Search results for: Elder care settings

Authors: Pennapa Palapin

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This study aimed to examine the management and development of forest tourism Kamchanoad. Ban Dung, Udon Thani sustainability. Data were collected by means of qualitative research including in-depth interviews, semi- structured, and then the data were summarized and discussed in accordance with the objectives. And make a presentation in the form of lectures. The target population for the study consisted of 16 people, including representatives from government agencies, community leaders and the community. The results showed that Guidelines for the Management and Development of Forest Tourism Kamchanoad include management of buildings and infrastructure such as roads, water, electricity, toilets. Other developments are the establishment of a service center that provides information and resources to facilitate tourists.; nature trails and informative signage to educate visitors on the path to the jungle Kamchanoad; forest activities for tourists who are interested only in occasional educational activities such as vegetation, etc.; disseminating information on various aspects of tourism through various channels in both Thailand and English, as well as a web site to encourage community involvement in the planning and management of tourism together with the care and preservation of natural resources and preserving the local cultural tourist area of Kamchanoad.

Keywords: Management and Development Guidelines, Tourist site, Sustainability.

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Authors: Chandra Prayaga, Lakshmi Prayaga, Aaron Wade, Kyle Rank, Gopi Shankar Mallu, Sri Satya Harsha Pola

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In today's tech-driven world, where connectivity shapes our daily lives, maintaining physical and emotional health is crucial. Athletic trainers play a vital role in optimizing athletes' performance and preventing injuries. However, a shortage of trainers impacts the quality of care. This study introduces a vision-based exercise monitoring system leveraging Google's MediaPipe library for precise tracking of bicep curl exercises and simultaneous posture monitoring. We propose a three-stage methodology: landmark detection, side detection, and angle computation. Our system calculates angles at the elbow, wrist, neck, and torso to assess exercise form. Experimental results demonstrate the system's effectiveness in distinguishing between good and partial repetitions and evaluating body posture during exercises, providing real-time feedback for precise fitness monitoring.

Keywords: Physical health, athletic trainers, fitness monitoring, technology driven solutions, Google's MediaPipe, landmark detection, angle computation, real-time feedback.

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Authors: Arundhati Devi Maibam, K. Ingocha Singh

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Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: Cervical cancer, Manipuri women, RIIMS, Socio-demographic risk factors.

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Authors: Muhibul H. Bhuyan, Mafujul Hasan

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If a person can monitor his/her heart rate regularly then he/she can detect heart disease early and thus he/she can enjoy longer life span. Therefore, this disease should be taken seriously. Hence, many health care devices and monitoring systems are being designed to keep track of the heart disease. This work reports a design and simulation processes of an Arduino microcontroller based heart rate measurement and monitoring system in Proteus environment. Clipping sensors were utilized to sense the heart rate of an individual from the finger tips. It is a digital device and uses mainly infrared (IR) transmitter (mainly IR LED) and receiver (mainly IR photo-transistor or IR photo-detector). When the heart pumps the blood and circulates it among the blood vessels of the body, the changed blood pressure is detected by the transmitter and then reflected back to the receiver accordingly. The reflected signals are then processed inside the microcontroller through a software written assembly language and appropriate heart rate (HR) is determined by it in beats per minute (bpm) from the detected signal for a duration of 10 seconds and display the same in bpm on the LCD screen in digital format. The designed system was simulated on several persons with varying ages, for example, infants, adult persons and active athletes. Simulation results were found very satisfactory.

Keywords: Heart rate measurement, design, simulation, Proteus, Arduino Uno microcontroller.

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Authors: Muntanavadee Maytapattana

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The purposes of the study were to evaluate the effectiveness of the Parent Training Program for Obesity Reduction (PTPOR) on health behaviors of school-age children. An Ecological Systems Theory (EST) was approached the study and a randomized control trial was used in this study. Participants were school-age overweight or obese children and their parents. One hundred and one parent-child dyads were recruited and random assigned into the PTPOR (N=30), Educational Intervention or EI (N=32), and control group (N=39). The parents in the PTPOR group participated in five sessions including an educational session, a cooking session, aerobic exercise training, 2-time group discussion sessions, and 4-time telephoned counseling sessions. Repeated Measure ANCOVA was used to analyze data. The results presented that the outcomes of the PTPOR group were better than the EI and the control groups at 1^st, 8^th, and 32^nd weeks after finishing the program such as child exercise behavior (F_(2,97) = 3.98, p = .02) and child dietary behavior (F_(2,97) = 9.42, p = .00). The results suggest that nurses and health care providers should utilize the PTPOR for child weight reduction and for the health promotion of a lifestyle among overweight and obese children.

