Search results for: medical records management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12944

Search results for: medical records management

12764 Medical Images Enhancement Using New Dynamic Band Pass Filter

Authors: Abdellatif Baba

Abstract:

In order to facilitate medical images analysis by improving their quality and readability, we present in this paper a new dynamic band pass filter as a general and suitable operator for different types of medical images. Our objective is to enrich the details of any treated medical image to make it sufficiently clear enough to give an understood and simplified meaning even for unspecialized people in the medical domain.

Keywords: medical image enhancement, dynamic band pass filter, analysis improvement

Procedia PDF Downloads 287
12763 Land Use Changes and Impact around Maladumba Lake and Forest Reserve, Nigeria

Authors: M. B. Abdullahi, S. M. Gumel

Abstract:

This study was carried out to analyze and describe biodiversity changes in representative communities around Maladumba Lake and Forest Reserve (MLFR), Bauchi, Nigeria. Primary and secondary data were collected through formal and informal interviews of key informants and survey of local communities and government records. There has been a change in biodiversity; some of the cropping systems have become nonexistent whereas others have developed. The main aspect of the changes has been the decline of species diversity due to degradation and over utilization. The changes have also been positive through the introduction and intensification of cropping system. Options have been open for people to manipulate the cropping systems in order to efficiently use the limited resources. Farmers have opted not only to intensify agricultural practices but also to deliberately restore some of the lost species. Reduction in the number of animals per household, adoption of new techniques of land management, changes in the type of crops cultivated and intensive use of the available resources are some of the indicators describing farmers’ efforts to cope with the changes. Sustainability of the farming system and biodiversity has been enhanced through peoples’ efforts that include planting trees and use of fertilizers.

Keywords: cropping systems, historical trends, household, land management, sustainability

Procedia PDF Downloads 391
12762 'Performance-Based' Seismic Methodology and Its Application in Seismic Design of Reinforced Concrete Structures

Authors: Jelena R. Pejović, Nina N. Serdar

Abstract:

This paper presents an analysis of the “Performance-Based” seismic design method, in order to overcome the perceived disadvantages and limitations of the existing seismic design approach based on force, in engineering practice. Bearing in mind, the specificity of the earthquake as a load and the fact that the seismic resistance of the structures solely depends on its behaviour in the nonlinear field, traditional seismic design approach based on force and linear analysis is not adequate. “Performance-Based” seismic design method is based on nonlinear analysis and can be used in everyday engineering practice. This paper presents the application of this method to eight-story high reinforced concrete building with combined structural system (reinforced concrete frame structural system in one direction and reinforced concrete ductile wall system in other direction). The nonlinear time-history analysis is performed on the spatial model of the structure using program Perform 3D, where the structure is exposed to forty real earthquake records. For considered building, large number of results were obtained. It was concluded that using this method we could, with a high degree of reliability, evaluate structural behavior under earthquake. It is obtained significant differences in the response of structures to various earthquake records. Also analysis showed that frame structural system had not performed well at the effect of earthquake records on soil like sand and gravel, while a ductile wall system had a satisfactory behavior on different types of soils.

Keywords: ductile wall, frame system, nonlinear time-history analysis, performance-based methodology, RC building

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12761 Causes of Death in Neuromuscular Disease Patients: 15-Year Experience in a Tertiary Care Hospital

Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

Abstract:

Background:Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods:From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results:Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

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12760 Correlation between Sleeping Disturbance and Academic Achievement in University Female Students

Authors: Amel Fayed, Shaden AlSubaih, Nouf Al-Qahtani, Asmaa Gosty, Asma Aljuhaimi

Abstract:

Introduction: Sleep difficulties are vastly predominant among adults and affect different aspects of their life. Many literatures found out that females are more liable to suffer from sleeping problems. College students are typical example of people dealing with daily pressure and stress to fulfill the daily tasks and responsibilities. In addition to their ultimate goal of achieving excellent academic records which require their full concentration and effort. Consequently, many of them start complaining of sleep deprivations which can undesirably affect their academic achievements. This study was aiming to investigate how prevalent is sleeping disorders among different colleges in the university and its relation their academic achievements. Methods: A cross-sectional study of female university students at Princess Norah Bint Abdulrahman University using self-administered questionnaire was conducted. Insomnia Severity Index (ISI) was used to assess different grades of insomnia. Students were requested to answer the questions evaluating their sleeping habits over the last two weeks. Participants reported their latest Grade Point Average (GPA). According to ISI, insomnia severity is reported as ‘No clinically significant’, ‘Subthreshold ‘,’ Clinical moderate insomnia’ and ‘Clinical severe’. Results: In the current study, 228 students participated; 172(75.4%) from medical colleges and 56 (24.6%) from non-medical colleges. About 80% of them claimed to have never taken any medications to help them sleep while only three students confirmed their regular use of sleep-inducing medications. About 16% of the students drink milk or other hot drinks to help them fall asleep. None of the students was suspected of having obstructive sleep apnea or apparent psychiatric disorder. According to ISI, 182 (79.8%) students suffered from subthreshold insomnia, 37 (16.2%) had clinical insomnia (moderate severity) and 9 (3.9%) of students had sleeping problems of non-clinically significance level. However, none of students was found to have severe clinical insomnia. Clinical moderate insomnia was reported in 15.1% of medical students and 19.6% of non-medical students. Moreover, about 82% of medical students suffered from subthreshold insomnia compared to 73.2% of non-medical students. This difference was not statistically significant (P=0.24). About 63% of medical students and 48% of non-medical students believed that high percentage of their colleagues are suffering from insomnias (p-value 0.08) The association between GPA and insomnia revealed that; 19.5% of low GPA group compared to 9.3% of high GPA group had clinical moderate insomnia. This association was not statistically significant (p=0.15). The correlation between the GPA and the ISI score was negative but not conclusive (r=-0.08, p-value = 0.29). More than 92% of all students agreed that sleeping problems affect their academic achievement to varying degrees. Conclusion: our results suggest that insomnia is commonly prevalent among female university students and might affect the students’ achievement. This study provides preliminary data about the quality of sleep among medical and non-medical university students which may be used to promote the healthy sleeping habits among female students.

