Search results for: medical science
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5830

Search results for: medical science

4600 Decision Support System for Hospital Selection in Emergency Medical Services: A Discrete Event Simulation Approach

Authors: D. Tedesco, G. Feletti, P. Trucco

Abstract:

The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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4599 Identification of Body Fluid at the Crime Scene by DNA Methylation Markers for Use in Forensic Science

Authors: Shirin jalili, Hadi Shirzad, Mahasti Modarresi, Samaneh Nabavi, Somayeh Khanjani

Abstract:

Identifying the source tissue of biological material found at crime scenes can be very informative in a number of cases. Despite their usefulness, current visual, catalytic, enzymatic, and immunologic tests for presumptive and confirmatory tissue identification are applicable only to a subset of samples, might suffer limitations such as low specificity, lack of sensitivity, and are substantially impacted by environmental insults. In addition their results are operator-dependent. Recently the possibility of discriminating body fluids using mRNA expression differences in tissues has been described but lack of long term stability of that Molecule and the need to normalize samples for each individual are limiting factors. The use of DNA should solve these issues because of its long term stability and specificity to each body fluid. Cells in the human body have a unique epigenome, which includes differences in DNA methylation in the promoter of genes. DNA methylation, which occurs at the 5′-position of the cytosine in CpG dinucleotides, has great potential for forensic identification of body fluids, because tissue-specific patterns of DNA methylation have been demonstrated, and DNA is less prone to degradation than proteins or RNA. Previous studies have reported several body fluid-specific DNA methylation markers.The presence or absence of a methyl group on the 5’ carbon of the cytosine pyridine ring in CpG dinucleotide regions called ‘CpG islands’ dictates whether the gene is expressed or silenced in the particular body fluid. Were described methylation patterns at tissue specific differentially methylated regions (tDMRs) to be stable and specific, making them excellent markers for tissue identification. The results demonstrate that methylation-based tissue identification is more than a proof-of-concept. The methodology holds promise as another viable forensic DNA analysis tool for characterization of biological materials.

Keywords: DNA methylation, forensic science, epigenome, tDMRs

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4598 Influence of Shading on a BIPV System’s Performance in an Urban Context: Case Study of BIPV Systems of the Science Center of Complexity Building of the National and Autonomous University of Mexico in Mexico City

Authors: Viridiana Edith Ardura Perea, José Luis Bermúdez Alcocer

Abstract:

The purpose of this paper is to establish the influence of shading on a Building Integrated Photovoltaic (BIPV) system´s performance in an urban context. The PV systems of the Science Center of Complexity (Centro de Ciencias de la Complejidad) Building based in the Main Campus of the National and Autonomous University of Mexico (UNAM) in Mexico City was taken as case study.  The PV systems are placed on the rooftop and on the south façade of the building.  The south-façade PV system, operating as sunshades, consists of two strings:  one at the ground floor and the other one at the first floor.  According to the building’s facility manager, the south-façade PV system generates 42% less electricity per kilowatt peak (kWp) installed than the one on the roof.  The methods applied in this study were Solar Radiation Analysis (SRA) simulations performed with the Insight 360 Plug-in from Revit 2018® and an on-site measurement using specialized tools.  The results of the SRA simulations showed that the shading casted by the PV system placed on the first floor on top of the PV system of the ground floor decreases its solar incident radiation over 50%.  The simulation outcome was compared and validated to the measured data obtained from the on-site measurement.  In conclusion, the loss factor achieved from the shading of the PVs is due to the surroundings and the PV system´s own design.  The south-façade BIPV system’s deficient design generates critical losses on its performance and decreases its profitability.

Keywords: building integrated photovoltaics design, energy analysis software, shading losses, solar radiation analysis

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4597 The Usefulness of Medical Scribes in the Emengecy Department

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

Abstract:

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

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4596 A Case Study of a Rehabilitated Child by Joint Efforts of Parents and Community

Authors: Fouzia Arif, Arif S. Mohammad, Hifsa Altaf, Lubna Raees

Abstract:

Introduction: The term "disability", refers to any condition that impedes the completion of daily tasks using traditional methods. In developing countries like Pakistan, disable population is usually excluded from the mainstream. In squatter settlements the situation is more critical. Sultanabad is one of the squatter settlements of Karachi. Purpose of case study is to improve the health of disabled children’s, and create awareness among the parents and community. Through a household visit, Shiraz, a young disabled boy of 15.5 years old was identified. Her mother articulated that her son was living normally and happily with his parents two years back. When he was 13 years old and student of class 8th, both his legs were traumatized in a Railway Train Accident while playing cricket. He got both femoral shaft fractured severely. He was taken to Jinnah Post Graduate Medical Centre (JPMC) where his left leg was amputated at above knee level and right leg was opened & fixed by reduction internally, luckily bone healed moderately with the passage of time. Methods: In Squatter settlements of Karachi Sultanabad, a survey was conducted in two sectors. Disability screening questionnaire was developed, collaboration with community through household visits, outreach sessions 23cases of disabled were identified who were socialized through sports, Musical program and get-together was organized with stockholder for creating awareness among community and parent’s. Collaboration was established with different NGOs, Government, stakeholders and community support for establishment of Physiotherapy Center. During home visit it was identified that Shiraz was on bed since last 1 year, his family could not afforded cost of physiotherapist and medical consultation due to poverty. Parents counseling was done mentioning that Shiraz needed to take treatment. After motivation his parents agreed for treatment. He was consulted by an orthopedic surgeon in AKUH, Who referred to DMC University of Health Science for rehabilitation service. There he was assessed and referred for Community Based Physiotherapy Centre Sultanabad. Physiotherapist visited home along with Coordinator for Special children and assessed him regularly, planned Physiotherapy treatment for abdominal, high muscles strutting exercise foot muscles strengthening exercise, knee mobilization weight bearing from partial to full weight gradually, also strengthen exercise were given for residual limb as the boy was dependent on it. He was also provided by an artificial leg and training was done. Result: Shiraz is now fully mobile, he can walk independently even out of home, functional ability progress improved and dependency factors reduced. It was difficult but not impossible. We all have sympathy but if we have empathy then we can rehabilitate the community in a better way. His parents are very happy and also the community is surprised to see him in such better condition. Conclusion: Combined efforts of physiotherapist, Coordinator of special children, community and parents made a drastic change in Shiraz’s case by continuously motivating him for better outcome. He is going to school regularly without support. Since he belongs to a poor family he faces financial constraints for education and clinical follow ups regularly.

