Search results for: Emergency Medical Services

Authors: Chiung-Hui Chen

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The Internet of Things (IoT) was designed for widespread convenience. With the smart tag and the sensing network, a large quantity of dynamic information is immediately presented in the IoT. Through the internal communication and interaction, meaningful objects provide real-time services for users. Therefore, the service with appropriate decision-making has become an essential issue. Based on the science of human behavior, this study employed the environment model to record the time sequences and locations of different behaviors and adopted the probability module of the hierarchical Hidden Markov Model for the inference. The statistical analysis was conducted to achieve the following objectives: First, define user behaviors and predict the user behavior routes with the environment model to analyze user purposes. Second, construct the hierarchical Hidden Markov Model according to the logic framework, and establish the sequential intensity among behaviors to get acquainted with the use and activity fabric of the intelligent environment. Third, establish the intensity of the relation between the probability of objects’ being used and the objects. The indicator can describe the possible limitations of the mechanism. As the process is recorded in the information of the system created in this study, these data can be reused to adjust the procedure of intelligent design services.

Keywords: Behavior, big data, hierarchical Hidden Markov Model, intelligent object.

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Authors: Samuel P. Prahlow, Anthony Sciuva, Katherine Bombly, Emily Wilson, Shiv Dhiman, Savita Arya

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A prevalence cohort study of atherosclerotic lesions within cadavers was performed to better understand and characterize the prevalence of atherosclerosis among Georgia residents within body donors in the Philadelphia College of Osteopathic Medicine (PCOM) - Georgia body donor program. We procured specimens from cadavers used for medical student, physical therapy student, and biomedical science student cadaveric anatomical dissection at PCOM - South Georgia and PCOM - Georgia. Tissues were prepared using hematoxylin and eosin (H&E) stain as histological slides by Colquitt Regional Medical Center Laboratory Services. One section from each of the following arteries was taken after cadaveric dissection at the site of most calcification palpated grossly (if present): left anterior descending coronary artery, left internal carotid artery, abdominal aorta, splenic artery, and hepatic artery. All specimens were graded and categorized according to the American Heart Association’s Modified and Conventional Standards for Atherosclerotic Lesions using x4, x10, x40 microscopic magnification. Our study cohort included 22 cadavers, with 16 females and 6 males. The average age was 72.54 and median age was 72, with a range of 52 to 90 years old. The cause of death determination listing vascular and/or cardiovascular causes were present on 6 of the 22 death certificates. 19 of 22 (86%) cadavers had at least a single artery grading > 5. Of the cadavers with at least a single artery graded at greater than 5, only 5 of 19 (26%) cadavers had a vascular or cardiovascular cause of death reported. Malignancy was listed as a cause of death on 7 (32%) of death certificates. The average atherosclerosis grading of the common hepatic, splenic and left internal carotid arteries (2.15, 3.05, and 3.36 respectively) were lower than the left anterior descending artery and the abdominal aorta (5.16 and 5.86 respectively). This prevalence study characterizes atherosclerosis found in five medium and large systemic arteries within cadavers from the state of Georgia.

Keywords: Atherosclerosis, cardiovascular, histology, pathology.

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Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

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Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: Robotics and automation, engineering management, engineering in medicine and biology, medical services, public healthcare.

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

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

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

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Authors: Manal Rauf

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Trained medical practitioners are produced from medical colleges serving in public and private sectors. Prime responsibility of teaching faculty is to inculcate required work ethic among the students by serving as role models for them. It is an observed fact that classroom incivility behaviours are providing a friction in achieving these targets. Present study aimed at identification of classroom incivility behaviours observed by teachers and students of public and private medical colleges as per Glasser’s Choice Theory, making a comparison and investigating the strategies being adopted by teachers of both sectors to control undesired class room behaviours. Findings revealed that a significant difference occurs between teacher and student incivility behaviours. Public sector teacher focussed on survival as a strong factor behind in civil behaviours whereas private sector teachers considered power as the precedent for incivility. Teachers of both sectors are required to use verbal as well as non-verbal immediacy to reach a healthy leaning environment.

