Search results for: inpatient medication order entry system

Authors: Nur Aisyah Jalalludin, Arwindra Rizqiawan, Goro Fujita

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In this study, we aim to demonstrate a microgrid system experimental simulation for an easy understanding of a large-scale microgrid system. This model is required for industrial training and learning environments. However, in order to create an exact representation of a microgrid system, the laboratory-scale system must fulfill the requirements of a grid-connected inverter, in which power values are assigned to the system to cope with the intermittent output from renewable energy sources. Aside from that, during changes in load capacity, the grid-connected system must be able to supply power from the utility grid side and microgrid side in a balanced manner. Therefore, droop control is installed in the inverter’s control board to maintain equal power sharing in both sides. This power control in a stand-alone condition and droop control in a grid-connected condition must be implemented in order to maintain a stabilized system. Based on the experimental results, power control and droop control can both be applied in the system by comparing the experimental and reference values.

Keywords: droop control, droop characteristic, grid-connected inverter, microgrid, power control

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Authors: D. Muley, H. S. Al-Mandhari

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This paper evaluates the performance of a multi-lane four-legged modern roundabout operating in Muscat using SIDRA model. The performance measures include Degree of Saturation (DOS), average delay, and queue lengths. The geometric and traffic data were used for model preparation. Gap acceptance parameters, critical gap, and follow-up headway were used for calibration of SIDRA model. The results from the analysis showed that currently the roundabout is experiencing delays up to 610 seconds with DOS 1.67 during peak hour. Further, sensitivity analysis for general and roundabout parameters was performed, amongst lane width, cruise speed, inscribed diameter, entry radius, and entry angle showed that inscribed diameter is the most crucial factor affecting delay and DOS. Upgradation of the roundabout to the fully signalized junction was found as the suitable solution which will serve for future years with LOS C for design year having DOS of 0.9 with average control delay of 51.9 seconds per vehicle.

Keywords: performance analysis, roundabout, sensitivity analysis, SIDRA

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Authors: Aijing Luo, Zirui Xin, Yifeng Yuan

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Background: With the rapid development of the online health community, more and more patients or families are seeking health information on the Internet. Objective: This study aimed to discuss how to fully reveal the health information needs expressed by hypertensive patients in their questions in the online environment. Methods: This study randomly selected 1,000 text records from the question data of hypertensive patients from 2008 to 2018 collected from the website www.haodf.com and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning the intention of each hypertensive patient based on the patient’s question and used co-occurrence network analysis to explore the features of the health information needs of hypertensive patients. Results: The classification system for health information needs of patients with hypertension is composed of 9 parts: 355 kinds of drugs, 395 kinds of symptoms and signs, 545 kinds of tests and examinations , 526 kinds of demographic data, 80 kinds of diseases, 37 kinds of risk factors, 43 kinds of emotions, 6 kinds of lifestyles, 49 kinds of questions. The characteristics of the explored online health information needs of the hypertensive patients include: i)more than 49% of patients describe the features such as drugs, symptoms and signs, tests and examinations, demographic data, diseases, etc. ii) these groups are most concerned about treatment (77.8%), followed by diagnosis (32.3%); iii) 65.8% of hypertensive patients will ask doctors online several questions at the same time. 28.3% of the patients are very concerned about how to adjust the medication, and they will ask other treatment-related questions at the same time, including drug side effects, whether to take drugs, how to treat a disease, etc.; secondly, 17.6% of the patients will consult the doctors online about the causes of the clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, medication, and examinations. Conclusion: In the online environment, the health information needs expressed by Chinese hypertensive patients to doctors are personalized; that is, patients with different background features express their questioning intentions to doctors. The classification system constructed in this study can guide health information service providers in the construction of online health resources, to help solve the problem of information asymmetry in communication between doctors and patients.

Keywords: online health community, health information needs, hypertensive patients, doctor-patient communication

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Authors: Ethan Shafer, Timothy Graziano

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This research seeks to answer whether first-year courses at institutions of higher learning can impact STEM major selection. Unlike many universities, an entry-level technology course (often referred to as CS0) is required for all United States Military Academy (USMA) students–regardless of major–in their first year of attendance. Students at the academy choose their major at the end of their first year of studies. Through student responses to a multi-semester survey, this paper identifies a number of factors that potentially influence STEM major selection. Student demographic data, pre-existing exposure and access to technology, perceptions of STEM subjects, and initial desire for a STEM major are captured before and after taking a CS0 course. An analysis of factors that contribute to student perception of STEM and major selection are presented. This work provides recommendations and suggestions for institutions currently providing or looking to provide CS0-like courses to their students.

