAH may be as effective as in-person delivery which has important implications for program access and impact.

The purpose of this qualitative study was to describe parent perceptions of the home exercise pro-gram (HEP) for their infant with congenital muscular torticollis (CMT), and how these perceptions evolved over a physical therapy (PT) plan of care. Twelve participants were recruited from a pediatric PT clinic, and nine completed interviews at three time points. Qualitative description and an iterative approach for thematic analysis of 27 interviews yielded three themes that corresponded to the research questions. The participants’ responses were categorized into three main themes: 1) parents’ perceptions of three key exercises within the HEP; 2) internal and external sources of stress; and 3) sources of empowerment and disempowerment. Regarding the HEP, parents articulated common sentiments for three frequently prescribed exercises for the management of CMT: 1) Tummy time was the fast favorite, 2) ipsilateral cervical rotation was perceived as stressful, and 3) contralateral cervical lateral flexion felt uncomfortable. Additionally, participants disclosed internal and external sources of stress (guilt, uncertainty, and the demands of returning to work) and sources of disempowerment (inconsistent messaging from providers, feeling overwhelmed) and empowerment (being able to see the bigger picture and clear communication and education about the diagnosis) with respect to managing their infant’s CMT. These themes provide insight into the evolution of parent perceptions over a PT plan of care for CMT. Participants’ insights suggest a need for consistent messaging regarding the diagnosis and evidence-based management of CMT, addressing parent stress, and modifying how exercises are taught. This study contributes updated research on parents’ experience with physical therapy and the HEP for their infant’s CMT.

The growing congestion in delivery rooms and maternity wards in Israeli hospitals is the underlying issue of the current study. The study sought to examine various alternatives for an effective public policy aimed at reducing congestion. The choice of Israel as a case study derives from its conspicuous imbalance between supply and demand in the maternity, resulting from the high demand for prenatal and birthing services on one hand and the low supply, both in absolute terms and relative to OECD countries, of medical resources such as physicians, nurses, and hospital beds. The research findings present fertility and birth data for Israel in the last decade, which are leading to increased congestion and crowding in delivery rooms and maternity wards at local hospitals. At the same time, two possible alternatives are proposed for designing and implementing public policy capable of contributing to the regulation of this congestion. One alternative is the option of home birth and the second is promoting the establishment of private birthing centers outside the hospitals. The research conclusions indicate that policy makers in Israel must anticipate the increasing congestion in hospital delivery rooms and maternity wards and expedite efforts at designing alternative solutions before the emergence of a crisis situation that will make it essential to identify immediate solutions. The study recommends exploring and advancing the adoption of the two alternatives simultaneously as part of public policy, in the assumption that the increasing demand for pregnancy and childbirth services in Israeli society will persist and therefore it is necessary to act to increase the supply of childbirth facilities.

Mental healthcare conditions in India are severely deficient, particularly concerning the living conditions of patients. Post-treatment, numerous individuals with mental illness are abandoned by their families, who may lack the willingness or financial means to care for them. These recovered patients often experience setbacks due to the absence of facilities aimed at developing the skills necessary for reintegrating into society. The lack of separate accommodations for recovered individuals forces them to reside with other patients, worsening their condition. The government is struggling to accommodate and finance the care of recovered patients, affecting those in need of treatment as hospital bed space becomes overwhelmed by the increasing number of cured individuals. Therefore, there is an urgent need for halfway homes. These facilities offer a range of services, including social, medical, psychological, and educational support, alongside housing. The term "halfway houses" reflects their position between fully independent living and highly regulated in-patient or correctional facilities. Following treatment, many patients experience abandonment by their families or encounter difficulties returning home due to memory loss. Recovered patients often live in confined spaces, lacking essential social skills. Therefore, establishing a workspace focused on teaching social and other necessary skills before reintegrating them into society would be a beneficial approach. This would provide a structured environment for individuals who have spent significant time in seclusion, assisting them in developing the skills needed to navigate societal challenges effectively. Recent reports indicate that over 2,000 cured patients are still housed in mental hospitals across the country, according to the NHRC. The NHRC has raised concerns about the situation, noting that all 46 Government Mental Healthcare Institutions in India display very poor and inhumane treatment of patients, leading to the issuance of notices. NHRC visits have revealed deplorable conditions in all 46 mental institutes across the country.

Researchers are always looking to find ways to use energy more efficiently while keeping people comfortable at home. They've tried different methods like fuzzy logic and genetic algorithms to do this. In this paper, we introduce a novel model that combines different techniques like data smoothing, optimization, machine learning, and control algorithms to reach this goal in smart homes. The proposed model is made up of three main parts: smoothing, optimization, and control. The smoothing part uses the Kalman filter to get rid of any unnecessary noise and make sure the data used to predict energy use is clean and smooth. The optimization part uses both genetic with firefly algorithms and artificial neural networks to minimize the gap between the actual environmental conditions and the conditions users find comfortable. It adjusts the comfort settings in real-time using machine learning. The control part uses Mamdani fuzzy logic to make sure energy is delivered in the best way possible to the systems that control temperature, lighting, etc., making the home comfortable and saving energy at the same time. Comparative analyses demonstrate the superiority of the proposed model over existing algorithms, including the Particle Swarm Optimization (PSO) algorithm. Additionally, the paper discusses the importance of adaptive controllers in addressing issues associated with incorrect PID controller selection and highlights the benefits of using the FA-GA in energy optimization and comfort improvement. Overall, the proposed model offers an effective solution for efficient energy consumption optimization and enhanced user comfort in diverse settings through the integration of advanced algorithms and optimization modules.

This study investigates why young adults live with their parents in Sweden. As young adults’ living arrangements affect decisions about marriage, education, childbirth, and participation in the workforce, more knowledge for policy makers is crucial to implementing effective policies to support young adults and promote financial independence and well-being. Using a data set from 1998 to 2021 at the municipal level in Sweden, we used a spatial autoregressive panel data model to examine the proportion of young adults living at home and regional disparities. The study uncovers intraregional variations, illustrating how different municipalities within Sweden exhibit different patterns of young adults living at home. Our findings reveal that economic factors, such as unemployment, significantly impact this pattern. The dynamics of the housing market, demographic factors, cultural differences, and location-specific characteristics also play an essential role in explaining this pattern. The findings suggest that the key drivers are the lack of rental housing, high unemployment rates, a high degree of urbanisation, interregional migration, and lack of social capital.