Keywords: academic achievement, females, insomnia, university student

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12759 The SHIFT of Consumer Behavior from Fast Fashion to Slow Fashion: A Review and Research Agenda

Authors: Priya Nangia, Sanchita Bansal

Abstract:

As fashion cycles become more rapid, some segments of the fashion industry have adopted increasingly unsustainable production processes to keep up with demand and enhance profit margins. The growing threat to environmental and social wellbeing posed by unethical fast fashion practices and the need to integrate the targets of SDGs into this industry necessitates a shift in the fashion industry's unsustainable nature, which can only be accomplished in the long run if consumers support sustainable fashion by purchasing it. Fast fashion is defined as low-cost, trendy apparel that takes inspiration from the catwalk or celebrity culture and rapidly transforms it into garments at high-street stores to meet consumer demand. Given the importance of identity formation to many consumers, the desire to be “fashionable” often outweighs the desire to be ethical or sustainable. This paradox exemplifies the tension between the human drive to consume and the will to do so in moderation. Previous research suggests that there is an attitude-behavior gap when it comes to determining consumer purchasing behavior, but to the best of our knowledge, no study has analysed how to encourage customers to shift from fast to slow fashion. Against this backdrop, the aim of this study is twofold: first, to identify and examine the factors that impact consumers' decisions to engage in sustainable fashion, and second, the authors develop a comprehensive framework for conceptualizing and encouraging researchers and practitioners to foster sustainable consumer behavior. This study used a systematic approach to collect data and analyse literature. The approach included three key steps: review planning, review execution, and findings reporting. Authors identified the keywords “sustainable consumption” and “sustainable fashion” and retrieved studies from the Web of Science (WoS) (126 records) and Scopus database (449 records). To make the study more specific, the authors refined the subject area to management, business, and economics in the second step, retrieving 265 records. In the third step, the authors removed the duplicate records and manually reviewed the articles to examine their relevance to the research issue. The final 96 research articles were used to develop this study's systematic scheme. The findings indicate that societal norms, demographics, positive emotions, self-efficacy, and awareness all have an effect on customers' decisions to purchase sustainable apparel. The authors propose a framework, denoted by the acronym SHIFT, in which consumers are more likely to engage in sustainable behaviors when the message or context leverages the following factors: (s)social influence, (h)habit formation, (i)individual self, (f)feelings, emotions, and cognition, and (t)tangibility. Furthermore, the authors identify five broad challenges that encourage sustainable consumer behavior and use them to develop novel propositions. Finally, the authors discuss how the SHIFT framework can be used in practice to drive sustainable consumer behaviors. This research sought to define the boundaries of existing research while also providing new perspectives on future research, with the goal of being useful for the development and discovery of new fields of study, thereby expanding knowledge.

Keywords: consumer behavior, fast fashion, sustainable consumption, sustainable fashion, systematic literature review

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12758 Steps towards the Development of National Health Data Standards in Developing Countries

Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

Abstract:

The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

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12757 Nurse's Professional Space: Psychiatric Outpatient Clinic of Ottawa's Montfort Hospital 1976-2002

Authors: Silvia Maria Moya

Abstract:

After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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12756 Interpersonal Communication Competence and Organizational Trust as Predictors of Psychological Wellbeing of Medical Practitioners in Imo State, Nigeria

Authors: Ethelbert C. Njoku

Abstract:

The primary determination of any individual is the achievement of wholesome health. This is applicable to the government too. This desire becomes a reality with the efforts of medical practitioners who work day and night to ensure that the health of people is not compromised in any form. To achieve this laudable goal, the psychological wellbeing of the practitioners must be unparalleled. They must be psychologically fit in order to deliver as expected. More so, the organization must be able to provide the basic ingredients of trust in the daily management of the organization. Significantly, proper Interpersonal Communication Competence remains a necessity in the overall realization of this goal. 200 participants took part in the study, and they were selected through convenient sampling method from hospitals in Imo State. The current study adopted cross sectional survey design in trying to find out if Interpersonal Communication Competence and Organizational Trust can predict Psychological Wellbeing of medical practitioners in Imo State. Standard Multiple Regression Analysis was used for data analysis. Interestingly, the results indicate that interpersonal communication competence and organizational trust predicted psychological wellbeing among medical practitioners. The implication of this study hinges on the fact that since Interpersonal Communication Competence and Organizational Trust are important for psychological wellbeing of medical practitioners, the government and managers should try to provide opportunities that enhance these variables in the organization for the psychological wellbeing of medical practitioners.

Keywords: interpersonal communication competence, medical practitioners, organizational trust, psychological wellbeing

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12755 The Use of Boosted Multivariate Trees in Medical Decision-Making for Repeated Measurements

Authors: Ebru Turgal, Beyza Doganay Erdogan

Abstract:

Machine learning aims to model the relationship between the response and features. Medical decision-making researchers would like to make decisions about patients’ course and treatment, by examining the repeated measurements over time. Boosting approach is now being used in machine learning area for these aims as an influential tool. The aim of this study is to show the usage of multivariate tree boosting in this field. The main reason for utilizing this approach in the field of decision-making is the ease solutions of complex relationships. To show how multivariate tree boosting method can be used to identify important features and feature-time interaction, we used the data, which was collected retrospectively from Ankara University Chest Diseases Department records. Dataset includes repeated PF ratio measurements. The follow-up time is planned for 120 hours. A set of different models is tested. In conclusion, main idea of classification with weighed combination of classifiers is a reliable method which was shown with simulations several times. Furthermore, time varying variables will be taken into consideration within this concept and it could be possible to make accurate decisions about regression and survival problems.

Keywords: boosted multivariate trees, longitudinal data, multivariate regression tree, panel data

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12754 Influence of Atmospheric Pollutants on Child Respiratory Disease in Cartagena De Indias, Colombia

Authors: Jose A. Alvarez Aldegunde, Adrian Fernandez Sanchez, Matthew D. Menden, Bernardo Vila Rodriguez

Abstract:

Up to five statistical pre-processings have been carried out considering the pollutant records of the stations present in Cartagena de Indias, Colombia, also taking into account the childhood asthma incidence surveys conducted in hospitals in the city by the Health Ministry of Colombia for this study. These pre-processings have consisted of different techniques such as the determination of the quality of data collection, determination of the quality of the registration network, identification and debugging of errors in data collection, completion of missing data and purified data, as well as the improvement of the time scale of records. The characterization of the quality of the data has been conducted by means of density analysis of the pollutant registration stations using ArcGis Software and through mass balance techniques, making it possible to determine inconsistencies in the records relating the registration data between stations following the linear regression. The results obtained in this process have highlighted the positive quality in the pollutant registration process. Consequently, debugging of errors has allowed us to identify certain data as statistically non-significant in the incidence and series of contamination. This data, together with certain missing records in the series recorded by the measuring stations, have been completed by statistical imputation equations. Following the application of these prior processes, the basic series of incidence data for respiratory disease and pollutant records have allowed the characterization of the influence of pollutants on respiratory diseases such as, for example, childhood asthma. This characterization has been carried out using statistical correlation methods, including visual correlation, simple linear regression correlation and spectral analysis with PAST Software which identifies maximum periodicity cycles and minimums under the formula of the Lomb periodgram. In relation to part of the results obtained, up to eleven maximums and minimums considered contemporary between the incidence records and the particles have been identified taking into account the visual comparison. The spectral analyses that have been performed on the incidence and the PM2.5 have returned a series of similar maximum periods in both registers, which are at a maximum during a period of one year and another every 25 days (0.9 and 0.07 years). The bivariate analysis has managed to characterize the variable "Daily Vehicular Flow" in the ninth position of importance of a total of 55 variables. However, the statistical correlation has not obtained a favorable result, having obtained a low value of the R2 coefficient. The series of analyses conducted has demonstrated the importance of the influence of pollutants such as PM2.5 in the development of childhood asthma in Cartagena. The quantification of the influence of the variables has been able to determine that there is a 56% probability of dependence between PM2.5 and childhood respiratory asthma in Cartagena. Considering this justification, the study could be completed through the application of the BenMap Software, throwing a series of spatial results of interpolated values of the pollutant contamination records that exceeded the established legal limits (represented by homogeneous units up to the neighborhood level) and results of the impact on the exacerbation of pediatric asthma. As a final result, an economic estimate (in Colombian Pesos) of the monthly and individual savings derived from the percentage reduction of the influence of pollutants in relation to visits to the Hospital Emergency Room due to asthma exacerbation in pediatric patients has been granted.

