Search results for: Health care provider

Authors: S. Abed, S. O’Neill

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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: Health care, nurse education, nurse leadership, nursing in Iraq, transformational leadership.

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Authors: Paulo Rocha

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Once in touch with the Criminal Justice System, offenders with mental disorder tend to return to custody more often than nondisordered individuals, which suggests they have not been receiving appropriate treatment in prison. In this scenario, diverting individuals into care as early as possible in their trajectory seems to be the appropriate approach to rehabilitate mentally unwell offenders and alleviate overcrowded prisons. This paper builds on an ethnographic research investigating the challenges encountered by practitioners working to divert offenders into care while attempting to establish cross-boundary interactions with professionals in the Criminal Justice System and Mental Health Services in the UK. Drawing upon the findings of the study, this paper suggests the development of adequate tools to enable liaison between agencies which ultimately results in successful interventions.

Keywords: Criminogenic needs, interagency collaboration, liaison and diversion, recidivism.

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Authors: Randa M. Ali, Naguiba F. Loutfy, Osama M. Awad

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Leishmaniasis is the collective name for a number of diseases caused by protozoan flagellates of the genus Leishmania, which is transmitted by Phlebotomine sandfly, the disease has diverse clinical manifestations and found in many areas of the world, particularly in Africa, Latin America, South and Central Asia, the Mediterranean basin and the Middle East. This study was done to assess primary health care physicians’ knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. It is a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study; only 20 PHP completed the questionnaire. 60 local inhabitants were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results showed that 11 (55%) percent of the physicians had satisfactory knowledge; they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. On the other hand when attitude of the primary health care physicians about leishmaniasis was measured, results showed that 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandfly as a vector of the disease is poor and needs to be corrected. (90%) of the interviewed inhabitants had not heard about leishmaniasis, Only 3 (5%) of them said they know sandfly and its role in transmission of leishmaniasis. Thus we conclude that knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of leishmaniasis, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that for inhabitants to take enough protective measures against the vector, they should perceive that it is responsible for causing a disease.

Keywords: Attitude, knowledge, PHP, leishmaniasis, sandfly, local inhabitants, inside and outside housing conditions.

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Authors: Rodrigo Barreiros Leal, Aracéli Cristina de Sousa Ferreira

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This study examines the possibility to apply the theory of multidimensional accounting (momentum accounting) in a Brazilian Navy-s Services Provider Military Organization (Organização Militar Prestadora de Serviços - OMPS). In general, the core of the said theory is the fact that Accounting does not recognize the inertia of transactions occurring in an entity, and that occur repeatedly in some cases, regardless of the implementation of new actions by its managers. The study evaluates the possibility of greater use of information recorded in the financial statements of the unit of analysis, within the strategic decisions of the organization. As a research strategy, we adopted the case study. The results infer that it is possible to use the theory in the context of a multidimensional OMPS, promoting useful information for decision-making and thereby contributing to the strengthening of the necessary alignment of its administration with the current desires of the Brazilian society.

Keywords: Multidimensional Accounting, Public Management, Decision Making.

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: Autism, intellectual developmental disabilities, advocacy, health inequalities, quality of care.

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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, Jr., James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the United States. The elevated death and disease rates among former slaves were attributable to lack of quality healthcare. To address the paucity of healthcare services, Meharry Medical College, an institution with the mission of educating minority professionals and serving the underserved population, was established in 1876. Purpose: The social ecological framework and partial least squares (PLS) path modeling were used to quantify the impact of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Thus, the study results could demonstrate the accomplishment of the College’s mission of training primary care professionals to serve in underserved areas. Methods: Various statistical methods were used to analyze alumni data from 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates in the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t-test was performed to detect the significant mean differences of respective clustering and criterion variables. Chi-square test was used to test if the proportions of primary care and non-primary care specialists are consistent with those of medical and dental graduates practicing in the designated community clusters. Finally, the PLS path model was constructed to explore the construct validity of analytic model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Results: Approximately 83% (3,192/3,864) of Meharry Medical College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the PLS path modeling demonstrated that alumni served as primary care professionals in communities with significantly lower socioeconomic status and higher adverse health outcome (p < .001). The PLS path modeling exhibited the meaningful interrelation between primary care professionals practicing communities and surrounding environments (socioeconomic statues and adverse health outcome), which yielded model reliability, validity, and applicability. Conclusion: This study applied social ecological theory and analytic modeling approaches to assess the attainment of Meharry Medical College’s mission of training primary care professionals to serve in underserved areas, particularly in communities with low socioeconomic status and high rates of adverse health outcomes. In summary, the majority of medical and dental graduates from Meharry Medical College provided primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcome, which demonstrated that Meharry Medical College has fulfilled its mission. The high reliability, validity, and applicability of this model imply that it could be replicated for comparable universities and colleges elsewhere.

