Search results for: smart home healthcare

Authors: Jayshree P. Zend, Ashatai B. Pawar

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The study was carried out in Parbhani district of Maharashtra state, India with the objectives to study environmental problems faced by flour mill workers, prevalence of work-related health hazards and the physiological cost of workers while performing work in flour mill in traditional method as well as improved method. The use of flour presser, dust controlling bag and noise and dust controlling mask developed by AICRP College of Home Science, VNMKV, Parbhani was considered as an improved method. This investigation consisted survey and experiment which was conducted in the respective locations of flour mills. Healthy, non-smoking 30 flour mill workers ranged between the age group of 20-50 yrs comprising 16 female and 14 male working at flour mill for 4-8 hrs/ day and 6 days/ week and had minimum five years experience of work in flour mill were selected for the study. Pulmonary function test of flour mill workers was carried out by trained technician at Dr. ShankarraoChavan Government Medical College, Nanded by using Electronic Spirometer. The data regarding heart rate (resting, working and recovery), energy expenditure, musculoskeletal problems and occupational health hazards and accidents were recorded by using pretested questionnaire. Scientific equipment used in the experiment were polar sport test heart rate monitor, Hygrometer, Goniometer, Dialed Thermometer, Sound Level Meter, Lux Meter, Ambient Air Sampler and Air Quality Monitor. The collected data were subjected to appropriate statistical analysis such as 't' test and correlation coefficient test. Results indicated that improved method i.e. use of noise and dust controlling mask, flour presser and dust controlling bag were effective in reducing physiological cost of work of flour mill workers. Lung function test of flour mill workers showed decreased values of all parameters, hence the results of present study support paying attention to use of personal protective noise and dust controlling mask by flour mill workers and also to the working conditions in flour mill especially ventilation and illumination level needs to be enhanced in flour mill. The study also emphasizes the need to develop some mechanism for lifting load of grains and unloading in the hopper. It is also suggested that the flour mill workers should use flour presser suitable to their height to avoid frequent bending and should use dust controlling bag to flour outlet of machine to reduce inhalable flour dust level in the flour mill.

Keywords: physiological cost, energy expenditure, musculoskeletal problems

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Authors: Innocent Uzougbo Onwuegbuzie, Siene Elizabeth Eke

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This study investigates cybersecurity challenges and solutions in managing Information and Communication Technology (ICT) at the Federal Polytechnic, Ado-Ekiti, South-West Nigeria. The rapid evolution of ICT has revolutionized organizational operations and impacted various sectors, including education, healthcare, and finance. While ICT advancements facilitate seamless communication, complex data analytics, and strategic decision-making, they also introduce significant cybersecurity risks such as data breaches, ransomware, and other malicious attacks. These threats jeopardize the confidentiality, integrity, and availability of information systems, necessitating robust cybersecurity measures. The primary aim of this research is to identify prevalent cybersecurity challenges in ICT management, evaluate their impact on the institution's operations, and assess the effectiveness of current cybersecurity solutions. Adopting a quantitative research approach, data was collected through surveys and structured questionnaires from students, staff, and IT professionals at the Federal Polytechnic, Ado-Ekiti. The findings underscore the critical need for continuous investment in cybersecurity technologies, employee and student training, and regulatory compliance to mitigate evolving cyber threats. This research contributes to bridging the knowledge gap in cybersecurity management and provides valuable insights into effective strategies and technologies for safeguarding ICT systems in educational institutions. The study's objectives are to enhance the security posture of the Federal Polytechnic, Ado-Ekiti, in an increasingly digital world by identifying and addressing the cybersecurity challenges faced by its ICT management.

Keywords: cybersecurity challenges, cyber threat mitigation, federal polytechnic Ado-Ekiti, ICT management

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Authors: D. Bheenick, M. Young, M.Elmussareh, A.Ali

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Objective: Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. Patient and methods: Retrospective data of patients presenting acutely to the urology department was collected between 13th January to 22nd March 2020 (pre-lockdown period) and 23rd March to 31st May 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Results: 1092 patients were included in the study. An overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. Conclusion: The admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Keywords: COVID-19, lockdown, admissions, urology

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Authors: Phusit Phukamchanoad, Bua Srikos

