Search results for: physician factors

Authors: Mia Schneeweiss, Joseph Merola

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Atopic dermatitis (AD) is a chronic inflammatory skin condition with a prevalence of 9.6 million in children under the age of 18 in the US, 3.2 million of those suffer severe AD. AD has significant effects on the quality of life and psychiatric comorbidity in affected patients. We sought to quantify the use of psychotropic medications and mental health services in children. We used longitudinal claims data form commercially insured patients in the US between 2003 and 2016 to identify children aged 18 or younger with a diagnosis of AD associated with an outpatient or inpatient encounter. A 180-day enrollment period was required before the first diagnosis of AD. Among those diagnosed, we computed the use of psychiatric services and dispensing of psychotropic medications during the following 6 months. Among 1.6 million children <18 years with a diagnosis of AD, most were infants (0-1 years: 17.6%), babies (1-2 years: 12.2%) and young children (2-4 years: 15.4). 5.1% were in age group 16-18 years. Among younger children 50% of patients were female, after the age of 14 about 60% were female. In 16-18 years olds 6.4% had at least one claim with a recorded psychopathology during the 6-month baseline period; 4.6% had depression, 3.3% anxiety, 0.3% panic disorder, 0.6% psychotic disorder, 0.1% anorexia. During the 6 months following the physician diagnosis of AD, 66% used high-potency topical corticosteroids, 3.5% used an SSRI, 0.3% used an SNRI, 1.2% used a tricyclic antidepressant, 1.4% used an antipsychotic medication, and 5.2% used an anxiolytic agent. 4.4% had an outpatient visit with a psychiatrist and 0.1% had been hospitalized with a psychiatric diagnosis. In 14-16 years olds, 4.7% had at least one claim with a recorded psychopathology during the 6-month baseline period; 3.3% had depression, 2.5% anxiety, 0.2% panic disorder, 0.5% psychotic disorder, 0.1% anorexia. During the 6 months following the physician diagnosis of AD, 68% used high-potency topical corticosteroids, 4.6% used an SSRI, 0.6% used an SNRI, 1.5% used a tricyclic antidepressant, 1.4% used an antipsychotic medication, and 4.6% used an anxiolytic agent. 4.7% had an outpatient visit with a psychiatrist and 0.1% had been hospitalized with a psychiatric diagnosis. In 12-14 years olds, 3.3% had at least one claim with a recorded psychopathology during the 6-month baseline period; 1.9% had depression, 2.2% anxiety, 0.1% panic disorder, 0.7% psychotic disorder, 0.0% anorexia. During the 6 months following the physician diagnosis of AD, 67% used high-potency topical corticosteroids, 2.1% used an SSRI, 0.1% used an SNRI, 0.7% used a tricyclic antidepressant, 0.9 % used an antipsychotic medication, and 4.1% used an anxiolytic agent. 3.8% had an outpatient visit with a psychiatrist and 0.05% had been hospitalized with a psychiatric diagnosis. In younger children psychopathologies were decreasingly common: 10-12: 2.8%; 8-10: 2.3%; 6-8: 1.3%; 4-6: 0.6%. In conclusion, there is substantial psychiatric comorbidity among children, <18 years old, with diagnosed atopic dermatitis in a US commercially insured population. Meaningful psychiatric medication use (>3%) starts as early as 12 years old.

Keywords: pediatric atopic dermatitis, phychotropic medication use, psychiatric comorbidity, claims database

Procedia PDF Downloads 156

Authors: Abir S. AL-Harrasi, Eyad B. AL-Zadjali, Zahran S. AL-Salti

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Entrepreneurship has captured the attention of policy-makers, educators and researchers in the last few decades. It has been regarded as a main driver for economic growth, development and employment generation in many countries worldwide. However, scholars have not agreed on the key factors that impact entrepreneurial intention. This study attempts, through an extensive literature review, to provide a holistic view and a more comprehensive understanding of the key factors that lead university undergraduate students to become entrepreneurs. A systematic literature review is conducted and several scientific articles and reports have been examined. The results of this study indicate that there are four main sets of factors: the personality-traits factors, contextual factors, motivational factors, and personal background factors. This research will serve as a base for future studies and will have valuable implications for policy makers and educators.

