Search results for: international classification of primary care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13006

Search results for: international classification of primary care

12226 Road Vehicle Recognition Using Magnetic Sensing Feature Extraction and Classification

Authors: Xiao Chen, Xiaoying Kong, Min Xu

Abstract:

This paper presents a road vehicle detection approach for the intelligent transportation system. This approach mainly uses low-cost magnetic sensor and associated data collection system to collect magnetic signals. This system can measure the magnetic field changing, and it also can detect and count vehicles. We extend Mel Frequency Cepstral Coefficients to analyze vehicle magnetic signals. Vehicle type features are extracted using representation of cepstrum, frame energy, and gap cepstrum of magnetic signals. We design a 2-dimensional map algorithm using Vector Quantization to classify vehicle magnetic features to four typical types of vehicles in Australian suburbs: sedan, VAN, truck, and bus. Experiments results show that our approach achieves a high level of accuracy for vehicle detection and classification.

Keywords: vehicle classification, signal processing, road traffic model, magnetic sensing

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12225 Counter-Hegemonic Movements and Their Consequences at the International Level: Transposing Gramsci to the 21st Century

Authors: Hanna Corsini

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This article provides an analysis of counter-hegemonic movements and their consequences for the neoliberal world order at the international level. Even if calls for change are becoming louder, current research on populist forces at the domestic level in comparative politics is lacking an investigation of the international dimensions of the rise of such movements. At the same time, in the International Relations field, the focus still remains on the surge of challengers at the global level, while the national one stays neglected. This paper argues that to fill this gap as identified in the academic literature, the concept of hegemony, and more precisely, as deployed by Antonio Gramsci, can bear some interesting insights. An adaptation to the 21st century of Gramsci’s concept is proposed, highlighting the explanatory power that key concepts of his theoretical framework have. Transposing it to contemporary politics provides precious elements for an in-depth understanding of counter-hegemonic movements and the consequences of their rise for the neoliberal world order. In an era of disruption and turmoil in national politics, International Relations theory cannot avoid to engage with this dimension. However, populism as a theoretical concept lacks the capacity to go beyond the domestic border. It is therefore essential to create a dialogue between these two fields. Ultimately, the paper claims that (counter-)hegemony is crucial to build a bridge between the international and the domestic level.

Keywords: counter-hegemonic movements, Gramsci, hegemony, international relations

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12224 Semantic Differences between Bug Labeling of Different Repositories via Machine Learning

Authors: Pooja Khanal, Huaming Zhang

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Labeling of issues/bugs, also known as bug classification, plays a vital role in software engineering. Some known labels/classes of bugs are 'User Interface', 'Security', and 'API'. Most of the time, when a reporter reports a bug, they try to assign some predefined label to it. Those issues are reported for a project, and each project is a repository in GitHub/GitLab, which contains multiple issues. There are many software project repositories -ranging from individual projects to commercial projects. The labels assigned for different repositories may be dependent on various factors like human instinct, generalization of labels, label assignment policy followed by the reporter, etc. While the reporter of the issue may instinctively give that issue a label, another person reporting the same issue may label it differently. This way, it is not known mathematically if a label in one repository is similar or different to the label in another repository. Hence, the primary goal of this research is to find the semantic differences between bug labeling of different repositories via machine learning. Independent optimal classifiers for individual repositories are built first using the text features from the reported issues. The optimal classifiers may include a combination of multiple classifiers stacked together. Then, those classifiers are used to cross-test other repositories which leads the result to be deduced mathematically. The produce of this ongoing research includes a formalized open-source GitHub issues database that is used to deduce the similarity of the labels pertaining to the different repositories.

Keywords: bug classification, bug labels, GitHub issues, semantic differences

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12223 The Effectiveness of Warm-Water Footbath on Fatigue in Cancer Patient Undergoing Chemotherapy

Authors: Yu-Wen Lin, Li-Ni Liu

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Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P < .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P < .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

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12222 Rt-Pcr Negative COVID-19 Infection in a Bodybuilding Competitor Using Anabolic Steroids: A Case Report

Authors: Mariana Branco, Nahida Sobrino, Cristina Neves, Márcia Santos, Afonso Granja, João Rosa Oliveira, Joana Costa, Luísa Castro Leite

Abstract:

This case reports a COVID-19 infection in an unvaccinated adult man with no history of COVID-19 and no relevant clinical history besides anabolic steroid use, undergoing weaning with tamoxifen after a bodybuilding competition. The patient presented a 4cm cervical mass 3 weeks after COVID-19 infection in his cohabitants. He was otherwise asymptomatic and tested negative to multiple RT-PCR tests. Nevertheless, the IgG COVID-19 antibody was positive, suggesting the previous infection. This report raises a potential link between anabolic steroid use and atypical COVID-19 onset. Objectives: The goals of this paper are to raise a potential link between anabolic steroid use and atypical COVID-19 onset but also to report an uncommon case of COVID-19 infection with consecutive negative gold standard tests. Methodology: The authors used CARE guidelines for case report writing. Introduction: This case reports a COVID-19 infection case in an unvaccinated adult man, with multiple serial negative reverse transcription polymerase chain reaction (RT-PCR) test results, presenting with single cervical lymphadenopathy. Although the association between COVID-19 and lymphadenopathy is well established, there are no cases with this presentation, and consistently negative RT-PCR tests have been reported. Methodologies: The authors used CARE guidelines for case report writing. Case presentation: This case reports a 28-year-old Caucasian man with no previous history of COVID-19 infection or vaccination and no relevant clinical history besides anabolic steroid use undergoing weaning with tamoxifendue to participation in a bodybuilding competition. He visits his primary care physician because of a large (4 cm) cervical lump, present for 3 days prior to the consultation. There was a positive family history for COVID-19 infection 3 weeks prior to the visit, during which the patient cohabited with the infected family members. The patient never had any previous clinical manifestation of COVID-19 infection and, despite multiple consecutive RT-PCR testing, never tested positive. The patient was treated with an NSAID and a broad-spectrum antibiotic, with little to no effect. Imagiological testing was performed via a cervical ultrasound, followed by a needle biopsy for histologic analysis. Serologic testing for COVID-19 immunity was conducted, revealing a positive Anti-SARS-CoV-2 IgG (Spike S1) antibody, suggesting the previous infection, given the unvaccinated status of our patient Conclusion: In patients with a positive epidemiologic context and cervical lymphadenopathy, physicians should still consider COVID-19 infection as a differential diagnosis, despite negative PCR testing. This case also raises a potential link between anabolic steroid use and atypical COVID-19 onset, never before reported in scientific literature.

Keywords: COVID-19, cervical lymphadenopathy, anabolic steroids, primary care

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12221 Nursing Experience in Improving Physical and Mental Well-Being of a Patient with Premature Menopause Osteoporosis and Sarcopenia in Nursing-Led Multi-Discipline Care

Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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12220 The Application of International Law in Terms of Earthlife Africa Johannesburg and Another v Minister of Energy and Others 65662/16 (2017) Case

Authors: M. van der Bank

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This study involves a legal analysis of the case Earthlife Africa Johannesburg v Minister of Environmental Affairs and Others. The case considered the impact of the Thabametsi Power Project if it operated to the expected year 2060 on the global climate and ever-changing climate, in South Africa. This judgment highlights the significance, place and principles of climate change and where climate change impacts the South African environmental law which has its founding principles in the Constitution of the Republic of South Africa, 1996. This paper seeks to examine the advances for climate change regulation and application in terms of international law, in South Africa, through a qualitative study involving comparative national and international case law. A literature review study was conducted to compare and contrast the various aspects of law in order to support the argument undertaken. The paper presents a detailed discussion of the current legislation and the position as it currently stands with reference to international law and interpretation. The relevant protections as outlined in the National Environmental Management Act will be discussed. It then proceeds to outline the potential liability of the Minister in the interpretation and application of international law.

Keywords: climate change; environment, environmental review, international law; and principles

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12219 Comparative Study of Accuracy of Land Cover/Land Use Mapping Using Medium Resolution Satellite Imagery: A Case Study

Authors: M. C. Paliwal, A. K. Jain, S. K. Katiyar

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Classification of satellite imagery is very important for the assessment of its accuracy. In order to determine the accuracy of the classified image, usually the assumed-true data are derived from ground truth data using Global Positioning System. The data collected from satellite imagery and ground truth data is then compared to find out the accuracy of data and error matrices are prepared. Overall and individual accuracies are calculated using different methods. The study illustrates advanced classification and accuracy assessment of land use/land cover mapping using satellite imagery. IRS-1C-LISS IV data were used for classification of satellite imagery. The satellite image was classified using the software in fourteen classes namely water bodies, agricultural fields, forest land, urban settlement, barren land and unclassified area etc. Classification of satellite imagery and calculation of accuracy was done by using ERDAS-Imagine software to find out the best method. This study is based on the data collected for Bhopal city boundaries of Madhya Pradesh State of India.

