Search results for: Medical tourism

Authors: Eric Y. Zhang, L. Acu

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This paper is to point out the limitations of modern medical research and why the Traditional Chinese Medicine (TCM) can help address the limitations. Many of the modern medical research results are based on the findings in fundamental research disciplines, such as physics, and chemistry. However, this foundation is not as solid as it seems. The theory proposed in this paper, the Law of Chasm, or the Chasm Theory, states that there are two categories of objects to be studied. One is non-life objects, or lifeless objects; the other is living beings, or the objects that are alive. The laws and findings obtained by studying non-life objects may not all be extended to living beings, and vice versa. TCM is the study of medicine based on living beings. Therefore, TCM findings may not exist in the body of the knowledge obtained from studying non-life objects.

Keywords: TCM, Traditional Chinese Medicine, Law of Chasm, Chasm Theory, living-beings, non-life.

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Authors: Rusyaizila Ramli, Nasriah Zakaria, Putra Sumari

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Privacy issues commonly discussed among researchers, practitioners, and end-users in pervasive healthcare. Pervasive healthcare systems are applications that can support patient-s need anytime and anywhere. However, pervasive healthcare raises privacy concerns since it can lead to situations where patients may not be aware that their private information is being shared and becomes vulnerable to threat. We have systematically analyzed the privacy issues and present a summary in tabular form to show the relationship among the issues. The six issues identified are medical information misuse, prescription leakage, medical information eavesdropping, social implications for the patient, patient difficulties in managing privacy settings, and lack of support in designing privacy-sensitive applications. We narrow down the issues and chose to focus on the issue of 'lack of support in designing privacysensitive applications' by proposing a privacy-sensitive architecture specifically designed for pervasive healthcare monitoring systems.

Keywords: Human Factors, Pervasive Healthcare, PrivacyIssues

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Authors: Ying Shen, Weihua Zhu

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Medical images are important to help identifying different diseases, for example, Magnetic resonance imaging (MRI) can be used to investigate the brain, spinal cord, bones, joints, breasts, blood vessels, and heart. Image segmentation, in medical image analysis, is usually the first step to find out some characteristics with similar color, intensity or texture so that the diagnosis could be further carried out based on these features. This paper introduces an improved C-means model to segment the MRI images. The model is based on information entropy to evaluate the segmentation results by achieving global optimization. Several contributions are significant. Firstly, Genetic Algorithm (GA) is used for achieving global optimization in this model where fuzzy C-means clustering algorithm (FCMA) is not capable of doing that. Secondly, the information entropy after segmentation is used for measuring the effectiveness of MRI image processing. Experimental results show the outperformance of the proposed model by comparing with traditional approaches.

Keywords: Magnetic Resonance Image, C-means model, image segmentation, information entropy.

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Authors: Nami Matsumoto

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This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.

Keywords: Health care, Japanese-English medical encounters, language barriers, trust.

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Authors: Kosmas Dimitropoulos, Athanasios Manitsaris, Ioannis Mavridis

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The paper presents an investigation into the role of virtual reality and web technologies in the field of distance education. Within this frame, special emphasis is given on the building of web-based virtual learning environments so as to successfully fulfill their educational objectives. In particular, basic pedagogical methods are studied, focusing mainly on the efficient preparation, approach and presentation of learning content, and specific designing rules are presented considering the hypermedia, virtual and educational nature of this kind of applications. The paper also aims to highlight the educational benefits arising from the use of virtual reality technology in medicine and study the emerging area of web-based medical simulations. Finally, an innovative virtual reality environment for distance education in medicine is demonstrated. The proposed environment reproduces conditions of the real learning process and enhances learning through a real-time interactive simulator.

Keywords: Distance education, medicine, virtual reality, web.

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: Clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula.

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Authors: Ren-Hua Kung, Jen-Chieh Liu , Chih-Teng Chang, Pei-Ti Chen

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The consumption capability of people in China has been a big issue to tourism business. Due to the increasing of China tourists, Taiwan-s government rescinded the category of people in China and opened up the non-stopped airline from China to Taiwan. The “one-day traveling style between China and Taiwan" has formed, hoping to bring business to Taiwan. Night market, which shows foreigners the very local character of Taiwan, contains various merchandise for consumers to purchase. With the increasing numbers of non-stopped airline, visiting Taiwan-s night markets has also been one of major activities to China-s tourists. The purpose of the present study is to understand the consumer behavior of China tourists in tourist night markets in Taipei and analyze that if their shopping motives cause the different shopping behaviors and post-purchase satisfaction and revisiting intention. The results reveled that for the China tourists, the motives of significant influence to the shopping behaviors. Also, the shopping behaviors significant influence to the whole satisfaction and the whole satisfaction significant influence to post-purchase behavior.