Keywords: entrepreneurship, entrepreneurial intention, literature review, economic growth

Procedia PDF Downloads 263

Authors: Yadchol Tawetanawanich

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Depression of elderly is a mental health problem that impacts tremendously on the elderly themselves, their family, and society. the purposes of this descriptive research were to examine prevalence rate of elderly depression and to study factors related to depression in elderly including 1) individual factors: sex, education, marital status, 2) economic factors: occupation, adequate income 3) health factors: chronic illnesses , disability, 4) social factors: family relationship, community relationship, 5) knowledge of depression, and 6) self-care behavior. The subject in this study included 273 elderly in Ladboakao sub-district, Banpong district, Ratchaburi province, Thailand. Data were collected through questionnaires and were analyzed using percentage, mean, standard deviation, chi-square, and one-way ANOVA. The results of the study revealed that: The prevalence rate of elderly depression were 21.61%, factors included economic factors, health factors, knowledge about depression, and self-care behavior were statistically significant positively related to depression of elderly (p<0.05), but individual factors and social factors were not significantly related to depression. It is also important for nurses to assess factors related to depression of the elderly in order to develop the model of care and use self-care strategies to contribute the positive outcomes.

Keywords: associated factors, depression, elderly, self-care

Procedia PDF Downloads 367

Authors: Mandy W. M. Chan, Samantha Y. N. Shek, Chi K. Yeung, Taro Kono, Henry H. L. Chan

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Fractional radiofrequency devices have shown to improve skin texture such as smoothness, rhytides, brightness as well as atrophic acne scars by increasing dermal thickness, dermal collagen content and dermal fibrillin content. The objective of the study is to assess the efficacy and adverse effects of this device on Asian patients with skin textural changes. In this study, 20 Chinese patients (ranging from 21-60 years old) with irregularities of skin texture, rhytides and acne scars were recruited. Patients received six treatments at 2-4 week intervals. Treatment was initiated with maximum energy tolerated and was adjustable during treatment if patients felt excessive discomfort. A total of two passes were delivered at each session. Physician assessment and standardized photographs were taken at baseline, all treatment visits and at one, two, and six month after final treatment. As a result, 17 patients were recruited and completed the study according to the study protocol. One patient withdrew after the first treatment due to reaction to local anesthesia and two patients were lost to follow-up. At six months follow-up, 71% of the patients were satisfied and 24% were very satisfied, while treatment physician reported various degrees of improvement based on the global assessment scale in 60% of the subjects. Anticipated side effects including erythema, edema, pinpoint bleeding, scabs formation and flare of acne were recorded, but there were no serious adverse effects noted. Conclude up, the use of fractional radiofrequency improves skin texture and appears to be safe in Asian patients. No long-term serious adverse effect was noted.

Keywords: Asian, fractional radiogrequency, skin, texture

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Authors: Hassan Manouchehri

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The present study aimed to identify and evaluate the factors affecting violence against women. The statistical population included all couples referring to family counseling centers in Tehran due to domestic violence during the past year. A number of 305 people were selected as a statistical sample using simple random sampling and Cochran's formula in unlimited conditions. A researcher-made questionnaire including 110 items was used for data collection. The face validity and content validity of the questionnaire were confirmed by 30 experts and its reliability was obtained above 0.7 for all studied variables in a preliminary test with 30 subjects and it was acceptable. In order to analyze the data, descriptive statistical methods were used with SPSS software version 22 and inferential statistics were used for modeling structural equations in Smart PLS software version 2. Evaluating the theoretical framework and domestic and foreign studies indicated that, in general, four main factors, including cultural and social factors, economic factors, legal factors, as well as medical factors, underlie violence against women. In addition, structural equation modeling findings indicated that cultural and social factors, economic factors, legal factors, and medical factors affect violence against women.