Keywords: Parent training program for obesity reduction, child health behaviors, school-age children.

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Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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Authors: Ayelet Gur

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Background: In recent years we are witnessing a welcome trend in which more children/persons with disabilities are living at home with their families and within their communities. This trend is related to various policy innovations as the UN Convention on the Rights of People with Disabilities that reflect a shift from the medical-institutional model to a human rights approach. We also witness the emergence of family centered approaches that perceive the family and not just the individual with the disability as a worthy target of policy planning, implementation and evaluation efforts. The current investigation aims to explore economic, psychological and social factors among households of families of children or adults with intellectual disabilities in Israel and to present policy recommendation. Methods: A national sample of 301 households was recruited through the education and employment settings of persons with intellectual disability. The main caregiver of the person with the disability (a parent) was interviewed. Measurements included the income and expense surveys; assets and debts questionnaire; the questionnaire on resources and stress; the social involvement questionnaire and Personal Wellbeing Index. Results: Findings indicate significant gaps in financial circumstances between households of families of children with intellectual disabilities and households of the general Israeli society. Households of families of children with intellectual disabilities report lower income and higher expenditures and loans than the general society. They experience difficulties in saving and coping with unexpected expenses. Caregivers (the parents) experience high stress, low social participation, low financial support from family, friend and non-governmental organizations and decreased well-being. They are highly dependent on social security allowances which constituted 40% of the household's income. Conclusions: Households' dependency on social security allowances may seem contradictory to the encouragement of persons with intellectual disabilities to favor independent living in light of the human rights approach to disability. New policy should aim at reducing caregivers' stress and enhance their social participation and support, with special emphasis on families of lower socio-economic status. Finally, there is a need to continue monitoring the economic and psycho-social needs of households of families of children with intellectual disabilities and other developmental disabilities.

Keywords: Disability policy, family policy, intellectual and developmental disabilities, Israel, households study, parents of children with disabilities.

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Authors: Bhaskar Basu

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Universities and higher education institutes are finding it increasingly difficult to engage students fruitfully through traditional pedagogic tools. Web 2.0 technologies comprising social networking sites (SNSs) offer a platform for students to collaborate and share information, thereby enhancing their learning experience. Despite the potential and reach of SNSs, its use has been limited in academic settings promoting higher education. The purpose of this paper is to assess the perception of social networking sites among business school students in India and analyze its role in enhancing quality of student experiences in a business school leading to the proposal of an agenda for future research. In this study, more than 300 students of a reputed business school were involved in a survey of their preferences of different social networking sites and their perceptions and attitudes towards these sites. A questionnaire with three major sections was designed, validated and distributed among  a sample of students, the research method being descriptive in nature. Crucial questions were addressed to the students concerning time commitment, reasons for usage, nature of interaction on these sites, and the propensity to share information leading to direct and indirect modes of learning. It was further supplemented with focus group discussion to analyze the findings. The paper notes the resistance in the adoption of new technology by a section of business school faculty, who are staunch supporters of the classical “face-to-face” instruction. In conclusion, social networking sites like Facebook and LinkedIn provide new avenues for students to express themselves and to interact with one another. Universities could take advantage of the new ways  in which students are communicating with one another. Although interactive educational options such as Moodle exist, social networking sites are rarely used for academic purposes. Using this medium opens new ways of academically-oriented interactions where faculty could discover more about students' interests, and students, in turn, might express and develop more intellectual facets of their lives. hitherto unknown intellectual facets.  This study also throws up the enormous potential of mobile phones as a tool for “blended learning” in business schools going forward.

