Search results for: Elder care settings

Authors: Tanya N. Beran, Michelle A. Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

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Although interprofessional practice is a collaborative approach for problem solving among health professionals, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists can be used to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal strategies to manage the conformity pressures that people face.

Keywords: Conformity, decision-making, interprofessional teams, medical simulation.

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Authors: Noor Azlina Mohd Salleh, Salmiah Kasolang, Ahmed Jaffar

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Green Lean Total Quality Management (TQM) System is a system comprises of Environmental Management System (EMS) practices which is integrated to TQM with Lean Manufacturing (LM) principles. The ultimate goal of this system is to focus on achieving total customer satisfaction and environmental care by removing eight wastes available in any process in an organization. A survey questionnaire was developed and distributed to 30 highly active automotive vendors in Malaysia and analyzed by SPSS v.17. It was found out that some vendors have been practicing TQM and LM while some have started to implement EMS. This study is only focusing on highly active companies that have been involved in MAJAICO Program and Proton Vendor Development Program. This is the first study conducted to know the current status of TQM, LM and EMS practices in highly active automotive companies in Malaysia. It was found out that EMS has been practiced by 16 companies out of 30. Within these 16 companies the approach is more holistic and green. This is a preliminary study that combined 4 awards practices, ISO/TS16949, Toyota Production System SAEJ4000, MAJAICO Lean Production System and EMS.

Keywords: Automotive Industry, Lean Manufacturing, Operational Engineering Management, Total Quality Management. Environmental Management System.

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Authors: R. F. Ajayi, U. Sidwaba, U. Feleni, S. F. Douman, E. Nxusani, L. Wilson, C. Rassie, O. Tovide, P. G. L. Baker, S. L. Vilakazi, R. Tshikhudo, E. I. Iwuoha

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Pyrazinamide (PZA) is among the first-line pro-drugs  in the tuberculosis (TB) combination chemotherapy used to treat  Mycobacterium tuberculosis. Numerous reports have suggested that  hepatotoxicity due to pyrazinamide in patients is due to inappropriate  dosing. It is, therefore necessary to develop sensitive and reliable  techniques for determining the PZA metabolic profile of diagnosed  patients promptly and at point-of-care. This study reports the  determination of PZA based on nanobiosensor systems developed  from disuccinimidyl octanedioate modified Cytochrome P450-2E1  (CYP2E1) electrodeposited on gold substrates derivatised with  (poly(8-anilino-1-napthalene sulphonic acid) PANSA/PVP-AgNPs  nanocomposites. The rapid and sensitive amperometric PZA  detection gave a dynamic linear range of 2µM to 16µM revealing a  limit of detection of 0.044µM and a sensitivity of 1.38µA/µM. The  Michaelis-Menten parameters; KM, KM app and IMAX were calculated to  be 6.0µM, 1.41µM and 1.51x10-6 A, respectively, indicating a  nanobiosensor suitable for use in serum.

Keywords: Cytochrome P450-2E1, Disuccinimidyl octanedioate, Pyrazinamide, Tuberculosis.

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Authors: K. Shiba, T. Kaburagi, Y. Kurihara

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With global aging, people who require care, such as people with dementia (PwD), are increasing within many developed countries. And PwDs may wander and unconsciously set foot outdoors, it may lead serious accidents, such as, traffic accidents. Here, round-the-clock monitoring by caregivers is necessary, which can be a burden for the caregivers. Therefore, an automatic wandering detection system is required when an elderly person wanders outdoors, in which case the detection system transmits a ‘moving’ followed by an ‘absence’ state. In this paper, we focus on the transition from the ‘resting’ to the ‘absence’ state, via the ‘moving’ state as one of the wandering transitions. To capture the transition of the three states, our method based on the hidden Markov model (HMM) is built. Using our method, the restraint where the ‘resting’ state and ‘absence’ state cannot be transmitted to each other is applied. To validate our method, we conducted the experiment with 10 subjects. Our results show that the method can classify three states with 0.92 accuracy.

Keywords: Wander, microwave Doppler sensor, respiratory frequency band, the state transition, hidden Markov model.