Keywords: violence against women, cultural and social factors, economic factors, legal factors, medical factors

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Authors: Taksina Bunbut, Kevin Wongleedee

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The purposes of this research were to study factors influencing the decision of international tourists to revisit Bangkok, Thailand. A random 200 samples was collected. Half the sample group was male and the other half was female. A questionnaire was used to collect data and small in-depth interviews were also used to get their opinions about importance of tourist decision making factors. The findings revealed that the majority of respondents rated these factors at medium level of importance. The ranking showed that the first three important factors were a safe place to stay, friendly people, and clean food. The three least important factors were a convenience transportation, clean country, and child friendly. In addition there was no significance difference between male and female in their ratings of the factors of influencing the decision of international tourists to revisit Bangkok, Thailand.

Keywords: factors, international tourists, revisit, Thailand

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Authors: Jami Wang, Brian Kao, Davin Agustines

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COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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Authors: Skirmante Mozuriunaite

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Contemporary metropolitan areas and large cities are dynamic, rapidly growing and continuously changing. Thus, urban transformations and mutations are not a new phenomenon, but rather a continuous process. Basic factors of urban transformation are related to development of technologies, globalisation, lifestyle, etc., which, in combination with local factors, have generated an extremely great variety of urban development conditions. This article discusses the main urbanisation processes in Lithuania during last 50 year period and social factors affecting urban functional mutations.

Keywords: dispersion, functional mutations, urbanization, urban mutations, social factors

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Authors: Mukisa Simon Peter Turker, Etomaru Irene

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This study examined factors determining the success of University-Industry Collaboration (UIC) in the science academic units (SAUs) at Makerere University. This was prompted by concerns about weak linkages between industry and the academic units at Makerere University. The study examined institutional, relational, output, and framework factors determining the success of UIC in the science academic units at Makerere University. The study adopted a predictive cross-sectional survey design. Data was collected using a questionnaire survey from 172 academic staff from the six SAUs at Makerere University. Stratified, proportionate, and simple random sampling techniques were used to select the samples. The study used descriptive statistics and linear multiple regression analysis to analyze data. The study findings reveal a coefficient of determination (R-square) of 0.403 at a significance level of 0.000, suggesting that UIC success was 40.3% at a standardized error of estimate of 0.60188. The strength of association between Institutional factors, Relational factors, Output factors, and Framework factors, taking into consideration all interactions among the study variables, was at 64% (R= 0.635). Institutional, Relational, Output and Framework factors accounted for 34% of the variance in the level of UIC success (adjusted R2 = 0.338). The remaining variance of 66% is explained by factors other than Institutional, Relational, Output, and Framework factors. The standardized coefficient statistics revealed that Relational factors (β = 0.454, t = 5.247, p = 0.000) and Framework factors (β = 0.311, t = 3.770, p = 0.000) are the only statistically significant determinants of the success of UIC in the SAU in Makerere University. Output factors (β = 0.082, t =1.096, p = 0.275) and Institutional factors β = 0.023, t = 0.292, p = 0.771) turned out to be statistically insignificant determinants of the success of UIC in the science academic units at Makerere University. The study concludes that Relational Factors and Framework Factors positively and significantly determine the success of UIC, but output factors and institutional factors are not statistically significant determinants of UIC in the SAUs at Makerere University. The study recommends strategies to consolidate Relational and Framework Factors to enhance UIC at Makerere University and further research on the effects of Institutional and Output factors on the success of UIC in universities.

Keywords: university-industry collaboration, output factors, relational factors, framework factors, institutional factors

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Authors: Ghada Soltane

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The objective of this study was to identify factors impacting supply chain collaboration. a quantitative study was carried out on a sample of 84 Tunisian industrial companies. To verify the research hypotheses and test the direct effect of these factors on supply chain collaboration a multiple regression method was used using SPSS 26 software. The results show that there are four factors direct effects that affect supply chain collaboration in a meaningful and positive way, including: trust, engagement, information sharing and information quality

Keywords: supply chain collaboration, factors of collaboration, principal component analysis, multiple regression

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Authors: Ali Alshahrani, Adel Almaai, Saad Garni

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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Alireza Abbasi Moshaii, Farshid Najafi

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In this paper a new model for centre of motion creating is proposed. This new method uses cables. So, it is very useful in robots because it is light and has easy assembling process. In the robots which need to be in touch with some things this method is very good. It will be described in the following. The accuracy of the idea is proved by an experiment. This system could be used in the robots which need a fixed point in the contact with some things and make a circular motion. Such as dancer, physician or repair robots.