Keywords: Asthma Incidence, BenMap, PM2.5, Statistical Analysis

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12753 Knowledge and Practices on Waste Disposal Management Among Medical Technology Students at National University – Manila

Authors: John Peter Dacanay, Edison Ramos, Cristopher James Dicang

Abstract:

Waste management is a global concern due to increasing waste production from changing consumption patterns and population growth. Proper waste disposal management is a critical aspect of public health and environmental protection. In the healthcare industry, medical waste is generated in large quantities, and if not disposed of properly, it poses a significant threat to human health and the environment. Efficient waste management conserves natural resources and prevents harm to human health, and implementing an effective waste management system can save human lives. The study aimed to assess the level of awareness and practices on waste disposal management, highlighting the understanding of proper disposal, potential hazards, and environmental implications among Medical Technology students. This would help to provide more recommendations for improving waste management practices in healthcare settings as well as for better waste management practices in educational institutions. From the collected data, a female of 21 years of age stands out among the respondents. With the frequency and percentage of medical technology students' knowledge of laboratory waste management being high, it indicates that all respondents demonstrated a solid understanding of proper disposal methods, regulations, risks, and handling procedures related to laboratory waste. That said, the findings emphasize the significance of education and awareness programs in equipping individuals involved in laboratory practices with the necessary knowledge to handle and dispose of hazardous and infectious waste properly. Most respondents demonstrate positive practices or are highly mannered in laboratory waste management, including proper segregation and disposal in designated containers. However, there are concerns about the occasional mixing of waste types, emphasizing the reiteration of proper waste segregation. Students show a strong commitment to using personal protective equipment and promptly cleaning up spills. Some students admit to improper disposal due to rushing, highlighting the importance of time management and safety prioritization. Overall, students follow protocols for hazardous waste disposal, indicating a responsible approach. The school's waste management system is perceived as adequate, but continuous assessment and improvement are necessary. Encouraging reporting of issues and concerns is crucial for ongoing improvement and risk mitigation. The analysis reveals a moderate positive relationship between the respondents' knowledge and practices regarding laboratory waste management. The statistically significant correlation with a p-value of 0.26 (p-value 0.05) suggests that individuals with higher levels of knowledge tend to exhibit better practices. These findings align with previous research emphasizing the pivotal role of knowledge in influencing individuals' behaviors and practices concerning laboratory waste management. When individuals possess a comprehensive understanding of proper procedures, regulations, and potential risks associated with laboratory waste, they are more inclined to adopt appropriate practices. Therefore, fostering knowledge through education and training is essential in promoting responsible and effective waste management in laboratory settings.

Keywords: waste disposal management, knowledge, attitude, practices

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12752 A Case-Series Analysis of Tuberculosis in Patients at Internal Medicine Department

Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

Abstract:

Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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12751 Cleaner Production Options for Fishery Wastes around Lake Tana-Ethiopia

Authors: Demisash, Abate Getnet, Gudisa, Ababo Geleta, Daba, Berhane Olani

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As consumption trends of fish are rising in Ethiopia, assessment of the environmental performance of Fisheries becomes vital. Hence, Cleaner Production Assessment was conducted on Lake Tana No.1 Fish Supply Association. This paper focuses on determining the characteristics, quantity, and setting up cleaner production options for the site with the experimental investigation. The survey analysis showed that illegal waste dumping in Lake Tana is common practice in the area, and some of the main reasons raised were they have no option than doing this for dis-charging fish wastes. Quantifying a fish waste by examination of records at the point of generation resulted in a generation rate of 72,822.61 kg per year, which is a significant amount of waste and needs management system. The result of the proximate analysis showed high free fat content of about 12.33%, and this was a good candidate for the production of biodiesel that has been set as an option for fish waste utilization. Among the different waste management options, waste reduction by product optimization, which involves biodiesel production, was chosen as a potential method. Laboratory scale experiments were performed to produce a renewable energy source from the wastes. The resulting biodiesel was characterized and found to have a density of 0.756kg/L, viscosity 0.24p, and 153°C flashpoints, which shows the product has values in compliance with the American Society for Testing and Materials (ASTM) standards.

Keywords: biodiesel, cleaner production, renewable energy, waste management

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12750 Performance Evaluation of Fingerprint, Auto-Pin and Password-Based Security Systems in Cloud Computing Environment