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Authors: Reza Ariaeinejad, Norm Archer

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Self-management is becoming a new emphasis for healthcare systems around the world. But there are many different problems with adoption of new health-related intervention systems. The situation is even more complicated for chronically ill patients with disabilities, illiteracy, and impairment in judgment in addition to their conditions, or having multiple co-morbidities. Providing online decision support to manage patient health and to provide better support for chronically ill patients is a new way of dealing with chronic disease management. In this study, the importance of mobile technology through an m-Health system that supports self-management interventions including the care provider, family and social support, education and training, decision support, recreation, and ongoing patient motivation to promote adherence and sustainability of the intervention are discussed. A proposed theoretical model for adoption and sustainability of system use is developed, based on UTAUT2 and IS Continuance of Use models, both of which have been pre-validated through longitudinal studies. The objective of this paper is to show the importance of using mobile technology in adoption and sustainability of use of an m-Health system which will result in commercially sustainable self-management support for chronically ill patients.

Keywords: M-health, e-health, self-management, disease.

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Authors: Joserra Díez, Ainhoa Meñika, Iñaki Sanz-Azkue, Arritokieta Ortuzar

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Biodiversity provides humans with a great range of ecosystemic services; it is therefore an indispensable resource and a legacy to coming generations. However, in the last decades, the increasing exploitation of the Planet has caused a great loss of biodiversity and its acquaintance has decreased remarkably; especially in urbanized areas, due to the decreasing attachment of humans to nature. Yet, the Primary Education curriculum primes the identification of flora and fauna to guarantee the knowledge of children on their surroundings, so that they care for the environment as well as for themselves. In order to produce effective didactic material that meets the needs of both teachers and pupils, it is fundamental to diagnose the current situation. In the present work, the knowledge on biodiversity of 3^rd cycle Primary Education students in Biscay (n=98) and its relation to the size of the town/city of their school is discussed. Two tests have been used with such aim: one for tree identification and the other one so that the students enumerated the species of trees and animals they knew. Results reveal that knowledge of students on tree identification is scarce regardless the size of the city/town and of their school. On the other hand, animal species are better known than tree species.

Keywords: Biodiversity, population, tree identification, animal identification.

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Authors: Chang, Chun-Lang, Liu, Chun-Kai

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This study, for its research subjects, uses patients who had undergone total knee replacement surgery from the database of the National Health Insurance Administration. Through the review of literatures and the interviews with physicians, important factors are selected after careful screening. Then using Cross Entropy Method, Genetic Algorithm Logistic Regression, and Particle Swarm Optimization, the weight of each factor is calculated and obtained. In the meantime, Excel VBA and Case Based Reasoning are combined and adopted to evaluate the system. Results show no significant difference found through Genetic Algorithm Logistic Regression and Particle Swarm Optimization with over 97% accuracy in both methods. Both ROC areas are above 0.87. This study can provide critical reference to medical personnel as clinical assessment to effectively enhance medical care quality and efficiency, prevent unnecessary waste, and provide practical advantages to resource allocation to medical institutes.

Keywords: Total knee replacement, Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization.

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Authors: J. Kolář, V. Dvořák

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In this work, we try to find the best setting of Computational Fluid Dynamic solver available for the problems in the field of supersonic internal flows. We used the supersonic air-toair ejector to represent the typical problem in focus. There are multiple oblique shock waves, shear layers, boundary layers and normal shock interacting in the supersonic ejector making this device typical in field of supersonic inner flows. Modeling of shocks in general is demanding on the physical model of fluid, because ordinary conservation equation does not conform to real conditions in the near-shock region as found in many works. From these reasons, we decided to take special care about solver setting in this article by means of experimental approach of color Schlieren pictures and pneumatic measurement. Fast pressure transducers were used to measure unsteady static pressure in regimes with normal shock in mixing chamber. Physical behavior of ejector in several regimes is discussed. Best choice of eddy-viscosity setting is discussed on the theoretical base. The final verification of the k-ω SST is done on the base of comparison between experiment and numerical results.

Keywords: CFD simulations, color Schlieren, k-ω SST, supersonic flows, shock waves.

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Authors: Okolie Uchenna, Ehiemere Ijeoma, Ezenduka Pauline, Ogbu Sylvester

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A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Keywords: Behavior change, diabetes mellitus, dietarymanagement, diet adherence.