Keywords: centre of motion, robotic cables, permanent touching, mechatronics engineering

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Authors: Reem Alshiha, Tanzila Saba

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Physical rehabilitation is the process of helping people to recover and be able to go back to their former activities that have been delayed due to external factors such as car accidents, old age and victims of strokes (chronic diseases and accidents, and those related to sport activities).The cost of hiring a personal nurse or driving the patient to and from the hospital could be costly and time-consuming. Also, there are other factors to take into account such as forgetfulness, boredom and lack of motivation. In order to solve this dilemma, some experts came up with rehabilitation software to be used with Microsoft Kinect to help the patients and their families for in-home rehabilitation. In home rehabilitation software is becoming more and more popular, since it is more convenient for all parties affiliated with the patient. In contrast to the other costly market-based systems that have no portability, Microsoft’s Kinect is a portable motion sensor that reads body movements and interprets it. New software development has made rehabilitation games available to be used at home for the convenience of the patient. The game will benefit its users (rehabilitation patients) in saving time and money. There are many software's that are used with the Kinect for rehabilitation, but the software that is chosen in this research is Kinectotherapy. Kinectotherapy software is used for rehabilitation patients in Riyadh clinics to test its acceptance by patients and their physicians. In this study, we used Kinect because it was affordable, portable and easy to access in contrast to expensive market-based motion sensors. This paper explores the importance of in-home rehabilitation by using Kinect with Kinectotherapy software. The software targets both upper and lower limbs, but in this research, the main focus is on upper-limb functionality. However, the in-home rehabilitation is applicable to be used by all patients with motor disability, since the patient must have some self-reliance. The targeted subjects are patients with minor motor impairment that are somewhat independent in their mobility. The presented work is the first to consider the implementation of in-home rehabilitation with real-time feedback to the patient and physician. This research proposes the implementation of in-home rehabilitation in Riyadh, Saudi Arabia. The findings show that most of the patients are interested and motivated in using the in-home rehabilitation system in the future. The main value of the software application is due to these factors: improve patient engagement through stimulating rehabilitation, be a low cost rehabilitation tool and reduce the need for expensive one-to-one clinical contact. Rehabilitation is a crucial treatment that can improve the quality of life and confidence of the patient as well as their self-esteem.

Keywords: x-box, rehabilitation, physical therapy, rehabilitation software, kinect

Procedia PDF Downloads 322

Authors: Khlaid Albishi

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This paper participates in giving new vision and explains the learning and acquisition processes of English language by analyzing a certain context. Five important factors in English language acquisition and learning are discussed and suitable solutions are provided. The factors are compared with the learners' linguistic background at Bisha College of Technology BCT attempting to link the issues faced by students and the research done on similar situations. These factors are phonology, age of acquisition, motivation, psychology and courses of English. These factors are very important; because they interfere and affect specific learning processes at BCT context and general English learning situations.

Keywords: language acquisition, language learning, factors, Bisha college

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Authors: Gani Pllana, Sadete Pllana, Albulena Pllana Breznica

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The history of appearance and development of technical fields in our country sheds light on the relationships they have entered into with social factors indicating what kinds of factors have prevailed in their appearance and development. Thus, for instance, at the end of the 19th century, a number of knowledge fields were stipulated by political factors, cultural and linguistic factors that are inextricably linked to our nation's efforts to arouse national consciousness through the growth of educational and cultural level of the people. Some sciences, through their fundamental special fields probably would be one of those factors that would accomplish this objective. Other factors were the opening of schools and the drafting of relevant textbooks thereby their accomplishment is to be achieved by means of written language. Therefore the first fundamental knowledge fields were embodied with them, such as mathematics, linguistics, geography.

