Search results for: clinical psychology
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 493

Search results for: clinical psychology

463 Traumatic Ankle Pain: Adequacy of Clinical Information in X-Ray Request with Reference to the Ottawa Ankle Rule

Authors: Rania Mustafa

Abstract:

This audit was conducted at Manchester University NHS Foundation Trust, Wythenshawe Hospital Radiology and Accident and Emergency [A&E] Department to assess the appropriateness of clinical information in X-ray requests, specifically in cases of acute ankle injuries. As per the Ottawa Ankle Rules and the recommendations of National Institute for Health and Care Excellence [NICE] and the Royal College of Radiology, we aimed to evaluate the appropriateness of referrals and the thoroughness of clinical information provided by Emergency Department [ED] clinicians for ankle radiography. Our goal was to achieve 100% compliance with these guidelines. The audit involved a comprehensive analysis spanning the period from August 2022 to January 2023, encompassing patient records, radiographic orders, and clinical assessments. Data collection included patient demographics, presenting complaints, clinical assessments, adherence to Ottawa Ankle Rules criteria, and subsequent radiography orders. Here we conducted two audit cycles, involving 38 patients in the first cycle and 86 patients in the second cycle. The data were furtherly filtered to include all patients who were referred from the ED for an ankle Xray with a history of acute trauma and age of more than 18 years. The key finding was that in August 2022, 60% of cases met the Ottawa Ankle Rules criteria accurately, indicating a need for improvement in adherence. However, by January 2023, there was a notable improvement, with 95% of cases accurately meeting the criteria. This significant change reflects an increased alignment with best practices for ankle radiography referrals.

Keywords: Ankle, injuries, Ottawa Ankle Rule, X-rays.

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462 The Effects of an Information Delivery Modality on Psychology of E-learning Students

Authors: Eunil Park, Angel P. del Pobil

Abstract:

Does a communication modality matter in delivering e-learning information? With the recent growth of broadcasting systems, media technologies and e-learning contents, various systems with different communication modalities have been introduced. In accordance with these trends, this study examines the effects of the information delivery modality on psychology of students. Findings from an experiment indicated that the delivering information which includes a video modality elicited higher degrees of credibility, quality, representativeness of content, and perceived suitability for delivering information than those of auditory information. However, there is no difference between content liking and attitude. The Implications of the findings and the limitations are discussed.

Keywords: Communication modality, e-learning, multimodality, students.

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461 Family Functionality in Mexican Children with Congenital and Non-Congenital Deafness

Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio

Abstract:

A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.

Keywords: Deafness, psychological support, family, adaptation to disability.

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460 Idiopathic Constipation can be Subdivided in Clinical Subtypes: Data Mining by Cluster Analysis on a Population based Study

Authors: Mauro Giacomini, Stefania Bertone, Carlo Mansi, Pietro Dulbecco, Vincenzo Savarino

Abstract:

The prevalence of non organic constipation differs from country to country and the reliability of the estimate rates is uncertain. Moreover, the clinical relevance of subdividing the heterogeneous functional constipation disorders into pre-defined subgroups is largely unknown.. Aim: to estimate the prevalence of constipation in a population-based sample and determine whether clinical subgroups can be identified. An age and gender stratified sample population from 5 Italian cities was evaluated using a previously validated questionnaire. Data mining by cluster analysis was used to determine constipation subgroups. Results: 1,500 complete interviews were obtained from 2,083 contacted households (72%). Self-reported constipation correlated poorly with symptombased constipation found in 496 subjects (33.1%). Cluster analysis identified four constipation subgroups which correlated to subgroups identified according to pre-defined symptom criteria. Significant differences in socio-demographics and lifestyle were observed among subgroups.

Keywords: Cluster analysis, constipation, data mining, statistical analysis.