Keywords: Classroom incivility behaviour, Glasser choice theory, Mehrabian immediacy theory, medical student.

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Authors: Rita C. Ramos

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Medical Surgical Nursing is one of the major subjects in nursing. This study examined the validity and reliability of the achievement examination utilizing the Classical Test Theory and Item Response Theory. The study answered the following objectives specifically : ( a) To establish the validity and reliability of the achievement examination utilizing Classical Test Theory and Item Response Theory ; ( b ) To determine the dimensionality measure of items and ( c ) to compare the item difficulty and item discrimination of the Medical Surgical Nursing Achievement examination using Classical Test Theory ( CTT ) and Item Response Theory ( IRT ). The developed instrument was administered to fourth year nursing students (N= 136) of a private university in Manila. The findings yielded the following results: The achievement examination is reliable both using CTT and IRT. The findings indicate person and item statistics from two frameworks are quite alike. The achievement examination formed a unidimensional construct.

Keywords: Achievement Examination, Item Response Theory, Medical Surgical, Nursing.

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Authors: M. Das Gupta, S. Banerjee

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

Keywords: Case based reasoning, Exudates, Retina image, Similarity based retrieval.

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Authors: Gurung S., Yadav B. N., Budhathoki SS.

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Problem based learning is one of the highly acclaimed learning methods in medical education since its first introduction at Mc-Master University in Canada in the 1960s. It has now been adopted as a teaching learning method in many medical colleges of Nepal. B.P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university is the second institute in Nepal to establish problem-based learning academic program and need-based teaching approach hence minimizing teaching through lectures since its inception. During the first two years of MBBS course, the curriculum is divided into various organ-systems incorporated with problem-based learning exercise each of one week duration.

Keywords: PBL, medical education.

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Authors: Mary L. G. S. Senna, Afonso R. Aquino

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The development of tourism causes negative impacts on the environment. It is in this context, through the Ecological Footprint (EF) method that this study aimed to characterize the impacts of ecotourism on the community of Mateiros, Jalapão, Brazil. The EF, which consisted in its original a method to construct a land use matrix, considering some major categories of human consumption such as food, housing, transportation, consumer goods and services, and six other categories from the main land use which are divided into the topics: land use, degraded environment, gardens, fertile land, pasture and forests protected by the government. The main objective of this index is to calculate the land area required for the production and maintenance of goods and services consumed by a community. The field research was conducted throughout the year of 2014 until July 2015. After the calculations of each category, these components were added according to the presented method in order to determine the annual EF of the tourism sector in Mateiros. The results show that the EF resulting from tourism in Mateiros is 2,194.22 hectares of land required for tourism activities in the region. The EF of tourism was considered high, nevertheless, if it is added the total of hectares needed annually for tourism activities, the result found would be 2,194.22 hectares needed to absorb the CO₂ emissions generated in the region directly from the tourism sector.

Keywords: Sustainable tourism, tourism ecological footprint, Jalapão/TO/Brazil.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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Authors: Salim Istyaq

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As we know, number of Internet users are increasing drastically. Now, people are using different online services provided by banks, colleges/schools, hospitals, online utility, bill payment and online shopping sites. To access online services, text-based authentication system is in use. The text-based authentication scheme faces some drawbacks with usability and security issues that bring troubles to users. The core element of computational trust is identity. The aim of the paper is to make the system more compliable for the imposters and more reliable for the users, by using the graphical authentication approach. In this paper, we are using the more powerful tool of encoding the options in graphical QR format and also there will be the acknowledgment which will send to the user’s mobile for final verification. The main methodology depends upon the encryption option and final verification by confirming a set of pass phrase on the legal users, the outcome of the result is very powerful as it only gives the result at once when the process is successfully done. All processes are cross linked serially as the output of the 1st process, is the input of the 2nd and so on. The system is a combination of recognition and pure recall based technique. Presented scheme is useful for devices like PDAs, iPod, phone etc. which are more handy and convenient to use than traditional desktop computer systems.

