Search results for: medical obligations

Authors: Amós García Montaño

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In a democracy, a public policy must be developed within the regulatory framework and considering citizen participation in its planning, design, execution, and evaluation stages, necessary factors to have both legal support and sufficient legitimacy for its operation. However, the complexity and magnitude of certain public problems results in difficulties for the generation of consensus among society members, leading to unstable and unsuccessful scenarios for the exercise of the right to citizen participation and the generation of effective and efficient public policies. This is the case of public policies against corruption, an issue that in Mexico is difficult to define and generates conflicting opinions. To provide a possible solution to this delicate reality, this paper analyzes the principle of reasonableness as a tool for identifying the basic elements that guarantee a fundamental level of the exercise of the right to citizen participation in the fight against corruption, adopting elements of human rights indicator methodologies. In this sense, the relevance of having a legal framework that establishes obligations to incorporate proactive and transversal citizen participation in the matter is observed. It is also noted the need to monitor the operation of various citizen participation mechanisms in the decision-making processes of the institutions involved in the fight and prevention of corruption, which lead to an increase in the improvement of the perception of the citizen role as a relevant actor in this field. It is concluded that the principle of reasonableness is presented as a very useful tool for the identification of basic elements that facilitate the fulfillment of human rights commitments in the field of public policies.

Keywords: anticorruption, public participation, public policies, reasonableness

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Authors: Ling-Lang Huang, Yih-Jer Wu

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Empathy is crucial for a patient-physician relationship and medical professionalism. Internet activity, gaming, or even addiction, have been more and more common among medical students. However, there’s been no report showing whether internet behavior has a substantial impact on empathy in medical students to our best knowledge. All year-2 medical students taking the optional course 'Narrative, Comprehension, and Communication' were enrolled. Internet behaviors are divided into two groups, 'internet users without online gaming (IU)' and 'internet users with online gaming (IG)', each group was further divided into 3 groups according to their average online retention time each day (< 2, 2 - 6, > 6 hours). Empathy was evaluated by the scores of the reports and humanities reflection after watching indicated movies, and by self-measured empathy questionnaire. All students taking the year-2 optional course 'Narrative, Comprehension, and Communication' were enrolled. As compared with students in the IU group, those in the IG group had significantly lower scores for the reports (81.3 ± 3.7 vs. 86.4 ± 5.1, P = 0.014). If further dividing the students into 5 groups (IU < 2, IU 2-6, IG < 2, IG 2 - 6, and IG > 6 hours), the scores were significantly and negatively correlated to online gaming with longer hours (r = -0.556, P = 0.006). However, there was no significant difference between IU and IG groups (33.0 ± 5.4 vs. 34.8 ± 3.2, P = n.s.), in terms of scores in the self-measured empathy questionnaire, neither was there any significant trend of scores along with longer online hours across the 5 groups (r = -0.164, P = n.s.). To date, there has been no evidence showing whether different internet behaviors (with or without online gaming) have distinct impacts on empathy. Although all of the medical students had a similarly good self-perception for empathy, our data suggested that online gaming did have a negative impact on their actual expression of empathy. Our observation has brought up an important issue for pondering: May IT- or gaming-assisted medical learning actually harm students’ empathy? In conclusion, this data suggests that long hours of online gaming harms expression of empathy, though all medics think themselves a person of high empathy.

Keywords: empathy. Internet, medical students, online gaming

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Authors: A. Chenafa, S. Boulenouar, M. Zitouni, M. Boukouria

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The sterilization of medical devices constitutes for all the medical professions, an inescapable obligation. It has for objective to prevent the infectious risk, both for the patient and for the medical team. The Dental surgeon as every healthcare professional has to master perfectly this subject and to train his staff to the various techniques of sterilization. It is the only way to assure the patients all the security for which they are entitled to wait when they undergo a dental care. It’s for it, that we undertook to lead an investigation aiming at estimating the sterilization practice at the dental surgeon of Sidi bel Abbes. The survey result showed a youth marked with the profession with a majority use of autoclave with cycle B and an almost total absence of the sterilization controls (test of Bowie and Dick). However, the majority of the dentists control and validate their sterilizers. Finally, our survey allowed us to describe some practices which must be improved regarding control, regarding qualification and regarding staff training. And suggestions were made in this sense.