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459 Some Reflexions on the Selfunderstanding of the Kazakh People: A Way of Building Identity in the Modern World

Authors: A.M. Kanagatova, J.Mahoney, A.R. Masalimova, T.H. Gabitov, A.B. Kalysh

Abstract:

This article explores the self-identity of the Kazakh people by way of identifying the roots of self-understanding in Kazakh culture. Unfortunately, Western methods of ethno psychology cannot fully capture what is unique about identity in Kazakh culture. Although Kazakhstan is the ninth largest country in terms of geographical space, Kazakh cultural identity is not wellknown in the West. In this article we offer an account of the national psychological features of the Kazakh people, in order to reveal the spiritual, mental, ethical dimensions of modern Kazakhs. These factors play a central role in the revival of forms of identity that are central to the Kazakh people.

Keywords: self-understanding, ethno psychology, stereotypes, nomadic culture, cultural identity

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458 Interventions and Supervision in Mental Health Services: Experiences of a Working Group in Brazil

Authors: Sonia Alberti

Abstract:

The Regional Conference to Restructure Psychiatric Care in Latin America, convened by the Pan American Health Organization (PAHO) in 1990, oriented the Brazilian Federal Act in 2001 that stipulated the psychiatric reform which requires deinstitutionalization and community-based treatment. Since then, the 15 years’ experience of different working teams in mental health led an academic working group – supervisors from personal practices, professors and researchers – to discuss certain clinical issues, as well as supervisions, and to organize colloquia in different cities as a methodology. These colloquia count on the participation of different working teams from the cities in which they are held, with team members with different levels of educational degrees and prior experiences, in order to increase dialogue right where it does not always appear to be possible. The principal aim of these colloquia is to gain interlocution between practitioners and academics. Working with the theory of case constructions, this methodology revealed itself helpful in unfolding new solutions. The paper also observes that there is not always harmony between what the psychiatric reform demands and clinical ethics.

Keywords: Mental health, supervision, clinical cases, Brazilian experience.

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457 Medical Imaging Techniques in Clinical Medicine

Authors: Sharan Badiger, Prema T. Akkasaligar

Abstract:

Medical imaging technology has experienced a dramatic change in the last few years. Medical imaging refers to the techniques and processes used to create images of the human body (or parts thereof) for various clinical purposes such as medical procedures and diagnosis or medical science including the study of normal anatomy and function. With the growth of computers and image technology, medical imaging has greatly influenced the medical field. The diagnosis of a health problem is now highly dependent on the quality and the credibility of the image analysis. This paper deals with the various aspects and types of medical imaging.

Keywords: Computed Tomography, Echocardiography, Medical Imaging, Magnetic Resonance, Ultrasound Imaging.

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456 Comparison of Different Neural Network Approaches for the Prediction of Kidney Dysfunction

Authors: Ali Hussian Ali AlTimemy, Fawzi M. Al Naima

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This paper presents the prediction of kidney dysfunction using different neural network (NN) approaches. Self organization Maps (SOM), Probabilistic Neural Network (PNN) and Multi Layer Perceptron Neural Network (MLPNN) trained with Back Propagation Algorithm (BPA) are used in this study. Six hundred and sixty three sets of analytical laboratory tests have been collected from one of the private clinical laboratories in Baghdad. For each subject, Serum urea and Serum creatinin levels have been analyzed and tested by using clinical laboratory measurements. The collected urea and cretinine levels are then used as inputs to the three NN models in which the training process is done by different neural approaches. SOM which is a class of unsupervised network whereas PNN and BPNN are considered as class of supervised networks. These networks are used as a classifier to predict whether kidney is normal or it will have a dysfunction. The accuracy of prediction, sensitivity and specificity were found for each type of the proposed networks .We conclude that PNN gives faster and more accurate prediction of kidney dysfunction and it works as promising tool for predicting of routine kidney dysfunction from the clinical laboratory data.

Keywords: Kidney Dysfunction, Prediction, SOM, PNN, BPNN, Urea and Creatinine levels.

