Search results for: Home health care supply chain

Authors: Raymond J. Jayabal, Chiew Tong Lau

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Partitions can play a significant role in minimising cochannel interference of Wireless LANs by attenuating signals across room boundaries. This could pave the way towards higher density deployments in home and office environments through spatial channel reuse. Yet, due to protocol limitations, the latest incantation of IEEE 802.11 standard is still unable to take advantage of this fact: Despite having clearly adequate Signal to Interference Ratio (SIR) over co-channel neighbouring networks in other rooms, its goodput falls significantly lower than its maximum in the absence of cochannel interferers. In this paper, we describe how this situation can be remedied via modest modifications to the standard.

Keywords: IEEE 802.11 Wireless LAN, spatial channel re-use, physical layer capture.

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Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez

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The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.

Keywords: Prostate cancer, quality of life, rehabilitation programme, response shift.

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Authors: Karama M. AL-Tamimi, Munir A. Al-Absi

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A new OTA-based logarithmic-control variable gain current amplifier (LCCA) is presented. It consists of two Operational Transconductance Amplifier (OTA) and two PMOS transistors biased in weak inversion region. The circuit operates from 0.6V DC power supply and consumes 0.6 μW. The linear-dB controllable output range is 43 dB with maximum error less than 0.5dB. The functionality of the proposed design was confirmed using HSPICE in 0.35μm CMOS process technology.

Keywords: LCCA, OTA, Logarithmic, VGA, Weak inversion, Current-mode

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Authors: Neha Asthana, Vishal Krishna Prasad

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Collaborative Planning and Forecasting is an innovative and systematic approach towards productive integration and assimilation of data synergized into information. The changing and variable market dynamics have persuaded global business chains to incorporate Collaborative Planning and Forecasting as an imperative tool. Thus, it is essential for the supply chains to constantly improvise, update its nature, and mould as per changing global environment.

Keywords: Information transfer, Forecasting, Optimization.

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Authors: Mary Gloria C. Njoku, Leonard A. Jason, Nicole Porter, Molly Brown

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The objective of this study was to examine the interaction between mode of illness onset and psychiatric comorbidity on the health outcomes of persons with ME/CFS. A total of 114 individuals with ME/CFS participated in this study. Individuals completed a battery of baseline measures including the fatigue severity scale and measures of disability. Findings indicated that those with sudden illness onset had more impaired physical health functioning. In addition, among individuals with sudden onset, those without psychiatric comorbidity had greater fatigue severity and lower overall physical health than those with psychiatric comordibity. In contrast, among individuals with gradual illness onset, those with psychiatric comorbity had higher fatigue severity than those without comorbid psychiatric disorders. The health outcomes of individuals who have ME/CFS with or without psychiatric comorbidity are impacted by the mode of illness onset and this suggest that it is important to examine these factors in future research.

Keywords: Health Outcomes, ME/CFS, Mode of Illness Onset, Psychiatric Comorbidity.

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Authors: S. Chebbi, A. Meddeb

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The distribution networks are often exposed to harmful incidents which can halt the electricity supply of the customer. In this context, we studied a real case of a critical zone of the Tunisian network which is currently characterized by the dysfunction of its plan of protection. In this paper, we were interested in the harmonization of the protection plan settings in order to ensure a perfect selectivity and a better continuity of service on the whole of the network.

Keywords: Distribution network Gabes-Tunisia, NEPLAN©DACH, protection plan settings, selectivity.

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Authors: Subodh Thankachan, Manisha Pattanaik, S. S. Rajput

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In this paper, a new BiCMOS CCII and CCCII, capable of operate at ±0.5V and having wide dynamic range with achieved bandwidth of 480MHz and 430MHz respectively have been proposed. The structures have been found to be insensitive to the threshold voltage variations. The proposed circuits are suitable for implementation using 0.25μm BiCMOS technology. Pspice simulations confirm the performance of the proposed structures.

Keywords: BiCMOS, Current conveyor, Compound current conveyor, Low supply voltage, Threshold voltage variation.