Abstract: Background: The Hospital-at-home (HAH) model is a viable alternative for conven-tional in-hospital stays worldwide. Serum electrolyte abnormalities are common in acute pa-tients, especially in those with many comorbidities. Pathologic changes in cardiac electrophysi-ology pose a potential risk during HAH stay. Periodical Electrocardiogram (ECG) tracing is therefore advised, but few studies evaluated the accuracy and efficiency of compact, self-activated ECG devices in the HAH settings. This study aimed to evaluate the reliability of such a device in comparison to a standard 12-lead ECG. Methods: We prospectively recruited consecu-tive patients admitted to the Sheba Beyond, virtual hospital, in the HAH department, during a 3-month duration. Each patient underwent a 12-lead ECG recording using the legacy device, and a consecutive recording by a compact 6-lead device. Baseline patients’ characteristics during hospi-talization were collected. Level of agreement between devices was measured by Cohen’s Kappa coefficient for inter-rater reliability (Ϗ). Results: Fifty patients were included in the study. 26 (52%) had electrolyte disturbances. Abnormal D-dimer values were observed in 33 (66%) pa-tients, and 12 (24%) patients had elevated troponin values. We found a level of 94.5% raw agreement between devices with regards to nine of the options included in the automatic read-out of the legacy device. The calculated Ϗ was 0.72, classified as substantial consensus. The rate of raw consensus regarding ECG intervals’ measurement (PR, RR, QT) was 78.5% and the calculated Ϗ was 0.42, corresponding to a moderate level of agreement. Conclusion: This is the first report to our knowledge regarding the feasibility of using a compact, 6-Lead ECG device in the setting of HAH to be safe and bearing satisfying agreement level with a legacy, 12-lead ECG device, en-abling quick, accessible arrythmia detection in this setting. Our findings bear a promise to the future development of telemedicine-based hospital at home methodology.

Respiratory therapist(RT)internet-supervised At-Home Telespirometry(AHT)was validated in pilot 22/95=23% ALS Clinic population. Erect, supine Vital Capacity(eFVC, sFVC)were measured longitudinally using ZephyRx smartphone interface and database recording in-clinic-conventional(Viaire-Vyasis-)and at-home-portable(MIR-Spirobank-Smart-)spirometers. Bland-Altman(BA)analysis supported content validity-precision and 7-day-test-re-test-validity [mean difference=0.15L(conventional–portable;95%CI -0.40L, 0.70L); = 2.7% predicted (conventional-portable;95%CI -12.1%, 17.5%) ]meeting ATS-ERS performance standards. RT Internet-supervised AHT measured sFVC was more frequently obtained[35/52=67.3 %]in-home-vs-in-clinic sFVC[9/21=42.9 %](Chi-Square;P=0.0533). Monthly mean eFVC slope decline for the eFVC > 60 % predicted baseline cohort was – 1.24% predicted per month[95% CI -2.15 ,-0.33% predicted]statistically significantly(P=0.015)less compared with the – 5.86% predicted per month[95% CI -9.44, -2.29 % predicted]decline for the eFVC < 60 % predicted baseline cohort and in this cohort was associated with statistically significant decreased survival(P=0.0219). RT Internet-supervised AHT facilitated initiation of non-invasive ventilation(NIV)in 5/22[23%]patients including 3/4[75%] homebound subjects. RT Internet-supervised AHT can be deployed for ALS patients stratified according to baseline eFVC for earlier detection of eFVC and sFVC decreases between clinic visits. A prospective research study[NCT05106569]is ongoing to further define the capability of online deployment of Respiratory therapist(RT)internet-supervised AHT in the timely initiation of NIV use to improve ALS respiratory care in larger numbers of ALS subjects.

The common dolphin is the second most bycaught species in Korean waters. To provide key information about their habitat boundaries and hotspots for spatial conservation and management, the spatial use of this species was examined using data obtained from sighting and bycatch surveys of cetacean during the past 20 years. The 95% minimum convex polygon and 95% density contour of fixed kernel suggested that the boundary of home range of common dolphins is limited to the coastal region (Busan-Sokcho) of the East Sea/Sea of Japan. From 50% density contours dawn by kernel density estimation, it was suggested that their hotspots are around the cost of Ulsan-Pohang, Doghae, and Sokcho within the home range. Common dolphins are not at all distributed in the Yellow Sea. Hence, shallow waters, such as the coastal region of the Yellow Sea, are not suitable habitats for common dolphins.

Background: Malnutrition is a widespread issue among old people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. This study examines the influence of continuing education on healthcare workers' attitudes and practices toward old people's nutrition. Aim: The study assesses healthcare workers' attitudes toward old people's nutrition using the validated Italian version of the SANN-G questionnaire, focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1,789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software. Results: Most respondents were female (68.59%) and aged 41–50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most displaying neutral or negative attitudes. Education on malnutrition significantly improved attitudes, particularly in assessment, intervention, and individualization. Younger respondents and nurses were more likely to have positive attitudes after educational interventions, while older respondents and physicians tended to show neutral or negative attitudes. Conclusion: Continuing education on malnutrition is crucial for fostering positive attitudes among healthcare workers. Specialized education leads to more proactive approaches, highlighting the need for targeted educational programs to improve old people's nutritional care.

Comprehensively understanding the spatial ecology and habitat preferences of endangered species is essential for population restoration and conservation. We investigated the home range and movement of the endangered Amur soft-shell turtle (Pelodiscus maackii) in the Ussuri River, Heilongjiang Province, Northeastern China. The study involved tracking 19 Amur soft-shell turtles from late June to mid-October, 2022, resulting in complete and partial home range size data for eight subadults and two adults, respectively. The primary analysis focused on eight subadults, and the models that best described daily movement were identified. We also explored the potential factors influencing home range size. Mean movement rate ranged from 39.18 ± 20.04 m to 72.45 ± 29.36 m and was positively correlated with the linear home range and water temperature. The most insightful home range estimate was a 95% kernel density estimate, employing likelihood cross-validation smoothing with constraints set to the river boundaries. The mean home range size was 1.02 ha and was not correlated with body size. Subadults tended to establish well-defined home ranges over time; whereas, defining home ranges for adults proved challenging. This research addresses a gap regarding the ecology of the Amur soft-shell turtle and provides a foundation for future conservation plans.

