Search results for: structural healthcare monitoring

Authors: Temesgen Geremew

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This study investigates the evolution of polythiophene nanoparticles (PThNPs) as surface-enhanced Raman spectroscopy (SERS) sensors for Pb²⁺ detection in river water. We analyze the PThNPs' optical, structural, and morphological properties at different stages of their development to understand their SERS performance. Techniques like UV-Vis spectroscopy, Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and scanning electron microscopy (SEM) are employed for characterization. The SERS sensitivity towards Pb²⁺ is evaluated by monitoring the peak intensity of a specific Raman band upon increasing metal ion concentration. The study aims to elucidate the relationship between the PThNPs' characteristics and their SERS efficiency for Pb²⁺ detection, paving the way for optimizing their design and fabrication for improved sensing performance in real-world environmental monitoring applications.

Keywords: polythiophene, Pb2+, SERS, nanoparticles

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Authors: Kingsley Agyapong

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Research conducted in recent years has delved into the concept of patient-perceived value within the context of co-creation, particularly in the realm of doctor-patient interactions within healthcare settings. However, existing scholarly discourse lacks exploration regarding the emergence of patient-derived value in the co-creation process, specifically within encounters involving patients and stakeholders such as doctors, nurses, pharmacists, and other healthcare professionals. This study aims to fill this gap by elucidating the perspectives of patients regarding the value they derive from their interactions with multiple stakeholders in the delivery of healthcare services. The fieldwork was conducted at a university clinic located in Ghana. Data collection procedures involved conducting 20 individual interviews with key informants on distinct value accrued from co-creation practices and interactions with stakeholders. The key informants consisted of patients receiving care at the university clinic during the Malaria Treatment Process. Three themes emerged from both the existing literature and the empirical data collected. The first theme, labeled as "patient value needs in co-creation," encapsulates elements such as communication effectiveness, interpersonal interaction quality, treatment efficacy, and enhancements to the overall quality of life experienced by patients during their interactions with healthcare professionals. The second theme, designated as "services that enhance patients' experience in value co-creation," pertains to patients' perceptions of services that contribute favourably to co-creation experiences, including initiatives related to health promotion and the provision of various in-house services that patients deem pertinent for augmenting their overall experiences. The third theme, titled "Challenges in the co-creation of patients' value," delineates obstacles encountered within the co-creation process, including health professionals' challenges in effectively following up with patients scheduled for review and prolonged waiting times for healthcare delivery. This study contributes to the patients' perceptions of value within the co-creation process during their interactions with service providers, particularly healthcare professionals. By gaining a deeper insight into this process, healthcare providers can enhance the delivery of patient-centered care, thereby leading to improved healthcare outcomes. The study further offers managerial implications derived from its findings, providing actionable insights for healthcare managers and policymakers aiming to optimize patient value creation in healthcare services. Furthermore, it suggests avenues for future research endeavors within healthcare settings.

Keywords: patient, healthcare, co-creation, malaria

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Authors: Ali Kheyroddin, Niloufar Mashhadiali, Frazaneh Kheyroddin

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In last decades, tubular systems employed for tall buildings were efficient structural systems. However, increasing the height of a building leads to an increase in structural material corresponding to the loads imposed by lateral loads. Based on this approach, new structural systems are emerging to provide strength and stiffness with the minimum premium for height. In this research, selected tube-type structural systems such as framed tubes, braced tubes, diagrids and hexagrid systems were applied as a single tube, tubular structures combined with braced core and outrigger trusses on a set of 48, 72, and 96-story, respectively, to improve integrated structural systems. This paper investigated structural material consumption by model structures focusing on the premium for height. Compared analytical results indicated that as the height of the building increased, combination of the structural systems caused the framed tube, hexagrid and braced tube system to pay fewer premiums to material tonnage while in diagrid system, combining the structural system reduced insignificantly the steel material consumption.