Keywords: Business school, India, learning, social media, social networking, university.

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Authors: Edelyn Alicar-Cadorna

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This study assessed the productivity and performance of the barangays in the Heritage City of Vigan in terms of the barangays- resource requirements, management of resources, produced goods and services, and outcomes of service delivery. The descriptive research design was used in the study employing the input-process-output-outcomes model. Findings of this study showed that the barangays were strong in terms of resource requirements which enabled them to produce goods and services. The barangays were also strong in terms of management of resources in development planning. They also showed great potential along fiscal administration, and had a moderately high capability in organization and management. However, the barangays appeared to be most wanting in the area of barangay legislation, but they were strong in community mobilization and they had strong linkages with POs, NGOs and educational institutions. In the delivery of social services, the barangays favored the maintenance of day care centers. However, the barangays seem to be weak in the delivery of economic services. They fared well along providing protective services such as in establishing a Barangay Disaster Coordinating Council and organizing a group of Barangay Tanod. In terms of environmental services, the barangays performed garbage collection and disposal; however, garbage still found their way in the streets in some barangays. The services delivered had effected an improved status of the barangays. However, the barangays are still facing some problems.

Keywords: Barangays, Performance and Productivity.

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Authors: Ka Yan Chan

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Cohabitation among couples has been increasingly common in recent decades. Nonetheless, insufficient attention was given to the impact of attachment on cohabitation. This study discussed the experience of cohabitation among women with insecure attachments by collecting qualitative data through semi-structured interviews. Through thematic analysis, the study explored the characteristics of the women, the formation of cohabitation, struggles, coping mechanisms, and the impacts of cohabitation on the women. Moreover, the influences of the family-of-origin on cohabitation and the needs of the women were explored. The findings indicated that insecure attachment and the family-of-origin had significant effects on cohabitation and the interaction among the cohabitating couples. Women with insecure attachments were more likely to enter cohabitation unconsciously and without discussing what cohabitation means for their relationship with their partners. The findings also suggested that committing to marriage was not the only method for the women to feel secure in the relationship. Instead, long-lasting love and care, as well as reliability from their partners, could satisfy their emotional needs. More importantly, the findings revealed that repairing attachment problems and dealing with challenges in life stage transition is associated with positive impacts on the cohabitation experience. Additionally, to meet the needs of diverse family structures and to provide all-rounded support for enhancing the wellbeing of individuals, cohabitants, and couples, a comprehensive intervention model of relationship enrichment was discussed. 

Keywords: cohabitation, family-of-origin, insecure attachment, relationship enrichment

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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, hard instance generation, NP-completeness.

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Authors: Mohammad K. Abedin, Mohammad Shahjahan, Zeenat Sultana, Tawfique Jahan, Jesmin Akter

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To strengthen social and behavior change communication (SBCC) capacity of Ministry of Health and Family Welfare (MoHFW) of the Government of Bangladesh, BCCP/BKMI developed two eLearning courses providing opportunities for professional development of SBCC Program Managers who have no access to training or refreshers training. The two eLearning courses – Message and Material Development (MMD) and Monitoring and Evaluation (MandE) of SBCC programs – went online in September 2015, where all users could register their participation so results could be monitored. Methodology: To assess the uses of these courses a randomly selected sample was collected to run a pre and post-test analyses and a phone survey were conducted. Systematic random sampling was used to select a sample of 75 MandE and 25 MMD course participants from a sampling frame of 179 and 51 respectively. Results: As of September 2016, more than 179 learners have completed the MandE course, and 49 learners have completed the MMD course. The users of these courses are program managers, university faculty members, and students. Encouraging results were revealed from the analysis of pre and post-test scores and a phone survey three months after course completion. Test scores suggested a substantial increase in knowledge. The pre-test scores findings suggested that about 19% learners scored high on the MandE. The post-test scores finding indicated a high score (92%) of the sample across 4 modules of MandE. For MMD course in pre-test scoring, 30% of the learners scored high, and 100% scored high at the post-test. It was found that all the learners in the phone survey have discussed the courses. Most of the sharing occurred with colleagues and friends, usually through face to face (70%) interaction. The learners reported that they did recommend the two courses to concerned people. About 67% MandE and 76% MMD learners stated that the concepts that they had to learn during the course were put into practice in their work settings. The respondents for both MandE and MMD courses have provided a valuable set of suggestions that would further strengthen the courses. Conclusions: The study showed that the initiative offered ample opportunities to build capacity in various ways in which the eLearning courses were used. It also highlighted the importance of scaling up these efforts to further strengthen the outcomes.

