Search results for: Accountable Care Organizations

Authors: Arundhati Devi Maibam, K. Ingocha Singh

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

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

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Authors: Muhibul H. Bhuyan, Mafujul Hasan

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

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

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Authors: Muntanavadee Maytapattana

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

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

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Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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

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

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Authors: Edelyn Alicar-Cadorna

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

Keywords: Barangays, Performance and Productivity.

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Authors: Ka Yan Chan

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

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

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Authors: Md. Royhanur Islam, Thomas Cansse, Md. Sahidul Islam, Atiqur Rahman Sunny

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The geographical location of Bangladesh makes it one of the most vulnerable countries to climate change. Climate-induced phenomena mainly affect the south-central region of Bangladesh (Laxmipur district) where they have begun to occur more frequently. The aim of the study was to identify the hydro-climatic factors that lead to weather-related disasters in the coastal areas and analyse the consequences of these factors on coastal livelihoods, with possible adaptation options using participatory rural appraisal (PRA) tools. The present study showed several disasters such as land erosion, depressions and cyclones, coastal flooding, storm surge, and precipitation. The frequency of these disasters is of a noticeable rate. Surveys have also discovered that land erosion is ongoing. Tidal water is being introduced directly into the mainland, and as a result of the salt intrusion, production capacity is declining. The coastal belt is an important area for fishing activities, but due to changed fishing times and a lack of Alternative Income Generating Activities (AIGAs), people have been forced to search for alternative livelihood options by taking both short-term and long-term adaptation options. Therefore, in order to increase awareness and minimize the losses, vulnerable communities must be fully incorporated into disaster response strategies. The government as well as national and international donor organizations should come forward and resolve the present situation of these vulnerable groups since otherwise, they will have to endure endless and miserable suffering due to the effects of climate change ahead in their lives.

Keywords: Adaptation, community, fishery development, livelihood.

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Authors: Hilmi Rafet Yüncü

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Today Internet has very important role to promote products and services all over the world. Companies and destinations in tourism industry use Internet to sell and to promote their core products to directly potential tourists. Internet technologies have redefined the relationships between tourists, tourism companies, and travel agents. The new relationship allows for accessing and tapping tourism information and services. Internet technologies ensure new opportunities to available for the tourism industry, including travel accommodation, and tourist destination organizations. Websites are important devices to the marketing of a destination. Most people make a research about the destination before arriving via internet. Governments have a considerable role in the process of marketing tourism destinations. Governments make policies and regulations; furthermore, they help to market destinations to potential tourists. Governments have a comprehensive overview of the sector to see changes in tourism market and design better policies, programs and marketing plans. At the same time, governments support developing of alternative tourism in the country with regulations and marketing tools. The aim of this study is to analyse of an Internet website of governmental tourism portal in Turkey to determine effectiveness about gastronomy tourism. The Turkish government has established a culture portal for foreign and local tourists. The Portal provides local and general information about tourism attractions of cities and Turkey. There are 81 official cities in Turkey and all these cities are conducted to analyse to determine how effective marketing is done by Turkish Government in the manner of gastronomy tourism. A content analysis will be conducted to Internet website of the portal with food content, recipes and gastronomic feature of cities.

Keywords: Content analysis, culture portal, gastronomy tourism, Turkey.

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Authors: Dimitrios Koukopoulos, Yiannis Stamatiou

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In this work, we present for the first time in our perception an efficient digital watermarking scheme for mpeg audio layer 3 files that operates directly in the compressed data domain, while manipulating the time and subband/channel domain. In addition, it does not need the original signal to detect the watermark. Our scheme was implemented taking special care for the efficient usage of the two limited resources of computer systems: time and space. It offers to the industrial user the capability of watermark embedding and detection in time immediately comparable to the real music time of the original audio file that depends on the mpeg compression, while the end user/audience does not face any artifacts or delays hearing the watermarked audio file. Furthermore, it overcomes the disadvantage of algorithms operating in the PCMData domain to be vulnerable to compression/recompression attacks, as it places the watermark in the scale factors domain and not in the digitized sound audio data. The strength of our scheme, that allows it to be used with success in both authentication and copyright protection, relies on the fact that it gives to the users the enhanced capability their ownership of the audio file not to be accomplished simply by detecting the bit pattern that comprises the watermark itself, but by showing that the legal owner knows a hard to compute property of the watermark.