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Research aimed to study the characteristics of a community in the social, economical and cultural context. This research used interviews and surveys members in Patthana Soi Ranongklang community, Dusit District, Bangkok. The results are as follows: In terms of overall conditions and characteristics, Patthana Soi Ranongklang community is located on the property of Treasury Department. 50 years ago the location of this community consisted of paddy fields with limited convenience in terms of transportation. Rama V Road was only a small narrow road with only three-wheelers and no buses. The majority of community members moved in from Makkhawan Rangsan Bridge. Thus, most community members were either workers or government officials as they were not the owners of the land. Therefore, there were no primary occupations within this 7 acres of the community. The development of the community started in 1981. At present, the community is continuously being developed and modernization is rapidly flowing in. One of the reasons was because main roads were amended, especially Rama V Road that allows more convenient transportation, leading to heightened citizens’ convenience. In terms of the economy and society, the research found out that the development and expansion of Rama V Road cause a change in the conditions of the area and buildings. Some building were improved and changed along the time, as well as the development of new facilities that cause the community members to continually become more materialistic. Jobs within the community started to appear, and areas were improved to allow for new building and housing businesses. The trend of jobs become more in variety, in terms of both jobs at home, such as workers, merchandizing, and small own businesses, and jobs outside the community, which became much more convenient as car drivers are used to the narrow roads inside the community. The location of the community next to Rama V Road also allows helo from government agencies to reach the community with ease. Moreover, the welfare of the community was well taken care of by the community committee. In terms of education, the research found that there are two schools: Wat Pracharabuedham School and Wat Noi Noppakun School, that are providing education within the community. The majority of the community received Bachelor degrees. In areas of culture, the research found that the culture, traditions, and beliefs of people in the community were mainly transferred from the old community, especially beliefs in Buddhism as the majority are Bhuddists. The main reason is because the old community was situated near Wat Makut Kasattriyaram. Therefore, the community members have always had Buddhist temples as the center of the community. In later years, more citizens moved in and bring along culture, traditions, and beliefs with them. The community members also took part in building a Dharma hall named Wat Duang Jai 72 Years Ranong Klang. Traditions that community members adhere to since the establishment of the community are the New Year merit making and Songkran Tradition.

Keywords: social capital, culture, Patthana Soi Ranongklang community, way of life

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Authors: Daud Muhammad

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Introduction: Ankle radiographs are frequently requested in Emergency Departments (ED) for patients presenting with traumatic ankle pain. The Ottawa Ankle Rules (OAR) serve as a clinical guideline to determine the necessity of these radiographs, aiming to reduce unnecessary imaging. This audit was conducted to evaluate the adequacy of clinical information provided in radiograph requests in relation to the OAR. Methods: A retrospective analysis was performed on 50 consecutive ankle radiograph requests under ED clinicians' names for patients aged above 5 years, specifically excluding follow-up radiographs for known fractures. The study assessed whether the provided clinical information met the criteria outlined by the OAR. Results: The audit revealed that none of the 50 radiograph requests contained sufficient information to satisfy the Ottawa Ankle Rules. Furthermore, 10 out of the 50 radiographs (20%) identified fractures. Discussion: The findings indicate a significant lack of adherence to the OAR, suggesting potential overuse of radiography and unnecessary patient exposure to radiation. This non-compliance may also contribute to increased healthcare costs and resource utilization, as well as possible delays in diagnosis and treatment. Recommendations: To address these issues, the following recommendations are proposed: (1) Education and Training: Enhance awareness and training among ED clinicians regarding the OAR. (2) Standardised Request Forms: Implement changes to imaging request forms to mandate relevant information according to the OAR. (3) Scan Vetting: Promote awareness among radiographers to discuss the appropriateness of scan requests with clinicians. (4) Regular re-audits should be conducted to monitor improvements in compliance.

Keywords: Ottawa ankle rules, ankle radiographs, emergency department, traumatic pain

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Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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Authors: Freda Adomaa, Samuel Oppong Boampong, Charles Gyamfi Rahman

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The living and working environment of migrants and their access to healthcare services induce good or poor health. This study was conducted to assess the factors associated with rural-urban migration and its associated health hazards among female adolescents. A sample size of two hundred (200) was chosen in which all responded to questionnaires comprising closed-ended questions, which were distributed to gather data from the respondents, after which it was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. The utilized three causes of rural-urban migration thus political, economic and socio-cultural. The study revealed that political situations such as regional inequality (65.4%) and ethnic conflicts (78.2%) whereas economic factors such as lack of amenities (82.3%), lack of employment in rural communities (77.4%), lack of education (74%), and poverty (85.3%) as well as socio-cultural factors such as divorced parents (65.6%), media influence (79.1%), family conflicts (59.4%) and appealing urban informal sector (65.2%) are major causes of migration. Respondents’ encountered challenges such as poor remuneration for services (87.2%), being maltreated by a colleague or worker (69%), sleeping in open space (73.3%), and harassment by the task force (71.4%) and teenage pregnancies (58.5%). The study concluded that the three variables play a key role in adolescent migration and when they travel they end up getting involved in serious health hazardous behaviors such as rapes as well as physical and psychological harassments’. The study, therefore, recommends that vocational training of the rural people on small scale industries (non-farm) activities that could generate an income for the rural household should be introduced.

Keywords: rural, urban, migration, female health hazards

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Authors: Najmeh Jafari, Sona Rostampour Yasouri

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Crimean-Congo hemorrhagic fever (CCHF) is an acute hemorrhagic disease. This disease is one of the common diseases between humans and animals, transmitted through tick bites or contact with the blood and secretions or carcasses of infected animals and humans. CCHF is more common in people who work with livestock, such as ranchers, butchers, farmers, slaughterhouse workers, healthcare workers, etc. Its hospital prevalence is also very high. Considering that CCHF can be transmitted through the consumption of food such as beef and sheep meat, this study aims to quickly identify and diagnose the Crimean-Congo fever virus in suspected patients through real-time PCR technique. In the summer of 1402, 20 blood samples were collected separately from Ahvaz and Gilan hospitals. An extraction kit was used to extract the virus RNA. Primers and probes were designed based on the S genomic region, the conserved region in CCHFV. Then, a real-time PCR technique was performed with specific primers and probes. It should be noted that the mentioned technique was repeated several times. The number of 4 samples from the examined samples was determined positive by real-time PCR. This technique has high sensitivity and specificity and the possibility of rapid detection of CCHFV. Therefore, the above method is a good candidate for quick disease diagnosis. By diagnosing the disease, the treatment process can be done faster, and the best prevention methods can be used to control the disease and prevent the death of patients.

