Search results for: preventive healthcare.

Authors: M. Winkens, P. Nyhuis

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Components with sensory properties such as gentelligent components developed at the Collaborative Research Centre 653 offer a new angle in terms of the full utilization of the remaining service life as well as preventive maintenance. The developed methodology of component status driven maintenance analyzes the stress data obtained during the component's useful life and on the basis of this knowledge assesses the type of maintenance required in this case. The procedure is derived from the case-based reasoning method and will be explained in detail. The method's functionality is demonstrated with real-life data obtained during test runs of a racing car prototype.

Keywords: Gentelligent Components, Preventive Maintenance, Case based Reasoning.

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Authors: B. Stroetmann, A. Aisenbrey

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

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

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Authors: M. Winkens, M. Goerke, P. Nyhuis

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This technical contribution treats of a novel approach to condition-oriented maintenance as elaborated by Collaborative Research Centre 653 at the Leibniz University in Hanover. The objective resides in the targeted analysis of information about a component's lifecycle for maintenance purposes. The information in question is collected by means of the Collaborative Research Centre's innovative technologies. This enables preventive maintenance of components on the basis of their condition. This contribution initially explains condition-oriented maintenance, before introducing the Collaborative Research Centre and finally presenting the methodology for analyzing the information. The current state of development is described and an outlook provided for expanding the methodology.

Keywords: Gentelligent Components, Preventive Maintenance, life cycle data.

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Authors: M. Bouguerra, I. Habi

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The continuity in the electric supply of the electric installations is becoming one of the main requirements of the electric supply network (generation, transmission, and distribution of the electric energy). The achievement of this requirement depends from one side on the structure of the electric network and on the other side on the avaibility of the reserve source provided to maintain the supply in case of failure of the principal one. The avaibility of supply does not only depends on the reliability parameters of the both sources (principal and reserve) but it also depends on the reliability of the circuit breaker which plays the role of interlocking the reserve source in case of failure of the principal one. In addition, the principal source being under operation, its control can be ideal and sure, however, for the reserve source being in stop, a preventive maintenances which proceed on time intervals (periodicity) and for well defined lengths of time are envisaged, so that this source will always available in case of the principal source failure. The choice of the periodicity of preventive maintenance of the source of reserve influences directly the reliability of the electric feeder system In this work and on the basis of the semi- markovian's processes, the influence of the time of interlocking the reserve source upon the reliability of an industrial electric network is studied and is given the optimal time of interlocking the reserve source in case of failure the principal one, also the influence of the periodicity of the preventive maintenance of the source of reserve is studied and is given the optimal periodicity.

Keywords: Semi-Markovians processes, reliability, optimization, industrial electric network.

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Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: Disposal, Healthcare waste, management, Montserrado County, Monrovia.

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Authors: Kgabo H. Badimo, Sheryl Buckley

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Knowledge is increasingly recognised in this, the knowledge era, as a strategic resource, by public sector organisations, in view of the public sector reform initiatives. People and knowledge play a vital role in attaining improved organisational performance and high service quality. Many government departments in the public sector have started to realise the importance of knowledge management in streamlining their operations and processes. This study focused on knowledge management in the public healthcare service organisations, where the concept of service provider competitiveness pales to insignificance, considering the huge challenges emanating from the healthcare and public sector reforms. Many government departments are faced with challenges of improving organisational performance and service delivery, improving accountability, making informed decisions, capturing the knowledge of the aging workforce, and enhancing partnerships with stakeholders. The purpose of this paper is to examine the knowledge management practices of the Gauteng Department of Health in South Africa, in order to understand how knowledge management practices influence improvement in organisational performance and healthcare service delivery. This issue is explored through a review of literature on dominant views on knowledge management and healthcare service delivery, as well as results of interviews with, and questionnaire responses from, the general staff of the Gauteng Department of Health. Web-based questionnaires, face-to-face interviews and organisational documents were used to collect data. The data were analysed using both the quantitative and qualitative methods. The central question investigated was: To what extent can the conditions required for successful knowledge management be observed, in order to improve organisational performance and healthcare service delivery in the Gauteng Department of Health. The findings showed that the elements of knowledge management capabilities investigated in this study, namely knowledge creation, knowledge sharing and knowledge application, have a positive, significant relationship with all measures of organisational performance and healthcare service delivery. These findings thus indicate that by employing knowledge management principles, the Gauteng Department of Health could improve its ability to achieve its operational goals and objectives, and solve organisational and healthcare challenges, thereby improving organisational performance and enhancing healthcare service delivery in Gauteng.