Keywords: femoral shaft fracture, trauma, orthopedic surgeon, physiotherapy treatment

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4595 Medical Student's Responses to Emotional Content in Doctor-Patient Communication: To Explore Differences in Communication Training of Medical Students and Its Impact on Doctor-Patient Communication

Authors: Stephanie Yun Yu Law

Abstract:

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

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

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4594 A Survey and Analysis on Inflammatory Pain Detection and Standard Protocol Selection Using Medical Infrared Thermography from Image Processing View Point

Authors: Mrinal Kanti Bhowmik, Shawli Bardhan Jr., Debotosh Bhattacharjee

Abstract:

Human skin containing temperature value more than absolute zero, discharges infrared radiation related to the frequency of the body temperature. The difference in infrared radiation from the skin surface reflects the abnormality present in human body. Considering the difference, detection and forecasting the temperature variation of the skin surface is the main objective of using Medical Infrared Thermography(MIT) as a diagnostic tool for pain detection. Medical Infrared Thermography(MIT) is a non-invasive imaging technique that records and monitors the temperature flow in the body by receiving the infrared radiated from the skin and represent it through thermogram. The intensity of the thermogram measures the inflammation from the skin surface related to pain in human body. Analysis of thermograms provides automated anomaly detection associated with suspicious pain regions by following several image processing steps. The paper represents a rigorous study based survey related to the processing and analysis of thermograms based on the previous works published in the area of infrared thermal imaging for detecting inflammatory pain diseases like arthritis, spondylosis, shoulder impingement, etc. The study also explores the performance analysis of thermogram processing accompanied by thermogram acquisition protocols, thermography camera specification and the types of pain detected by thermography in summarized tabular format. The tabular format provides a clear structural vision of the past works. The major contribution of the paper introduces a new thermogram acquisition standard associated with inflammatory pain detection in human body to enhance the performance rate. The FLIR T650sc infrared camera with high sensitivity and resolution is adopted to increase the accuracy of thermogram acquisition and analysis. The survey of previous research work highlights that intensity distribution based comparison of comparable and symmetric region of interest and their statistical analysis assigns adequate result in case of identifying and detecting physiological disorder related to inflammatory diseases.

Keywords: acquisition protocol, inflammatory pain detection, medical infrared thermography (MIT), statistical analysis

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4593 Brain Connectome of Glia, Axons, and Neurons: Cognitive Model of Analogy

Authors: Ozgu Hafizoglu

Abstract:

An analogy is an essential tool of human cognition that enables connecting diffuse and diverse systems with physical, behavioral, principal relations that are essential to learning, discovery, and innovation. The Cognitive Model of Analogy (CMA) leads and creates patterns of pathways to transfer information within and between domains in science, just as happens in the brain. The connectome of the brain shows how the brain operates with mental leaps between domains and mental hops within domains and the way how analogical reasoning mechanism operates. This paper demonstrates the CMA as an evolutionary approach to science, technology, and life. The model puts forward the challenges of deep uncertainty about the future, emphasizing the need for flexibility of the system in order to enable reasoning methodology to adapt to changing conditions in the new era, especially post-pandemic. In this paper, we will reveal how to draw an analogy to scientific research to discover new systems that reveal the fractal schema of analogical reasoning within and between the systems like within and between the brain regions. Distinct phases of the problem-solving processes are divided thusly: stimulus, encoding, mapping, inference, and response. Based on the brain research so far, the system is revealed to be relevant to brain activation considering each of these phases with an emphasis on achieving a better visualization of the brain’s mechanism in macro context; brain and spinal cord, and micro context: glia and neurons, relative to matching conditions of analogical reasoning and relational information, encoding, mapping, inference and response processes, and verification of perceptual responses in four-term analogical reasoning. Finally, we will relate all these terminologies with these mental leaps, mental maps, mental hops, and mental loops to make the mental model of CMA clear.