Keywords: E-learning course, message and material development, monitoring and evaluation, social and behavior change communication.

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Authors: Masaki Yamaguchi, Daimei Sasayama, Shinsuke Washizuka

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The goal of this study was to examine the possibility of salivary cytokines for the screening of attention deficit hyperactivity disorder (ADHD) in children. We carried out a case-control study, including 19 children with ADHD and 17 healthy children (controls). A multiplex bead array immunoassay was used to conduct a multi-analysis of 27 different salivary cytokines. Six salivary cytokines (interleukin (IL)-1β, IL-8, IL12p70, granulocyte colony-stimulating factor (G-CSF), interferon gamma (IFN-γ), and vascular endothelial growth factor (VEGF)) were significantly associated with the presence of ADHD (p < 0.05). An informative salivary cytokine panel was developed using VEGF by logistic regression analysis (odds ratio: 0.251). Receiver operating characteristic analysis revealed that assessment of a panel using VEGF showed “good” capability for discriminating between ADHD patients and controls (area under the curve: 0.778). ADHD has been hypothesized to be associated with reduced cerebral blood flow in the frontal cortex, due to reduced VEGF levels. Our study highlights the possibility of utilizing differential salivary cytokine levels for point-of-care testing (POCT) of biomarkers in children with ADHD.

Keywords: Cytokine, saliva, attention deficit hyperactivity disorder, child, biomarker.

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Authors: Mutshinye Manguvhewa, Maria Florence, Mansoo Yu

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Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential elements related with substance use among women of childbearing-age. Factors associated with substance use during pregnancy were explored using qualitative research approach and bio-ecological theoretical framework was utilised to guide the study. Participants were selected using purposive sampling. Participants accessed from the Department of Social Development who met the inclusion criteria of the study were interviewed using semi structured interviews. Participants were referred for psychological intervention during the interview if deemed necessary. Braun and Clarke’s six phases of thematic analysis were used to analyse the data. The study adhered to ethical measures for the participants’ protection. Participants had been knowledgeable about the study earlier than the initiation of the interviews and the important points of their voluntary participation had been explained. The key findings from this study illustrate that social factors, individual area and romantic relationship are the major contributing factors to substance use among pregnant ladies in this sample. Recommendations arising from the study encompass that the stakeholders, rehabilitation centers, Department of Health and future researchers ought to act proactively against substance use all through pregnancy.

Keywords: Bio-ecological factors, pregnancy risk awareness, antenatal care, substance use.

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Authors: Bharat Jhamnani, SK Singh

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Sampling and analysis of leachate from Bhalaswa landfill and groundwater samples from nearby locations, clearly indicated the likely contamination of groundwater due to landfill leachate. The results of simulation studies carried out for the migration of Chloride from landfill shows that the simulation results are in consonance with the observed concentration of Chloride in the vicinity of landfill facility. The solid waste disposal system presently being practiced in Delhi consists of mere dumping of wastes generated, at three locations Bhalaswa, Ghazipur, and Okhla without any regard to proper care for the protection of surrounding environment. Bhalaswa landfill site in Delhi, which is being operated as a dump site, is expected to become cause of serious groundwater pollution in its vicinity. The leachate from Bhalaswa landfill was found to be having a high concentration of chlorides, as well as DOC, COD. The present study was undertaken to determine the likely concentrations of principle contaminants in the groundwater over a period of time due to the discharge of such contaminants from landfill leachates to the underlying groundwater. The observed concentration of chlorides in the groundwater within 75m of the radius of landfill facility was found to be in consonance with the simulated concentration of chloride in groundwater considering one dimensional transport model, with finite mass of contaminant source. Governing equation of contaminant transport involving advection and diffusion-dispersion was solved in matlab7.0 using finite difference method.