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455 Motivating the Independent Learner at the Arab Open University, Kuwait

Authors: Hassan A. Sharafuddin, Chekra A. Allani

Abstract:

Academicians at the Arab Open University have always voiced their concern about the efficacy of the blended learning process. Based on 75% independent study and 25% face-toface tutorial, it poses the challenge of the predisposition to adjustment. Being used to the psychology of traditional educational systems, AOU students cannot be easily weaned from being spoonfed. Hence they lack the motivation to plunge into self-study. For better involvement of AOU students into the learning practices, it is imperative to diagnose the factors that impede or increase their motivation. This is conducted through an empirical study grounded upon observations and tested hypothesis and aimed at monitoring and optimizing the students’ learning outcome. Recommendations of the research will follow the findings.

Keywords: Academic performance, blended learning, educational psychology, independent study, pedagogy.

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454 The Design of the HL7 RIM-based Sharing Components for Clinical Information Systems

Authors: Wei-Yi Yang, Li-Hui Lee, Hsiao-Li Gien, Hsing-Yi Chu, Yi-Ting Chou, Der-Ming Liou

Abstract:

The American Health Level Seven (HL7) Reference Information Model (RIM) consists of six back-bone classes that have different specialized attributes. Furthermore, for the purpose of enforcing the semantic expression, there are some specific mandatory vocabulary domains have been defined for representing the content values of some attributes. In the light of the fact that it is a duplicated effort on spending a lot of time and human cost to develop and modify Clinical Information Systems (CIS) for most hospitals due to the variety of workflows. This study attempts to design and develop sharing RIM-based components of the CIS for the different business processes. Therefore, the CIS contains data of a consistent format and type. The programmers can do transactions with the RIM-based clinical repository by the sharing RIM-based components. And when developing functions of the CIS, the sharing components also can be adopted in the system. These components not only satisfy physicians- needs in using a CIS but also reduce the time of developing new components of a system. All in all, this study provides a new viewpoint that integrating the data and functions with the business processes, it is an easy and flexible approach to build a new CIS.

Keywords: HL7, Reference Information Model (RIM), web service, process management.

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453 Impact of Positive Psychology Education and Interventions on Well-Being: A Study of Students Engaged in Pastoral Care

Authors: Inna R. Edara, Haw-Lin Wu

Abstract:

Positive psychology investigates human strengths and virtues and promotes well-being. Relying on this assumption, positive interventions have been continuously designed to build pleasure and happiness, joy and contentment, engagement and meaning, hope and optimism, satisfaction and gratitude, spirituality, and various other positive measures of well-being. In line with this model of positive psychology and interventions, this study investigated certain measures of well-being in a group of 45 students enrolled in an 18-week positive psychology course and simultaneously engaged in service-oriented interventions that they chose for themselves based on the course content and individual interests. Students’ well-being was measured at the beginning and end of the course. The well-being indicators included positive automatic thoughts, optimism and hope, satisfaction with life, and spirituality. A paired-samples t-test conducted to evaluate the impact of class content and service-oriented interventions on students’ scores of well-being indicators indicated statistically significant increase from pre-class to post-class scores. There were also significant gender differences in post-course well-being scores, with females having higher levels of well-being than males. A two-way between groups analysis of variance indicated a significant interaction effect of age by gender on the post-course well-being scores, with females in the age group of 56-65 having the highest scores of well-being in comparison to the males in the same age group. Regression analyses indicated that positive automatic thought significantly predicted hope and satisfaction with life in the pre-course analysis. In the post-course regression analysis, spiritual transcendence made a significant contribution to optimism, and positive automatic thought made a significant contribution to both hope and satisfaction with life. Finally, a significant test between pre-course and post-course regression coefficients indicated that the regression coefficients at pre-course were significantly different from post-course coefficients, suggesting that the positive psychology course and the interventions were helpful in raising the levels of well-being. The overall results suggest a substantial increase in the participants’ well-being scores after engaging in the positive-oriented interventions, implying a need for designing more positive interventions in education to promote well-being.  

