Search results for: provider recommendation

Authors: Laila Yasir Al-Harthy, Ali H. Al-Badi

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As an emerging business model, cloud computing has been initiated to satisfy the need of organizations and to push Information Technology as a utility. The shift to the cloud has changed the way Information Technology departments are managed traditionally and has raised many concerns for both, public and private sectors. The purpose of this study is to investigate the possibility of cloud computing services replacing services provided traditionally by IT departments. Therefore, it aims to 1) explore whether organizations in Oman are ready to move to the cloud; 2) identify the deciding factors leading to the adoption or rejection of cloud computing services in Oman; and 3) provide two case studies, one for a successful Cloud provider and another for a successful adopter. This paper is based on multiple research methods including conducting a set of interviews with cloud service providers and current cloud users in Oman; and collecting data using questionnaires from experts in the field and potential users of cloud services. Despite the limitation of bandwidth capacity and Internet coverage offered in Oman that create a challenge in adopting the cloud, it was found that many information technology professionals are encouraged to move to the cloud while few are resistant to change. The recent launch of a new Omani cloud service provider and the entrance of other international cloud service providers in the Omani market make this research extremely valuable as it aims to provide real-life experience as well as two case studies on the successful provision of cloud services and the successful adoption of these services.

Keywords: cloud computing, cloud deployment models, cloud service models, deciding factors

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Authors: Oluwaseun Adeleke, Samuel Ikan, Anthony Nwala, Mopelola Raji, Fidelis Edet

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Background: The risks associated with each pregnancy is carried almost entirely by a woman; however, the decision about whether and when to get pregnant is a subject that several others contend with her to make. The self-care concept offers women of reproductive age the opportunity to take control of their health and its determinants with or without the influence of a healthcare provider, family, and friends. DMPA-SC Self-injection (SI) is becoming the cornerstone of contraceptive self-care and has the potential to expand access and create opportunities for women to take control of their reproductive health. Methodology: To obtain insight into the influences that interfere with a woman’s capacity to make contraceptive choices independently, the Delivering Innovations in Selfcare (DISC) project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach and data collected analyzed using a codebook and Atlas-TI. The research team members came together for participatory analysis workshop to explore and interpret emergent themes. Findings: Insights indicate that women are increasingly finding their voice and independently seek services to prevent a deterioration of their economic situation and achieve personal ambitions. Women who hold independent decision-making power still prefer to share decision making power with their male partners. Male partners’ influence on women’s use of family planning and self-inject was most dominant. There were examples of men’s support for women’s use of contraception to prevent unintended pregnancy, as well as men withholding support. Other men outrightly deny their partners from obtaining contraceptive services and their partners cede this sexual and reproductive health right without objection. A woman’s decision to initiate family planning is affected by myths and misconceptions, many of which have cultural and religious origins. Some tribes are known for their reluctance to use contraception and often associate stigma with the pursuit of family planning (FP) services. Information given by the provider is accepted, and, in many cases, clients cede power to providers to shape their SI user journey. A provider’s influence on a client’s decision to self-inject is reinforced by their biases and concerns. Clients are inhibited by the presence of peers during group education at the health facility. Others are motivated to seek FP services by the interest expressed by peers. There is also a growing trend in the influence of social media on FP uptake, particularly Facebook fora. Conclusion: The convenience of self-administration at home is a benefit for those that contend with various forms of social influences as well as covert users. Beyond increasing choice and reducing barriers to accessing Sexual and Reproductive Health (SRH) services, it can initiate the process of self-discovery and agency in the contraceptive user journey.

Keywords: selfcare, self-empowerment, agency, DMPA-SC, contraception, family planning, influences

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Authors: Davit Khachatryan, Shuo Xiang

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Numerous published studies on the use of prazosin in the treatment of PTSD-related sleep disturbances in adult population have resulted in updates to the recommendation for prazosin for nightmares that showed its strength of evidence elevated from C to B in the US Department of Veterans Affairs clinical practice guideline. In addition, the American Academy of Sleep Medicine clinical practice guideline gave prazosin a level-A recommendation for the treatment of PTSD-associated nightmares. The aim of this review is to summarize the available literature for prazosin use for nightmares and other sleep disturbances in children and adolescents with PTSD. Method: A comprehensive search for studies on prazosin use for sleep disturbances in child and adolescent population with PTSD has been performed. We looked at MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, Scopus, Web of Science, and Cochrane CENTRAL databases. Results: Compared to adult population with similar psychopathology, the available literature in child and adolescent population is scarce. Despite increased interest in prazosin in the management of PTSD, only six studies investigating this medication in children and adolescents have been published. Conclusion: A large randomized control trial on this topic is needed for more definite evidence on the efficacy and safety of prazosin in the treatment of nightmares in children and adolescents with PTSD.