Keywords: Shopping Motivation, Shopping Behavior, Satisfaction, Post-Purchase Behavior

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Authors: Khatesiree Sripoothon, Usanee Sengpanich, Rattana Sittioum

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The objective of this study is to examine the factors influencing consumer purchasing decisions about healthy food. This model consists of two latent variables: Consumer Perception relating to NCDs and Consumer Perceived Product Value. The study was conducted in the northern provinces of Thailand, which are popular with tourists and have received support from the government for health and wellness tourism. A survey was used as the data collection method, and the questionnaire was applied to 385 consumers. An accidental sampling method was used to identify the sample. The statistics of frequency, percentage, mean, and structural equation model were used to analyze the data obtained. Additionally, all factors had a significant positive influence on healthy food purchasing decisions (p<0.001) and were predictive of healthy food purchasing decisions at 46.20% (R2=0.462). Also, these findings seem to underline the supposition that consumer perceptions of NCDs and perceived product value are key variables that strengthen the competitive effects of healthy-friendly business entrepreneurs. Moreover, it reduces the countries' public health costs for treating patients with the disease of NCDs in Thailand.

Keywords: healthy food, perceived product value, perception of noncommunicable diseases, purchasing decisions

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Authors: Keiko Shimazu, Yasuhiro Maida, Tetsuya Sugata, Daisuke Tamakoshi, Kenji Makabe, Haruki Suzuki

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In this paper, we report how to acquire serious victims’ locations in the Acute Stage of Large-scale Disasters, in an Emergency Information Network System designed by us. The background of our concept is based on the Great East Japan Earthquake occurred on March 11^th, 2011. Through many experiences of national crises caused by earthquakes and tsunamis, we have established advanced communication systems and advanced disaster medical response systems. However, Japan was devastated by huge tsunamis swept a vast area of Tohoku causing a complete breakdown of all the infrastructures including telecommunications. Therefore, we noticed that we need interdisciplinary collaboration between science of disaster medicine, regional administrative sociology, satellite communication technology and systems engineering experts. Communication of emergency information was limited causing a serious delay in the initial rescue and medical operation. For the emergency rescue and medical operations, the most important thing is to identify the number of casualties, their locations and status and to dispatch doctors and rescue workers from multiple organizations. In the case of the Tohoku earthquake, the dispatching mechanism and/or decision support system did not exist to allocate the appropriate number of doctors and locate disaster victims. Even though the doctors and rescue workers from multiple government organizations have their own dedicated communication system, the systems are not interoperable.

Keywords: Crisis management, disaster mitigation, messing, MGRS, Satellite communication system.

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Authors: Vichada Chokesikarin

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The study aims to determine which factors account for customer satisfaction and to investigate the relationship between entrepreneurial orientation and business success, in particular, context of the information understanding of hostel business in Pranakorn district, Bangkok and the significant element of entrepreneurship in tourism industry. This study covers 352 hostels customers and 61 hostel owners/managers nearby Khao San road. Data collection methods were used by survey questionnaire and a series of hypotheses were developed from services marketing literature. The findings suggest the customer satisfaction most influenced by image, service quality, room quality and price accordingly. Furthermore the findings revealed that significant relationships exist between entrepreneurial orientation and business success; while competitive aggressiveness was found unrelated. The ECSI model’s generic measuring customer satisfaction was found partially mediate the business success. A reconsideration of other variables applicable should be supported with the model of hostel business. The study provides context and overall view of hostel business while discussing from the entrepreneurial orientation to customer satisfaction, thereby reducing decision risk on hostel investment.

Keywords: Customer satisfaction, ECSI Model, entrepreneurial orientation, small hotels, hostel, business performance.

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Authors: Sultan Noman Qasem

Abstract:

This paper presents an evolutionary algorithm for solving multi-objective optimization problems-based artificial neural network (ANN). The multi-objective evolutionary algorithm used in this study is genetic algorithm while ANN used is radial basis function network (RBFN). The proposed algorithm named memetic elitist Pareto non-dominated sorting genetic algorithm-based RBFN (MEPGAN). The proposed algorithm is implemented on medical diseases problems. The experimental results indicate that the proposed algorithm is viable, and provides an effective means to design multi-objective RBFNs with good generalization capability and compact network structure. This study shows that MEPGAN generates RBFNs coming with an appropriate balance between accuracy and simplicity, comparing to the other algorithms found in literature.