Keywords: ahvaz, crimean-congo hemorrhagic fever, gilan, real time PCR

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Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Valeria Tatano, Francesca Guidolin, Francesca Peltrera

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The preservation of historical Italian heritage, at the urban and architectural scale, has to consider restrictions and requirements connected with conservation issues and usability needs, which are often at odds with historical heritage preservation. Recent decades have been marked by the search for increased accessibility not only of public and private buildings, but to the whole historical city, also for people with disability. Moreover, in the last years the concepts of Smart City and Healthy City seek to improve accessibility both in terms of mobility (independent or assisted) and fruition of goods and services, also for historical cities. The principles of Inclusive Design have introduced new criteria for the improvement of public urban space, between current regulations and best practices. Moreover, they have contributed to transforming “special needs” into an opportunity of social innovation. These considerations find a field of research and analysis in the historical city of Venice, which is at the same time a site of UNESCO world heritage, a mass tourism destination bringing in visitors from all over the world and a city inhabited by an aging population. Due to its conformation, Venetian urban fabric is only partially accessible: about four thousand bridges divide thousands of islands, making it almost impossible to move independently. These urban characteristics and difficulties were the base, in the last 20 years, for several researches, experimentations and solutions with the aim of eliminating architectural barriers, in particular for the usability of bridges. The Venetian Municipality with the EBA Office and some external consultants realized several devices (e.g. the “stepped ramp” and the new accessible ramps for the Venice Marathon) that should determine an innovation for the city, passing from the use of mechanical replicable devices to specific architectural projects in order to guarantee autonomy in use. This paper intends to present the state-of-the-art in bridges accessibility, through an analysis based on Inclusive Design principles and on the current national and regional regulation. The purpose is to evaluate some possible strategies that could improve performances, between limits and possibilities of interventions. The aim of the research is to lay the foundations for the development of a strategic program for the City of Venice that could successfully bring together both conservation and improvement requirements.

Keywords: accessibility of historical cities, historical heritage preservation, inclusive design, technological and social innovation

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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Authors: I. Nanako, Mariko Era, Hiroshi Morita

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Objectives: Japanese uses TATAMI rather than flooring at home. Igusa ( Juncus effuses var. decipiens ), which is commonly known in the forms of TATAMI. Juncus spp. grow at a relatively high humidity area (Japan, China and Southeast Asia ). Yatsushiro region in the southern part of Kumamoto prefecture is major produing area of Igusa. Igusa found to have honeycomb structure and was also shown to have the ability to control humidity. And Igusa has been used as a medicinal herb for diuretic and antiphlogistic agent. In previous study, we investigated antimicrobial effects of Igusa, and showed high antimicrobial activity against food poisoning bacteria. Therefore, the food trays blended Igusa can be kept clean by antimicrobial activity of Igusa. We focus on ‘Igusa foam materials’. In this study, we investigated the antibacterial and antifungal activity of Igusa, and new application to foam materials for food industry. Materials and method: We used Igusa foam materials (3 × 3 × 3 cm) as a sample. We set about fifteen types of samples combined with a commercial antibacterial agent A, a commercial antibacterial agent B, potassium laurate (C12K) and a commercial antifungal agent C, a commercial antifungal agent D and a commercial antifungal agent E. We selected four bacteria strains (Escherichia coli NBRC 3972, Staphylococus aureus NBRC 12732, Salmonella typhimurium NBRC 13245, Bacillus subtilis NBRC 3335 ) and three fungus strains (Penicillium pinophilum NBRC 6345, Cladosporium cladosporioides NBRC 30314, Aspergillus oryzae NBRC 5238 ). The fungus was cultured at 30 °C on Igusa foam materials after inoculation of the fungus for fourteen days. The bacteria was cultured at 30 °C on Igusa foam materials after inoculation of the bacteria for three days. And the Igusa foam materials were washed with 10 mL normal saline after three days. The normal saline washed Igusa foam materials plated the NA medium. After, It was cultured at 30 °C and used colony counting method. Result and Conclusion: The fifteen types of sample of Igusa foam materials had antifungal activity against C. cladosporioides, A. oryzae and P. pinophilum for fourteen days. The four types of sample contained potassium laurate and antibacterial agent A, sample contained antibacterial agent B and antifungal agent D, sample contained A and antifungal agent E, sample contained B and E had antibacterial activity against B. subtilis. The three types of sample contained potassium laurate and A, sample contained B and D, sample contained A and E had antibacterial activity against S. typhimurium. The five types of sample contained potassium laurate and A, sample contained B and D, sample contained A and E, sample contained B and E, sample contained B and antifungal agent C had antibacterial activity against E. coli and S. aureus. These results indicate that Igusa of Igusa foam materials had high antifungal activity. In addition, Igusa foam materials combined with a commercial antibacterial agent had antibacterial activity. In the future, we consider that use of Igusa foam materials may be spread from food industry.

Keywords: antibacterial, antifungal, foam materials, Igusa

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Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown

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Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.

Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: Eric Awich Ochen

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The end of the conflict in Northern Uganda in 2006 brought about an opportunity for the youth to return to their original home and contribute to the peace building and development process of their communities. Post-conflict is used here to refer to the post-armed conflict situation and activities of rebels of Joseph Kony in northern Uganda. While the rebels remain very much active in the Sudan and Central African Republic, in Uganda the last confrontations occurred around 2006 or earlier, and communities have returned to their homes and began the process of rebuilding their lives. It is argued that socio-economic reconstruction is at the heart of peacebuilding and sustenance of positive peace in the aftermath of conflict, as it has a bearing on post-conflict stability and good governance. We recognize that several post-conflict interventions within Northern Uganda have targeted women and children with a strong emphasis on family socio-economic empowerment and capacity building, including access to micro finance. The aim of this study was to examine the participation of the youth in post-conflict peace building and development in Northern Uganda by assessing the breadth and width of their engagement and the stages of programming cycle that they are involved in, interrogating the space for participation and how they are facilitating or constraining participation. It was further aimed at examining the various dimensions of participation at play in Northern Uganda and where this fits within the conceptual debates on peace building and development in the region. Supporting young people emerging out of protracted conflict to re-establish meaningful socio-economic engagements and livelihoods is fundamental to their participation in the affairs of the community. The study suggests that in the post-conflict development context of Northern Uganda, participation has rarely been disaggregated or differentiated by sectors or groups. Where some disaggregation occurs, then the main emphasis has always been on either women or children. It appears therefore that little meaningful space has thus been created for young people to engage and participate in peace building initiatives within the region. In other cases where some space is created for youth participation, this has been in pre-conceived programs or interventions conceived by the development organizations with the youth or young people only invited to participate at particular stages of the project implementation cycle. Still within the implementation of the intervention, the extent to which young people participate is bounded, with little power to influence the course of the interventions or make major decisions. It is thus visible that even here young people mainly validate and legitimize what are predetermined processes only act as pawns in the major chess games played by development actors (dominant peace building partners). This paper, therefore, concludes that the engagement of the youth in post-conflict peace building has been quite problematic and tokenistic and has not given the adequate youth space within which they could ably participate and express themselves in the ensuing interventions.

Keywords: youth, conflict, peace building, participation

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Authors: Chamaraja Parulli

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Family is an important social institution devoted to the growth of a child, and parents are the important agents of socialization. Mentally challenged children are those who are affected by intellectual disability, which is manifested by limitation in intellectual functioning and adoptive behavior. Intellectual disability affects about 3-4 percentage of the general population. Intellectual disability is caused by genetic condition, problems during pregnancy, problems during childbirth, or illness. Mental retardation is the world’s most complex and challenging issue. The stigmatization of disability results in social and economic marginalization. Parents of the mentally challenged children will have a very high level of parenting stress, which is significantly more than the stress perceived by the parents of the children without disability. The prevalence of severe mental disorder called Schizophrenia is among 1.1 percent of the total population in India. On the other hand, 11 to 12 percent is the overall lifetime occurrence rate of mental disorders. While the government has a separate program for mental health, the segment is marred by lack of adequate doctors and infrastructure. Mentally retarded children have certain limitations in mental functioning and skills, which makes them slow learners in speaking, walking, and taking care of their personal needs such as dressing and eating. Accepting a child with mental handicap becomes difficult for parents and to the whole family, as they have to face many problems, including those of management, finance, deprivation of rest, and leisure. Also, the problems faced by the parents can be seen in different areas like – educational, psychological, social, emotional, financial and family related issues. The study brought out various difficulties and problems faced by the parents as well as family members. The findings revealed that the mental retardation is not only a medico-psychological problem but also a socio-cultural problem. The study results, however, indicate that the quality of life of the family having children with mental retardation can be improved to a greater extent by building up a child-friendly ambience at home. The main aim of the present study is to assess the problems faced by the parents of mentally challenged children, with the help of personal interview data collected from the parents of mentally challenged children, residing in Shimoga District of Karnataka State, India. These individuals were selected using stratified random sampling method. Organizing effective intervention programs for parents, family, society, and educational institutions towards reduction of family stress, augmenting the family’s strengths, increasing child’s competence and enhancing the positive attitudes and values of the society will go a long way for the peaceful existence of the mentally challenged children.

Keywords: mentally challenged children, intellectual disability, special children, social infrastructure, differently abled, psychological stress, marginalization

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Authors: Scott Hollier, Ruchi Permvattana