Keywords: braced tube, diagrid, framed tube, hexagrid

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Authors: M. Taha, Hala H. Zayed, T. Nazmy, M. Khalifa

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Recently, traffic monitoring has attracted the attention of computer vision researchers. Many algorithms have been developed to detect and track moving vehicles. In fact, vehicle tracking in daytime and in nighttime cannot be approached with the same techniques, due to the extreme different illumination conditions. Consequently, traffic-monitoring systems are in need of having a component to differentiate between daytime and nighttime scenes. In this paper, a HSV-based day/night detector is proposed for traffic monitoring scenes. The detector employs the hue-histogram and the value-histogram on the top half of the image frame. Experimental results show that the extraction of the brightness features along with the color features within the top region of the image is effective for classifying traffic scenes. In addition, the detector achieves high precision and recall rates along with it is feasible for real time applications.

Keywords: day/night detector, daytime/nighttime classification, image classification, vehicle tracking, traffic monitoring

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Authors: Feng Wang, Shencheng Ni, Shuying Han, Shanhong You

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With the development of optical communication, optical performance monitoring (OPM) has received more and more attentions. Since optical signal-to-noise ratio (OSNR) is directly related to bit error rate (BER), it is one of the important parameters in optical networks. Recently, artificial neural network (ANN) has been greatly developed. ANN has strong learning and generalization ability. In this paper, a method of OSNR monitoring based on delay-tap sampling (DTS) and ANN has been proposed. DTS technique is used to extract the eigenvalues of the signal. Then, the eigenvalues are input into the ANN to realize the OSNR monitoring. The experiments of 10 Gb/s non-return-to-zero (NRZ) on–off keying (OOK), 20 Gb/s pulse amplitude modulation (PAM4) and 20 Gb/s return-to-zero (RZ) differential phase-shift keying (DPSK) systems are demonstrated for the OSNR monitoring based on the proposed method. The experimental results show that the range of OSNR monitoring is from 15 to 30 dB and the root-mean-square errors (RMSEs) for 10 Gb/s NRZ-OOK, 20 Gb/s PAM4 and 20 Gb/s RZ-DPSK systems are 0.36 dB, 0.45 dB and 0.48 dB respectively. The impact of chromatic dispersion (CD) on the accuracy of OSNR monitoring is also investigated in the three experimental systems mentioned above.

Keywords: artificial neural network (ANN), chromatic dispersion (CD), delay-tap sampling (DTS), optical signal-to-noise ratio (OSNR)

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Authors: Soo Hong Da, Ng Zheng Yao, Burra Venkata Durga Kumar

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The Healthcare sector is a business that consists of providing medical services, manufacturing medical equipment and drugs as well as providing medical insurance to the public. Most of the time, the data stored in the healthcare database is to be related to patient’s information which is required to be accurate when it is accessed by authorized stakeholders. In distributed systems, one important issue is concurrency in the system as it ensures the shared resources to be synchronized and remains consistent through multiple read and write operations by multiple clients. The problems of concurrency in the healthcare sector are who gets the access and how the shared data is synchronized and remains consistent when there are two or more stakeholders attempting to the shared data simultaneously. In this paper, a framework that is beneficial to distributed healthcare sector concurrent environment is proposed. In the proposed framework, four different level nodes of the database, which are national center, regional center, referral center, and local center are explained. Moreover, the frame synchronization is not symmetrical. There are two synchronization techniques, which are complete and partial synchronization operation are explained. Furthermore, when there are multiple clients accessed at the same time, synchronization types are also discussed with cases at different levels and priorities to ensure data is synchronized throughout the processes.

Keywords: resources, healthcare, concurrency, synchronization, stakeholders, database

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Authors: Priya Nambisan, Lien B. Nguyen