The background of this work is related to the scheduling of household appliances, taking into account variations in energy costs during the day, due to official Brazilian domestic tariffs: constant and white. The white tariff can reach an average price of around 17\% lower than the constant, but charges twice its value at peak hours. In addition to cost reduction, we propose a methodology to reduce user discomfort due to time shifting of controllable devices, presenting a balanced solution through the analytical analysis of a new method here called tariff space, derived from white tariff posts. To achieve this goal, we explore the geometric properties of the movement of devices through the tariff space (geometric locus of the load), over which we can define a limited region in which the cost of a load under the white tariff will be equal to or less than the constant tariff. As a trial for the efficiency of this new methodology, we collected some benchmarks (such as execution time and memory usage) against a classic multi-objective algorithm (Hierarchical) available in the language portfolio in which the project has been executed (Julia language). As a result, both methodologies achieve similar results, but the one presented in this article shows a significant reduction in processing time and memory usage, which could lead to the future implementation of the solution in a simple, low-cost embedded system like an ARM cortex M.

Meals on Wheels (MoWs) are critical in enabling adults with care and support needs to live independently. However, many individuals are unaware that the service exists. The aim of this study was to review the websites of local authorities in the UK, and those of 3^rd-party providers they signpost to, to establish the quality of online information available on MoWs services, and the websites’ overall quality. Two data capture forms were used to extract information from local authority and 3^rd-party providers, consisting of 35 items across five domains, and 36 items across five domains, respectively. Items were awarded a score based on whether certain criteria were met or not, resulting in a maximum total score of 50 and 43 points for each local authority, and 3^rd-party provider, website, respectively. A total of 271 websites (223 local authority and 48 3^rd-party provider) were reviewed. The mean total score was 14.9 (SD 10.6, range: 1-40 points) for local authority websites, and 21.4 (SD 5.3, range: 10-35 points) for 3^rd-party provider websites. For all websites combined, online provision of MoWs information was generally poor, with the vast majority of websites (69.4%, n=188) assessed as requiring improvement, whereas only 4.4% of websites (n=12) were assessed as very good. These findings suggest that local authorities and 3^rd-party providers in the UK should seek to improve their online information provision on MoWs to enhance awareness of the service, and ensure that potential service users, and individuals who refer them to the service, can access high-quality information on MoWs.

Quite a number of new metered parking systems have been introduced in recent years by the local authorities of various spa towns in Poland in connection with home zone conversion projects. The traffic signs posted in these locations were limited to the beginning and end of the demarcated parking area. Traffic circle (TC) is an example of traffic calming measures (TCM) used in home zones to slow down the traffic (case study – home zone in a small spa village). This article presents the results of a study investigating the speed reductions obtained with a home zone and traffic circle used as traffic calming measures. The indispensable speed surveys were carried out in relation to this study in two periods: in summer when the streets are crowded with tourists and in September with little pedestrian traffic. Two research hypotheses were formulated as part of the speed data analysis to verify the slowing effect of traffic circle and the relevance of traffic circles design parameters and location, road function and the surrounding streetscape. For each hypothesis statistical analyses were carried out using two nonparametric tests: two-sample Kolmogorov–Smirnov test and median test. The third research hypothesis formulated in this study was related to sustainable development factors related to fuel consumption and traffic-related air pollution including carbon dioxide, carbon monoxide, nitrogen oxide and hydrocarbons. This hypothesis was verified by estimating the amount of air pollution in the home zone under analysis in three different situations (scenarios): in summer with the travel speed reduced by pedestrian traffic to ca. 8–10 km/h and in September with a small number of pedestrians and 20–25 km/h resulting speed between traffic circles, reduced at traffic circle, and in a theoretical 30 km/h zone with 25–30 km/h assumed speed between traffic circles, dropping at traffic circle. These analyses confirmed the appropriateness of traffic circle as a home zone traffic calming measure, as long as its design is based on a detailed analysis of the relevant factors, including location, road function and the surrounding streetscape.

Home enteral nutrition (HEN) is recommended for patients with nutritional requirements who can stay in the familiar environment. HEN guidelines recommend assessing health-related quality of life (HRQoL) to evaluate the effect of the treatment. NutriQoL® is a specific questionnaire developed to assess HRQoL in patients receiving HEN and validated in Spanish population. An observational, descriptive, and prospective study was carried out in two Spanish hospitals to describe the evolution of HRQoL, nutritional and health status in patients receiving HEN in routine clinical practice. Fifty-seven patients participated in the study, of whom 36 were followed-up after their inclusion. Most of them were at risk or moderate malnutrition (61.1%) or showed severe malnutrition (27.8%) at baseline. Patients with HEN showed an overall good HRQoL with a mean basal NutriQoL® score of 69.4, which increased to 74.3 after 12 months of follow-up; fifteen patients showed a clinically significant difference (≥4 points) after three months. The proportion of at-risk or severely malnourished patients decreased at the end of the follow-up period and, according to the physicians, their health status improved. Additionally, physicians considered useful the HRQoL evaluation in clinical practice. In conclusion, HRQoL is probably related to nutritional status improvement and, thus, should be considered for nutritional evaluation in clinical practice.

With increased participation in telework expected to continue, to support emerging hybrid work models in the aftermath of the Covid-19, it is important to consider the long-term impact this practice could have on sustainability outcomes. This paper describes a systematic review of 113 academic journal articles and identifies associations between telework and sustainability, explored by previous researchers. Those associations were categorized and discussed, based on their contributions to different United Nations Social Development Goals. Most of research was found to focus on countries classified as having a very high human development index status, and regions with a low, medium or high human development index, largely ignored. The SWOT matrix technique was used to illustrate the strengths and weaknesses identified in the current literature as well as threats and opportunities for future work. This can help to ensure policy coherence and that strategies to promote one outcome, such as economic productivity improvements, does not undermine another, such as improved health. Practical implications and potential research opportunities were identified across a range of SDG impact areas, including good health and well-being, gender equality, reduced inequality, climate mitigation, sustainable cities and resilient communities. On the whole, our impression is that increased rates of telework present an important opportunity to improve sustainability outcomes, however, it will be important that integrated and holistic policy is developed that mitigates key risks.