Keywords: Graphical Password, OTP, QR Codes, Recognition based graphical user authentication, usability and security.

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Authors: Ju-Chun Chien

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Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.

Keywords: Long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior.

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Authors: Mohammad R. Jafari, Francois G. Bernardeau

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With its arid climate, Qatar experiences low annual rainfall, intense storms, and high evaporation rates. However, the fast-paced rate of infrastructure development in the capital city of Doha has led to recurring instances of surface water flooding as well as rising groundwater levels. Public Work Authority (PWA/ASHGHAL) has implemented an approach to collect and discharge the flood water into a) positive gravity systems; b) Emergency Flooding Area (EFA) – Evaporation, Infiltration or Storage off-site using tankers; and c) Discharge to deep injection wells. As part of the flood prevention scheme, 21 deep injection wells have been constructed to discharge the collected surface and groundwater table in Doha city. These injection wells function as an alternative in localities that do not possess either positive gravity systems or downstream networks that can accommodate additional loads. These injection wells are 400-m deep and are constructed in a complex karstic subsurface condition with large cavities. The injection well system will discharge collected groundwater and storm surface runoff into the permeable Umm Er Radhuma Formation, which is an aquifer present throughout the Persian Gulf Region. The Umm Er Radhuma formation contains saline water that is not being used for water supply. The injection zone is separated by an impervious gypsum formation which acts as a barrier between upper and lower aquifer. State of the art drilling, grouting, and geophysical techniques have been implemented in construction of the wells to assure that the shallow aquifer would not be contaminated and impacted by injected water. Injection and pumping tests were performed to evaluate injection well functionality (injectability). The results of these tests indicated that majority of the wells can accept injection rate of 200 to 300 m³ /h (56 to 83 l/s) under gravity with average value of 250 m³ /h (70 l/s) compared to design value of 50 l/s. This paper presents design and construction process and issues associated with these injection wells, performing injection/pumping tests to determine capacity and effectiveness of the injection wells, the detailed design of collection system and conveying system into the injection wells, and the operation and maintenance process. This system is completed now and is under operation, and therefore, construction of injection wells is an effective option for flood control.

Keywords: Deep injection well, wellhead assembly system, emergency flood area, flood prevention scheme, geophysical tests, pumping and injection tests, Qatar geology.

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Authors: Ryota Sugino, Satoshi Mizoguchi, Koji Kimita, Keiichi Muramatsu, Tatsunori Matsui, Yoshiki Shimomura

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Improving added value and productivity of services entails improving both value-in-exchange and value-in-use. Value-in-use is realized by value co-creation, where providers and receivers create value together. In higher education services, value-in-use comes from learners achieving learning outcomes (e.g., knowledge and skills) that are consistent with their learning goals. To enhance the learning outcomes of a learner, it is necessary to enhance and utilize the abilities of the teacher along with the abilities of the learner. To do this, however, the learner and the teacher need to build a consensus about their respective roles. Teachers need to provide effective learning content; learners need to choose the appropriate learning strategies by using the learning content through consensus building. This makes consensus building an important factor in value co-creation. However, methods to build a consensus about their respective roles may not be clearly established, making such consensus difficult. In this paper, we propose some strategies for consensus building between a teacher and a learner in value co-creation. We focus on a teacher and learner co-design and propose an analysis method to clarify a collaborative design process to realize value co-creation. We then analyze some counseling data obtained from a university class. This counseling aimed to build a consensus for value-in-use, learning outcomes, and learning strategies between the teacher and the learner.

Keywords: Consensus building, value co-creation, higher education, learning service.