Keywords: dental surgeon, medical devices, sterilization, survey

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Authors: Nitin Joseph

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Objectives: This study was done to assess emotional intelligence levels and to find out its association with socio demographic variables and perceived stress among medical students. Material and Methods: This study was done among first and second year medical students. Data was collected using a self-administered questionnaire. Results: Emotional intelligence scores was found to significantly increase with age of the participants (F=2.377, P < 0.05). Perceived stress was found to be significantly more among first year (t=1.997, P=0.05). Perceived stress was found to significantly decrease with increasing emotional intelligence scores (r = – 0.226, P < 0.001). Conclusion: First year students were found to be more vulnerable to stress than their seniors probably due to lesser emotional intelligence. As both these parameters are related, ample measures to improve emotional intelligence needs to be supported in the training curriculum of beginners so as to make them more stress free during early student life.

Keywords: emotional intelligence, medical students, perceived stress, socio demographic variables

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Authors: Mbuzeni Mathenjwa

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Upon their independence, most African countries adopted constitutions that proclaim respect for the rule of law. The decision to constitutionalise the rule of law is basically informed by the countries’ experience during the colonial era which was characterised by discrimination on various grounds including race, gender and religion. Despite the promise to be bound by and adhere to the rule of law, disrespect for the rule of law has become a norm in the African continent. This is evident from the reported incidence of abuse of power, failure to perform obligations imposed by law and flagrant disregard of the law by the Executive including the heads of states in the continent. In some African countries including South Africa, the courts of law have been approached to rule on the legality of the decisions of the executives, taken contrary to the prescripts of the law. South African Courts have laid down a number of decisions wherein they found that the conduct of the executive contravenes the rule of law. Consequently decisions of the executive have been declared invalid by courts. In this regard courts have become a safety net in preserving the rule of law in. Accordingly, this paper discusses the role of the courts in preserving the rule of law in Africa. This it does by explaining the notion of judicial independence and the doctrine of the rule of law. The explanation on the notion of judicial independence is relevant because only an independent judiciary can effectively review and set aside the decision of the executive including the president of a country. Furthermore, a comparative overview of the enforcement of the rule of law in African countries is done. The methods used for this research is literature review, and study of legislation and case law in selected African countries relating to the independence of the judiciary and the rule of law. Finally, a conclusion is drawn on the role of the independent judiciary to preserve the rule of law in Africa.

Keywords: Africa, constitutions, independence, judiciary

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Authors: Suvankar Chakraborty

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Introduction: Corporate Social Responsibility means the obligations of business to act in a manner which will serve the best interests of the Society. The Companies Act , 2013 for the first time has emphasized on the fact that every company having net worth of rupees five hundred crore or more, or turnover of rupees one thousand crore or more or a net profit of rupees five crore or more during any financial year shall constitute a Corporate Social Responsibility Committee of the Board consisting of three or more directors, out of which at least one director shall be an independent director. In the previous Companies Act, 1956 there was no such compulsion for constituting a Corporate Social Responsibility Committee. Objective: This study examines the changes in the perception of corporate sectors so far as social responsibility is concerned. Methodology: The study is based on secondary data obtained from various websites of different corporate sectors and the Gazette of India related to Companies Act, 1956 and the new Companies Act, 2013. For capturing the perception of the corporate world regarding the provisions of CSR in the new Companies Act, 2013, primary data has been collected through structured questionnaire. Findings: Corporate Social Responsibility can put a company on a strong base of sustainable development and in facing the business risk of foreclosure or winding up. Shouldering social responsibility on a long-term basis can help a company not only in increasing its reputation in the business world but also helps in minimizing Government intervention. . But, there can hardly be any universal rule that the area of social responsibility being wholly and solely dependent on the ethical aspect of the corporate sectors. But having said that it may be asserted that business ethics may be a key driver of CSR activities rather than rule based CSR activities in the years to come.

Keywords: business ethics, corporate social responsibility, companies act, 2013, CSR committee

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Authors: Haykal. Kay-Anne

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The health and well-being of students is a priority for the Faculty of Medicine at the University of Ottawa. The demands of medical studies are extreme, and many studies confirm that the prevalence of psychological distress is very high among medical students and that it is higher than that of the general population of the same age. The main goal is to identify risk factors for mental health among medical students at the University of Ottawa. The secondary objectives are to determine the variation of these risk factors according to demographic variables, as well as to determine if there is a change in the mental health of students during the 1st and 3rd years of their study. Medical students have a mandatory first and third-year wellness check meeting. This assessment includes a questionnaire on demographic information, mental health, and risk factors such as physical health, sleep, social support, financial stress, education and career, stress and drug use and/or alcohol. Student responses were converted to numerical values and analyzed statistically. The results show that 61% of the variation in the mean of the mental health score is explained by the following risk factors (R2 = 0.61, F (9.396) = 67.197, p < 0.01): lack of sleep and fatigue (β = 0.281, p < 0.001), lack of social support (β = 0.217, p <0.001), poor study or career development (β = 0.195, p < 0.001) and an increase stress and drug and alcohol use (β = -0.239, p < 0.001). No demographic variable has a significant effect on the presence of risk factors. In addition, fixed-effects regression demonstrated significantly lower mental health (p < 0.1) among first-year students (M = 0.587, SD = 0.072) than among third-year students (M = 0.719, SD = 0.071). This preliminary study indicates the need to continue data collection and analysis to increase the significance of the study results. As risk factors are present at the beginning of medical studies, it is important to offer resources to students very early in their medical studies and to have close monitoring and supervision.