Keywords: analogy, analogical reasoning, brain connectome, cognitive model, neurons and glia, mental leaps, mental hops, mental loops

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4592 Securing Internet of Things Devices in Healthcare industry: An Investigation into Efficient and Effective Authorization Procedures

Authors: Maruf Farhan, Abdul Salih, Sikandar Ali Tahir

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Protecting patient information's confidentiality is paramount considering the widespread use of Internet of Things (IoT) gadgets in medical settings. This study's subjects are decentralized identifiers (DIDs) and verifiable credentials (VCs) in conjunction with an OAuth-based authorization framework, as they are the key to protecting IoT healthcare devices. DIDs enable autonomous authentication and trust formation between IoT devices and other entities. To authorize users and enforce access controls based on verified claims, VCs offer a secure and adaptable solution. Through the proposed method, medical facilities can improve the privacy and security of their IoT devices while streamlining access control administration. A Smart pill dispenser in a hospital setting is used to illustrate the advantages of this method. The findings demonstrate the value of DIDs, VCs, and OAuth-based delegation in protecting the IoT devices. Improved processes for authorizing and controlling access to IoT devices are possible thanks to the research findings, which also help ensure patient confidentiality in the healthcare sector.

Keywords: Iot, DID, authorization, verifiable credentials

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4591 Soil Quality State and Trends in New Zealand’s Largest City after Fifteen Years

Authors: Fiona Curran-Cournane

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Soil quality monitoring is a science-based soil management tool that assesses soil ecosystem health. A soil monitoring program in Auckland, New Zealand’s largest city, extends from 1995 to the present. The objective of this study was to firstly determine changes in soil parameters (basic soil properties and heavy metals) that were assessed from rural land in 1995-2000 and repeated in 2008-2012. The second objective was to determine differences in soil parameters across various land uses including native bush, rural (horticulture, pasture and plantation forestry) and urban land uses using soil data collected in more recent years (2009-2013). Across rural land, mean concentrations of Olsen P had significantly increased in the second sampling period and was identified as the indicator of most concern, followed by soil macroporosity, particularly for horticultural and pastoral land. Mean concentrations of Cd were also greatest for pastoral and horticultural land and a positive correlation existed between these two parameters, which highlights the importance of analysing basic soil parameters in conjunction with heavy metals. In contrast, mean concentrations of As, Cr, Pb, Ni and Zn were greatest for urban sites. Native bush sites had the lowest concentrations of heavy metals and were used to calculate a ‘pollution index’ (PI). The mean PI was classified as high (PI > 3) for Cd and Ni and moderate for Pb, Zn, Cr, Cu, As, and Hg, indicating high levels of heavy metal pollution across both rural and urban soils. From a land use perspective, the mean ‘integrated pollution index’ was highest for urban sites at 2.9 followed by pasture, horticulture and plantation forests at 2.7, 2.6, and 0.9, respectively. It is recommended that soil sampling continues over time because a longer spanning record will allow further identification of where soil problems exist and where resources need to be targeted in the future. Findings from this study will also inform policy and science direction in regional councils.

Keywords: heavy metals, pollution index, rural and urban land use, soil quality

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4590 High Phosphate-Containing Foods and Beverages: Perceptions of the Future Healthcare Providers on Their Harmful Effect in Excessive Consumption

Authors: ATM Emdadul Haque

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Phosphorus is an essential nutrient which is regularly consumed with food and exists in the body as phosphate. Phosphate is an important component of cellular structures and needed for bone mineralization. Excessive accumulation of phosphate is an important driving factor of mortality in chronic renal failure patients; of relevance, these patients are usually provided health care by doctors, nurses, and pharmacists. Hence, this study was planned to determine the level of awareness of the future healthcare providers about the phosphate-containing foods and beverages and to access their knowledge on the harmful effects of excess phosphate consumption. A questionnaire was developed and distributed among the year-1 medical, nursing and pharmacy students. 432 medical, nursing and pharmacy students responded with age ranging from 18-24 years. About 70% of the respondents were female with a majority (90.7%) from Malay ethnicity. Among the respondents, 29.9% were medical, 35.4% were the pharmacy and 34.7% were nursing students. 79.2% students knew that phosphate was an important component of the body, but only 61.8% knew that consuming too much phosphate could be harmful to the body. Despite 97% of the students knew that carbonated soda contained high sugar, surprisingly 77% of them did not know the presence of high phosphate in the same soda drinks; in the similar line of observation, 67% did not know the presence of it in the fast food. However, it was encouraging that 94% of the students wanted to know more about the effects of phosphate consumption, 74.3% were willing to give up drinking soda and eating fast food, and 52% considered taking green coconut water instead of soda drinks. It is, therefore, central to take an educational initiative to increase the awareness of the future healthcare providers about phosphate-containing food and its harmful effects in excessive consumptions.

Keywords: high phosphate containing foods and beverages, excessive consumption, future health care providers, phosphorus

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4589 Test and Evaluation of Patient Tracking Platform in an Earthquake Simulation

Authors: Nahid Tavakoli, Mohammad H. Yarmohammadian, Ali Samimi

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In earthquake situation, medical response communities such as field and referral hospitals are challenged with injured victims’ identification and tracking. In our project, it was developed a patient tracking platform (PTP) where first responders triage the patients with an electronic tag which report the location and some information of each patient during his/her movement. This platform includes: 1) near field communication (NFC) tags (ISO 14443), 2) smart mobile phones (Android-base version 4.2.2), 3) Base station laptops (Windows), 4) server software, 5) Android software to use by first responders, 5) disaster command software, and 6) system architecture. Our model has been completed through literature review, Delphi technique, focus group, design the platform, and implement in an earthquake exercise. This paper presents consideration for content, function, and technologies that must apply for patient tracking in medical emergencies situations. It is demonstrated the robustness of the patient tracking platform (PTP) in tracking 6 patients in a simulated earthquake situation in the yard of the relief and rescue department of Isfahan’s Red Crescent.