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Authors: Abdul Baqi, Zaid Mohammad

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Reinforced concrete stair slabs with mid landings i.e. Dog-legged shaped are conventionally designed as per specifications of standard codes of practices which guide about the effective span according to the varying support conditions. Presently, the behavior of such slabs has been investigated using Finite Element method. A single flight stair slab with landings on both sides and supported at ends on wall, and a multi flight stair slab with landings and six different support arrangements have been analyzed. The results obtained for stresses, strains and deflections are used to describe the behavior of such stair slabs, including locations of critical moments and deflections. Values of critical moments obtained by F.E. analysis have also have been compared with that obtained from conventional analysis. Analytical results show that the moments are also critical near the kinks i.e. junction of mid-landing and inclined waist slab. This change in the behavior of dog-legged stair slab may be due to continuity of the material in transverse direction in two landings adjoining the waist slab, hence additional stiffness achieved. This change in the behavior is generally not taken care of in conventional method of design.

Keywords: Dog-legged, Stair slab, F.E. Analysis, Landing, Reinforced concrete.

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Authors: Z. Karakus, Z. Ozer

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Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: E-Learning, Medication Administration, Nursing, Nursing Students.

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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Authors: Živa Ravnikar, Alfonso Bahillo Martinez, Barbara Goličnik Marušić

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Climate change mitigation has been formally adopted and announced by countries over the globe, where cities are targeting carbon neutrality through various more or less successful, systematic, and fragmentary actions. The article is based on the fact that environmental conditions affect human comfort and the usage of space. Urban planning can, with its sustainable solutions, not only support climate mitigation in terms of a planet reduction of global warming but as well enabling natural processes that in the immediate vicinity produce environmental conditions that encourage people to walk or cycle. However, the article draws attention to the importance of integrating climate consideration into urban planning, where detailed environmental data play a key role, enabling urban planners to improve or monitor environmental conditions on cycle paths. In a practical aspect, this paper tests a particular ICT tool, a prototype used for environmental data. Data gathering was performed along the cycling lanes in Ljubljana (Slovenia), where the main objective was to assess the tool's data applicable value within the planning of comfortable cycling lanes. The results suggest that such transportable devices for in-situ measurements can help a researcher interpret detailed environmental information, characterized by fine granularity and precise data spatial and temporal resolution. Data can be interpreted within human comfort zones, where graphical representation is in the form of a map, enabling the link of the environmental conditions with a spatial context. The paper also provides preliminary results in terms of the potential of such tools for identifying the correlations between environmental conditions and different spatial settings, which can help urban planners to prioritize interventions in places. The paper contributes to multidisciplinary approaches as it demonstrates the usefulness of such fine-grained data for better consideration of microclimatology in urban planning, which is a prerequisite for creating climate-comfortable cycling lanes promoting active mobility.

Keywords: Information and communication technology tools, urban planning, human comfort, microclimate, cycling lanes.

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Authors: Y. Lacroix, J.-F. Malbranque

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We present a chronological evolution for naval telecommunication networks. We distinguish periods: with or without multiplexers, with switch systems, with federative systems, with medium switching, and with medium switching with wireless networks. This highlights the introduction of new layers and technology in the architecture. These architectures are presented using layer models of transmission, in a unified way, which enables us to integrate pre-existing models. A ship of a naval fleet has internal communications (i.e. applications' networks of the edge) and external communications (i.e. the use of the means of transmission between edges). We propose architectures, deduced from the layer model, which are the point of convergence between the networks on board and the HF, UHF radio, and satellite resources. This modelling allows to consider end-to-end naval communications, and in a more global way, that is from the user on board towards the user on shore, including transmission and networks on the shore side. The new architectures need take care of quality of services for end-to-end communications, the more remote control develops a lot and will do so in the future. Naval telecommunications will be more and more complex and will use more and more advanced technologies, it will thus be necessary to establish clear global communication schemes to grant consistency of the architectures. Our latest model has been implemented in a military naval situation, and serves as the basic architecture for the RIFAN2 network.

Keywords: Equilibrium beach profile, eastern tombolo of Giens, potential function, erosion.