Keywords: resolution, accuracy assessment, land use mapping, satellite imagery, ground truth data, error matrices

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12218 State’s Responsibility of Space Debris

Authors: Athari Farhani

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Abstract The existence of space debris is a direct implication of human activities in outer space. The amount of orbital debris resulting from human exploration and use of outer space has been steadily increasing in the history of human exploration and use of outer space, so that space debris in the responsibility of the launching state. Space debris not only hs a direct impact on environmentalpollution but can also harm and endanger the safety of human life. Despite the legal provisions governing the exploration and use of outer space, both international space law and liability convention, however, these legal provisions are only basic prinsiples, so that further thought or effort are needed, such as new international legal instruments to regulate the existence of space debris. The method used in this research is normative juridical with an approach to written legal regulation, especially international agreements related to space law.

Keywords: state’s responsibility, space debris, outerspace, international law

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12217 The Impact of COVID-19 on Antibiotic Prescribing in Primary Care in England: Evaluation and Risk Prediction of the Appropriateness of Type and Repeat Prescribing

Authors: Xiaomin Zhong, Alexander Pate, Ya-Ting Yang, Ali Fahmi, Darren M. Ashcroft, Ben Goldacre, Brian Mackenna, Amir Mehrkar, Sebastian C. J. Bacon, Jon Massey, Louis Fisher, Peter Inglesby, Kieran Hand, Tjeerd van Staa, Victoria Palin

Abstract:

Background: This study aimed to predict risks of potentially inappropriate antibiotic type and repeat prescribing and assess changes during COVID-19. Methods: With the approval of NHS England, we used the OpenSAFELY platform to access the TPP SystmOne electronic health record (EHR) system and selected patients prescribed antibiotics from 2019 to 2021. Multinomial logistic regression models predicted the patient’s probability of receiving an inappropriate antibiotic type or repeating the antibiotic course for each common infection. Findings: The population included 9.1 million patients with 29.2 million antibiotic prescriptions. 29.1% of prescriptions were identified as repeat prescribing. Those with same-day incident infection coded in the EHR had considerably lower rates of repeat prescribing (18.0%), and 8.6% had a potentially inappropriate type. No major changes in the rates of repeat antibiotic prescribing during COVID-19 were found. In the ten risk prediction models, good levels of calibration and moderate levels of discrimination were found. Important predictors included age, prior antibiotic prescribing, and region. Patients varied in their predicted risks. For sore throat, the range from 2.5 to 97.5th percentile was 2.7 to 23.5% (inappropriate type) and 6.0 to 27.2% (repeat prescription). For otitis externa, these numbers were 25.9 to 63.9% and 8.5 to 37.1%, respectively. Interpretation: Our study found no evidence of changes in the level of inappropriate or repeat antibiotic prescribing after the start of COVID-19. Repeat antibiotic prescribing was frequent and varied according to regional and patient characteristics. There is a need for treatment guidelines to be developed around antibiotic failure and clinicians provided with individualised patient information.

Keywords: antibiotics, infection, COVID-19 pandemic, antibiotic stewardship, primary care

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12216 Planning the Journey of Unifying Medical Record Numbers in Five Facilities and the Expected Challenges: Case Study in Saudi Arabia

Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

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Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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12215 MSIpred: A Python 2 Package for the Classification of Tumor Microsatellite Instability from Tumor Mutation Annotation Data Using a Support Vector Machine

Authors: Chen Wang, Chun Liang

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Microsatellite instability (MSI) is characterized by high degree of polymorphism in microsatellite (MS) length due to a deficiency in mismatch repair (MMR) system. MSI is associated with several tumor types and its status can be considered as an important indicator for tumor prognostic. Conventional clinical diagnosis of MSI examines PCR products of a panel of MS markers using electrophoresis (MSI-PCR) which is laborious, time consuming, and less reliable. MSIpred, a python 2 package for automatic classification of MSI was released by this study. It computes important somatic mutation features from files in mutation annotation format (MAF) generated from paired tumor-normal exome sequencing data, subsequently using these to predict tumor MSI status with a support vector machine (SVM) classifier trained by MAF files of 1074 tumors belonging to four types. Evaluation of MSIpred on an independent 358-tumor test set achieved overall accuracy of over 98% and area under receiver operating characteristic (ROC) curve of 0.967. These results indicated that MSIpred is a robust pan-cancer MSI classification tool and can serve as a complementary diagnostic to MSI-PCR in MSI diagnosis.