Keywords: guidelines, prazosin, PTSD, sleep disturbance

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Authors: Sri Widati, Ira Nurmala

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The Se’i Tradition was considered to contribute highly to the high maternal mortality rate in South Amanuban, East Nusa Tenggara. This tradition is still preserved due to the social support that has influenced the decision to carry out the Se’i to pregnant women and post-partum women. The purpose of this study is to analyze this social support towards the Se’i Tradition on pregnant women in East Nusa Tenggara. This research was an explorative study with in-depth interviews, observations, and focus group discussions (FGD) in collecting the data. This study showed that emotional support towards Se’i was commonly given by families, specifically by the mother-in laws. Instrumental support was shown by the husbands and the traditional midwives who helped delivered the babies. Informational support was found on the pregnant women and their mother-in laws. Appraisal support was given by all the neighbors and relatives of the pregnant women by telling how comfortable it was to go through this tradition which eventually affected those women to carry it out themselves. The Se’i Tradition is still carried out and mostly supported by the relatives of the pregnant women. The first recommendation of this study is to suggest people to only follow the suggestions from the local health staff to give birth in the local health centers and not to do the tradition anymore. The second recommendation is to urge the government to give support in the form of transportation facilities for pregnant women to reach the local health staff.

Keywords: the Se’i tradition, social support, pregnant women, maternal mortality, post-partum women

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Authors: Fitri Nugraheni, Adwitya Bhaskara, N. Faried Hanafi

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Coastal is one area that can be a place to live. Various buildings can be built in the area around the beach. Many Indonesians use beaches as housing and work, but we know that coastal areas are identical to tsunami and wind. Costs incurred due to permanent damage caused by tsunamis and wind disasters in Indonesia can be minimized by replacing permanent buildings into semi-permanent buildings. Semi-permanent buildings can be realized by using cold-formed steel as a building. Thus, the purpose of this research is to provide efficient semi-permanent building recommendations for residents around the coast. The research is done by first designing the building model by using sketch-up software, then the validation phase is done in consultation with the expert consultant of cold form steel structure. Based on the results of the interview there are several revisions on several sides of the building by adding some bracing rods on the roof, walls and floor frame. The result of this research is recommendation of semi-permanent building model, where the nature of the building; easy to disassemble and install (knockdown), tsunami-friendly (continue the tsunami load), cost and time efficient (using cold-formed-steel and prefabricated GRC), zero waste, does not require many workers (less labor). The recommended building design concept also keeps the architecture side in mind thus it remains a comfortable occupancy for the residents.

Keywords: construction method, cold-formed steel, efficiency, semi-permanent building, tsunami

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Authors: Udaykumar R., M. S. Ganachari

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In order to engage community pharmacies in Tuberculosis care, a survey has been conducted in Belgaum city, Karnataka state, India. After the survey divided into two groups one is control group and another one is intervention group. One is dispensing of anti-tuberculosis drugs, and another one is non-availability of anti-tuberculosis drugs. Those community pharmacists who are voluntarily interesting for becoming DOTS (Directly observed treatment short course) provider and RNTCP (Revised national tuberculosis control programme) objectives. Structured training is conducted for community pharmacist who are dispensing anti-tuberculosis drugs. The training module includes record maintaining, reporting to the RNTCP, Medication adherence etc. In case of non-availability of anti-tuberculosis drugs, the district RNTCP has been given training for community pharmacist by providing free of drugs to the community pharmacies. So, community pharmacies can dispense anti-tuberculosis drugs to the patients. The target of this study is Private community pharmacies. A simple random sampling method is used and 550 private community pharmacy shops has been involved in Belgaum city of Karnataka state, India. Significance of the Study: This study mainly focused on training of DOTS (Directly observed treatment short course) to the private community pharmacist. Indian Govt. Considers Private Providers as Assets for TB Control and Care to Achieve National Strategic Plan for TB Elimination 2017-2025. The Govt. has not fully tapped the Potential of Private Pharmacies to Fight TB. Providing DOTS as per patient’s convenience through community DOT Providers with periodic monitoring may reduce the treatment Default. We explore RNTCP objectives interventions that can have directly managed by private community pharmacy shop. Objectives: Survey of anti-tuberculosis drugs in Community pharmacy shop in Belgaum city. Interested community pharmacist who are willing to become DOTS (Directly observed treatment short course) Provider. Major Findings:Most of the community pharmacist are dispensing anti-tuberculosis drugs without having knowledge of DOTS therapy and RNTCP objectives. No community pharmacist is aware of RNTCP and Tuberculosis burden in India. Most of the Pharmacist agreed to come for RNTCP Training module for the community pharmacist. Some of the community pharmacist not dispensing anti-tuberculosis drugs and they agreed to become official DOTS provider. Concluding Statement: Awareness of role of community pharmacist on tuberculosis control and care has been neglected. More than 50% of tuberculosis patients seeking treatments from privatesector. In this study finds the major gap between government and private sector on tuberculosis treatment.

