Search results for: health-care centers
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2539

Search results for: health-care centers

919 Cultural Practices as a Coping Measure for Women who Terminated a Pregnancy in Adolescence: A Qualitative Study

Authors: Botshelo Rachel Sebola

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Unintended pregnancy often results in pregnancy termination. Most countries have legalised the termination of a pregnancy, and pregnant adolescents can visit designated clinics without their parents’ consent. In most African and Asian countries, certain cultural practices are performed following any form of childbirth, including abortion, and such practices are ingrained in societies. The aim of this paper was to understand how women who terminated a pregnancy during adolescence coped by embracing cultural practices. A descriptive multiple case study design was adopted for the study. In-depth, semi-structured interviews and reflective diaries were used for data collection. 13 women aged 20 to 35 years who had terminated a pregnancy in adolescence participated in the study. Three women kept their soiled sanitary pads, burned them to ash and waited for the rainy season to scatter the ash in a flowing stream. This ritual was performed to appease the ancestors, ask them for forgiveness and as a send-off for the aborted foetus. Five women secretly consulted Sangoma (traditional healers) to perform certain rituals. Three women isolated themselves to perform herbal cleansings, and the last two chose not to engage in any sexual activity for one year, which led to the loss of their partners. This study offers a unique contribution to understanding the solitary journey of women who terminate a pregnancy. The study challenges healthcare professionals who work in clinics that offer pregnancy termination services to look beyond releasing the foetus to advocating and providing women with the necessary care and support in performing cultural practices.

Keywords: adolescence, culture, case study, pregnancy

Procedia PDF Downloads 83
918 Information Management Approach in the Prediction of Acute Appendicitis

Authors: Ahmad Shahin, Walid Moudani, Ali Bekraki

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This research aims at presenting a predictive data mining model to handle an accurate diagnosis of acute appendicitis with patients for the purpose of maximizing the health service quality, minimizing morbidity/mortality, and reducing cost. However, acute appendicitis is the most common disease which requires timely accurate diagnosis and needs surgical intervention. Although the treatment of acute appendicitis is simple and straightforward, its diagnosis is still difficult because no single sign, symptom, laboratory or image examination accurately confirms the diagnosis of acute appendicitis in all cases. This contributes in increasing morbidity and negative appendectomy. In this study, the authors propose to generate an accurate model in prediction of patients with acute appendicitis which is based, firstly, on the segmentation technique associated to ABC algorithm to segment the patients; secondly, on applying fuzzy logic to process the massive volume of heterogeneous and noisy data (age, sex, fever, white blood cell, neutrophilia, CRP, urine, ultrasound, CT, appendectomy, etc.) in order to express knowledge and analyze the relationships among data in a comprehensive manner; and thirdly, on applying dynamic programming technique to reduce the number of data attributes. The proposed model is evaluated based on a set of benchmark techniques and even on a set of benchmark classification problems of osteoporosis, diabetes and heart obtained from the UCI data and other data sources.

Keywords: healthcare management, acute appendicitis, data mining, classification, decision tree

Procedia PDF Downloads 349
917 Autism Disease Detection Using Transfer Learning Techniques: Performance Comparison between Central Processing Unit vs. Graphics Processing Unit Functions for Neural Networks

Authors: Mst Shapna Akter, Hossain Shahriar

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Neural network approaches are machine learning methods used in many domains, such as healthcare and cyber security. Neural networks are mostly known for dealing with image datasets. While training with the images, several fundamental mathematical operations are carried out in the Neural Network. The operation includes a number of algebraic and mathematical functions, including derivative, convolution, and matrix inversion and transposition. Such operations require higher processing power than is typically needed for computer usage. Central Processing Unit (CPU) is not appropriate for a large image size of the dataset as it is built with serial processing. While Graphics Processing Unit (GPU) has parallel processing capabilities and, therefore, has higher speed. This paper uses advanced Neural Network techniques such as VGG16, Resnet50, Densenet, Inceptionv3, Xception, Mobilenet, XGBOOST-VGG16, and our proposed models to compare CPU and GPU resources. A system for classifying autism disease using face images of an autistic and non-autistic child was used to compare performance during testing. We used evaluation matrices such as Accuracy, F1 score, Precision, Recall, and Execution time. It has been observed that GPU runs faster than the CPU in all tests performed. Moreover, the performance of the Neural Network models in terms of accuracy increases on GPU compared to CPU.

Keywords: autism disease, neural network, CPU, GPU, transfer learning

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916 Data-Driven Performance Evaluation of Surgical Doctors Based on Fuzzy Analytic Hierarchy Processes

Authors: Yuguang Gao, Qiang Yang, Yanpeng Zhang, Mingtao Deng

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To enhance the safety, quality and efficiency of healthcare services provided by surgical doctors, we propose a comprehensive approach to the performance evaluation of individual doctors by incorporating insights from performance data as well as views of different stakeholders in the hospital. Exploratory factor analysis was first performed on collective multidimensional performance data of surgical doctors, where key factors were extracted that encompass assessment of professional experience and service performance. A two-level indicator system was then constructed, for which we developed a weighted interval-valued spherical fuzzy analytic hierarchy process to analyze the relative importance of the indicators while handling subjectivity and disparity in the decision-making of multiple parties involved. Our analytical results reveal that, for the key factors identified as instrumental for evaluating surgical doctors’ performance, the overall importance of clinical workload and complexity of service are valued more than capacity of service and professional experience, while the efficiency of resource consumption ranks comparatively the lowest in importance. We also provide a retrospective case study to illustrate the effectiveness and robustness of our quantitative evaluation model by assigning meaningful performance ratings to individual doctors based on the weights developed through our approach.