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Authors: Faizal A. Samman, Thomas Hollstein, Manfred Glesner

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A synchronous network-on-chip using wormhole packet switching and supporting guaranteed-completion best-effort with low-priority (LP) and high-priority (HP) wormhole packet delivery service is presented in this paper. Both our proposed LP and HP message services deliver a good quality of service in term of lossless packet completion and in-order message data delivery. However, the LP message service does not guarantee minimal completion bound. The HP packets will absolutely use 100% bandwidth of their reserved links if the HP packets are injected from the source node with maximum injection. Hence, the service are suitable for small size messages (less than hundred bytes). Otherwise the other HP and LP messages, which require also the links, will experience relatively high latency depending on the size of the HP message. The LP packets are routed using a minimal adaptive routing, while the HP packets are routed using a non-minimal adaptive routing algorithm. Therefore, an additional 3-bit field, identifying the packet type, is introduced in their packet headers to classify and to determine the type of service committed to the packet. Our NoC prototypes have been also synthesized using a 180-nm CMOS standard-cell technology to evaluate the cost of implementing the combination of both services.

Keywords: Network-on-Chip, Parallel Pipeline Router Architecture, Wormhole Switching, Two-Level Priority Service.

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Authors: Zhanna Mingaleva, Irina Mirskikh

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Innovational development of regions in Russia is generally faced with the essential influence from federal and local authorities. The organization of effective mechanism of innovation development (and self-development) is impossible without establishment of defined institutional conditions in the analyzed field. Creative utilization of scientific concepts and information should merge, giving rise to continuing innovation and advanced production. The paper presents an analysis of institutional conditions in the field of creation and development of innovation activity infrastructure and transferring of knowledge and skills between different economic agents in Russia. Knowledge is mainly privately owned, developed through R&D investments and incorporated into technology or a product. Innovation infrastructure is a strong concentration mechanism of advanced facilities, which are mainly located inside large agglomerations or city-regions in order to benefit from scale effects in both input markets (human capital, private financial capital) and output markets (higher education services, research services). The empirical results of the paper show that in the presence of more efficient innovation and knowledge transfer and transcoding system and of a more open attitude of economic agents towards innovation, the innovation and knowledge capacity of regional economy is much higher.

Keywords: knowledge economy, innovational development, transfer of knowledge, institutional preconditions, innovation andknowledge capacity.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: Advanced palliative aquatics care, magnetic field therapy, medical device, research design.

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Authors: Mugabe Nzarama Gabriel

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In Rwanda, many healthcare organizations are still using a paper based patients’ data record system although it still present weaknesses to share health patients’ information across different services when necessary. In developed countries, the EHR has been put in place to revolutionize the paper based record system but still the EHR has some challenges related to privacy, security, or interoperability. The purpose of this research was to assess the existing patients’ data record system in healthcare sector in Rwanda, see what an EHR can improve to the system in place and assess the acceptance of EHR as system which is interoperable, very secure and interoperable and see whether stakeholders are ready to adopt the system. The case based methodology was used and TAM theoretical framework to design the questionnaire for the survey. A judgmental sample across two cases, CHUB and Hopital de Nemba, has been selected and SPSS has been used for descriptive statistics. After a qualitative analysis, the findings showed that the paper based record is useful, gives complete information about the patient, protects the privacy of patients but it is still less secure and less interoperable. The respondents shown that they are ready to use the proposed EHR System and want it secure, capable of enforcing the privacy but still they are not all ready for the interoperability. A conclusion has been formulated; recommendations and further research have been proposed.

Keywords: EHR system, healthcare service, TAM, privacy, interoperability.

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Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

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In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Keywords: Healthcare, flexibility, patient satisfaction, behavioral intention.

