An internet of things-based automatic brain tumor detection system

Due to the advances in information and communication technologies, the usage of the internet of things (IoT) has reached an evolutionary process in the development of the modern health care environment. In the recent human health care analysis system, the amount of brain tumor patients has increased severely and placed in the 10th position of the leading cause of death. Previous state-of-the-art techniques based on magnetic resonance imaging (MRI) faces challenges in brain tumor detection as it requires accurate image segmentation. A wide variety of algorithms were developed earlier to classify MRI images which are computationally very complex and expensive. In this paper, a cost-effective stochastic method for the automatic detection of brain tumors using the IoT is proposed. The proposed system uses the physical activities of the brain to detect brain tumors. To track the daily brain activities, a portable wrist band named Mi Band 2, temperature, and blood pressure monitoring sensors embedded with Arduino-Uno are used and the system achieved an accuracy of 99.3%. Experimental results show the effectiveness of the designed method in detecting brain tumors automatically and produce better accuracy in comparison to previous approaches.

In Search of A Contemporary Definition of Meaningful Engagement: A systematic literature review

Consumer engagement is emerging as an important trend in a contemporary health care environment. Yet, a universal definition of meaningful consumer engagement has not been determined. This paper presents our systematic literature review findings, which intended to consolidate the definition of consumer engagement (or related terms) in the context of health care to date to arrive at a definition for meaningful consumer engagement in healthcare. Literature searches were performed in MEDLINE, CINAHL, Embase and PsychINFO in June 2021. Using a combination of medical subject headings (MeSH) terms, Emtree search headings and free text words, a total of 82 records were identified. After reviewing in line with PRISMA methodology, 23 articles were considered relevant to the development of the definition of consumer engagement. The methodology of these papers was analysed using the revised Mixed Methods Appraisal Tool (MMAT) (2018). A total of 13 of these papers were then further analysed for a definition of meaningful consumer engagement or characteristics of consumer engagement. None of the definitions found comprehensively defined meaningful consumer engagement but instead, five described meaningful consumer engagement. Therefore, a new definition of meaningful consumer engagement is proposed, which is based upon the synthesis of the characteristics of meaningful consumer engagement and person-centred care. This new definition speaks to what is it means to be consumers of health care rather than patients and acknowledged the importance of the reciprocity of the exchange relationship of ‘consumers’, the importance of leadership, and the emerging evidence around diversity and inclusion trust and partnership which requires active involvement and participation.

Reflective abilities of nursing students: A thematic analysis of reflection journals

Objective: Reflective writing is consistently linked to improved clinical decision-making. However, analyzing the journals to evaluate the reflective abilities of nursing students is scanty locally. This study aimed to assess the reflective skills of undergraduate nursing students.Methods: A qualitative thematic content analysis using the Lasater Clinical Judgment Evaluation Rubric was used to assess the reflective abilities of 33 undergraduate nursing students in 138 journal entries. Guided by Gibb's reflective model, the students documented their experiences during a clinical attachment at a National Referral Hospital in Kenya between February and August 2018. Data coding and thematic linking were done using NVIVO version 11. Results: Reflective abilities differed across gender and to some extent across years of study. Most participants were more likely to notice the deviation from the norm, whether patient-related or health care environment-related. Moreover, they demonstrated the ability to respond to the situation, self-evaluate, and develop action plans for future encounters. However, the majority struggled with interpreting findings.Conclusions: Gender differences exist in the way nursing students reflect. Most nursing students focus on describing the situation rather than developing solutions. There is, however, an indication of developing reflective abilities across the year of study.

The Role of Gender in the History of the Professional Development of South African Nursing and Nursing Organisations

Historically, female nurse leaders endeavoured to make nursing a profession by establishing nursing organisations that could act as agents of change. They were hampered by sociocultural notions of gender: men dominating society, politics, and the economy. Nurses therefore needed positive working relationships with male leaders. In South Africa, such gender dynamics led to the South African Nursing Association (SANA), being influenced by a political system, that is, apartheid, which had dire consequences for the profession. This article illustrates that historically the emerging nursing profession was intimately connected with a changing society: female nurses strove for economic and professional independence but were confined by a male-dominated (medical) society. South African female nurse leaders never openly challenged the political status quo. It is recommended that current South African nursing organisations advocate for gender equality and clarify how they can foster a health-care environment in which gender diversity is the norm.

Empowerment: What can Nurse Leaders Do to Encourage an Empowering Environment for Nurses Working in the Mental Health Area?

<p>Nurses, as the majority of the mental health workforce have a valuable contribution to make at a policy development level. The 1998 report from the Ministerial Taskforce on Nursing supports this statement but also indicates that there is a general reluctance by nurses to participate in policy development. For nurses to have control over their practice they need to have input into policy development. Nurses having control over their practice has been linked to nursing empowerment. Therefore the question explored in this research project is: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area? The literature reviewed for this project includes empowerment, power, the history of nursing in relation to women's role in society, oppression and resistance, and literature on Critical Social Theory as the underlying theoretical and philosophical position which informs the research process. In order to answer the research question a single focus group was used to gather data from a group of registered nurses practising in mental health. Focus groups as a data collection method produce data and insights that would be less accessible without the interaction found in the group. The key themes to emerge from the data analysis were; power is an important component of empowerment and power relationships; and at a systems level, professional, organisational, and political influences impact on feelings of empowerment and/or disempowerment. These key themes are discussed in relation to the literature and the broader social and cultural context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations for nurse leaders who aim to provide an empowering environment for nurses practising in mental health.</p>

Empowerment: What can Nurse Leaders Do to Encourage an Empowering Environment for Nurses Working in the Mental Health Area?