Keywords: analytic hierarchy processes, factor analysis, fuzzy logic, performance evaluation

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915 On Cloud Computing: A Review of the Features

Authors: Assem Abdel Hamed Mousa

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The Internet of Things probably already influences your life. And if it doesn’t, it soon will, say computer scientists; Ubiquitous computing names the third wave in computing, just now beginning. First were mainframes, each shared by lots of people. Now we are in the personal computing era, person and machine staring uneasily at each other across the desktop. Next comes ubiquitous computing, or the age of calm technology, when technology recedes into the background of our lives. Alan Kay of Apple calls this "Third Paradigm" computing. Ubiquitous computing is essentially the term for human interaction with computers in virtually everything. Ubiquitous computing is roughly the opposite of virtual reality. Where virtual reality puts people inside a computer-generated world, ubiquitous computing forces the computer to live out here in the world with people. Virtual reality is primarily a horse power problem; ubiquitous computing is a very difficult integration of human factors, computer science, engineering, and social sciences. The approach: Activate the world. Provide hundreds of wireless computing devices per person per office, of all scales (from 1" displays to wall sized). This has required new work in operating systems, user interfaces, networks, wireless, displays, and many other areas. We call our work "ubiquitous computing". This is different from PDA's, dynabooks, or information at your fingertips. It is invisible; everywhere computing that does not live on a personal device of any sort, but is in the woodwork everywhere. The initial incarnation of ubiquitous computing was in the form of "tabs", "pads", and "boards" built at Xerox PARC, 1988-1994. Several papers describe this work, and there are web pages for the Tabs and for the Boards (which are a commercial product now): Ubiquitous computing will drastically reduce the cost of digital devices and tasks for the average consumer. With labor intensive components such as processors and hard drives stored in the remote data centers powering the cloud , and with pooled resources giving individual consumers the benefits of economies of scale, monthly fees similar to a cable bill for services that feed into a consumer’s phone.

Keywords: internet, cloud computing, ubiquitous computing, big data

Procedia PDF Downloads 380
914 Influential Health Care System Rankings Can Conceal Maximal Inequities: A Simulation Study

Authors: Samuel Reisman

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Background: Comparative rankings are increasingly used to evaluate health care systems. These rankings combine discrete attribute rankings into a composite overall ranking. Health care equity is a component of overall rankings, but excelling in other categories can counterbalance low inequity grades. Highly ranked inequitable health care would commend systems that disregard human rights. We simulated the ranking of a maximally inequitable health care system using a published, influential ranking methodology. Methods: We used The Commonwealth Fund’s ranking of eleven health care systems to simulate the rank of a maximally inequitable system. Eighty performance indicators were simulated, assuming maximal ineptitude in equity benchmarks. Maximal rankings in all non-equity subcategories were assumed. Subsequent stepwise simulations lowered all non-equity rank positions by one. Results: The maximally non-equitable health care system ranked first overall. Three subsequent stepwise simulations, lowering non-equity rankings by one, each resulted in an overall ranking within the top three. Discussion: Our results demonstrate that grossly inequitable health care systems can rank highly in comparative health care system rankings. These findings challenge the validity of ranking methodologies that subsume equity under broader benchmarks. We advocate limiting maximum overall rankings of health care systems to their individual equity rankings. Such limits are logical given the insignificance of health care system improvements to those lacking adequate health care.

Keywords: global health, health equity, healthcare systems, international health

Procedia PDF Downloads 399
913 Design of a Computer Vision Based Exercise Video Game for Senior Citizens

Authors: June Tay, Ivy Chia

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There are numerous changes, both mental and physical, taking place when people age. We need to understand the different aspects required for healthy living, including meeting nutritional needs, regular physical activities to keep agility, sufficient rest and sleep to have physical and mental well-being, social engagement to avoid the risk of social isolation and depression, and access to healthcare to detect and manage chronic conditions. Promoting physical activities for an ageing population is necessary as many may have enjoyed sedentary lifestyles for some time. In our study, we evaluate the considerations when designing a computer vision video game for the elderly. We need to design some low-impact activities, such as stretching and gentle movements, because some elderly individuals may have joint pains or mobility issues. The exercise game should consist of simple movements that are easy to follow and remember. It should be fun and enjoyable so that they can be motivated to do some exercise. Social engagement can keep the elderly motivated and competitive, and they are more willing to engage in game exercises. Elderly citizens can compare their game scores and try to improve them. We propose a computer vision-based video game for the elderly that will capture and track the movement of the elderly hand pushing a ball on the screen into a circle. It can be easily set up using a PC laptop with a webcam. Our video game adhered to the design framework we employed, and it encompassed ease of use, a simple graphical interface, easy-to-play game exercise, and fun gameplay.