Keywords: education, STEM, pedagogy, digital literacy

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Authors: Truong Nguyen Luan Vu, Le Hieu Giang, Le Linh

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The fractional–order proportional integral (FOPI) controller tuning rules based on the fractional calculus for the cascade control system are systematically proposed in this paper. Accordingly, the ideal controller is obtained by using internal model control (IMC) approach for both the inner and outer loops, which gives the desired closed-loop responses. On the basis of the fractional calculus, the analytical tuning rules of FOPI controller for the inner loop can be established in the frequency domain. Besides, the outer loop is tuned by using any integer PI/PID controller tuning rules in the literature. The simulation study is considered for the stable process model and the results demonstrate the simplicity, flexibility, and effectiveness of the proposed method for the cascade control system in compared with the other methods.

Keywords: Bode’s ideal transfer function, fractional calculus, fractional–order proportional integral (FOPI) controller, cascade control system

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Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto

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Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.

Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan

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Authors: Mamta M. Barapatre, V. N. Sahare

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Since from long time two wheeled vehicle self-balancing has always been a back-breaking task for both human and robots. Leaning a bicycle driving is long time process and goes through building knowledge base for parameter decision making while balancing robots. In order to create this machine learning phase with embedded system the proposed system is designed. The system proposed aims to construct a bicycle automaton, power-driven by an electric motor, which could balance by itself and move along a specific path. This path could be wavy with bumps and varying widths. The key aim was to construct a cycle which self-balances itself by controlling its handle. In order to take a turn, the mass was transferred to the center. In order to maintain the stability, the bicycle bot automatically turned the handle and a turn. Some problems were faced by the team which were Speed, Steering mechanism through mass- distribution (leaning), Center of mass location and gyroscopic effect of its wheel. The idea proposed have potential applications in automation of transportation system and is most efficient.

Keywords: gyroscope-flywheel, accelerometer, servomotor-controller, self stability concept

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Authors: Neelam Singha

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The present work intends to analyze the system dynamics of Hashimoto’s thyroiditis with the assistance of fractional calculus. Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disorder in which the immune system attacks the thyroid gland, which gradually results in interrupting the normal thyroid operation. Consequently, the feedback control of the system gets disrupted due to thyroid follicle cell lysis. And, the patient perceives life-threatening clinical conditions like goiter, hyperactivity, euthyroidism, hyperthyroidism, etc. In this work, we aim to obtain the approximate solution to the posed fractional-order problem describing Hashimoto’s thyroiditis. We employ the Adomian decomposition method to solve the system of fractional-order differential equations, and the solutions obtained shall be useful to provide information about the effect of medical care. The numerical technique is executed in an organized manner to furnish the associated details of the progression of the disease and to visualize it graphically with suitable plots.

Keywords: adomian decomposition method, fractional derivatives, Hashimoto's thyroiditis, mathematical modeling

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Authors: Armel Asongu Nkembi, Ahmad Fawad

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The aim of this paper is to determine in a concise way the transfer function that characterizes a DC electrical motor with a helix. In practice it can be obtained by applying a particular input to the system and then, based on the observation of its output, determine an approximation to the transfer function of the system. In our case, we use a step input and find the transfer function parameters that give the simulated first-order time response. The simulation of the system is done using MATLAB/Simulink. In order to determine the parameters, we assume a first order system and use the Broida approximation to determine the parameters and then its Mean Square Error (MSE). Furthermore, we design a PID controller for the control process first in the continuous time domain and tune it using the Ziegler-Nichols open loop process. We then digitize the controller to obtain a digital controller since most systems are implemented using computers, which are digital in nature.

Keywords: transfer function, step input, MATLAB, Simulink, DC electrical motor, PID controller, open-loop process, mean square process, digital controller, Ziegler-Nichols

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Authors: Maria Ahmadnezhad, Mohammad Reza Soltanpour

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Electrohydraulic servo systems have been used in industry in a wide number of applications. Its dynamics ‎are highly nonlinear and also have large extent of model uncertainties and external disturbances. In this ‎thesis, a robust back-stepping control (RBSC) scheme is proposed to overcome the problem of ‎disturbances and system uncertainties effectively and to improve the tracking performance of EHS ‎systems. In order to implement the proposed control scheme, the system uncertainties in EHS systems ‎are considered as total leakage coefficient and effective oil volume. In addition, in order to obtain the ‎virtual controls for stabilizing system, the update rule for the system uncertainty term is induced by the ‎Lyapunov control function (LCF). To verify the performance and robustness of the proposed control ‎system, computer simulation of the proposed control system using Matlab/Simulink Software is ‎executed. From the computer simulation, it was found that the RBSC system produces the desired ‎tracking performance and has robustness to the disturbances and system uncertainties of EHS systems.‎