Keywords: Audio watermarking, mpeg audio layer 3, hard instance generation, NP-completeness.

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Authors: Rami Darwish

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The transport industry is transitioning to sustainable industrial systems to meet its environmental targets. At the heart of this transition lies the electrification of bus systems, which involves the introduction and testing of sustainable technologies in protected environments for customer evaluation. While the transition necessitates business-model innovation, practical implementation has proven to be complex. This article delves into efforts to present the business model of a bus operator engaged in public procurement with the goal of facilitating the industry's shift towards electrification. Through an in-depth case study, the influence of public contracts’ design on the evolution of a technology and the operator's business model for electrification is explored. While the extant literature suggests that public procurement can facilitate business-model innovation and sustainable development, the findings reveal that public-contract design can limit value creation and value capture in potential business models, locking organizations into existing business models and hindering the socio-technical transition to sustainability. Interestingly, public-procurement contract design can play a pivotal role in preventing sustainable innovations from breaking through. This highlights the importance of contract design as a vehicle for dialogue between businesses and authorities that can enable systemic change. The case study also illuminates a paradoxical scenario in which the transport authority was required to reconcile the efficiency and stability required for bus transport with the potential benefits of electrification technologies promising sustainability. Finally, recommendations for navigating and addressing this tension are provided. The implications of these findings extend to the literature on discontinuous innovation and business-model innovation.

Keywords: Sustainable transition, public procurement, business-model innovation, discontinuous innovation, lock-in.

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Authors: Jayshree Patnaik, Bhaskar Bhowmick

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The economic growth of any nation is steered and dependent on innovation in technology. It can be preferably argued that technology has enhanced the quality of life. Technology is linked both with an economic and a social structure. But there are some parts of the world or communities which are yet to reap the benefits of technological innovation. Business and organizations are now well equipped with cutting-edge innovations that improve the firm performance and provide them with a competitive edge, but rarely does it have a positive impact on any community which is weak and marginalized. In recent times, it is observed that communities are actively handling social or ecological issues with the help of indigenous technologies. Thus, "Appropriate Technology" comes into the discussion, which is quite prevalent in the rural third world. Appropriate technology grew as a movement in the mid-1970s during the energy crisis, but it lost its stance in the following years when people started it to describe it as an inferior technology or dead technology. Basically, there is no such technology which is inferior or sophisticated for a particular region. The relevance of appropriate technology lies in penetrating technology into a larger and weaker section of community where the “Bottom of the pyramid” can pay for technology if they find the price is affordable. This is a theoretical paper which primarily revolves around how appropriate technology has faded and again evolved in both developed and developing countries. The paper will try to focus on the various concepts, history and challenges faced by the appropriate technology over the years. Appropriate technology follows a documented approach but lags in overall design and diffusion. Diffusion of technology into the poorer sections of community remains unanswered until the present time. Appropriate technology is multi-disciplinary in nature; therefore, this openness allows having a varied working model for different problems. Appropriate technology is a friendly technology that seeks to improve the lives of people in a constraint environment by providing an affordable and sustainable solution. Appropriate technology needs to be defined in the era of modern technological advancement for sustainability.

Keywords: Appropriate technology, community, developing country, sustainability.