<p>Nurses, as the majority of the mental health workforce have a valuable contribution to make at a policy development level. The 1998 report from the Ministerial Taskforce on Nursing supports this statement but also indicates that there is a general reluctance by nurses to participate in policy development. For nurses to have control over their practice they need to have input into policy development. Nurses having control over their practice has been linked to nursing empowerment. Therefore the question explored in this research project is: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area? The literature reviewed for this project includes empowerment, power, the history of nursing in relation to women's role in society, oppression and resistance, and literature on Critical Social Theory as the underlying theoretical and philosophical position which informs the research process. In order to answer the research question a single focus group was used to gather data from a group of registered nurses practising in mental health. Focus groups as a data collection method produce data and insights that would be less accessible without the interaction found in the group. The key themes to emerge from the data analysis were; power is an important component of empowerment and power relationships; and at a systems level, professional, organisational, and political influences impact on feelings of empowerment and/or disempowerment. These key themes are discussed in relation to the literature and the broader social and cultural context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations for nurse leaders who aim to provide an empowering environment for nurses practising in mental health.</p>

P.209 Novel 3D printing for complex cranial reconstruction in neurosurgery - A case series

Background: Cranial reconstruction is a common consequence of neurosurgical disease and intervention following craniectomy, trauma, infection, congenital defects, or neoplasm. Most commonly, Computer Aided Design-Computer Aided Manufacturing (CAD-CAM) technology is utilized in cases where autologous bone cannot be used. These patient-specific implants provide excellent cosmesis, however individual costs range from $800-15,000, making routine use challenging in the current Canadian health care environment. Here we present a novel method using desktop 3D printers to manufacture patient-specific molds for intraoperative reconstruction of various cranial defects. Methods: Our first patient presented following two separate traumas requiring decompressive craniectomy and subsequent posterior fossa decompression without interval cranioplasty. The second patient required reconstruction during resection of intraosseous meningioma. Both cases were performed using a titanium-mesh/poly-methyl-methacrylate (Ti-PMMA) construct draped over the mold. The third case, cranioplasty following decompressive craniectomy outside the country, was performed using a “two piece” mold and PMMA was casted into the mold and allowed to harden. Results: Patients reported satisfaction with cosmesis, without adverse outcomes. Cost per case was $50-100, representing an estimated cost savings of $685,000 per year in Canada. Conclusions: Given excellent outcomes in addition to cost effectiveness, this case series provides evidence for use of this alternate technique with similar patient outcomes.

Supporting Advance Practice Providers in the Emergency Department Using Telehealth

This chapter focuses on the role of advanced practice providers (APPs) in the context of emergency telehealth by describing one of the first successful programs, started in 2003, at the University of Mississippi Medical Center (UMMC). Important issues germane to developing a program to provide telehealth supervision to APPs are covered. Specific concerns addressed by UMMC as the program was developed are described and generalized to the current health care environment. Major considerations regarding delivery models, contracts, technology, rationale for using APPs, regulatory concerns, and educational preparation are also discussed.

P.210 Transitioning from Pediatric to Adult care: a Qualitative Study of Patients with Hydrocephalus and their Caregivers

Background: Hydrocephalus is a common pediatric neurosurgical condition that requires lifelong care into adulthood. Significant gaps in care are thought to exist for youth transitioning to adult care, but little is known about how patients and their caregivers feel about the process. This study examines the perceptions of adolescents, young adults and caregivers when transitioning from pediatric to adult care at a single Canadian center. Methods: 40 patient/caregivers (7 adolescents, 13 young adults and 20 parents) treated at BC Children’s Hospital participated in semi-structured interviews using the qualitative research methodologies of grounded theory. Interviews were transcribed verbatim and coded, with common themes identified. Results: Four overarching themes relating to the process of transitioning from pediatric to adult care were identified: (1): Inadequacy of communication between pediatric and adult care teams and patients/caregivers; (2) Uncertainty relating to the prospect of life as an adult with hydrocephalus; (3) Anxiety and fear regarding navigating a new health care environment; and (4) sadness at the loss relationships with the pediatric health care team. Conclusions: We identified a general dissatisfaction with the transitioning process for hydrocephalus. Common themes and concerns identified may form the basis of an improved transitioning model for youth with hydrocephalus as they become adults.

Incentivizing Full-time Employment for New Graduate Nurses in Ontario: Impact of Policy on Care

There is consensus that a professional full-time nursing workforce leads to better patient outcomes and a safer health care environment. In 2007, the Ontario Ministry of Health and Long-Term Care introduced the Nursing Graduate Guarantee (NGG), a policy mechanism designed to strengthen the nursing workforce by increasing full-time (FT) employment for newly graduated nurses. Several factors have affected the supply and employment status of nurses in the province over the past two decades, including the introduction of unregulated health care workers and crises such as SARS and COVID-19. A secondary analysis of the College of Nurses of Ontario registration database was conducted to identify and evaluate trends in the supply and employment of nurses in Ontario prior to and following introduction of the NGG. The results demonstrate that full-time employment of new registered nurses and new registered practical nurses initially increased but has since fallen to below pre-policy levels. Part-time work among newly graduated nurses is increasing across all sectors, signaling a diminishing effect of the NGG investments over time. Investments in health human resources have a stabilizing effect on the nursing workforce. Ensuring an adequate number of nurses is necessary for crisis preparation, management and recovery, particularly in sectors with low surge capacity such as long-term care. However, sustained financial, political, public, and professional support is required.