Keywords: Radial basis function network, Hybrid learning, Multi-objective optimization, Genetic algorithm.

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Authors: Chu-Chu, Liao

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The main purpose of this study is to analyze the relationship of leisure agriculture park visitors on tourist destination image, environmental perception, travel experiences and revisiting willingness. This study used questionnaires to Xinshe leisure agriculture park visitors- targeted convenience sampling manner total of 636 valid questionnaires. Valid questionnaires by descriptive statistics, correlation analysis and multiple regression analysis, the study found that: 1. The agricultural park visitors- correlations exist between the destination image, perception of the environment, tourism experience and revisiting willingness. 2."Excellent facilities and services", "space atmosphere comfortable" and "the spacious paternity outdoor space" imagery, of visitors- "revisiting willingness predict. 3. Visitors- in leisure agriculture park "environmental perception" and "travel experience, future revisiting willingness predict. According to the analysis of the results, the study not only operate on the recommendations of the leisure farm owners also provide follow-up study direction for future researchers.

Keywords: Leisure farms, image, travel experience, revisiting willingness, environmental perception.

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Authors: C. Hönnscheidt, R. Krull

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Oxidative stress makes up common incidents in eukaryotic metabolism. The presence of diverse components disturbing the equilibrium during oxygen metabolism increases oxidative damage unspecifically in living cells. Body´s own ubiquinone (Q10) seems to be a promising drug in defending the heightened appearance of reactive oxygen species (ROS). Though, its lipophilic properties require a new strategy in drug formulation to overcome their low bioavailability. Consequently, the manufacture of heterogeneous nanodispersions is in focus for medical applications. The composition of conventional nanodispersions is made up of a drug-consisting core and a surfactive agent, also named as surfactant. Long-termed encapsulation of the surfactive components into tissues might be the consequence of the use during medical therapeutics. The potential of provoking side-effects is given by their nonbiodegradable properties. Further improvements during fabrication process use the incorporation of biodegradable components such as modified γ-polyglutamic acid which decreases the potential of prospective side-effects.

Keywords: Biopolymers, γ-Polyglutamic acid, Oxidative stress, Ubiquinone.

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Authors: S. O. Adeosun, O. I. Sekunowo, O. P. Gbenebor, W. A. Ayoola, A. O. Odunade, T. A. Idowu

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Sand cast samples of the as-received 66/34Mg-Al alloy were first homogenized at 4900C and then divided into three groups on which annealing, normalising and artificial ageing were respectively carried out. Thermal ageing of the samples involved treatment at 5000C, soaked for 4 hours and quenched in water at ambient temperature followed by tempering at 2000C for 2 hours. Test specimens were subjected to microstructure and mechanical analyses and the results compared. Precipitation of significant volume of stable Mg17Al12 crystals in the aged specimen’s matrix conferred superior mechanical characteristics compared with the annealed, normalized and as-cast specimens. The ultimate tensile strength was 93.4MPa with micro-hardness of 64.9HRC and impact energy (toughness) of 4.05J. In particular, its Young modulus was 10.4GPa which compared well with that of cortical (trabecule) bone’s modulus that varies from 12-17GPa.

Keywords: Mg-Al alloy, artificial ageing, medical implant, cortical bone, mechanical properties.

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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Authors: González A. Julio, Ramírez L. Leonardo, Puerta A. Gabriel

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Telemedicine services use a large amount of data, most of which are diagnostic images in Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7) formats. Metadata is generated from each related image to support their identification. This study presents the use of decision trees for the optimization of information search processes for diagnostic images, hosted on the cloud server. To analyze the performance in the server, the following quality of service (QoS) metrics are evaluated: delay, bandwidth, jitter, latency and throughput in five test scenarios for a total of 26 experiments during the loading and downloading of DICOM images, hosted by the telemedicine group server of the Universidad Militar Nueva Granada, Bogotá, Colombia. By applying decision trees as a data mining technique and comparing it with the sequential search, it was possible to evaluate the search times of diagnostic images in the server. The results show that by using the metadata in decision trees, the search times are substantially improved, the computational resources are optimized and the request management of the telemedicine image service is improved. Based on the experiments carried out, search efficiency increased by 45% in relation to the sequential search, given that, when downloading a diagnostic image, false positives are avoided in management and acquisition processes of said information. It is concluded that, for the diagnostic images services in telemedicine, the technique of decision trees guarantees the accessibility and robustness in the acquisition and manipulation of medical images, in improvement of the diagnoses and medical procedures in patients.