Keywords: electro hydraulic servo system, back-stepping control, robust back-stepping control, Lyapunov redesign

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Authors: Frederick Huie, Lauren Fusfeld, William Burchenal, Scott Howell, Alyssa McVey, Thomas F. Goss

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Alzheimer’s Disease (AD) is a degenerative brain disease characterized by memory loss and cognitive decline that presents a substantial economic burden for patients and health insurers in the US. This study evaluates the payer budget impact of the DISCERN™ test in the diagnosis and management of patients with symptoms of dementia evaluated for AD. DISCERN™ comprises three assays that assess critical factors related to AD that regulate memory, formation of synaptic connections among neurons, and levels of amyloid plaques and neurofibrillary tangles in the brain and can provide a quicker, more accurate diagnosis than tests in the current diagnostic pathway (CDP). An Excel-based model with a three-year horizon was developed to assess the budget impact of DISCERN™ compared with CDP in a Medicare Advantage plan with 1M beneficiaries. Model parameters were identified through a literature review and were verified through consultation with clinicians experienced in diagnosis and management of AD. The model assesses direct medical costs/savings for patients based on the following categories: •Diagnosis: costs of diagnosis using DISCERN™ and CDP. •False Negative (FN) diagnosis: incremental cost of care avoidable with a correct AD diagnosis and appropriately directed medication. •True Positive (TP) diagnosis: AD medication costs; cost from a later TP diagnosis with the CDP versus DISCERN™ in the year of diagnosis, and savings from the delay in AD progression due to appropriate AD medication in patients who are correctly diagnosed after a FN diagnosis.•False Positive (FP) diagnosis: cost of AD medication for patients who do not have AD. A one-way sensitivity analysis was conducted to assess the effect of varying key clinical and cost parameters ±10%. An additional scenario analysis was developed to evaluate the impact of individual inputs. In the base scenario, DISCERN™ is estimated to decrease costs by $4.75M over three years, equating to approximately $63.11 saved per test per year for a cohort followed over three years. While the diagnosis cost is higher with DISCERN™ than with CDP modalities, this cost is offset by the higher overall costs associated with CDP due to the longer time needed to receive a TP diagnosis and the larger number of patients who receive a FN diagnosis and progress more rapidly than if they had received appropriate AD medication. The sensitivity analysis shows that the three parameters with the greatest impact on savings are: reduced sensitivity of DISCERN™, improved sensitivity of the CDP, and a reduction in the percentage of disease progression that is avoided with appropriate AD medication. A scenario analysis in which DISCERN™ reduces the utilization for patients of computed tomography from 21% in the base case to 16%, magnetic resonance imaging from 37% to 27% and cerebrospinal fluid biomarker testing, positive emission tomography, electroencephalograms, and polysomnography testing from 4%, 5%, 10%, and 8%, respectively, in the base case to 0%, results in an overall three-year net savings of $14.5M. DISCERN™ improves the rate of accurate, definitive diagnosis of AD earlier in the disease and may generate savings for Medicare Advantage plans.

Keywords: Alzheimer’s disease, budget, dementia, diagnosis.

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Authors: Bu Seog Ju, Ho Young Son, Yong Hee Ryu

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This study is focused on the evaluation of seismic fragility of multi-story piping system installed in critical structures, isolated with triple friction pendulum bearing. The concept of this study is to isolate the critical building structure as well as nonstructural component, especially piping system in order to mitigate the earthquake damage and achieve the reliable seismic design. Then, the building system and multi-story piping system was modeled in OpenSees. In particular, the triple friction pendulum isolator was accounted for the vertical and horizontal coupling behavior in the building system subjected to seismic ground motions. Consequently, in order to generate the seismic fragility of base-isolated multi-story piping system, 21 selected seismic ground motions were carried out, by using Monte Carlo Simulation accounted for the uncertainties in demand. Finally, the system-level fragility curves corresponding to the limit state of the piping system was conducted at each T-joint system, which was commonly failure points in piping systems during and after an earthquake. Additionally, the system-level fragilities were performed to the first floor and second floor level in critical structures.