Keywords: Groundwater, landfill, leachate, solid waste.

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Authors: A. Schuchter, M. Promegger

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The outbreak of the COVID-19 pandemic has shown us that online education is so much more than just a cool feature for teachers – it is an essential part of modern teaching. In online math teaching, it is common to use tools to share screens, compute and calculate mathematical examples, while the students can watch the process. On the other hand, flipped classroom models are on the rise, with their focus on how students can gather knowledge by watching videos and on the teacher’s use of technological tools for information transfer. This paper proposes a co-educational teaching approach for coding and engineering subjects with the help of drone-building to spark interest in technology and create a platform for knowledge transfer. The project combines aspects from mathematics (matrices, vectors, shaders, trigonometry), physics (force, pressure and rotation) and coding (computational thinking, block-based programming, JavaScript and Python) and makes use of collaborative-shared 3D Modeling with clara.io, where students create mathematics knowhow. The instructor follows a problem-based learning approach and encourages their students to find solutions in their own time and in their own way, which will help them develop new skills intuitively and boost logically structured thinking. The collaborative aspect of working in groups will help the students develop communication skills as well as structural and computational thinking. Students are not just listeners as in traditional classroom settings, but play an active part in creating content together by compiling a Handbook of Knowledge (called “open book”) with examples and solutions. Before students start calculating, they have to write down all their ideas and working steps in full sentences so other students can easily follow their train of thought. Therefore, students will learn to formulate goals, solve problems, and create a ready-to use product with the help of “reverse engineering”, cross-referencing and creative thinking. The work on drones gives the students the opportunity to create a real-life application with a practical purpose, while going through all stages of product development.

Keywords: Flipped classroom, co-creational education, coding, making, drones, co-education, ARCS-model, problem-based learning.

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Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: Baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum.

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Authors: Atena Sajedin, Shokoufeh Zakernejad, Soheil Faridi, Mehrdad Javadi, Reza Ebrahimpour

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This paper illustrates the use of a combined neural network model for classification of electrocardiogram (ECG) beats. We present a trainable neural network ensemble approach to develop customized electrocardiogram beat classifier in an effort to further improve the performance of ECG processing and to offer individualized health care. We process a three stage technique for detection of premature ventricular contraction (PVC) from normal beats and other heart diseases. This method includes a denoising, a feature extraction and a classification. At first we investigate the application of stationary wavelet transform (SWT) for noise reduction of the electrocardiogram (ECG) signals. Then feature extraction module extracts 10 ECG morphological features and one timing interval feature. Then a number of multilayer perceptrons (MLPs) neural networks with different topologies are designed. The performance of the different combination methods as well as the efficiency of the whole system is presented. Among them, Stacked Generalization as a proposed trainable combined neural network model possesses the highest recognition rate of around 95%. Therefore, this network proves to be a suitable candidate in ECG signal diagnosis systems. ECG samples attributing to the different ECG beat types were extracted from the MIT-BIH arrhythmia database for the study.

Keywords: ECG beat Classification; Combining Classifiers;Premature Ventricular Contraction (PVC); Multi Layer Perceptrons;Wavelet Transform

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Authors: Paria Soleimani, Arezoo Neshati

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Myocardial infarction is one of the leading causes of death in the world. Some of these deaths occur even before the patient reaches the hospital. Myocardial infarction occurs as a result of impaired blood supply. Because the most of these deaths are due to coronary artery disease, hence the awareness of the warning signs of a heart attack is essential. Some heart attacks are sudden and intense, but most of them start slowly, with mild pain or discomfort, then early detection and successful treatment of these symptoms is vital to save them. Therefore, importance and usefulness of a system designing to assist physicians in early diagnosis of the acute heart attacks is obvious. The main purpose of this study would be to enable patients to become better informed about their condition and to encourage them to seek professional care at an earlier stage in the appropriate situations. For this purpose, the data were collected on 711 heart patients in Iran hospitals. 28 attributes of clinical factors can be reported by patients; were studied. Three logistic regression models were made on the basis of the 28 features to predict the risk of heart attacks. The best logistic regression model in terms of performance had a C-index of 0.955 and with an accuracy of 94.9%. The variables, severe chest pain, back pain, cold sweats, shortness of breath, nausea and vomiting, were selected as the main features.