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Authors: Justinian Anatory, Ekael Stephen Manase

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The use of mobile phones is growing tremendously all over the world. In Tanzania there are a number of operators licensed by Tanzania Communications Regulatory Authority (TCRA) aiming at attracting customers into their networks. So far telecommunications market competition has been very stiff. Various measures are being taken by mobile operators to survive in the market. Such measure include introducing of different air time bundles on daily, weekly and monthly at lower tariffs. Other measures include the introduction of normal tariff, tourist package and one network. Despite of all these strategies, there is a dynamic competition in the market which needs to be explored. Some influences which attract customers to choose a certain mobile operator are of particular interest. This paper is investigating if the network effects and Quality of Services (QoS) influence mobile customers in selection of their mobile network operators. Seventy seven students from high learning institutions in Dodoma Municipality in Tanzania participated in responding to prepared questionnaires. The data was analyzed using Statistical Package for Social Science (SPSS) Software. The results indicate that, network coverage does influence customers in selection of mobile operators. In addition, this paper proposes further research in some areas especially where the study came up with different findings from what the theory has in place.

Keywords: Network effects, Quality of services, Consumer Buying, mobile operators.

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Authors: Sri Lakshmi Kanniah, Mohd Naz’ri Mahrin

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More and more businesses and services are depending on software to run their daily operations and business services. At the same time, cyber-attacks are becoming more covert and sophisticated, posing threats to software. Vulnerabilities exist in the software due to the lack of security practices during the phases of software development. Implementation of secure software development practices can improve the resistance to attacks. Many methods, models and standards for secure software development have been developed. However, despite the efforts, they still come up against difficulties in their deployment and the processes are not institutionalized. There is a set of factors that influence the successful deployment of secure software development processes. In this study, the methodology and results from a systematic literature review of factors influencing the implementation of secure software development practices is described. A total of 44 primary studies were analysed as a result of the systematic review. As a result of the study, a list of twenty factors has been identified. Some of factors that affect implementation of secure software development practices are: Involvement of the security expert, integration between security and development team, developer’s skill and expertise, development time and communication between stakeholders. The factors were further classified into four categories which are institutional context, people and action, project content and system development process. The results obtained show that it is important to take into account organizational, technical and people issues in order to implement secure software development initiatives.

Keywords: Secure software development, software development, software security, systematic literature review.

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Authors: Shin-Jer Yang, Kai-Tai Yang

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In response to a changing world and the fast growth of the Internet, more and more enterprises are replacing web-based services with cloud-based ones. Multi-tenancy technology is becoming more important especially with Software as a Service (SaaS). This in turn leads to a greater focus on the application of Identity and Access Management (IAM). Conventional Near-Field Communication (NFC) based verification relies on a computer browser and a card reader to access an NFC tag. This type of verification does not support mobile device login and user-based access management functions. This study designs an NFC-based third-party cloud identity and access management scheme (NFC-IAM) addressing this shortcoming. Data from simulation tests analyzed with Key Performance Indicators (KPIs) suggest that the NFC-IAM not only takes less time in identity identification but also cuts time by 80% in terms of two-factor authentication and improves verification accuracy to 99.9% or better. In functional performance analyses, NFC-IAM performed better in salability and portability. The NFC-IAM App (Application Software) and back-end system to be developed and deployed in mobile device are to support IAM features and also offers users a more user-friendly experience and stronger security protection. In the future, our NFC-IAM can be employed to different environments including identification for mobile payment systems, permission management for remote equipment monitoring, among other applications.

Keywords: Cloud service, multi-tenancy, NFC, IAM, mobile device.