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Authors: Osamah M. Al-Qershi, Khoo Bee Ee

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In recent years image watermarking has become an important research area in data security, confidentiality and image integrity. Many watermarking techniques were proposed for medical images. However, medical images, unlike most of images, require extreme care when embedding additional data within them because the additional information must not affect the image quality and readability. Also the medical records, electronic or not, are linked to the medical secrecy, for that reason, the records must be confidential. To fulfill those requirements, this paper presents a lossless watermarking scheme for DICOM images. The proposed a fragile scheme combines two reversible techniques based on difference expansion for patient's data hiding and protecting the region of interest (ROI) with tamper detection and recovery capability. Patient's data are embedded into ROI, while recovery data are embedded into region of non-interest (RONI). The experimental results show that the original image can be exactly extracted from the watermarked one in case of no tampering. In case of tampered ROI, tampered area can be localized and recovered with a high quality version of the original area.

Keywords: DICOM, reversible, ROI-based, watermarking.

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Authors: K. Shiba, T. Kobayashi, T. Kaburagi, Y. Kurihara

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Elderly population in the world is increasing, and consequently, their nursing burden is also increasing. In such situations, monitoring and evaluating their daily action facilitates efficient nursing care. Especially, we focus on an unconscious activity during sleep, i.e. turnover. Monitoring turnover during sleep is essential to evaluate various conditions related to sleep. Bedsores are considered as one of the monitoring conditions. Changing patient’s posture every two hours is required for caregivers to prevent bedsore. Herein, we attempt to develop an unconstrained nocturnal monitoring system using a sensing device based on piezoelectric ceramics that can detect the vibrations owing to human body movement on the bed. In the proposed method, in order to construct a multi-points sensing, we placed two sensing devices under the right and left legs at the head-side of an ordinary bed. Using this equipment, when a subject lies on the bed, feature is calculated from the output voltages of the sensing devices. In order to evaluate our proposed method, we conducted an experiment with six healthy male subjects. Consequently, the period during which turnover occurs can be correctly classified as the turnover period with 100% accuracy.

Keywords: Turnover, piezoelectric ceramics, multi-points sensing, unconstrained monitoring system.

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Authors: Alexander V. Libin, Manon Schladen, Assya Pascalev, Nawar Shara, Miriam Philmon, Yuri Millo, Joseph Verbalis

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Chronic conditions carry with them strong emotions and often lead to charged relationships between patients and their health providers and, by extension, patients and health researchers. Persons are both autonomous and relational and a purely cognitive model of autonomy neglects the social and relational basis of chronic illness. Ensuring genuine informed consent in research requires a thorough understanding of how participants perceive a study and their reasons for participation. Surveys may not capture the complexities of reasoning that underlies study participation. Contradictory reasons for participation, for instance an initial claim of altruism as rationale and a subsequent claim of personal benefit (therapeutic misconception), affect the quality of informed consent. Individuals apply principles through the filter of personal values and lived experience. Authentic autonomy, and hence authentic consent to research, occurs within the context of patients- unique life narratives and illness experiences.

Keywords: ethical dilemmas, open source technology, patient education, psychology of decision making

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Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

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Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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Authors: Mohamed Mounir Tellache, Hiroyuki Kambara, Yasuharu Koike, Makoto Miyakoshi, Natsue Yoshimura

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This study explores the practicality of using electroencephalographic (EEG) independent components to predict eight-direction finger movements in pseudo-real-time. Six healthy participants with individual-head MRI images performed finger movements in eight directions with two different arm configurations. The analysis was performed in two stages. The first stage consisted of using independent component analysis (ICA) to separate the signals representing brain activity from non-brain activity signals and to obtain the unmixing matrix. The resulting independent components (ICs) were checked, and those reflecting brain-activity were selected. Finally, the time series of the selected ICs were used to predict eight finger-movement directions using Sparse Logistic Regression (SLR). The second stage consisted of using the previously obtained unmixing matrix, the selected ICs, and the model obtained by applying SLR to classify a different EEG dataset. This method was applied to two different settings, namely the single-participant level and the group-level. For the single-participant level, the EEG dataset used in the first stage and the EEG dataset used in the second stage originated from the same participant. For the group-level, the EEG datasets used in the first stage were constructed by temporally concatenating each combination without repetition of the EEG datasets of five participants out of six, whereas the EEG dataset used in the second stage originated from the remaining participants. The average test classification results across datasets (mean ± S.D.) were 38.62 ± 8.36% for the single-participant, which was significantly higher than the chance level (12.50 ± 0.01%), and 27.26 ± 4.39% for the group-level which was also significantly higher than the chance level (12.49% ± 0.01%). The classification accuracy within [–45°, 45°] of the true direction is 70.03 ± 8.14% for single-participant and 62.63 ± 6.07% for group-level which may be promising for some real-life applications. Clustering and contribution analyses further revealed the brain regions involved in finger movement and the temporal aspect of their contribution to the classification. These results showed the possibility of using the ICA-based method in combination with other methods to build a real-time system to control prostheses.

