Search results for: patient information resources
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 17168

Search results for: patient information resources

16868 Energy Complementary in Colombia: Imputation of Dataset

Authors: Felipe Villegas-Velasquez, Harold Pantoja-Villota, Sergio Holguin-Cardona, Alejandro Osorio-Botero, Brayan Candamil-Arango

Abstract:

Colombian electricity comes mainly from hydric resources, affected by environmental variations such as the El Niño phenomenon. That is why incorporating other types of resources is necessary to provide electricity constantly. This research seeks to fill the wind speed and global solar irradiance dataset for two years with the highest amount of information. A further result is the characterization of the data by region that led to infer which errors occurred and offered the incomplete dataset.

Keywords: energy, wind speed, global solar irradiance, Colombia, imputation

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16867 A Qualitative Study of Approaches Used by Physiotherapists to Educate Patients with Chronic Low Back Pain

Authors: Styliani Soulioti, Helen Fiddler

Abstract:

The aim of this study was to investigate the approaches used by physiotherapists in the education of patients with chronic low back pain (cLBP) and the rationale that underpins their choice of approach. Therapeutic patient education (TPE) is considered to be an important aspect of modern physiotherapy practice, as it helps patients achieve better self-management and a better understanding of their problem. Previous studies have explored this subject, but the reasoning behind the choices physiotherapists make as educators has not been widely explored, thus making it difficult to understand areas that could be addressed in order to improve the application of TPE.A qualitative study design, guided by a constructivist epistemology was used in this research project. Semi-structured interviews were used to collect data from 7 physiotherapists. Inductive coding and thematic analysis were used, which allowed key themes to emerge. Data analysis revealed two overarching themes: 1) patient-centred versus therapist-centred educational approaches, and 2) behaviourist versus constructivist educational approaches. Physiotherapists appear to use a patient-centred-approach when they explore patients’ beliefs about cLBP and treatment expectations. However, treatment planning and goal-setting were guided by a therapist-centred approach, as physiotherapists appear to take on the role of the instructor/expert, whereas patients were viewed as students. Using a constructivist approach, physiotherapists aimed to provide guidance to patients by combining their professional knowledge with the patients’ individual knowledge, to help the patient better understand their problem, reflect upon it and find a possible solution. However, educating patients about scientific facts concerning cLBP followed a behaviourist approach, as an instructor/student relationship was observed and the learning content was predetermined and transmitted in a one-way manner. The results of this study suggest that a lack of consistency appears to exist in the educational approaches used by physiotherapists. Although patient-centeredness and constructivism appear to be the aims set by physiotherapists in order to optimise the education they provide, a student-teacher relationship appears to dominate when it comes to goal-setting and delivering scientific information.

Keywords: chronic low back pain, educational approaches, health education, patient education

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16866 Employee Assessment Systems in the Structures of Corporate Groups

Authors: D. Bąk-Grabowska, K. Grzesik, A. Iwanicka, A. Jagoda

Abstract:

The process of human resources management in the structures of corporate groups demonstrates certain specificity, resulting from the division of decision-making and executive competencies, which occurs within these structures between a parent company and its subsidiaries. The subprocess of employee assessment is considered crucial, since it provides information for the implementation of personnel function. The empirical studies conducted in corporate groups, within which at least one company is located in Poland, confirmed the critical significance of employee assessment systems in the process of human resources management in corporate groups. Parent companies, most often, retain their decision-making authority within the framework of the discussed process and introduce uniform employee assessment and personnel controlling systems to subsidiary companies. However, the instruments for employee assessment applied in corporate groups do not present such specificity.

Keywords: corporate groups, employee periodical assessment system, holding, human resources management

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16865 The Role of Libraries in the Context of Indian Knowledge Based Society

Authors: Sanjeev Sharma

Abstract:

We are living in the information age. Information is not only important to an individual but also to researchers, scientists, academicians and all others who are doing work in their respective fields. The 21st century which is also known as the electronic era has brought several changes in the mechanism of the libraries in their working environment. In the present scenario, acquisition of information resources and implementation of new strategies have brought a revolution in the library’s structures and their principles. In the digital era, the role of the library has become important as new information is coming at every minute. The knowledge society wants to seek information at their desk. The libraries are managing electronic services and web-based information sources constantly in a democratic way. The basic objective of every library is to save the time of user which is based on the quality and user-orientation of services. With the advancement of information communication and technology, the libraries should pay more devotion to the development trends of the information society that would help to adjust their development strategies and information needs of the knowledge society. The knowledge-based society demands to re-define the position and objectives of all the institutions which work with information, knowledge, and culture. The situation is the era of digital India is changing at a fast speed. Everyone wants information 24x7 and libraries have been recognized as one of the key elements for open access to information, which is crucial not only to individual but also to democratic knowledge-based information society. Libraries are especially important now a day the whole concept of education is focusing more and more independent e-learning and their acting. The citizens of India must be able to find and use the relevant information. Here we can see libraries enter the stage: The essential features of libraries are to acquire, organize, store and retrieve for use and preserve publicly available material irrespective of the print as well as non-print form in which it is packaged in such a way that, when it is needed, it can be found and put to use.

Keywords: knowledge, society, libraries, culture

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16864 The Oral Production of University EFL Students: An Analysis of Tasks, Format, and Quality in Foreign Language Development

Authors: Vera Lucia Teixeira da Silva, Sandra Regina Buttros Gattolin de Paula

Abstract:

The present study focuses on academic literacy and addresses the impact of semantic-discursive resources on the constitution of genres that are produced in such context. The research considers the development of writing in the academic context in Portuguese. Researches that address academic literacy and the characteristics of the texts produced in this context are rare, mainly with focus on the development of writing, considering three variables: the constitution of the writer, the perception of the reader/interlocutor and the organization of the informational text flow. The research aims to map the semantic-discursive resources of the written register in texts of several genres and produced by students in the first semester of the undergraduate course in Letters. The hypothesis raised is that writing in the academic environment is not a recurrent literacy practice for these learners and can be explained by the ontogenetic and phylogenetic nature of language development. Qualitative in nature, the present research has as empirical data texts produced in a half-yearly course of Reading and Textual Production; these data result from the proposition of four different writing proposals, in a total of 600 texts. The corpus is analyzed based on semantic-discursive resources, seeking to contemplate relevant aspects of language (grammar, discourse and social context) that reveal the choices made in the reader/writer interrelationship and the organizational flow of the Text. Among the semantic-discursive resources, the analysis includes three resources, including (a) appraisal and negotiation to understand the attitudes negotiated (roles of the participants of the discourse and their relationship with the other); (b) ideation to explain the construction of the experience (activities performed and participants); and (c) periodicity to outline the flow of information in the organization of the text according to the genre it instantiates. The results indicate the organizational difficulties of the flow of the text information. Cartography contributes to the understanding of the way writers use language in an effort to present themselves, evaluate someone else’s work, and communicate with readers.

Keywords: academic writing, Portuguese mother tongue, semantic-discursive resources, academic context

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16863 A Case Study of Al-Shifa: A Healthcare Information System in Oman

Authors: Khamis Al-Gharbi, Said M. Gattoufi, Ali H. Al-Badi, Ali Al-Hashmi

Abstract:

The case study presents the progression of a project management of Al-Shifa, a healthcare information system in Oman. The case study describes the evolution of the implementation of a healthcare information system tailored to meet the needs of the healthcare units under the supervision of the Ministry of Health (MOH) in Oman. A focus group methodology was used for collecting the relevant information from the main project's stakeholders. In addition reports about the project made available for the researchers. The case analysis is made based on the Project Management approach developed by the Project Management Institute (PMI). The main finding that there was no formal project management approach adopted by the MOH for the development and implementation of the herewith mentioned healthcare information system project. Furthermore, the project had suffered a scope creep in terms of features, cost and time-schedule. The recommendations of the authors, for the rescue of the project from its current dilemma, consist of technological, administrative and human resources development actions.