Keywords: assessment of mental health, medical students, risk factors for mental health, wellness assessment

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Authors: Kawthar F. Albasri, Abdullah M. AlHudaithi, Dana B. AlTurairi, Abdullaziz S. AlQuraini, Adoub Y. AlDerazi, Reem A. Hubail, Haitham A. Jahrami

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Several studies have found that medical students have a significant prevalence of anxiety. The purpose of this review paper is to carefully evaluate the current research on anxiety among medical students in the MENA region and, as a result, estimate the prevalence of these disturbances. Multiple databases, including the CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, Embase, MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, PsycINFO (Psychological Information Database), Scopus, Web of Science, UpToDate, ClinicalTrials.gov, WHO Global Health Library, EbscoHost, ProQuest, JAMA Network, and ScienceDirect, were searched. The retrieved article reference lists were rigorously searched and rated for quality. A random effects meta-analysis was performed to compute estimates. The current meta-analysis revealed an alarming estimated pooled prevalence of anxiety (K = 46, N = 27023) of 52.5% [95%CI: 43.3%–61.6%]. A total of 62.0% [95% CI 42.9%; 78.0%] of the students (K = 18, N = 16466) suffered from anxiety during the COVID-19 pandemic, while 52.5% [95% CI 43.3%; 61.6%] had anxiety before COVID-19. Based on the GAD-7 measure, a total of 55.7% [95%CI 30.5%; 78.3%] of the students (K = 10, N = 5830) had anxiety, and a total of 54.7% of the students (K = 18, N = 12154) [95%CI 42.8%; 66.0%] had anxiety using the DASS-21 or 42 measure. Anxiety is a common issue among medical students, making it a genuine problem. Further research should be conducted post-COVD 19, with a focus on anxiety prevention and intervention initiatives for medical students.

Keywords: anxiety, medical students, MENA, meta-analysis, prevalence

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Authors: Tanakrit Doltanakarn

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Introduction: These days, cannabis is being accepted in many countries due to the fact that cannabis could be use in medical. The medical cannabis is used to treat and reduce the pain many diseases. For example, neuropathic pain, Parkinson, autism disorders, cancer pain reduce the adverse effect of chemotherapy, diabetes, and migraine. Active ingredients in cannabis that modulate patients' perceptions of their conditions include Δ9‐tetrahydrocannabinol (THC), cannabidiol (CBD), flavonoids, and terpenes. However, there is an adverse effect of cannabis, cardiovascular effects, psychosis, schizophrenia, mood disorder, and cognitive alternation. These effects are from the THC and CBD ingredients in the cannabis. The metabolize processes of delta-9 THC to 11-OH-delta 9 -THC (inactive form), THC were cause of adverse effects. Interestingly, the distributions of CYP2C9 gene (CYP2C9*2 and CYP2C9*3, poor metabolizer) that might affect incidences of adverse effects in patients who treated with medical cannabis. Objective: The aim of this study we want to investigate the association between genetic polymorphism of CYP2C9 frequency and Thai patients who treated with medical cannabis. Materials and Methods:We recruited sixty-five unrelated Thai patients from the College of Pharmacy, Rangsit University. DNA were extracted using Genomic DNA Mini Kit. Genotyping of CYP2C9*2 (430C>T, rs1799853) and CYP2C9*3 (1075A>C, rs1057910) were genotyped by the TaqMan Real-time PCR assay. Results: Among these 31 medicals cannabis-induced ADRs patients, they were diagnosed with 22 (33.85%) tachycardia and 3 (4.62%) arrhythmia. There were 34 (52.31%) medical cannabis-tolerant controls who were included in this study.40 (61.53%) Thai patients were female, and 25 (38.46%) were male, with median age of 57 (range 27 – 87) years. In this study, we found none of the medical cannabis-induced ADRs carried CYP2C9*2 variant along with medical cannabis-tolerant control group. CYP2C9*3 variant (intermediate metabolizer, IM) was found just only one of thirty-one (3.23%) in the medical cannabis-induced ADRs and two of thirty-fourth (5.88%) in the tolerant controls. Conclusions: Thus, the distribution of CYP2C9 alleles offer a comprehensive view of pharmacogenomics marker in Thai population that could be used as a reference for worldwide to investigate the pharmacogenomics application.