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Women participate extensively in the healthcare field, professionally (as physicians, nurses, dietitians, etc.) as well as informally (as caregivers at home). This provides them with a better understanding of the health needs of people. Women are also in the forefront of using social media and other mobile health related apps. Further, many health mobile apps are specifically designed for women users. All of these indicate the potential for women to be successful entrepreneurs in healthcare, especially, in the area of mobile health app development. However, extant research in entrepreneurship has paid limited attention to women entrepreneurship in healthcare. The objective of this study is to determine the key factors that shape the intentions and actions of women entrepreneurs with regard to their entrepreneurial pursuits in the healthcare field. Specifically, the study advances several hypotheses that relate key variables such as personal skills and capabilities, experience, support from institutions and family, and perceptions regarding entrepreneurship to individual intentions and actions regarding entrepreneurship (specifically, in the area of mobile apps). The study research model will be validated using survey data collected from potential women entrepreneurs in the healthcare field – students in the area of health informatics and engineering. The questionnaire-based survey relates to woman respondents’ intention to become entrepreneurs in healthcare and the key factors (independent variables) that may facilitate or inhibit their entrepreneurial intentions and pursuits. The survey data collection is currently ongoing. We also plan to conduct semi-structured interviews with around 10-15 women entrepreneurs who are currently developing mobile apps to understand the key issues and challenges that they face in this area. This is an exploratory study and as such our goal is to combine the findings from the regression analysis of the survey data and that from the content analysis of the interview data to inform on future research on women entrepreneurship in healthcare. The study findings will hold important policy implications, specifically for the development of new programs and initiatives to promote women entrepreneurship, particularly in healthcare and technology areas.

Keywords: women entrepreneurship, healthcare, mobile apps, health apps

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Authors: Ahmad Saifullah Mazlan, Hossein Basser, Shatirah Akib

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Scouring pattern evaluation and measuring its depth around coastal and offshore structures is very essential issue to assure the safety of the structures as well as providing needed design parameters. Scouring is known as one of the important phenomena which threatens the safety of infrastructures. Several countermeasures have been developed to control scouring by protecting the structures against water flow attack directly or indirectly by changing the water flow pattern. Recently, monitoring methods for estimating water flow pattern and scour depth are studied to track the safety of structures. Since most of studies regarding scouring is related to monitoring scouring around piers in rivers therefore it is necessary to develop researches investigating scouring around piers in coastal and offshore areas. This paper describes a review of monitoring methods may be used for detecting scour depth around piers in coastal and offshore structures.

Keywords: scour, monitoring, pier, coastal, offshore

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Authors: Carmen Silvia Gabriel, Maria de Fátima Paiva Brito, Mariane de Paula Candido, Vanessa Barato Oliveira

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Patient identification is a necessary practice to ensure patient safety in any healthcare environment, including emergency care units, test laboratories, home care and clinics. The present study aimed to provide evidence that can effectively contribute to practices concerning patient identification. Its objective was to investigate patient identification in basic healthcare units through patient safety standards. To do so, a descriptive and non-experimental research outline study was carried out to inquire how patient identification takes place in a particular situation. All technical manager nurses from the chosen healthcare facilities were included in the sample for the study. Data was collected in September of 2014 after approval from the Committee of Ethics. All researched institutions fit the same profile: they’re public facilities for general care with observation beds. None of them has a wristband identification protocol or policy. Only one institution mentioned using some kind of visual identification; namely, body tags separated by colors according to the type of care, but it still does not apply the recommended tags by the Brazilian Ministry of Health. This study allowed the authors to acknowledge how important the commitment from the whole healthcare team in the patient identification process is and also acknowledge how necessary it is to implement institutional policies that may aid the healthcare units in this area to promote a quality and safe patient care.

Keywords: patient safety, identification, nursing, emergency care units

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Authors: Lesley Clack, Rachel Ellison, Elizabeth Chambers

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A belief exists that there are huge gender and racial disparities among hospital CEO’s in the United States, and historically, male, Caucasian healthcare executives have made significantly larger salaries than females and other races. With a recent focus on reducing barriers and disparities in healthcare, it remains to be seen whether there have been changes in these disparities over time. The purpose of this study was to explore disparities among salaries of hospital executives in the United States. Analysis of salary data was conducted utilizing online hospital salary databases. Statistical analysis was conducted to examine the significance of the differences. Results indicated that there had been improvements in disparities among some ethnicities. Gender disparities remain the largest gap. The implications of this study are significant for the field of healthcare management as disparities can affect both social dynamics and organizational culture. Understanding where disparities lie is the first step towards bridging the gap and reducing barriers for cultural diversity within healthcare management.