Urinary and fecal incontinence as well as skin pressure injury are common healthcare problems in nursing home; however, these prevalence and related risk factors were not well understood in the Japanese special elderly nursing home settings. We surveyed the prevalence of urinary, fecal and double incontinence, and skin pressure injury among the elderly living in special elderly nursing home in Japan. A nationwide cross-sectional epidemiological survey was conducted with a total of 4,881 residents. The prevalence of urinary, fecal and double incontinence was 82.9%, 68.9% and 64.9%, respectively. Skin pressure injury was found in 283 residents (283/4881, 5.8%). Age, Care-Needs level, loss of voiding desire, and fecal incontinence were significant risk factors for urinary incontinence. Residential period, Care-Needs level, loss of voiding and defecation desires, and urinary incontinence were significant risk factors for fecal incontinence. Only male sex was a significant risk factor for skin pressure injury. Our study revealed continence status and the prevalence of pressure skin injury among older adult residents who receive an end-of-life care in special nursing homes in Japan. Further studies should be conducted to examine whether recovery of urinary and fecal sensations improves continence status.

Virus-infected Flu is a common disease. To date, no specific drugs are available to manage the symptoms of cough, headache and sputum production. An alternative Chinese herb medicine is introduced for virus-infected Flu or similar infection. Before hospitalization, some of patients may scare for cross-infection with mild symptoms or hardly go to hospital if encountered a temporary lockdown or quarantine. Some Chinese practice self-treatment of cough, headache and sputum production by inhalation of volatile chemicals from onion and garlic. Author used to take the same alternative approach of inhalation of onion, garlic or scallions for self-treatment when suffered virus caused flu with cough, headache and sputum production at onset disease. In this article, the biomedical effects of onion and garlic are reviewed. To help patients with mild symptoms of virus infected Flu, a simple home-based treatment was suggested to self-treatment because of temporary isolation and hardly going to hospitalization. The alternative approach may also suggest for some mild virus infected respiratory diseases caused by virus at onset disease.

Internet of things security will be a big challenge for the enterprises working behind the build-up of the internet of things, and it’s application. With IoT, another buzzword is blockchain-based cryptocurrency bitcoin. Blockchain technology has proven itself as one of the most secured existing technology. In this paper, we have discussed the significant challenges that will come up in identity management due to the heterogeneity of devices. We have proposed a solution for privacy preservation using secure identity management and possible communication methodology by using public key-based cryptography used in the blockchain. We have taken the ecosystem of smart home management and smart health management. At last, we have concluded with the discussion of futuristic applications of blockchain in other applications of the internet of things.

In contrast to physical sustainable measures carried out in homes, such as insulation, the installation of a Home Energy Management System (HEMS) has no direct and immediate energy-saving effect. A HEMS gives insight into resident behaviour regarding energy use. When this is linked to the appropriate feedback, the resident is in a position to change his or her behaviour. This should result in reduced gas and/or electricity consumption. The aim of our study is to contribute towards the effective use of home energy management systems (HEMS) by identifying types of homeowners in relation to the use of HEMS. The research methods used were a literature review and the Q-method. A survey using the Q-method was conducted among 39 owners of single-family homes in various Rotterdam neighbourhoods. In order to find shared views among respondents, a principal component analysis (PCA) was performed. Five different types of homeowner could be distinguished: the optimists, the privacy-conscious, the technicians, the sceptics, and the indifferent. Their opinions vary as regards the added value of a HEMS, what characteristics a HEMS should have, how much confidence they have in the energy-saving effect of such systems, and their views on the privacy and safety of HEMS. The target group classification can be used as input for a way in which local stakeholders, e.g. a municipality, can offer HEMS that is in line with the wishes of the homeowner.

Informal dementia home caregiving is viewed negatively and can result in caregiver depression and anxiety from burnout, potentially compromising caregiving. Solutions are unclear, as caregiving relationships are unique—caregiver creation of a graphic memoir may help to mitigate the negative dementia narrative and reduce experienced burnout. This investigation examines the writing of a graphic memoir by one informal dementia home caregiver, created with the help of a cartoon illustrator and a publisher who edited, printed, and made the graphic memoir available at the psychiatric bookstore considered the largest in North America. Mother of the illustrator and the editor and publisher of this graphic memoir, this author provides the perspective taken in this investigation. The analysis, developed by this author, represents psychoanalytic narrative research, serving as the historical method. Aided by email threads between the publisher/caregiver, publisher/printer, and publisher/bookseller, and a published interview with the dementia caregiver are answers to how writing, illustrating, and publishing the graphic memoir affected the caregiver’s narrative reconstruction and burnout. Providing an example for other informal dementia home caregivers similarly to write and illustrate a publishable graphic memoir for their positive narrative reconstruction and to help decrease their depression and anxiety from burnout is the aim.

This research explores the impact of working from home on employees' happiness, collaboration, and promotion prospects using machine learning techniques. The study is guided by three research questions aiming to investigate the correlation between working from home and employees' collaboration and promotion prospects. Moreover, the research aims to find a relationship between the number of households and employees' happiness levels while working from home. The data is collected from ICT engineers working at a technology company in Sweden through a questionnaire-based survey. Probability sampling was selected for data collection to reduce bias and enhance the generalizability of the findings. The data is pre-processed and then analysed in Jupyter Notebook using the Python programming language. Various libraries and models, including Pandas, NumPy, Matplotlib, Seaborn, and Scikit-learn, were employed for data analysis. Both Pearson correlation and p-values in Pearson correlation were used in this study to analyse the relationships between different variables.However, based on the results, this study did not find any significant relationship between working from home and employees' promotion prospects or collaboration issues. Additionally, the results did not provide evidence of a significant relationship between the number of households of employees and their happiness levels while working from home.

