Search results for: health care organization

Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

Abstract:

Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: Multidisciplinary approach, neuropalliative care, research, quality of life.

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Authors: Hsing-Yi Kao, Der-Ming Liou

Abstract:

Transferring patient information between medical care sites is necessary to deliver better patient care and to reduce medical cost. So developing of electronic medical records is an important trend for the world.The Continuity of Care Document (CCD) is product of collaboration between CDA and CCR standards. In this study, we will develop a system to generate medical records with entry level based on CCD template module.

Keywords: Continuity Care Document, medical record, entrylevel

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Authors: Daniella Kucsma

Abstract:

The examination of the Public Service Organization’s performance evaluation includes several steps that help public organizations to develop a more efficient system. Public sector organizations have different characteristics than the competitive sector, so it can be stated that other/new elements become more important in their performance processes. The literature in this area is diverse, so highlighting an indicator system can be useful for introducing a system, but it is also worthwhile to measure the specific elements of the organization. In the case of a public service organization, due to the service obligation, it is usually possible to talk about a high number of users, so compliance is more difficult. For the organization, it is an important target to place great emphasis on the increase of service standards and the development of related processes. In this research, the health sector is given a prominent role, as it is a sensitive area where both organizational and individual performance is important for all participants. As a primary step, the content of the strategy is decisive, as this is important for the efficient structure of the process. When designing any system, it is important to review the expectations of the stakeholders, as this is primary when considering the design. The goal of this paper is to build the foundations of a performance management and indexing framework that can help a hospital to provide effective feedback and a direction that is important in assessing and developing a service and can become a management philosophy.

Keywords: health sector, public sector, performance management, strategy

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Authors: Toshio Akimitsu, Yoichi Okabe, Akira Hirose

Abstract:

Many experimental results suggest that more precise spike timing is significant in neural information processing. We construct a self-organization model using the spatiotemporal patterns, where Spike-Timing Dependent Plasticity (STDP) tunes the conduction delays between neurons. We show that the fluctuation of conduction delays causes globally continuous and locally distributed firing patterns through the self-organization.

Keywords: Self-organization, synfire-chain, Spike-Timing Dependent Plasticity, distributed information representation

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Authors: Lorho Mary Maheo, Arundhati Maibam Devi

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Background: Maternal and child health (MCH) cares are the health services provided to mothers and children. It includes the health promotion, preventive, curative and rehabilitation health care for mothers and children. Materials and method: The present study sample comprises of 208 women within the age range 15-69 years from two remote villages of Tamenglong District in Manipur. They were randomly chosen for assessing their health as well as the child’s health adopting an interview schedule method. Results: The findings of the study revealed that majority (80%) of the women have their first conception in their first year of married life. A decadal change has been observed with regard to the last pregnancy i.e., antenatal check-up, place of delivery as well as the service provider. However, irrespective of age of the women, home delivery is still preferred though very few are locally trained. Pre- and post-delivery resting period vary depending on the busy schedule of the agricultural works as the population under study is basically agriculturist. Postnatal care remains to be traditional as they are strongly associated with cultural beliefs and practices that continue to prevail in the studied community. Breast feeding practices such as colostrums given, initiation of breastfeeding, weaning was all taken into account.  Immunization of children has not reached the expected target owing to a variety of reasons. Maternal health care also includes use of birth control measures. The health status of women would invariably improve if family planning is meaningfully adopted. Only 10.1% of the women adopted the modern birth control implying its deep-rooted value attached to the children. Based on the self-assessment report on their health treatment a good number of the respondents resorted to self-medication even to the extent of buying allopathic medicine without a doctor’s prescription. One important finding from the study is the importance attributed to the traditional health care system which is easily affordable and accessible to the villagers. Conclusion: The overall condition of maternal and child care is way behind till now as no adequate/proper health services are available.

Keywords: Antenatal, breastfeeding, child health, maternal, Tamenglong District.