Keywords: about computer vision, video games, gerontology technology, caregiving

Procedia PDF Downloads 80
912 Thai Student Ability on Speexx Language Training Program

Authors: Toby Gibbs, Glen Craigie, Suwaree Yordchim

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Using the Speexx Online Language Training Program with Thai students has allowed us to evaluate their learning comprehension and track their progression through the English language program. Speexx sets the standard for excellence and innovation in web-based language training and online coaching services. The program is designed to improve the business communication skills of language learners for Thai students. Speexx consists of English lessons, exercises, tests, web boards, and supplementary lessons to help students practice English. The sample groups are 191 Thai sophomores studying Business English with the department of Humanities and Social Science. The data was received by standard deviation (S.D.) value from questionnaires and samples provided from the Speexx training program. The results found that most Thai sophomores fail the Speexx training program due to their learning comprehension of the English language is below average. With persisted efforts on new training methods, the success of the Speexx Language Training Program can break through the cultural barriers and help future students adopt English as a second language. The Speexx results revealed four main factors affecting the success as follows: 1) Future English training should be pursued in applied Speexx development. 2) Thai students didn’t see the benefit of having an Online Language Training Program. 3) There is a great need to educate the next generation of learners on the benefits of Speexx within the community. 4) A great majority of Thai Sophomores didn't know what Speexx was. A guideline for self-reliance planning consisted of four aspects: 1) Development planning: by arranging groups to further improve English abilities with the Speexx Language Training program and encourage using Speexx every day. Local communities need to develop awareness of the usefulness of Speexx and share the value of using the program among family and friends. 2) Humanities and Social Science staff should develop skills using this Online Language Training Program to expand on the benefits of Speexx within their departments. 3) Further research should be pursued on the Thai Students progression with Speexx and how it helps them improve their language skills with Business English. 4) University’s and Language centers should focus on using Speexx to encourage learning for any language, not just English.

Keywords: ability, comprehension, sophomore, speexx

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911 Realization and Characterizations of Conducting Ceramics Based on ZnO Doped by TiO₂, Al₂O₃ and MgO

Authors: Qianying Sun, Abdelhadi Kassiba, Guorong Li

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ZnO with wurtzite structure is a well-known semiconducting oxide (SCO), being applied in thermoelectric devices, varistors, gas sensors, transparent electrodes, solar cells, liquid crystal displays, piezoelectric and electro-optical devices. Intrinsically, ZnO is weakly n-type SCO due to native defects (Znⱼ, Vₒ). However, the substitutional doping by metallic elements as (Al, Ti) gives rise to a high n-type conductivity ensured by donor centers. Under CO+N₂ sintering atmosphere, Schottky barriers of ZnO ceramics will be suppressed by lowering the concentration of acceptors at grain boundaries and then inducing a large increase in the Hall mobility, thereby increasing the conductivity. The presented work concerns ZnO based ceramics, which are fabricated with doping by TiO₂ (0.50mol%), Al₂O₃ (0.25mol%) and MgO (1.00mol%) and sintering in different atmospheres (Air (A), N₂ (N), CO+N₂(C)). We obtained uniform, dense ceramics with ZnO as the main phase and Zn₂TiO₄ spinel as a secondary and minor phase. An important increase of the conductivity was shown for the samples A, N, and C which were sintered under different atmospheres. The highest conductivity (σ = 1.52×10⁵ S·m⁻¹) was obtained under the reducing atmosphere (CO). The role of doping was investigated with the aim to identify the local environment and valence states of the doping elements. Thus, Electron paramagnetic spectroscopy (EPR) determines the concentration of defects and the effects of charge carriers in ZnO ceramics as a function of the sintering atmospheres. The relation between conductivity and defects concentration shows the opposite behavior between these parameters suggesting that defects act as traps for charge carriers. For Al ions, nuclear magnetic resonance (NMR) technique was used to identify the involved local coordination of these ions. Beyond the six and forth coordinated Al, an additional NMR signature of ZnO based TCO requires analysis taking into account the grain boundaries and the conductivity through the Knight shift effects. From the thermal evolution of the conductivity as a function of the sintering atmosphere, we succeed in defining the conditions to realize ZnO based TCO ceramics with an important thermal coefficient of resistance (TCR) which is promising for electrical safety of devices.

Keywords: ceramics, conductivity, defects, TCO, ZnO

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910 The Ecosystem of Food Allergy Clinical Trials: A Systematic Review

Authors: Eimar Yadir Quintero Tapias

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Background: Science is not generally self-correcting; many clinical studies end with the same conclusion "more research is needed." This study hypothesizes that first, we need a better appraisal of the available (and unavailable) evidence instead of creating more of the same false inquiries. Methods: Systematic review of ClinicalTrials.gov study records using the following Boolean operators: (food OR nut OR milk OR egg OR shellfish OR wheat OR peanuts) AND (allergy OR allergies OR hypersensitivity OR hypersensitivities). Variables included the status of the study (e g., active and completed), availability of results, sponsor type, sample size, among others. To determine the rates of non-publication in journals indexed by PubMed, an advanced search query using the specific Number of Clinical Trials (e.g., NCT000001 OR NCT000002 OR...) was performed. As a prophylactic measure to prevent P-hacking, data analyses only included descriptive statistics and not inferential approaches. Results: A total of 2092 study records matched the search query described above (date: September 13, 2019). Most studies were interventional (n = 1770; 84.6%) and the remainder observational (n = 322; 15.4%). Universities, hospitals, and research centers sponsored over half of these investigations (n = 1208; 57.7%), 308 studies (14.7%) were industry-funded, and 147 received NIH grants; the remaining studies got mixed sponsorship. Regarding completed studies (n = 1156; 55.2%), 248 (21.5%) have results available at the registry site, and 417 (36.1%) matched NCT numbers of journal papers indexed by PubMed. Conclusions: The internal and external validity of human research is critical for the appraisal of medical evidence. It is imperative to analyze the entire dataset of clinical studies, preferably at a patient-level anonymized raw data, before rushing to conclusions with insufficient and inadequate information. Publication bias and non-registration of clinical trials limit the evaluation of the evidence concerning therapeutic interventions for food allergy, such as oral and sublingual immunotherapy, as well as any other medical condition. Over half of the food allergy human research remains unpublished.