Keywords: Disadvantaged Community, K-means Cluster Analysis, PLS Path Modeling, Primary care.

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Authors: Yung-Ting Chang, Chung-You Tsai, Yu-Chuan Li

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Nosocomial (i.e., hospital-acquired) infections (NI) is a major cause of morbidity and mortality in hospitals. NI rate is higher in intensive care units (ICU) than in the general ward due to patients with severe symptoms, poor immunity, and accepted many invasive therapies. Contact behaviors between health caregivers and patients is one of the infect factors. It is difficult to obtain complete contact records by traditional method of retrospective analysis of medical records. This paper establishes a contact history inferential model (CHIM) intended to extend the use of Proximity Sensing of rapid frequency identification (RFID) technology to transferring all proximity events between health caregivers and patients into clinical events (close-in events, contact events and invasive events).The results of the study indicated that the CHIM can infer proximity care activities into close-in events and contact events. The infection control team could redesign and build optimal workflow in the ICU according to the patient-specific contact history which provided by our automatic tracing system.

Keywords: Active Radio Frequency Identification, Intensive Care Unit, Nosocomial Infections

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Authors: Muhammad Liaquat Ali, Nasir-uddin Khan, Mushtaq Hussain, Asif Mansoor, Muhammad Shahid

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Population in rural areas are scattered in the form of different villages or settlements. The proper selection of land to launch any educational or health activities to equally facilitate both the genders is the sticky situation, both for Govt. and Private organizations. Govt. spends substantial funds for the establishment of education institution/health centre at the place which is feasible and accessible to general public. However for specific gender, the gender population is also considered so that both the gender may be benefited equally. In this research, efforts have been made to illustrate how one can choose or locate the best central place/ area in Taluka Kunri of district Umerkot Sindh Pakistan where the Educational or Health activity is to be initiated. For the purpose the concept of centre of mass theorem is used as a tool to develop mathematical model, subsequently utilize in achieving the objectives.

Keywords: Centre of mass theorem, Establishment of technical/ vocational/ health care centre, Gender population of taluka Kunri of District Umerkot, Graphical interpretation of town committee/villages.

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Authors: Hiroki Yoshikai, Shin’ichi Arakawa, Tetsuya Takine, Masayuki Murata

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API (Application Programming Interface) economy is expected to create new value by converting corporate services such as information processing and data provision into APIs and using these APIs to connect services. Understanding dynamics of a market of API economy under strategies of participants is crucial to fully maximize the values of API economy. To capture the behavior of a market in which the number of participants changes over time, we present a time-evolving market model for a platform in which API providers who provide APIs to service providers participate in addition to service providers and consumers. Then, we use the market model to clarify the role API providers play in expanding market participants and forming ecosystems. The results show that the platform with API providers increased the number of market participants by 67% and decreased the cost to develop services by 25% compared to the platform without API providers. Furthermore, during the expansion phase of the market, it is found that the profits of participants are mostly the same when 70% of the revenue from consumers is distributed to service providers and API providers. It is also found that, when the market is mature, the profits of the service provider and API provider will decrease significantly due to their competitions and the profit of the platform increases.

Keywords: API Economy, ecosystem, platform, API providers.

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Authors: Jefrey Pilusa, Tumisang Seodigeng

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This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: Autoclave, disposal, fuel, incineration, medical waste.

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Authors: Narges Razeghi

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In studies on psychological health and children-s personality development and in researches on emotional distresses, children-s behavioral disorders associated with mother deprivation, are known as the major cause of mental disorders. Therefore, for identification of children-s attachment styles in nursery-s children are of significant importance. For this purpose, to compare the attachment styles between children of nursery with those provided care by their families, the Separation Anxiety Test (SAT) of Slough and et al was administered on 72 children (36 in nursery and 36 family-cared). The results indicated, almost half of children in both groups have insecure attachment styles. Tendency ratio of both groups of children towards Secure and Ambivalent Insecure styles are almost the same. However the avoidant style of attachment in children of nursery is more than those provided care by their families. The children under family care compared to the children of nursery, in the situations of separation from their mothers in the first day of school and sleeping in their room, have shown more self reliance.

Keywords: Attachment style, Separation Anxiety Test (SAT), Children, Nursery, Emotional and Behavioral Disorders

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Authors: Nami Matsumoto

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This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.

Keywords: Health care, Japanese-English medical encounters, language barriers, trust.

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Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

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The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: Clique, clan, electronic health records, physician collaboration.

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Authors: J. Luché-Thayer, C. Perronne, C. Meseko

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We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: Conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent.

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Authors: Yah-Ling Hung

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eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.

Keywords: eHealth, health intervention, health literacy, usability evaluation.