Keywords: Knowledge Management, Healthcare Service Delivery, Public Healthcare, Public Sector.

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Authors: H. M. Nuralam, Z. Xiao-lan, B. K. Dubey, D. Wen-Chuan

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Healthcare waste (HCW) is one of the major concerns in environmental issues due to its infectious and hazardous nature that is requires specific treatment and systematic management prior to final disposal. This study aimed to assess HCW management system in Dhaka City (DC), Bangladesh, by investigating the present practices implemented by the city. In this study, five different healthcare establishments were selected in DC. Field visits and interviews with health personnel and staff who are concerned with the waste management were conducted. The information was gathered through questionnaire focus on the different aspect of HCW management like, waste segregation and collection, storage and transport, awareness as well. The results showed that a total of 7,215 kg/day (7.2 ton/day) of waste were generated, of which 79.36% (5.6 ton/day) was non-hazardous waste and 20.6% (1.5 ton/day) was hazardous waste. The rate of waste generation in these healthcare establishments (HCEs) was 2.6 kg/bed/day. There was no appropriate and systematic management of HCWs except at few private HCEs that segregate their hazardous waste. All the surveyed HCEs dumped their HCW together with the municipal waste, and some staff members were also found to be engaged in improper handling of the generated waste. Furthermore, the used sharp instruments, saline bags, blood bags and test tubes were collected for resale or reuse. Nevertheless, the lack of awareness, appropriate policy, regulation and willingness to act, were responsible for the improper management of HCW in DC. There was lack of practical training of concerned healthcare to handle the waste properly, while the nurses and staff were found to be aware of the health impacts of HCW.

Keywords: Awareness, disposal, Dhaka City, healthcare waste management, waste generation.

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Authors: M. Karbakhsh, M. Shamseddini Motlagh, M. Khansari

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The purpose of this research was to demonstrate prevalence of post-exposure preventive measures (PEP) after needlestick injuries and its relationship with locus of control beliefs in a sample of medical students. In this cross-sectional study, 300 medical students with history of having experienced needle stick injuries (NSI) for at least once filled in a questionnaire to determine if they perceived themselves to be responsible and effective in preventing blood born infections after NSI. About 38% of students did not seek any professional consult or PEP after NSI due to lack of enough time or access, anxiety about tests results, belief in uselessness of followup and not being able to change destiny. These 114 students were not different from others regarding their scores on NSI specific scale of locus of health control. Thus, the potentiality of NSI locus of control beliefs in predicting PEP was not seen in this study.

Keywords: health care workers, locus of health control, needle stick injuries, post-exposure prevention.

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Authors: Anass Rahouti, Guillaume Salze, Ruggiero Lovreglio, Sélim Datoussaïd

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In healthcare facilities, training the staff for firefighting and evacuation in real buildings is very challenging due to the presence of a vulnerable population in such an environment. In a standard environment, traditional approaches, such as fire drills, are often used to train the occupants and provide them with information about fire safety procedures. However, those traditional approaches may be inappropriate for a vulnerable population and can be inefficient from an educational viewpoint as it is impossible to expose the occupants to scenarios similar to a real emergency. Immersive serious games could be used as an alternative to traditional approaches to overcome their limitations. Serious games are already being used in different safety domains such as fires, earthquakes and terror attacks for several building types (e.g., office buildings, train stations, tunnels, etc.). In this study, we developed an immersive serious game to improve the fire safety skills of staff in healthcare facilities. An accurate representation of the healthcare environment was built in Unity3D by including visual and audio stimuli inspired from those employed in commercial action games. The serious game is organised in three levels. In each of them, the trainee is presented with a specific fire emergency and s/he can perform protective actions (e.g., firefighting, helping non-ambulant occupants, etc.) or s/he can ignore the opportunity for action and continue the evacuation. In this paper, we describe all the steps required to develop such a prototype, as well as the key questions that need to be answered, to develop a serious game for firefighting and evacuation in healthcare facilities.