Keywords: health care, disparities, management, executives

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Authors: Kyle Yatich Terik, Collins Oduor

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The current healthcare system has made healthcare more accessible and efficient by the use of information technology through the implementation of computer algorithms that generate menus based on the diagnosis. While many systems just like these have been created over the years, their main objective is to help healthy individuals calculate their calorie intake and assist them by providing food selections based on a pre-specified calorie. That application has been proven to be useful in some ways, and they are not suitable for monitoring, planning, and managing hospital patients, especially that critical condition their dietary needs. The system also addresses a number of objectives, such as; the main objective is to be able to design, develop and implement an efficient, user-friendly as well as and interactive dietary management system. The specific design development objectives include developing a system that will facilitate a monitoring feature for users using graphs, developing a system that will provide system-generated reports to the users, dietitians, and system admins, design a system that allows users to measure their BMI (Body Mass Index), the system will also provide food template feature that will guide the user on a balanced diet plan. In order to develop the system, further research was carried out in Kenya, Nairobi County, using online questionnaires being the preferred research design approach. From the 44 respondents, one could create discussions such as the major challenges encountered from the manual dietary system, which include no easily accessible information of the calorie intake for food products, expensive to physically visit a dietitian to create a tailored diet plan. Conclusively, the system has the potential of improving the quality of life of people as a whole by providing a standard for healthy living and allowing individuals to have readily available knowledge through food templates that will guide people and allow users to create their own diet plans that consist of a balanced diet.

Keywords: DMS, dietitian, patient, administrator

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Authors: Cesar Eduardo Hernández Curiel, Victor Hugo Benítez Baltazar, Jesús Horacio Pacheco Ramírez

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This paper is devoted to present the advances in the design of a prototype that is able to supervise the complex behavior of water quality parameters such as pH and temperature, via a real-time monitoring system. The current water quality tests that are performed in government water quality institutions in Mexico are carried out in problematic locations and they require taking manual samples. The water samples are then taken to the institution laboratory for examination. In order to automate this process, a water quality monitoring system based on wireless sensor networks is proposed. The system consists of a sensor node which contains one pH sensor, one temperature sensor, a microcontroller, and a ZigBee radio, and a base station composed by a ZigBee radio and a PC. The progress in this investigation shows the development of a water quality monitoring system. Due to recent events that affected water quality in Mexico, the main motivation of this study is to address water quality monitoring systems, so in the near future, a more robust, affordable, and reliable system can be deployed.

Keywords: pH measurement, water quality monitoring, wireless sensor networks, ZigBee

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Authors: Jeanne Grace, Melkamu D. Kassa

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Background: Despite the recognized benefits of physical exercise, including a reduction of health risk factor indicators, illness and deaths related to Non-Communicable Diseases (NCDs) like cardiovascular disease, diabetes, hypertension, and cancer, the extent of its recognition and use as a prevention strategy by healthcare professionals working in Ethiopian referral hospitals is unknown. Objective: This study explored healthcare professionals’ use of physical exercise as a non-communicable disease prevention strategy in the Ethiopian public sector healthcare system. Methods: In this cross-sectional study, a self-administered questionnaire was conducted after being piloted to ensure validity and reliability. For the study, 312 participants were selected from 13 purposively selected Ethiopian referral hospitals, these being 99 physicians who were purposively selected and 213 nurses who were proportionately and randomly selected. Results: The results indicated that three-quarters (78%) of healthcare professionals working in Ethiopian hospitals are not using physical exercise as a strategy to prevent NCDs. Increased specialization (AOR = 20.203, p < 0.001), longer service years (AOR = 0.041, p = 0.014), young age (AOR = 19.871, p < 0.001), and being male (AOR = 0.269, p < 0.001), were predictors of using physical exercise as a strategy for the prevention of NCDs. Conclusion: Healthcare professionals’ utilization of physical exercise as a strategy for NCDs prevention was inadequate in Ethiopia. Given the increasing burden of NCD disease in Ethiopia, training nurses, physicians and medical managers have to acknowledge the use of physical exercise as an NCD prevention strategy. The results of this study highlight the importance of formulating physical exercise intervention strategies for NCDs patients, and the need to incorporate training for healthcare professionals on the type, intensity, duration, and frequency of physical exercise to prevent NCDs in the Ethiopian healthcare system.