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Authors: Charles P. Mukumba, Kahilu K. Shakantu

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Achieving the Sustainable Development Goals (SDGs) is critical to achieving transformational results that support Zambia's developmental agenda. Public procurement is integral to the government's mission to deliver goods and services in a timely and economical manner beyond the value of money spent. This study explores the link between sustainable public procurement and the SDGs in Zambia. To validate the established links with public sector procurement in Zambia, the study employed qualitative research using semi-structured interviews with 12 public procurement officials. The collected data were analysed using thematic analysis. The findings indicate that public procurement plays a fundamental role in achieving the SDGs by helping deliver core public services that support SDGs and systematizing and co-delivering added value along the way. The study further established the importance of sustainable public procurement within the development context. The interviews were limited to mainstream public sector procurement entities in Lusaka, Zambia. Sustainable public procurement actions have the potential to impact SDGs. Promoting sustainable public procurement will enhance sustainable development and significantly improve the supply chain, benefiting the economy, society and environment. Findings will inform policy-makers how to strategically design sustainable public procurement policy by attuning it to procuring entities' objectives and priorities to contribute to attaining SDGs.

Keywords: Sustainable public procurement, sustainable development goals, SDG targets, Zambia.

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Authors: G. Gürsel, K. H. Gülkesen, N. Zayim, A. Arifoğlu, O. Saka

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User satisfaction is one of the most used success indicators in the research of information system (IS). Literature shows user expectations have great influence on user satisfaction. Both expectation and satisfaction of users are important for Hospital Information Systems (HIS). Education, IS experience, age, attitude towards change, business title, sex and working unit of the hospital, are examined as the potential determinant of the medical users’ expectations. Data about medical user expectations are collected by the “Expectation Questionnaire” developed for this study. Expectation data are used for calculating the Expectation Meeting Ratio (EMR) with the evaluation framework also developed for this study. The internal consistencies of the answers to the questionnaire are measured by Cronbach´s Alpha coefficient. The multivariate analysis of medical user’s EMRs of HIS is performed by forward stepwise binary logistic regression analysis. Education and business title is appeared to be the determinants of expectations from HIS.

Keywords: Evaluation, Fuzzy Logic, Hospital Information System, User Expectation.

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Authors: S. Brahim, M. S. Mohamad, E. Zakaria, N. Sarnon@Kusenin

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This study aimed to explore the practical experience of child welfare caseworkers and professionalism in child case management in Malaysia. This paper discussed the specific social work practice competency and the challenges faced by child caseworkers in the fieldwork. This research was qualitative with grounded theory approach. Four sessions of focused group discussion (FGD) were conducted involving a total of 27 caseworkers (child protector and probation officers) in the Klang Valley. The study found that the four basic principles of knowledge in child case management namely: 1. knowledge in child case management; 2. professional values of caseworkers towards children; 3. skills in managing cases; and 4. culturally competent practice in child case management. In addition, major challenges faced by the child case manager are the capacity and commitment of the family in children’s rehabilitation program, the credibility of caseworkers are being challenged, and the challenges of support system from intra and interagency. This study is important for policy makers to take into account the capacity and the needs of the child’s caseworker in accordance with the national social work competency framework. It is expected that case management services for children will improve systematically in line with national standards.

Keywords: Social work practice, child case management, competency-based knowledge, and professionalism.

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Authors: Cleto J. Sauer Jr

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Introduction: Brazil’s new national curriculum guidelines (NCG) for medical education were published in 2014, presenting active learning methodologies as a cornerstone. Simulation was initially applied for aviation pilots’ training and is currently applied in health sciences. The high-fidelity simulator replicates human body anatomy in detail, also reproducing physiological functions and its use is increasing in medical schools. Realistic Simulation (RS) has pedagogical aspects that are aligned with Brazil’s NCG teaching concepts. The main objective of this study is to carry on a narrative review on RS’s aspects that are aligned with Brazil’s new NCG teaching concepts. Methodology: A narrative review was conducted, with search in three databases (PubMed, Embase and BVS) of studies published between 2010 and 2020. Results: After systematized search, 49 studies were selected and divided into four thematic groups. RS is aligned with new Brazilian medical curriculum as it is an active learning methodology, providing greater patient safety, uniform teaching, and student's emotional skills enhancement. RS is based on reflective learning, a teaching concept developed for adult’s education. Conclusion: RS is a methodology aligned with NCG teaching concepts and has potential to assist in the implementation of new Brazilian medical school’s curriculum. It is an immersive and interactive methodology, which provides reflective learning in a safe environment for students and patients.