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Authors: L. Lindsay, S. A. Coleman, D. Kerr, B. J. Taylor, A. Moorhead

Abstract:

Cognitive decline and frailty is apparent in older adults leading to an increased likelihood of the risk of falling. Currently health care professionals have to make professional decisions regarding such risks, and hence make difficult decisions regarding the future welfare of the ageing population. This study uses health data from The Irish Longitudinal Study on Ageing (TILDA), focusing on adults over the age of 50 years, in order to analyse health risk factors and predict the likelihood of falls. This prediction is based on the use of machine learning algorithms whereby health risk factors are used as inputs to predict the likelihood of falling. Initial results show that health risk factors such as long-term health issues contribute to the number of falls. The identification of such health risk factors has the potential to inform health and social care professionals, older people and their family members in order to mitigate daily living risks.

Keywords: Classification, falls, health risk factors, machine learning, older adults.

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Authors: Toshio Akimitsu, Yoichi Okabe, Akira Hirose

Abstract:

Many experimental results suggest that more precise spike timing is significant in neural information processing. We construct a self-organization model using the spatiotemporal pat-terns, where Spike-Timing Dependent Plasticity (STDP) tunes the conduction delays between neurons. We show that, for highly syn-chronized inputs, the fluctuation of conduction delays causes globally continuous and locally distributed firing patterns through the self-organization.

Keywords: Self-organization, synfire-chain, Spike-Timing DependentPlasticity, distributed information representation.

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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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Authors: Federico Cabitza, Marco P. Locatelli, Marcello Sarini, Carla Simone

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The paper shows how the CASMAS modeling language, and its associated pervasive computing architecture, can be used to facilitate continuity of care by providing members of patientcentered communities of care with a support to cooperation and knowledge sharing through the usage of electronic documents and digital devices. We consider a scenario of clearly fragmented care to show how proper mechanisms can be defined to facilitate a better integration of practices and information across heterogeneous care networks. The scenario is declined in terms of architectural components and cooperation-oriented mechanisms that make the support reactive to the evolution of the context where these communities operate.

Keywords: Pervasive Computing, Communities of Care, HeterogeneousCare Networks, Multi-Agent System.

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Authors: R. Schweighoffer, N. Nagy, E. Reeves, B. Liebig

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Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.

Keywords: Collaboration, healthcare networks, palliative care, Switzerland.

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

Abstract:

Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: Health care provider, hospital, weight management, weight control.

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Authors: R. Poonsuph

Abstract:

Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

Abstract:

Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: Antenatal care, knowledge, practice, attitude, pregnant women.

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

Abstract:

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

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

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Authors: Leslie Beale

Abstract:

Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: Health promotion, emotional health, patients with chronic disease, patient-centered care.

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Authors: Adekunle O. Afolabi, Pekka Toivanen

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The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: Recommendation systems, healthcare, internet of things, real-time, homecare.

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Authors: M. Mikušová

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The main aim of this paper is to present a clear and comprehensive picture of the process of a crisis in the organization which will help to better understand its possible developments. For a description of the sequence of individual steps and an indication of their causation and possible variants of the developments, a detailed flow diagram with verbal comment is applied. For simplicity, the process of the crisis is observed in four basic phases called: symptoms of the crisis, diagnosis, action and prevention. The model highlights the complexity of the phenomenon of the crisis and that the various phases of the crisis are interweaving.

Keywords: Crisis, management, model, organization.

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Authors: Erin Lynne Plettenberg, Jeremy Vickery

Abstract:

In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: Ontology, logic modeling, electronic medical records, information extraction, vetted web mining.

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Authors: Andrej Miklošík, Eva Hvizdová, Štefan Žák

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Many companies have switched their processes to project-oriented in the last years. This brings new possibilities and effectiveness not only in the field of external processes connected with the product delivery but also the internal processes as well. However centralized project organization which is based on the role of project manager in the team has proved insufficient in some cases. Agile methods of project organization are trying to solve this problem by bringing new view on the project organization, roles, processes and competences. Scrum is one of these methods which builds on the principles of knowledge management to drive the project to effectiveness from all view angles. Using this method to organize internal and delivery projects helps the organization to create and share knowledge throughout the company. It also supports forming unique competences of individuals and project teams and drives innovations in the company.