Keywords: exercise, medical managers, nurses, physicians

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Authors: Nick Woodier, Paul Sampson, Iain Moppett

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Background: For years, healthcare across the world has recognised that patients are coming to harm from the very processes meant to help them. In response, healthcare tells itself that it needs to ‘be more like aviation.’ Aviation safety is highly regarded by those in healthcare and is seen as an exemplar. Specifically, healthcare is keen to learn from how aviation uses near misses to make their industry safer. Healthcare is rife with near misses; however, there has been little progress addressing them, with most research having focused on reporting. Addressing the factors that contribute to near misses will potentially help reduce the number of significant, harm patientsafety incidents. While the healthcare literature states the need to learn from aviation’s use of near misses, there is nothing that describes how best to do this. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from aviation to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how aviation, amongst other safety-critical industries, manages near misses. Results: Twelve aviation interviews contributed to the GT across passenger airlines, air traffic control, and bodies involved in policy, regulation, and investigation. The scoping review identified 83 articles across a range of safety-critical industries, but only seven focused on aviation. The GT identified that aviation interprets the term ‘near miss’ in different ways, commonly using it to specifically refer to near-miss air collisions, also known as Airproxes. Other types of near misses exist, such as health and safety, but the reporting of these and the safety climate associated with them is not as mature. Safety culture in aviation was regularly discussed, with evidence that culture varies depending on which part of the industry is being considered (e.g., civil vs. business aviation). Near misses are seen as just one part of an extensive safety management system, but processes to support their reporting and their analysis are not consistent. Their value alone is also questionable, with the challenge to long-held beliefs originating from the ‘common cause hypothesis.’ Conclusions: There is learning that healthcare can take from how parts of aviation manage and learn from near misses. For example, healthcare would benefit from a formal safety management system that currently does not exist. However, it may not be as simple as ‘healthcare should learn from aviation’ due to variation in safety maturity across the industry. Healthcare needs to clarify how to incorporate near misses into learning and whether allocating resources to them is of value; it was heard that catastrophes have led to greater improvements in safety in aviation.

Keywords: aviation safety, patient safety, near miss, safety management systems

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Authors: Mehwish Sarfaraz Ahmad

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Background: There is a prevailing perception in Pakistan that private hospitals offer better services than government hospitals. Unfortunately, Pakistan faces challenges in providing efficient healthcare due to limited resources and management capabilities, resulting in demotivation among healthcare workers. Aim: The purpose of this study was to conduct a comprehensive assessment of the occupational health and well-being of healthcare workers in both public and private sector tertiary care hospitals in Lahore, Pakistan, to compare the well-being of healthcare professionals in these two sectors and investigate the influence of workplace culture and experiences on their overall health. Methods: A cross-sectional study was conducted using a validated International Questionnaire, and data from 440 participants was collected using a stratified random sampling technique from a diverse group of healthcare professionals from the public and private tertiary care hospitals in Lahore, Pakistan. The researcher conducted a comparative analysis using appropriate statistical tests, such as Anova, t-tests, chi-square tests, and regression analysis, to explore potential relationships between various factors. Results: The majority of respondents (70.2%) reported their health as "Good" or "Very good, a small percentage (8.2%) rated their health as "Poor," while 24.1% considered their health as "Fair". 39.6% reported being satisfied with their workplace culture, while a majority of 60.4% indicated being unsatisfied with their workplace culture. Results showed that workplace culture has a positive correlation with the overall health and well-being of healthcare professionals. The study found significant differences in health ratings, prevalence of chronic health conditions, workplace culture, and safety perceptions between healthcare professionals in public and private sector tertiary care hospitals. Conclusion: The study's findings emphasize the significance of promoting a positive workplace culture, ensuring workplace safety, and addressing chronic health conditions among healthcare workers.

Keywords: occupational health and well-being, workplace culture, frequency of fatigue, availabity of benefits

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Authors: Mariem Kchaou, Wiem Khlif, Faiez Gargouri

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Modeling business processes is an essential task when evaluating, improving, or documenting existing business processes. To be efficient in such tasks, a business process model (BPM) must have high structural quality and high performance. Evidently, evaluating the performance of a business process model is a necessary step to reduce time, cost, while assessing the structural quality aims to improve the understandability and the modifiability of the BPMN model. To achieve these objectives, a set of structural and performance measures have been proposed. Since the diversity of measures, we propose a framework that integrates both structural and performance aspects for classifying them. Our measure classification is based on business process model perspectives (e.g., informational, functional, organizational, behavioral, and temporal), and the elements (activity, event, actor, etc.) involved in computing the measures. Then, we implement this framework in a tool assisting the structural quality and the performance of a business process. The tool helps the designers to select an appropriate subset of measures associated with the corresponding perspective and to calculate and interpret their values in order to improve the structural quality and the performance of the model.