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The purpose of this abstract is to share the findings of a recently completed disability-related Internet of Things (IoT) project undertaken at Curtin University in Australia. The project focused on identifying how IoT could support people with disabilities with their educational outcomes. To achieve this, the research consisted of an analysis of current literature and interviews conducted with students with vision, hearing, mobility and print disabilities. While the research acknowledged the ability to collect data with IoT is now a fairly common occurrence, its benefits and applicability still need to be grounded back into real-world applications. Furthermore, it is important to consider if there are sections of our society that may benefit from these developments and if those benefits are being fully realised in a rush by large companies to achieve IoT dominance for their particular product or digital ecosystem. In this context, it is important to consider a group which, to our knowledge, has had little specific mainstream focus in the IoT area –people with disabilities. For people with disabilities, the ability for every device to interact with us and with each other has the potential to yield significant benefits. In terms of engagement, the arrival of smart appliances is already offering benefits such as the ability for a person in a wheelchair to give verbal commands to an IoT-enabled washing machine if the buttons are out of reach, or for a blind person to receive a notification on a smartphone when dinner has finished cooking in an IoT-enabled microwave. With clear benefits of IoT being identified for people with disabilities, it is important to also identify what implications there are for education. With higher education being a critical pathway for many people with disabilities in finding employment, the question as to whether such technologies can support the educational outcomes of people with disabilities was what ultimately led to this research project. This research will discuss several significant findings that have emerged from the research in relation to how consumer-based IoT can be used in the classroom to support the learning needs of students with disabilities, how industrial-based IoT sensors and actuators can be used to monitor and improve the real-time learning outcomes for the delivery of lectures and student engagement, and a proposed method for students to gain more control over their learning environment. The findings shared in this presentation are likely to have significant implications for the use of IoT in the classroom through the implementation of affordable and accessible IoT solutions and will provide guidance as to how policies can be developed as the implications of both benefits and risks continue to be considered by educators.

Keywords: disability, higher education, internet of things, students

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Authors: Caitlin Bailey, Marian Frattarola Saulino, Beth Steinberg

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Today, virtually all programs offered to people with intellectual and developmental disabilities tout themselves as person-centered, community-based and inclusive, yet there is a vast range in type and quality of services that use these similar descriptors. The issue is exacerbated by the fields’ measurement practices around quality, inclusion, independent living, choice and person-centered outcomes. For instance, community inclusion for people with disabilities is often measured by the number of times person steps into his or her community. These measurement approaches set standards for quality too low so that agencies supporting group home residents to go bowling every week can report the same outcomes as an agency that supports one person to join a book club that includes people based on their literary interests rather than disability labels. Ultimately, lack of delineation in measurement contributes to the confusion between face value “quality” and true quality services and supports for many people with disabilities and their families. This exploratory study adopts alternative approaches to quality measurement including co-production methods and systems theoretical framework in order to identify the factors that 1) lead to high-quality supports and, 2) differentiate high-quality services. Project researchers have partnered with community practitioners who are all committed to providing quality services and supports but vary in the degree to which they are actually able to provide them. The study includes two parts; first, an online survey distributed to more than 500 agencies that have demonstrated commitment to providing high-quality services; and second, four in-depth case studies with agencies in three United States and Israel providing a variety of supports to children and adults with disabilities. Results from both the survey and in-depth case studies were thematically analyzed and coded. Results show that there are specific factors that differentiate service quality; however meaningful quality measurement practices also require that researchers explore the contextual factors that contribute to quality. These not only include direct services and interactions, but also characteristics of service users, their environments as well as organizations providing services, such as management and funding structures, culture and leadership. Findings from this study challenge researchers, policy makers and practitioners to examine existing quality service standards and measurements and to adopt alternate methodologies and solutions to differentiate and scale up evidence-based quality practices so that all people with disabilities have access to services that support them to live, work, and enjoy where and with whom they choose.

Keywords: co-production, inclusion, independent living, quality measurement, quality supports

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Authors: Phoutsathaphone Sibounheuang, Phayom Sookaneknun Olson, Chanuttha Ploylearmsang, Santiparp Sookaneknun, Chanthanom Manithip

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Patient satisfaction is an outcome that can be measured and used to improve diabetes care and management. There are limited instruments for assessing patient satisfaction covering the whole process of diabetes management. In this study, the questionnaire was developed with items pooled from a systematic review of qualitative studies of patients’ and healthcare providers’ perspectives in diabetes management. The questionnaire consists of 11 domains with 45 items. The Thai version was translated to Lao and then checked by back-translating it into Thai. We tested the questionnaire on 150 diabetes patients in Thailand and 150 in Lao People Democratic Republic (PDR). Validity was performed by factor analysis and Pearson correlation. Internal consistency reliability was estimated by calculating Cronbach’s alpha. The study was approved by the Mahasarakham University Ethics Committee, and the National Ethics Committee for Health Research, Lao PDR. The Thai and Lao versions showed the construct validity by principal component analysis. This consisted of 11 domains which account for 71.23% of the variance (Thai version) and 71.66% of the variance (Lao version) in the total patient satisfaction scores. The Kaiser-Meyer-Olkin (KMO) measures were 0.85 for the Thai version and 0.75 for the Lao version. The Bartlett tests of sphericity of both versions were significant (p < 0.001). The factor loadings of all items in both versions were > 0.40. The convergent validity of the Thai and Lao versions was 93.63% and 79.54% respectively. The discriminant validity for the Thai and Lao versions was 92.68% and 88.68% respectively. Cronbach’s alpha was 0.95 in both versions. The Patient Satisfaction Questionnaire (PSQ) in both versions had acceptable properties. This study has yielded evidence supporting the validity and reliability of both versions.