Sensor fusion algorithms and models have been widely used in recent times. Although research evidence has informed the use of sensor fusion models in diverse applications, there is room for improvement, especially in home-based health monitoring applications which require less supervision and technical knowledge of users. The present work compares data mining-based fusion software packages such as RapidMiner Studio, Anaconda, Weka, and Orange, and proposes a data fusion framework suitable for in-home applications. 574 privacy-friendly (binary) images and 1,722 datasets gleaned from thermal and Radar sensing solutions respectively, were fused using the software packages on instances of homogeneous and heterogeneous data aggregation. Experimental results indicated that the proposed fusion framework achieved an average Classification Accuracy of 84.7% and 95.7% on homogeneous and heterogeneous datasets respectively, with the help of data mining and machine learning models such as Naïve Bayes, Decision Tree, Neural Network, Random Forest, Stochastic Gradient Descent, Support Vector Machine, K-Nearest Neighbours and CN2 induction. Further evaluation of the sensor data fusion framework based on cross validation of features indicated average values of 94.4% for Classification Accuracy, 95.7% Precision and 96.4% for Recall.

Meals on Wheels (MoWs) provide access to daily meals and social contact to adults with care and support needs.MoWs could be essential for the increasing rates of an ageing population and adults living with complex needs in England, yet many do not know that the service exists. This study aimed to explore the perceptions of MoWs service users, and people who refer them to MoWs (‘referrers’), with accessing and setting up the service in England, and what information would be valued when considering accessing MoWs services.Semi-structured interviews were conducted in May-July 2022 with seven service users and 21 referrers, recruited from four MoWs providers across England. Data were analysed using thematic analysis. Participants indicated various pathways into the service, but referrers (family members) were more likely to be the ones enquiring about, and setting up, MoWs for service users. Once an enquiry about MoWs had been made, the service was perceived as straightforward to set up.However, existing preconceptions and stereotypes about the service (e.g. bringing to mind ‘school meals’, aimed solely at older adults) were perceived to act as barriers to accessing MoWs.Information that participants deemed important to have available when deciding on whether to access MoWs related to the meals (e.g. nutritional value, variety, need for any preparation, catering for individual needs), the specific services provided (e.g. wellbeing checks, daily social contact), the reliability and flexibility of delivery, and the cost of services. These findings could inform MoWs providers’ public awareness strategies about MoWs, in order to facilitate referrals to the service for adults with care and support needs.

The study reports about a case of a lung cancer patient with increasing difficulties in falling asleep and frequent periods of wakefulness. Severe dyspnea related to pneumonitis caused as a side effect of immunotherapy worsened the situation. Eventually, fear of falling asleep developed, including panic attacks and anxiety of choking, which was shown to lead to nights of complete wakefulness. The patient did not only sleep poorly; he did not sleep at all at night for several days, as evidenced by the notes he made during the night. Polygraphy showed no evidence of sleep-disordered breathing, but frequent periods of wakefulness and reduced basal saturation around 90% during sleep due to lung changes such as extensive functional failure of the left upper lobe with position-dependent shunts. The authors hypothesized that the symptoms described were causally related to a drop in oxygen saturation in the patient's blood. Therefore, they pursued the goal of finding a measurement technique that is as inexpensive as possible and that the patient can operate without outside assistance and great effort. So the patient started using a low-cost wearable device that allows simultaneous measurements of blood oxygen content, pulse rate and movement intensity. It consists of a finger ring with pulse oximetry sensor and a wristband with the control unit containing a vibration motor. The described device reliably warned of disturbances in oxygen concentration in the blood during the night with its vibration alarm. By use of that device during the whole night at home, the events of reduced oxygen saturation and the anxiety symptoms were reduced. Sleep disturbances with sudden awakenings did not occur when using the device. The patient benefited from the security gained in this way and slept much more peacefully, and he could spend nights without waking up again. In conclusion, wearable oximeters with vibration alarm can be recommended for patients’ home care in lung cancer patients.

Capturing complexity is both a conceptual and a practical challenge in palliative care. The HexCom model has proved to be an instrument with strong reliability and valid for describing the needs and strengths of patients in home care. In order to explore whether it is also perceived to be helpful in enhancing coordinated and patient-centered care at a practical level, a methodological study was carried out to assess the face validity of the model. Particularly, a Delphi method involving a group of 15 experts representing the full spectrum of healthcare professionals involved in palliative care was carried out. The results show that there is a high level of agreement, with a Content Validity Index-Item greater than 0.92 both with regard to the complexity model and the HexCom-Red, HexCom-Basic and HexCom-Clin instruments, and higher than 0.85 regarding the HexCom-Figure and the HexCom-Patient instruments. This consensus confirms that the HexCom model and the different instruments that are derived from it are valued as useful tools for a broad range of healthcare professional in coordinately capturing of complexity in healthcare practice.

We applied evolutionary game theory to extend a resource constrained security game model for confidentiality attacks in an Advanced Metering Infrastructure (AMI), which is a component of IoT-enabled Smart Grids. The AMI is modelled as a tree structure where each node aggregates the information of its children before encrypting it and passing it on to its parent. As a part of the model, we developed a discretization scheme for solving the replicator equations. The aim of this work is to explore the space of possible behaviours of attackers and to develop a framework where the AMI nodes adaptively select the most profitable strategies. Using this model, we simulated the evolution of a population of attackers and defenders on various cases resembling the real life implementation of AMI. We discuss in depth how to enhance security in AMI using evolutionary game theory either by a priori analysis or as a tool to run dynamic and adaptive infrastructure defence.

The management of the electrical energy still raises a huge interest for end-users at the household level. Home electricity management systems (HEMS) have recently emerged both to warrant uninterruptible power and high power quality, and to decrease the cost of electricity consumption, by either shifting it in off peak time or smoothing it. Such a HEMS requires a bidirectional DC-AC converter, specifically when an energy transfer is required between a storage system and the AC-grid, and vice versa. This article points out the relevance of an innovative topology based on sinusoidal waveforms from the generation of sine half-waves. Such a topology is based on a DC-DC stage equivalent to an adjustable output voltage source and a DC-AC stage (H-bridge) which are in series. The results of a complete experimental procedure prove the feasibility to improve the power quality of the output signals in terms of total harmonic distortion (THD-values about 5%). The complexity of the proposed converter is minimized in comparison with multilevel topologies. Finally, wide band-gap semiconductor devices (SiC MOSFETs) are helpful both to warrant the compactness and the high efficiency (about 96%) of the bidirectional converter, whatever its operation mode (inverter or rectifier mode).