Keywords: Curriculum, high-fidelity simulator, medical education, realistic simulation.

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Authors: Pongsiri K.

Abstract:

This research aimed to study the market feasibility for new brand coffee house, the case study of Thailand.. This study is a mixed methods research combining quantitative research and the qualitative research. Primary data 350 sets of questionnaires were distributed, and the high quality completed questionnaires of 320 sets returned. Research samples are identified as customers’ of Hi-end department stores in Thailand. The sources of secondary data were critical selected from highly reliable sources, both from public and private sectors. The results were used to classify the customer group into two main groups, the younger than 25 and the older than 25years old. Results of the younger group, are give priority to the dimension of coffee house and its services dimension more than others, then branding dimension and the product dimension respectively. On the other hand, the older group give the difference result as they rate the important of the branding, coffee house and its services, then the product respectively. Coffee consuming is not just the trend but it has become part of people lifestyle. And the new cultures also created by the wise businessman. Coffee was long produced and consumed in Thailand. But it is surprisingly the hi-end brand coffee houses in Thai market are mostly imported brands. The café business possibility for Thai brand coffee house in Thai market were discussed in the paper.

Keywords: Coffee House, Café, Coffee Consuming and new entry branding, market feasibility

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Authors: Y. Y. Su, K. T. Win, H. C. Chiu

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This study used Item Analysis, Exploratory Factor Analysis (EFA) and Reliability Analysis (Cronbach-s α value) to exam the Questions which selected by the Delphi method based on the issue of “Socio-technical system (STS)" and user-centered perspective. A structure questionnaire with seventy-four questions which could be categorized into nine dimensions (healthcare environment, organization behaviour, system quality, medical data quality, service quality, safety quality, user usage, user satisfaction, and organization net benefits) was provided to evaluate EMR of the Taiwanese healthcare environment.

Keywords: Instrument development, Reliability test, Validity test, Electronic Medical Record Evaluation.

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Authors: Siau-Chuin Liew, Siau-Way Liew, Jasni Mohd Zain

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Digital watermarking in medical images can ensure the authenticity and integrity of the image. This design paper reviews some existing watermarking schemes and proposes a reversible tamper detection and recovery watermarking scheme. Watermark data from ROI (Region Of Interest) are stored in RONI (Region Of Non Interest). The embedded watermark allows tampering detection and tampered image recovery. The watermark is also reversible and data compression technique was used to allow higher embedding capacity.

Keywords: data compression, medical image, reversible, tamperdetection and recovery, watermark.

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Authors: Jin-Tae Lee, Jung-Hoon Suh, Sang-Soo Jang, Jae-Il Lee

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Information and communication service providers (ICSP) that are significant in size and provide Internet-based services take administrative, technical, and physical protection measures via the information security check service (ISCS). These protection measures are the minimum action necessary to secure the stability and continuity of the information and communication services (ICS) that they provide. Thus, information assets are essential to providing ICS, and deciding the relative importance of target assets for protection is a critical procedure. The risk analysis model designed to decide the relative importance of information assets, which is described in this study, evaluates information assets from many angles, in order to choose which ones should be given priority when it comes to protection. Many-sided risk analysis (MSRS) grades the importance of information assets, based on evaluation of major security check items, evaluation of the dependency on the information and communication facility (ICF) and influence on potential incidents, and evaluation of major items according to their service classification, in order to identify the ISCS target. MSRS could be an efficient risk analysis model to help ICSPs to identify their core information assets and take information protection measures first, so that stability of the ICS can be ensured.

Keywords: Information Asset, Information CommunicationFacility, Evaluation, ISCS (Information Security Check Service), Evaluation, Grade.

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