Keywords: Fire Safety, healthcare, serious game, training.

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Authors: Vishwambhar Prasad Sati

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This article examines cloudburst-triggered natural hazards mainly flashfloods and landslides in the Uttarakhand Himalaya. It further describes mechanism and implications of natural hazards and illustrates the preventive and mitigation measures. We conducted this study through collection of archival data, case study of cloudburst hit areas, and rapid field visit of the affected regions. In the second week of August 2017, about 50 people died and huge losses to property were noticed due to cloudburst-triggered flashfloods. Our study shows that although cloudburst triggered hazards in the Uttarakhand Himalaya are natural phenomena and unavoidable yet, disasters can be minimized if preventive measures are taken up appropriately. We suggested that construction of human settlements, institutions and infrastructural facilities along the seasonal streams and the perennial rivers should be avoided to prevent disasters. Further, large-scale tree plantation on the degraded land will reduce the magnitude of hazards.

Keywords: Cloudburst, flashfloods, landslides, fragile landscape, Uttarakhand Himalaya.

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Authors: Supunmali Ahangama, Danny Chiang Choon Poo

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Health analytics (HA) is used in healthcare systems for effective decision making, management and planning of healthcare and related activities. However, user resistances, unique position of medical data content and structure (including heterogeneous and unstructured data) and impromptu HA projects have held up the progress in HA applications. Notably, the accuracy of outcomes depends on the skills and the domain knowledge of the data analyst working on the healthcare data. Success of HA depends on having a sound process model, effective project management and availability of supporting tools. Thus, to overcome these challenges through an effective process model, we propose a HA process model with features from rational unified process (RUP) model and agile methodology.

Keywords: Agile methodology, health analytics, unified process model, UML.

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Authors: Nathan C. Lea, Tony Austin, Stephen Hailes, Dipak Kalra

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This paper introduces a tool that is being developed for the expression of information security policy controls that govern electronic healthcare records. By reference to published findings, the paper introduces the theory behind the use of knowledge management for automatic and consistent security policy assertion using the formalism called the Secutype; the development of the tool and functionality is discussed; some examples of Secutypes generated by the tool are provided; proposed integration with existing medical record systems is described. The paper is concluded with a section on further work and critique of the work achieved to date.

Keywords: Information Security Policy, Electronic Healthcare Records, Knowledge Management, Archetypes, Secutypes.

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Authors: J. Cwiklak, M. Grzegorzewski, M. Adamski

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The paper presents results of the project conducted in Poland devoted to study on bird strikes at military airfields. The main aim of this project was to develop methods of aircraft protection against threats from birds. The studies were carried out using two methods. One by transect and the other one by selected sector scanning. During the research, it was recorded, that 104 species of birds in the number about of 36000 were observed. The most frequent ones were starling Sturnus vulgaris (31.0%), jackdaw Corvus monedula (18.3%), rook Corvus frugilegus (15.9 %), lapwing Vanellus vanellus (6.2%). Moreover, it was found, that starlings constituted the most serious threat. It resulted from their relatively high attendance at the runway (about 300 individuals). Possible repellent techniques concerning of the Deblin military airfield were discussed. The analysis of the birds’ concentration depending on the altitude, part of the day, year, part of the airfield constituted a base to work out critical flight phase and appropriate procedures to prevent bird strikes.

Keywords: Airport, bird strikes, flight safety, preventive methods.