Keywords: construct validity, diabetes management, patient satisfaction, questionnaire development, reliability

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Authors: Peri Ozlem Yuksel-Sokmen, Irfan Cagtay

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Oral languages are destined to disappear rapidly in the absence of interventions aimed at encouraging their usage by young children. The seminal language preservation model proposed by Fishman (1991) stresses the importance of multiple generations using the endangered L1 while engaged in daily routines with younger children. Over the last two decades Fishman (2001) has used his intergenerational transmission model in documenting the revitalization of Basque languages, providing evidence that families are transmitting Euskara as a first language to their children with success. In our study, to motivate usage of Lazuri, we asked caregivers to speak the language while engaged with their toddlers (12 to 48 months) in semi-structured play, and included both parents (N=32) and grandparents (N=30) as play partners. This unnatural prompting to speak only in Lazuri was greeted with reluctance, as 90% of our families indicated that they had stopped using Lazuri with their children. Nevertheless, caregivers followed instructions and produced 67% of their utterances in Lazuri, with another 14% of utterances using a combination of Lazuri and Turkish (Codeswitch). Although children spoke mostly in Turkish (83% of utterances), frequencies of caregiver utterances in Lazuri or Codeswitch predicted the extent to which their children used the minority language in return. This trend suggests that home interventions aimed at encouraging dyads to communicate in a non-preferred, endangered language can effectively increase children’s usage of the language. Alternatively, this result suggests than any use of the minority language on the part of the children will promote its further usage by caregivers. For researchers examining links between play, culture, and child development, structured play has emerged as a critical methodology (e.g., Frost, Wortham, Reifel, 2007, Lilliard et al., 2012; Sutton-Smith, 1986; Gaskins & Miller, 2009), allowing investigation of cultural and individual variation in parenting styles, as well as the role of culture in constraining the affordances of toys. Toy props, as well as picture-books in native languages, can be used as tools in the transmission and preservation of endangered languages by allowing children to explore adult roles through enactment of social routines and conversational patterns modeled by caregivers. Through adult-guided play children not only acquire scripts for culturally significant activities, but also develop skills in expressing themselves in culturally relevant ways that may continue to develop over their lives through community engagement. Further pedagogical tools, such as language games and e-learning, will be discussed in this proposed oral talk.

Keywords: language intervention, pedagogical tools, endangered languages, Lazuri

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Authors: Harshadkumar Rajgor, Jeff Butterworth

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Background: Barretts oesophagus increases the risk of developing oesophageal adenocarcinoma. Over the last 40 years, there has been a 6 fold increase in the incidence of oesophageal adenocarcinoma in the western world and the incidence rates are increasing at a greater rate than cancers of the colon, breast and lung. Endoscopic mucosal resection (EMR) is a relatively new technique being used by 2 centres in the greater midlands cancer network. EMR can be used for curative or staging purposes, for high-grade dysplasia’s and T1 tumours of the oesophagus. EMR is also suitable for those who are deemed high risk for oesophagectomy. EMR has a recurrence rate of 21% according to the Wiesbaden data. Method: A retrospective study of prospectively collected data was carried out involving 24 patients who had EMR for curative or staging purposes. Complications of residual or recurrent disease following EMR that required further treatment were investigated. Results: In 54% of cases residual or recurrent disease was suspected. 96% of patients were given clear and concise information regarding their diagnosis of high-grade dysplasia or T1 tumours. All 24 patients consulted the same specialist healthcare team. Conclusion: EMR is a safe and effective treatment for patients who have high-grade dysplasia and T1NO tumours. In 54% of cases residual or recurrent disease was suspected. Initially, only single resections were undertaken. Multiple resections are now being carried out to reduce the risk of recurrence. Complications from EMR remain low in this series and consisted of a single episode of post procedural bleeding.

Keywords: endoscopic mucosal resection, oesophageal dysplasia, T1 tumours, cancer network

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Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

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Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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Authors: Hamed Ahari, Behrouz Akbari Adreghani, Vadood Razavilar, Amirali Anvar, Sima Moradi, Hourieh Shalchi

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Considering the ever increasing population and industrialization of the developmental trend of humankind's life, we are no longer able to detect the toxins produced in food products using the traditional techniques. This is due to the fact that the isolation time for food products is not cost-effective and even in most of the cases, the precision in the practical techniques like the bacterial cultivation and other techniques suffer from operator errors or the errors of the mixtures used. Hence with the advent of nanotechnology, the design of selective and smart sensors is one of the greatest industrial revelations of the quality control of food products that in few minutes time, and with a very high precision can identify the volume and toxicity of the bacteria. Methods and Materials: In this technique, based on the bacterial antibody connection to nanoparticle, a sensor was used. In this part of the research, as the basis for absorption for the recognition of bacterial toxin, medium sized silica nanoparticles of 10 nanometer in form of solid powder were utilized with Notrino brand. Then the suspension produced from agent-linked nanosilica which was connected to bacterial antibody was positioned near the samples of distilled water, which were contaminated with Staphylococcus aureus bacterial toxin with the density of 10-3, so that in case any toxin exists in the sample, a connection between toxin antigen and antibody would be formed. Finally, the light absorption related to the connection of antigen to the particle attached antibody was measured using spectrophotometry. The gene of 23S rRNA that is conserved in all Staphylococcus spp., also used as control. The accuracy of the test was monitored by using serial dilution (l0-6) of overnight cell culture of Staphylococcus spp., bacteria (OD600: 0.02 = 107 cell). It showed that the sensitivity of PCR is 10 bacteria per ml of cells within few hours. Result: The results indicate that the sensor detects up to 10-4 density. Additionally, the sensitivity of the sensors was examined after 60 days, the sensor by the 56 days had confirmatory results and started to decrease after those time periods. Conclusions: Comparing practical nano biosensory to conventional methods like that culture and biotechnology methods(such as polymerase chain reaction) is accuracy, sensitiveness and being unique. In the other way, they reduce the time from the hours to the 30 minutes.