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Authors: Niloofar Khedri, Masoud Rahgozar, MahmoudReza Hashemi

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Design patterns describe good solutions to common and reoccurring problems in program design. Applying design patterns in software design and implementation have significant effects on software quality metrics such as flexibility, usability, reusability, scalability and robustness. There is no standard rule for using design patterns. There are some situations that a pattern is applied for a specific problem and this pattern uses another pattern. In this paper, we study the effect of using chain of patterns on software quality metrics.

Keywords: Design Patterns, Design patterns' Relationship, Software quality Metrics, Software Engineering.

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Authors: Sie-Tiong Ha, Teck-Leong Lee, Yip-Foo Win, Siew-Ling Lee, Guan-Yeow Yeap

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A homologous series of aromatic esters, 4-nalkanoyloxybenzylidene- 4--bromoanilines, nABBA, consisting of two 1,4-disubstituted phenyl cores and a Schiff base central linkage was synthesized. All the members can be differed by the number of carbon atoms at terminal alkanoyloxy chain (CnH2n-1COO-, n = 2, 6, 18). The molecular structure of nABBA was confirmed with infrared spectroscopy, nuclear magnetic resonance (NMR) spectroscopy and electron-ionization mass (EI-MS) spectrometry. Mesomorphic properties were studied using differential scanning calorimetry and polarizing optical microscopy.

Keywords: Liquid Crystals, Schiff base, Smectic, Mesomorphic

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Authors: Rehan Jamil, Irfan Jamil, Ming Li, Zhao Jinquan

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Energy is the important source for the development of the society and it‘s the basic support of national economy and the base for human living. As the development of economy, abrupt increase of population and continuous improvement of living standards, the demand of energy increases continuously, which caused the impetuous scramble of energy source in the world, and urged the attention of the countries for current status and development trends of energy.

Keywords: Energy, Energy Supply Situation, Energy Production & Consumption.

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Authors: Kouassi Dongo, Christian Zurbrügg, Gueladio Cissé1, Brigit Obrist, Marcel Tanner, Jean Biémi

Abstract:

This study analyzed environmental health risks and people-s perceptions of risks related to waste management in poor settlements of Abidjan, to develop integrated solutions for health and well-being improvement. The trans-disciplinary approach used relied on remote sensing, a geographic information system (GIS), qualitative and quantitative methods such as interviews and a household survey (n=1800). Mitigating strategies were then developed using an integrated participatory stakeholder workshop. Waste management deficiencies resulting in lack of drainage and uncontrolled solid and liquid waste disposal in the poor settlements lead to severe environmental health risks. Health problems were caused by direct handling of waste, as well as through broader exposure of the population. People in poor settlements had little awareness of health risks related to waste management in their community and a general lack of knowledge pertaining to sanitation systems. This unfortunate combination was the key determinant affecting the health and vulnerability. For example, an increased prevalence of malaria (47.1%) and diarrhoea (19.2%) was observed in the rainy season when compared to the dry season (32.3% and 14.3%). Concerted and adapted solutions that suited all the stakeholders concerned were developed in a participatory workshop to allow for improvement of health and well-being.

Keywords: Abidjan, environmental health risks, informalsettlements, vulnerability, waste management.

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Authors: Yngvar Berg, Mehdi Azadmehr

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In this paper we present a linear autozeroing ultra lowvoltage amplifier. The autozeroing performed by all ULV circuits is important to reduce the impact of noise and especially avoid power supply noise in mixed signal low-voltage CMOS circuits. The simulated data presented is relevant for a 90nm TSMC CMOS process.

Keywords: Low-voltage, trans conductance amplifier, linearity, floating-gate.

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Authors: H. Apaza, L. Chévez, H. Loro

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Plastic and microplastic pollution in human food chain is a big problem for human health that requires more elaborated techniques that can identify their presences in different kinds of food. Hyperspectral imaging technique is an optical technique than can detect the presence of different elements in an image and can be used to detect plastics and microplastics in a scene. To do this statistical techniques are required that need to be evaluated and compared in order to find the more efficient ones. In this work, two problems related to the presence of plastics are addressed, the first is to detect and identify pieces of plastic immersed in almond seeds, and the second problem is to detect and quantify microplastic in almond flour. To do this we make use of the analysis hyperspectral images taken in the range of 900 to 1700 nm using 4 unmixing techniques of hyperspectral imaging which are: least squares unmixing (LSU), non-negatively constrained least squares unmixing (NCLSU), fully constrained least squares unmixing (FCLSU), and scaled constrained least squares unmixing (SCLSU). NCLSU, FCLSU, SCLSU techniques manage to find the region where the plastic is found and also manage to quantify the amount of microplastic contained in the almond flour. The SCLSU technique estimated a 13.03% abundance of microplastics and 86.97% of almond flour compared to 16.66% of microplastics and 83.33% abundance of almond flour prepared for the experiment. Results show the feasibility of applying near-infrared hyperspectral image analysis for the detection of plastic contaminants in food.