Keywords: medical cannabis, adverse effect, CYP2C9, thai patients

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Authors: Kuo-Kai Lin, Po-Lun Chang

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Background: The Emergency Care Research Institute released a list for the top 10 medical technology hazards in 2017, with the following hazard topping the list: ‘infusion errors can be deadly if simple safety steps are overlooked.’ In addition, hospitals use various assessment items to evaluate the safety of their medical equipment, confirming the importance of medical equipment safety. In recent years, the topic of patient safety has garnered increasing attention. Accordingly, various agencies have established patient safety-related committees to coordinate, collect, and analyze information regarding abnormal events associated with medical practice. Activities to promote and improve employee training have been introduced to diminish the recurrence of medical malpractice. Objective: To allow nursing personnel to acquire the skills needed to operate common medical equipment and update and review such skills whenever necessary to elevate medical care quality and reduce patient injuries caused by medical equipment operation errors. Method: In this study, a quasi-experimental design was adopted and nurses from a regional teaching hospital were selected as the study sample. Online videos instructing the operation method of common medical equipment were made and quick response codes were designed for the nursing personnel to quickly access the videos when necessary. Senior nursing supervisors and equipment experts were invited to formulate a ‘Scale-based Questionnaire for Assessing Nursing Personnel’s Operational Knowledge of Common Medical Equipment’ to evaluate the nursing personnel’s literacy regarding the operation of the medical equipment. From March to October 2017, an employee training on medical equipment operation and a practice course (simulation course) were implemented, after which the effectiveness of the training and practice course were assessed. Results: Prior to and after the training and practice course, the 66 participating nurses scored 58 and 87 on ‘operational knowledge of common medical equipment,’ respectively (showing a significant statistical difference; t = -9.407, p < .001); 53.5 and 86.3 on ‘operational knowledge of 12-lead electrocardiography’ (z = -2.087, p < .01), respectively; 40 and 79.5 on ‘operational knowledge of cardiac defibrillators’ (z = -3.849, p < .001), respectively; 90 and 98 on ‘operational knowledge of Abbott pumps’ (z = -1.841, p = 0.066), respectively; and 8.7 and 13.7 on ‘perceived competence’ (showing a significant statistical difference; t = -2.77, p < .05). In the participating hospital, medical equipment operation errors were observed in both 2016 and 2017. However, since the implementation of the intervention, medical equipment operation errors have not yet been observed up to October 2017, which can be regarded as the secondary outcome of this study. Conclusion: In this study, innovative teaching strategies were adopted to effectively enhance the professional literacy and skills of nursing personnel in operating medical equipment. The training and practice course also elevated the nursing personnel’s related literacy and perceived competence of operating medical equipment. The nursing personnel was thus able to accurately operate the medical equipment and avoid operational errors that might jeopardize patient safety.

Keywords: medical equipment, digital teaching plan, simulation-based teaching plan, operational knowledge, patient safety

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Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

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Describing clinical cases according to a clinical charting standard that enforces interoperability and enables connected care services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. This article presented a multi-tenant extension to the problem-oriented medical record that we have prototyped previously upon using the GraphQL Application Programming Interface to represent the notion of a problem list. Our implemented extension enables physicians and patients to collaboratively describe the patient case via using multi chatbots to collaboratively describe the patient case using the SOAP charting standard. Our extension also connects the described SOAP patient case with the HL7 FHIR (Health Interoperability Resources) medical record for connecting the patient case to the bench data.

Keywords: problem-oriented medical record, graphQL, chatbots, SOAP

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Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria

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In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.