Keywords: allergy, clinical trials, immunology, systematic reviews

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909 Evaluation of the Safety and Performance of Blood Culture Practices Using BD Safety-Lokᵀᴹ Blood Collection Sets in the Emergency Room

Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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908 Thermal Stability and Electrical Conductivity of Ca₅Mg₄₋ₓMₓ(VO₄)₆ (0 ≤ x ≤ 4) where M = Zn, Ni Measured by Impedance Spectroscopy

Authors: Anna S. Tolkacheva, Sergey N. Shkerin, Kirill G. Zemlyanoi, Olga G. Reznitskikh, Pavel D. Khavlyuk

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Calcium oxovanadates with garnet related structure are multifunctional oxides in various fields like photoluminescence, microwave dielectrics, and magneto-dielectrics. For example, vanadate garnets are self-luminescent compounds. They attract attention as RE-free broadband excitation and emission phosphors and are candidate materials for UV-based white light-emitting diodes (WLEDs). Ca₅M₄(VO₄)₆ (M = Mg, Zn, Co, Ni, Mn) compounds are also considered promising for application in microwave devices as substrate materials. However, the relation between their structure, composition and physical/chemical properties remains unclear. Given the above-listed observations, goals of this study are to synthesise Ca₅M₄(VO₄)₆ (M = Mg, Zn, Ni) and to study their thermal and electrical properties. Solid solutions Ca₅Mg₄₋ₓMₓ(VO₄)₆ (0 ≤ x ≤ 4) where M is Zn and Ni have been synthesized by sol-gel method. The single-phase character of the final products was checked by powder X-ray diffraction on a Rigaku D/MAX-2200 X-ray diffractometer using Cu Kα radiation in the 2θ range from 15° to 70°. The dependence of thermal properties on chemical composition of solid solutions was studied using simultaneous thermal analyses (DSC and TG). Thermal analyses were conducted in a Netzch simultaneous analyser STA 449C Jupiter, in Ar atmosphere, in temperature range from 25 to 1100°C heat rate was 10 K·min⁻¹. Coefficients of thermal expansion (CTE) were obtained by dilatometry measurements in air up to 800°C using a Netzsch 402PC dilatometer; heat rate was 1 K·min⁻¹. Impedance spectra were obtained via the two-probe technique with an impedance meter Parstat 2273 in air up to 700°C with the variation of pH₂O from 0.04 to 3.35 kPa. Cation deficiency in Ca and Mg sublattice under the substitution of MgO with ZnO up to 1/6 was observed using Rietveld refinement of the crystal structure. Melting point was found to decrease with x changing from 0 to 4 in Ca₅Mg₄₋ₓMₓ(VO₄)₆ where M is Zn and Ni. It was observed that electrical conductivity does not depend on air humidity. The reported study was funded by the RFBR Grant No. 17–03–01280. Sample attestation was carried out in the Shared Access Centers at the IHTE UB RAS.

Keywords: garnet structure, electrical conductivity, thermal expansion, thermal properties

Procedia PDF Downloads 154
907 Effect of Psychological Stress to the Mucosal IL-6 and Helicobacter pylori Activity in Functional Dyspepsia and Myocytes

Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin

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Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.

Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress

Procedia PDF Downloads 280
906 An Assessment of Sexual Informational Needs of Breast Cancer Patients in Radiation Oncology

Authors: Li Hoon Lim, Nur Farhanah Said, Katie Simmons, Eric Pei Ping Pang, Sharon Mei Mei Wong

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Background and Purpose: Research regarding the sexual impact of breast cancer treatment on Asian women is both sensitive and scarce. This study aims to assess and evaluate the sexual health needs and concerns of breast cancer radiotherapy patients. It is hoped that awareness will be increased and an appropriate intervention can be developed to address the needs of future breast cancer patients. Methods: 110 consecutive unselected breast cancer patients were recruited prospectively. Questionnaires were administered once for patient undergoing radiotherapy to the breast. This study employed an anonymous questionnaire; any breast radiotherapy patient who can read English can voluntarily receive and complete the survey. The questionnaire consisted of items addressing demographics, potential informational needs, and educational preferences. Results: Patients’ interest to address sexual concerns decreases with age (p=0.024). Coherently, sexual concerns of patients are reported to decrease with age (p=0.015) where 70% of all respondents below age 50 [age 20-29 (60%); 30-39 (56.3%); 40-49(55.1%)] have started to have sexual concerns regarding their treatment effects on their sexual health. Patients who underwent breast conservation surgery (42.2%) and reconstruction surgery (83.3%) were more likely to have concerns about sexual health versus patients who underwent mastectomy (36.7%) (p=0.032). 74.2% of patients with sexual concern regardless of age would initiate conversation with their healthcare providers (p < 0.001). Conclusions: The results showed a staggering interest of female patients wanting information on this area which would not only boost their confidence and body image but also address concerns of the effect of breast radiotherapy on sexual health during their treatment.