Keywords: Brain-computer interface, BCI, electroencephalography, EEG, finger motion decoding, independent component analysis, pseudo-real-time motion decoding.

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Authors: M. Dahiru, O. I. Enabulele

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The research aims to investigate the occurrence of multidrug-resistant Acinetobacter, in carrot and estimate the role of carrot in its transmission in a rapidly growing urban population. Thus, 50 carrot samples were collected from Jakara wastewater irrigation farms and are analyzed on MacConkey agar and screened by Microbact 24E (Oxoid) and susceptibility of isolates is tested against 10 commonly used antibiotics. Acinetobacter baumannii and A. lwoffii were isolated in 22.00% and 16% of samples respectively. Resistance to ceporex and penicillin of 36.36% and 27.27% in A. baumannii, and sensitivity to ofloxacin, pefloxacin, gentimycin and co-trimoxazole were observed. However, for A. lwoffii apart from 37.50% resistance to ceporex, it was also resistant to all other drugs tested. There were similarities in the resistances shown by A. baumannii and A. lwoffii to fluoroquinolones and β- lactame drug families in addition to between sulfonamide and animoglycoside demonstrated by A. lwoffii. Significant correlation in similarities were observed at P < 0.05 to CPX to NA (46.2%), and SXT to AU (52.6%) A. baumannii and A. lwoffii respectively and high multi drug resistance (MDR) of 27.27% and 62.50% by A. baumannii and A. lwoffii respectively. The occurrence of multidrug-resistance pathogen in carrot is a serious challenge to public health care, especially in a rapidly growing urban population where subsistence agriculture contributes greatly to urban livelihood and source of vegetables.

Keywords: Urban agriculture, Public health, Fluoroquinolone, Sulfonamide, Multidrug-resistance.

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Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

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Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: Cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma.

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Authors: Virgil Miranda, Gissele Mosqueda, Pablo Delgado, Yimesker Yihun

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Muscular fatigue affects the muscle activation that is needed for producing the desired clinical outcome. Integrating optimal muscle relaxation periods into a variety of health care rehabilitation protocols is important to maximize the efficiency of the therapy. In this study, four muscle relaxation periods (30, 60, 90 and 120 seconds) and their effectiveness in producing consistent muscle activation of the muscle biceps brachii between sets of an elbow flexion and extension task were investigated among a sample of 10 subjects with no disabilities. The same resting periods were then utilized in a controlled exoskeleton-based exercise for a sample size of 5 subjects and have shown similar results. On average, the muscle activity of the biceps brachii decreased by 0.3% when rested for 30 seconds, and it increased by 1.25%, 0.76% and 0.82% when using muscle relaxation periods of 60, 90 and 120 seconds, respectively. The preliminary results suggest that a muscle relaxation period of about 60 seconds is needed for optimal continuous muscle activation within rehabilitation regimens. Robot-based rehabilitation is good to produce repetitive tasks with the right intensity and knowing the optimal resting period will make the automation more effective.

Keywords: Rest intervals, muscle biceps brachii, robot rehabilitation, muscle fatigue.

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Authors: I. Kočvarová, E. Machů, N. Bártlová

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The issue of inclusion - segregation in the current Czech educational system is highly actual due to changes in legislation. It applies primarily to pupils with special educational needs, but it should also apply to pupils with giftedness. The paper presents chosen results of an exploratory survey that was carried out on a convenience sample of 1101 Czech teachers working in lower secondary education (ISCED2). The rate of teachers´ agreement with segregation of gifted pupils in the education system was monitored during this investigation. A validated questionnaire of our own design was used for the purpose of this investigation. The results were compared across groups of teachers in terms of selected variables. Results show that 36,3 % of teachers incline to segregation (rather than inclusion) of gifted pupils. Teachers who are not educated in this field and have no experience in teaching gifted pupils tend to support their segregation more in comparison with other teachers. Teachers of specialized schools for gifted pupils paradoxically agree with segregation to a slightly lesser extent than teachers from traditional schools, but they also manifest the most hesitant attitude in this issue. Preferences for segregation of gifted pupils are not related to attitudes toward gifted pupils or teachers' self-evaluation in terms of care for the gifted. Investigation indicates that the issue of education of gifted children and their inclusion in the educational system needs more space within the further education of teachers.