Keywords: performance, structural quality, perspectives, tool, classification framework, measures

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Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: disposal, healthcare waste, management, Montserrado County, Monrovia

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Authors: Masahiko Suzuki, Takashi Kato , Masahiro Kobayashi

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In our company, the monitoring system for signal equipment has already implemented. So, we can know the state of signal equipment, sitting in the control room or the maintenance center. But this system was installed over 20 years ago, so it cannot stand the needs such as 'more stable operation', 'broadband data transfer', 'easy construction and easy maintenance'. To satisfy these needs, we studied the monitoring system using radio communication as a new method which can realize the operation in the terrible environment along railroads. In these studies, we have developed the terminals and repeaters based on the ZigBee protocol and have implemented the application using two different radio bands simultaneously. At last, we got the good results from the fundamental examinations using the developed equipment.

Keywords: monitoring, radio communication, 2 bands, ZigBee

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Authors: Lucian Stefanita Grigore, Damian Gorgoteanu, Cristian Molder, Amado Stefan, Daniel Constantin

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The purpose of this article is to present an analytical-numerical study on the structural behavior of a sunken autonomous underwater vehicle (AUV) for emergency intervention. The need for such a study was generated by the key objective of the ERL-Emergency project. The project aims to develop a system of collaborative robots for emergency response. The system consists of two robots: unmanned ground vehicles (UGV) on tracks and the second is an AUV. The system of collaborative robots, AUV and UGV, will be used to perform missions of monitoring, intervention, and rescue. The main mission of the AUV is to dive into the maritime space of an industrial port to detect possible leaks in a pipeline transporting petroleum products. Another mission is to close and open the valves with which the pipes are provided. Finally, you will need to be able to lift a manikin to the surface, which you can take to land. Numerical analysis was performed by the finite element method (FEM). The conditions for immersing the AUV at 100 m depth were simulated, and the calculations for different fluid flow rates were repeated. From a structural point of view, the stiffening areas and the enclosures in which the command-and-control elements and the accumulators are located have been especially analyzed. The conclusion of this research is that the AUV meets very well the established requirements.

Keywords: analytical-numerical, emergency, FEM, robotics, underwater

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: Marc Dorval, Marie-Hélène Jobin

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This work presents the various perspectives, dimensions, components and definitions given to quality in the operations management (OM) and healthcare services (HCS) literature in time, highlighting gaps and learning opportunities between the two disciplines through a thorough search into their rich and distinct body of knowledge. Greater and new insights about the general nature of quality are obtained with findings such as in OM, quality has been approached in six fairly distinct paradigms (excellence, value, conformity to specifications, attributes, satisfaction and meeting or exceeding customer expectations), whereas in HCS, two approaches are prominent (Donabedian’s structure, process and outcomes model and Lohr and Schroeder’s circumscribed definition). The two disciplines views on quality seem to have progressed much in parallel with little cross-learning from each other. This work then proposes an encompassing definition of quality as a lever and suggests further research and development avenues for a better use of the concept of quality by academics and practitioners alike toward the goals of greater organizational performance and improved management in healthcare and possibly other service domains.

Keywords: healthcare, management, operations, quality, services

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Authors: Shakiera Sallie, Angela James

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Global concern about healthcare-associated infections through the transmission of microorganisms, resulting in outbreaks in overcrowded intensive care units (ICU), is current. Medical equipment and surfaces in the immediate patient zone, the high-touch objects, may become contaminated. A study was conducted across six intensive care units in a healthcare facility to determine the understanding and practice of the cleaning of high-touch objects (HTO), and an intervention program was undertaken. A mixed-method approach with the selection of ICUs, HTOs, and healthcare personnel was undertaken. Data collection included Ultra-Violet instruments, a questionnaire, and an intervention. In the pre-intervention, 41 (52.5%) of the healthcare personnel (n=78) rated their understanding of HTOs as “sufficient”; post-intervention, it was 67 (75%), (n=89), p=0.0015, indicates an improvement. The UV stamp percentage compliance to indicate whether cleaning of the HTOs had taken place across the six intensive care units before the intervention ranged from 0% compliance to 88% compliance, and after, it ranged from 67% to 91%. An intervention program on the cleaning of HTOs and the transmission cycle of microorganisms in the ICUs enhanced the healthcare personnel’s understanding and practices on the importance of environmental cleaning.