Keywords: breast cancer, breast radiotherapy, sexual health, sexual impact

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905 Transvaginal Repair of Anterior Vaginal Wall Prolapse with Polyvinylidene Fluoride (PVDF) Mesh: An Alternative for Previously Restricted Materials

Authors: Mohammad-Javad Eslami, Mahtab Zargham, Farshad Gholipour, Mohammadreza Hajian, Katayoun Bakhtiari, Sakineh Hajebrahimi, Melina Eghbal, Ziba Farajzadegan

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Introduction: To study the mid-term safety and functional outcomes of transvaginal anterior vaginal wall prolapse repair using polyvinylidene fluoride (PVDF) mesh (DynaMesh®-PR4) by the double trans-obturator technique (TOT). Methods: Between 2015 and 2020, we prospectively included women with symptomatic high-stage anterior vaginal wall prolapse with or without uterine prolapse or stress urinary incontinence (SUI) in the study. The patients underwent transvaginal repair of the prolapse using PVDF mesh in two medical centers. We followed all patients for at least 12 months. We recorded the characteristics of vaginal and sexual symptoms, urinary incontinence, and prolapse stage pre- and postoperatively using International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF), and Pelvic Organ Prolapse Quantification (POP-Q) system, respectively. Results: One hundred eight women were included in the final analysis with a mean follow-up time of 34.5 ± 18.6 months. The anatomical success was achieved in 103 (95.4%) patients. There was a significant improvement in patients’ vaginal symptoms, urinary incontinence, and quality of life scores postoperatively (p < 0.0001). Only six patients (5.5%) had mesh extrusion, five of whom were managed successfully. The total rates of complications and de novo urinary symptoms were 21.3% and 7.4%, respectively. Significant pain was reported in 17 cases (15.7%). Conclusion: Our findings show that using PVDF mesh in the double TOT technique for anterior vaginal wall prolapse repair is a safe procedure with high anatomic and functional success rates and acceptable complication rates in mid-term follow-up.

Keywords: stress urinary incontinence (SU, incontinence questionnaire-vaginal symptoms (ICIQ-VS), polyvinylidene fluoride (PVDF) mes, double trans-obturator technique (TOT)

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904 A Case Study of Clinicians’ Perceptions of Enterprise Content Management at Tygerberg Hospital

Authors: Temitope O. Tokosi

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Healthcare is a human right. The sensitivity of health issues has necessitated the introduction of Enterprise Content Management (ECM) at district hospitals in the Western Cape Province of South Africa. The objective is understanding clinicians’ perception of ECM at their workplace. It is a descriptive case study design of constructivist paradigm. It employed a phenomenological data analysis method using a pattern matching deductive based analytical procedure. Purposive and s4nowball sampling techniques were applied in selecting participants. Clinicians expressed concerns and frustrations using ECM such as, non-integration with other hospital systems. Inadequate access points to ECM. Incorrect labelling of notes and bar-coding causes more time wasted in finding information. System features and/or functions (such as search and edit) are not possible. Hospital management and clinicians are not constantly interacting and discussing. Information turnaround time is unacceptably lengthy. Resolving these problems would involve a positive working relationship between hospital management and clinicians. In addition, prioritising the problems faced by clinicians in relation to relevance can ensure problem-solving in order to meet clinicians’ expectations and hospitals’ objective. Clinicians’ perception should invoke attention from hospital management with regards technology use. The study’s results can be generalised across clinician groupings exposed to ECM at various district hospitals because of professional and hospital homogeneity.

Keywords: clinician, electronic content management, hospital, perception, technology

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903 The Effect of Reminiscence Therapy with Ethernet-Based Videos on Cognition and Apathy in Elderly with Mild Dementia

Authors: Ayse Inel Manav, Nuray Simsek

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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.

Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy

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902 Effectiveness of Coping Strategies Adopted by the Small Holder Farmers for Poverty Alleviation in Niger State, Nigeria

Authors: Noimot A. Bakare, Rotimi S. Olaleye, Bolaji O. Adeniji

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The study examined the effectiveness of selected coping strategies for poverty alleviation among smallholder farmers in Niger State, Nigeria. Data were collected with the aid of interview schedule. A multistage random sampling technique was used to select 225 respondents from 3 geographical zones in the State. Data were analyzed using descriptive and inferential statistics. The results showed that majority (83.1%) of the respondents were within the age of 21-50 years, mostly male (76.0%) and married (77.8%). The highest educational level attained was quranic education. Findings showed that coping strategies commonly adopted by the farmers were; use of food stuff (94.2%), money savings(76.6%), reduction in expenditure(74.2%) and food consumption (65.2%). Also, there was high awareness of primary healthcare and fadama development poverty alleviation programmes by Government and non-governmental organizations. Regression model indicated a significant and positive relationship between the educational level of farmers, farm size, contact with extension and effectiveness of poverty coping strategies. Pearson correlation coefficient shows a correlation between coping strategies adopted and their effectiveness(r = 0.599, P < 0.01). However, t- test shows a significant difference between coping strategies adopted by the male and female farmers (t= -2.63, P < 0.01). It is recommended that awareness on poverty alleviation programmes aimed at improving the productivity of farming activities should be intensified while farmers should be involved in the planning and implementation of these programmes.

Keywords: coping strategies, effectiveness, farmers, poverty alleviation.