Keywords: test and evaluation, patient tracking platform, earthquake, simulation

Procedia PDF Downloads 136
4588 Awareness and Utilization of Social Network Tools among Agricultural Science Students in Colleges of Education in Ogun State, Nigeria

Authors: Adebowale Olukayode Efunnowo

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This study was carried out to assess the awareness and utilization of Social Network Tools (SNTs) among agricultural science students in Colleges of Education in Ogun State, Nigeria. Simple random sampling techniques were used to select 280 respondents from the study area. Descriptive statistics was used to describe the objectives while Pearson Product Moment Correlation was used to test the hypothesis. The result showed that the majority (71.8%) of the respondents were single, with a mean age of 20 years. Almost all (95.7%) the respondents were aware of Facebook and 2go as a Social Network Tools (SNTs) while 85.0% of the respondents were not aware of Blackplanet, LinkedIn, MyHeritage and Bebo. Many (41.1%) of the respondents had views that using SNTs can enhance extensive literature survey, increase internet browsing potential, promote teaching proficiency, and update on outcomes of researches. However, 51.4% of the respondents perceived that SNTs usage as what is meant for the lecturers/adults only while 16.1% considered it as mainly used by internet fraudsters. Findings revealed that about 50.0% of the respondents browsed Facebook and 2go daily while more than 80% of the respondents used Blackplanet, MyHeritage, Skyrock, Bebo, LinkedIn and My YearBook as the need arise. Major constraints to the awareness and utilization of SNTs were high cost and poor quality of ICTs facilities (77.1%), epileptic power supply (75.0%), inadequate telecommunication infrastructure (71.1%), low technical know-how (62.9%) and inadequate computer knowledge (61.1%). The result of PPMC analysis showed that there was an inverse relationship between constraints and utilization of SNTs at p < 0.05. It can be concluded that constraints affect efficient and effective utilization of SNTs in the study area. It is hereby recommended that management of colleges of education and agricultural institutes should provide good internet connectivity, computer facilities, and alternative power supply in order to increase the awareness and utilization of SNTs among students.

Keywords: awareness, utilization, social network tools, constraints, students

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4587 Frailty Patterns in the US and Implications for Long-Term Care

Authors: Joelle Fong

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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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4586 Carl Wernicke and the Origin of Neurolinguistics in Breslau: A Case Study in the Domain of the History of Linguistics

Authors: Aneta Daniel

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The subject of the study is the exploration of the origins and dynamics of the development of language studies, which have been labelled as neurolinguistics. It is worth mentioning that the origins of neurolinguistics are to be found in the research conducted by German scientists before the Second World War in Breslau Universität (presently Wroclaw). The dominant figure in these studies was professor Carl Wernicke, whose students continued and creatively developed projects of their master within this area. Professor Carl Wernicke, a German physician, anatomist, psychiatrist, and neuropathologist, is primarily known for his influential research on aphasia. His research, as well as those conducted by professor Paul Broca, has led to breakthroughs in the location of brain functions, particularly speech. Years later the theses of the pioneers of cognitive neurology (Carl Wernicke and Paul Broca) were developed by other neurolinguists. The main objective of the investigation is the reconstruction of the group of scientists –the students of Carl Wernicke– who contributed to the development of neurolinguistics. The scholars were mainly neurologists and psychiatrists and dealt with the branch of science that had not been named neurolinguistics at that time. The profiles of the scholars will be analysed and presented as the members of the group of researchers who have contributed to the breakthroughs in psychology and neuroscience. The research material consists of archival records documenting the research of professor Carl Wernicke and the researchers from Breslau (presently Wroclaw) which is one of the fastest growing cities in Europe. In 1870, when Carl Wernicke became the medical doctor, Breslau was full of cultural events: festivals and circus shows were held in the city center. Today we can come back to these events due to 'Breslauer Zeitung (1870)', which precisely describes all the events that took place on particular days. It is worth noting that those were the beginnings of antisemitism in Breslau. Many theses and articles that have survived in the libraries in Wroclaw and all over the world contribute to the development of neuroscience. The history of research on the brain and speech analysis, including the history of psychology and neuroscience, areas from which neurolinguistics is derived, will be presented.