Keywords: community pharmacist, directly observed treatment short course(DOTS), revised national tuberculosis control programme (RNTCP), private pharmacies, anti-tuberculosis drugs

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Authors: Dorothy I. Riddle

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Limited mobility (or an inability to walk more than 15 meters without sitting down to rest) restricts full community participation for 13 percent of Canadian adults or 4.2 million persons), yet Canadian accessibility standards are silent on distance to be walked as an accessibility barrier to be addressed. Instead, they focus on ensuring access for the wheeled mobility devices used regularly by le The Accessible Canada Act mandates that Canada be barrier free by 2040, which will necessitate eliminating distance to be walked as a barrier in federal programs and services. This paper details the results of a multi-year research project funded by Accessibility Standards Canada to document the lived experience of those struggling with limited mobility and make recommendations regarding how to ensure accessibility for those with limited mobility. Over 2,600 Canadians from across Canada participated in an online survey and follow-up focus groups. The results underscored the importance of providing not only mobility supports in public facilities but also the information necessary for planning access to federal programs and services. As numerous participants indicated, if they weren’t sure how far they would have to walk, they simply stayed home and depended on friends and relatives for help with errands or appointments. This included failing to participate in civic activities, such as voting, for fear of having to walk too far and stand unsupported for too long. Types of information that were deemed critical included whether or not mobility aids were available, where seating to rest was located throughout the facility, what alternatives to standing while waiting for service and having to walk to the service provider (rather than the provider coming to the customer) were available, and diagrams of accessible parking and its relationship to elevators and services.

Keywords: accessibility standards, distance to be walked, limited mobility, mobility aids, service to customer

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Authors: Zhaohan Xie, Yining Yu, Mingliang Chen

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As research has shown a convergent tendency for aversion to AI recommendation, it is imperative to find a way to promote AI usage and better harness the technology. In the context of e-commerce, this study has found evidence that people show less avoidance of algorithms when recommending search products compared to experience products. This is due to people’s different attribution of mind to AI versus humans, as suggested by mind perception theory. While people hold the belief that an algorithm owns sufficient capability to think and calculate, which makes it competent to evaluate search product attributes that can be obtained before actual use, they doubt its capability to sense and feel, which is essential for evaluating experience product attributes that must be assessed after experience in person. The result of the behavioral investigation (Study 1, N=112) validated that consumers show low purchase intention to experience products recommended by AI. Further consumer neuroscience study (Study 2, N=26) using Event-related potential (ERP) showed that consumers have a higher level of cognitive conflict when faced with AI recommended experience product as reflected by larger N2 component, while the effect disappears for search product. This research has implications for the effective employment of AI recommenders, and it extends the literature on e-commerce and marketing communication.

Keywords: algorithm recommendation, consumer behavior, e-commerce, event-related potential, experience product, search product

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Authors: Abdul Basit Kiani, Maryam Kiani

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Online developers now have the tools necessary to create online apps that are not only reliable but also highly interactive, thanks to the introduction of JavaScript frameworks and APIs. The objective is to give a broad overview of the recent advances in the area. The fusion of machine learning (ML) and artificial intelligence (AI) has expanded the possibilities for web development. Modern websites now include chatbots, clever recommendation systems, and customization algorithms built in. In the rapidly evolving landscape of modern websites, it has become increasingly apparent that user engagement and personalization are key factors for success. To meet these demands, websites now incorporate a range of innovative technologies. One such technology is chatbots, which provide users with instant assistance and support, enhancing their overall browsing experience. These intelligent bots are capable of understanding natural language and can answer frequently asked questions, offer product recommendations, and even help with troubleshooting. Moreover, clever recommendation systems have emerged as a powerful tool on modern websites. By analyzing user behavior, preferences, and historical data, these systems can intelligently suggest relevant products, articles, or services tailored to each user's unique interests. This not only saves users valuable time but also increases the chances of conversions and customer satisfaction. Additionally, customization algorithms have revolutionized the way websites interact with users. By leveraging user preferences, browsing history, and demographic information, these algorithms can dynamically adjust the website's layout, content, and functionalities to suit individual user needs. This level of personalization enhances user engagement, boosts conversion rates, and ultimately leads to a more satisfying online experience. In summary, the integration of chatbots, clever recommendation systems, and customization algorithms into modern websites is transforming the way users interact with online platforms. These advanced technologies not only streamline user experiences but also contribute to increased customer satisfaction, improved conversions, and overall website success.