Keywords: Hope, optimism, positive automatic thoughts, satisfaction with life, spirituality, well-being.

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452 Poincaré Plot for Heart Rate Variability

Authors: Mazhar B. Tayel, Eslam I. AlSaba

Abstract:

Heart is the most important part in the body of living organisms. It affects and is affected by any factor in the body. Therefore, it is a good detector for all conditions in the body. Heart signal is a non-stationary signal; thus, it is utmost important to study the variability of heart signal. The Heart Rate Variability (HRV) has attracted considerable attention in psychology, medicine and has become important dependent measure in psychophysiology and behavioral medicine. The standards of measurements, physiological interpretation and clinical use for HRV that are most often used were described in many researcher papers, however, remain complex issues are fraught with pitfalls. This paper presents one of the nonlinear techniques to analyze HRV. It discusses many points like, what Poincaré plot is and how Poincaré plot works; also, Poincaré plot's merits especially in HRV. Besides, it discusses the limitation of Poincaré cause of standard deviation SD1, SD2 and how to overcome this limitation by using complex correlation measure (CCM). The CCM is most sensitive to changes in temporal structure of the Poincaré plot as compared toSD1 and SD2.

Keywords: Heart rate variability, chaotic system, Poincaré, variance, standard deviation, complex correlation measure.

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451 Automated Thickness Measurement of Retinal Blood Vessels for Implementation of Clinical Decision Support Systems in Diagnostic Diabetic Retinopathy

Authors: S.Jerald Jeba Kumar, M.Madheswaran

Abstract:

The structure of retinal vessels is a prominent feature, that reveals information on the state of disease that are reflected in the form of measurable abnormalities in thickness and colour. Vascular structures of retina, for implementation of clinical diabetic retinopathy decision making system is presented in this paper. Retinal Vascular structure is with thin blood vessel, whose accuracy is highly dependent upon the vessel segmentation. In this paper the blood vessel thickness is automatically detected using preprocessing techniques and vessel segmentation algorithm. First the capture image is binarized to get the blood vessel structure clearly, then it is skeletonised to get the overall structure of all the terminal and branching nodes of the blood vessels. By identifying the terminal node and the branching points automatically, the main and branching blood vessel thickness is estimated. Results are presented and compared with those provided by clinical classification on 50 vessels collected from Bejan Singh Eye hospital..

Keywords: Diabetic retinopathy, Binarization, SegmentationClinical Decision Support Systems.

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450 Problem-based Learning Approach to Human Computer Interaction

Authors: Oon-Seng Tan

Abstract:

Human Computer Interaction (HCI) has been an emerging field that draws in the experts from various fields to enhance the application of computer programs and the ease of computer users. HCI has much to do with learning and cognition and an emerging approach to learning and problem-solving is problembased learning (PBL). The processes of PBL involve important cognitive functions in the various stages. This paper will illustrate how closely related fields to HCI, PBL and cognitive psychology can benefit from informing each other through analysing various cognitive functions. Several cognitive functions from cognitive function disc (CFD) would be presented and discussed in relation to human-computer interface. This paper concludes with the implications of bridging the gaps amongst these disciplines.

Keywords: problem-based learning, human computerinteraction, cognitive psychology, Cognitive Function Disc (CFD)

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449 Negative RT-PCR in a Newborn Infected with Zika Virus: A Case Report

Authors: Vallejo Michael, Acuña Edgar, Roa Juan David, Peñuela Rosa, Parra Alejandra, Casallas Daniela, Rodriguez Sheyla

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Congenital Zika Virus Syndrome is an entity composed by a variety of birth defects presented in newborns that have been exposed to the Zika Virus during pregnancy. The syndrome characteristic features are severe microcephaly, cerebral tissue abnormalities, ophthalmological abnormalities such as uveitis and chorioretinitis, arthrogryposis, clubfoot deformity and muscular tone abnormalities. The confirmatory test is the Reverse transcription polymerase chain reaction (RT-PCR) associated to the physical findings. Here we present the case of a newborn with microcephaly whose mother presented a confirmed Zika Virus infection during the third trimester of pregnancy, despite of the evident findings and the history of Zika infection the RT-PCR in amniotic and cerebrospinal fluid of the newborn was negative. RT-PCR has demonstrated a low sensibility in samples with low viral loads, reason why, we propose a clinical diagnosis in patients with clinical history of Zika Virus infection during pregnancy accompanied by evident clinical manifestations of the child.