Authors: Emmanuel Ogala

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Cloud computing has been envisioned as the next-generation architecture of Information Technology (IT) enterprise. In contrast to traditional solutions where IT services are under physical, logical and personnel controls, cloud computing moves the application software and databases to the large data centres, where the management of the data and services may not be fully trustworthy. This is due to the fact that the systems are opened to the whole world and as people tries to have access into the system, many people also are there trying day-in day-out on having unauthorized access into the system. This research contributes to the improvement of cloud computing security for better operation. The work is motivated by two problems: first, the observed easy access to cloud computing resources and complexity of attacks to vital cloud computing data system NIC requires that dynamic security mechanism evolves to stay capable of preventing illegitimate access. Second; lack of good methodology for performance test and evaluation of biometric security algorithms for securing records in cloud computing environment. The aim of this research was to evaluate the performance of an integrated security system (ISS) for securing exams records in cloud computing environment. In this research, we designed and implemented an ISS consisting of three security mechanisms of biometric (fingerprint), auto-PIN and password into one stream of access control and used for securing examination records in Kogi State University, Anyigba. Conclusively, the system we built has been able to overcome guessing abilities of hackers who guesses people password or pin. We are certain about this because the added security system (fingerprint) needs the presence of the user of the software before a login access can be granted. This is based on the placement of his finger on the fingerprint biometrics scanner for capturing and verification purpose for user’s authenticity confirmation. The study adopted the conceptual of quantitative design. Object oriented and design methodology was adopted. In the analysis and design, PHP, HTML5, CSS, Visual Studio Java Script, and web 2.0 technologies were used to implement the model of ISS for cloud computing environment. Note; PHP, HTML5, CSS were used in conjunction with visual Studio front end engine design tools and MySQL + Access 7.0 were used for the backend engine and Java Script was used for object arrangement and also validation of user input for security check. Finally, the performance of the developed framework was evaluated by comparing with two other existing security systems (Auto-PIN and password) within the school and the results showed that the developed approach (fingerprint) allows overcoming the two main weaknesses of the existing systems and will work perfectly well if fully implemented.

Keywords: performance evaluation, fingerprint, auto-pin, password-based, security systems, cloud computing environment

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12749 A Software Tool for Computer Forensic Investigation Using Client-Side Web History Visualization

Authors: Francisca Onaolapo Oladipo, Peter Afam Ugwu

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Records of user activities which are valuable for forensic investigation purposes are provided by web browsers -these records in most cases are not in visual formats that are easily understood, thereby requiring some extra processes. This paper describes the implementation of a software tool for client-side web history visualization providing suitable forensic evidence for investigative purposes. Visual C#, Perl and gnuplot were deployed on Windows Operating System (OS) environment to implement the system and the resulting tool parses and transforms a web browser history into a visual format that enables an investigator to quickly and efficiently explore, understand, and interpret the user online activities in the context of a specific investigation. The system was tested using two forensic cases: the client-side web history files generated by Mozilla Firefox browser was extracted using MozillaHistoryView utility, then parsed and visualized using bar and stacked column charts. From the visual representation, results of user web activities across various productive and non-productive websites were obtained.

Keywords: history, forensics, visualization, web activities

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12748 Implementing a Hospitalist Co-Management Service in Orthopaedic Surgery

Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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12747 Cluster Analysis of Students’ Learning Satisfaction

Authors: Purevdolgor Luvsantseren, Ajnai Luvsan-Ish, Oyuntsetseg Sandag, Javzmaa Tsend, Akhit Tileubai, Baasandorj Chilhaasuren, Jargalbat Puntsagdash, Galbadrakh Chuluunbaatar

Abstract:

One of the indicators of the quality of university services is student satisfaction. Aim: We aimed to study the level of satisfaction of students in the first year of premedical courses in the course of Medical Physics using the cluster method. Materials and Methods: In the framework of this goal, a questionnaire was collected from a total of 324 students who studied the medical physics course of the 1st course of the premedical course at the Mongolian National University of Medical Sciences. When determining the level of satisfaction, the answers were obtained on five levels of satisfaction: "excellent", "good", "medium", "bad" and "very bad". A total of 39 questionnaires were collected from students: 8 for course evaluation, 19 for teacher evaluation, and 12 for student evaluation. From the research, a database with 39 fields and 324 records was created. Results: In this database, cluster analysis was performed in MATLAB and R programs using the k-means method of data mining. Calculated the Hopkins statistic in the created database, the values are 0.88, 0.87, and 0.97. This shows that cluster analysis methods can be used. The course evaluation sub-fund is divided into three clusters. Among them, cluster I has 150 objects with a "good" rating of 46.2%, cluster II has 119 objects with a "medium" rating of 36.7%, and Cluster III has 54 objects with a "good" rating of 16.6%. The teacher evaluation sub-base into three clusters, there are 179 objects with a "good" rating of 55.2% in cluster II, 108 objects with an "average" rating of 33.3% in cluster III, and 36 objects with an "excellent" rating in cluster I of 11.1%. The sub-base of student evaluations is divided into two clusters: cluster II has 215 objects with an "excellent" rating of 66.3%, and cluster I has 108 objects with an "excellent" rating of 33.3%. Evaluating the resulting clusters with the Silhouette coefficient, 0.32 for the course evaluation cluster, 0.31 for the teacher evaluation cluster, and 0.30 for student evaluation show statistical significance. Conclusion: Finally, to conclude, cluster analysis in the model of the medical physics lesson “good” - 46.2%, “middle” - 36.7%, “bad” - 16.6%; 55.2% - “good”, 33.3% - “middle”, 11.1% - “bad” in the teacher evaluation model; 66.3% - “good” and 33.3% of “bad” in the student evaluation model.