Keywords: Javascript, machine learning, artificial intelligence, web development

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Authors: Mohd Azraei Pangah Pa'at, Mohd Ruzlin Mohd Mokhtar, Norhidayu Rameli, Tashia Marie Anthony, Huzainie Shafi Abd Halim

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Partial Discharge (PD) diagnostic mapping testing is one of the main diagnostic testing techniques that are widely used in the field or onsite testing for underground power cable in medium voltage level. The existence of PD activities is an early indication of insulation weakness hence early detection of PD activities can be determined and provides an initial prediction on the condition of the cable. To effectively manage the results of PD Mapping test, it is important to have acceptable criteria to facilitate prioritization of mitigation action. Tenaga Nasional Berhad (TNB) through Distribution Network (DN) division have developed PD severity model name Severity Index (SI) for offline PD mapping test since 2007 based on onsite test experience. However, this severity index recommendation action had never been revised since its establishment. At presence, PD measurements data have been extensively increased, hence the severity level indication and the effectiveness of the recommendation actions can be analyzed and verified again. Based on the new revision, the recommended action to be taken will be able to reflect the actual defect condition. Hence, will be accurately prioritizing preventive action plan and minimizing maintenance expenditure.

Keywords: partial discharge, severity index, diagnostic testing, medium voltage, power cable

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Authors: Livy Febria Tedjamulia, Aas Nurasyiah, Ivana Josephin Purnama, Monika Diah Maharani Kusumastuti, Achmad Ridwan Ariyantoro

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Papua's candy is one of Indonesia’s indigenous consumption consisting of areca nut (Areca catechu), forest betel fruit (Piper aduncum), and CaCO3. This research aims to determine the concentration of tannins in areca nut, alkaloids in areca nut, flavonoids in forest betel fruit; detect their interaction and CaCO3; also toform a standardize consumption recommendation. The research methodwas includingDPPH assay for papua’s candy mixture, which resulted in IC50 value. Data analysis used is mathematical linear regression for each experiment. The test result of alkaloid is a Rf value of 0.773, while concentration of tannin and flavonoidare 0.603 mgGAE/g and 125.402 gQE/g, respectively. The IC50 value shows number of 3.0403, showing high antioxidant capacity.Other antioxidant assays were being studied using literature review, namely trolox and oxygen radical absorbance capacity, to figure out interaction among the bioactive compounds. It turned out that the interaction detected is antagonistic, which means the compound that is joined already has a stable molecular structure so that could reduce free radicals by donating hydrogen atoms. The recommendation consumptions given are 4 areca nuts, 5 forest betels, and 1 gram of lime betel. Therefore, papua's candy has its potential to be developed into functional food.

Keywords: antioxidant, bioactive compounds interaction, free radical, papua’s candy

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.

Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine

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Authors: Adekunle O. Afolabi, Pekka Toivanen

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The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: recommendation systems, Internet of Things, healthcare, homecare, real-time

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Authors: Kedar J. Mahadeshwar

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Concept introduction: This paper talks about how an innovative cloud based analytics enabled solution that could address a major industry challenge that is approaching all of us globally faster than what one would think. The world of supply chain for drugs and devices is changing today at a rapid speed. In the US, the Drug Supply Chain Security Act (DSCSA) is a new law for Tracing, Verification and Serialization phasing in starting Jan 1, 2015 for manufacturers, repackagers, wholesalers and pharmacies / clinics. Similarly we are seeing pressures building up in Europe, China and many countries that would require an absolute traceability of every drug and device end to end. Companies (both manufacturers and distributors) can use this opportunity not only to be compliant but to differentiate themselves over competition. And moreover a country such as UAE can be the leader in coming up with a global solution that brings innovation in this industry. Problem definition and timing: The problem of counterfeit drug market, recognized by FDA, causes billions of dollars loss every year. Even in UAE, the concerns over prevalence of counterfeit drugs, which enter through ports such as Dubai remains a big concern, as per UAE pharma and healthcare report, Q1 2015. Distribution of drugs and devices involves multiple processes and systems that do not talk to each other. Consumer confidence is at risk due to this lack of traceability and any leading provider is at risk of losing its reputation. Globally there is an increasing pressure by government and regulatory bodies to trace serial numbers and lot numbers of every drug and medical devices throughout a supply chain. Though many of large corporations use some form of ERP (enterprise resource planning) software, it is far from having a capability to trace a lot and serial number beyond the enterprise and making this information easily available real time. Solution: The solution here talks about a service provider that allows all subscribers to take advantage of this service. The solution allows a service provider regardless of its physical location, to host this cloud based traceability and analytics solution of millions of distribution transactions that capture lots of each drug and device. The solution platform will capture a movement of every medical device and drug end to end from its manufacturer to a hospital or a doctor through a series of distributor or retail network. The platform also provides advanced analytics solution to do some intelligent reporting online. Why Dubai? Opportunity exists with huge investment done in Dubai healthcare city also with using technology and infrastructure to attract more FDI to provide such a service. UAE and countries similar will be facing this pressure from regulators globally in near future. But more interestingly, Dubai can attract such innovators/companies to run and host such a cloud based solution and become a hub of such traceability globally.