Keywords: Aphasia, brain injury, Carl Wernicke, language, neurolinguistics

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4585 Improvements of the Difficulty in Hospital Acceptance at the Scene by the Introduction of Smartphone Application for Emergency-Medical-Service System: A Population-Based Before-And-After Observation Study in Osaka City, Japan

Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Taku Iwami, Takashi Kawamura, Takeshi Shimazu

Abstract:

Background: Recently, the number of ambulance dispatches has been increasing in Japan and it is, therefore, difficult to accept emergency patients to hospitals smoothly and appropriately because of the limited hospital capacity. To facilitate the request for patient transport by ambulances and hospital acceptance, the emergency information system using information technology has been built up and introduced in various communities. However, its effectiveness has not been insufficiently revealed in Japan. In 2013, we developed a smartphone application system that enables the emergency-medical-service (EMS) personnel to share information about on-scene ambulance and hospital situation. The aim of this study was to assess the introduction effect of this application for EMS system in Osaka City, Japan. Methods: This study was a retrospective study with population-based ambulance records of Osaka Municipal Fire Department. This study period was six years from January 1, 2010 to December 31, 2015. In this study, we enrolled emergency patients that on-scene EMS personnel conducted the hospital selection for them. The main endpoint was difficulty in hospital acceptance at the scene. The definition of difficulty in hospital acceptance at the scene was to make >=5 phone calls by EMS personnel at the scene to each hospital until a decision to transport was determined. The definition of the smartphone application group was emergency patients transported in the period of 2013-2015 after the introduction of this application, and we assessed the introduction effect of smartphone application with multivariable logistic regression model. Results: A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 smartphone application group (50.0%) in 2010-2012 and 300,395 non-smartphone application group (50.0%) in 2013-2015. The proportion of the difficulty in hospital acceptance was 14.2% (42,585/300,131) in the smartphone application group and 10.9% (32,819/300,395) in the non-smartphone application group, and the difficulty in hospital acceptance significantly decreased by the introduction of the smartphone application (adjusted odds ration; 0.730, 95% confidence interval; 0.718-0.741, P<0.001). Conclusions: Sharing information between ambulance and hospital by introducing smartphone application at the scene was associated with decreasing the difficulty in hospital acceptance. Our findings may be considerable useful for developing emergency medical information system with using IT in other areas of the world.

Keywords: difficulty in hospital acceptance, emergency medical service, infomation technology, smartphone application

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4584 An Overview of Suicidality in American Indians and Alaska Natives

Authors: Christopher S. Perez, Kendal C. Boyd

Abstract:

global suicide rates have decreased in recent decades, rates in the United States have increased by 35.2 percent since 1999.American Indians and Alaska Natives (AI/AN) have the highest rates of suicide in the U.S., with approximately 22 suicides per 100,000 people as of 2019. AI/AN have experienced significant historical trauma resulting in disproportionate rates of substance abuse and mental disorders. This literature review aimed to identify the demographic and clinical risk and protective factors for American Indians and Alaska Natives and provide an overview of suicidality in this population. The literature reflected varying definitions of suicidality depending on region, with some AI/AN tribesconceptualizing suicide through a spiritual framework, while others defined suicide in the biomedical sense. Furthermore, AI/AN adults and adolescents experienced higher rates of suicidal ideation when compared to other racial groups. Religious preference, sexual orientation, prior suicidal behavior, psychiatric admission, history of abuse, substance abuse, family history of mental illness, family history of substance abuse, family history of suicidal behaviors, domestic violence, and trauma were discussed as factors related to suicidality. Recommendations included increasing access to and utilization of mental health and medical services, culturally adapting suicide prevention programs to AI/AN communities, increasing support for LGBTQ+ AI/AN, providing opportunities that reinforce ethnic identity, and post-hospitalization follow-up care. The following databases were utilized to obtain peer-reviewed articles for this literature review: Complementary Index, Academic Search Premier, Science Direct, PsycInfo, Social Sciences Citation Index, PsycArticles, PubMed, EbscoHost, and PsycBooks. Articles that examined Native populations outside of the United States did not cite a primary source and/or were published before 1990 were excluded.

Keywords: alaska native, american indian, protective factors, risk factors, suicidality, suicide

Procedia PDF Downloads 95
4583 Using Variation Theory in a Design-based Approach to Improve Learning Outcomes of Teachers Use of Video and Live Experiments in Swedish Upper Secondary School

Authors: Andreas Johansson

Abstract:

Conceptual understanding needs to be grounded on observation of physical phenomena, experiences or metaphors. Observation of physical phenomena using demonstration experiments has a long tradition within physics education and students need to develop mental models to relate the observations to concepts from scientific theories. This study investigates how live and video experiments involving an acoustic trap to visualize particle-field interaction, field properties and particle properties can help develop students' mental models and how they can be used differently to realize their potential as teaching tools. Initially, they were treated as analogs and the lesson designs were kept identical. With a design-based approach, the experimental and video designs, as well as best practices for a respective teaching tool, were then developed in iterations. Variation theory was used as a theoretical framework to analyze the planned respective realized pattern of variation and invariance in order to explain learning outcomes as measured by a pre-posttest consisting of conceptual multiple-choice questions inspired by the Force Concept Inventory and the Force and Motion Conceptual Evaluation. Interviews with students and teachers were used to inform the design of experiments and videos in each iteration. The lesson designs and the live and video experiments has been developed to help teachers improve student learning and make school physics more interesting by involving experimental setups that usually are out of reach and to bridge the gap between what happens in classrooms and in science research. As students’ conceptual knowledge also rises their interest in physics the aim is to increase their chances of pursuing careers within science, technology, engineering or mathematics.