Keywords: fragility, friction pendulum bearing, nonstructural component, seismic

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Authors: Pholosho M. Kgopa, Phatu W. Mashela, Alen Manyevere

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Increasing incidents of drought spells in most Sub-Saharan Africa call for using alternative sources of water for irrigation in arid and semi-arid regions. A study was conducted to investigate chemical composition of borehole and treated wastewater from different sampling disposal sites at University of Limpopo Experimental Farm (ULEF). A 4 × 5 factorial experiment, with the borehole as a reference sampling site and three other sampling sites along the wastewater disposal system was conducted over five months. Water samples were collected at four sites namely, (a) exit from Pond 16 into the furrow, (b) entry into night-dam, (c) exit from night dam to irrigated fields and (d) exit from borehole to irrigated fields. Water samples were collected in the middle of each month, starting from July to November 2016. Samples were analysed for pH, EC, Ca, Mg, Na, K, Al, B, Zn, Cu, Cr, Pb, Cd and As. The site × time interactions were highly significant for Ca, Mg, Zn, Cu, Cr, Pb, Cd, and As variables, but not for Na and K. Sampling site was highly significant on all variables, with sampling period not significant for K and Na. Relative to water from the borehole, Na concentration in wastewater samples from the night-dam exit, night-dam entry and Pond16 exit were lower by 69, 34 and 55%, respectively. Relative to borehole water, Al was higher in wastewater sampling sites. In conclusion, both sampling site and period affected the chemical composition of treated wastewater.

Keywords: irrigation water quality, spatial effects, temporal effects, water reuse, water scarcity

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Authors: Larissa Burruano, Sergey Grabovyj, Irina Nguen

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The study aimed to assess the level of adherence to anti retroviral therapy (ART) and to examine the relationship between adherence and risk behavior factor (drug use) among patients infected with HIV. The patients with newly diagnosed or established HIV infection under follow-up at the Sumskij Regional Centre for AIDS Prevention in Ukraine were eligible for this study. Medical records were used to measure the patient’s adherence to medication. Measurements were obtained at month 6 and at month 12 to calculate the number of medication omission during the past 30 days: (on a 2-point scale – once until three in a month – were considered adherent, three and more in a month – were considered non-adherent). Of the 50 study participants, 27 (54.0%) were men and 23 (46.0%) women. The mean age is 35.2 years (SD= 5.1). A majority of the patients (82.0%) is in the age group of 25-30 years. The main level of adherence was 74.0% and 66.0% at 6 and 12 months, respectively. The main routes of HIV transmission were drug injection among men 12 (44.4%) and sexual contact among women 11 (47.8%). Univariate analyses indicated that patients who had lower level of education were more likely to have been non-adherent at month 6- (X2 =5.1, n=50, p < .05) and at month 12 (X2 = 4.34, n=50, p < .05). Multivariate tests showed that only age (OR= 1.163 [95% CI 0.98–1.370]) was significant independent predictor of treatment adherence, while gender, education, employment status were not predictive for the risk of developing non-compliance. There was not a significant interaction between non-adherence and intravenous drug use. Consistent with these findings, younger people were more likely to have missed a dose of their medication because they had a greater sense of invulnerability than older patients. The study indicates that the socio demographic characteristic should be taken into an account in the future research regarding adherence in the case of HIV infection. If the patient anti retroviral adherence can be improved by qualitatively better medical care in all regions of the Ukraine, behavioral changes in the population can to be expected in the long term.

Keywords: HIV, antiretroviral therapy, adherence, Ukraine, Eastern Europe

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Authors: Nabil Ahmed Kamal Badawy, Ali Falah Alhajraf, Mawaheb Falah Alsamdan

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Objectives: To estimate the prevalence of self-medication with over-the-counter pain relievers (acetaminophen, ibuprofen, and aspirin) among Kuwaiti citizens above the age of 16 years old and describe their patterns of use, perceived awareness of, and concerns about the drugs’ potential side effects. Design: A descriptive cross-sectional questionnaire-based survey. Setting: Samples were selected from the six Kuwaiti governorates. Subjects: The data were collected over a four-month period in 2012, from 850 subjects who identified as Kuwaiti citizens. These subjects were recruited using stratified random sampling. Results: Overall, a 67% response rate was obtained. In total, 68% (573) of the respondents reported the use of over-the-counter pain relievers. Women, middle-aged or single individuals, and those who had completed higher education used these drugs more than any other subgroup (p<0.05). We found evidence of inappropriate use of these drugs, with 15% (88) of the consumers using them almost daily. Further, 19% (111) of the consumers exceeded the recommended dosage at least once. Not only were 81% of the consumers unaware of the potential side effects, but also more than 61% were not concerned about them. Women were more knowledgeable than men regarding the maximum dose (p=0.036, OR 1.49, CI 1.03–2.17). Consumers with higher levels of education did not show distinct knowledge regarding the maximum allowed dose of the drugs (p=0.252, OR 1.71, CI 0.68-4.25). Conclusion: The results showed a high prevalence of self-medication with over-the-counter pain relievers among Kuwaiti citizens. The subjects showed marked unawareness and a lack of concern regarding the potential complications resulting from the inappropriate use of these analgesics. This demonstrates the need for educational interventions directed toward both patients and health care workers.