Keywords: project management, information system, healthcare, Al-Shifa, Oman

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16862 Pulmonary Hydatid Cyst in a 13-Year-Old Child: A Case Report

Authors: Ghada Esheba, Bayan Hafiz, Ashwaq Al-Qarni, Abdulelah AlMalki, Esraa Kaheel

Abstract:

Hydatid disease is caused by genus Echinococcus, it is transmitted to human through sheep and cattle. People who lived in an endemic area should be suspected to have the disease. Pulmonary hydatid disease can be presented by respiratory manifestations as in our case. We report a case of child, 13 years old, who was presented by shortness of breath and non-productive cough 2 months ago. The patient had an attack of hemoptysis 3 months ago but there is no history of fever, other constitutional symptoms or any medical illness. The patient has had a close contact with a horse. On examination, the patient was oriented and vitally stable. Both side of chest were moving equally with decrease air entry on the left side of the chest. Cervical lymph node enlargement was also detected. The case was provisionally diagnosed as tuberculosis. The x-ray was normal, while CT scan showed two cysts in the left side. The patient was treated surgically with resection of both cysts without lobectomy. Broncho-alveolar lavage was done and together with plural effusion and both cysts were sent for histopathology. The patient received the following medication: albendazole 200MG/BID/Orally for 30 days and Cefuroxime 250MG/Q12H/Orally for 10 days.

Keywords: Echinococcus granulosus, hydatid disease, pediatrics, pulmonary hydatid cyst

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16861 A Novel Method for Live Debugging of Production Web Applications by Dynamic Resource Replacement

Authors: Khalid Al-Tahat, Khaled Zuhair Mahmoud, Ahmad Al-Mughrabi

Abstract:

This paper proposes a novel methodology for enabling debugging and tracing of production web applications without affecting its normal flow and functionality. This method of debugging enables developers and maintenance engineers to replace a set of existing resources such as images, server side scripts, cascading style sheets with another set of resources per web session. The new resources will only be active in the debug session and other sessions will not be affected. This methodology will help developers in tracing defects, especially those that appear only in production environments and in exploring the behaviour of the system. A realization of the proposed methodology has been implemented in Java.

Keywords: live debugging, web application, web resources, inconsistent bugs, tracing

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16860 Increasing Adherence to Preventative Care Bundles for Healthcare-Associated Infections: The Impact of Nurse Education

Authors: Lauren G. Coggins

Abstract:

Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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16859 The Nurse Practitioner’s Role Functions in Multi-Specialist Team When Caring for a Metastatic Colon Cancer Patient with Acute Intestinal Obstruction

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

Abstract:

Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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16858 Towards a Resources Provisioning for Dynamic Workflows in the Cloud

Authors: Fairouz Fakhfakh, Hatem Hadj Kacem, Ahmed Hadj Kacem

Abstract:

Cloud computing offers a new model of service provisioning for workflow applications, thanks to its elasticity and its paying model. However, it presents various challenges that need to be addressed in order to be efficiently utilized. The resources provisioning problem for workflow applications has been widely studied. Nevertheless, the existing works did not consider the change in workflow instances while they are being executed. This functionality has become a major requirement to deal with unusual situations and evolution. This paper presents a first step towards the resources provisioning for a dynamic workflow. In fact, we propose a provisioning algorithm which minimizes the overall workflow execution cost, while meeting a deadline constraint. Then, we extend it to support the dynamic adding of tasks. Experimental results show that our proposed heuristic demonstrates a significant reduction in resources cost by using a consolidation process.

Keywords: cloud computing, resources provisioning, dynamic workflow, workflow applications

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16857 Digital Self-Care Intervention Evaluation from the Perspective of Healthcare Users

Authors: Dina Ziadlou, Anthony Sunjaya, Joyzen Cortez Ramos, Romario Muñoz Ramos, Richard Dasselaar

Abstract:

This study aimed to evaluate the opinions of users using digital health technologies to prevent, promote, and maintain their health and well-being with or without the support of a healthcare provider to delineate an overview of the future patient journey while considering the strategic initiatives in the digital transformation era. This research collected the opinions of healthcare clients through a structural questionnaire to collect user accessibility, user knowledge, user experience, user engagement, and personalized medicine to investigate the mindset of the users and illustrate their opinions, expectations, needs, and voices about digital self-care expansion. In the realm of digital transformation, the accessibility of users to the internet, digital health platforms, tools, and mobile health applications have revolutionized the healthcare ecosystem toward nurturing informed and empowered patients who are tech-savvy and can take the initiative to be in charge of their health, involved in medical decision-making, and seek digital health innovations to prevent diseases and promote their healthy lifestyles. Therefore, the future of the patient journey is digital self-care intervention in a healthcare ecosystem where the partnership of patients in healthcare services is tied to their health information and action ownership.