Keywords: acoustic trap, design-based research, experiments, variation theory

Procedia PDF Downloads 81
4582 H. P. Grice’s Cooperative Principle in a Reproductive Health Clinic in Kenya

Authors: Melvin Ouma

Abstract:

Language is one of the most crucial tools in medical interaction. Its importance is as great today as it was many decades ago. Difficulty in openly discussing certain diseases and body parts is one of the challenges in language use in medical contexts. Guided by H. P. Grice’s Cooperative Principle, this paper explores the flouting of the cooperative principles in Swahili speaking medical setting. The paper examines how men flout the maxims using the Swahili language when reporting reproductive health problems to the doctor. The data used was gathered from a qualitative study carried out in a reproductive health clinic in a public facility in Nakuru County, Kenya. All the research protocols were observed by acquiring all the research permits. Respondents' ethical considerations of consent, privacy, and confidentiality were observed. The respondents recruited were men who visited the reproductive health clinic and voluntarily agreed to participate in the study without coercion or compensation. Participant observation was the key data collection tool, with the doctor and patient conversation digitally recorded. The researcher was allowed into the clinic in a socially acceptable role. Male patients flouted the maxims of quantity, quality, relation, and manner in order to describe their reproductive health problems without embarrassment using the Swahili language. The flouting was done through the discursive strategies of narration and circumlocution. Flouting of the maxims was acceptable to the doctor and patient due to the fact that sexual intercourse and private body parts are taboo topics and uncomfortable to talk about. The quality of health care received by the patient depended on the doctor’s patience when all the maxims were flouted. In the reproductive health clinic, flouting of maxims hindered communication and, at the same time, enhanced communication between the doctor and patient.

Keywords: cooperative principle, doctor, men, reproductive health

Procedia PDF Downloads 97
4581 The Use of Respiratory Index of Severity in Children (RISC) for Predicting Clinical Outcomes for 3 Months-59 Months Old Patients Hospitalized with Community-Acquired Pneumonia in Visayas Community Medical Center, Cebu City from January 2013 - June 2

Authors: Karl Owen L. Suan, Juliet Marie S. Lambayan, Floramay P. Salo-Curato

Abstract:

Objective: To predict the outcome among patients admitted with community-acquired pneumonia (ages 3 months to 59 months old) admitted in Visayas Community Medical Center using the Respiratory Index of Severity in Children (RISC). Design: A cross-sectional study design was used. Setting: The study was done in Visayas Community Medical Center, which is a private tertiary level in Cebu City from January-June 2013. Patients/Participants: A total of 72 patients were initially enrolled in the study. However, 1 patient transferred to another institution, thus 71 patients were included in this study. Within 24 hours from admission, patients were assigned a RISC score. Statistical Analysis: Cohen’s kappa coefficient was used for inter-rater agreement for categorical data. This study used frequency and percentage distribution for qualitative data. Mean, standard deviation and range were used for quantitative data. To determine the relationship of each RISC score parameter and the total RISC score with the outcome, a Mann Whitney U Test and 2x2 Fischer Exact test for testing associations were used. A p value less of than 0.05 alpha was considered significant. Results: There was a statistical significance between RISC score and clinical outcome. RISC score of greater than 4 was correlated with intubation and/or mortality. Conclusion: The RISC scoring system is a simple combination of clinical parameters and a reliable tool that will help stratify patients aged 3 months to 59 months in predicting clinical outcome.

Keywords: RISC, clinical outcome, community-acquired pneumonia, patients

Procedia PDF Downloads 296
4580 Is There Relationship between Cyberchondria and Emotional Intelligence among Omani University Students? A Descriptive Correlational Study

Authors: Mohammed Qutishat, Khaldoun Aldiabat, Khaled Bader, Mohammad Al Qadire

Abstract:

Cyberchondria refers to the irrational increase of distress about the condition of one's health as a consequence of the World Wide Web quest for medical details. The aim of this study was to examine the relationship between emotional intelligence and cyberchondria among Omani university students. A descriptive correlational design was used to collect data from eligible 370 participants using the Emotional Intelligence Questionnaire, and the short-form version of the Cyberchondria Severity Scale (CSS-12) between January and May 2020 at XX University-Oman. The participants’ age ranged between 18 and 37 years (M = 20.28). The majority of the participants were female, 59.7% (n = 221), single 99.5% (368), in their second academic year, 29.2% (n =108). The mean score of cyberchondria experiences was 32.51, and the mean score of emotional intelligence was 34.91. Linear regression indicated a strong association between cyberchondria and emotional intelligence [F (34.639) = 5.885, P=.000], with a .086 R². In conclusion, the exchange of expertise and peer networking for health-related details utilizing the Internet can benefit students with and without having health problems. Further research and methods should be developed to help students track the online medical tools effectively for the right purposes.

Keywords: emotional intelligence, cyberchondria, smartphone addiction, social media

Procedia PDF Downloads 243
4579 Organ Donation after Medical Aid in Dying: A Critical Study of Clinical Processes and Legal Rules in Place

Authors: Louise Bernier

Abstract:

Under some jurisdictions (including Canada), eligible patients can request and receive medical assistance in dying (MAiD) through lethal injections, inducing their cardiocirculatory death. Those same patients can also wish to donate their organs in the process. If they qualify as organ donors, a clinical and ethical rule called the 'dead donor rule' (DDR) requires the transplant teams to wait after cardiocirculatory death is confirmed, followed by a 'no touch' period (5 minutes in Canada) before they can proceed with organ removal. The medical procedures (lethal injections) as well as the delays associated with the DDR can damage organs (mostly thoracic organs) due to prolonged anoxia. Yet, strong scientific evidences demonstrate that operating differently and reconsidering the DDR would result in more organs of better quality available for transplant. This idea generates discomfort and resistance, but it is also worth considering, especially in a context of chronic shortage of available organs. One option that could be examined for MAiD’ patients who wish and can be organ donors would be to remove vital organs while patients are still alive (and under sedation). This would imply accepting that patient’s death would occur through organ donation instead of lethal injections required under MAiD’ legal rules. It would also mean that patients requesting MAiD and wishing to be organ donors could aspire to donate better quality organs, including their heart, an altruistic gesture that carries important symbolic value for many donors and their families. Following a patient centered approach, our hypothesis is that preventing vital organ donation from a living donor in all circumstance is neither perfectly coherent with how legal mentalities have evolved lately in the field of fundamental rights nor compatible with the clinical and ethical frameworks that shape the landscape in which those complex medical decisions unfold. Through a study of the legal, ethical, and clinical rules in place, both at the national and international levels, this analysis raises questions on the numerous inconsistencies associated with respecting the DDR with patients who have chosen to die through MAiD. We will begin with an assessment of the erosion of certain national legal frameworks that pertain to the sacred nature of the right to life which now also includes the right to choose how one wishes to die. We will then study recent innovative clinical protocols tested in different countries to help address acute organ shortage problems in creative ways. We will conclude this analysis with an ethical assessment of the situation, referring to principles such as justice, autonomy, altruism, beneficence, and non-malfeasance. This study will build a strong argument in favor of starting to allow vital organ donations from living donors in countries where MAiD is already permitted.

Keywords: altruism, autonomy, dead donor rule, medical assistance in dying, non-malfeasance, organ donation

Procedia PDF Downloads 173
4578 Argumentation Frameworks and Theories of Judging

Authors: Sonia Anand Knowlton

Abstract:

With the rise of artificial intelligence, computer science is becoming increasingly integrated in virtually every area of life. Of course, the law is no exception. Through argumentation frameworks (AFs), computer scientists have used abstract algebra to structure the legal reasoning process in a way that allows conclusions to be drawn from a formalized system of arguments. In AFs, arguments compete against each other for logical success and are related to one another through the binary operation of the attack. The prevailing arguments make up the preferred extension of the given argumentation framework, telling us what set of arguments must be accepted from a logical standpoint. There have been several developments of AFs since its original conception in the early 90’s in efforts to make them more aligned with the human reasoning process. Generally, these developments have sought to add nuance to the factors that influence the logical success of competing arguments (e.g., giving an argument more logical strength based on the underlying value it promotes). The most cogent development was that of the Extended Argumentation Framework (EAF), in which attacks can themselves be attacked by other arguments, and the promotion of different competing values can be formalized within the system. This article applies the logical structure of EAFs to current theoretical understandings of judicial reasoning to contribute to theories of judging and to the evolution of AFs simultaneously. The argument is that the main limitation of EAFs, when applied to judicial reasoning, is that they require judges to themselves assign values to different arguments and then lexically order these values to determine the given framework’s preferred extension. Drawing on John Rawls’ Theory of Justice, the examination that follows is whether values are lexical and commensurable to this extent. The analysis that follows then suggests a potential extension of the EAF system with an approach that formalizes different “planes of attack” for competing arguments that promote lexically ordered values. This article concludes with a summary of how these insights contribute to theories of judging and of legal reasoning more broadly, specifically in indeterminate cases where judges must turn to value-based approaches.

Keywords: computer science, mathematics, law, legal theory, judging

Procedia PDF Downloads 58
4577 Constructing Evaluation Indicators for the Supply of Urban-Friendly Shelters from the Perspective of the Needs of the Elderly People in Taiwan

Authors: Chuan-Ming Tung, Tzu-Chiao Yuan

Abstract:

This research aims to construct the supply indicators and weights of shelter space from a perspective of the needs of the elderly by virtue of literature review, a systematical compilation of related regulations, and the use of the Analytical Hierarchy Process method, the questionnaires regarding the indicators filled out by 16 experts and scholars. The researcher then used 3 schools and 2 activity centers in Banqiao District, New Taipei City, as study cases to evaluate the ‘friendliness’ degree/level for the supply of shelters meeting the needs of elderly people. The supply evaluation indicators of friendly shelters meeting the needs of the elderly include "Administrative Operations and Service Needs" and "Residence-related and Living Needs"; under the "Administrative Operations and Service Needs" are "Management Operations and Information Provision", "Shelter Space Preparedness and Logistics Support", "Medical Care and Social Support", and "Shelters and Medical Environment", a total of 17 assessment items in four indicators, while under the "Residence-related and Living Needs" are "Dietary Needs", "Sleep Needs", "Hygiene and Sanitation Needs", "Accessibility and Convenience Needs ", etc., a total of 18 assessment items in four indicators. The results show that "Residence-related and Living Needs" is the most important item in the main levels of the supply indicators of the needs for friendly shelters to elderly people (weigh value 0.5504), followed by "Administrative Operations and Service Needs" (0.4496). The order of importance of the supply indicators of friendly shelters for the needs of elderly people is as follows: "Hygiene and Sanitation Needs" (0.1721), "Dietary Needs" (0.1340), "Medical Care and Social Support" (0.1300), "Sleep Needs" (0.1277), "Accessibility and Convenience Needs" (0.1166), "Basic Environment of Shelters" (0.1145), "Shelter Space Preparedness and Logistics Support" (0.1115) and "Management Operations and Information Provision" (0.0936). In addition, it can be noticed from the results of the case evaluation that the provision of refuges and shelters, mainly from schools and activity centers, is extremely inadequate for the needs of the elderly. In a set of comprehensive comparisons and contrasts, the evaluation indicators of refuges and shelters that need to be improved are "Medical Care and Social Support", "Hygiene and Sanitation Needs", "Sleep Needs", "Dietary Needs", and "Shelter Space Preparedness and Logistics Support".

