Search results for: planning patient care information system.

Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

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West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: Elder care settings, family caregiver, home care, geriatric hospital care, long term care facility.

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Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

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This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: Electrocardiography, monitoring, surgery, wireless system.

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Authors: Jayesh K., Ganesh T., Suganthi D., Mohan R., Rakesh C. J., Sarojkumar D. M., Jacob S. J.

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Prior to the use of detectors, characteristics comparison study was performed and baseline established. In patient specific QA, the portal dosimetry mean values of area gamma, average gamma and maximum gamma were 1.02, 0.31 and 1.31 with standard deviation of 0.33, 0.03 and 0.14 for IMRT and the corresponding values were 1.58, 0.48 and 1.73 with standard deviation of 0.31, 0.06 and 0.66 for VMAT. With ImatriXX 2-D array system, on an average 99.35% of the pixels passed the criteria of 3%-3 mm gamma with standard deviation of 0.24 for dynamic IMRT. For VMAT, the average value was 98.16% with a standard deviation of 0.86. The results showed that both the systems can be used in patient specific QA measurements for IMRT and VMAT. The values obtained with the portal dosimetry system were found to be relatively more consistent compared to those obtained with ImatriXX 2-D array system.

Keywords: Gamma, IMRT, QA, TPS, VMAT.

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Authors: Priyanka Sen, Kaibalya Prasad Panda, Soumyakanta Samantaray, Sreyasee Rout, Bishnupriya Biswal

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Deregulation in the power system industry and the invention of new technologies for producing electrical energy has led to innovations in power system planning. Distributed generation (DG) is one of the most attractive technologies that bring different kinds of advantages to a lot of entities, engaged in power systems. In this paper, a model for considering DGs in the power system planning problem is presented. Dynamic power system planning for reduction of maintenance and operational cost is presented in this paper. In addition to that, a modified particle swarm optimization (PSO) is used to find the optimal topology solution. Voltage Profile Improvement Index (VPII) and Line Loss Reduction Index (LLRI) are taken as benefit index of employing DG. The effectiveness of this method is demonstrated through examination of IEEE 30 bus test system.

Keywords: Distributed generation, line loss reduction index, particle swarm optimization, power system, voltage profile improvement index.

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Authors: Komwit Surachat, Supasit Kajkamhaeng, Kasikrit Damkliang, Watanyoo Tiprat, Taninnuch Wacharanimit

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An accident is an unexpected and unplanned situation that happens and affects human in a negative outcome. The accident can cause an injury to a human biological organism. Thus, the provision of initial care for an illness or injury is very important move to prepare the patients/victims before sending to the doctor. In this paper, a First Aid Application is developed to give some directions for preliminary taking care of patient/victim via Android mobile device. Also, the navigation function using Google Maps API is implemented in this paper for searching a suitable path to the nearest hospital. Therefore, in the emergency case, this function can be activated and navigate patients/victims to the hospital with the shortest path.

Keywords: First Aid Application, Android, Google Maps API, Navigation System.

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Authors: A. Kampker, P. Burggräf, Y. Bäumers

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In order to be competitive, companies have to reduce their production costs while meeting increasing quality requirements. Therefore, companies try to plan their assembly processes as detailed as possible. However, increasing product individualization leading to a higher number of variants, smaller batch sizes and shorter product life cycles raise the question to what extent the effort of detailed planning is still justified. An important approach in this field of research is the concept of determining the economic planning depth for assembly process planning based on production specific influencing factors. In this paper first solution hypotheses as well as a first draft of the resulting method will be presented.

Keywords: Assembly process planning, economic planning depth, planning benefit, planning effort.