Keywords: Cloud storage, decision trees, diagnostic image, search, telemedicine.

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Authors: Riham A. Ragheb, Ingy M. Naguib

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Conservation and urban investment are a prerequisite to improve the quality of life. Since the historic street is a part of the economic system, it should be able to play an important role in the city development by upgrading all services, public open spaces and reuse of historical buildings and sites. Furthermore, historical conservation enriches the political, economic, social, cultural and functional aspects of the site. Rosetta has been selected as an area of study because it has a unique character due to its possession of a variety of monuments and historical buildings. The aim of this research is to analyze the existing situation of an historic street named El Sheikh Kandil, to be able to identify the potentials and problems. The paper gives a proposal for the redesign and reinvestment of the street and the reuse for the historical buildings to serve the community, users and visitors. Then, it concludes with recommendations to improve quality of life through the rehabilitation of the historical buildings and strengthening of the cultural and historical identity of the street. Rosetta city can benefit from these development proposals by preserving and revitalizing its unique character which leads to tourism development and benefits from the new investments.

Keywords: Adaptive reuse, heritage street, historic investment, restoration, urban design.

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Authors: R. Sinthavalai, N. Memongkol, N. Patthanaprechawong, J. Viriyanantavong, C. Choosuk

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In Thailand, the practice of pre-hospital Emergency Medical Service (EMS) in each area reveals the different growth rates and effectiveness of the practices. Those can be found as the diverse quality and quantity. To shorten the learning curve prior to speed-up the practices in other areas, story telling and lessons learnt from the effective practices are valued as meaningful knowledge. To this paper, it was to ascertain the factors, lessons learnt and best practices that have impact as contributing to the success of prehospital EMS system. Those were formulized as model prior to speedup the practice in other areas. To develop the model, Malcolm Baldrige National Quality Award (MBNQA), which is widely recognized as a framework for organizational quality assessment and improvement, was chosen as the discussion framework. Remarkably, this study was based on the consideration of knowledge capture; however it was not to complete the loop of knowledge activities. Nevertheless, it was to highlight the recognition of knowledge capture, which is the initiation of knowledge management.

Keywords: Emergency Medical Service, Modeling, MBNQA, Thailand.

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Authors: Nuha Omran Abokhdair, Azizah Bt Abdul Manaf

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Reversible watermarking is a special branch of image watermarking, that is able to recover the original image after extracting the watermark from the image. In this paper, an adaptive prediction-based reversible watermarking scheme is presented, in order to increase the payload capacity of MRI medical images. The scheme divides the image into two parts, Region of Interest (ROI) and Region of Non-Interest (RONI). Two bits are embedded in each embeddable pixel of RONI and one bit is embedded in each embeddable pixel of ROI. The experimental results demonstrate that the proposed scheme is able to achieve high embedding capacity. This is mainly caused by two reasons. First, the pixels that were excluded from data embedding due to overflow/underflow are used for data embedding. Second, large location map that need to be added to watermark data as overhead is eliminated and thus lower data embedding capacity is prevented. Moreover, the scheme provides good visual quality to the watermarked image.

Keywords: Medical image watermarking, reversible watermarking, Difference Expansion, Prediction-Error Expansion.

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Authors: R. Tandlich, S. Hoossein, K. A. Tagwira, M. M. Marais, T. A. Ludwig, R. P. Chidziva, M. N. Munodawafa, W. M. Wrench

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Response to the public health-related emergencies is analysed here for a rural university in South Africa. The structure of the designated emergency plan covers all the phases of the disaster management cycle. The plan contains elements of the vulnerability model and the technocratic model of emergency management. The response structures are vertically and horizontally integrated, while the planning contains elements of scenario-based and functional planning. The available number of medical professionals at the Rhodes University, along with the medical insurance rates, makes the staff and students potentially more medically vulnerable than the South African population. The main improvements of the emergency management are required in the tornado response and the information dissemination during health emergencies. The latter should involve the increased use of social media and e-mails, following the Taylor model of communication. Infrastructure must be improved in the telecommunication sector in the face of unpredictable electricity outages.

Keywords: Public health, Rural university, Taylor model of communication.