Keywords: microsatellite instability, pan-cancer classification, somatic mutation, support vector machine

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12214 The Effect of Feature Selection on Pattern Classification

Authors: Chih-Fong Tsai, Ya-Han Hu

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The aim of feature selection (or dimensionality reduction) is to filter out unrepresentative features (or variables) making the classifier perform better than the one without feature selection. Since there are many well-known feature selection algorithms, and different classifiers based on different selection results may perform differently, very few studies consider examining the effect of performing different feature selection algorithms on the classification performances by different classifiers over different types of datasets. In this paper, two widely used algorithms, which are the genetic algorithm (GA) and information gain (IG), are used to perform feature selection. On the other hand, three well-known classifiers are constructed, which are the CART decision tree (DT), multi-layer perceptron (MLP) neural network, and support vector machine (SVM). Based on 14 different types of datasets, the experimental results show that in most cases IG is a better feature selection algorithm than GA. In addition, the combinations of IG with DT and IG with SVM perform best and second best for small and large scale datasets.

Keywords: data mining, feature selection, pattern classification, dimensionality reduction

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12213 Blood Ketones as a Point of Care Testing in Paediatric Emergencies

Authors: Geetha Jayapathy, Lakshmi Muthukrishnan, Manoj Kumar Reddy Pulim , Radhika Raman

Abstract:

Introduction: Ketones are the end products of fatty acid metabolism and a source of energy for vital organs such as the brain, heart and skeletal muscles. Ketones are produced in excess when glucose is not available as a source of energy or it cannot be utilized as in diabetic ketoacidosis. Children admitted in the emergency department often have starvation ketosis which is not clinically manifested. Decision on admission of children to the emergency room with subtle signs can be difficult at times. Point of care blood ketone testing can be done at the bedside even in a primary level care setting to supplement and guide us in our management decisions. Hence this study was done to explore the utility of this simple bedside parameter as a supplement in assessing pediatric patients presenting to the emergency department. Objectives: To estimate blood ketones of children admitted in the emergency department. To analyze the significance of blood ketones in various disease conditions. Methods: Blood ketones using point of care testing instrument (ABOTTprecision Xceed Pro meters) was done in patients getting admitted in emergency room and in out-patients (through sample collection centre). Study population: Children aged 1 month to 18 years were included in the study. 250 cases (In-patients) and 250 controls (out-patients) were collected. Study design: Prospective observational study. Data on details of illness and physiological status were documented. Blood ketones were compared between the two groups and all in patients were categorized into various system groups and analysed. Results: Mean blood ketones were high in in-patients ranging from 0 to 7.2, with a mean of 1.28 compared to out-patients ranging from 0 to 1.9 with a mean of 0.35. This difference was statistically significant with a p value < 0.001. In-patients with shock (mean of 4.15) and diarrheal dehydration (mean of 1.85) had a significantly higher blood ketone values compared to patients with other system involvement. Conclusion: Blood ketones were significantly high (above the normal range) in pediatric patients who are sick requiring admission. Patients with various forms of shock had very high blood ketone values as found in diabetic ketoacidosis. Ketone values in diarrheal dehydration were moderately high correlating to the degree of dehydration.

Keywords: admission, blood ketones, paediatric emergencies, point of care testing

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12212 Qualitative Data Analysis for Health Care Services

Authors: Taner Ersoz, Filiz Ersoz

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This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.

Keywords: multiple correspondence analysis, multivariate categorical data, health care services, health satisfaction survey

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12211 Patients' Out-Of-Pocket Expenses-Effectiveness Analysis of Presurgical Teledermatology

Authors: Felipa De Mello-Sampayo

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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.

Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time

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12210 Health Care using Queuing Theory

Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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12209 A Study on Classic Literature Education in Primary School Using Out-of-School Literature Appreciation Program: An Practice Study Applied to Primary School in Korea

Authors: Hyo Jung Lee

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The purpose of this study is to develop a literature appreciation education program for classic literatures and apply them to the field, and to derive the achievements and improvement points. Classic literature is a work of value recognized in the context of literature history and culture history, and learners can develop interest in literature and inherit tradition through appreciation of classic literature. However, in Korean educational environment, classic literature is a means for college entrance examination, and many learners analyze contents and language in textbooks and concentrate on memorizing the whole plot. This study is one of the reasons that classic literature appreciation education is not done properly and it is not able to give an opportunity to appreciate the whole work in the early learning stage. In Korean primary education, classic literature is used as a means to achieve the goals of reading, writing, speaking and listening, rather than being used as a material for its own appreciation. It is problematic to make the piece appreciation experience fragmentary. This study proposes a program to experience classic literatures by linking school education and school library with primary school students in grades 4-6. We work with local primary schools (siheung-si, gyeonggi-do, Korea) to provide appropriate activities and rewards to learners, observe their participation, and introduce student learning outcomes. Through this, we are able to systematically improve the learner 's ability to appreciate the literature and to diversify primary education.

Keywords: classic literature education, primary education, out-of-school program, learning by appreciation experience

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12208 EU Policies in Determining Refugee Status

Authors: Adriano Mortada

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Human history is rife with conflict, and the question of refugee status determination and their rehabilitation has been up for debate since. Refugee Status Determination is the administrative or legal process by which UNHCR or governments determine whether a person seeking international protection or asylum can be identified as a refugee under international, regional, or national law. Refugee Status Determination is considered to be a vital process in aiding refugees’ realization of their rights under international law. One of the major reasons why the refugee status determination is considered an “issue”, and is one that is much debated upon annually, is the fact that the national bureaucratic systems are rigid and unbending. This is particularly concerning in the 21st century despite human advancement in policy and diplomacy, working in tandem with the United Nations and their charters and resolutions on human rights and dignity. The paper seeks to criticize the European member states' response to the refugee crisis and their inflexible and prejudiced bureaucratic systems when it comes to refugee status determination. The paper looks at multiple case studies as primary evidence and the alternate case studies where the system helped refugees, like those in Jordan, Pakistan, Turkey, and Lebanon. The main concern of the paper is to highlight the bias in the selected European systems, which do not stem from the Human Rights Charter but rather on the basis of geographical backgrounds, cultural and religious affiliations of those seeking refugee status or asylum in their respective countries. The paper hopes to not only create awareness about this issue but also provide a research background to advocacy programs to bring a change in the systems.

Keywords: refugee status determination, human rights, bureaucracy, United Nations, European Union

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12207 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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12206 Application of Data Mining Techniques for Tourism Knowledge Discovery

Authors: Teklu Urgessa, Wookjae Maeng, Joong Seek Lee

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Application of five implementations of three data mining classification techniques was experimented for extracting important insights from tourism data. The aim was to find out the best performing algorithm among the compared ones for tourism knowledge discovery. Knowledge discovery process from data was used as a process model. 10-fold cross validation method is used for testing purpose. Various data preprocessing activities were performed to get the final dataset for model building. Classification models of the selected algorithms were built with different scenarios on the preprocessed dataset. The outperformed algorithm tourism dataset was Random Forest (76%) before applying information gain based attribute selection and J48 (C4.5) (75%) after selection of top relevant attributes to the class (target) attribute. In terms of time for model building, attribute selection improves the efficiency of all algorithms. Artificial Neural Network (multilayer perceptron) showed the highest improvement (90%). The rules extracted from the decision tree model are presented, which showed intricate, non-trivial knowledge/insight that would otherwise not be discovered by simple statistical analysis with mediocre accuracy of the machine using classification algorithms.

Keywords: classification algorithms, data mining, knowledge discovery, tourism

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12205 The Effects of Cultural Self-Efficacy and Perceived Social Support on Acculturative Stress of International Postgraduate Students in the United Kingdom

Authors: Rhea Mathews

Abstract:

The purpose of the study is to investigate the effects of perceived social support and cultural self-efficacy on the acculturative stress of international postgraduate students in the United Kingdom. The study adopted Berry, Kim, Minde & Mok’s (1987) acculturative framework on acculturative stress and examined the relationship between the variables. The study hypothesized that perceived social support and cultural self-efficacy would predict lower levels of acculturative stress among students. Postgraduate students in the United Kingdom (N = 76) completed three surveys measuring the variables; Acculturative Stress Scale for International Students, Multidimensional Scale of Perceived Social Support, and Cultural Self-efficacy for Adolescents. To evaluate the role of the perceived social support and cultural self-efficacy in determining the acculturative stress level of international students, multiple linear regression was employed. Both independent variables exhibited a significant, negative relationship with acculturative stress (p < 0.001; p < 0.01). Results described that cultural self-efficacy and perceived social support significantly predicted acculturative stress (p < 0.01). Together, the variables accounted for 22% of the variance in acculturative stress scores (adjusted R² = 0.22), with cultural self-efficacy playing a larger role in predicting the dependent variable. Limitations and implications of the study are noted. The findings of the study are discussed in relation to enhancing international students’ acculturative experience when relocating to a new environment.

Keywords: acculturative stress, coping, cultural adjustment, cultural self-efficacy, international education, international students, migration, perceived social support

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12204 Accuracy Improvement of Traffic Participant Classification Using Millimeter-Wave Radar by Leveraging Simulator Based on Domain Adaptation

Authors: Tokihiko Akita, Seiichi Mita

Abstract:

A millimeter-wave radar is the most robust against adverse environments, making it an essential environment recognition sensor for automated driving. However, the reflection signal is sparse and unstable, so it is difficult to obtain the high recognition accuracy. Deep learning provides high accuracy even for them in recognition, but requires large scale datasets with ground truth. Specially, it takes a lot of cost to annotate for a millimeter-wave radar. For the solution, utilizing a simulator that can generate an annotated huge dataset is effective. Simulation of the radar is more difficult to match with real world data than camera image, and recognition by deep learning with higher-order features using the simulator causes further deviation. We have challenged to improve the accuracy of traffic participant classification by fusing simulator and real-world data with domain adaptation technique. Experimental results with the domain adaptation network created by us show that classification accuracy can be improved even with a few real-world data.

Keywords: millimeter-wave radar, object classification, deep learning, simulation, domain adaptation

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12203 Attribute Index and Classification Method of Earthquake Damage Photographs of Engineering Structure

Authors: Ming Lu, Xiaojun Li, Bodi Lu, Juehui Xing

Abstract:

Earthquake damage phenomenon of each large earthquake gives comprehensive and profound real test to the dynamic performance and failure mechanism of different engineering structures. Cognitive engineering structure characteristics through seismic damage phenomenon are often far superior to expensive shaking table experiments. After the earthquake, people will record a variety of different types of engineering damage photos. However, a large number of earthquake damage photographs lack sufficient information and reduce their using value. To improve the research value and the use efficiency of engineering seismic damage photographs, this paper objects to explore and show seismic damage background information, which includes the earthquake magnitude, earthquake intensity, and the damaged structure characteristics. From the research requirement in earthquake engineering field, the authors use the 2008 China Wenchuan M8.0 earthquake photographs, and provide four kinds of attribute indexes and classification, which are seismic information, structure types, earthquake damage parts and disaster causation factors. The final object is to set up an engineering structural seismic damage database based on these four attribute indicators and classification, and eventually build a website providing seismic damage photographs.

Keywords: attribute index, classification method, earthquake damage picture, engineering structure

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12202 Critical Approach to Define the Architectural Structure of a Health Prototype in a Rural Area of Brazil

Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

Abstract:

A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: architectural typology, developing countries, local construction techniques, primary health care.

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12201 Classification of Cosmological Wormhole Solutions in the Framework of General Relativity

Authors: Usamah Al-Ali

Abstract:

We explore the effect of expanding space on the exoticity of the matter supporting a traversable Lorentzian wormhole of zero radial tide whose line element is given by ds2 = dt^2 − a^2(t)[ dr^2/(1 − kr2 −b(r)/r)+ r2dΩ^2 in the context of General Relativity. This task is achieved by deriving the Einstein field equations for anisotropic matter field corresponding to the considered cosmological wormhole metric and performing a classification of their solutions on the basis of a variable equations of state (EoS) of the form p = ω(r)ρ. Explicit forms of the shape function b(r) and the scale factor a(t) arising in the classification are utilized to construct the corresponding energy-momentum tensor where the energy conditions for each case is investigated. While the violation of energy conditions is inevitable in case of static wormholes, the classification we performed leads to interesting solutions in which this violation is either reduced or eliminated.