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Authors: Kelly R. Mazzer, Debra J. Rickwood, Thea Vanags

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Young people have a high prevalence of mental health problems, yet tend not to seek help. Trusted adults in young people-s lives, such as teachers and sports coaches, can make a major positive contribution to the mental health of young people. Teachers and sports coaches may be in a position to be effective in supporting young people-s mental health through promotion, prevention and early intervention. This study reports findings from interviews with 21 teachers and 13 sports coaches of young people aged 12 to 18 in Canberra, Australia, regarding their perceptions of the relevance and effectiveness of their role in supporting young people-s mental health. Both teachers and coaches perceived having influential but slightly different roles to play in supporting mental health. There may be potential to elevate the influence of teachers and coaches as sources of support for young people and their mental health care.

Keywords: Early intervention, mental health promotion, coaches, teachers, young people

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Authors: Qatawneh H., Yousef S., Shirvani H.

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The purpose of this article is to propose a model designed to achieve Total Knowledge Transfer in the public health sector. The Total Knowledge Transfer Model integrated four essential organizational factors which have been under examined in totality in the literature. The research design was inductive in nature and used a case study for accomplishing the research objectives. The researcher investigated the factors that created a base to design a framework for total knowledge transfer in the public health sector. The results of this study are drawn from a fairly large sample in only two hospitals. A further research can be conducted to cover more responses from a wider health sector. The Total Knowledge Transfer Model is essential to improve the transfer and application of total common health knowledge.

Keywords: Health Care, Knowledge Management, Knowledge Transfer.

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Authors: M. Ricardo Lang, A. Costa, I. Iesbik, K. Haag, L. Trindade Buffara, O. Reimann Junior, C. Auswaldt Steclan

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Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with systemic arterial hypertension (SAH) being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyslipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: Biomarkers, population, stroke, sex, stroke unit.

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Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: Emergency nurses, nursing care, workload, work sampling.

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Authors: Ademuyiwa, M. O., Sanni, S. A.

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The importance of maternal nutritional practices during pregnancy cannot be overemphasized. This paper assessed the consumption pattern and dietary practices of 50 pregnant women selected using purposive sampling technique from three health care centres (Primary Health Care Centre, Obantoko; Primary Health Care Centre Alabata; and the General Hospital, Odeda) in Odeda Local Government Area of Ogun State, Nigeria. Structured questionnaire was used to elicit information on socioeconomic status, consumption pattern and dietary practices. Data were analyzed using the Statistical Package for Social Sciences (SPSS, 17). The results indicated that about 58% of the pregnant women were below the age of 30 while 42% were ages 28-40 years. Only 16% had tertiary education while (38%) had secondary education, 52% earn income through petty trading. On food intake, 52% got their energy source from rice on a daily basis, followed by pap (38%) and eko (34%). For protein intake, 36% consumed bean cake on a daily basis while 66% consumed moinmoin 2-3 times a week. Orange (48%) and Green Leafy vegetable (40%) accounted for the mostly consumed fruit and vegetable on daily basis. In terms of animal origin, fish (76%), meat (58%) and eggs (30%) were consumed daily, while chicken and snail were consumed occasionally by 54% and 42%, respectively. Forty-six percent (46%) of the pregnant women eat more than three times daily; while 60% of the women eat outside their homes with 42% respondents eat out lunch and only two percent least eaten out dinner. It is important to increase in awareness campaign to sensitize the pregnant women on the importance of good nutrition especially fruits, vegetables and dairy products. 

Keywords: Consumption Pattern, Dietary Practices, Pregnant, Women, Nigeria.

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Authors: B. Muhammadani

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Health workforce is a fundamental component of health system and plays a significant role in delivering effective health care services. However, there is a crucial shortage of skilled personnel which make them prone to work in stressful conditions. In spite of excessively high workload and burnout among the staff, little attention is given to their job satisfaction level which has serious implications on the productivity and effective performance of staff to achieve organizational goals. Therefore, this study aims to explore the job satisfaction of midwives working in the labor ward of the Lady Dufferin Hospital, Karachi. A cross-sectional survey was conducted. The short version of Minnesota Job Satisfaction Questionnaire was administered on a convenient sample group of 22 midwives to gather information on their job satisfaction. The results demonstrated that midwives were overall satisfied with their job. The level of job satisfaction was however found different in various positions within midwifery cadre. The head of midwives was highly satisfied as compared to midwifery staff who works under the supervision of head. The level of satisfaction of team leaders fall between the head and staff of midwifery. Similar trends were observed for both intrinsic and extrinsic job satisfaction. Such evidences on these issues are essential and useful as it helps explore the attitudes of individuals towards work which has direct implications on access to quality care services. Strategic interventions are required at organizational level to provide motivators and satisfiers to health workers for their work related satisfaction and enhanced motivation.

Keywords: Health workforce, job satisfaction, motivation, workload, burnout, midwives, health system.