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Authors: He YuanYan

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In recent years, China has implemented the reform of land and space planning. As an important public policy, land and space planning plays a vital role in the construction and development of cities. Land and space planning throughout the country is in full swing, but there are still many disputes from all walks of life. The content, scope, and specific implementation process of land and space planning are also ambiguous, leading to the integration of multiple regulation problems such as unclear authority, unclear responsibilities, and poor planning results during the implementation of land and space planning. Therefore, it is necessary to sort out the development and evolution of domestic and foreign land space planning, clarify the problems and cruxes from the current situation of China's land space planning, and sort out the obstacles and countermeasures to the implementation of this policy, so as to deepen the understanding of the connotation of land space planning. It is of great practical significance for all planners to correctly understand and clarify the specific contents and methods of land space planning and to smoothly promote the implementation of land space planning at all levels.

Keywords: Territorial spatial planning, public policy, land space, overall planning.

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Authors: Hae-Won Seo, Yong-Gu Lee

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Recent progress in the next generation of automobile technology is geared towards incorporating information technology into cars. Collectively called smart cars are bringing intelligence to cars that provides comfort, convenience and safety. A branch of smart cars is connected-car system. The key concept in connected-cars is the sharing of driving information among cars through decentralized manner enabling collective intelligence. This paper proposes a foundation of the information model that is necessary to define the driving information for smart-cars. Road conditions are modeled through a unique data structure that unambiguously represent the time variant traffics in the streets. Additionally, the modeled data structure is exemplified in a navigational scenario and usage using UML. Optimal driving route searching is also discussed using the proposed data structure in a dynamically changing road conditions.

Keywords: Connected-car, data modeling, route planning, navigation system.

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: Lean, Service improvement, SERVQUAL, Care home service.

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: Geocoding, chronic disease management, quality of diabetes care, rate ratio.

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Authors: Mengist Hailemariam, Silma Yoseph

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A well designed and executed Production Planning and Control (PPC) system is one of the key levers for superior performance in the current manufacturing set-up. Hence, measuring the PPC system performance has become a necessity for long term success. The present study examined PPC related issues which impact the production capacity and productivity of leather companies with special focus on Kombolcha Tannery Share Company (KTSC), Ethiopia. Physical observation, interview, and questionnaire were used to generate necessary information from the respondents and reach valid conclusions. Company annual reports were referred and analyzed to triangulate primary data. Consequently, the study revealed that KTSC runs below its capacity due to its inefficient PPC system being in use for which the root causes were identified. The study thereby conceptualizes a PPC system improvement framework comprising three pillars viz., management culture, internal capability and performance measurement together with key considerations in each case. The study findings enable the company to recognize the importance of efficient PPC system as a source of competitive advantage. It also aid managers in evaluating various PPC execution schemes to enhance productivity.

Keywords: Ethiopia, Leather manufacturing, Production planning and control, PPC improvement framework.

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Authors: V. Phupha, T. Lantharthong, N. Rugthaicharoencheep

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The problem of generation expansion planning (GEP) has been extensively studied for many years. This paper presents three topics in GEP as follow: statistical model, models for generation expansion, and expansion problem. In the topic of statistical model, the main stages of the statistical modeling are briefly explained. Some works on models for GEP are reviewed in the topic of models for generation expansion. Finally for the topic of expansion problem, the major issues in the development of a longterm expansion plan are summarized.

Keywords: Generation expansion planning, strategies, power system

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Authors: C. Yagci, F. Iscan

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In this study, spatial differences of Power Transmission Line (PTL) and effects of the situation before and after the urban regeneration are studied by using Geographical Information System (GIS). In addition, a questionable and analyzable structure is acquired by developed system. In the study area many parcels on the PTL were analyzed. The amount of the parcels, which are affected by the negativity of PTL is clearly seen with the aid of generated maps. Some kind of changes are exhibited in the system, which are created by GIS, for instance before urban regeneration PTL was very close to people’s private properties and huge parts of PTL were among the buildings, however; after urban regeneration electricity lines were changed their locations to the underground. According to the results, GIS can be used as a device in planning and managing of PTL in urban regeneration projects and can be used for analyses. By the help of GIS technology, necessary investigations should be carried out in urban regeneration applications for creating sustainable cities.