Keywords: Coronary heart disease, acute heart attacks, prediction, logistic regression.

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Authors: Prakash Singh

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The aim of this study was to investigate the extent of teachers’ experiences of tobephobia (TBP) in their heterogeneous classrooms and what impact this had on their emotions and job satisfaction. The expansive and continuously changing demands for quality and equal education for all students in educational organisations that have limited resources connotes that the negative effects of TBP cannot be simply ignored as being non-existent in the educational environment. As this quantitative study reveals, teachers disliking their job with low expectations, lack of motivation in their workplace and pessimism, result in their low self-esteem. When there is pessimism in the workplace, then the employees’ self-esteem will inevitably be low, as pointed out by 97.1% of the respondents in this study. Self-esteem is a reliable indicator of whether employees are happy or not in their jobs and the majority of the respondents in this study agreed that their experiences of TBP negatively impacted on their self-esteem. Hence, this exploratory study strongly indicates that productivity in the workplace is directly linked to the employees’ expectations, self-confidence and their self-esteem. It is therefore inconceivable for teachers to be productive in their regular classrooms if their genuine professional concerns, anxieties, and curriculum challenges are not adequately addressed. This empirical study contributes to our knowledge on TBP because it clearly outlines some of the teaching problems that we are grappling with and constantly experience in our schools in this century. Therefore, it is imperative that the tobephobic experiences of teachers are not merely documented, but appropriately addressed with relevant action by every stakeholder associated with education so that our teachers’ emotions and job satisfaction needs are fully taken care of.

Keywords: Demotivated teachers’ pessimism, low expectations of teachers’ job satisfaction, Self-esteem, Tobephobia.

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Authors: Rachel Hurdley, Jane Hopkinson

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This article is based on observation of a cross-disciplinary, cross-institutional team that worked on an intervention called ‘Memory Mate’ for use in a UK Cancer Centre. This aimed to improve treatment outcomes for patients who had comorbid dementia or other memory impairment. Comorbid patients present ambiguous, spoiled identities, problematising the boundaries of health specialisms and frames of understanding. Memory Mate is theorised as a boundary object facilitating service transformation by changing relations between oncology and mental health care practice. It crosses the boundaries between oncology and mental health. Its introduction signifies an important step in reconfiguring relations between the specialisms. As a boundary object, it contains parallel, even contesting worlds, with potential to enable an eventual synthesis of the double stigma of cancer and dementia. Memory Mate comprises physical things, such as an animation, but its principal value is in the interaction it initiates across disciplines and services. It supports evolution of practices to address a newly emergent challenge for health service provision, namely the cancer patient with comorbid dementia/cognitive impairment. Getting clinicians from different disciplines working together on a practical solution generates a dialogue that can shift professional identity and change the culture of practice.

Keywords: Boundary object, cancer, dementia, interdisciplinary teams.

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Authors: Ibrahim A. Alkali

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There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: Caregiving, Inpatient setting, Integration, Patient Families.

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Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

Abstract:

The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL), its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know how to cope with having a family member with hepatitis C and more importantly to know what should you say and what shouldn’t you say as a positive hopeful attitude is essential for combating HCV chronic infection.

Keywords: Hepatitis C virus chronic infection, physical health component and mental health component of QoL, total quality of life.