Stroke causes disability and significantly affects patient quality of life. Post-stroke rehabilitation of upper limb function is crucial, as it affects daily activities and individual autonomy. Traditional rehabilitation methods often require frequent visits to specialized centers, which can be costly and challenging. This study investigated the effectiveness of a home-based self-training device, "Kenko Yusuri," in improving upper limb function in patients with chronic stroke. This multicenter prospective intervention study used a quasi-randomized controlled trial design. Ninety-three outpatients from five hospitals in Japan were enrolled and assigned to either the intervention group who used the "Kenko Yusuri" device or the control group who underwent conventional rehabilitation. All patients received botulinum toxin type A (BoNT-A) injections to treat upper limb spasticity. The primary outcome measure was the Fugl-Meyer Assessment (FMA) of upper-extremity motor function. Secondary outcomes included the modified Ashworth scale (MAS) score, range of motion (ROM), and chronic pain assessments. The intervention group demonstrated significantly greater improvements in FMA total scores than the control group. Patients with moderate paralysis experienced the greatest benefits from the intervention. There were no significant between-group differences in MAS scores or ROM measurements. Pain and wrist ROM showed improvement in the intervention group. Home-based training with a shaking device significantly improved upper limb function in patients with moderate chronic post-stroke paralysis. This approach aligns with the principles of use-dependent plasticity and offers a feasible and cost-effective alternative to traditional rehabilitation methods.

Aim: To analyze a single center's experience with Short Bowel Syndrome/ Chronic Intestinal Failure (SBS/CIF) in adult patients treated with Home Parenteral Nutrition (HPN). Materials and methods: In the last thirty years, 13 patients with SBS/CIF were included in an HPN program. Results: Between 1992 and 2023, 13 patients were included in an HPN program. The primary underlying pathology was acute mesenteric ischemia. The median age of the starting HPN was 44 years old. Most are submitted to several surgeries of extensive intestinal resection with posterior intestinal reconstruction. Five of the 13 patients have died while on HPN for a median of 42 months. The causes of death HPN-related were catheter sepsis, endocarditis with cardiac failure, or hepatic failure. One patient died due to underlying pathology: pelvic abscesses and bleeding related to radiotherapy. Eight patients remain alive with a median time of HPN of 173 months. During the HPN support, the most frequent complications were venous catheter infection and venous territory thrombosis. None of the eight patients alive have hepatic failure. Two patients recently started teduglutide, with good tolerance, and need reduction of HPN support. All these eight patients have a satisfactory quality of life (parenteral support needs range between five to two nutrition bags per week). Conclusion: HPN remains the gold standard of SBS/CIF treatment, although Teduglutide may reduce HPN needs and HPN complications and provide a better quality of life. An HPN multidisciplinary healthcare group support is essential to ensure these patients' survival and quality of life. Keywords Short bowel Syndrome, Chronic Intestinal failure, Home Parenteral Nutrition, Teduglutide, Complications of Parenteral Support.

Plant biotechnology is dependent today on accessing broader plant genetic resources for food and agriculture (PGRFA) diversity for ensuring food security for our future. Heterogenous agricultural lands are considered today as hotspot for biodiversity, and they also exist in the hilly mountain areas of Romanian’s Carpathians. The scope of this review is to describe traditional home-hardens related to the land use of households and cultivated species from Moșna commune, Sibiu County, Romania. The survey was realized with the support of authorities and local stakeholders from 2010 up to 2019. The results of this survey revealed that maintenance of crop species structure and land use of traditional households is longer than 100 years. Consequently at least 15 traditional Saxon home-gardens of 120 taken into the study may be defined. Today these home-garden covers a media of 26% of the total area of a household and should be part of a surface ranging between 5,000 and 1,500 m2. The first Local Council Decision in Romania in 2019 supporting the recognition of landraces and home-gardens as heritage values was officially adopted supporting the need to more access bottom-up approaches for supporting biodiversity conservation.

Wearable technology will become available and allow prolonged electroencephalography (EEG) monitoring in the home environment of patients with epilepsy. Neurologists analyse the EEG visually and annotate all seizures, which patients often under report. Visual analysis of a 24 hour EEG recording typically takes one to two hours. Reliable automated seizure detection algorithms will be crucial to reduce this analysis. We study a dataset of behind-the-ear EEG measurements. Our first aim was to develop a methodology to reduce the EEG dataset by classifying part of the data automatically, while retaining 100% detection sensitivity (DS). Prediction confidences are determined by temperature scaling of the classification model outputs and trust scores. A DS of approximately 90% (99%) can be achieved when automatically classifying around 90% (60%) of the data. Perfect DS can be achieved when automatically classifying 50% of the data. Our second contribution demonstrates that a common modelling strategy, where predictions from several short EEG segments are used to obtain a final prediction, can be improved by filtering out untrustworthy segments with low trust scores. The false detection rate shows a relative decrease between 21% and 43%, and the DS shows a small increase or decrease.

In Europe we can see a change in the social structure in the last period. Average life expectancy has increased dramatically over the last 50 years. Because of the improved life situation and advanced level of health care, older people are slower. With advancing age, the likelihood of experiencing a variety of constraints such as visual impairment, reduced hearing or physical ability increases. In such a life stage tenants are often forced to leave their long-term living space because these homes can not serve "new" individual needs and the resulting personal protection goal. This transition from the privacy of their home to the new environment often appears to be a painful change. They will take their familiar and well-known surroundings, because their homes can not be adapted to serve new needs. It must be the policy’s role to create a new inclusive social space and the requirement for architects and designers to create new goals for the design of an adaptable environment. This is a comprehensive approach to the design of the outer and inner space that could serve people even if there is an unexpected situation and changes in movement and physiological limitations of older people. The contribution shows the results of the survey conducted in Germany and Slovakia. In the survey respondents expressed their opinion on what they considered important in creating an adaptive environment. Results are processed graphically with explanation. The results were mainly for designers and developers of the indoor environment. Based on the results of the questionnaire survey, studies of possible modifications in the interior of the flats were then prepared. The contribution yielded these results in three age groups of respondents; i. people aged 35, 50 and over 50.