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901 Need Assessments of Midwives in Public's Health Center (Puskesmas) at Sukabumi Municipal, Province of Jawa Barat, Indonesia

Authors: Al Asyary, Meita Veruswati, Dian Ayyubi

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Sukabumi municipal has highest rank for maternal mortality in Indonesia with 102 by 100,000 live birth with almost 80% of birth were not attended by skilled birth attendant (SBA). Although universal health coverage has been implemented, availability and sufficiency of SBA, such as midwife in this developing country, are problematic agenda for the quality of public healthcare as well as decreasing maternal mortality rate. This study aims to describe the equal distribution of midwives in Sukabumi municipal as support of government’s program named Millennium Development Goals (MDGs) that suppressed maternal mortality rate in Indonesia. We conducted an observational study with Workload Indicator of Staffing Need (WISN) analysis to present the dispersion of midwives by their activities and workloads in 37 Puskesmas. We also generated in-depth interview with several executive chief of health sections, including chief of health offices in Sukabumi municipal. It resulted inferentially that several activities in midwives’ program were differed at once of existing than needed condition ideally (ρ value = 0.002 < 0.05). Meanwhile, decision for midwives’ procurement and placement were held by un-systematically procedure such as based on where the midwife was staying, and it also progressed by neighborhood issue priorities. The absence of formal regulation in local government is a serious problem that indicated poor political commitment, while access to SBA shall be focused carefully.

Keywords: developing country, health professional resources, health policy, need assessment

Procedia PDF Downloads 168
900 Designing an Integrated Platform for Real-Time Recommendations Sharing among the Aged and People Living with Cancer

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

Procedia PDF Downloads 152
899 Improved Classification Procedure for Imbalanced and Overlapped Situations

Authors: Hankyu Lee, Seoung Bum Kim

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The issue with imbalance and overlapping in the class distribution becomes important in various applications of data mining. The imbalanced dataset is a special case in classification problems in which the number of observations of one class (i.e., major class) heavily exceeds the number of observations of the other class (i.e., minor class). Overlapped dataset is the case where many observations are shared together between the two classes. Imbalanced and overlapped data can be frequently found in many real examples including fraud and abuse patients in healthcare, quality prediction in manufacturing, text classification, oil spill detection, remote sensing, and so on. The class imbalance and overlap problem is the challenging issue because this situation degrades the performance of most of the standard classification algorithms. In this study, we propose a classification procedure that can effectively handle imbalanced and overlapped datasets by splitting data space into three parts: nonoverlapping, light overlapping, and severe overlapping and applying the classification algorithm in each part. These three parts were determined based on the Hausdorff distance and the margin of the modified support vector machine. An experiments study was conducted to examine the properties of the proposed method and compared it with other classification algorithms. The results showed that the proposed method outperformed the competitors under various imbalanced and overlapped situations. Moreover, the applicability of the proposed method was demonstrated through the experiment with real data.

Keywords: classification, imbalanced data with class overlap, split data space, support vector machine

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898 Readiness of Iran’s Insurance Industry Salesforce to Accept Changing to Become Islamic Personal Financial Planners

Authors: Pedram Saadati, Zahra Nazari

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Today, the role and importance of financial technology businesses in Iran have increased significantly. Although, in Iran, there is no Islamic or non-Islamic personal financial planning field of study in the universities or educational centers, the profession of personal financial planning is not defined, and there is no software introduced in this regard for advisors or consumers. The largest sales network of financial services in Iran belongs to the insurance industry, and there is an untapped market for international companies in Iran that can contribute to 130 thousand representatives in the insurance industry and 28 million families by providing training and personal financial advisory software. To the best of the author's knowledge, despite the lack of previous internal studies in this field, the present study investigates the level of readiness of the salesforce of the insurance industry to accept this career and its technology. The statistical population of the research is made up of managers, insurance sales representatives, assistants and heads of sales departments of insurance companies. An 18-minute video was prepared that introduced and taught the job of Islamic personal financial planning and explained its difference from its non-Islamic model. This video was provided to the respondents. The data collection tool was a research-made questionnaire. To investigate the factors affecting technology acceptance and job change, independent T descriptive statistics and Pearson correlation were used, and Friedman's test was used to rank the effective factors. The results indicate the mental perception and very positive attitude of the insurance industry activists towards the usefulness of this job and its technology, and the studied sample confirmed the intention of training in this knowledge. Based on research results, the change in the customer's attitude towards the insurance advisor and the possibility of increasing income are considered as the reasons for accepting. However, Restrictions on using investment opportunities due to Islamic financial services laws and the uncertainty of the position of the central insurance in this regard are considered as the most important obstacles.

Keywords: fintech, insurance, personal financial planning, wealth management

Procedia PDF Downloads 48
897 Efficiency of Natural Metabolites on Quality Milk Production in Mixed Breed Cows.

Authors: Mariam Azam, Sajjad Ur Rahman, Mukarram Bashir, Muhammad Tahir, Seemal Javaid, Jawad, Aoun Muhammad, Muhammad Zohaib, Hannan Khan

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Products of microbial origin are of great importance as they have proved their value in healthcare and nutrition, use of these microbial metabolites acquired from partially fermented soya hulls and wheat bran along with Saccharomyces cerevisiae (DL-22 S/N) substantiates to be a great source for an increase in the total milk production and quality yield.1×109 CFU/ml cells of Saccharomyces cerevisiae (DL-22 S/N) were further grown under in-vivo conditions for the assessment of quality milk production. Two groups with twelve cows, each having the same physical characteristics (Group A and Group B), were under study, Group A was daily fed with 12gm of biological metabolites and 22% protein-pelleted feed. On the other hand, the animals of Group B were provided with no metabolites in their feed. In thirty days of trial, improvement in the overall health, body score, milk protein, milk fat, yield, incidence rate of mastitis, ash, and solid not fat (SNF) was observed. The collected data showed that the average quality milk production was elevated up to 0.45 liter/h/d. However, a reduction in the milk fats up to 0.45% and uplift in the SNF value up to 0.53% of cow milk was also observed. At the same time, the incidence rate of mastitis recorded for the animals under trial was reduced to half, and improved non specific immunity was reported.