Keywords: GIS, power transmission line, urban regeneration, technology.

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Authors: Divya Agarwal, Pushpendra S. Bharti

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Autonomous mobile robots (AMR) are expected as smart tools for operations in every automation industry. Path planning and obstacle avoidance is the backbone of AMR as robots have to reach their goal location avoiding obstacles while traversing through optimized path defined according to some criteria such as distance, time or energy. Path planning can be classified into global and local path planning where environmental information is known and unknown/partially known, respectively. A number of sensors are used for data collection. A number of algorithms such as artificial potential field (APF), rapidly exploring random trees (RRT), bidirectional RRT, Fuzzy approach, Purepursuit, A* algorithm, vector field histogram (VFH) and modified local path planning algorithm, etc. have been used in the last three decades for path planning and obstacle avoidance for AMR. This paper makes an attempt to review some of the path planning and obstacle avoidance algorithms used in the field of AMR. The review includes comparative analysis of simulation and mathematical computations of path planning and obstacle avoidance algorithms using MATLAB 2018a. From the review, it could be concluded that different algorithms may complete the same task (i.e. with a different set of instructions) in less or more time, space, effort, etc.

Keywords: Autonomous mobile robots, obstacle avoidance, path planning, and processing time.

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Authors: Sang Keun Rhee, Hyojeong Jin, Jihye Lee, Misoo Kwon, Myon-Woong Park, Sungdo Ha

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Extensive information is required within a R&D environment, and a considerable amount of time and efforts are being spent on finding the necessary information. An adaptive information providing system would be beneficial to the environment, and a conceptual model of the resources, people and context is mandatory for developing such applications. In this paper, an information model on various contexts and resources is proposed which provides the possibility of effective applications for use in adaptive information systems within a R&D project and meeting environment.

Keywords: Adaptive Hypermedia, Adaptive System, ContextAwareness, Information Model, Information System, Personalisation.

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Authors: M. Haddadzade, M. R. Razfar, M. Farahnakian

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Integration of process planning and scheduling functions is necessary to achieve superior overall system performance. This paper proposes a methodology for integration of process planning and scheduling for prismatic component that can be implemented in a company with existing departments. The developed model considers technological constraints whereas available time for machining in shop floor is the limiting factor to produce multiple process plan (MPP). It takes advantage of MPP while guarantied the fulfillment of the due dates via using overtime. This study has been proposed to determinate machining parameters, tools, machine and amount of over time within the minimum cost objective while overtime is considered for this. At last the illustration shows that the system performance is improved by as measured by cost and compatible with due date.

Keywords: Due date, Integration, Multiple process plan, Process planning, Scheduling.

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Authors: T. Turan, Ç. Erdoğan

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As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.

Keywords: Children, evidence based practice, nursing, oral care.

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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: D. Pérez, M. M. E. Alemany

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In this work, a framework to model the Supply Chain (SC) Collaborative Planning (CP) process is proposed. The main contributions of this framework concern 1) the presentation of the decision view, the most important one due to the characteristics of the process, jointly within the physical, organisation and information views, and 2) the simultaneous consideration of the spatial and temporal integration among the different supply chain decision centres. This framework provides the basis for a realistic and integrated perspective of the supply chain collaborative planning process and also the analytical modeling of each of its decisional activities.

Keywords: Collaborative Planning, Decision View, Distributed Decision-Making, Framework.