Keywords: Zika Virus, polymerase chain reaction, microcephaly, amniotic fluid.

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448 On the Combination of Patient-Generated Data with Data from a Secure Clinical Network Environment – A Practical Example

Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: Data integration, disease-related malnutrition, expert systems, mobile health.

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447 Q-Map: Clinical Concept Mining from Clinical Documents

Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala

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Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.

Keywords: Information retrieval (IR), unified medical language system (UMLS), Syntax Based Analysis, natural language processing (NLP), medical informatics.

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446 When Psychology Meets Ecology: Cognitive Flexibility for Quarry Rehabilitation

Authors: J. Fenianos, C. Khater, D. Brouillet

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Ecological projects are often faced with reluctance from local communities hosting the project, especially when this project involves variation from preset ideas or classical practices. This paper aims at appreciating the contribution of environmental psychology through cognitive flexibility exercises to improve the acceptability of local communities in adopting more ecological rehabilitation scenarios. The study is based on a quarry site located in Bekaa- Lebanon. Four groups were considered with different levels of involvement, as follows: Group 1 is Training (T) – 50 hours of on-site training over 8 months, Group 2 is Awareness (A) – 2 hours of awareness raising session, Group 3 is Flexibility (F) – 2 hours of flexibility exercises and Group 4 is the Control (C). The results show that individuals in Group 3 (F) who followed flexibility sessions accept comparably the ecological rehabilitation option over the more classical one. This is also the case for the people in Group 1 (T) who followed a more time-demanding “on-site training”. Another experience was conducted on a second quarry site combining flexibility with awareness-raising. This research confirms that it is possible to reduce resistance to change thanks to a limited in-time intervention using cognitive flexibility. This methodological approach could be transferable to other environmental problems involving local communities and changes in preset perceptions.

Keywords: Acceptability, ecological restoration, environmental psychology, Lebanon, local communities, resistance to change.

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445 Long Term Follow-Up, Clinical Outcomes and Quality of Life after Total Arterial Revascularisation versus Conventional Coronary Surgery: A Retrospective Study

Authors: Jitendra Jain, Cassandra Hidajat, Hansraj Riteesh Bookun

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Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.

Keywords: CABG, MACCEs, quality of life, total arterial revascularization.

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444 Improving Decision Support for Organ Transplant

Authors: I. McCulloh, A. Placona, D. Stewart, D. Gause, K. Kiernan, M. Stuart, C. Zinner, L. Cartwright

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We find in our data that an alarming number of viable deceased donor kidneys are discarded every year in the US, while waitlisted candidates are dying every day. We observe as many as 85% of transplanted organs are refused at least once for a patient that scored higher on the match list. There are hundreds of clinical variables involved in making a clinical transplant decision and there is rarely an ideal match. Decision makers exhibit an optimism bias where they may refuse an organ offer assuming a better match is imminent. We propose a semi-parametric Cox proportional hazard model, augmented by an accelerated failure time model based on patient-specific suitable organ supply and demand to estimate a time-to-next-offer. Performance is assessed with Cox-Snell residuals and decision curve analysis, demonstrating improved decision support for up to a 5-year outlook. Providing clinical decision-makers with quantitative evidence of likely patient outcomes (e.g., time to next offer and the mortality associated with waiting) may improve decisions and reduce optimism bias, thus reducing discarded organs and matching more patients on the waitlist.

Keywords: Decision science, KDPI, optimism bias, organ transplant.