Keywords: high touch objects, infections, intensive care units, intervention program, microorganisms

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Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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Authors: Tyler D. Cesarone, Tatiana M. Wugalter

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The movement of patients from the Global North to the Global South in pursuit of inexpensive healthcare and touristic experiences dominates the academic discourse on international medical travel (IMT). However, medical travel exists in higher numbers between Global South countries as patients who lack trust in, and feel disenfranchised by, their national healthcare systems seek treatment in nearby countries. Through a review of the existing literature, this paper examines patterns of IMT in the Middle East, Southeast Asia, and Southern Africa, distinguishing North-South medical tourism from South-South intra-regional medical mobility (IRMM). Evidence from these case studies demonstrates that notions of medical distrust and disenfranchisement, rooted in low-resourced and poor quality healthcare systems, are key drivers of IRMM in the Global South. The movement of patients from lower income to proximate higher income countries not only reveals tensions between patients and their healthcare systems but widens gaps in the quality of healthcare between departing and destination countries. In analyzing these cross-regional similarities, the paper moves beyond the current literature’s focus on singular case studies to expose global patterns of South-South IRMM. This presents a shift from the traditional focus on North-South medical tourism, demonstrating how disparities in healthcare systems both influence and are influenced by IRMM.

Keywords: global South, healthcare quality, international medical travel (IMT), intra-regional medical mobility (IRMM), medical disenfranchisement, medical distrust, medical tourism

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Authors: Ekin Ozer, Maria Q. Feng, Rupa Purasinghe

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Structural deterioration of bridge systems possesses an ongoing threat to the transportation networks. Besides, landmark bridges’ integrity and safety are more than sole functionality, since they provide a strong presence for the society and nations. Therefore, an innovative and sustainable method to inspect landmark bridges is essential to ensure their resiliency in the long run. In this paper, a recently introduced concept, smartphone-based modal frequency estimation is addressed, and this paper targets to authenticate the fidelity of smartphone-based vibration measurements gathered from three landmark suspension bridges. Firstly, smartphones located at the bridge mid-span are adopted as portable and standalone vibration measurement devices. Then, their embedded accelerometers are utilized to gather vibration response under operational loads, and eventually frequency domain characteristics are deduced. The preliminary analysis results are compared with the reference publications and high-quality monitoring data to validate the usability of smartphones on long-span landmark suspension bridges. If the technical challenges such as high period of vibration, low amplitude excitation, embedded smartphone sensor features, sampling, and citizen engagement are tackled, smartphones can provide a novel and cost-free crowdsourcing tool for maintenance of these landmark structures. This study presents the early phase findings from three signature structures located in the United States.

Keywords: smart and mobile sensing, structural health monitoring, suspension bridges, vibration analysis

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Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: S. Ithai, A. Oloo

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The emergence of globalization has cultivated an international consensus that without economic development; it is very unlikely that a country may realize social or political development. It is equally important to note that the economic effect on social development automatically influence the country healthcare services as healthcare systems are improved and adopted. For decades and before 1980's, the colonial and the Governments of Kenya had pursued a goal to provide free healthcare services to its citizen with minimal success; but as population increased, this endeavor became almost a mirage. The challenge called for a change of strategy with introduction of cost sharing which also could not guarantee sustainability of healthcare services in the country due to increased number of poor people and poverty. An involvement of multisectral approach to provision of health individual, collaboration and adoption of all dimensions through globalization provides a ray of hope to not only economic, political and social development but also guaranteed equitable and reliable healthcare systems in Kenya and specifically referral healthcare services at KNH. With the advent of globalization, KNH has made positive strides that have guaranteed patients with reliable healthcare services. These include increased donor funding, collaboration levels, training and research as well as enhanced the hospital relations with international partners. During this period, the hospital has increased number of local doctors and nurses, enhanced transfer of skills, innovations and technologies which are driving forces to quality and efficient healthcare services. The period has also brought in challenges for the hospital which include increased competition, attraction of qualified nurses and doctors to international are some the issues that have made the hospital to spend more resources in research and development in order to stay afloat. This paper reveals the link between globalization and healthcare and its influence on institution policy choice. However, the process is not expected to take place automatically without institutional initiatives if KNH is to reap the benefits of globalization. KNH need to make use of the existing infrastructure, human resources and donor confidence, the opportunities that are indeed important in propelling KNH toward Vision 2030 and achieving the desired Millennium Development Goals (MDGs).