Keywords: digital health, patient engagement, self-care intervention, digital self-care intervention, digital transformation

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16856 Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control

Authors: Gorazd Karer

Abstract:

When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents are one of the main tasks of the anesthesiologist. However, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. The paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a UDP-based communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of a medical device manufacturer and is implemented in Matlab-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: closed-loop control, depth of anesthesia (DoA), modeling, optical signal acquisition, patient state index (PSi), UDP communication protocol

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16855 Unravelling the Impact of Job Resources: Alleviating Job-Related Anxiety to Forster Employee Creativity Within the Oil and Gas Industry

Authors: Nana Kojo Ayimadu Baafi, Kwesi Amponsah-Tawiah

Abstract:

The study investigated the relationship between job-related anxiety and employee creativity. The study further explored the role of job resources in moderating the relationship between job-related anxiety and employee creativity within the oil and gas industries. The study utilized a cross-sectional survey design. A non-probability sampling technique, specifically convenience sampling, was used to sample 1200 participants from multiple companies within the oil and gas industries. The collected data were analyzed using Regression analysis and PROCESS macro for the moderation analysis. The study empirically demonstrated a negative significant relationship between job-related anxiety and employee creativity. It also exhibited that job resources moderated the relationship between job-related anxiety and creativity. This study addresses gaps in previous studies by highlighting the significance of job resources in how job-related anxiety affects employee creativity.

Keywords: employee creativity, job-related anxiety, job resource, human resources

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16854 Underdiagnosis of Supraclavicular Brachial Plexus Metastasis in the Shadow of Cervical Disc Herniation: Insights from a Lung Cancer Case Study

Authors: Eunhwa Jun

Abstract:

This case report describes the misdiagnosis of a patient who presented with right arm pain as cervical disc herniation. The patient had several underlying conditions, including hypertension, diabetes mellitus, liver cirrhosis, a history of lung cancer with left lower lobe lobectomy, and adjuvant chemoradiotherapy. An external cervical spine MRI revealed central protruding discs at the C4-5-6-7 levels. Despite treatment with medication and epidural blocks, the patient's pain persisted. A C-RACZ procedure was planned, but the patient's pain had worsened before admission. Using ultrasound, a brachial plexus block was attempted, but the brachial plexus eluded clear visualization, hinting at underlying neurological complexities. Chest CT revealed a new, large soft tissue mass in the right supraclavicular region with adjacent right axillary lymphadenopathy, leading to the diagnosis of metastatic squamous cell carcinoma. Palliative radiation therapy and chemotherapy were initiated as part of the treatment plan, and the patient's pain score decreased to 3 out of 10 on the Numeric Rating Scale (NRS), revealing the pain was due to metastatic lung cancer.

Keywords: supraclavicula brachial plexus metastasis, cervical disc herniation, brachial plexus block, metastatic lung cancer

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16853 Audit Management of Constipation According to National Institute for Health and Care Excellence Guideline

Authors: Areej Makeineldein Mustafa

Abstract:

The study evaluates the management processes and healthcare provider compliance with the National Institute for Health and Care Excellence recommendations for constipation management. We aimed to evaluate the adherence to National Institute for Health and Care Excellence guidelines in the management of constipation during the period from February to June 2023. We collected data from a random sample ( 51 patients) over 4 months with inclusion criteria for patients above 60 who were just admitted to the care of the elderly department during this period. Patient age, sex, medical records for constipation, acute or chronic constipation, or opioid-induced constipation, and treatment options were used to identify constipation and the type of treatment given. Our findings indicate that there is a gap between practice and National Institute for Health and Care Excellence guideline steps; only 3 patient was given medications according to National Institute for Health and Care Excellence guidelines in order of combination or steps of escalation. Addressing these gaps could potentially lead to enhanced patient outcomes and an overall improvement in the quality of care provided to individuals suffering from constipation.

Keywords: constipation, elderly, management, patient

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16852 A Theoretical Framework of Patient Autonomy in a High-Tech Care Context

Authors: Catharina Lindberg, Cecilia Fagerstrom, Ania Willman

Abstract:

Patients in high-tech care environments are usually dependent on both formal/informal caregivers and technology, highlighting their vulnerability and challenging their autonomy. Autonomy presumes that a person has education, experience, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could, therefore, be considered paradoxical, as in most cases these persons have impaired physical and/or metacognitive capacity. Therefore, to understand the prerequisites for patients to experience autonomy in high-tech care environments and to support them, there is a need to enhance knowledge and understanding of the concept of patient autonomy in this care context. The development of concepts and theories in a practice discipline such as nursing helps to improve both nursing care and nursing education. Theoretical development is important when clarifying a discipline, hence, a theoretical framework could be of use to nurses in high-tech care environments to support and defend the patient’s autonomy. A meta-synthesis was performed with the intention to be interpretative and not aggregative in nature. An amalgamation was made of the results from three previous studies, carried out by members of the same research group, focusing on the phenomenon of patient autonomy from a patient perspective within a caring context. Three basic approaches to theory development: derivation, synthesis, and analysis provided an operational structure that permitted the researchers to move back and forth between these approaches during their work in developing a theoretical framework. The results from the synthesis delineated that patient autonomy in a high-tech care context is: To be in control though trust, co-determination, and transition in everyday life. The theoretical framework contains several components creating the prerequisites for patient autonomy. Assumptions and propositional statements that guide theory development was also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients to remain or obtain patient autonomy in high-tech care environments were revealed: the strategy of control, the strategy of partnership, the strategy of trust, and the strategy of transition. This study suggests an extended knowledge base founded on theoretical reasoning about patient autonomy, providing an understanding of the strategies used by patients to achieve autonomy in the role of patient, in high-tech care environments. When possessing knowledge about the patient perspective of autonomy, the nurse/carer can avoid adopting a paternalistic or maternalistic approach. Instead, the patient can be considered to be a partner in care, allowing care to be provided that supports him/her in remaining/becoming an autonomous person in the role of patient.

Keywords: autonomy, caring, concept development, high-tech care, theory development

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16851 Patient Service Improvement in Public Emergency Department Using Discrete Event Simulation

Authors: Dana Mohammed, Fatemah Abdullah, Hawraa Ali, Najat Al-Shaer, Rawan Al-Awadhi, , Magdy Helal

Abstract:

We study the patient service performance at the emergency department of a major Kuwaiti public hospital, using discrete simulation and lean concepts. In addition to the common problems in such health care systems (over crowdedness, facilities planning and usage, scheduling and staffing, capacity planning) the emergency department suffered from several cultural and patient behavioural issues. Those contributed significantly to the system problems and constituted major obstacles in maintaining the performance in control. This led to overly long waiting times and the potential of delaying providing help to critical cases. We utilized the visual management tools to mitigate the impact of the patients’ behaviours and attitudes and improve the logistics inside the system. In addition a proposal is made to automate the date collection and communication within the department using RFID-based barcoding system. Discrete event simulation models were developed as decision support systems; to study the operational problems and assess achieved improvements. The simulation analysis resulted in cutting the patient delays to about 35% of their current values by reallocating and rescheduling the medical staff. Combined with the application of the visual management concepts, this provided the basis to improving patient service without any major investments.

Keywords: simulation, visual management, health care system, patient

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16850 Development of a Model for Predicting Radiological Risks in Interventional Cardiology

Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

Abstract:

Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

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16849 Ensuring Compliancy in Traditional Tibetan Medicine Treatment Through Patient Education

Authors: Nashalla Gwyn Nyinda

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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.

Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes

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16848 Medical Student's Responses to Emotional Content in Doctor-Patient Communication: To Explore Differences in Communication Training of Medical Students and Its Impact on Doctor-Patient Communication

Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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16847 Knowledge Engineering Based Smart Healthcare Solution

Authors: Rhaed Khiati, Muhammad Hanif

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In the past decade, smart healthcare systems have been on an ascendant drift, especially with the evolution of hospitals and their increasing reliance on bioinformatics and software specializing in healthcare. Doctors have become reliant on technology more than ever, something that in the past would have been looked down upon, as technology has become imperative in reducing overall costs and improving the quality of patient care. With patient-doctor interactions becoming more necessary and more complicated than ever, systems must be developed while taking into account costs, patient comfort, and patient data, among other things. In this work, we proposed a smart hospital bed, which mixes the complexity and big data usage of traditional healthcare systems with the comfort found in soft beds while taking certain concerns like data confidentiality, security, and maintaining SLA agreements, etc. into account. This research work potentially provides users, namely patients and doctors, with a seamless interaction with to their respective nurses, as well as faster access to up-to-date personal data, including prescriptions and severity of the condition in contrast to the previous research in the area where there is lack of consideration of such provisions.