Keywords: Educational system, evaluation, gifted pupil, inclusion, segregation, teacher.

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Authors: B. Stroetmann, A. Aisenbrey

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The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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Authors: A. Giani

Abstract:

The current pedagogical culture recognizes an educational scope within the sports practices. It is widely accepted, in the pedagogical culture, that thanks to the acquisition and development of motor skills, it is also possible to exercise abilities that concern the way of facing and managing the difficulties of everyday life. Sport is a peculiar educational environment: the children have the opportunity to discover the possibilities of their body, to correlate with their peers, and to learn how to manage the rules and the relationship with authorities, such as coaches. Educational aspects of the sport concern both non-formal and formal educational environments. Coaches play a critical role in an agonistic sphere: exactly like the competencies developed by the children, coaches have to work on their skills to properly set up the educational scene. Facing these new educational tasks - which are not new per se, but new because they are brought back to awareness - a few questions arise: does the coach have adequate preparation? Is the training of the coach in this specific area appropriate? This contribution aims to explore the issue in depth by focusing on the reality of the Football School. Starting from a possible sense of pedagogical inadequacy detected during a series of meetings with several football clubs in Piedmont (Italy), there have been highlighted some important educational needs within the professional training of sports coaches. It is indeed necessary for the coach to know the processes underlying the educational relationship in order to better understand the centrality of the assessment during the educational intervention and to be able to manage the asymmetry in the coach-athlete relationship. In order to provide a response to these pedagogical needs, a formative plan has been designed to allow both an in-depth study of educational issues and a correct self-evaluation of certain pedagogical skills’ control levels, led by the coach. This plan has been based on particular practices, the Educational Practices of Pre-test (EPP), a specific version of community practices designed for the extracurricular activities. The above-mentioned practices realized through the use of texts meant as pre-tests, promoted a reflection within the group of coaches: they set up real and plausible sports experiences - in particular football, triggering a reflection about the relationship’s object, spaces, and methods. The characteristic aspect of pre-tests is that it is impossible to anticipate the reflection as it is necessarily connected to the personal experience and sensitivity, requiring a strong interest and involvement by participants: situations must be considered by the coaches as possible settings in which they could be found on the field.

Keywords: Relational needs, responsibility, self-evaluation, values.

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Authors: Kerstin Grunden, Ann Svensson, Berit Forsman, Christina Karlsson, Ayman Obeid

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The research question of the article is to explore whether the dialogue meetings method could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in municipalities, or not. A testbed was planned to be implemented in a retirement home in a Swedish municipality, and the practitioners worked with a pre-study of that testbed. In the article, the dialogue between the researchers and the practitioners in the dialogue meetings is described and analyzed. The potential of dialogue meetings as an arena for learning and reflection among researchers and practitioners is discussed. The research methodology approach is participatory action research with mixed methods (dialogue meetings, focus groups, participant observations). The main findings from the dialogue meetings were that the researchers learned more about the use of traditional research methods, and the practitioners learned more about how they could improve their use of the methods to facilitate change processes in their organization. These findings have the potential both for the researchers and the practitioners to result in more relevant use of research methods in change processes in organizations. It is concluded that dialogue meetings could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in a health care organization.

Keywords: Dialogue meetings, implementation, reflection, test bed, welfare technology, participatory action research.

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Authors: Ghias ul Hassan, Bilal Nasir, Israr ul Haque, ShafiqAwan, Ghias Un NabiTayyab, S. Hassan Akhtar Bokhari, Khawar Saeed, Qazi Masroor

Abstract:

Introduction: Pegylated Interferon and Ribavirin combination is standard of care in the management of chronic HCV infected patients. Efficacy of the therapy is judged by the ability to achieve biochemical and virological response as judged by RVR, EVR, ETR and SVR.Objective: To evaluate the efficacy of newly marketed biosimilar Pegylated Interferon Alpha 40KD (Peg INF) in chronic HCV patients. Materials and methods: This was observational, prospective multicentre study to evaluate the ability of biosimilar pegylated interferon alfa 2a (40KD) along with Ribavirin (weight based) to achieve SVR. The enrolled patients were separated into Naïve (A), Relapsers (B) and Non Responders(C) based on the previous history of interferon exposure and its response. The RGT was followed on ALT and RVR, EVR, ETR and SVR.Results:As per protocol analysis estimated SVR for three groups is 86.6% for naïve, 89.4% for relapsers and 52.4% for non-responders to standard interferon. Conclusion: It is concluded that Bio-similar pegylated interferon alfa-2a (40kD) along with Ribavirin has good anti-viral efficacy in Naïve, Relapsers and Non-responders to standard IFN of chronic HCV infected patients requiring treatment.

Keywords: SVR (Sustained virological response), NR (Nonresponders), Pegylated Interferon.

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Authors: Dimitrios Koukopoulos, Yiannis Stamatiou

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In this work, we present for the first time in our perception an efficient digital watermarking scheme for mpeg audio layer 3 files that operates directly in the compressed data domain, while manipulating the time and subband/channel domain. In addition, it does not need the original signal to detect the watermark. Our scheme was implemented taking special care for the efficient usage of the two limited resources of computer systems: time and space. It offers to the industrial user the capability of watermark embedding and detection in time immediately comparable to the real music time of the original audio file that depends on the mpeg compression, while the end user/audience does not face any artifacts or delays hearing the watermarked audio file. Furthermore, it overcomes the disadvantage of algorithms operating in the PCMData domain to be vulnerable to compression/recompression attacks, as it places the watermark in the scale factors domain and not in the digitized sound audio data. The strength of our scheme, that allows it to be used with success in both authentication and copyright protection, relies on the fact that it gives to the users the enhanced capability their ownership of the audio file not to be accomplished simply by detecting the bit pattern that comprises the watermark itself, but by showing that the legal owner knows a hard to compute property of the watermark.

Keywords: Audio watermarking, mpeg audio layer 3, hardinstance generation, NP-completeness.

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Authors: Okwan Frank

Abstract:

Maternal health outcome is one of the major population development challenges in Sub-Saharan Africa. The region has the highest maternal mortality ratio, despite the progressive economic growth in the region during the global economic crisis. It has been hypothesized that increase in economic growth will reduce the level of maternal mortality. The purpose of this study is to investigate the existence of the negative relationship between health outcome proxy by maternal mortality ratio and economic growth in Sub-Saharan Africa. The study used the Pooled Mean Group estimator of ARDL Autoregressive Distributed Lag (ARDL) and the Kao test for cointegration to examine the short-run and long-run relationship between maternal mortality and economic growth. The results of the cointegration test showed the existence of a long-run relationship between the variables considered for the study. The long-run result of the Pooled Mean group estimates confirmed the hypothesis of an inverse relationship between maternal health outcome proxy by maternal mortality ratio and economic growth proxy by Gross Domestic Product (GDP) per capita. Thus increasing economic growth by investing in the health care systems to reduce pregnancy and childbirth complications will help reduce maternal mortality in the sub-region.

Keywords: Economic growth, maternal mortality, pool mean group, Sub-Saharan Africa.

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Authors: Somenath Mukherjee, Rajdeep Ray, Raj Kumar Samanta, Mofazzal H. Khondekar, Gautam Sanyal

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In next generation wireless networks (i.e., 4G and beyond), one of the main objectives is to ensure highest level of customer satisfaction in terms of data transfer speed, decrease in cost and delay, non-rejection and no drop of calls, availability of ‘always-on’ connectivity and services, continuity of connected services, hastle-free roaming in addition to the convenience of use of network services from anywhere and anytime. To take care of these requirements effectively, internet service providers (ISPs) and network planners have to go for major capacity enhancement of network resources and at the same time these resources are to be used effectively and efficiently to reduce cost and to increase revenue. In this work, the effective bandwidth available in a Mobile Switching Center (MSC) of a wireless network providing multi-class multimedia services is analyzed. Bandwidth requirement of the users for a customized Quality of Service (QoS) is estimated. The findings of the QoS estimation are applied for the capacity planning and admission control of the multi-class traffic flows coming into the MSC.

Keywords: Next generation wireless network, mobile switching center, multi-class traffic, quality of service, admission control, effective bandwidth.

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