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Authors: Nevena Stolba, A Min Tjoa

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

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

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Authors: H. L. Chan, T. M. Choi, C. L. Hui, S. F. Ng

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In this study, we explore the use of information for inventory decision in the healthcare organization (HO). We consider the scenario when the HO can make use of the information collected from some correlated products to enhance its inventory planning. Motivated by our real world observations that HOs adopt RFID and bar-coding system for information collection purpose, we examine the effectiveness of these systems for inventory planning with Bayesian information updating. We derive the optimal ordering decision and study the issue of Pareto improvement in the supply chain. Our analysis demonstrates that RFID system will outperform the bar-coding system when the RFID system installation cost and the tag cost reduce to a level that is comparable with that of the barcoding system. We also show how an appropriately set wholesale pricing contract can achieve Pareto improvement in the HO supply chain.

Keywords: Efficient consumer response program, healthcare, inventory management, RFID system, bar-coding system.

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Authors: Elham Rastegari, Amirmasood Rahmani, Saeed Setayeshi

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The hospital and the health-care center of a community, as a place for people-s life-care and health-care settings, must provide more and better services for patients or residents. After Establishing Electronic Medical Record (EMR) system -which is a necessity- in the hospital, providing pervasive services is a further step. Our objective in this paper is to use pervasive computing in a case study of healthcare, based on EMR database that coordinates application services over network to form a service environment for medical and health-care. Our method also categorizes the hospital spaces into 3 spaces: Public spaces, Private spaces and Isolated spaces. Although, there are many projects about using pervasive computing in healthcare, but all of them concentrate on the disease recognition, designing smart cloths, or provide services only for patient. The proposed method is implemented in a hospital. The obtained results show that it is suitable for our purpose.

Keywords: Pervasive computing, RFID, Health-care.

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Authors: Mohd Zuhair, Ram Babu Roy

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This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

Keywords: Health insurance, out of pocket expenditure, universal healthcare, sustainability.

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Authors: Roy Fritzsche, Rainer Lasch

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Avoidable unscheduled maintenance events and unnecessary spare parts deliveries are mostly caused by an incorrect choice of the underlying maintenance strategy. For a faster and more efficient supply of spare parts for aircrafts of an airline we examine options for improving the underlying logistics network integrated in an existing aviation industry network. This paper presents a dynamic prediction model as decision support for maintenance method selection considering requirements of an entire flight network. The objective is to guarantee a high supply of spare parts by an optimal interaction of various network levels and thus to reduce unscheduled maintenance events and minimize total costs. By using a prognostics-based preventive maintenance strategy unscheduled component failures are avoided for an increase in availability and reliability of the entire system. The model is intended for use in an aviation company that utilizes a structured planning process based on collected failures data of components.

Keywords: Aviation industry, Prognosis, Reliability, Preventive maintenance.

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Authors: Shishir Kumar, Chhaya Gangwal, Seema Raj

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Public health informatics (PHI) which has seen successful implementation in the developed world, become the buzzword in the developing countries in providing improved healthcare with enhanced access. In rural areas especially, where a huge gap exists between demand and supply of healthcare facilities, PHI is being seen as a major solution. There are factors such as growing network infrastructure and the technological adoption by the health fraternity which provide support to these claims. Public health informatics has opportunities in healthcare by providing opportunities to diagnose patients, provide intra-operative assistance and consultation from a remote site. It also has certain barriers in the awareness, adaptation, network infrastructure, funding and policy related areas. There are certain medico-legal aspects involving all the stakeholders which need to be standardized to enable a working system. This paper aims to analyze the potential and challenges of Public health informatics services in rural communities.

Keywords: PHI, e-health, Public health.

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Authors: Cuong D. Dao, Rob J.I. Basten, Andreas Hartmann

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This paper studies the optimal maintenance planning of preventive maintenance and renewal activities for components in a single railway track when the available time for maintenance is limited. The rail-track system consists of several types of components, such as rail, ballast, and switches with different preventive maintenance and renewal intervals. To perform maintenance or renewal on the track, a train free period for maintenance, called a possession, is required. Since a major possession directly affects the regular train schedule, maintenance and renewal activities are clustered as much as possible. In a highly dense and utilized railway network, the possession time on the track is critical since the demand for train operations is very high and a long possession has a severe impact on the regular train schedule. We present an optimization model and investigate the maintenance schedules with and without the possession capacity constraint. In addition, we also integrate the social-economic cost related to the effects of the maintenance time to the variable possession cost into the optimization model. A numerical example is provided to illustrate the model.