Keywords: big data, smart healthcare, distributed systems, bioinformatics

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16846 Role of Imaging in Alzheimer's Disease Trials: Impact on Trial Planning, Patient Recruitment and Retention

Authors: Kohkan Shamsi

Abstract:

Background: MRI and PET are now extensively utilized in Alzheimer's disease (AD) trials for patient eligibility, efficacy assessment, and safety evaluations but including imaging in AD trials impacts site selection process, patient recruitment, and patient retention. Methods: PET/MRI are performed at baseline and at multiple follow-up timepoints. This requires prospective site imaging qualification, evaluation of phantom data, training and continuous monitoring of machines for acquisition of standardized and consistent data. This also requires prospective patient/caregiver training as patients must go to multiple facilities for imaging examinations. We will share our experience form one of the largest AD programs. Lesson learned: Many neurological diseases have a similar presentation as AD or could confound the assessment of drug therapy. The inclusion of wrong patients has ethical and legal issues, and data could be excluded from the analysis. Centralized eligibility evaluation read process will be discussed. Amyloid related imaging abnormalities (ARIA) were observed in amyloid-β trials. FDA recommended regular monitoring of ARIA. Our experience in ARIA evaluations in large phase III study at > 350 sites will be presented. Efficacy evaluation: MRI is utilized to evaluate various volumes of the brain. FDG PET or amyloid PET agents has been used in AD trials. We will share our experience about site and central independent reads. Imaging logistic issues that need to be handled in the planning phase will also be discussed as it can impact patient compliance thereby increasing missing data and affecting study results. Conclusion: imaging must be prospectively planned to include standardizing imaging methodologies, site selection process and selecting assessment criteria. Training should be transparently conducted and documented. Prospective patient/caregiver awareness of imaging requirement is essential for patient compliance and reduction in missing imaging data.

Keywords: Alzheimer's disease, ARIA, MRI, PET, patient recruitment, retention

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16845 Information Security Dilemma: Employees' Behaviour on Three-Dimensions to Failure

Authors: Dyana Zainudin, Atta Ur-Rahman, Thaier Hamed

Abstract:

This paper explains about human nature concept as to understand the significance of information security in employees’ mentality including leaders in an organisation. By studying on a theory concept of the latest Von Solms fourth waves, information security governance basically refers to the concept of a set of methods, techniques and tools that responsible for protecting resources of a computer system to ensure service availability, confidentiality and integrity of information. However, today’s information security dilemma relates to the acceptance of employees mentality. The major causes are a lack of communication and commitment. These types of management in an organisation are labelled as immoral/amoral management which effects on information security compliance. A recovery action is taken based on ‘learn a lesson from incident events’ rather than prevention. Therefore, the paper critically analysed the Von Solms fourth waves’ theory with current human events and its correlation by studying secondary data and also from qualitative analysis among employees in public sectors. ‘Three-dimensions to failure’ of information security dilemma are explained as deny, don’t know and don’t care. These three-dimensions are the most common vulnerable behaviour owned by employees. Therefore, by avoiding the three-dimensions to failure may improve the vulnerable behaviour of employees which is often related to immoral/amoral management.

Keywords: information security management system, information security behaviour, information security governance, information security culture

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16844 [Keynote Talk]: Water Resources Vulnerability Assessment to Climate Change in a Semi-Arid Basin of South India

Authors: K. Shimola, M. Krishnaveni

Abstract:

This paper examines vulnerability assessment of water resources in a semi-arid basin using the 4-step approach. The vulnerability assessment framework is developed to study the water resources vulnerability which includes the creation of GIS-based vulnerability maps. These maps represent the spatial variability of the vulnerability index. This paper introduces the 4-step approach to assess vulnerability that incorporates a new set of indicators. The approach is demonstrated using a framework composed of a precipitation data for (1975–2010) period, temperature data for (1965–2010) period, hydrological model outputs and the water resources GIS data base. The vulnerability assessment is a function of three components such as exposure, sensitivity and adaptive capacity. The current water resources vulnerability is assessed using GIS based spatio-temporal information. Rainfall Coefficient of Variation, monsoon onset and end date, rainy days, seasonality indices, temperature are selected for the criterion ‘exposure’. Water yield, ground water recharge, evapotranspiration (ET) are selected for the criterion ‘sensitivity’. Type of irrigation and storage structures are selected for the criterion ‘Adaptive capacity’. These indicators were mapped and integrated in GIS environment using overlay analysis. The five sub-basins, namely Arjunanadhi, Kousiganadhi, Sindapalli-Uppodai and Vallampatti Odai, fall under medium vulnerability profile, which indicates that the basin is under moderate stress of water resources. The paper also explores prioritization of sub-basinwise adaptation strategies to climate change based on the vulnerability indices.