Keywords: agile software development, knowledge management, knowledge dissemination, project management, SCRUM

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Authors: Mehtap Dursun, E. Ertugrul Karsak, Melis Almula Karadayi

Abstract:

The management of the health-care wastes is one of the most important problems in Istanbul, a city with more than 12 million inhabitants, as it is in most of the developing countries. Negligence in appropriate treatment and final disposal of the healthcare wastes can lead to adverse impacts to public health and to the environment. This paper employs a fuzzy multi-criteria group decision making approach, which is based on the principles of fusion of fuzzy information, 2-tuple linguistic representation model, and technique for order preference by similarity to ideal solution (TOPSIS), to evaluate health-care waste (HCW) treatment alternatives for Istanbul. The evaluation criteria are determined employing nominal group technique (NGT), which is a method of systematically developing a consensus of group opinion. The employed method is apt to manage information assessed using multigranularity linguistic information in a decision making problem with multiple information sources. The decision making framework employs ordered weighted averaging (OWA) operator that encompasses several operators as the aggregation operator since it can implement different aggregation rules by changing the order weights. The aggregation process is based on the unification of information by means of fuzzy sets on a basic linguistic term set (BLTS). Then, the unified information is transformed into linguistic 2-tuples in a way to rectify the problem of loss information of other fuzzy linguistic approaches.

Keywords: Group decision making, health care waste management, multi-criteria decision making, OWA, TOPSIS, 2-tuple linguistic representation

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Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: Average run length, Bernoulli CUSUM chart, beta binomial posterior predictive distribution, clinical indicator, health care organization, highest posterior density interval.

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Authors: Bill D. Geis, Frederick Newman

Abstract:

Suicide and wrongful death forensic cases are the fastest rising tort in mental health law. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from US state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. But suicide ideation, in the matter of suicide risk determination, may be a necessary but insufficient target of lethal suicide risk assessment. Assessment of near-term suicide risk—assessment that goes beyond verbalized suicide ideation and relates to acute crisis variables—is likely needed. Specifically, such other or additional suicide risk variable assessment may be required in the context of lethal suicide risk situations, as opposed to the discernment of general, nonlethal suicide behavior as a standard of practice (whether a patient is having suicidal thoughts or exhibiting an ambivalent suicide attempt potential). In the current study, verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The Lethal Suicide Risk Assessment, Acute Model, and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training and become the legal standard of care for expected clinical behavior. Without this expanded clinical assessment perspective, the standard of care for suicide assessment is out of sync with current knowledge—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: Forensic evaluation, standard of care, suicide, suicide assessment, wrongful death.

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Authors: Parul Khanna, Pavol Zavarsky, Dale Lindskog

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Doxing is a term derived from documents, and hence consists of collecting information on an organization or individual through social media websites, search engines, password cracking methods, social engineering tools and other sources of publicly displayed information. The main purpose of doxing attacks is to threaten, embarrass, harass and humiliate the organization or individual. Various tools are used to perform doxing. Tools such as Maltego visualize organization’s architecture which helps in determining weak links within the organization. This paper discusses limitations of Maltego Chlorine CE 3.6.0 and suggests measures as to how organizations can use these tools to protect themselves from doxing attacks.

Keywords: Advanced Persistent Threat, FOCA, OSINT, PII.

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Authors: A. Bulatbayeva, A. Kusainov, P. Makhanova, A. Bashchikulov

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In the article there have been revealed the properties of designing the research teaching the military masters and in the context it has been offered the program of mastering by the masters military men the methodology of research work, in the course of practical teaching activity there has been considered the developed and approbated model of organization of the process of mastering by the masters the methodology of research work. As a whole, the research direction of master preparation leaves its sign to the content of education, forms of organization of educational process, scientific work of masters. In this connection the offered in the article properties of organization of research teaching and a model of organization of mastering by the masters military men the methodology of research work can be taken into account when designing the content of master preparation.

Keywords: Masters militaries, Methodology of research work, Military knowledge, Research teaching.