Keywords: awareness of side effects, concern, patterns of use, prevalence

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Authors: Rama Debbarma

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The present study deals with the performance of Linear base isolation system to mitigate seismic response of structures characterized by random system parameters. This involves optimization of the tuning ratio and damping properties of the base isolation system considering uncertain system parameters. However, the efficiency of base isolator may reduce if it is not tuned to the vibrating mode it is designed to suppress due to unavoidable presence of system parameters uncertainty. With the aid of matrix perturbation theory and first order Taylor series expansion, the total probability concept is used to evaluate the unconditional response of the primary structures considering random system parameters. For this, the conditional second order information of the response quantities are obtained in random vibration framework using state space formulation. Subsequently, the maximum unconditional root mean square displacement of the primary structures is used as the objective function to obtain optimum damping parameters Numerical study is performed to elucidate the effect of parameters uncertainties on the optimization of parameters of linear base isolator and system performance.

Keywords: linear base isolator, earthquake, optimization, uncertain parameters

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Authors: Domingos Vita, Patrick Brady

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Background: There is a tuberculosis (TB) epidemic in Angola that has been getting worse for more than a decade despite the active implementation of the DOTS strategy. The aim of this study was to directly interrogate healthcare workers involved in TB control on what they consider to be the drivers of the TB epidemic in Angola. Methods: Twenty four in-depth qualitative interviews were conducted with medical staff working in this field in the provinces of Luanda and Benguela. Results: The healthcare professionals see the migrant working poor as a particular problem for the control of TB. These migrants are constructed as ‘Rural People’ and are seen as non-compliant and late-presenting. This is a stigmatized and marginal group contending with the additional stigma associated with TB infection. The healthcare professionals interviewed also see the interruption of treatment and self medication generally as a better explanation for the TB epidemic than urbanization or lack of medication. Conclusions: The local narrative is in contrast to previous explanations used elsewhere in the developing world. To be effective policy must recognize the local issues of the migrant workforce, interruption of treatment and the stigma associated with TB in Angola.

Keywords: Africa, Angola, migrants, qualitative, research, tuberculosis

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Authors: Chang-Bin Ha, Young-Min Ko, Seongjoo Lee, Hyoung-Kyu Song

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In this paper, the signaling scheme using phase shifting is proposed for the improved performance of the Wi-Fi backscatter system. Because the communication in the Wi-Fi backscatter system is based on on-off modulation and impedance modulation by unit of packet, the data rate is very low compared to the conventional wireless systems. Also, because the Wi-Fi backscatter system is based on the RF-powered device, the achievement of high reliability is difficult. In order to increase the low data rate, the proposed scheme transmits information of multiple bits during one packet period. Also, in order to increase the reliability, the proposed scheme shifts the phase of signal in according to the transmitting information. The simulation result shows that the proposed scheme has the improved throughput performance.

Keywords: phase shifting, RF-powered device, Wi-Fi backscatter system, IoT

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Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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Authors: Samuel Attias, Elad Schiff, Zahi Arnon, Eran Ben-Arye, Yael Keshet, Ibrahim Matter, Boker Lital Keinan