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Authors: Ayman A. Aly, Abdallah A. Alshnnaway

Abstract:

The general idea behind the filter is to average a pixel using other pixel values from its neighborhood, but simultaneously to take care of important image structures such as edges. The main concern of the proposed filter is to distinguish between any variations of the captured digital image due to noise and due to image structure. The edges give the image the appearance depth and sharpness. A loss of edges makes the image appear blurred or unfocused. However, noise smoothing and edge enhancement are traditionally conflicting tasks. Since most noise filtering behaves like a low pass filter, the blurring of edges and loss of detail seems a natural consequence. Techniques to remedy this inherent conflict often encompass generation of new noise due to enhancement. In this work a new fuzzy filter is presented for the noise reduction of images corrupted with additive noise. The filter consists of three stages. (1) Define fuzzy sets in the input space to computes a fuzzy derivative for eight different directions (2) construct a set of IFTHEN rules by to perform fuzzy smoothing according to contributions of neighboring pixel values and (3) define fuzzy sets in the output space to get the filtered and edged image. Experimental results are obtained to show the feasibility of the proposed approach with two dimensional objects.

Keywords: Additive noise, edge preserving filtering, fuzzy image filtering, noise reduction, two dimensional mechanical images.

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Authors: Peter Boyes, Sarah Sharples, Paul Tennent, Gary Priestnall, Jeremy Morley

Abstract:

Significant long-term investment projects can involve complex decisions. These are often described as capital projects and the factors that contribute to their complexity include budgets, motivating reasons for investment, stakeholder involvement, interdependent projects, and the delivery phases required. The complexity of these projects often requires management groups to be established involving stakeholder representatives, these teams are inherently multidisciplinary. This study uses two university campus capital projects as case studies for this type of management group. Due to the interaction of projects with wider campus infrastructure and users, decisions are made at varying spatial granularity throughout the project lifespan. This spatial-related context brings complexity to the group decisions. Sensemaking is the process used to achieve group situational awareness of a complex situation, enabling the team to arrive at a consensus and make a decision. The purpose of this study is to understand the role of people and data in complex spatial related long-term decision and sensemaking processes. The paper aims to identify and present issues experienced in practical settings of these types of decision. A series of exploratory semi-structured interviews with members of the two projects elicit an understanding of their operation. From two stages of thematic analysis, inductive and deductive, emergent themes are identified around the group structure, the data usage, and the decision making within these groups. When data were made available to the group, there were commonly issues with perception of veracity and validity of the data presented; this impacted the ability of the group to reach consensus and therefore for decision to be made. Similarly, there were different responses to forecasted or modelled data, shaped by the experience and occupation of the individuals within the multidisciplinary management group. This paper provides an understanding of further support required for team sensemaking and decision making in complex capital projects. The paper also discusses the barriers found to effective decision making in this setting and suggests opportunities to develop decision support systems in this team strategic decision-making process. Recommendations are made for further research into the sensemaking and decision-making process of this complex spatial-related setting.

Keywords: decision making, decisions under uncertainty, real decisions, sensemaking, spatial, team decision making

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Authors: S. Impey, D. Berry, S. Furtado, M. Galvin, L. Grogan, O. Hardiman, L. Hederman, M. Heverin, V. Wade, L. Douris, D. O'Sullivan, G. Stephens

Abstract:

Healthcare is a knowledge-rich environment. This knowledge, while valuable, is not always accessible outside the borders of individual clinics. This research aims to address part of this problem (at a study site) by constructing a maximal data set (knowledge artefact) for motor neurone disease (MND). This data set is proposed as an initial knowledge base for a concurrent project to develop an MND patient data platform. It represents the domain knowledge at the study site for the duration of the research (12 months). A knowledge elicitation method was also developed from the lessons learned during this process - the WICKED method. WICKED is an anagram of the words: eliciting and confirming data, information, knowledge, wisdom. But it is also a reference to the concept of wicked problems, which are complex and challenging, as is eliciting expert knowledge. The method was evaluated at a second site, and benefits and limitations were noted. Benefits include that the method provided a systematic way to manage data, information, knowledge and wisdom (DIKW) from various sources, including healthcare specialists and existing data sets. Limitations surrounded the time required and how the data set produced only represents DIKW known during the research period. Future work is underway to address these limitations.

Keywords: Healthcare, knowledge acquisition, maximal data sets, action design science.

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Authors: Nevena Stolba, A Min Tjoa

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Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.

Keywords: data mining, data warehousing, decision-support systems, evidence-based medicine.