Keywords: Rail-track components, maintenance, optimal clustering, possession capacity.

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Authors: Y. Atilgan Şengül

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Health information technologies promise higher quality, safer care and much more for both patients and professionals. Despite their promise, they are costly to develop and difficult to implement. On the other hand, user acceptance and usage determine the success of implemented information technology in healthcare. This study provides a model to understand health professionals’ perception and expectation of health information technology. Extensive literature review has been conducted to determine the main factors to be measured. A questionnaire has been designed as a measurement model and submitted to the personnel of an in vitro fertilization clinic. The respondents’ degree of agreement according to five-point Likert scale was 72% for convenient access to data and 69.4% for the importance of data security. There was a significant difference in acceptance of electronic data storage for female respondents. Also, other significant differences between professions were obtained.

Keywords: Healthcare, health informatics, medical record system, questionnaire.

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Authors: Debolina Chatterjee, Suhita Chopra Chatterjee

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Imprisonment is an expansive concept, as it is regulated by laws under criminal justice system of the state. The state sets principles of punishment to control offenders and also puts limits to excess punitive control. One significant way through which it exercises control is through rules governing healthcare of imprisoned population. Prisons signify specialized settings which accommodate both medical and legal concerns. The provision of care operates within the institutional paradigm of punishment. This requires the state to negotiate adequately between goals of punishment and fulfilment of basic human rights of offenders. The present study is based on a critical analysis of prison healthcare standards in India, which include government policies and guidelines. It also demonstrates how healthcare is delivered by drawing insights from a primary study conducted in a correctional home in the state of West Bengal, India, which houses both male and female inmates. Forty women were interviewed through semi-structured interviews, followed by focus group discussions. Doctors and administrative personnel were also interviewed. Findings show how institutional practices control women through subversion of the role of doctors to prison administration. Also, poor healthcare infrastructure, unavailability of specialized services, hierarchies between personnel and inmates make prisons unlikely sites for therapeutic intervention. The paper further discusses how institutional practices foster gender-based discriminatory practices.

Keywords: Imprisonment, imprisoned women, prison healthcare, prison policies.

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Authors: Nasser M. Amaitik, Ngwan F. Elsagzli

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Lean technique is very important in the service and industrial fields. It is defined as an effective tool to eliminate the wastes. In lean the wastes are defined as anything which does not add value to the end product. There are wastes that can be avoided, but some are unavoidable for many reasons.    

The present study aims to apply the principles of lean in two different sectors, healthcare and industry. Two case studies have been selected to apply the experimental work. The first case was Al-Jalaa Hospital, while the second case study was the Technical Company of Aluminum Sections in Benghazi, LIBYA. In both case studies the Value Stream Map (VSM) of the current state has been constructed. The proposed plans have been implemented by merging or eliminating procedures or processes.

The results obtained from both case studies showed improvement in Capacity, Idle time and Utilized time.

Keywords: Healthcare service delivery, Idle time, Lean principles, Utilized time, Value stream mapping, Wastes.

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Authors: Ogunduyile O. Oluwgbenga

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Recent advancements in sensor technologies and Wireless Body Area Networks (WBANs) have led to the development of cost-effective healthcare devices which can be used to monitor and analyse a person-s physiological parameters from remote locations. These advancements provides a unique opportunity to overcome current healthcare challenges of low quality service provisioning, lack of easy accessibility to service varieties, high costs of services and increasing population of the elderly experienced globally. This paper reports on a prototype implementation of an architecture that seamlessly integrates Wireless Body Area Network (WBAN) with Web services (WS) to proactively collect physiological data of remote patients to recommend diagnostic services. Technologies based upon WBAN and WS can provide ubiquitous accessibility to a variety of services by allowing distributed healthcare resources to be massively reused to provide cost-effective services without individuals physically moving to the locations of those resources. In addition, these technologies can reduce costs of healthcare services by allowing individuals to access services to support their healthcare. The prototype uses WBAN body sensors implemented on arduino fio platforms to be worn by the patient and an android smart phone as a personal server. The physiological data are collected and uploaded through GPRS/internet to the Medical Health Server (MHS) to be analysed. The prototype monitors the activities, location and physiological parameters such as SpO2 and Heart Rate of the elderly and patients in rehabilitation. Medical practitioners would have real time access to the uploaded information through a web application.