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443 Health Care Ethics in Vulnerable Populations: Clinical Research through the Patient's Eyes

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

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

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

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442 A Medical Images Based Retrieval System using Soft Computing Techniques

Authors: Pardeep Singh, Sanjay Sharma

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Content-Based Image Retrieval (CBIR) has been one on the most vivid research areas in the field of computer vision over the last 10 years. Many programs and tools have been developed to formulate and execute queries based on the visual or audio content and to help browsing large multimedia repositories. Still, no general breakthrough has been achieved with respect to large varied databases with documents of difering sorts and with varying characteristics. Answers to many questions with respect to speed, semantic descriptors or objective image interpretations are still unanswered. In the medical field, images, and especially digital images, are produced in ever increasing quantities and used for diagnostics and therapy. In several articles, content based access to medical images for supporting clinical decision making has been proposed that would ease the management of clinical data and scenarios for the integration of content-based access methods into Picture Archiving and Communication Systems (PACS) have been created. This paper gives an overview of soft computing techniques. New research directions are being defined that can prove to be useful. Still, there are very few systems that seem to be used in clinical practice. It needs to be stated as well that the goal is not, in general, to replace text based retrieval methods as they exist at the moment.

Keywords: CBIR, GA, Rough sets, CBMIR

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441 A New Failure Analysis for Maintenance Management in Complex Hospitals

Authors: R. Miniati, F. Dori, E. Iadanza, M. Fregonara Medici

Abstract:

management of medical devices in hospitals includes the planning of medical equipment acquisition and maintenance. The presence of critical and non-critical areas together with technological proliferation render the management of medical devices very complex. This study creates an easy and objective methodology for the analysis of medical equipment maintenance, that makes the management of medical devices more feasible. The study has been carried out at Florence Hospital Careggi and it aims to help the clinical engineering department to manage medical equipment by clarifying the hospital situation through a characterization of the different areas, technologies and fault typologies.

Keywords: Clinical Engineering, Maintenance, Medical DevicesManagement, Key Performance Indicators.

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440 Medical Knowledge Management in Healthcare Industry

Authors: B. Stroetmann, A. Aisenbrey

Abstract:

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

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

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439 Peculiarities of Comprehending the Subjective Well- Being by Student with High and Low Level of Emotional Intelligence

Authors: Veronika Pivkina, Alla Kim, Khon Nataliya

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In this paper, the actuality of the study, and the role of subjective well-being problem in modern psychology and the comprehending of subjective well-being by current students is defined. The purpose of this research is to educe peculiarities of comprehending of subjective well-being by students with various levels of emotional intelligence. Methods of research are adapted Russian-Language questionnaire of K. Riff 'The scales of psychological well-being'; emotional intelligence questionnaire of D. V. Lusin. The research involved 72 students from different universities and disciplines aged between 18 and 24. Analyzing the results of the studies, it can be concluded that the understanding of happiness in different groups of students with high and low levels of overall emotional intelligence is different, as well as differentiated by gender. Students with a higher level of happiness possess more capacity and higher need to control their emotions, to cause and maintain the desired emotions and control something undesirable.

Keywords: Subjective well-being, emotional intelligence, psychology of comprehending, students.

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438 Development and Validation of the Response to Stressful Situations Scale in the General Population

Authors: C. Barreto Carvalho, C. da Motta, M. Sousa, J. Cabral, A. L. Carvalho, E. B. Peixoto

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The aim of the current study was to develop and validate a Response to Stressful Situations Scale (RSSS) for the Portuguese population. This scale assesses the degree of stress experienced in scenarios that can constitute positive, negative and more neutral stressors, and also describes the physiological, emotional and behavioral reactions to those events according to their intensity. These scenarios include typical stressor scenarios relevant to patients with schizophrenia, which are currently absent from most scales, assessing specific risks that these stressors may bring on subjects, which may prove useful in non-clinical and clinical populations (i.e. Patients with mood or anxiety disorders, schizophrenia). Results from Principal Components Analysis and Confirmatory Factor Analysis of two adult samples from general population allowed to confirm a three-factor model with good fit indices: χ2 (144)= 370.211, p = 0.000; GFI = 0.928; CFI = 0.927; TLI = 0.914, RMSEA = 0.055, P(rmsea ≤0.005) = .096; PCFI = .781. Further data analysis of the scale revealed that RSSS is an adequate assessment tool of stress response in adults to be used in further research and clinical settings, with good psychometric characteristics, adequate divergent and convergent validity, good temporal stability and high internal consistency.