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Authors: Masaki Yamaguchi, Daimei Sasayama, Shinsuke Washizuka

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

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

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Authors: Saif Obaid Alkaabi, Nabil Ayad

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Governments constantly seek to offer faster, more secure, efficient and effective services for their citizens. Recent changes and developments to communication services and technologies, mainly due the Internet, have led to immense improvements in the way governments of advanced countries carry out their interior operations Therefore, advances in e-government services have been broadly adopted and used in various developed countries, as well as being adapted to developing countries. The implementation of advances depends on the utilization of the most innovative structures of data techniques, mainly in web dependent applications, to enhance the main functions of governments. These functions, in turn, have spread to mobile and wireless techniques, generating a new advanced direction called m-government. This paper discusses a selection of available m-government applications and several business modules and frameworks in various fields. Practically, the m-government models, techniques and methods have become the improved version of e-government. M-government offers the potential for applications which will work better, providing citizens with services utilizing mobile communication and data models incorporating several government entities. Developing countries can benefit greatly from this innovation due to the fact that a large percentage of their population is young and can adapt to new technology and to the fact that mobile computing devices are more affordable. The use of models of mobile transactions encourages effective participation through the use of mobile portals by businesses, various organizations, and individual citizens. Although the application of m-government has great potential, it does have major limitations. The limitations include: the implementation of wireless networks and relative communications, the encouragement of mobile diffusion, the administration of complicated tasks concerning the protection of security (including the ability to offer privacy for information), and the management of the legal issues concerning mobile applications and the utilization of services.

Keywords: E-government, m-government, system dependability, system security, trust.

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Authors: Mutshinye Manguvhewa, Maria Florence, Mansoo Yu

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

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

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Authors: Bharat Jhamnani, SK Singh

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

Keywords: Groundwater, landfill, leachate, solid waste.

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Authors: Sareh Rajabi, Taha Anjamrooz, Salwa Bheiry

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Sustainability of construction projects is an important issue to be addressed since the sector will continue to be developed in the coming years, especially in developing countries. Thus, it is significant to discover approaches and solutions for improving sustainability. Currently, the construction industry is the largest consumer of natural resources. This is the same in other countries in the Gulf region, and the United Arab Emirates (UAE) has limited natural resources such as water, electricity, etc. Recently, the UAE has taken several actions in order to implement sustainable initiatives within its construction industry. Within the industry, the contractors’ role is significant in promoting sustainable development by taking the responsibility to minimize their negative impacts on the environment and society, and maximize their economic distribution. In this research, sustainability will be studied as an important key to bring competitive advantages to contracting organizations. The contractors should understand the need to improve their sustainable performance in order to expand their business competitiveness. Competitiveness at the construction project level refers to a contractor’s ability to compete for a project. There is less focus on how to improve contractors’ competitiveness by implementing sustainable construction practices. Based on an inclusive literature review on the relationship between sustainability performance and business competitiveness, this research will conduct a study of sustainable practice in the construction industry and the relationship between sustainability performance and business competitiveness in order to develop a framework for evaluating how contractors can improve their competitiveness in terms of more efficient processes, enhancements in productivity, and lower costs of compliance in order to reduce the initial project cost and obtain market opportunities in the UAE. The research findings will provide a framework that can be a useful guideline for contractors to develop their sustainability policy, strategy and practice for meeting the increased requirements for sustainable development in construction.

Keywords: Sustainable construction practice, sustainability, competitiveness, construction industry, contractors.

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Authors: Mevlüt Gül, Hilal Yılmaz, M. Göksel Akpınar, Ayse Karadağ Gürsoy, Özge Bayındır

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Milk is a very important nutrient. Low productivity is a problem of Turkish dairy farming. During recent years, Turkish government has supported cooperatives that assist milk producers and encouraged farmers to become cooperative members. Turkish government established several ways to support specially smallholders. For example Ministry of Agriculture and Rural Affairs (MARA) provided two to four cows to villagers on a grant or loan basis with a long repayment period at low interest rates by cooperatives. Social Support Project in Rural Areas (SSPRA) is another support program targeting only disadvantaged people, especially poor villager. Both programs have a very strong social support component and similar objectives. But there are minor differences between them in terms of target people, terms and conditions of the credit supplied Isparta province in Mediterranean region of Turkey is one of the supported regions. MARA distributed dairy cows to 1072 farmers through 16 agricultural cooperatives in Isparta province in the context of SSPRA. In this study, economic-social impacts on dairy cattle project implemented through cooperatives were examined in Isparta. Primary data were collected from 12 cooperatives- president. The data were obtained by personal interview through a questionnaire and to cooperatives and given to farms benefiting from the project in order to reveal the economic and social developments. Finding of the study revealed that project provided new job opportunities and improved quality of livestock. It was found that producers who benefited from the project were more willing to participate in cooperative or other producer organizations.