Keywords: e-health for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device

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Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance

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Authors: Randy M. Fitratullah, Afriwardi, Nurhayati

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Overweight-obesity caused by exercise. The objective of this research is to analyze the relation between exercise with the incidence of overweight-obesity of medical students of medical faculty of Andalas Univesity batch 2013. This is an analytical observational research with case-control method. This research conducted in FK Unand on September-October 2015. The population of this research is medical students batch 2013. 26 samples (13 samples were case, 13 samples were control) were taken by purposive sampling technique and analysed using statistical univariate and bivariate analysis. Exercise questionnaire was used as research instruments. Based on the interview with questionnaire, anaerobic exercise was majority in case group and aerobic exercise was majority in control group. The case and control group have a rare category in exercise. Less category was majority in exercise duration of case and enough category was majority in control group. Bivariate analysis is using chi-square test with cell combining to 2x2 table, obtained p-value=0.097 in sort of exercise, p-value=1,000 in the frequency of exercise, and p-value=0,112 in duration of exercise, which means statistically unsignificant. There is no relation between exercise with the incidence of overweight-obesity of medical students of FK Unand batch 2013. For medical students suffers overweight-obesity is suggested for increase the frequency of exercise.

Keywords: overweight-obesity, exercise, aerobic, anaerobic, frequency, duration

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Authors: Shadrack Mambo, Karim Djouani, Yskandar Hamam, Barend van Wyk, Patrick Siarry

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This paper discusses the current trends in medical image registration techniques and addresses the need to provide a solid theoretical foundation for research endeavours. Methodological analysis and synthesis of quality literature was done, providing a platform for developing a good foundation for research study in this field which is crucial in understanding the existing levels of knowledge. Research on medical image registration techniques assists clinical and medical practitioners in diagnosis of tumours and lesion in anatomical organs, thereby enhancing fast and accurate curative treatment of patients. Literature review aims to provide a solid theoretical foundation for research endeavours in image registration techniques. Developing a solid foundation for a research study is possible through a methodological analysis and synthesis of existing contributions. Out of these considerations, the aim of this paper is to enhance the scientific community’s understanding of the current status of research in medical image registration techniques and also communicate to them, the contribution of this research in the field of image processing. The gaps identified in current techniques can be closed by use of artificial neural networks that form learning systems designed to minimise error function. The paper also suggests several areas of future research in the image registration.

Keywords: image registration techniques, medical images, neural networks, optimisaztion, transformation

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Authors: Pranab Kumar Goswami

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According to WHO, over 1000 million people worldwide are employed in small-scale industries. The ‘garment’ industry’ is one such industry in developing countries. These garment SMEs are mostly run by private establishments in the unorganized sector to avoid legal obligations of OSH provisions. The OSH standards are very poor and even basic health and safety provisions are not provided in such units. The study has been conducted in India among workers employed in the ‘garment’ industry with the objectives to analyze the types and extent of occupational health hazards of the garment workers and to assess the relationship of sociodemographic and occupational factors with various health hazards. The survey method, the tabular method followed by applying simple statistical technique, has been taken into account to analyze the data collected from three SME garment industries in Delhi (India-Asia). The study was conducted in Delhi from August-2019 to October-2020. A random sampling of 70 workers from three factories has been chosen for this study. The study shows that most of the workers were males (82%) and were in the 18-50 age group (78%), with none below 18 years of age. It was found that 26% of the workers were illiterate and most of them belonged to poor socioeconomic status. The study revealed that the nature of the hazards in garment industries in India is mostly physical and mechanical. We found that musculoskeletal problems (54%) were the commonest health problem. The body areas commonly affected were neck, low back, hand, wrist, finger, and shoulder. If garment workers’ health is affected by occupational hazards, it will impact on national health and economic growth of developing countries. Health is a joint responsibility of both government and employing authority.

Keywords: garment, MSD, health hazard, social factor

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Authors: Grace Omowunmi Soyebi

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A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved, this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, computing, data, innovation

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Authors: Eugene Wong, Felix Chan, Linsey Chen, Joey Cheung

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The widespread use of technologies and cyber/digital means for complex maritime operations have led to a sharp rise in global cyber-attacks. They have generated an increasing number of liability disputes, insurance claims, and legal proceedings. An array of antiquated case law, regulations, international conventions, and obsolete contractual clauses drafted in the pre-technology era have become grossly inadequate in addressing the contemporary challenges. This paper offers a critique of the ambiguity of cybersecurity liabilities under the obligation of seaworthiness entailed in the Hague-Visby Rules, which apply either by law in a large number of jurisdictions or by express incorporation into the shipping documents. This paper also evaluates the legal and technological criteria for assessing whether a vessel is properly equipped with the latest offshore technologies for navigation and cargo delivery operations. Examples include computer applications, networks and servers, enterprise systems, global positioning systems, and data centers. A critical analysis of the carriers’ obligations to exercise due diligence in preventing or mitigating cyber-attacks is also conducted in this paper. It is hoped that the present study will offer original and crucial insights to policymakers, regulators, carriers, cargo interests, and insurance underwriters closely involved in dispute prevention and resolution arising from cybersecurity liabilities.