Keywords: microbial metabolites, post-biotics, animal supplements, animal nutrition, proteins, animal production, fermentation

Procedia PDF Downloads 99
896 The Hierarchical Model of Fitness Services Quality Perception in Serbia

Authors: Mirjana Ilic, Dragan Zivotic, Aleksandra Perovic, Predrag Gavrilovic

Abstract:

The service quality perception depends on many factors, such as the area in which the services are provided, socioeconomic status, educational status, experience, age and gender of consumers, as well as many others. For this reason, it is not possible to apply instrument for establishing the service quality perception that is developed in other areas and in other populations. The aim of the research was to form an instrument for assessing the quality perception in the field of fitness in Serbia. After analyzing the available literature and conducting a pilot research, there were 15 isolated areas in which it was possible to observe the service quality perception. The areas included: material and technical basis, secondary facilities, coaches, programs, reliability, credibility, security, rapid response, compassion, communication, prices, satisfaction, loyalty, quality outcomes and motives. These areas were covered by a questionnaire consisted of 100 items where the number of items varied from area to area from 3 up to 11. The questionnaire was administered to 350 subjects of both genders (174 men and 176 women) aged from 18 to 68 years, being beneficiaries of fitness services for at least 1 year. In each of the areas was conducted a factor analysis in its exploratory form by principal components method. The number of significant factors has been determined in accordance with the Kaiser Guttman criterion. The initial factor solutions were simplified using the Varimax rotation. Analyses per areas have produced from 1 to 4 factors. Afterward, the factor analysis of factor scores on the first principal component of each of the respondents in each of the analyzed area was performed, and the factor structure was obtained with four latent dimensions interpreted as offer, the relationship with the coaches, the experience of quality and the initial impression. This factor structure was analysed by hierarchical analysis of Oblique factors, which in the second order space produced single factor interpreted as a general factor of the service quality perception. The resulting questionnaire represents an instrument which can serve managers in the field of fitness to optimize the centers development, raising the quality of services in line with consumers needs and expectations.

Keywords: fitness, hierarchical model, quality perception, factor analysis

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895 Higher Education Leadership and Creating Sites of Institutional Belonging: A Global Case Study

Authors: Lisa M. Coleman

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The focus on disability, LGBTQ+, and internationalization has certainly been the subject of much research and programmatic across higher education. Many universities have entered into global partnerships with varying success and challenges across the various areas, including laws and policies. Attentiveness to the specific nuances of global inclusion, diversity, equity, belonging, and access (GIDBEA) and the leadership to support these efforts is crucial to the development of longstanding success across the programs. There have been a number of shifts related to diversification across student and alumni bodies. These shifts include but are not limited to how people identify gender, race, and sexuality (and the intersections across such identities), as well as trends across emerging and diverse disability communities. NYU is the most international campus in the United States, with the most campuses and sites outside of its county of origin and the most international students and exchange programs than any other university. As a result, the ongoing work related to GIDEBA is at the center of much of the leadership, administrative, and research efforts. Climate assessment work across NYU’s diverse global campus landscape will serve as the foundation to exemplify best practices related to data collection and dissemination, community and stakeholder engagement, and effective implementation of innovative strategies to close gap areas as identified. The data (quantitative and qualitative) and related research findings represent data collected from close to 22,000 stakeholders across the NYU campuses. The case study centers on specific methodological considerations, data integrity, stakeholder engagement from across student-faculty, staff, and alumni constituencies, and tactics to advance specific GIDBEA initiatives related to navigating shifting landscapes. Design thinking, incubation, and co-creation strategies have been employed to expand, leverage, actualize, and implement GIDBEA strategies that are – concrete, measurable, differentiated, and specific to global sites and regions and emerging trends.

Keywords: disability, LGBTQ+, DEI, research, case studies

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894 Tussle of Intellectual Property Rights and Privacy Laws with Reference to Artificial Intelligence

Authors: Lipsa Dash, Gyanendra Sahu

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Intelligence is the cornerstone of humans, and now they have created a counterpart of themselves artificially. Our understanding of the word intelligence is a very perspective based and mostly superior understanding of what we read, write, perceive and understand the adversities around better. A wide range of industrial sectors have also started involving the technology to perceive, reason and act. Similarly, intellectual property is the product of human intelligence and creativity. The World Intellectual Property Organisation is currently working on technology trends across the globe, and AI tops the list in the digital frontier that will have a profound impact on the world, transforming the way we live and work. Coming to Intellectual Property, patents and creations of the AI’s itself have constantly been in question. This paper explores whether AI’s can fit in the flexibilities of Trade Related Intellectual Property Studies and gaps in the existing IP laws or rthere is a need of amendment to include them in the ambit. The researcher also explores the right of AI’s who create things out of their intelligence and whether they could qualify to be legal persons making the other laws applicable on them. Differentiation between AI creations and human creations are explored in the paper, and the need of amendments to determine authorship, ownership, inventorship, protection, and identification of beneficiary for remuneration or even for determining liability. The humans and humanoids are all indulged in matters related to Privacy, and that attracts another constitutional legal issue to be addressed. The authors will be focusing on the legal conundrums of AI, transhumanism, and the Internet of things.