Keywords: needs of the elderly people, urban shelters, evaluation indicators/indices., taiwan

Procedia PDF Downloads 75
4576 Clustering Based Level Set Evaluation for Low Contrast Images

Authors: Bikshalu Kalagadda, Srikanth Rangu

Abstract:

The important object of images segmentation is to extract objects with respect to some input features. One of the important methods for image segmentation is Level set method. Generally medical images and synthetic images with low contrast of pixel profile, for such images difficult to locate interested features in images. In conventional level set function, develops irregularity during its process of evaluation of contour of objects, this destroy the stability of evolution process. For this problem a remedy is proposed, a new hybrid algorithm is Clustering Level Set Evolution. Kernel fuzzy particles swarm optimization clustering with the Distance Regularized Level Set (DRLS) and Selective Binary, and Gaussian Filtering Regularized Level Set (SBGFRLS) methods are used. The ability of identifying different regions becomes easy with improved speed. Efficiency of the modified method can be evaluated by comparing with the previous method for similar specifications. Comparison can be carried out by considering medical and synthetic images.

Keywords: segmentation, clustering, level set function, re-initialization, Kernel fuzzy, swarm optimization

Procedia PDF Downloads 347
4575 Disaster Victim Identification: A Social Science Perspective

Authors: Victor Toom

Abstract:

Albeit it is never possible to anticipate the full range of difficulties after a catastrophe, efforts to identify victims of mass casualty events have become institutionalized and standardized with the aim of effectively and efficiently addressing the many challenges and contingencies. Such ‘disaster victim identification’ (DVI) practices are dependent on the forensic sciences, are subject of national legislation, and are reliant on technical and organizational protocols to mitigate the many complexities in the wake of catastrophe. Apart from such technological, legal and bureaucratic elements constituting a DVI operation, victims’ families and their emotions are also part and parcel of any effort to identify casualties of mass human fatality incidents. Take for example the fact that forensic experts require (antemortem) information from the group of relatives to make identification possible. An identified body or body part is also repatriated to kin. Relatives are thus main stakeholders in DVI operations. Much has been achieved in years past regarding facilitating victims’ families’ issues and their emotions. Yet, how families are dealt with by experts and authorities is still considered a difficult topic. Due to sensitivities and required emphatic interaction with families on the one hand, and the rationalized DVI efforts, on the other hand, there is still scope for improving communication, providing information and meaningful inclusion of relatives in the DVI effort. This paper aims to bridge the standardized world of DVI efforts and families’ experienced realities and makes suggestions to further improve DVI efforts through inclusion of victims’ families. Based on qualitative interviews, the paper narrates involvement and experiences of inter alia DVI practitioners, victims’ families, advocates and clergy in the wake of the 1995 Srebrenica genocide which killed approximately 8,000 men, and the 9/11 in New York City with 2,750 victims. The paper shows that there are several models of including victims’ families into a DVI operation, and it argues for a model of where victims’ families become a partner in DVI operations.

Keywords: disaster victim identification (DVI), victims’ families, social science (qualitative), 9/11 attacks, Srebrenica genocide

Procedia PDF Downloads 230
4574 Getting to Know ICU Nurses and Their Duties

Authors: Masih Nikgou

Abstract:

ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

Procedia PDF Downloads 71
4573 Method for Improving Antidepressants Adherence in Patients with Depressive Disorder: Systemic Review and Meta-Analysis

Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

Abstract:

Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

Procedia PDF Downloads 132
4572 Subjective versus Objective Assessment for Magnetic Resonance (MR) Images

Authors: Heshalini Rajagopal, Li Sze Chow, Raveendran Paramesran

Abstract:

Magnetic Resonance Imaging (MRI) is one of the most important medical imaging modality. Subjective assessment of the image quality is regarded as the gold standard to evaluate MR images. In this study, a database of 210 MR images which contains ten reference images and 200 distorted images is presented. The reference images were distorted with four types of distortions: Rician Noise, Gaussian White Noise, Gaussian Blur and DCT compression. The 210 images were assessed by ten subjects. The subjective scores were presented in Difference Mean Opinion Score (DMOS). The DMOS values were compared with four FR-IQA metrics. We have used Pearson Linear Coefficient (PLCC) and Spearman Rank Order Correlation Coefficient (SROCC) to validate the DMOS values. The high correlation values of PLCC and SROCC shows that the DMOS values are close to the objective FR-IQA metrics.

Keywords: medical resonance (MR) images, difference mean opinion score (DMOS), full reference image quality assessment (FR-IQA)

Procedia PDF Downloads 455
4571 Wearable Heart Rate Sensor Based on Wireless System for Heart Health Monitoring

Authors: Murtadha Kareem, Oliver Faust

Abstract:

Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

Procedia PDF Downloads 160