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Authors: C. Caçador, M. J. Reis Lima, J. Oliveira, M. J. Veiga, M. Teixeira Veríssimo, F. Ramos, M. C. Castilho, E. Teixeira-Lemos

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In the present study we evaluated the nutritional status of 214 institutionalized elderly residents of both genders, aged 65 years and older of 11 care homes located in the district of Viseu (center of Portugal). The evaluation was based on anthropometric measurements and the Mini Nutritional Assessment (MNA) score.

The mean age of the subjects was 82.3 ± 6.1 years-old. Most of the elderly residents were female (72.0%). The majority had 4 years of formal education (51.9%) and was widowed (74.3%) or married (14.0%).

Men presented a mean age of 81.2±8.5 years-old, weight 69.3±14.5 kg and BMI 25.33±6.5 kg/m². In women, the mean age was 84.5±8.2 years-old, weight 61.2±14.7 kg and BMI 27.43±5.6 kg/m².

The evaluation of the nutritional status using the MNA score showed that 24.0% of the residents show a risk of undernutrition and 76.0% of them were well nourished.

There was a high prevalence of obese (24.8%) and overweight residents (33.2%) according to the BMI. 7.5% were considered underweight.

We also found that according to their waist circumference measurements 88.3% of the residents were at risk for cardiovascular disease (CVD) and 64.0% of them presented very high risk for CVD (WC≥88 cm for women and WC ≥102 cm for men).

The present study revealed the coexistence of a dual form of malnutrition (undernourished and overweight) among the institutionalized Portuguese concomitantly with an excess of abdominal adiposity. The high prevalence of residents at high risk for CVD should not be overlooked.

Given the vulnerability of the group of institutionalized elderly, our study highlights the importance of the classification of nutritional status based on both instruments: the BMI and the MNA.

Keywords: Nutritional status, MNA, BMI, elderly.

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Authors: Sotirios Raptis

Abstract:

Linking social needs to social classes using different criteria may lead to social services misuse. The paper discusses using ML and Neural Networks (NNs) in linking public services in Scotland in the long term and advocates, this can result in a reduction of the services cost connecting resources needed in groups for similar services. The paper combines typical regression models with clustering and cross-correlation as complementary constituents to predict the demand. Insurance companies and public policymakers can pack linked services such as those offered to the elderly or to low-income people in the longer term. The work is based on public data from 22 services offered by Public Health Services (PHS) Scotland and from the Scottish Government (SG) from 1981 to 2019 that are broken into 110 years series called factors and uses Linear Regression (LR), Autoregression (ARMA) and 3 types of back-propagation (BP) Neural Networks (BPNN) to link them under specific conditions. Relationships found were between smoking related healthcare provision, mental health-related health services, and epidemiological weight in Primary 1(Education) Body Mass Index (BMI) in children. Primary component analysis (PCA) found 11 significant factors while C-Means (CM) clustering gave 5 major factors clusters.

Keywords: Probability, cohorts, data frames, services, prediction.

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Authors: Md. Sayeed Akhter, Md. Akhtar Hossain Mazumder, Syeda Afreena Mamun

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Bangladesh is a patriarchal and male dominated country. Traditional, cultural, social, and religious values and practices have reinforced the lower status of women accorded to them in society and have limited their opportunities for education, technical and vocational training, and involvement with earning activities outside their households. After independence numbers of women are doing job outside their households. This study attempts to find out the reasons of engaging in earning activities outside households and difficulties faced by upper and lower class working women in Bangladesh. To explore the objectives and research questions of the study descriptive techniques had been used. Survey was conducted among the women who were working in Rajshahi city of Bangladesh and face-to-face interviews were conducted to collect data. Findings of the study illustrates that most of the upper class working women engaged into job because they wanted to utilized their education and to bring solvency in the family, and they spend their income for meeting the needs of all the members of the family. On the other hand, most of the lower class working women involved into earning activities outside their households because they want to bring solvency in their families and spend their income on household expenditure. Both classes became tensed for their children because they had to stay at their working place for long time. Therefore, day care center should be established besides their working place for their children.

Keywords: Working Women, Reasons for Doing Jobs, Working Environment, Difficulties Faced.

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