Keywords: cloud, pharmaceutical, supply chain, tracking

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Authors: Munachiso A. Muoneke

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The global healthcare system faces unprecedented challenges of fragmented information systems, inefficient data management, and limited service accessibility. With the rapid evolution of digital technologies, there is a dire need to develop integrated technological infrastructures that can reinvent healthcare delivery from its core. This research addresses the significant gap between existing healthcare technologies and the growing demand for more responsive, secure, and patient-centered medical services. The study uses a mixed-method research approach, combining quantitative system performance analysis and qualitative healthcare provider interviews to comprehensively evaluate the limitations of the current digital health infrastructure. Across multiple healthcare settings, technological barriers are mapped to help develop a robust framework for assessing and redesigning digital health platforms. The research reveals significant potential for technology to transform healthcare delivery. It reveals that strategic technological interventions can reduce administrative inefficiencies by up to 40%, improving patient data security and creating more responsive healthcare ecosystems. The research shows how integrated digital infrastructure can bridge existing gaps in healthcare service delivery, improving patient access and healthcare provider coordination. By providing a practical framework for the transformation of digital health infrastructure, this research offers actionable insights for healthcare providers, technology developers and policy makers seeking to modernize healthcare service delivery in an increasingly digital world.

Keywords: decentralized healthcare, digital health, healthcare systems transformation, patient-centric technology

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Authors: Lucas Bublitz, Michael Herdrich

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By achieving the first commercialization approval in San Francisco the Autonomous Driving (AD) industry proves the technology maturity of the SAE L4 AD systems and the corresponding software and hardware stack. This milestone reflects the upcoming phase in the industry, where the focus is now about scaling and supervising larger autonomous vehicle (AV) fleets in different operation areas. This requires an operation framework, which organizes and assigns responsibilities to the relevant AV technology and operation stakeholders from the AV system provider, the Remote Intervention Operator, the MaaS provider and regulatory & approval authority. This holistic operation framework consists of technological, processual, and organizational activities to ensure safe operation for fully automated vehicles. Regarding the supervision of large autonomous vehicle fleets, a major focus is on the continuous field monitoring. The field monitoring approach must reflect the safety and security criticality of incidents in the field during driving operation. This includes an automatic containment approach, with the overall goal to avoid safety critical incidents and reduce downtime by a malfunction of the AD software stack. An End-to-end (E2E) field monitoring approach detects critical faults in the field, uses a knowledge-based approach for evaluating the safety criticality and supports the automatic containment of these E/E faults. Applying such an approach will ensure the scalability of AV fleets, which is determined by the handling of incidents in the field and the continuous regulatory compliance of the technology after enhancing the Operational Design Domain (ODD) or the function scope by Functions on Demand (FoD) over the entire digital product lifecycle.

Keywords: field monitoring, incident management, multicompliance management for AI in AD, root cause analysis, database approach

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Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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Authors: Jack R. McKenzie, Peter A. Appleby, Thomas House, Neil Walton

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Cold-start is a notoriously difficult problem which can occur in recommendation systems, and arises when there is insufficient information to draw inferences for users or items. To address this challenge, a contextual bandit algorithm – the Fast Approximate Bayesian Contextual Cold Start Learning algorithm (FAB-COST) – is proposed, which is designed to provide improved accuracy compared to the traditionally used Laplace approximation in the logistic contextual bandit, while controlling both algorithmic complexity and computational cost. To this end, FAB-COST uses a combination of two moment projection variational methods: Expectation Propagation (EP), which performs well at the cold start, but becomes slow as the amount of data increases; and Assumed Density Filtering (ADF), which has slower growth of computational cost with data size but requires more data to obtain an acceptable level of accuracy. By switching from EP to ADF when the dataset becomes large, it is able to exploit their complementary strengths. The empirical justification for FAB-COST is presented, and systematically compared to other approaches on simulated data. In a benchmark against the Laplace approximation on real data consisting of over 670, 000 impressions from autotrader.co.uk, FAB-COST demonstrates at one point increase of over 16% in user clicks. On the basis of these results, it is argued that FAB-COST is likely to be an attractive approach to cold-start recommendation systems in a variety of contexts.