Keywords: exotoxin, nanobiosensor, recognition, Staphylococcus aureus

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Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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Authors: Boris Barbolyas, Kristina Buckova, Tomas Volensky, Cyril Belavy, Ladislav Dedik

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Background: Based on statokinezigram, the human balance control is often studied. Approach to human postural reaction analysis is based on a combination of stabilometry output signal with retroreflective marker data signal processing, analysis, and understanding, in this study. The study shows another original application of Method of Developed Statokinesigram Trajectory (MDST), too. Methods: In this study, the participants maintained quiet bipedal standing for 10 s on stabilometry platform. Consequently, bilateral vibration stimuli to Achilles tendons in 20 s interval was applied. Vibration stimuli caused that human postural system took the new pseudo-steady state. Vibration frequencies were 20, 60 and 80 Hz. Participant's body segments - head, shoulders, hips, knees, ankles and little fingers were marked by 12 retroreflective markers. Markers positions were scanned by six cameras system BTS SMART DX. Registration of their postural reaction lasted 60 s. Sampling frequency was 100 Hz. For measured data processing were used Method of Developed Statokinesigram Trajectory. Regression analysis of developed statokinesigram trajectory (DST) data and retroreflective marker developed trajectory (DMT) data were used to find out which marker trajectories most correlate with stabilometry platform output signals. Scaling coefficients (λ) between DST and DMT by linear regression analysis were evaluated, too. Results: Scaling coefficients for marker trajectories were identified for all body segments. Head markers trajectories reached maximal value and ankle markers trajectories had a minimal value of scaling coefficient. Hips, knees and ankles markers were approximately symmetrical in the meaning of scaling coefficient. Notable differences of scaling coefficient were detected in head and shoulders markers trajectories which were not symmetrical. The model of postural system behavior was identified by MDST. Conclusion: Value of scaling factor identifies which body segment is predisposed to postural instability. Hypothetically, if statokinesigram represents overall human postural system response to vibration stimuli, then markers data represented particular postural responses. It can be assumed that cumulative sum of particular marker postural responses is equal to statokinesigram.

Keywords: center of pressure (CoP), method of developed statokinesigram trajectory (MDST), model of postural system behavior, retroreflective marker data

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Authors: Kebret Kebede, Anthony Scinta

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Obesity is the most prevalent global problem that continues to rise at alarming rates both in the industrialized and developing countries. Adipose tissue is an endocrine tissue that secretes numerous chemical signals, hormones, lipids, cytokines and coagulation factors as well as prompting insulin resistance which is a primary contributor to Type II Diabetes- one of its most common adverse effects on health. Other hormones whose levels are linked to obesity and nutritional state are leptin, IGF-1, and adiponectin. Several studies indicate that obesity is the leading cause of high levels of cholesterol that leads to fatty liver disease, gallstones, hypertension, increased risk for cancer and degenerative joint disease that primarily affects the weight bearing joints of the lower extremities. The activation of inflammatory pathways promotes synovial pathology that results in accelerated degeneration of the joints. The study examines the prevalence of obesity in the US female population in comparison to that of the developing world and its emergence as a significant and potentially modifiable risk factor in degenerative disease of the hip and knee joints that has resulted in staggering healthcare cost. Studies have shown that as the prevalence of obesity rises, we continue to see a rise in degenerative joint disease. The percentage of arthritis cases linked directly to obesity has risen from 3 percent in 1971 to 18 percent in 2002. A person with obesity is around 60 percent more likely to develop arthritis than someone of normal body weight. In women, obesity is associated with increased mortality from breast, cervical, endometrial and ovarian cancer that may accompany debilitating joint diseases and restricted mobility.

Keywords: obesity, endocrine, degenerative, mortality, joint diseases, cancer, debilitating, mobility

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Authors: Fuseina Mahama, Lieselot Vanhaverbeke

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This research investigates the impact of patronage determinants on the distance consumers are willing to travel to patronize a tire shop. Although store patronage has been acknowledged as an important domain and has received substantial research interest, most of the studies so far conducted focus on grocery retail, leaving other categories of goods widely unexplored. In this study, we focus on car tires and provide a new perspective to the specific factors that influence tire shop patronage. An online survey of consumers’ tyre purchasing behaviour was conducted among private car owners in Belgium. A sample of 864 respondents was used in the study, with almost four out of five of them being male. 84% of the respondents had purchased a car tyre in the last 24 months and on average travelled 22.4kms to patronise a tyre shop. We tested the direct and mediated effects of store choice determinants on distance consumers are willing to travel. All hypotheses were tested using Structural Equation Modelling (SEM). Our findings show that with an increase in the consumer’s age the distance they were willing to travel to a tire shop decreased. Similarly, consumers who deemed proximity an important determinant of a tire shop our findings confirmed a negative effect on willingness to travel. On the other hand, the determinants price, personal contact and professionalism all had a positive effect on distance. This means that consumers actively sought out tire shops with these characteristics and were willing to travel longer distances in order to visit them. The indirect effects of the determinants flexible opening hours, family recommendation, dealer reputation, receiving auto service at home and availability of preferred brand on distance are mediated by dealer trust. Gender had a minimal effect on distance, with females exhibiting a stronger relation in terms of dealer trust as compared to males. Overall, we found that market relevant factors were better predictors of distance; and proximity, dealer trust and professionalism have the most profound effects on distance that consumers are willing to travel. This is related to the fact that the nature of shopping goods (among which are car tires) typically reinforces consumers to be more engaged in the shopping process, therefore factors that have to do with the store (e.g. location) and shopping process play a key role in store choice decision. These findings are very specific to shopping goods and cannot be generalized to other categories of goods. For marketers and retailers these findings can have direct implications on their location strategies. The factors found to be relevant to tire shop patronage will be used in our next study to calibrate a location model to be utilised to identify the optimum location for siting new tyre shop outlets and service centres.