Keywords: adaptive capacity, exposure, overlay analysis, sensitivity, vulnerability

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16843 Overview of Resources and Tools to Bridge Language Barriers Provided by the European Union

Authors: Barbara Heinisch, Mikael Snaprud

Abstract:

A common, well understood language is crucial in critical situations like landing a plane. For e-Government solutions, a clear and common language is needed to allow users to successfully complete transactions online. Misunderstandings here may not risk a safe landing but can cause delays, resubmissions and drive costs. This holds also true for higher education, where misunderstandings can also arise due to inconsistent use of terminology. Thus, language barriers are a societal challenge that needs to be tackled. The major means to bridge language barriers is translation. However, achieving high-quality translation and making texts understandable and accessible require certain framework conditions. Therefore, the EU and individual projects take (strategic) actions. These actions include the identification, collection, processing, re-use and development of language resources. These language resources may be used for the development of machine translation systems and the provision of (public) services including higher education. This paper outlines some of the existing resources and indicate directions for further development to increase the quality and usage of these resources.

Keywords: language resources, machine translation, terminology, translation

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16842 A Mixed Approach to Assess Information System Risk, Operational Risk, and Congolese Microfinance Institutions Performance

Authors: Alfred Kamate Siviri, Angelus Mafikiri Tsongo, Jean Robert Kala Kamdjoug

Abstract:

Digitalization and information systems well organized have been selected as relevant measures to mitigate operational risks within organizations. Unfortunately, information system comes with new threats that can cause severe damage and quick organization lockout. This study aims to measure perceived information system risks and their effects on operational risks within the microfinance institution in D.R. Congo. Also, the factors influencing the operational risk are identified, and the link between operational risk with other risks and performance is to be assessed. The study proposes a research model drawn on the combination of Resources-Based-View, dynamic capabilities, the agency theory, the Information System Security Model, and social theories of risk. Therefore, we suggest adopting a mixed methods research with the sole aim of increasing the literature that already exists on perceived operational risk assessment and its link with other risk and performance, a focus on IT risk.

Keywords: Democratic Republic Congo, information system risk, microfinance performance, operational risk

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16841 Communication Design in Newspapers: A Comparative Study of Graphic Resources in Portuguese and Spanish Publications

Authors: Fátima Gonçalves, Joaquim Brigas, Jorge Gonçalves

Abstract:

As a way of managing the increasing volume and complexity of information that circulates in the present time, graphical representations are increasingly used, which add meaning to the information presented in communication media, through an efficient communication design. The visual culture itself, driven by technological evolution, has been redefining the forms of communication, so that contemporary visual communication represents a major impact on society. This article presents the results and respective comparative analysis of four publications in the Iberian press, focusing on the formal aspects of newspapers and the space they dedicate to the various communication elements. Two Portuguese newspapers and two Spanish newspapers were selected for this purpose. The findings indicated that the newspapers show a similarity in the use of graphic solutions, which corroborate a visual trend in communication design. The results also reveal that Spanish newspapers are more meticulous with graphic consistency. This study intended to contribute to improving knowledge of the Iberian generalist press.

Keywords: communication design, graphic resources, Iberian press, visual journalism

Procedia PDF Downloads 245
16840 A Novel Algorithm for Production Scheduling

Authors: Ali Mohammadi Bolban Abad, Fariborz Ahmadi

Abstract:

Optimization in manufacture is a method to use limited resources to obtain the best performance and reduce waste. In this paper a new algorithm based on eurygaster life is introduced to obtain a plane in which task order and completion time of resources are defined. Evaluation results show our approach has less make span when the resources are allocated with some products in comparison to genetic algorithm.

Keywords: evolutionary computation, genetic algorithm, particle swarm optimization, NP-Hard problems, production scheduling

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16839 Nursing Experience for a Lung Cancer Patient Undergoing First Time Concurrent Chemotherapy and Radiation Therapy

Authors: Hui Ling Chen

Abstract:

This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

Procedia PDF Downloads 131