Keywords: cold-start learning, expectation propagation, multi-armed bandits, Thompson Sampling, variational inference

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Authors: C. L. Huang, J. J. Sia

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The interest-based social networks, also known as social bookmark sharing systems, are useful platforms for people to conveniently read and collect internet resources. These platforms also providing function of social networks, and users can share and explore internet resources from the social networks. Providing personalized internet resources to users is an important issue on these platforms. This study uses two types of relationship on the social networks—following and follower and proposes a collaborative recommender system, consisting of two main steps. First, this study calculates the relationship strength between the target user and the target user's followings and followers to find top-N similar neighbors. Second, from the top-N similar neighbors, the articles (internet resources) that may interest the target user are recommended to the target user. In this system, users can efficiently obtain recent, related and diverse internet resources (knowledge) from the interest-based social network. This study collected the experimental dataset from Diigo, which is a famous bookmark sharing system. The experimental results show that the proposed recommendation model is more accurate than two traditional baseline recommendation models but slightly lower than the cosine model in accuracy. However, in the metrics of the diversity and executing time, our proposed model outperforms the cosine model.

Keywords: recommender systems, social networks, tagging, bookmark sharing systems, collaborative recommender systems, knowledge management

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Authors: Najla Alhkalaf

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The focus of this study is answering the following question: How do e-government services in Bahrain support the productivity of SMEs? This study examines the current E-government function in enhancing SME productivity in Bahrain through analysing the efficiency of e- government by viewing its facilitators and barriers from the perspective of different stakeholders. The study aims to identify and develop best practice guidelines with the end-goal of creating a standardised channel of communication between e-government and SMEs that fulfil the requirement of SME owners, and thus achieve the prime objective of e-government. E-government services for SMEs have been offered in Bahrain since 2005. However, the current services lack the required mechanism for SMEs to fully take advantage of these services because of lagging communication between service provider and end-user. E-government employees believe that a lack of awareness and trust are the main stumbling block, whereas the SME owners believe that there is a lack of sufficiency in the content and efficiency provided through e- services. A questionnaire has been created based on a pilot study that highlighted the main indicators of e-government efficiency and SMEs productivity as well as previous studies conducted on this subject. This allowed for quantitative data to be extracted. Also interviews were conducted with SME owners and government employees from both case studies, which formed the qualitative data for this study. The findings portray that both the service provider and service receiver largely agree on the existence of most of the technical and administrative barriers. However, the data reflects a level of dissatisfaction from the SME side, which contradicts with the perceived level of satisfaction from the government employees. Therefore, the data supports the argument that assures the existence of a communication gap between stakeholders. To this effect, this research would help build channels of communication between stakeholders, and then induces a plan unlocking the potential of e-government application. The conclusions of this study will help devise an optimised E-government strategy for Bahrain.

Keywords: e-government, SME, e-services, G2B, government employees' perspective, entrepreneurs' perspective, enterprise

Procedia PDF Downloads 238

Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Holistic and patient-centred palliative care and support require an integrated system of care that includes health and social service providers working together to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the benefits and challenges of mobilizing multidisciplinary care teams for health care professionals and social service providers. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed, and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers posed by multidisciplinary care teams. Three main findings emerged: First, the data highlighted the benefits of multidisciplinary care teams for both patient outcomes and quality of life and provider mental health; second, the data showed that the lack of a system-wide integrated communication system reduces the quality of patient care and increases provider stress while working in multidisciplinary care teams; finally, the data demonstrated the existence of implicit hierarchies between disciplines, this coupled with different disciplinary perspectives of palliative care provision can lead to friction and challenges within care teams. These findings will have important implications for the future of palliative care as they will help to facilitate and build stronger person-centred/relationship-centred palliative care practices by naming the challenges faced by multidisciplinary palliative care teams and providing examples of best practices.

Keywords: public health palliative care, palliative care nursing, care networks, integrated health care, palliative care approach, public health, multidisciplinary work, care teams

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Authors: Jasper Kevin C. Dionisio, Denise Mae M. Unsay

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In a manufacturing firm, controlling the process ensures that optimum efficiency, productivity, and quality in an organization are achieved. An operation with no standardized procedure yields a poor productivity, inefficiency, and an out of control process. This study focuses on controlling the small intestine processing of a chicken dressing plant through the use of Statistical Process Control (SPC). Since the operation does not employ a standard procedure and does not have an established standard time, the process through the assessment of the observed time of the overall operation of small intestine processing, through the use of X-Bar R Control Chart, is found to be out of control. In the solution of this problem, the researchers conduct a motion and time study aiming to establish a standard procedure for the operation. The normal operator was picked through the use of Westinghouse Rating System. Instead of utilizing the traditional motion and time study, the researchers used the X-Bar R Control Chart in determining the process average of the process that is used for establishing the standard time. The observed time of the normal operator was noted and plotted to the X-Bar R Control Chart. Out of control points that are due to assignable cause were removed and the process average, or the average time the normal operator conducted the process, which was already in control and free form any outliers, was obtained. The process average was then used in determining the standard time of small intestine processing. As a recommendation, the researchers suggest the implementation of the standard time established which is with consonance to the standard procedure which was adopted from the normal operator. With that recommendation, the whole operation will induce a 45.54 % increase in their productivity.