Keywords: artificial intelligence, humanoids, healthcare, privacy, legal conundrums, transhumanism

Procedia PDF Downloads 124
893 Reviewing the Effect of Healing Design on Mental Health Establishments in the Context of India

Authors: Aratrika Sarkar, Jayita Guha Niyogi

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This paper focuses on the application of general healing design theories to modulate them into case-specific and contextual design considerations. Existing literature focuses on the relationship between architecture and mental health. Primary case studies are selected in India to focus on the effect of a specific location on design considerations. They are qualitatively analysed to further contextualise the inferences from the literature study. An academic project is cited as an example to apply the learnings from the study and understand the influence of various parameters on the design process for further conclusion. Literature studies, case studies and hypothetical design applications helped in finding the different ways of achieving the similar goal of a sensitive approach toward mental health. Along with salutogenic parameters, category of establishment, age group, location of the site and user preference plays a crucial role in the design process. Design of mental health establishments, especially in India, has to involve transparency between stakeholders and users. Owing to different climatic zones and diverse sociocultural traditions, the approach toward healing should adapt accordingly. It should be an effort towards striking a balance between contradictory elements of healing design and resolving the dilemmas with sensitivity and consensus. Lastly, the design should not force a person towards communication or companionship but rather let the person realise that naturally through the healing process.

Keywords: contextual healing design, deinstitutionalisation, Indian mental healthcare establishments, environmental psychology, salutogenesis, therapeutic design

Procedia PDF Downloads 107
892 COVID-19 in Nigeria: An external Analysis from the perspective of social media

Authors: Huseyin Arasli, Maryam Abdullahi, Tugrul Gunay

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One of the prominence elements used by the destination marketing organization (DMO) as a marketing strategy is the application of Social media tools. During the current spread of coronavirus disease (COVID-19), travel restriction was placed in most countries of the world, leading to the closure of borders movement. It should be noted that most tourism travelers depend on social media to obtain and exchange different kinds of information about COVID-19 in an unprecedented scale. The situational information people received is valued, which calls for the response of the tourism industry on the epidemic. Therefore, it is highly important to recognize such situational information and to understand how people spread this propaganda on social media platforms so that suitable information that relates the COVID-19 epidemic is available in a manner that will not tarnish the marketing strategies, festival planners. Data for this research study was collected from the desk review, which is a secondary source data, online blogs, and interview through social media chat. The results of this research show that the widespread of COVID-19 pandemics led to rapid lockdown in states and cities all over Nigeria, causing declining demands in hotels, airlines, recreation, and tourism centers. Additionally, billions of dollars lost has been recorded in the high increase of hotels and travel bookings cancellations which caused hundreds and thousands of job loss in the country. The result of this research also revealed that COVID-19 is causing more havoc on the unemployment rate indices of the country. Similarly, the over-dependence of government on petroleum has further caused considerable revenue loss, thereby raising a high poverty rate among less privileged Nigerians. Based on this result, the study suggested that there is an urgent need for the government to diversify its economy by looking at other different sectors such as tourism and agricultural farm produce to harmonize other commercial trades sectors in the country.

Keywords: social media, destination marketing organizations, DMOs, cultural COVID-19, coronavirus, hospitality, travel tour, tourism

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891 Death Anxiety, Quality of Life, and Self-Esteem of the Elderly in Surat Thani Province, Thailand

Authors: W. Phokhwang-Just, A. Saraketrin, P. Thongpet, J. Udomkitpipat, J. Kaewsakulthong

Abstract:

The more people get older and live longer, the more health problems they may have. This cross-sectional study aims to study a correlation between death anxiety, quality of life, and self-esteem as well as factors affecting these variables in the elderly living in Surat Thani Province, Thailand. Of 382 elderly people, who were proportionally sampled from 19 districts in Surat Thani Province, 256 (67%) already returned the questionnaires. The Thai version of Templer’s Death Anxiety, Quality of Life (WHO-BREF), and of Rosenberg’s Self-Esteem Questionnaires were employed. The result showed that the samples had a mean age of 72 years old, 53% were female, 62% were married, 61% graduated with primary-school, and 61% had at least one chronic disease Approximately, 19% of them had 3 diseases. The quality of life (QOL), self-esteem (SE), and death anxiety (DA) of samples were in moderate (n= 91, mean = 86.89, SD = 15.47), high (n = 138, mean = 29.33, SD=4.77), and low level (n= 85, mean = 6.23, SD= 3.65), respectively. The QOL was not significantly different between male and female as well as among different marital status. The female elderly had more DA and less SE than male (t= 2.095, df = 83; t =-3.258, df =135, respectively, p < 0.05). The female elderly, who were separated or widow, had a higher level of DA than did the married elderly (LSD: p < 0.05). The married elderly had a higher level of SE than did the separated, widowed (Tukey HSD, LSD: p < 0.05), or single elderly (LSD: p < 0.05). The more diseases the elderly got, the lower level of QOL they had (r = -0.335, p < 0.05). The QOL was significantly correlated with SE (r =0.434, p < 0.05), but not significantly related to DA (r = -0.200, p = 0.069). The lower level of SE the elderly had, the higher level of DA they become (r = -2.71, p < 0.05). In order to promote the QOL, the SE of the elderly should be enhanced. Consequently, the DA can be minimized. Healthcare providers should provide care that promotes QOL, SE, and reduces DA of the elderly, especially those, who are female, single, and separated or widowed as well as those, who have more diseases than the others

Keywords: death anxiety, quality of life, self-esteem, elderly

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890 Lessons Learned in Developing a Clinical Information System and Electronic Health Record (EHR) System That Meet the End User Needs and State of Qatar's Emerging Regulations

Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath

Abstract:

The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.

Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics

Procedia PDF Downloads 361