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Background: Despite the extensive use of manual therapies, reflexology in particular, no validated tools have been developed to evaluate patients' beliefs, attitudes and expectations regarding reflexology. Such tools however are essential to improve the results of the reflexology treatment, by better adjusting it to the patients' attitudes and expectations. The tool also enables assessing correlations with clinical results of interventional studies using reflexology. Methods: The IBEAR (Inpatient Beliefs, Expectations and Attitudes toward Reflexology) tool contains 25 questions (8 demographic and 17 specifically addressing reflexology), and was constructed in several stages: brainstorming by a multidisciplinary team of experts; evaluation of each of the proposed questions by the experts' team; and assessment of the experts' degree of agreement per each question, based on a Likert 1-7 scale (1 – don't agree at all; 7 – agree completely). Cronbach's Alpha was computed to evaluate the questionnaire's reliability while the Factor analysis test was used for further validation (228 patients). The questionnaire was tested and re-tested (48h) on a group of 199 patients to assure clarity and reliability, using the Pearson coefficient and the Kappa test. It was modified based on these results into its final form. Results: After its construction, the IBEAR questionnaire passed the expert group's preliminary consensus, evaluation of the questions' clarity (from 5.1 to 7.0), inner validation (from 5.5 to 7) and structural validation (from 5.5 to 6.75). Factor analysis pointed to two content worlds in a division into 4 questions discussing attitudes and expectations versus 5 questions on belief and attitudes. Of the 221 questionnaires collected, a Cronbach's Alpha coefficient was calculated on nine questions relating to beliefs, expectations, and attitudes regarding reflexology. This measure stood at 0.716 (satisfactory reliability). At the Test-Retest stage, 199 research participants filled in the questionnaire a second time. The Pearson coefficient for all questions ranged between 0.73 and 0.94 (good to excellent reliability). As for dichotomic answers, Kappa scores ranged between 0.66 and 1.0 (mediocre to high). One of the questions was removed from the IBEAR following questionnaire validation. Conclusions: The present study provides evidence that the proposed IBEAR-16 questionnaire is a valid and reliable tool for the characterization of potential reflexology patients and may be effectively used in settings which include the evaluation of inpatients' beliefs, expectations, and attitudes toward reflexology.

Keywords: reflexology, attitude, expectation, belief, CAM, inpatient

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Authors: Mojahid F. Saeed Osman

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Repairable items inventory system is a management tool used to incorporate all information concerning inventory levels and movements for repaired and new items. This paper presents development of an effective simulation model for managing the inventory of repairable items for a production system where production lines send their faulty items to a repair shop considering the stochastic failure behavior and repair times. The developed model imitates the process of handling the on-hand inventory of repaired items and the replenishment of the inventory of new items using Economic Order Quantity and Reorder Point ordering policy in a flexible and risk-free environment. We demonstrate the appropriateness and effectiveness of the proposed simulation model using an illustrative case problem. The developed simulation model can be used as a reliable tool for estimating a healthy on-hand inventory of new and repaired items, backordered items, and downtime due to unavailability of repaired items, and validating and examining Economic Order Quantity and Reorder Point ordering policy, which would further be compared with other ordering strategies as future work.

Keywords: inventory system, repairable items, simulation, maintenance, economic order quantity, reorder point

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Authors: Amjaad Alsalamah, Liyakathunsia Syed

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Transportation is an essential need for many people to go to their work, school, and home. In particular, the main common method inside many cities is to drive the car. Driving a car can be an easy job to reach the destination and load all stuff in a reasonable time. However, deciding to find a parking lot for a car can take a long time using the traditional system that can issue a paper ticket for each customer. The old system cannot guarantee a parking lot for all customers. Also, payment methods are not always available, and many customers struggled to find their car among a numerous number of cars. As a result, this research focuses on providing an online smart parking system in order to save time and budget. This system provides a flexible management system for both parking owner and customers by receiving all request via the online system and it gets an accurate result for all available parking and its location.

Keywords: smart parking system, IoT, tracking system, process model, cost, time

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Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

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Authors: J. P. Reges, L. C. S. Mazza, E. J. Braga, J. A. Bessa, A. R. Alexandria

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This paper proposes the development of control and automation of irrigation system located sunflower harvest in the Teaching Unit, Research and Extension (UEPE), the Apodi Plateau in Limoeiro do Norte. The sunflower extraction, which in turn serves to get the produced oil from its seeds, animal feed, and is widely used in human food. Its nutritional potential is quite high what makes of foods produced from vegetal, very rich and healthy. The focus of research is to make the autonomous irrigation system sunflower crop from programmable logic control energized with alternative energy sources, solar photovoltaics. The application of automated irrigation system becomes interesting when it provides convenience and implements new forms of managements of the implementation of irrigated cropping systems. The intended use of automated addition to irrigation quality and consequently brings enormous improvement for production of small samples. Addition to applying the necessary and sufficient features of water management in irrigation systems, the system (PLC + actuators + Renewable Energy) will enable to manage the quantitative water required for each crop, and at the same time, insert the use of sources alternative energy. The entry of the automated collection will bring a new format, and in previous years, used the process of irrigation water wastage base and being the whole manual irrigation process.