Keywords: seaworthiness, cybersecurity, liabilities, risks, maritime, transport

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Authors: Lucile Richard

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Contemporary thinkers studying biopolitics and its lethal logic find little interest in Foucault's "vague sketch of the pastorate.” Despite pastoral power being depicted as the matrix of governmentality in the genealogy of biopower, most post-Foucauldian theorists disregard its study. Sovereign power takes precedence in the examination of the governmental connection between care, violence, and death. Questioning this recurring motif, this article advocates for a feminist exploration of pastoral power. It argues that giving attention to the genealogy of the pastorate is essential to account for the carelessness that runs today's politics. Examining Foucault's understanding of this "power to care" uncovers the link between care work and politics, a facet of governmentality often overlooked in sovereignty-centered perspectives. His description of “pastoral insurrections”, in so far as it highlights that caring, far from being excluded from politics, is the object of competing problematizations, also calls for a more nuanced and complex comprehension of the politicization of care and care work than the ones developed by feminist theorists. As such, it provides an opportunity to delve into under-theorized dimensions of the "care crisis" in feminist accounts. On one hand, it reveals how populations are disciplined and controlled, not only through caregiving obligations, but also through being assigned or excluded from receiving care. On the other, it stresses that the organization of the public sphere is just as important as the organization of the private sphere, which is the main focus for most feminists, in preventing marginalized perspectives on caring from gaining political momentum.

Keywords: Foucault, feminist theory, resistance, pastoral power, crisis of care, biopolitics

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Authors: Siti Nor Amira Bt. Mohamad, Mohamad Yazis B. Ali Basah, Muhammad Ridhwan B. Ab. Aziz, Khairil Faizal B. Khairi, Mazlynda Bt. Md. Yusuf, Hisham B. Sabri

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The understanding of risk and the concept of it occurs associated in Islamic financing was well-known in the financial industry by the using of Profit-and-Loss Sharing (PLS). It was presently in any Islamic financial transactions in order to comply with shariah rules. However, the existence of risk in Murabahah contract of financing is an ability that the counterparty is unable to complete its obligations within the agreed terms. Therefore, it is called as credit or default risk. Credit risk occurs when the client fails to make timely payment after the bank makes complete delivery of assets. Thus, it affects the growth of the bank as the banking business is in no position to have appropriate measures to cover the risk. Therefore, the bank may impose penalty on the outstanding balance. This paper aims to highlight the credit risk determinant and issues surrounding in Islamic bank in Malaysia in terms of Murabahah financing and how to manage it by using the proper techniques. Finally, it explores the credit risk management concept that might solve the problems arise. The study found that the credit risk can be managed properly by improving the use of comprehensive reference checklist of business partners on their character and past performance as well as their comprehensive database. Besides that, prevention of credit risk can be done by using collateral as security against the risk and we also argue on the Shariah guidelines and procedures should be implement coherently by the banking business because so that the risk would be control by having an effective instrument for Islamic modes of financing.

Keywords: Islamic banking, credit risk, Murabahah financing, risk mitigation

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Authors: Wendy Maddison

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This paper describes an Action Research project which was undertaken to inform professional practice in order to develop a newly created Centre for Student Success in the specific context of transnational medical and nursing education in the Middle East. The objectives were to enhance the academic performance, persistence, integration and personal and professional development of a multinational study body, in particular in relation to preclinical medical students, and to establish a comfortable, friendly and student-driven environment within an Irish medical university recently established in Bahrain. Expatriating a new part of itself into a corner of the world and within a context which could be perceived as the antithesis of itself, in particular in terms of traditional cultural and organisational values, the university has had to innovate in the range of services, programmes and other offerings which engages and supports the academic success of medical and nursing students as they “encounter the world in the classroom” in the context of an Arab Islamic culture but within a European institution of transnational education, engaging with a global learning environment locally. The outcomes of the project resulted in the development of a specific student success ‘signature’ for this particular transnational higher education context.

Keywords: transnational higher education, medical education, action research, student success, Middle Eastern context, student persistence in the global-local, student support mechanisms

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Authors: M. Dasgupta, S. Banerjee

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Content Based Image Retrieval (CBIR) coupled with Case Based Reasoning (CBR) is a paradigm that is becoming increasingly popular in the diagnosis and therapy planning of medical ailments utilizing the digital content of medical images. This paper presents a survey of some of the promising approaches used in the detection of abnormalities in retina images as well in mammographic screening and detection of regions of interest in MRI scans of the brain. We also describe our proposed algorithm to detect hard exudates in fundus images of the retina of Diabetic Retinopathy patients.