Keywords: Food, plastic, microplastic, NIR hyperspectral imaging, unmixing.

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Authors: Krzysztof J. Czarnocki, F. Silveira, E. Czarnocka, K. Szaniawska

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Research background: Problems related to the occupational health and decreasing level of safety occur commonly in the construction industry. Important factor in the occupational safety in construction industry is scaffold use. All scaffolds used in construction, renovation, and demolition shall be erected, dismantled and maintained in accordance with safety procedure. Increasing demand for new construction projects unfortunately still is linked to high level of occupational accidents. Therefore, it is crucial to implement concrete actions while dealing with scaffolds and risk assessment in construction industry, the way on doing assessment and liability of assessment is critical for both construction workers and regulatory framework. Unfortunately, professionals, who tend to rely heavily on their own experience and knowledge when taking decisions regarding risk assessment, may show lack of reliability in checking the results of decisions taken. Purpose of the article: The aim was to indicate crucial parameters that could be modeling with Risk Assessment Model (RAM) use for improving both building enterprise productivity and/or developing potential and safety climate. The developed RAM could be a benefit for predicting high-risk construction activities and thus preventing accidents occurred based on a set of historical accident data. Methodology/Methods: A RAM has been developed for assessing risk levels as various construction process stages with various work trades impacting different spheres of enterprise activity. This project includes research carried out by teams of researchers on over 60 construction sites in Poland and Portugal, under which over 450 individual research cycles were carried out. The conducted research trials included variable conditions of employee exposure to harmful physical and chemical factors, variable levels of stress of employees and differences in behaviors and habits of staff. Genetic modeling tool has been used for developing the RAM. Findings and value added: Common types of trades, accidents, and accident causes have been explored, in addition to suitable risk assessment methods and criteria. We have found that the initial worker stress level is more direct predictor for developing the unsafe chain leading to the accident rather than the workload, or concentration of harmful factors at the workplace or even training frequency and management involvement.

Keywords: Civil engineering, occupational health, productivity, safety climate.

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Authors: Aswir Premadi, Mohammad Syuhaimi Ab. Rahman, Mohamad Najib Moh. Saupe, KasmiranJumari

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An optical fault monitoring in FTTH-PON using ACS is demonstrated. This device can achieve real-time fault monitoring for protection feeder fiber. In addition, the ACS can distinguish optical fiber fault from the transmission services to other customers in the FTTH-PON. It is essential to use a wavelength different from the triple-play services operating wavelengths for failure detection. ACS is using the operating wavelength 1625 nm for monitoring and failure detection control. Our solution works on a standard local area network (LAN) using a specially designed hardware interfaced with a microcontroller integrated Ethernet.

Keywords: ACS, monitoring tool, FTTH-PON.

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Authors: Ivelina N. Cholakova, Tihomir B. Takov, Radostin Ts. Tsankov, Nicolas Simonne, Slavka S. Tzanova

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Adjacent Hall microsensors, comprising a silicon substrate and four contacts, providing simultaneously two supply inputs and two differential outputs, are characterized. The voltage related sensitivity is in the order of 0.11T-1, and a cancellation method for offset compensation is used, achieving residual offset in the micro scale which is also compared to a single Hall plate.

Keywords: Adjacent Hall sensors, offset compensation, voltage related sensitivity, 0.18μm CMOS technology.