Keywords: automation, control, sunflower, irrigation, programming, renewable energy

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Authors: Patcharapa Thaweekul, Paskorn Sritipsukho

Abstract:

Background: During the training period of the 6-year medical curriculum, medical students seem to have many risk behaviors of developing obesity. This study aims to demonstrate the prevalence and risk behavior of obesity and related metabolic disorders among the final-year medical students of Thammasat University as well as the change in nutritional status during studying program. Methods: 123 participants were asked to complete the self-report questionnaires. Weight, height, waist circumference and blood pressure were obtained. Blood samples were drawn for total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides and plasma glucose. Body weight and height of the medical students in the first year were obtained from the medical report at the entry. Results: The prevalence of overweight and obesity at the entry to medical school was 22.0% and increased to 30.1% in the final year. Two obese students (5.4%) was diagnosed as metabolic syndrome. During 6-year curriculum, the BMI gained in male medical students were more significant as compared to female students (1.76±1.74 and 0.43±1.82 kg/m2, respectively; p <.001). The current BMI is significantly correlated with the BMI at entry. Serum LDL-C in the overweight/obese students was significantly higher as compared to the normal weight and underweight group. Sleep deprivation was a significantly frequent behavior in the overweight/obese students. Conclusion: Medical students, as having high-risk behaviors, should be assessed for the nutritional status and metabolic parameters. Medical schools should promote the healthy behaviors to increase the healthy eating and exercise habits and reduced the risk behaviors among them.

Keywords: medical students, metabolic syndrome, obesity, risk behaviors

Procedia PDF Downloads 243

Authors: Pimploi Tirastittam, Sawanath Treesathon, Amornrath Ongkawat

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Learning Management System (LMS) is the system which uses to manage the learning in order to grouping the content and learning activity between the lecturer and learner including online examination and evaluation. Nowadays, it is the borderless learning era so the learning activities can be accessed from everywhere in the world and also anytime via the information technology and media. The learner can easily access to the knowledge so the different in time and distance is not a constraint for learning anymore. The learning pattern which was used in this research is the integration of the in-class learning and online learning via internet and will be able to monitor the progress by the Learning management system which will create the fast response and accessible learning process via the social media. In order to increase the capability and freedom of the learner, the system can show the current and history of the learning document, video conference and also has the chat room for the learner and lecturer to interact to each other. So the objectives of the “The Design and Applied of Learning Management System via Social Media on Internet: Case Study of Operating System for Business Subject” are to expand the opportunity of learning and to increase the efficiency of learning as well as increase the communication channel between lecturer and student. The data of this research was collect from 30 users of the system which are students who enroll in the subject. And the result of the research is in the “Very Good” which is conformed to the hypothesis.

Keywords: Learning Management System, social media, Operating System, information technology

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Authors: Zahra A. Barzegar, Maryam B. Golboo

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In this paper, the manner of obtaining hierarchies and privacy entry of traditional houses in providing a safe place in the city of Shiraz will be evaluated by qualitative–descriptive methods and 6 old houses are the case study. The houses of Shiraz, as the houses in other cities in Iran are a response to climate and physical features. The old part of Shiraz has a compressed and dense texture in which the houses are in narrow and tight alleys. In this regard, the principles of traditional house entrance design have been introduced. The results show that every house has a private entrance. Direction of the entry of most houses is toward the south and with a turn to the South-East side. Entrance to yard path in all the cases is not straight, and this had been done by using 90 degrees rotates of the corridor leading to the yard. Vestibule provides a private place for the house and entrance stairway to the rooftop is located inside it.

Keywords: entrance, components of entrance, hierarchy, frontage, Shiraz houses

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Authors: David Amoah Oduro

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In the ever-evolving terrain of international business, a profound revolution is underway, guided by the swift integration and advancement of disruptive technologies like digital analytics. In today's international business landscape, where competition is fierce, and decisions are data-driven, the essence of this paper lies in offering a tangible roadmap for practitioners. It is a guide that bridges the chasm between theory and actionable insights, helping businesses, investors, and entrepreneurs navigate the complexities of international expansion into sub-Saharan Africa. This practitioner paper distils essential insights, methodologies, and actionable recommendations for businesses seeking to leverage digital analytics in their pursuit of market entry and expansion across the African continent. What sets this paper apart is its unwavering focus on a region ripe with potential: sub-Saharan Africa. The adoption and adaptation of digital analytics are not mere luxuries but essential strategic tools for evaluating countries and entering markets within this dynamic region. With the spotlight firmly fixed on sub-Saharan Africa, the aim is to provide a compelling resource to guide practitioners in their quest to unearth the vast opportunities hidden within sub-Saharan Africa's digital desert. The paper illuminates the pivotal role of digital analytics in providing a data-driven foundation for market entry decisions. It highlights the ability to uncover market trends, consumer behavior, and competitive landscapes. By understanding Africa's incredible diversity, the paper underscores the importance of tailoring market entry strategies to account for unique cultural, economic, and regulatory factors. For practitioners, this paper offers a set of actionable recommendations, including the creation of cross-functional teams, the integration of local expertise, and the cultivation of long-term partnerships to ensure sustainable market entry success. It advocates for a commitment to continuous learning and flexibility in adapting strategies as the African market evolves. This paper represents an invaluable resource for businesses, investors, and entrepreneurs who are keen on unlocking the potential of digital analytics for informed market entry in Africa. It serves as a guiding light, equipping practitioners with the essential tools and insights needed to thrive in this dynamic and diverse continent. With these key insights, methodologies, and recommendations, this paper is a roadmap to prosperous and sustainable market entry in Africa. It is vital for anyone looking to harness the transformational potential of digital analytics to create prosperous and sustainable ventures in a region brimming with promise. In the ever-advancing digital age, this practitioner paper becomes a lodestar, guiding businesses and visionaries toward success amidst the unique challenges and rewards of sub-Saharan Africa's international business landscape.