Keywords: ooperative, Dairy Cattle, Economic Impact, Livestock Support Project, Social Impact.

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

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

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

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Authors: Kunchit Pirapake

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Application of Geo-Informatic technology in land tenure and land use on the economic crop area, to create sustainable land, access to the area, and produce sustainable food for the demand of its people in the community. The research objectives are to 1) apply Geo-Informatic Technology on land ownership and agricultural land use (cash crops) in the research area, 2) create GIS database on land ownership and land use, 3) create database of an online Geoinformation system on land tenure and land use. The results of this study reveal that, first; the study area is on high slope, mountains and valleys. The land is mainly in the forest zone which was included in the Forest Act 1941 and National Conserved Forest 1964. Residents gained the rights to exploit the land passed down from their ancestors. The practice was recognized by communities. The land was suitable for cultivating a wide variety of economic crops that was the main income of the family. At present the local residents keep expanding the land to grow cash crops. Second; creating a database of the geographic information system consisted of the area range, announcement from the Interior Ministry, interpretation of satellite images, transportation routes, waterways, plots of land with a title deed available at the provincial land office. Most pieces of land without a title deed are located in the forest and national reserve areas. Data were created from a field study and a land zone determined by a GPS. Last; an online Geo-Informatic System can show the information of land tenure and land use of each economic crop. Satellite data with high resolution which could be updated and checked on the online Geo-Informatic System simultaneously.

Keywords: Geo-Informatic Technology, Land Tenure, Online Geo-Informatic System, Land Use of cash crops.

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Authors: Paria Soleimani, Arezoo Neshati

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

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

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Authors: Prakash Singh

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

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

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Authors: Hind Bouami, Patrick Millot

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Handling life-critical systems complexity requires to be equipped with appropriate technology and the right human agents’ functions such as knowledge, experience, and competence in problem’s prevention and solving. Human agents are involved in the management and control of human-machine system’s performance. Documenting human agent’s situation awareness is crucial to support human-machine designers’ decision-making. Knowledge about risks, critical parameters and factors that can impact and threaten automation system’s performance should be collected using preventive and retrospective approaches. This paper aims to document operators’ situation awareness through the analysis of automated organizations’ feedback. The analysis of automated hospital pharmacies feedback helps identify and control critical parameters influencing human machine interaction in order to enhance system’s performance and security. Our human machine system evaluation approach has been deployed in Macon hospital center’s pharmacy which is equipped with automated drug dispensing systems since 2015. Automation’s specifications are related to technical aspects, human-machine interaction, and human aspects. The evaluation of drug delivery automation performance in Macon hospital center has shown that the performance of the automated activity depends on the performance of the automated solution chosen, and also on the control of systemic factors. In fact, 80.95% of automation specification related to the chosen Sinteco’s automated solution is met. The performance of the chosen automated solution is involved in 28.38% of automation specifications performance in Macon hospital center. The remaining systemic parameters involved in automation specifications performance need to be controlled. 

Keywords: Life-critical systems, situation awareness, human-machine interaction, decision-making.

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Authors: Rachel Hurdley, Jane Hopkinson

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

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

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Authors: Ibrahim A. Alkali

Abstract:

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

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

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

Abstract:

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

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

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Authors: Ayman A. Aly, Abdallah A. Alshnnaway

Abstract:

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

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

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

Abstract:

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

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

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Authors: Nevena Stolba, A Min Tjoa

Abstract:

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

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

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

Abstract:

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

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

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

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

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

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

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

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

Keywords: Nutritional status, MNA, BMI, elderly.

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Authors: Sotirios Raptis

Abstract:

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

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

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