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Authors: Gianluca Cornetta, Abdellah Touhafi, David J. Santos, Jose Manuel Vazquez

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In this work a new platform for mobile-health systems is presented. System target application is providing decision support to rescue corps or military medical personnel in combat areas. Software architecture relies on a distributed client-server system that manages a wireless ad-hoc networks hierarchy in which several different types of client operate. Each client is characterized for different hardware and software requirements. Lower hierarchy levels rely in a network of completely custom devices that store clinical information and patient status and are designed to form an ad-hoc network operating in the 2.4 GHz ISM band and complying with the IEEE 802.15.4 standard (ZigBee). Medical personnel may interact with such devices, that are called MICs (Medical Information Carriers), by means of a PDA (Personal Digital Assistant) or a MDA (Medical Digital Assistant), and transmit the information stored in their local databases as well as issue a service request to the upper hierarchy levels by using IEEE 802.11 a/b/g standard (WiFi). The server acts as a repository that stores both medical evacuation forms and associated events (e.g., a teleconsulting request). All the actors participating in the diagnostic or evacuation process may access asynchronously to such repository and update its content or generate new events. The designed system pretends to optimise and improve information spreading and flow among all the system components with the aim of improving both diagnostic quality and evacuation process.

Keywords: IEEE 802.15.4 (ZigBee), IEEE 802.11 a/b/g (WiFi), distributed client-server systems, embedded databases, issue trackers, ad-hoc networks.

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Authors: Ball J., Capanni N., Watt S.

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This paper argues that fostering mutual understanding in landscape planning is as much about the planners educating stakeholder groups as the stakeholders educating the planners. In other words it is an epistemological agreement as to the meaning and nature of place, especially where an effort is made to go beyond the quantitative aspects, which can be achieved by the phenomenological experience of the Virtual Reality (VR) environment. This education needs to be a bi-directional process in which distance can be both temporal as well as spatial separation of participants, that there needs to be a common framework of understanding in which neither 'side' is disadvantaged during the process of information exchange and it follows that a medium such as VR offers an effective way of overcoming some of the shortcomings of traditional media by taking advantage of continuing technological advances in Information, Technology and Communications (ITC). In this paper we make particular reference to this as an extension to Geographical Information Systems (GIS). VR as a two-way communication tool offers considerable potential particularly in the area of Public Participation GIS (PPGIS). Information rich virtual environments that can operate over broadband networks are now possible and thus allow for the representation of large amounts of qualitative and quantitative information 'side-by-side'. Therefore, with broadband access becoming standard for households and enterprises alike, distributed virtual reality environments have great potential to contribute to enabling stakeholder participation and mutual learning within the planning context.

Keywords: 3D, communication, geographical information systems, planning, public participation, virtual reality, visualisation.

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Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Piero Favino, Luca Preis

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A settlement strategy is to anticipate and respond the needs of existing and future communities through the provision of primary health care facilities in marginalized areas. Access to a health care network is important to improving healthcare coverage, often lacking, in developing countries. The study explores that a good sanitary system strategy of rural contexts brings advantages to an existing settlement: improving transport, communication, water and social facilities. The objective of this paper is to define a possible methodology to implement primary health care facilities in disadvantaged areas of emerging countries. In this research, we analyze the case study of Lauro de Freitas, a municipality in the Brazilian state of Bahia, part of the Metropolitan Region of Salvador, with an area of 57,662 km² and 194.641 inhabitants. The health localization system in Lauro de Freitas is an integrated process that involves not only geographical aspects, but also a set of factors: population density, epidemiological data, allocation of services, road networks, and more. Data were collected also using semi-structured interviews and questionnaires to the local population. Synthesized data suggest that moving away from the coast where there is the greatest concentration of population and services, a network of primary health care facilities is able to improve the living conditions of small-dispersed communities. Based on the health service needs of populations, we have developed a methodological approach that is particularly useful in rural and remote contexts in emerging countries.

Keywords: Primary health care, developing countries, policy health planning, settlement strategy.