The proposed research methodology aims to design a generally implementable framework for providing a house owner/member with the immediate notification of an on-going theft (unauthorized access to their premises). For this purpose, a rigorous analysis of existing systems was undertaken to identify research gaps. The problems found with existing systems were that they can only identify the intruder after the theft, or cannot distinguish between human and non-human objects. Wireless Sensors Networks (WSNs) combined with the use of Internet of Things (IoT), Cognitive Internet of Things, Internet of Medical Things, and Cloud Computing are expanding smart home concepts and solutions, and their applications. The primary objective of the present research work was to design and develop IoT and cloud computing based smart home solutions. In addition, we also propose a novel smart home anti-theft system that can detect an intruder, even if they have partially/fully hidden their face using clothing, leather, fiber, or plastic materials. The proposed system can also detect an intruder in the dark using a CCTV camera without night vision facility. The fundamental idea was to design a cost-effective and efficient system for an individual to be able to detect any kind of theft in real-time and provide instant notification of the theft to the house owner. The system also promises to implement home security with large video data handling in real-time.

We estimated the daily intakes of chlorpyrifos and cypermethrin via ingestion of indoor dust and outdoor soils using the Stochastic Human Exposure and Dose Simulation Model on a probabilistic approach for Taiwan’s homes. Variable information for the daily intake estimation, such as concentration, ingestion rate, body weight, was adopted from previous studies. Monte Carlo simulation was performed with 1,000,000 iterations to simulate a single daily intake, which was shown in terms of percentage of the Acceptable Daily Intake (ADI) of either insecticide. The daily intakes were minimal with a 99% probability; at 99.9th percentile, however, the total intakes leaped to 13.1% and 20.0% of the respective ADIs of chlorpyrifos and cypermethrin. The sensitivity analysis indicated that concentration was the most determinant variable. Compared to the data of daily intakes via dietary ingestion of vegetables derived from a previous study, the estimated intakes by this study were considerable at the highest percentile, which referred to insecticide residues few days after insecticide application. Consequently, the non-dietary ingestion exposure to either insecticide was negligible in most cases; nevertheless, for those with indoor insecticide applications, the daily intakes for young children could be of concern. Frequently home cleaning is recommended to reduce the exposure.

Globally, workplace stress and anxiety are at an all-time high, with 42% of employees experiencing daily work-related stress and anxiety. Drawing from workplace anxiety (WA) theory (Cheng &amp; McCarthy, 2018), we advance a model that considers four job demands – role ambiguity, work overload, job insecurity, and work-home conflict – as sources of daily WA, and in turn the downstream effects of WA on psychological capital (PsyCap). Our model posits gender as a moderator of the association between job demands and WA, and digital technology characteristics as moderators of the association between WA and PsyCap. We tested our predictions on a sample of 162 South African employees. Consistent with our predictions, we found positive effects of job demands on WA, with the relationship being stronger for females. Contrary to expectations, we found positive effects of WA on PsyCap, suggesting an adaptive function of WA. Perceived ease of use of digital technology moderated the association between WA and PsyCap, such that the association was strong at higher levels of perceived ease of use. This research advances our understanding of the sources of WA, the adaptive function of WA, and predictors of PsyCap. Broadly, our study adds to understanding emotions’ impact on workplace behavior.

Canadians overwhelmingly do not want to live in long-term-care (LTC) facilities when they age; yet many end up there for lack of homecare, because family caregivers burn out, or because they and their professional advisors are unaware of alternatives to institutions. Not only is institutional dementia care problem-driven, it segregates disabled people, thereby abrogating human rights. Because systemic ageism and ableism cloud elder care, institutions remain the default option for Canadians with dementia. Yet, decades of deinstitutionalization enabled younger disabled Canadians to live in the community with supports. Why not elders? We describe a plethora of noninstitutional dementia-care alternatives. We then present a roadmap for considering all relevant care options in service plans, one that incorporates supported decision-making by people with dementia. We propose a paradigm shift in how Canada serves its elder citizens—not just the current generation, but those to come, including ourselves.

Formula feeding, as an alternative to breastfeeding, offers benefits such as convenience and consistent nutrition. Among the drawbacks of formula feeding, however, is potential dilution or concentration errors in the of formula during preparation that may lead to infant health issues. The present study aimed to investigate the accuracy of caregiver measurements as they prepared infant formula under multiple conditions, compared with manufacturer specifications. A diverse sample of caregivers (N = 84) participated in this cross-over experimental study. Participants hand-scooped infant formula powder and poured water to prepare 4oz and 7oz feedings, using both a standardized set of infant formula products and participants’ own products. Linear mixed effects models were used to estimate fixed effects of target amount (4oz versus 7oz) and products (participant versus researcher) on mean absolute percent error (MAPE) of measurement. Across all conditions MAPE was significantly greater for measuring powder than for water (9.0% vs. 4.4%; p&lt;0.001) with a combined powder and water MAPE at 13.0%. Greater measurement error was associated with the odd-sized 7oz preparation and participants’ own products. We observed considerable variability and substantial error during infant formula preparation, particularly for hand-scooping of powder, which tended toward higher values than the theoretical gold standard.

Childhood hygiene education has resulted in individuals engaging in hand washing and mask wearing to cope with COVID-19. Individuals can form sustainable development-related habits through childhood education.

Parent education programs, offered via family-school partnerships, offer an effective means for promoting the mental health and educational functioning of children and adolescents at a whole-of-school level. However, these programs often have low uptake. This study aimed to identify strategies for increasing the uptake of parent education programs within preschool and school settings. A three-round Delphi procedure was employed to obtain expert consensus on strategies that are important and feasible in educational settings. First, thirty experts rated statements identified from the literature and a stakeholder forum. Next, experts re-appraised statements, including new statements generated from the first round. Ninety statements were endorsed by ≥ 80% of the experts. Primary themes include strategies for program selection, strategies for increasing the accessibility of programs and the understanding of educational staff on parent engagement and child mental health, strategies for program development, promotion, and delivery, as well as strategies for increasing parent and community engagement. This study offers a set of consensus strategies for improving the uptake of parent education programs within family-school partnership.