Keywords: Android Smart phone, Arduino Fio, Web application server, Wireless Body Area Networks.

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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: Chimaobi V. Okolo, Kenneth A. Okpala, Johnbull S. Ogboi

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A teeming set of doctors that graduated from various universities within and outside Nigeria with the hope of practicing in the country, has their hope shattered because of poor financing, lack of medical equipments and a very weak healthcare systems. Such hydra headed challenges, allows room for quackery which increasingly contributes to the cause of mortality in Nigeria. With a view of reversing the challenges of healthcare delivery and financing in Nigeria, African Health Market for Equity (AHME), a project funded by the Bill and Melinda Gates foundation [With contribution from Department For International Development (DFID)] and currently implemented in three African Countries (Nigeria, Kenya and Ghana) over a Five (5) year period supports the healthcare sector via Medical credit fund (MCF). The study examines the impact of credit policy and medical credit funding on Nigerian health market. Ordinary least square analysis, correlation and granger causality tests were employed to measure the extent to which the Nigerian healthcare market has been influenced. Medical credit fund significantly and positively influenced average monthly turnover of private healthcare providers and Commercial bank’s lending rate had a weak relationship with access to credit/approved loans (13.46%). The programme has so far made 13.91% progress, which is very poor, considering the minimum targeted private health care providers (437.6) and expected number of loan approvals (180.4) for the two years. Medical credit policy in Nigeria should be revised to include private healthcare providers in rural area for more positive impact and increased returns. Good brand advert and sensitization of the programme to stakeholders and health pressure group, and an extension of the programme beyond five years is necessary to better address the issues raised in the study.

Keywords: Credit, health market, medical credit facility, policy.

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Authors: C. Mallada Fernández

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Economic development and globalization of international markets have created a favourable atmosphere for the emergence of new forms of crime such as money laundering or financing of terrorism, which may contribute to destabilized and damage economic systems. In particular, money laundering have acquired great importance since the 11S attacks, what has caused on the one hand, the establishment and development of preventive measures and, on the other hand, a progressive hardening of penal measures. Since then, the regulations imposed to fight against money laundering have been viewed as key components also in the fight against terrorist financing. Terrorism, at the beginning, was a “national” crime connected with internal problems of the State (for instance the RAF in Germany or ETA in Spain) but in the last 20 years has started to be an international problem that is connected with the defence and security of the States. Therefore, the new strategic concept for the defense and security of NATO has a comprehensive list of security threats to the Alliance, such as terrorism, international instability, money laundering or attacks on cyberspace, among others. With this new concept, money laundering and terrorism has become a priority in the national defense.

In this work we will analyze the methods to combat these new threats to the national security. We will study the preventive legislations to combat money laundering and financing of terrorism, the UIF that exchange information between States, and the hawala-Banking.

Keywords: Control of financial flows, money laundering, terrorism, financing of terrorism.

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Authors: Marina Nosik, Irina Rymanova, Sergei Sevostyanihin, Natalya Sergeeva, Alexander Sobkin

Abstract:

This paper presents results of the survey regarding the awareness about HIV/AIDS among HIV-infected individuals. A questionnaire covering various aspects of HIV-infection was conducted among 110 HIV-infected individuals who attended the G.A. Zaharyan Moscow Tuberculosis Clinic, Department for treatment of TB patients with HIV. The questionnaire included questions about modes of HIV transmission and preventive measures against HIV/AIDS, as well as questions about age, gender, education and employment status. The survey revealed that the respondents in the whole had a good knowledge regarding modes of HIV transmission and preventive measures against HIV/AIDS: about 83,6% male respondents and 85,7% female respondents gave an accurate answers regarding the HIV-infection. However, the overwhelming majority of the study participants, that is, 88,5% men and 98% women, was quite ignorant about the risk of acquiring HIV through saliva and toothbrush of HIV-infected individual. Though that risk is rather insignificant, it is still biologically possible. And this gap in knowledge needs to be filled. As the study showed another point of concern was the fact, that despite the knowledge of HIV transmission risk through unprotected sex about 40% percent of HIVpositive men and 25% of HIV-positive women did not insist on using condoms with their sexual partners. These findings indicate that there are still some aspects about HIV-infection which needed to be clarified and explained through more detailed and specific educational programs.

Keywords: AIDS, HIV transmission risks, HIV misconceptions, risk behavior.

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Authors: Satadal Das, Parthasarathi Sengupta

Abstract:

With millions of livestock wealth in India including cattle, and buffaloes, the National Animal Disease Control Program targeted a massive Brucella vaccination program. As a part of it in the state of West Bengal Veterinary healthcare assistants participated in the program in 2021. The aim of this study was to elucidate the burden of brucellosis in those healthcare assistants and to pinpoint the main causes of such infection. We contacted the healthcare assistants to find out whether they were infected during the vaccination program. Our findings indicated many Veterinary healthcare assistants who participated in the program developed symptoms and signs suggestive of brucellosis. Laboratory tests indicated many confirmed Brucellosis cases. However, this may not include many asymptomatic cases. Detailed analysis revealed that in most of them there was a history of needle prick injury about a month back during the vaccination program, which was mainly due to ferocious or disturbed animals. Few also complained that they were not properly trained or proper personal protective types of equipment were not provided. All of them were treated in referral hospitals following a standard protocol of the Government Health Department and now they are followed up. Thus we conclude that proper care during the vaccination of animals should be followed, prophylactic treatment for needle prick injuries should be given, and training and supply of personal protective equipment should be monitored.

Keywords: Occupational brucellosis, needle prick injury, brucella vaccination, personal protective equipment.

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Authors: Niwatchai Namwichisirikul

Abstract:

Due to the emergence of “Humanized Healthcare" introduced by Professor Dr. Prawase Wasi in 2003[1], the development of this paradigm tends to be widely implemented. The organizations included Healthcare Accreditation Institute (public organization), National Health Foundation, Mahidol University in cooperation with Thai Health Promotion Foundation, and National Health Security Office (Thailand) have selected the hospitals or infirmaries that are qualified for humanized healthcare since 2008- 2010 and 35 of them are chosen to be the outstandingly navigating organizations for the development of humanized healthcare, humanized healthcare award [2]. The research aims to study the current issue, characteristics and patterns of hospital administration contributing to humanized healthcare system in Thailand. The selected case studies are from four hospitals including Dansai Crown Prince Hospital, Leoi; Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and Prathai Hospital, Nakhonrachasima. The methodology is in-depth interviewing with 10 staffs working as hospital executive directors, and representatives from leader groups including directors, multidisciplinary hospital committees, personnel development committees, physicians and nurses in each hospital. (Total=40) In addition, focus group discussions between hospital staffs and general people (including patients and their relatives, the community leader, and other people) are held by means of setting 4 groups including 8 people within each group. (Total=128) The observation on the working in each hospital is also implemented. The findings of the study reveal that there are five important aspects found in each hospital including (1) the quality improvement under the mental and spiritual development policy from the chief executives and lead teams, leaders as Role model and they have visionary leadership; (2) the participation hospital administration system focusing on learning process and stakeholder- needs, spiritual human resource management and development; (3) the relationship among people especially staffs, team work skills, mutual understanding, effective communication and personal inner-development; (4) organization culture relevant to the awareness of patients- rights as well as the participation policy including spiritual growth achieving to the same goals, sharing vision, developing public mind, and caring; and (5) healing structures or environment providing warmth and convenience for hospital staffs, patients and their relatives and visitors.

Keywords: Hospital administration, Humanized healthcare.

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