Keywords: motion and time study, process controlling, statistical process control, X-Bar R Control chart

Procedia PDF Downloads 217

Authors: Shakila N. Senarath, Dinesh Asanka, Janaka Wijayanayake

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The necessity of cosmetic products is arising to fulfill consumer needs of personality appearance and hygiene. A cosmetic product consists of various chemical ingredients which may help to keep the skin healthy or may lead to damages. Every chemical ingredient in a cosmetic product does not perform on every human. The most appropriate way to select a healthy cosmetic product is to identify the texture of the body first and select the most suitable product with safe ingredients. Therefore, the selection process of cosmetic products is complicated. Consumer surveys have shown most of the time, the selection process of cosmetic products is done in an improper way by consumers. From this study, a content-based system is suggested that recommends cosmetic products for the human factors. To such an extent, the skin type, gender and price range will be considered as human factors. The proposed system will be implemented by using Machine Learning. Consumer skin type, gender and price range will be taken as inputs to the system. The skin type of consumer will be derived by using the Baumann Skin Type Questionnaire, which is a value-based approach that includes several numbers of questions to derive the user’s skin type to one of the 16 skin types according to the Bauman Skin Type indicator (BSTI). Two datasets are collected for further research proceedings. The user data set was collected using a questionnaire given to the public. Those are the user dataset and the cosmetic dataset. Product details are included in the cosmetic dataset, which belongs to 5 different kinds of product categories (Moisturizer, Cleanser, Sun protector, Face Mask, Eye Cream). An alternate approach of TF-IDF (Term Frequency – Inverse Document Frequency) is applied to vectorize cosmetic ingredients in the generic cosmetic products dataset and user-preferred dataset. Using the IF-IPF vectors, each user-preferred products dataset and generic cosmetic products dataset can be represented as sparse vectors. The similarity between each user-preferred product and generic cosmetic product will be calculated using the cosine similarity method. For the recommendation process, a similarity matrix can be used. Higher the similarity, higher the match for consumer. Sorting a user column from similarity matrix in a descending order, the recommended products can be retrieved in ascending order. Even though results return a list of similar products, and since the user information has been gathered, such as gender and the price ranges for product purchasing, further optimization can be done by considering and giving weights for those parameters once after a set of recommended products for a user has been retrieved.

Keywords: content-based filtering, cosmetics, machine learning, recommendation system

Procedia PDF Downloads 135

Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

Procedia PDF Downloads 90

Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

Procedia PDF Downloads 103

Authors: Folajinmi Oluwasina, Magbagbeola Dairo, Ikeoluwapo Ajayi

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Contraception has proven to be an effective way of controlling fertility and spacing births. Studies have shown that contraception can avert the high-risk pregnancies and consequently reduce maternal deaths up to 32%. Uptake of modern contraception is promoted as a mechanism to address the reproductive health needs of men and women, as well as the crucial challenge of rapid population increase. A cross- sectional descriptive study using a two- stage systematic sampling technique was used to select 530 women of reproductive age out of 20,000 households. Respondents were interviewed using a semi-structured questionnaire. Knowledge was assessed on a 5 point score in which a score of ≤ 2 rated poor while perception was scored on 36 points score in which a score of ≤ 18 was rated low. Data were analyzed using descriptive statistics, Chi-square test and logistic regression at p< 0.05. There were 530 respondents. Age of respondents was 30.3 ±7.8 years, and 73.0% were married. About 90% had good knowledge of contraception while 60.8% had used contraceptives. The commonest source of information about contraception was mass media (72.8%). Minority (26.1%) obtained husbands approval before using contraceptive while 20.0% had used modern contraceptives before the first birth. Many (54.5%) of the respondents agreed that contraception helps in improving standard of living and 64.7% had good perception about contraception. Factors that hindered effective uptake of contraception services included poor service provider’s attitude (33.3%) and congestion at the service centers (4.5%). Respondents with nonuse of contraceptive before first birth are less likely to subsequently use contraceptives (OR= 0.324, 95% CI= 0.1-0.5). Husband approval of contraceptives use was the major determinant of women’s contraceptive use (OR = 3.4, 95% CI = 1.3-8.7). Respondents who had family planning centers not more than 5 kilometers walking distance to their residence did not significantly use contraception services (41.5%) more than 21.1% of those who had to take means of transportation to the service venues. This study showed that majority of the respondents were knowledgeable and aware of contraception services, but husband’s agreement on the use of modern contraceptives remains poor. Programmes that enhances husbands approval of modern contraception is thus recommended.