Induction heating (IH) technology is widely recognized and utilized in residential applications due to its high efficiency and safe operating characteristics. Resonant inverter circuits are widely used in IH systems because of their high efficiency and ability to perform soft-switching. Among the various resonant inverters used in IH systems, the single-switch quasi-resonant (SSQR) inverter topology is typically preferred for low-cost and low-output-power applications. Despite its cost advantage, the SSQR topology has a relatively narrow soft-switching range, which can be unstable depending on the electrical parameters of the load and the resonant converter circuit. Accurately determining the capacitance value of the resonant capacitor and the inductance value of the induction coil, which are the key circuit elements of the SSQR induction cooker, is crucial for designing a reliable, efficient, and durable cooking system. In other words, there exists a critical relationship between the resonant converter circuit parameters, load characteristics, and safe operating conditions. Additionally, when considering closed-loop control methods used for power control and safety, selecting appropriate resonant circuit elements becomes vital in ensuring both reliable and efficient operation. This paper focuses on a novel and simplified design method for the SSQR inverter utilized in household appliances. The proposed method and its advantages in terms of the safe operating area of the switch are theoretically investigated and verified through simulations and prototype circuits.

The home is becoming a key location for healthcare delivery, including the use of technology driven by autonomous systems (AS) to monitor and support healthcare plans. Using the example of a smart mirror, this paper describes the outcomes of focus groups with people with multiple sclerosis (MS; n=6) and people who have had a stroke (n=15) to understand their attitudes towards the use of AS for healthcare in the home. We thematic analysis to analyse the data. The results indicate that the use of such technology depends on the level of adaptability and responsiveness to the users’ specific circumstances, including their relationships with the healthcare system. A smart mirror would need to support manual entry, responsive goal setting, effective aggregation of data sources and integration with other technology, have a range of input methods, be supportive rather than prescriptive in messaging, and give the user full control of their data. Barriers to adoption include a perceived lack of portability and practicality, lack of accessibility and inclusivity, a sense of redundancy, being overwhelmed by multiple technological devices, and a lack of trust in data sharing. These results inform the development and deployment of future health technologies based on the lived experiences of people with health conditions who require ongoing care.

Domestic cats (Felis catus) are widespread worldwide as the most popular pets. This medium-sized carnivore have well-known negative effects on biodiversity, but there is still need to better understand the proximate causes of its predation. Based on a citizen science project, we assessed the role of spatiotemporal (i.e., latitude, longitude and seasons), climatic (i.e., rainfall), anthropogenic (i.e., human footprint, HFI) and individual (i.e., sex and age) variables on the number of preys returned home by cats in metropolitan France. Over the 5 048 cats monitored between 2015 and 2022, prey from 12 different classes (n= 36 568) were returned, being 68% mammals, 21% birds and 8% squamates. Shrews brought home by cats peaked during summer, while rodents were recorded during summer-autumn. Birds brought home by cats peaked in spring-summer and in autumn, and lizards in spring and in late summer. Lower HFI was associated with more voles and mice brought home and the opposite trend was observed for lizards and birds. Younger cats were more prone to bring home shrews, birds and reptiles. Although environmental factors play a minor role in prey brought home by cats, some geographical characteristics of prey species distribution partly explains the hunting behaviour of cats.

Background: Portable oxygen concentrators (POCs) have shown efficacy in delivering adequate oxygen for various patient scenarios; however, there is a lack of research on POCs’ efficacy across different respiratory rates specifically among COPD patients. Methods: This bench study was conducted using the IngMar Medical Active Servo Lung 5000 attached to flexible tubing, which simulated an adult patient’s nares. An oxygen analyzer (Maxtec Handi+) was connected to the tubing 6 inches below the nares to estimate the inspired oxygen concentration at the adult trachea. A standard nasal cannula was placed in the simulated patient nares, which was also attached to each POC. The IngMar Lung was programmed to simulate a COPD patient at the following respiratory rates: 15, 20, 30, and 40 breaths/min. POC devices were then compared to an oxygen wall outlet and a standard oxygen concentrator (non-portable CAIRE device). The POCs included the CAIRE FreeStyle Comfort (with Autosat), CAIRE FreeStyle Comfort (without Autosat), Inogen G4, Inogen G5, Phillips SimplyGo Mini, GCE Zen-O lite, Drive Medical iGo2, and Kingon POCs. Descriptive statistics and ANOVAs were computed to determine statistically significant differences between POCS and control devices (wall oxygen and standalone oxygen concentrator). Results: Across most respiratory rate scenarios, the wall oxygen and standalone oxygen concentrator (control group) resulted higher oxygen measurements compared to the POCs. Among the POCs on setting 2, the highest oxygen measurement for 15, 30, and 40 breaths/min was the CAIRE FreeStyle Comfort with AutoSat on sensitivity 5 (24.43%, 24.81%, and 25.0%, respectively). On setting 2, the 20 breaths/min highest oxygen measurement was the Inogen G4 (24.43%). For setting 5, the highest oxygen measurement for 15 breaths/min and 40 breaths/min was the CAIRE FreeStyle Comfort without AutoSat (31.56% and 26.13%, respectively), while the highest oxygen measurement for 20 breaths/min was the Inogen G5 (30.26%), and the highest oxygen measurement for 30 breaths/min was the CAIRE FreeStyle Comfort with AutoSat on sensitivity level 5 (27.89%). Conclusions: The oxygen administered through the wall and the standalone CAIRE oxygen concentrator all delivered higher oxygen levels compared to the POCs (with the exception of the 40 breaths/min scenario on setting 2). However, among the POCs, the CAIRE Freestyle Comfort with AutoSat, CAIRE Freestyle Comfort without AutoSat, and the Inogen G4 all performed the best among the various breathing rate scenarios.