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Authors: Åsa Smedberg

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There are different kinds of online systems on the Internet for people who need support and develop new knowledge. Online communities and Ask the Expert systems are two such systems. In the health care area, the number of users of these systems has increased at a rapid pace. Interactions with medical trained experts take place online, and people with concerns about similar health problems come together to share experiences and advice. The systems are also used as storages and browsed for health information. Over the years, studies have been conducted of the usage of the different systems. However, in what ways the systems can be used together to enhance learning has not been explored. This paper presents results from a study of online health-communities and an Ask the Expert system for people who suffer from overweight. Differences and similarities in regards to posted issues and replies are discussed, and suggestions for a new holistic design of the two systems are presented.

Keywords: Learning, Ask the Expert, online community, healthcare, holistic, overweight.

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Authors: Stella Ouma, M. E. Herselman

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The Application of e-health solutions has brought superb advancements in the health care industry. E-health solutions have already been embraced in the industrialized countries. In an effort to catch up with the growth, the developing countries have strived to revolutionize the healthcare industry by use of Information technology in different ways. Based on a technology assessment carried out in Kenya – one of the developing countries – and using multiple case studies in Nyanza Province, this work focuses on an investigation on how five rural hospitals are adapting to the technology shift. The issues examined include the ICT infrastructure and e-health technologies in place, the knowledge of participants in terms of benefits gained through the use of ICT and the challenges posing barriers to the use of ICT technologies in these hospitals. The results reveal that the ICT infrastructure in place is inadequate for e-health implementations as a result to various challenges that exist. Consequently, suggestions on how to tackle the various challenges have been addressed in this paper.

Keywords: Challenges, e-health, healthcare, information communication technology, rural areas.

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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Authors: Jinn-Yi Yeh, Tai-Hsi Wu

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Hemodialysis patients might suffer from unhealthy care behaviors or long-term dialysis treatments. Ultimately they need to be hospitalized. If the hospitalization rate of a hemodialysis center is high, its quality of service would be low. Therefore, how to decrease hospitalization rate is a crucial problem for health care. In this study we combined temporal abstraction with data mining techniques for analyzing the dialysis patients' biochemical data to develop a decision support system. The mined temporal patterns are helpful for clinicians to predict hospitalization of hemodialysis patients and to suggest them some treatments immediately to avoid hospitalization.

Keywords: Hemodialysis, Temporal abstract, Data mining, Healthcare quality.

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Authors: Petr Cernohorsky, Jan Voracek

Abstract:

Well-developed strategic marketing planning is the essential prerequisite for establishment of the right and unique competitive advantage. Typical market, however, is a heterogeneous and decentralized structure with natural involvement of individual or group subjectivity and irrationality. These features cannot be fully expressed with one-shot rigorous formal models based on, e.g. mathematics, statistics or empirical formulas. We present an innovative solution, extending the domain of agent based computational economics towards the concept of hybrid modeling in service provider and consumer market such as telecommunications. The behavior of the market is described by two classes of agents - consumer and service provider agents - whose internal dynamics are fundamentally different. Customers are rather free multi-state structures, adjusting behavior and preferences quickly in accordance with time and changing environment. Producers, on the contrary, are traditionally structured companies with comparable internal processes and specific managerial policies. Their business momentum is higher and immediate reaction possibilities limited. This limitation underlines importance of proper strategic planning as the main process advising managers in time whether to continue with more or less the same business or whether to consider the need for future structural changes that would ensure retention of existing customers or acquisition of new ones.

Keywords: Agent-based computational economics, hybrid modeling, strategic marketing, system dynamics.

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Authors: Essam Abd-Elrazek

Abstract:

With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.

Keywords: Medical Informatics, telemedicine, e-health systems.

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Authors: Antonio Di Leva, Carla Reyneri, Michele Sonnessa

Abstract:

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

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

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Authors: S. Fujiwara, T. Kaburagi, K. Kobayashi, K. Watanabe, Y. Kurihara

Abstract:

This paper describes a novel sensor device, a pressure pulse wave meter, which uses a bidirectional condenser microphone. The microphone work as a microphone as well as a sensor with high gain over a wide frequency range; they are also highly reliable and economic. Currently aging is becoming a serious social issue in Japan causing increased medical expenses in the country. Hence, it is important for elderly citizens to check health condition at home, and to care the health conditions through daily monitoring. Given this circumstances, we developed a novel pressure pulse wave meter based on a bidirectional condenser microphone: this device is used as a measuring instrument of health conditions.

Keywords: Bidirectional microphone, pressure pulse wave meter, health condition.

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Authors: Ayman M. Mansour

Abstract:

In this paper, we propose an intelligent system that is used for monitoring the health conditions of patients. Monitoring the health condition of patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The ability of making medical decisions, the quality of medical is expected to be improved.

Keywords: GSM, SMS, Patient, Monitoring system, Fuzzy Logic, Multi-agent system.

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