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Authors: Juan L. Castro, Maria I. NavarroVictor Lopez, Eduardo M. Eisman, Jose M. Zurita

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This paper describes the Multilingual Virtual Simulated Patient framework. It has been created to train the social skills and testing the knowledge of primary health care medical students. The framework generates conversational agents which perform in serveral languages as virtual simulated patients that help to improve the communication and diagnosis skills of the students complementing their training process.

Keywords: Medical training, conversational agents, patient modeling.

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Authors: Jenny K. Ubaque, Edward P. Guillen, Juan S. Solórzano, Leonardo J. Ramírez

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The health care must be a right for people around the world, but in order to guarantee the access to all, it is necessary to overcome geographical barriers. Telemedicine take advantage of Information Communication Technologies to deploy health care services around the world. To achieve those goals, it is necessary to use existing last mile solution to create access for home users, which is why is necessary to establish the channel characteristics for those kinds of services. This paper presents an analysis of network performance of last mile solution for the use of IPTV broadcasting with the application of streaming for telemedicine apps.

Keywords: Telemedicine, IPTV, GPON, ADSL2+, COAXIAL, Jumbogram.

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Authors: Novita Verayanti Manalu, Alvin Salim, Esti Yunitasari

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Background: Palliative care is caring holistically for patients and families to improve their quality of life. The approach by a multidisciplinary team requires integrated collaboration based on sufficient knowledge of the principles of palliative care as a whole, especially for nurses. Therefore, this study wants to find out the level of knowledge about palliative care of the nurses along the relationship with attitude and performance. Method: This study applies cross-sectional survey design and allows the respondents to fill two questionnaires to determine the level of knowledge and attitude toward palliative care, while one questionnaire is filled by the head nurse to evaluate nurses’ performance. The relationship was analyzed by Spearman rho’s correlation in alpha < 0.05 by SPSS. Results: The majority of respondents were females, age above 25 years old, and married. Most of the nurses are staff nurses and the ratio of education level is not significantly different. The knowledge level is poor, while the attitude and performance are in adequate level. Knowledge may affect attitude, but it does not happen toward performance. Conclusion: There is a need for increased knowledge about palliative care to improve attitude and work performance. Future researchers might use this finding as reference to conduct further study in improving knowledge of palliative care.

Keywords: Knowledge, attitude, work performance, palliative care.

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Authors: F. Lievens, M. Jordanova

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Telemedicine is brought to life by contemporary changes of our world and summarizes the entire range of services that are at the crossroad of traditional healthcare and information technology. It is believed that eHealth can help in solving critical issues of rising costs, care for ageing and housebound population, staff shortage. It is a feasible tool to provide routine as well as specialized health service as it has the potential to improve both the access to and the standard of care. eHealth is no more an optional choice. It has already made quite a way but it still remains a fantastic challenge for the future requiring cooperation and coordination at all possible levels. The strategic objectives of this paper are: 1. To start with an attempt to clarify the mass of terms used nowadays; 2. To answer the question “Who needs eHealth"; 3. To focus on the necessity of bridging telemedicine and medical (health) informatics as well as on the dual relationship between them; as well as 4. To underline the need of networking in understanding, developing and implementing eHealth.

Keywords: E-Health/telemedicine, networking, medical informatics.

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Authors: Wijittra Srisorn

Abstract:

This research studied about green logistics and the expected benefit that organization gotten when adapted to green logistics also the organization concerned about the important activity in green logistics to apply in implementation from study was found that the benefit of green logistics that organization was gotten by logistics management which was the increased efficiency process of management the product from producer to customer all of reduce production cost, increased value added save energy and prevented environment together From study was found that the organization had green logistics to apply in logistics activities in supply chain since downstream till upstream to prevent environment as follow 1). Purchasing process, trade facilitation enhance such as linking of information technology during business to business (B2B business). 2). Productions process improved by business logistics improvement 3). Warehouse management process such as recycled packaging, moving goods in to warehouse, transportation goods and inside receiving and delivery products plan.

Keywords: Green Logistics, Trade Facilitation, Business Logistics Improvement, Double handling.

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

Abstract:

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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