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Authors: Tatiana L. Gorbunova

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The research is dedicated to the study of the polluted river inflow impact on the Black Sea coastal marine environment within the watercourse’s plumes in the Greater Sochi area applying bioassay methods with using freshwater and marine microalgae. River waters were analyzed using microalgae Chlorella vulgaris Beijer and sea waters were tested with marine diatoms Phaeodactylum tricornutum Bohlin. Experiments included algae cells abundancy growth assessments in acute (24 hours), sub-acute (72 hours) and chronic (168 hours/7 days) tests. The increase in algal cell growth rates compared to the control in the summer period was detected as a consequence of the recreational activities intensification during the tourism seasonal peak. Most of the analyzed samples demonstrated a significant effect of algae cells growth stimulation compared to the control. It is established that under the impact of contaminants carried by river’s drain to the sea, the capacity of the coastal marine ecosystem is partially capable to compensate its effect on the coastal biocenosis, but the general trends of the impact processes remain constant.

Keywords: Algae abundance growth, bioassay, microalgae, modeling.

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Authors: Gabriela Lindemann, Danilo Schmidt, Thomas Schrader, Dietmar Keune

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The amount and heterogeneity of data in biomedical research, notably in interdisciplinary fields, requires new methods for the collection, presentation and analysis of information. Important data from laboratory experiments as well as patient trials are available but come out of distributed resources. The Charité - University Hospital Berlin has established together with the German Research Foundation (DFG) a new information service centre for kidney diseases and transplantation (Open European Nephrology Science Centre - OpEN.SC). Beside a collaborative aspect to create new research groups every single partner or institution of this science information centre making his own data available is allowed to search the whole data pool of the various involved centres. A core task is the implementation of a non-restricting open data structure for the various different data sources. We decided to use a modern RDF model and in a first phase transformed original data coming from the web-based Electronic Patient Record database TBase©.

Keywords: Medical databases, Resource Description Framework (RDF), metadata repository.

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Authors: Cristina G. Dascalu, Elena Mihaela Carausu, Daniela Manuc

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The medical studies often require different methods for parameters selection, as a second step of processing, after the database-s designing and filling with information. One common task is the selection of fields that act as risk factors using wellknown methods, in order to find the most relevant risk factors and to establish a possible hierarchy between them. Different methods are available in this purpose, one of the most known being the binary logistic regression. We will present the mathematical principles of this method and a practical example of using it in the analysis of the influence of 10 different psychiatric diagnostics over 4 different types of offences (in a database made from 289 psychiatric patients involved in different types of offences). Finally, we will make some observations about the relation between the risk factors hierarchy established through binary logistic regression and the individual risks, as well as the results of Chi-squared test. We will show that the hierarchy built using the binary logistic regression doesn-t agree with the direct order of risk factors, even if it was naturally to assume this hypothesis as being always true.

Keywords: Databases, risk factors, binary logisticregression, hierarchy.

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Authors: Luke S. Carlos A. Thompson

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The medical model of disability, though beneficial for the medical professional, is often exclusionary, restrictive and dehumanizing when applied to the lived experience of disability. As a result, a critique of this model was constructed called the social model of disability. Much of the language used to articulate the purpose behind the social model of disability can be summed up within the word inclusion. However, this essay asserts that inclusiveness is an incomplete aspiration. The social model, as it currently stands, does not aid in creating a society where those with impairments actually belong. Rather, the social model aids in lessening the visibility, or negative consequence of, difference. Therefore, the social model does not invite society to welcome those with physical and intellectual impairments. It simply aids society in ignoring the existence of impairment by removing explicit forms of exclusion. Rather than simple inclusion, then, this essay uses John Swinton’s concept of friendship and Jean Vanier’s understanding of belonging to better articulate the intended outcome of the social model—a society where everyone can belong.

Keywords: Belong, community, disability, exclusion, friendship, inclusion.

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Authors: Anwar Sadat

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Today, the Internet based communication has widen the opportunity of event monitoring system in the medical field. There is always a need of analyzing and designing secure and reliable mobile communication between the hospital and biomedical engineers mobile units. This study has been carried out to find possible solution using SIP-based event notification for alerting the technical staff about the Biomedical Device (BMD) status and Patients treatment session. The Session Initiation Protocol (SIP) can be used to create a medical event notification system. SIP can work on a variety of devices. Its adoption as the protocol of choice for third generation wireless networks allows for a robust and scalable environment. One of the advantages of SIP is that it supports personal mobility through the separation of user addressing and device addressing. The solution for Telemed alert notification system is based on SIP - Specific Event Notification. The aim of this project is to extend mobility service to the hospital technicians who are using Telemedicine system.