Keywords: questionnaire, data mining, k-means method, silhouette coefficient

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12746 Dengue Prevention and Control in Kaohsiung City

Authors: Chiu-Wen Chang, I-Yun Chang, Wei-Ting Chen, Hui-Ping Ho, Ruei-Hun Chang, Joh-Jong Huang

Abstract:

Kaohsiung City is located in the tropical region where has Aedes aegypti and Aedes albopictus distributed; once the virus invades, it’s can easily trigger local epidemic. Besides, Kaohsiung City has a world-class airport and harbor, trade and tourism are close and frequently with every country, especially with the Southeast Asian countries which also suffer from dengue. Therefore, Kaohsiung City faces the difficult challenge of dengue every year. The objectives of this study was to enhance dengue clinical care, border management and vector surveillance in Kaohsiung City by establishing an larger scale, innovatively and more coordinated dengue prevention and control strategies in 2016, including (1) Integrated medical programs: facilitated 657 contract medical institutions, widely set up NS1 rapid test in clinics, enhanced triage and referrals system, dengue case daily-monitoring management (2) Border quarantine: comprehensive NS1 screening for foreign workers and fisheries when immigration, hospitalization and isolation for suspected cases, health education for high risk groups (foreign students, other tourists) (3) Mosquito control: Widely use Gravitrap to monitor mosquito density in environment, use NS1 rapid screening test to detect community dengue virus (4) Health education: create a dengue app for people to immediately inquire the risk map and nearby medical resources, routine health education to all districts to strengthen public’s dengue knowledge, neighborhood cleaning awards program. The results showed that after new integration of dengue prevention and control strategies fully implemented in Kaohsiung City, the number of confirmed cases in 2016 declined to 342 cases, the majority of these cases are the continuation epidemic in 2015; in fact, only two cases confirmed after the 2016 summer. Besides, the dengue mortality rate successfully decreased to 0% in 2016. Moreover, according to the reporting rate from medical institutions in 2014 and 2016, it dropped from 27.07% to 19.45% from medical center, and it decreased from 36.55% to 29.79% from regional hospital; however, the reporting rate of district hospital increased from 11.88% to 15.87% and also increased from 24.51% to 34.89% in general practice clinics. Obviously, it showed that under the action of strengthening medical management, it reduced the medical center’s notification ratio and improved the notification ratio of general clinics which achieved the great effect of dengue clinical management and dengue control.

Keywords: dengue control, integrated control strategies, clinical management, NS1

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12745 Integrative Review: Impact of Transitional Care on Self-Management of Chronic Conditions in Un/Underinsured Populations

Authors: Ashleigh Medina

Abstract:

Chronic conditions account for the majority of total health care spending both in the United States and globally. Encouraging self-management to improve chronic conditions, which in turn could decrease the strain placed on hospitals, requires resources to address the patient’s social concerns in addition to their medical concerns. Transitional care has been identified as a possible bridge between acutely managing conditions at the hospital to chronically managing conditions in a community setting. The aim of this integrative review was to examine the impact of transitional care on self-management outcomes of chronic conditions in un/underinsured populations. Both transitional care, by assisting with resources such as funding sources for healthcare and medications or identifying a healthcare provider for continued care, and self-management, by increasing responsibility for one’s care through goal setting and taking action, can impact health outcomes while providing health care cost-savings.

Keywords: chronic conditions, self-management, transitional care, uninsured

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12744 The Impacts of New Digital Technology Transformation on Singapore Healthcare Sector: Case Study of a Public Hospital in Singapore from a Management Accounting Perspective

Authors: Junqi Zou

Abstract:

As one of the world’s most tech-ready countries, Singapore has initiated the Smart Nation plan to harness the full power and potential of digital technologies to transform the way people live and work, through the more efficient government and business processes, to make the economy more productive. The key evolutions of digital technology transformation in healthcare and the increasing deployment of Internet of Things (IoTs), Big Data, AI/cognitive, Robotic Process Automation (RPA), Electronic Health Record Systems (EHR), Electronic Medical Record Systems (EMR), Warehouse Management System (WMS in the most recent decade have significantly stepped up the move towards an information-driven healthcare ecosystem. The advances in information technology not only bring benefits to patients but also act as a key force in changing management accounting in healthcare sector. The aim of this study is to investigate the impacts of digital technology transformation on Singapore’s healthcare sector from a management accounting perspective. Adopting a Balanced Scorecard (BSC) analysis approach, this paper conducted an exploratory case study of a newly launched Singapore public hospital, which has been recognized as amongst the most digitally advanced healthcare facilities in Asia-Pacific region. Specifically, this study gains insights on how the new technology is changing healthcare organizations’ management accounting from four perspectives under the Balanced Scorecard approach, 1) Financial Perspective, 2) Customer (Patient) Perspective, 3) Internal Processes Perspective, and 4) Learning and Growth Perspective. Based on a thorough review of archival records from the government and public, and the interview reports with the hospital’s CIO, this study finds the improvements from all the four perspectives under the Balanced Scorecard framework as follows: 1) Learning and Growth Perspective: The Government (Ministry of Health) works with the hospital to open up multiple training pathways to health professionals that upgrade and develops new IT skills among the healthcare workforce to support the transformation of healthcare services. 2) Internal Process Perspective: The hospital achieved digital transformation through Project OneCare to integrate clinical, operational, and administrative information systems (e.g., EHR, EMR, WMS, EPIB, RTLS) that enable the seamless flow of data and the implementation of JIT system to help the hospital operate more effectively and efficiently. 3) Customer Perspective: The fully integrated EMR suite enhances the patient’s experiences by achieving the 5 Rights (Right Patient, Right Data, Right Device, Right Entry and Right Time). 4) Financial Perspective: Cost savings are achieved from improved inventory management and effective supply chain management. The use of process automation also results in a reduction of manpower costs and logistics cost. To summarize, these improvements identified under the Balanced Scorecard framework confirm the success of utilizing the integration of advanced ICT to enhance healthcare organization’s customer service, productivity efficiency, and cost savings. Moreover, the Big Data generated from this integrated EMR system can be particularly useful in aiding management control system to optimize decision making and strategic planning. To conclude, the new digital technology transformation has moved the usefulness of management accounting to both financial and non-financial dimensions with new heights in the area of healthcare management.

Keywords: balanced scorecard, digital technology transformation, healthcare ecosystem, integrated information system

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12743 The Best Prediction Data Mining Model for Breast Cancer Probability in Women Residents in Kabul

Authors: Mina Jafari, Kobra Hamraee, Saied Hossein Hosseini

Abstract:

The prediction of breast cancer disease is one of the challenges in medicine. In this paper we collected 528 records of women’s information who live in Kabul including demographic, life style, diet and pregnancy data. There are many classification algorithm in breast cancer prediction and tried to find the best model with most accurate result and lowest error rate. We evaluated some other common supervised algorithms in data mining to find the best model in prediction of breast cancer disease among afghan women living in Kabul regarding to momography result as target variable. For evaluating these algorithms we used Cross Validation which is an assured method for measuring the performance of models. After comparing error rate and accuracy of three models: Decision Tree, Naive Bays and Rule Induction, Decision Tree with accuracy of 94.06% and error rate of %15 is found the best model to predicting breast cancer disease based on the health care records.

Keywords: decision tree, breast cancer, probability, data mining

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12742 Process Mining as an Ecosystem Platform to Mitigate a Deficiency of Processes Modelling

Authors: Yusra Abdulsalam Alqamati, Ahmed Alkilany

Abstract:

The teaching staff is a distinct group whose impact is on the educational process and which plays an important role in enhancing the quality of the academic education process. To improve the management effectiveness of the academy, the Teaching Staff Management System (TSMS) proposes that all teacher processes be digitized. Since the BPMN approach can accurately describe the processes, it lacks a clear picture of the process flow map, something that the process mining approach has, which is extracting information from event logs for discovery, monitoring, and model enhancement. Therefore, these two methodologies were combined to create the most accurate representation of system operations, the ability to extract data records and mining processes, recreate them in the form of a Petri net, and then generate them in a BPMN model for a more in-depth view of process flow. Additionally, the TSMS processes will be orchestrated to handle all requests in a guaranteed small-time manner thanks to the integration of the Google Cloud Platform (GCP), the BPM engine, and allowing business owners to take part throughout the entire TSMS project development lifecycle.

Keywords: process mining, BPM, business process model and notation, Petri net, teaching staff, Google Cloud Platform

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12741 Congenital Heart Defect(CHD) “The Silent Crises”; The Need for New Innovative Ways to Save the Ghanaian Child - A Retrospective Study

Authors: Priscilla Akua Agyapong

Abstract:

Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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12740 Comparison of Carcass Weight of Pure and Mixed Races Namebar 30-Day Squabs

Authors: Sepehr Moradi, Mehdi Asadi Rad

Abstract:

The aim of this study is to evaluate and compare carcass weight of pure and mixed races Namebar 30-day pigeons to investigate about their sex, race, and some auxiliary variables. In this paper, 68 pieces of pigeons as 34 male and female pairs with equal age are studied randomly. A natural incubation was done from each pair. All produced chickens were slaughtered at 30 days age after 12 hours hunger. Then their carcasses were weighted by a scale with one gram precision. A covariance analysis was used since there were many auxiliary variables and unequal observations. SAS software was used for statistical analysis. Mean weight of carcass in pure race (Namebar-Namebar) with 8 records, 219.5±61.3 gr and mixed races of Kabood-Namebar, Parvazy-Namebar, Tizpar-Namebar, Namebar-Kabood, Namebar-Tizpar, and Namebar-Parvazy with 8, 10, 8, 12, 12, and 10 records were 369.9±54.6, 338.3±52.7, 224.5±73.6, 142.3±67.8, 155.6±56.2, and 170.2±55 gr, respectively.. Difference carcass weight of 30-day of Namebar-Namebar race with Namebar-Kabood, Namebar-Parvazy, Namebar-Tizpar, Parvazy-Namebar and Tizpar-Namebar mixed races was not significant, and was significant in level 5% with Kabood- Namebar (P < 0.05). Effect of sex and age were also significant in 1% level (P < 0.01), but mutual effect of sex and race was not significant. The results showed that most and least weights of carcass belonged to Kabood-Namebar and Namebar-Kabood.