Keywords: contraception services, service provider’s attitude, uptake, husbands approval

Procedia PDF Downloads 366

Authors: A. Attahiru, Rabi Abdullahi Danjuma, Fatima Bint

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Language and culture are two concepts which are closely related that one affects the other. This paper attempts to examine the definition of language and culture by discussing the relationship between them. The paper further presents some instructional strategies for the teaching of language and culture as well as the influence of culture on language. It also looks at its implication to language education and finally some recommendation and conclusion were drawn.

Keywords: culture, language, relationship, strategies, teaching

Procedia PDF Downloads 416

Authors: Vishnu Pratap Singh Kirar

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In the cloud computing hierarchy IaaS is the lowest layer, all other layers are built over it. Thus it is the most important layer of cloud and requisite more importance. Along with advantages IaaS faces some serious security related issue. Mainly Security focuses on Integrity, confidentiality and availability. Cloud computing facilitate to share the resources inside as well as outside of the cloud. On the other hand, cloud still not in the state to provide surety to 100% data security. Cloud provider must ensure that end user/client get a Quality of Service. In this report we describe possible aspects of cloud related security.

Keywords: cloud computing, cloud networking, IaaS, PaaS, SaaS, cloud security

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Authors: Mohammad Mohammadi, Mohammad Pashmchi

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Background: Malnutrition commonly develops and worsens following gastric cancer surgery, particularly after discharge, which is associated with adverse outcomes. Former studies have primarily focused on patients during their hospital stay period, and there is limited evidence regarding the recommendation of nutritional interventions for patients after discharge from the hospital following gastric cancer surgery. This review is aimed to evaluate the efficiency of post-discharge dietary counseling with oral nutritional supplements (ONS), and dietary counseling alone on post-surgical nutritional outcomes in patients undergoing gastric cancer surgery. Methods: The four databases of Embase, PubMed, web of science, and google scholar were searched up to November 2022 for relevant randomized controlled trials. The Cochrane Collaboration’s assessment tool for randomized trials was used to evaluate the quality of studies. Results: Compared to patients who only received dietary counseling, patients who received both dietary counseling and ONS had considerably higher SMI, BMI, and less weight loss and sarcopenia occurrence rate. The patients who had received dietary counseling and ONS had significantly lower risk of chemotherapy intolerance. No differences in the readmission rate between the two groups was found. In terms of the quality of life, concomitant dietary advice and ONS significantly was associated with lower appetite loss and fatigue rate, but there was no difference in the other outcomes between the two groups. Conclusions: Post-discharge dietary advice with ONS following gastric cancer surgery may improve skeletal muscle maintenance, nutritional outcomes, quality of life variables, and chemotherapy tolerance. This evidence supports the recommendation of post-discharge dietary advice with ONS for patients who underwent gastric cancer surgery.

Keywords: gastric cancer surgery, oral nutritional supplements, malnutrition, gastric cancer

Procedia PDF Downloads 74

Authors: Hend Albassam, Nouf Alrumaih

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Nowadays we are in the age of technologies and communication and there is no doubt that technologies such as the Internet can offer many advantages for many business fields, and the health field is no execution. In fact, using the Internet provide us with a new path to improve the quality of health care throughout the world. The e-healthcare offers many advantages such as: efficiency by reducing the cost and avoiding duplicate diagnostics, empowerment of patients by enabling them to access their medical records, enhancing the quality of healthcare and enabling information exchange and communication between healthcare organizations. There are many problems that result from using papers as a way of communication, for example, paper-based prescriptions. Usually, the doctor writes a prescription and gives it to the patient who in turn carries it to the pharmacy. After that, the pharmacist takes the prescription to fill it and give it to the patient. Sometimes the pharmacist might find difficulty in reading the doctor’s handwriting; the patient could change and counterfeit the prescription. These existing problems and many others heighten the need to improve the quality of the healthcare. This project is set out to develop a distributed e-healthcare system that offers some features of e-health and addresses some of the above-mentioned problems. The developed system provides an electronic health record (EHR) and enables communication between separate health care organizations such as the clinic, pharmacy and laboratory. To develop this system, the Service Oriented Architecture (SOA) is adopted as a design approach, which helps to design several independent modules that communicate by using web services. The layering design pattern is used in designing each module as it provides reusability that allows the business logic layer to be reused by different higher layers such as the web service or the website in our system. The experimental analysis has shown that the project has successfully achieved its aims toward solving the problems related to the paper-based healthcare systems and it enables different health organization to communicate effectively. It implements four independent modules including healthcare provider, pharmacy, laboratory and medication information provider. Each module provides different functionalities and is used by a different type of user. These modules interoperate with each other using a set of web services.

Keywords: e-health, services oriented architecture (SOA), web services, interoperability

Procedia PDF Downloads 305