Keywords: Biomedical, Mobility Service, Notify, Proxy Server, SIP, Subscribe, Telemedicine.

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Authors: Poramet Saeng-On

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This research aims to develop ways of lodging business management of Bang Khonthi community in Samut Songkram province that are appropriate with the cultural context of the Bang Khonthi community. Eight lodging business owners were interviewed. It was found that lodging business that are family business must be done with passion, correct understanding of self, culture, nature, Thai way of life, thorough, professional development, environmentally concerned, building partnerships with various networks both community level, and public sector and business cohorts. Public relations should be done through media both traditional and modern outlets, such as websites and social networks to provide customers convenience, security, happiness, knowledge, love and value when travel to Bang Khonthi. This will also help them achieve sustainability in business, in line with the 10 Home Stay Standard Thailand. Suggestions for operators are as follows: Operators need to improve their public relations work. They need to use technology in public relations such as the internet. Management standards must be improved. Souvenir and local products shops should be arranged in the compound. Product pricing must be set accordingly. They need to join hands to help each other. Quality of the business operation should be raised to meet the standards. Educational measures to reduce the impact caused by tourism on the community such as efforts to reduce energy consumption.

Keywords: Homestay, lodging business, management, standard.

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Authors: Nemir Al-Azzawi, Harsa A. Mat Sakim, Wan Ahmed K. Wan Abdullah, Yasmin Mohd Yacob

Abstract:

Feature-based registration is an effective technique for clinical use, because it can greatly reduce computational costs. However, this technique, which estimates the transformation by using feature points extracted from two images, may cause misalignments. To handle with this limitation, we propose to extract the salient edges and extracted control points (CP) of medical images by using efficiency of multiresolution representation of data nonsubsampled contourlet transform (NSCT) that finds the best feature points. The MR images were first decomposed using the NSCT, and then Edge and CP were extracted from bandpass directional subband of NSCT coefficients and some proposed rules. After edge and CP extraction, mutual information was adopted for the registration of feature points and translation parameters are calculated by using particle swarm optimization (PSO). The experimental results showed that the proposed method produces totally accurate performance for registration medical CT-MR images.

Keywords: Feature-based registration, mutual information, nonsubsampled contourlet transform, particle swarm optimization.

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

Abstract:

The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: Alcohol screening, AUDIT-C, CAGE, Hazardous drinking.

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Authors: Vassilis S. Kodogiannis, John N. Lygouras

Abstract:

In this research study, an intelligent detection system to support medical diagnosis and detection of abnormal lesions by processing endoscopic images is presented. The images used in this study have been obtained using the M2A Swallowable Imaging Capsule - a patented, video color-imaging disposable capsule. Schemes have been developed to extract texture features from the fuzzy texture spectra in the chromatic and achromatic domains for a selected region of interest from each color component histogram of endoscopic images. The implementation of an advanced fuzzy inference neural network which combines fuzzy systems and artificial neural networks and the concept of fusion of multiple classifiers dedicated to specific feature parameters have been also adopted in this paper. The achieved high detection accuracy of the proposed system has provided thus an indication that such intelligent schemes could be used as a supplementary diagnostic tool in endoscopy.

Keywords: Medical imaging, Computer aided diagnosis, Endoscopy, Neuro-fuzzy networks, Fuzzy integral.

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Authors: Chamseddine Barki, Salam Labidi, Hanen Boussi Rahmouni

Abstract:

In this article, we present the principle and suitable methodology for the design of a medical ontology that highlights the radiological and dosimetric knowledge, applied in diagnostic radiology and radiation-therapy. Our ontology, which we named «Onto.Rap», is the subject of radiation protection in medical and radiology centers by providing a standardized regulatory oversight. Thanks to its added values of knowledge-sharing, reuse and the ease of maintenance, this ontology tends to solve many problems. Of which we name the confusion between radiological procedures a practitioner might face while performing a patient radiological exam. Adding to it, the difficulties they might have in interpreting applicable patient radioprotection standards. Here, the ontology, thanks to its concepts simplification and expressiveness capabilities, can ensure an efficient classification of radiological procedures. It also provides an explicit representation of the relations between the different components of the studied concept. In fact, an ontology based-radioprotection expert system, when used in radiological center, could implement systematic radioprotection best practices during patient exam and a regulatory compliance service auditing afterwards.

Keywords: Ontology, radiology, medicine, knowledge, radiation protection, audit.

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