Keywords: global analytics, digital analytics, sub-Saharan Africa, data analytics

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Authors: C. Puangsawat, C. Limotai, P. Srikhachin

Abstract:

Bio-psycho-social caring was required for promoting the quality of life of the patients with epilepsy (PWE), despite controlled seizures. Multifaceted issues emerge at the epilepsy clinic. Unpredicted seizures, antiepileptic drug compliance problems/adverse effects, psychiatric, and social problems are all needed to be explored and managed. The Nursing Service System (NSS) at the tertiary epilepsy clinic (TEC) was consequently developed for improving the clinical care for PWE. Case manager concept was integrated as the framework guiding the processes and strategies used for developing the NSS as well as the roles of the multidisciplinary team at the clinic. This study aimed to report the outcomes of the developed NSS integrated case manager concept. The processes of our developed NSS program included 1) screening for patient’s problems using questionnaire prior to seeing epileptologists i.e., assessing the patient’s risk to develop acute seizures at the clinic, issues related to medication use, and uncovered psychiatric and social problems; and 2) assigning the patients at risk to be evaluated and managed by appropriate team. Nurses specializing in epilepsy in coordination with the multidisciplinary team implemented the NSS to promote coordinated work among the team which consists of epileptologists, nurses, pharmacists, psychologists, and social workers. Determination of the role of each person and their responsibilities along with joint care plan were clearly established. One year after implementation, the rate of acute seizure occurrence at the clinic was decreased, and satisfactory feedback from the patients was received. In order to achieve an optimal goal to promote self-management behaviors in PWE, continuing the NSS and systematic assessment of its effectiveness is required.

Keywords: case manager concept, nursing service system, patients with epilepsy, quality of life

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Authors: Asma Rebaya, Kaouther Gasmi, Imen Amari, Salem Hasnaoui

Abstract:

Over these last years, applications such as telecommunications, signal processing, digital communication with advanced features (Multi-antenna, equalization..) witness a rapid evaluation accompanied with an increase of user exigencies in terms of latency, the power of computation… To satisfy these requirements, the use of hardware/software systems is a common solution; where hardware is composed of multi-cores and software is represented by models of computation, synchronous data flow (SDF) graph for instance. Otherwise, the most of the embedded system designers utilize Simulink for modeling. The issue is how to simplify the c code generation, for a multi-cores platform, of an application modeled by Simulink. To overcome this problem, we propose a workflow allowing an automatic transformation from the Simulink model to the SDF graph and providing an efficient schedule permitting to optimize the number of cores and to minimize latency. This workflow goes from a Simulink application and a hardware architecture described by IP.XACT language. Based on the synchronous and hierarchical behavior of both models, the Simulink block diagram is automatically transformed into an SDF graph. Once this process is successfully achieved, the scheduler calculates the optimal cores’ number needful by minimizing the maximum density of the whole application. Then, a core is chosen to execute a specific graph task in a specific order and, subsequently, a compatible C code is generated. In order to perform this proposal, we extend Preesm, a rapid prototyping tool, to take the Simulink model as entry input and to support the optimal schedule. Afterward, we compared our results to this tool results, using a simple illustrative application. The comparison shows that our results strictly dominate the Preesm results in terms of number of cores and latency. In fact, if Preesm needs m processors and latency L, our workflow need processors and latency L'< L.

Keywords: hardware/software system, latency, modeling, multi-cores platform, scheduler, SDF graph, Simulink model, workflow

Procedia PDF Downloads 245