Keywords: globalization, Kenyatta National Hospital, native, healthcare

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Authors: Bassem Boshra Thabet, Mohammed Ibrahim Elsabagh, Mohammad Adly Talaat

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The number of cellular mobile phone users has increased enormously worldwide over the last two decades. Consequently, the monitoring of the performance of the Mobile Network Operators (MNOs) in terms of network coverage and broadband signal strength has become vital for both of the MNOs and regulators. This monitoring helps telecommunications operators and regulators keeping the market playing fair and most beneficial for users. However, the adopted methodologies to facilitate this continuous monitoring process are still problematic regarding cost, effort, and reliability. This paper introduces My Operator Coverage (MOC) system that is using Internet of Things (IoT) concepts and tools to monitor the MNOs performance using a crowd-sourced real-time methodology. MOC produces robust and reliable geographical maps for the user-perceived quality of the MNOs performance. MOC is also meant to enrich the telecommunications regulators with concrete, and up-to-date information that allows for adequate mobile market management strategies as well as appropriate decision making.

Keywords: mobile performance monitoring, crowd-sourced applications, mobile broadband performance, cellular networks monitoring

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Authors: Liesbeth Van Kelst, Jozefiene Jansens

Abstract:

Background: All care providers within mother and child care are confronted, at some point in their career, with the care for parents who (will) lose or have lost a baby. Obtaining the correct attitude and communicating well during these difficult moments are aspects that many healthcare provides continue to struggle with. Parents still encounter well-intentioned but inappropriate communication from healthcare providers. Aim: To study how communication, both verbal and non-verbal, around the death of a baby during pregnancy, birth, or in the first ten days postnatal was experienced by parents and healthcare providers. Methods: A qualitative study using grounded theory principles was conducted. Data were collected through 22 individual face-to-face in-depth interviews with parents who had lost a baby (n = 12) and intramural caregivers, such as midwives, nurses, gynecologists and neonatologists (n=10). In the first phase, data were analyzed within each group separately (parents and healthcare providers) and in the second phase, findings from both groups were compared and analyzed according to meta-synthesis principles. Results: The themes that emerged from the data demonstrated congruent experiences between the group of the parents and the health care providers. Both strengths and weaknesses in current care were named and suggestions for appropriate communication were formulated. Conclusion: Since most health care providers only occasionally care for parents with a deceased baby, a communication tool can optimize communication between healthcare professionals and parents who lose a baby. This is very important as the words which are said at this difficult period last a lifetime in the heads of parents.

Keywords: communication, death, perinatal loss, stillbirth

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Authors: Dragan Kljajic, Nikola Djuric, Karolina Kasas-Lazetic, Danka Antic

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Wireless communications have been expanded very fast in recent decades. This technology relies on an extensive network of base stations and antennas, using radio frequency signals to transmit information. Devices that use wireless communication, while offering various services, basically act as sources of non-ionizing electromagnetic fields (EMF). Such devices are permanently present in the human vicinity and almost constantly radiate, causing EMF pollution of the environment. This fact has initiated development of modern systems for observation of the EMF pollution, as well as for risk assessment. This paper presents the Serbian electromagnetic field monitoring network – SEMONT, designed for automated, remote and continuous broadband monitoring of EMF in the environment. Measurement results of the SEMONT monitoring at one of the test locations, within the main campus of the University of Novi Sad, are presented and discussed, along with corresponding exposure assessment of the general population, regarding the Serbian legislation.

Keywords: EMF monitoring, exposure assessment, sensor nodes, wireless network

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