Keywords: case based reasoning, exudates, retina image, similarity based retrieval

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Authors: Murat Iskender Aktaş, Sadi Ergin, Rasime Acar Aktaş

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In the light of fast-paced changes and developments in the health sector, the Ministry of Health started a new structuring with decree law numbered 663 within the scope of the Project of Transformation in Health. Accordingly, hospitals should ensure patient satisfaction through more efficient, more effective use of resources and sustainable finance by placing patients in the centre and should operate to increase efficiency to its maximum level while doing these. Within this study, in order to find out how efficient the hospitals were in terms of medical waste management between the years 2011-2014, the data from six hospitals of Amasya Public Hospitals Union were evaluated separately through Data Envelopment Analysis (DEA) method. First of all, input variables were determined. Input variables were the number of patients admitted to polyclinics, the number of inpatients in clinics, the number of patients who were operated and the number of patients who applied to the laboratory. Output variable was the cost of medical wastes in Turkish liras. Each hospital’s total medical waste level before and after public hospitals union; the amounts of average medical waste per patient admitted to polyclinics, per inpatient in clinics, per patient admitted to laboratory and per operated patient were compared within each group. In addition, average medical waste levels and costs were compared for Turkey in general and Europe in general. Paired samples t-test was used to find out whether the changes (increase-decrease) after public hospitals union were statistically significant. The health facilities that were unsuccessful in terms of medical waste management before and after public hospital union and the factors that caused this failure were determined. Based on the results, for each health facility that was ineffective in terms of medical waste management, the level of improvement required for each input was determined. The results of the study showed that there was an improvement in medical waste management applications after the health facilities became a member of public hospitals union; their medical waste levels were lower than the average of Turkey and Europe while the averages of cost of disposal were the highest.

Keywords: medical waste management, cost of medical waste, public hospitals, data envelopment analysis

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Authors: Rachelly Ashwall, Ephraim Tabory

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In an attempt to reduce the level of a major identity-based conflict in Israel between Ultra-orthodox and secular Jews, several initiatives in recent years have tried to bring members of the two societies together in facilitated joint discussion forums. Our study analyzes the impact of two types of such programs: joint mediation training classes and confrontation-based learning programs that are designed to facilitate discussions over controversial issues. These issues include claims about an unequal shouldering of national obligations such as military service, laws requiring public observance of the Sabbath, and discrimination against women, among others. The study examines the factors that enabled the two groups to reduce their social distance, and increase their understanding of each other, and develop a recognition and tolerance of the other group's particular social identity. The research conducted over a course of two years involved observations of the activities of the groups, interviews with the participants, and analysis of the social media used by the groups. The findings demonstrate the progression from a mutual initial lack of knowledge about habits, norms, and attitudes of the out-group to an increasing desire to know, understand and more readily accept the identity of a previously rejected outsider. Participants manifested more respect, concern for and even affection for those whose identity initially led them to reject them out of hand. We discuss the implications for seemingly intractable identity-based conflict in fragile societies.

Keywords: identity-based conflict, intergroup relations, joint mediation learning, out-group recognition, social identity

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Authors: Yuli Paola Cifuentes Sanabria, Lina Paola Beltrán Beltrán, Leonardo Juan Ramírez López

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The availability to deploy mobile applications for healthcare is increasing daily thru different mobile app stores. But within these capabilities the number of hacking attacks has also increased, in particular into medical mobile applications. The security vulnerabilities in medical mobile apps can be triggered by errors in code, incorrect logic, poor design, among other parameters. This is usually used by malicious attackers to steal or modify the users’ information. The aim of this research is to analyze the vulnerabilities detected in mobile medical apps according to risk factor standards defined by OWASP in 2014.

Keywords: mHealth apps, OWASP, protocols, security vulnerabilities, risk factors

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Authors: Robin L. Rohrer

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Introduction: Pre-natal or early childhood exposure to the medical radiation used in diagnosis or treatment is an identified risk for childhood cancers but can be difficult to document. The author developed a family questionnaire/interview form to identify possible exposures. Aims: This retrospective study examines pre-natal and early childhood medical radiation exposure in a cohort of children diagnosed with a solid tumor including brain tumors from 1985-2015 at the Children’s Hospital of Pittsburgh (CHP). The hospital is a tri-state regional referral center which treats about 150-180 new cases of cancer in children per year. About 70% are diagnosed with a solid tumor. Methods: Each consented family so far (approximately 50% of the cohort) has been interviewed in person or by the phone call. Medical staff and psycho- social staff referred patient families for the interview with the author. Results: Among the families interviewed to date at least one medical radiation exposure has been identified (pre-conception, pre-natal or early childhood) in over 70% of diagnosed children. These exposures have included pre-conception sinus or chest CT or X-ray in either parent, sinus CT or X-ray in the mother or diagnostic radiation of chest or abdomen in children. Conclusions: Exposures to medical radiation for a child later diagnosed with cancer may occur at several critical junctures. These exposures may well contribute to a ‘perfect storm’ in the still elusive causes of childhood cancer. The author plans to expand the study from 1975 to present to hopefully further document these junctures.