Keywords: Assessment, stress events, stress response, stress vulnerability.

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437 The Care Management Network as an Effective Intervention in Mitigating the Risks of Hypertension

Authors: Feng-Chuan Pan, Fang-Yue Liu

Abstract:

Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Keywords: hypertension, joint care management network, cardiovascular diseases, metabolic syndrome.

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436 Design of Stainless Steel Implant for Fractured Distal Femur

Authors: Abhishek Soni, Bhagat Singh

Abstract:

Perfect restoration of fractured distal femur has been a challenging task for the medical practitioners. In the present study, model of a fractured bone has been created using the scan data of the damaged bone. Thereafter, customized implant of Stainless Steel (SS-316L) for this fractured femur bone is modeled using the reverse engineering approach. Clinical set-up is prepared by assembling all the models together. Stress and deformation analysis of this clinical set-up has been performed in order to check the load bearing capacity and intactness of the joint. From this analysis, it has been inferred that the stresses and deformation developed due to the static load of the person is within the permissible limits.

Keywords: Biomechanical evaluations, customized implant, reverse engineering, stainless steel alloy.

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435 The PARADIGMA Approach for Cooperative Work in the Medical Domain

Authors: Antonio Di Leva, Carla Reyneri, Michele Sonnessa

Abstract:

PARADIGMA (PARticipative Approach to DIsease Global Management) is a pilot project which aims to develop and demonstrate an Internet based reference framework to share scientific resources and findings in the treatment of major diseases. PARADIGMA defines and disseminates a common methodology and optimised protocols (Clinical Pathways) to support service functions directed to patients and individuals on matters like prevention, posthospitalisation support and awareness. PARADIGMA will provide a platform of information services - user oriented and optimised against social, cultural and technological constraints - supporting the Health Care Global System of the Euro-Mediterranean Community in a continuous improvement process.

Keywords: Decision Support Systems, Ontology, Healt Care, Clinical Pathway

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434 Oral Examination: An Important Adjunct to the Diagnosis of Dermatological Disorders

Authors: Sanjay Saraf

Abstract:

The oral cavity can be the site for early manifestations of mucocutaneous disorders (MD) or the only site for occurrence of these disorders. It can also exhibit oral lesions with simultaneous associated skin lesions. The MD involving the oral mucosa commonly presents with signs such as ulcers, vesicles and bullae. The unique environment of the oral cavity may modify these signs of the disease, thereby making the clinical diagnosis an arduous task. In addition to the unique environment of oral cavity, the overlapping of the signs of various mucocutaneous disorders, also makes the clinical diagnosis more intricate. The aim of this review is to present the oral signs of dermatological disorders having common oral involvement and emphasize their   importance in   early detection of the systemic disorders. The aim is also to highlight the necessity of oral examination by a dermatologist while examining the skin lesions. Prior to the oral examination, it must be imperative for the dermatologists and the dental clinicians to have the knowledge of oral anatomy. It is also important to know the impact of various diseases on oral mucosa, and the characteristic features of various oral mucocutaneous lesions. An initial clinical oral examination is may help in the early diagnosis of the MD. Failure to identify the oral manifestations may reduce the likelihood of early treatment and lead to more serious problems. This paper reviews the oral manifestations of immune mediated dermatological disorders with common oral manifestations.

Keywords: Vesiculobullous lesions, Desquamative gingivitis, Nikolsky’s sign, Erythema.

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