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Authors: Chang, Chun-Lang, Liu, Chun-Kai

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This study, for its research subjects, uses patients who had undergone total knee replacement surgery from the database of the National Health Insurance Administration. Through the review of literatures and the interviews with physicians, important factors are selected after careful screening. Then using Cross Entropy Method, Genetic Algorithm Logistic Regression, and Particle Swarm Optimization, the weight of each factor is calculated and obtained. In the meantime, Excel VBA and Case Based Reasoning are combined and adopted to evaluate the system. Results show no significant difference found through Genetic Algorithm Logistic Regression and Particle Swarm Optimization with over 97% accuracy in both methods. Both ROC areas are above 0.87. This study can provide critical reference to medical personnel as clinical assessment to effectively enhance medical care quality and efficiency, prevent unnecessary waste, and provide practical advantages to resource allocation to medical institutes.

Keywords: Total knee replacement, Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization.

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: Sickle cell disease, quality of life, anxiety, depression, socio-demographic characteristics, Ghana.

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Authors: Elham Shirvani–Ghadikolaei, Seyed Mahdi Sajjadi

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State of the art technology has the tremendous impact on our life, in this situation education system have been influenced as well as. In this paper, tried to compare two space of learning text and hypertext with each other, and some challenges of using hypertext in religious education. Regarding the fact that, hypertext is an undeniable part of learning in this world and it has highly beneficial for the education process from class to office and home. In this paper tried to solve this question: the consequences and challenges of applying hypertext in religious education. Also, the consequences of this survey demonstrate the role of curriculum designer and planner of education to solve this problem.

Keywords: Hyper-textual, education, religious text, religious education.

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Authors: Soon-Tai Park, Haeryong Park, Myoung-sun Noh, Yoo-Jae Won

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There are many expand of Wi-Fi zones provided mobile careers and usage of wireless access point at home as increase of usage of wireless internet caused by the use of smart phone. This paper shows wireless local area network status, security threats of WLAN and functionality of major wireless access point in Korea. We propose security countermeasures concerned with life cycle of access point from manufacturing to installation, using and finally disposal. There needed to releasing with configured secure at access point. Because, it is most cost effective resolution than stage of installation or other life cycle of access point.

Keywords: Wireless LAN Security, Wi-Fi Security, Wireless Access Point, Product Life-Cycle

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Authors: Mahdi Ebrahimzadeh

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In this paper we introduce an ultra low power CMOS LC oscillator and analyze a method to design a low power low phase noise complementary CMOS LC oscillator. A 1.8GHz oscillator is designed based on this analysis. The circuit has power supply equal to 1.1 V and dissipates 0.17 mW power. The oscillator is also optimized for low phase noise behavior. The oscillator phase noise is -126.2 dBc/Hz and -144.4 dBc/Hz at 1 MHz and 8 MHz offset respectively.

Keywords: LC oscillator, Low Power, Low Phase Noise

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Authors: A. A. Kudysheva, A. N. Kudyshev

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In present article the model of Blended Learning, its advantage at foreign language teaching, and also some problems that can arise during its use are considered. The Blended Learning is a special organization of learning, which allows to combine classroom work and modern technologies in electronic distance teaching environment. Nowadays a lot of European educational institutions and companies use such technology. Through this method: student gets the opportunity to learn in a group (classroom) with a teacher and additionally at home at a convenient time; student himself sets the optimal speed and intensity of the learning process; this method helps student to discipline himself and learn to work independently.

Keywords: Foreign language, information and communication technology (ICT), model of Blended Learning, virtual cool room, technophobia

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Authors: Myoung Ro Kim, Gilwon Yoon

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A game using electro-oculography (EOG) as control signal was introduced in this study. Various EOG signals are generated by eye movements. Even though EOG is a quite complex type of signal, distinct and separable EOG signals could be classified from horizontal and vertical, left and right eye movements. Proper signal processing was incorporated since EOG signal has very small amplitude in the order of micro volts and contains noises influenced by external conditions. Locations of the electrodes were set to be above and below as well as left and right positions of the eyes. Four control signals of up, down, left and right were generated. A microcontroller processed signals in order to simulate a DDR game. A LCD display showed arrows falling down with four different head directions. This game may be used as eye exercise for visual concentration and acuity. Our proposed EOG control signal can be utilized in many other applications of human machine interfaces such as wheelchair, computer keyboard and home automation.

Keywords: DDR game, EOG, eye movement.