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Authors: Jincan Li, Mingyu Gao, Zhiwei He, Yuxiang Yang, Zhongfei Yu, Yuanyuan Liu

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Building an appropriate motion model is crucial for trajectory planning of robots and determines the operational quality directly. An adaptive acceleration and deceleration motion planning based on trigonometric functions for the end-effector of 6-DOF robots in Cartesian coordinate system is proposed in this paper. This method not only achieves the smooth translation motion and rotation motion by constructing a continuous jerk model, but also automatically adjusts the parameters of trigonometric functions according to the variable inputs and the kinematic constraints. The results of computer simulation show that this method is correct and effective to achieve the adaptive motion planning for linear trajectories.

Keywords: 6-DOF robots, motion planning, trigonometric function, kinematic constraints

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Authors: E. Fosch-Villaronga

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This paper pioneers Care Robot Impact Assessment (CRIA), a methodology used to identify, analyze, mitigate and eliminate the risks posed by the insertion of non-medical personal care robots (PCR) in medical care facilities. Its precedent instruments [Privacy and Surveillance Impact Assessment (PIA and SIA)] fall behind in coping with robots. Indeed, personal care robots change dramatically how care is delivered. The paper presents a specific risk-sector methodology, identifies which robots are under its scope and presents some of the challenges introduced by these robots.

Keywords: Ethics, Impact Assessment, Law, Personal Care Robots.

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Authors: Guilherme Ribeiro, Alexandre Oliveira, Antonio Ferreira, Shyam Visweswaran, Gregory Cooper

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Patient-specific models are instance-based learning algorithms that take advantage of the particular features of the patient case at hand to predict an outcome. We introduce two patient-specific algorithms based on decision tree paradigm that use AUC as a metric to select an attribute. We apply the patient specific algorithms to predict outcomes in several datasets, including medical datasets. Compared to the patient-specific decision path (PSDP) entropy-based and CART methods, the AUC-based patient-specific decision path models performed equivalently on area under the ROC curve (AUC). Our results provide support for patient-specific methods being a promising approach for making clinical predictions.

Keywords: Approach instance-based, area Under the ROC Curve, Patient-specific Decision Path, clinical predictions.

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Authors: Feng-Chuan Pan, Fang-Yue Liu

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Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Keywords: hypertension, joint care management network, cardiovascular diseases, metabolic syndrome.

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization.

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Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

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In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Keywords: Healthcare, flexibility, patient satisfaction, behavioral intention.

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Authors: Chinlun Lai, Lunjyh Jiang

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Due to the heavy burden and pressure of caring for infants, an integrated automatic baby watching system based on IoT smart sensing and deep learning machine vision techniques is proposed in this paper. By monitoring infant body conditions such as heartbeat, breathing, body temperature, sleeping posture, as well as the surrounding conditions such as dangerous/sharp objects, light, noise, humidity and temperature, the proposed system can analyze and predict the obvious/potential dangerous conditions according to observed data and then adopt suitable actions in real time to protect the infant from harm. Thus, reducing the burden of the caregiver and improving safety efficiency of the caring work. The experimental results show that the proposed system works successfully for the infant care work and thus can be implemented in various life fields practically.

Keywords: Baby care system, internet of things, deep learning, machine vision.

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Authors: Shang-Ping Lin, Shi-Hwa Lo, Ho-Li Yang

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Company mergers and acquisitions reached their peak in the twenty-first century. Mergers and acquisitions have become one of the competitive strategies for external growth. In general, it is believed that mergers and acquisitions can create synergies. However, they require complete information technology system and service integration, especially in the banking industry. Much of the research has focused on performance evaluation, shareholder equity allocation, or even the increase of company market value after the merger and acquisition, whereas few scholars have focused on information system integration post merger and acquisition. This study indicates the role of information systems after a merger and acquisition, explaining the benefits of information system integration using a merger and acquisition case in the banking industry as an example. In addition, we discuss factors that affect the performance of information system integration, and utilize system dynamics to interpret the relationship among factors that affect information system integration performance in the banking industry after a merger and acquisition.

Keywords: Merger and Acquisition, Information SystemIntegration, System Dynamics

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