Keywords: Albanian language, development of terminology, standardization of terminology, technical fields

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Authors: K. Sekulová, M. Šimon

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This article focuses on upper-extremity musculoskeletal disorders risk assessment model at workplace. In this model are used risk factors that are responsible for musculoskeletal system damage. Based on statistic calculations the model is able to define what risk of MSD threatens workers who are under risk factors. The model is also able to say how MSD risk would decrease if these risk factors are eliminated.

Keywords: ergonomics, musculoskeletal disorders, occupational diseases, risk factors

Procedia PDF Downloads 527

Authors: Abdullah M. Alodhaiani, Yasir A. Alturki, Mohamed A. Elkady

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Complex power flow distribution factors, which relate line complex power flows to the bus injected complex powers, have been widely used in various power system planning and analysis studies. In particular, AC distribution factors have been used extensively in the recent power and energy pricing studies in free electricity market field. As was demonstrated in the existing literature, many of the electricity market related costing studies rely on the use of the distribution factors. These known distribution factors, whether the injection shift factors (ISF’s) or power transfer distribution factors (PTDF’s), are linear approximations of the first order sensitivities of the active power flows with respect to various variables. This paper presents a novel model for evaluating the universal distribution factors (UDF’s), which are appropriate for an extensive range of power systems analysis and free electricity market studies. These distribution factors are used for the calculations of lines complex power flows and its independent of bus power injections, they are compact matrix-form expressions with total flexibility in determining the position on the line at which line flows are measured. The proposed approach was tested on IEEE 9-Bus system. Numerical results demonstrate that the proposed approach is very accurate compared with exact method.

Keywords: distribution factors, power system, sensitivity factors, electricity market

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Authors: Neeti Sharma, Harshika Pareek, Prerna Puri, Manika Mohan

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The present study is aimed at studying the significant relationship between anxiety and depression in chronic headache patients. Chronic Headache patients coming to the Neurology Unit-1 Outpatient Department of the Sawai Mansingh Hospital (SMS) Jaipur, Rajasthan, were included in this study. The sample consisted of 100 patients (N=100). Initially patients were examined by a physician and then they were assessed for Anxiety and Depression using the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Rating Scale for Depression. The relevant information was recorded on a Performa designed for this purpose comprising of socio-demographic variables like age, gender and triggering factors. The correlation-coefficient indicated a significant positive relationship between the anxiety and depression in chronic headache patients. These findings implicate high prevalence of anxiety and depression in the general population, and also indicate an association between headache and psychological disorders. Many evidences support the anxiety-headache-depression syndrome as a distinct disorder, and the association of co-morbid psychiatric illness with headache intractability. This study highlights the importance of prospective research for studying the developmental course and consequences of headache syndromes. Also, various psychotherapies should be applied to the headache patients so as to treat them, at the onset level of anxiety and depression, with the help of medication.

Keywords: anxiety, chronic headaches, depression, HAM-A, HAM

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Authors: Athar Imtiaz, Abduljalil S. Al-Mudhary, Taha Mirhashemi, Roslina Ibrahim

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Information Technology (IT) is being used by almost all organizations throughout the world. However, its success at supporting and improving business is debatable. There is always the risk of IT project failure and studies have proven that a large number of IT projects indeed do fail. There are many components that further the success of IT projects; these have been studied in previous studies. Studies have found the most necessary components for success in software development projects, executive information systems etc. In this study, previous literature that has looked into these success promoting factors have been critically reviewed and analyzed. Fifteen critical Success Factors (CSF) of IT projects were enlisted and examined. These factors can be applied to all IT projects and is not specific to a particular type of IT/IS project. A hypothesis was also generated after the evaluation of the factors.