Keywords: squab, Namebar race, 30-day carcass weight, pigeons

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12739 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh

Authors: Mannan Mridha, Mohammad S. Islam

Abstract:

Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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12738 Waste Management in Africa

Authors: Peter Ekene Egwu

Abstract:

Waste management is of critical importance in Africa for reasons related to public health, human dignity, climate resilience and environmental preservation. However, delivering waste management services requires adequate funding, which has generally been lacking in a context where the generation of waste is outpacing the development of waste management infrastructure in most cities. The sector represents a growing percentage of cities’ greenhouse gas (GHG) emissions, and some of the African cities profiled in this study are now designing waste management strategies with emission reduction in mind.

Keywords: management waste material, Africa, uses of new technology to manage waste, waste management

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12737 Real-Time Big-Data Warehouse a Next-Generation Enterprise Data Warehouse and Analysis Framework

Authors: Abbas Raza Ali

Abstract:

Big Data technology is gradually becoming a dire need of large enterprises. These enterprises are generating massively large amount of off-line and streaming data in both structured and unstructured formats on daily basis. It is a challenging task to effectively extract useful insights from the large scale datasets, even though sometimes it becomes a technology constraint to manage transactional data history of more than a few months. This paper presents a framework to efficiently manage massively large and complex datasets. The framework has been tested on a communication service provider producing massively large complex streaming data in binary format. The communication industry is bound by the regulators to manage history of their subscribers’ call records where every action of a subscriber generates a record. Also, managing and analyzing transactional data allows service providers to better understand their customers’ behavior, for example, deep packet inspection requires transactional internet usage data to explain internet usage behaviour of the subscribers. However, current relational database systems limit service providers to only maintain history at semantic level which is aggregated at subscriber level. The framework addresses these challenges by leveraging Big Data technology which optimally manages and allows deep analysis of complex datasets. The framework has been applied to offload existing Intelligent Network Mediation and relational Data Warehouse of the service provider on Big Data. The service provider has 50+ million subscriber-base with yearly growth of 7-10%. The end-to-end process takes not more than 10 minutes which involves binary to ASCII decoding of call detail records, stitching of all the interrogations against a call (transformations) and aggregations of all the call records of a subscriber.

Keywords: big data, communication service providers, enterprise data warehouse, stream computing, Telco IN Mediation

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12736 Using the Clinical Decision Support Platform, Dem DX, to Assess the ‘Urgent Community Care Team’s Notes Regarding Clinical Assessment, Management, and Healthcare Outcomes

Authors: R. Tariq, R. Lee

Abstract:

Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

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12735 The Efficacy of Psychological Interventions for Psychosis: A Systematic Review and Network Meta-Analysis

Authors: Radu Soflau, Lia-Ecaterina Oltean

Abstract:

Background: Increasing evidence supports the efficacy of psychological interventions for psychosis. However, it is unclear which one of these interventions is most likely to address negative psychotic symptoms and related outcomes. We aimed to determine the relative efficacy of psychological and psychosocial interventions for negative symptoms, overall psychotic symptoms, and related outcomes. Methods: To attain this goal, we conducted a systematic review and network meta-analysis. We searched for potentially eligible trials in PubMed, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases up until February 08, 2022. We included randomized controlled trials that investigated the efficacy of psychological for adults with psychosis. We excluded interventions for prodromal or “at risk” individuals, as well as patients with serious co-morbid medical or psychiatric conditions (others than depressive and/or anxiety disorders). Two researchers conducted study selection and performed data extraction independently. Analyses were run using STATA network and mvmeta packages, applying a random effect model under a frequentist framework in order to compute standardized mean differences or risk ratio. Findings: We identified 47844 records and screened 29466 records for eligibility. The majority of eligible interventions were delivered in addition to pharmacological treatment. Treatment as usual (TAU) was the most frequent common comparator. Theoretically driven psychological interventions generally outperformed TAU at post-test and follow-up, displaying small and small-to-medium effect sizes. A similar pattern of results emerged in sensitivity analyses focused on studies that employed an inclusion criterion for relevant negative symptom severity. Conclusion: While the efficacy of some psychological interventions is promising, there is a need for more high-quality studies, as well as more trials directly comparing psychological treatments for negative psychotic symptoms.

Keywords: psychosis, network meta-analysis, psychological interventions, efficacy, negative symptoms

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