Keywords: pediatric, solid tumors, medical radiation, cancer

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Authors: Yuanping Yang, Ruolin Zhou, Xingyu Liu, Lianbin Wu

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Based on the challenges of silanization of pharmaceutical glass packaging materials, the silicone oil high-temperature baking method consumes a lot of energy; silicone oil is generally physically adsorbed on the inner surface of the medical vials, leading to protein adsorption on the surface of the silicone oil and fall off, so that the number of particles in the drug solution increases, which brings potential risks to people. In this paper, a new silanizing method is proposed. High-efficiency silanization is achieved by grafting trimethylsilyl groups to the inner surface of medical vials by chemical bond at low temperatures. The inner wall of the vial successfully obtained stable hydrophobicity, and the water contact Angle of the surface reached 100°~110°. With the increase of silicified reagent concentration, the water resistance of corresponding treatment vials increased gradually. This treatment can effectively reduce the risk of pH value increase and sodium ion leaching.

Keywords: low-temperature silanization, medical vials, chemical bonding, hydrophobicity

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Authors: Ying-Lun Tseng Chiu-Ying Chen

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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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Authors: Amhimmid Mohammed Saffour, Abdelkader Salama

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Filtering is a part of image enhancement techniques, it is used to enhance certain details such as edges in the image that are relevant to the application. Additionally, filtering can even be used to eliminate unwanted components of noise. Medical images typically contain salt and pepper noise and Poisson noise. This noise appears to the presence of minute grey scale variations within the image. In this paper, different filters techniques namely (Median, Wiener, Rank order3, Rank order5, and Average) were applied on CT medical images (Brain and chest). We using all these filters to remove salt and pepper noise from these images. This type of noise consists of random pixels being set to black or white. Peak Signal to Noise Ratio (PSNR), Mean Square Error r(MSE) and Histogram were used to evaluated the quality of filtered images. The results, which we have achieved shows that, these filters, are more useful and they prove to be helpful for general medical practitioners to analyze the symptoms of the patients with no difficulty.

Keywords: CT imaging, median filter, adaptive filter and average filter, MATLAB

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Authors: Nilgün Katrancı, Pınar Göv

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With the acceleration and assessment of quality and patient safety works in healthcare services in the 21st century, activities to reduce errors have gained importance. The prevention and reduction of unintended consequences related to healthcare services and errors made during the delivery of healthcare services can be achieved by understanding the causes of the errors. Communication is the basic reason most frequently seen in such cases. Nurses who communicate with patients more closely and for longer time play a more critical role in ensuring patient safety compared to other healthcare professionals. To reduce the risk of medical errors and increase the quality of care, it is important to raise the awareness of nurses about patient safety in training period. This descriptive study was conducted between February 2017 and May 2017 to assess intern students' attitudes towards and knowledge of patient safety and medical errors. The target population of the study consists of intern students at the Faculty of Nursing in Gaziantep University (N=180). The study did not apply any sample selection method, and the research group consisted of 90 female and 37 male senior students who were available and accepted to take part in the study (N=127). The study used personal information form and medical error attitude scale to collect data. The medical error attitude scale consists of 16 items and 3 sub-dimensions. The most frequently seen medical error in the clinics the interns worked at was found as ‘Failure to comply with asepsis rules’ with a rate of 67,7%. The most frequent case among reasons for not disclosing an error is ‘noticing and correcting the error before affecting the patient’ with the rate of 70,9%. The most frequently expressed implications of disclosing a serious error for the intern students participating in the study are ‘harming patient trust (78%)’ and ‘possibility of overreaction by patient (62,2%)’. According to the results of the study, the awareness of the students about the importance of medical errors and error reporting was found high (3,48 ± 0,49). Consequently, it is important to assess and positively improve the attitudes of nurses and other healthcare professionals towards medical errors for the determination of causes of medical errors and their prevention.

Keywords: healthcare service, intern student, medical error, patient safety

Procedia PDF Downloads 178