Keywords: critical success factors, CSF, IT projects, IS projects, software development projects

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Authors: Nazirah Zainul Abidin, Nurul Zahirah Mokhtar Azizi

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Cost has always been the leading concern in green building development. The perception that construction cost for green building is higher than conventional buildings has only made the discussion of green building cost more difficult. Understanding the factors that will influence the cost of green construction is expected to shed light into what makes green construction more or at par with conventional projects, or perhaps, where cost can be optimised. This paper identifies the elements of cost before shifting the attention to the influencing factors. Findings from past studies uncovered various factors related to cost which are grouped into five focal themes i.e. awareness, knowledge, financial, technical, and government support. A conceptual framework is produced in a form of a flower diagram indicating the cost influencing factors of green building development. These factors were found to be both physical and non-physical aspects of a project. The framework provides ground for the next stage of research that is to further explore how these factors influence the project cost and decision making.

Keywords: green project, factors influencing cost, hard cost, soft cost

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Authors: Faith-Michael E. Uzoka, Boluwaji A. Akinnuwesi, Taiwo Amoo, Flora Aladi, Stephen Fashoto, Moses Olaniyan, Joseph Osuji

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The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

Keywords: medical diagnosis, tropical diseases, fuzzy cognitive map, decision support filters, malaria differential diagnosis

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Authors: Supattra Kanchanopast

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The purpose of this research was to identify factors that influenced the trust of e-commerce within retail businesses. In order to achieve the objectives of this research, the researcher collected data from random e-commerce users in Bangkok. The data was comprised of the results of 382 questionnaires. The data was analyzed by using descriptive statistics, which included frequency, percentages, and the standard deviation of pertinent factors. Multiple regression analysis was also used. The findings of this research revealed that the majority of the respondents were female, 25-40 years old, and graduated a bachelor degree. The respondents mostly worked in private sectors and had monthly income between 15,000-25,000 baht. The findings also indicate that information quality factors, website design factors, service quality factor, security factor and advertising factors as significant factors effecting customer trust of e-commerce in online retail. The hypotheses testing revealed that these factors in e-commerce had an effect on customer’s trust in the same direction with high level.

Keywords: e-commerce, online retail, Retail business, trust, website

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Authors: C. Lalitha, R. Sayee, D. Apoorva

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Reproductive failure or infertility may be due to several factors that are not limited to one sex. It remains a common problem causing significant psychological distress to those affected individuals and who are increasingly seeking medical advice. Male infertility means inability to induce conception in normal woman within a year. The etiological factors associated with male infertility are anatomical, developmental, seminal, hormonal, immunological and environmental factors. The paper was aimed to highlight the environmental factors and its association to male infertility and seasonality of birth and its influence. The data was collected from the 75 male patients referred with infertility for karyotyping and counseling. Their age ranged from 21 to 45 years. It is opined that certain occupations are preferentially associated with male infertility.

Keywords: environmental, occupational, seasonal, male infertility

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Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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Authors: Kemal Izci

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Assessment forms an important part of instruction. Assessment that aims to support learning is known as formative assessment and it contributes student’s learning gain and motivation. However, teachers rarely use assessment formatively to aid their students’ learning. Thus, reviewing the factors that limit or support teachers’ practices of formative assessment will be crucial for guiding educators to support prospective teachers in using formative assessment and also eliminate limiting factors to let practicing teachers to engage in formative assessment practices during their instruction. The study, by using teacher’s change environment framework, reviews literature on formative assessment and presents a tentative model that illustrates the factors impacting teachers’ adoption of formative assessment in their teaching. The results showed that there are four main factors consisting personal, contextual, resource-related and external factors that influence teachers’ practices of formative assessment.