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Authors: Raya A. Jones

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This paper interrogates online representations of robot companions for children, including promotional material by manufacturers, media articles and technology blogs. The significance of the study lies in its contribution to understanding attitudes to robots. The prospect of childcare robots is particularly controversial ethically, and is associated with emotive arguments. The sampled material is restricted to relatively recent posts (the past three years) though the analysis identifies both continuous and changing themes across the past decade. The method extrapolates social representations theory towards examining the ways in which information about robotic products is provided for the general public. Implications for social acceptance of robot companions for the home and robot ethics are considered.

Keywords: Acceptance of robots, childcare robots, ethics, social representations.

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Authors: Nomataru P. Gontse, Lavanithum Joseph

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Deafness coupled with a lack of support and resources in developing countries poses a serious threat to the well- being of children. The mismatch between the needs of persons with disabilities and the resources available to them is a key factor in service provision in resource constrained contexts. Furthermore, deafness in children is the most common childhood sensory disorder in developing countries, and as such seriously affected with regard to resource constraints. This paper discusses the issues and research protocol for a Ph.D. study that aims to develop a practice guideline that is contextually sensitive and includes an interdisciplinary approach that will improve the outcomes of learners and the relationships in hearing households with deaf learners in rural areas of the Eastern Cape, one of the poorest provinces in South Africa. The guideline developed will consider the lived experiences of deaf children and their hearing families on the impact deafness has on their relationships and communication at home. Ethical clearance for the study has been obtained. The methodology is a mixed-methods approach in the form of a survey using questionnaires and semi-structured interviews with deaf learners in primary and high school and their hearing parents to get their perspective on the impact deafness has on their relationships and communication at home. The study is conducted using adolescent learners from Grades 7 to 12 (excluding learners younger than 12 years and older than 21 years). An audiologist, teachers, and support staff will also give their views on how the intervention is currently done and possible suggestions on how management can be done differently. Data collection will be conducted in isiXhosa by the researcher, as isiXhosa is dominant in this region. The interviews will be conducted in South African Sign Language by the sign language interpreter for deaf learners and educational professionals. An expected outcome for this study is the development of recommendations and a practice guideline for deaf children diagnosed late from rural or under-resourced environments. To ensure the implementation of the findings, in the end, professionals will be given feedback on the outcomes of the study so that they can identify areas within their practices that require updated knowledge. The developed guideline is expected to have an impact on the Department of Education policies both regionally and nationally, providing recommendations for a strategic management plan and practice guidelines for this vulnerable and marginalized population. The IsiXhosa specific context could be generalized to other similar contexts.

Keywords: Deafness, family-centred approach, early identification, rural communities.

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Authors: E. Farshidi, N. Ahmadpoor

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In this paper, a alternative structure method for continuous time sigma delta modulator is presented. In this modulator for implementation of integrators in loop filter second generation current conveyors are employed. The modulator is designed in CMOS technology and features low power consumption (<2.8mW), low supply voltage (±1.65), wide dynamic range (>65db), and with 180khZ bandwidth. Simulation results confirm that this design is suitable for data converters.

Keywords: Current Conveyor, continuous, sigma delta, MOS, modulator

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Authors: Ju-Chun Chien

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

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

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Authors: Chiung-Ju Huang, Yuan-Hong Ho

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This paper develops the fiscal health index of 21 local governments in Taiwan over the 1984 to 2010 period. A quantile regression analysis was used to explore the extent that economic variables, political budget cycles, and legislative checks and balances, impact different quantiles of fiscal health index for a country over a sample period of time. Our findings suggest that local governments at the lower quantile are significantly benefited from political budget cycles and the increase in central government revenues, while legislative effective checks and balances and the increase in central government expenditures have a significantly negative effect on local fiscal health. When local governments are in the upper tail of the distribution, legislative checks and balances and growth in macroeconomics have significant and adverse effects on the fiscal health of local governments. However, increases in central government revenues have significant and positive effects on the health status of local government in Taiwan.

Keywords: Fiscal health, political budget cycles, legislative checks and balances, quantile regression.

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Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

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Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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Authors: Lara Dutil-Fafard, Caroline Rhéaume, Patrick Archambault, Daniel Lafond, Neal W. Pollock

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Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

Keywords: Decision support system, event sequence diagram, exploration mission, medical autonomy, scenario-based queries, space medicine.

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