Keywords: dealer trust, distance to store, tire store patronage, willingness to travel

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Authors: Vesa Salminen, Esa Santakallio, Heikki Ruohomaa

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Introduction: The city of Riihimäki has decided robotics on well-being, service and industry as the main focus area on their ecosystem strategy. Robotics is going to be an important part of the everyday life of citizens and present in the working day of the average citizen and employee in the future. For that reason, also education system and education programs on all levels of education from diaper age to doctorate have been directed to fulfill this ecosystem strategy. Goal: The objective of this activity has been to develop education continuity from diaper age to doctorate. The main target of the development activity is to create a unique robotics study entity that enables ongoing robotics studies from preprimary education to university. The aim is also to attract students internationally and supply a skilled workforce to the private sector, capable of the challenges of the future. Methodology: Education instances (high school, second grade, Universities on all levels) in a large area of Tavastia Province have gradually directed their education programs to support this goal. On the other hand, applied research projects have been created to make proof of concept- phases on areal real environment field labs to test technology opportunities and digitalization to change business processes by applying robotic solutions. Customer-oriented applied research projects offer for students in robotics education learning environments to learn new knowledge and content. That is also a learning environment for education programs to adapt and co-evolution. New content and problem-based learning are used in future education modules. Major findings: Joint robotics education entity is being developed in cooperation with the city of Riihimäki (primary education), Syria Education (secondary education) and HAMK (bachelor and master education). The education modules have been developed to enable smooth transitioning from one institute to another. This article is introduced a case study of the change of education of wellbeing education because of digitalization and robotics. Riihimäki's Elderly citizen's service house, Riihikoti, has been working as a field lab for proof-of-concept phases on testing technology opportunities. According to successful case studies also education programs on various levels of education have been changing. Riihikoti has been developed as a physical learning environment for home care and robotics, investigating and developing a variety of digital devices and service opportunities and experimenting and learn the use of equipment. The environment enables the co-development of digital service capabilities in the authentic environment for all interested groups in transdisciplinary cooperation.

Keywords: ecosystem strategy, digitalization and robotics, education continuity, learning environment, transdisciplinary co-operation

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Authors: Mari A. Virtanen, Elina Haavisto, Eeva Liikanen, Maria Kääriäinen

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Rapid technological development and digitalization has affected also on higher education. During last twenty years multiple of electronic and mobile learning (e-learning, m-learning) platforms have been developed and have become prevalent in many universities and in the all fields of education. Ubiquitous learning (u-learning) is not that widely known or used. Ubiquitous learning environments (ULE) are the new era of computer-assisted learning. They are based on ubiquitous technology and computing that fuses the learner seamlessly into learning process by using sensing technology as tags, badges or barcodes and smart devices like smartphones and tablets. ULE combines real-life learning situations into virtual aspects and can be flexible used in anytime and anyplace. The aim of this study was to assess the effects of ubiquitous 360 o learning environment on higher education students’ clinical histotechnology competence. A quasi-experimental study design was used. 57 students in biomedical laboratory science degree program was assigned voluntarily to experiment (n=29) and to control group (n=28). Experimental group studied via ubiquitous 360o learning environment and control group via traditional web-based learning environment (WLE) in a 8-week educational intervention. Ubiquitous 360o learning environment (ULE) combined authentic learning environment (histotechnology laboratory), digital environment (virtual laboratory), virtual microscope, multimedia learning content, interactive communication tools, electronic library and quick response barcodes placed into authentic laboratory. Web-based learning environment contained equal content and components with the exception of the use of mobile device, interactive communication tools and quick response barcodes. Competence of clinical histotechnology was assessed by using knowledge test and self-report developed for this study. Data was collected electronically before and after clinical histotechnology course and analysed by using descriptive statistics. Differences among groups were identified by using Wilcoxon test and differences between groups by using Mann-Whitney U-test. Statistically significant differences among groups were identified in both groups (p<0.001). Competence scores in post-test were higher in both groups, than in pre-test. Differences between groups were very small and not statistically significant. In this study the learning environment have developed based on 360o technology and successfully implemented into higher education context. And students’ competence increases when ubiquitous learning environment were used. In the future, ULE can be used as a learning management system for any learning situation in health sciences. More studies are needed to show differences between ULE and WLE.

Keywords: competence, higher education, histotechnology, ubiquitous learning, u-learning, 360o

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

Procedia PDF Downloads 159