Keywords: assessment practices, formative assessment, teacher education, factors for use of formative assessment

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Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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Authors: Sevim Oztimurlenk

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This is an exploratory study on the information behavior of human resource managers. This study is conducted by using a questionnaire survey and an interview. The data is gathered from 140 HR managers who are members of the People Management Association of Turkey (PERYÖN), and the 15 interviewees were chosen among those 140 survey participants randomly. The goal of this exploratory study is to investigate the impact of some factors (i.e., gender, age, work experience, number of employee reporting, company size, industry type) on HR managers’ information behavior. More specifically, it examines if there is a relationship between those factors and HR managers’ information behavior in terms of what kind of information sources they consult and reviews and whom they prefer to communicate with for information sharing. It also aims to find out additional factors influencing the information behavior of HR managers. The results of the study show that age and industry type are the two factors affecting the information behavior of HR managers, among other factors investigated in terms of information source, use and share. Moreover, personality, technology, education, organizational culture, and culture are the top five factors among the 24 additional factors suggested by HR managers who participated in this study.

Keywords: information behavior, information use, information source, information share, human resource managers

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Authors: Sidra Jawed

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The accessibility constructs and the body privilege discourse has been a major problem while dealing with health inequities and inaccessibility. The inherent problem in this arbitrary view of disability is that disability would never be the productive way of living. For past thirty years, disability activists have been working to differentiate ‘impairment’ from ‘disability’ and probing for more understanding of limitation imposed by society, this notion is ultimately known as the Social Model of Disability. The vulnerable population as disability community remains marginalized and seen relentlessly fighting to highlight the importance of social factors. It does not only constitute physical architectural barriers and famous blue symbol of access to the healthcare but also invisible, intangible barriers as attitudes and behaviours. Conventionally the idea of ‘disability’ has been laden with prejudiced perception amalgamating with biased attitude. Equity in contemporary setup necessitates the restructuring of organizational structure. Apparently simple, the complex interplay of disability and contemporary healthcare set up often ends up at negotiating vital components of basic healthcare needs. The role of society is indispensable when it comes to people with disability (PWD), everything from the access to healthcare to timely interventions are strongly related to the set up in place and the attitude of healthcare providers. It is vital to understand the association between assumptions and the quality of healthcare PWD receives in our global healthcare setup. Most of time the crucial physician-patient relationship with PWD is governed by the negative assumptions of the physicians. The multifaceted, troubled patient-physicians’ relationship has been neglected in past. To compound it, insufficient work has been done to explore physicians’ perspective about the disability and access to healthcare PWD have currently. This research project is directed towards physicians’ perspective on the intersection of health and access of healthcare for PWD. The principal aim of the study is to explore the perception of disability in family medicine physicians, highlighting the underpinning of medical perspective in healthcare institution. In the quest of removing barriers, the first step must be to identify the barriers and formulate a plan for future policies, involving all the stakeholders. There would be semi-structured interviews to explore themes as accessibility, medical training, construct of social model and medical model of disability, time limitations, financial constraints. The main research interest is to identify the obstacles to inclusion and marginalization continuing from the basic living necessities to wide health inequity in present society. Physicians point of view is largely missing from the research landscape and the current forum of knowledge with regards to physicians’ standpoint. This research will provide policy makers with a starting point and comprehensive background knowledge that can be a stepping stone for future researches and furthering the knowledge translation process to strengthen healthcare. Additionally, it would facilitate the process of knowledge translation between the much needed medical and disability community.

Keywords: disability, physicians, social model, accessibility

Procedia PDF Downloads 196

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Abdul Razak Rahmat, Azizah Ahmad, Azman Ta’aa

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The deployment of Business Intelligence (BI) for organization at the beginning phase is very crucial. Results from the previous studies found that more than half of the BI project fails to meet the objective even though a lot money are spent. Based on that problem, the readiness level of BI for the organization is important to identify in order to reduce the risk before the actual BI project is implemented. In this paper, rigorous literature review on the aspect success factors such as Critical Success Factors (CSFs), Readiness Factors (RFs), Success Factors (SFs), are discussed by different authors. The paper also adopted a few models from previous study as a guide for the assessment of BI readiness. The expected finding from this research is the Business Intelligent Readiness Model (BiRM) as a guild before implement the BI system.

Keywords: business intelligence readiness model, business intelligence for higher learning, BI readiness factors, BI critical success factors(CSF)

Procedia PDF Downloads 351