Keywords: general relativity, Einstein field equations, energy conditions, cosmological wormhole

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12200 Technologic Information about Photovoltaic Applied in Urban Residences

Authors: Stephanie Fabris Russo, Daiane Costa Guimarães, Jonas Pedro Fabris, Maria Emilia Camargo, Suzana Leitão Russo, José Augusto Andrade Filho

Abstract:

Among renewable energy sources, solar energy is the one that has stood out. Solar radiation can be used as a thermal energy source and can also be converted into electricity by means of effects on certain materials, such as thermoelectric and photovoltaic panels. These panels are often used to generate energy in homes, buildings, arenas, etc., and have low pollution emissions. Thus, a technological prospecting was performed to find patents related to the use of photovoltaic plates in urban residences. The patent search was based on ESPACENET, associating the keywords photovoltaic and home, where we found 136 patent documents in the period of 1994-2015 in the fields title and abstract. Note that the years 2009, 2010, 2011, 2012, 2013 and 2014 had the highest number of applicants, with respectively, 11, 13, 23, 29, 15 and 21. Regarding the country that deposited about this technology, it is clear that China leads with 67 patent deposits, followed by Japan with 38 patents applications. It is important to note that most depositors, 50% are companies, 44% are individual inventors and only 6% are universities. On the International Patent classification (IPC) codes, we noted that the most present classification in results was H02J3/38, which represents provisions in parallel to feed a single network by two or more generators, converters or transformers. Among all categories, there is the H session, which means Electricity, with 70% of the patents.

Keywords: photovoltaic, urban residences, technology forecasting, prospecting

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12199 Is Swaziland on Track with the 2015 Millennium Development Goals?

Authors: A. Sathiya Susuman

Abstract:

Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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12198 Young Women in Residential Care: The Interplay between Dominant Narratives and Personal Stories

Authors: M. A. Marlow, R. Sørly, H. K. Kaatrakoski

Abstract:

Social work practice produces and circulates dominant narratives of young women in residential care. These stories are characterised by negative descriptions and hopelessness while dismissing the capabilities of narrative practice. This paper gives an account of how young women with histories in residential care can resist the dominant narratives. The analysis is based on a study of five young women aged 17 to 26 years old with different backgrounds and experiences with Norwegian residential care. The meaning of the context is analysed based on two interviews that were completed and one that was cancelled in the field. The contextual narrative analysis was oriented around the understanding of stories as performances and provided insight into a possible future storytelling practice in social work. The first author’s field notes are included as part of the data material in the analysis and provide a picture of important knowledge development related to stories and the value of being able to tell one’s own experiences. Faced with the dominant narratives that define young women with negative experiences with residential care, we provide a more contextualised understanding of storytelling as a possibility for positive change. To allow young women to create new stories from their lives, we, as both social workers and researchers, must be aware of what kinds of stories we relate to our own practices.

Keywords: context analysis, narrative research, rejection, residential care, social work practice

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12197 Maternal Health Care Utilization and Its Effect on Pregnancy Outcome in Nepal

Authors: Adrita Banerjee, Ajeet Kumar Singh

Abstract:

Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy and delivery. The quality of antenatal care can be monitored through the content of services received and the kind of information mothers are given during their visit. Objective: The paper tries to examine the association between ANC check-ups and size/ birth weight. It also focuses on investigating the relationship between utilization of recommended prenatal care for mothers and its effect on infant survival in Nepal. Data and methods: This paper uses data from Nepal demographic Health Survey 2011. To understand the relationship bi-variate statistical analysis and logistic regressions has been done. Maternal health care utilization include ANC check-ups i.e. the type of ante-natal care providers, the number and timing of the visit. The various components of the check-ups include intake of iron tablets/syrups, intestinal parasitic drugs, etc. Results: The results show that women who had no antenatal care visits about 40% had small sized babies at the time of birth compared to women to had at least 3 ANC check up. Women who had at least 3 check-ups 17% of the babies have a small size. It has also been found that about 50 % of the women prefer ANC check-ups during pregnancies which have resulted in lowering the infant mortality by about 40% during 1996-2011. Conclusion: Ante natal care check is care and monitoring of the pregnant woman and her foetus throughout pregnancy. ANC checks have an effect on the infant health and child survival. A woman who had at least three check-ups the possibilities of adverse effect on infant health and infant survival was significantly lower. The findings argue for a more enhanced focus on ANC check-ups for improving the maternal and child health in Nepal.

Keywords: maternal, health, pregnancy, outcome

Procedia PDF Downloads 238