Search results for: neuropalliative care

Authors: Y. Cifuentes, L. Beltrán, L. Ramírez

Abstract:

The availability to deploy mobile applications for health care is increasing daily thru different mobile app stores. But within these capabilities the number of hacking attacks has also increased, in particular into medical mobile applications. The security vulnerabilities in medical mobile apps can be triggered by errors in code, incorrect logic, poor design, among other parameters. This is usually used by malicious attackers to steal or modify the users’ information. The aim of this research is to analyze the vulnerabilities detected in mobile medical apps according to risk factor standards defined by OWASP in 2014.

Keywords: mHealth apps, OWASP, protocols, security vulnerabilities, risk factors.

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Authors: Sudeep Marwaha, Punam Bedi

Abstract:

Ontologies play an important role in semantic web applications and are often developed by different groups and continues to evolve over time. The knowledge in ontologies changes very rapidly that make the applications outdated if they continue to use old versions or unstable if they jump to new versions. Temporal frames using frame versioning and slot versioning are used to take care of dynamic nature of the ontologies. The paper proposes new tags and restructured OWL format enabling the applications to work with the old or new version of ontologies. Gene Ontology, a very dynamic ontology, has been used as a case study to explain the OWL Ontology with Temporal Tags.

Keywords: Frame and slot Versioning, OWL, OntologyVersioning, Semantic Web.

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Authors: Monika Nuffer, Wesley Nuffer

Abstract:

The problem of obesity is one that continues to be faced in the United States health care system and across the developing world. Prescription medications are available, but are often very expensive with minimal insurance coverage. The over-the-counter diet aid industry is a robust one, selling billions of dollars in products every year. It is important for clinicians to understand the myriad of different nutritional supplements marketed for obesity, and to weigh the evidence behind these products. This manuscript outlines the most commonly used nutritional supplements currently marketed for weight loss, reviewing the evidence with a focus on the efficacy and safety of these products.

Keywords: Obesity, weight loss, herbal products, nutritional supplements

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Authors: Pronab Ganguly, Ahmed A. Moustafa

Abstract:

Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.

Keywords: Schizophrenia, holistic management, antipsychotics, quality of life.

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Authors: J. Samuel Jesudoss

Abstract:

The purpose of the study was to find out the efficacy of selected mobility exercises and participation in special games on psychomotor abilities, functional abilities and skill performance among intellectually disabled children of age group under 14. Thirty male students who were studying in Balar Kalvi Nilayam and YMCA College Special School, Chennai, acted as subjects for the study. They were only mild and moderate in intellectual disability. These students did not undergo any special training or coaching programme apart from their regular routine physical activity classes as a part of the curriculum in the school. They were attached at random, based on age in which 30 belonged to under 14 age group, which was divided into three equal group of ten for each experimental treatment. 10 students (Treatment group I) underwent calisthenics and special games participation, 10 students (Treatment group II) underwent aquatics and special games participation, 10 students (Treatment group III) underwent yoga and special games participation. The subjects were tested on selected criterion variables prior (pre test) and after twelve weeks of training (post test). The pre and post test data collected from three groups on functional abilities(self care, learning, capacity for independent living), psychomotor variables(static balance, eye hand coordination, simple reaction time test) and skill performance (bocce skill, badminton skill, table tennis skill) were statistically examined for significant difference, by applying the analysis ANACOVA. Whenever an 'F' ratio for adjusted test was found to be significant for adjusted post test means, Scheffe-s test was followed as a post-hoc test to determine which of the paired mean differences was significant. The result of the study showed that among under 14 age groups there was a significant improvement on selected criterion variables such as, Balance, Coordination, self-care and learning and also in Bocce, Badminton & Table Tennis skill performance, due to mobility exercises and participation in special games. However there were no significant differences among the groups.

Keywords: Functional ability, intellectually disabled, Mobility exercises, Psychomotor ability.

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Authors: Punam Bedi, Sudeep Marwaha

Abstract:

Ontologies play an important role in semantic web applications and are often developed by different groups and continues to evolve over time. The knowledge in ontologies changes very rapidly that make the applications outdated if they continue to use old versions or unstable if they jump to new versions. Temporal frames using frame versioning and slot versioning are used to take care of dynamic nature of the ontologies. The paper proposes new tags and restructured OWL format enabling the applications to work with the old or new version of ontologies. Gene Ontology, a very dynamic ontology, has been used as a case study to explain the OWL Ontology with Temporal Tags.

Keywords: Frame and slot Versioning, OWL, OntologyVersioning, Semantic Web.

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Authors: Zuzana Crhova, Karel Kolman, Drahomíra Pavelkova

Abstract:

Knowledge is considered as an important asset which can help organizations to create competitive advantage. The necessity of taking care of these assets is more important in these days – in days of turbulent changes in business environment. Knowledge could facilitate adaption to constant changes. The aim of this paper is to describe how the knowledge sharing can be supported in the manufacturing companies. The methods of case studies and grounded theory were used to present information gained by carrying out semistructured interviews. Results show that knowledge sharing is supported in very similar ways in respondent companies.

Keywords: Case Study, Human Resource Management, Knowledge, Knowledge Sharing.

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Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

Abstract:

The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: Caregiving, design basics, family integration, hospital ward, sustainability.

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Authors: Serap Akcan, Ali Kokangul

Abstract:

We consider a single-echelon, single-item inventory system where both demand and lead-time are stochastic. Continuous review policy is used to control the inventory system. The objective is to calculate the reorder point level under stochastic parameters. A case study is presented in Neonatal Intensive Care Unit.

Keywords: Inventory control system, reorder point level, stochastic demand, stochastic lead time

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Authors: Mamta Patel, R. N. Patel

Abstract:

Transmission and distribution lines are vital links between the generating unit and consumers. They are exposed to atmosphere, hence chances of occurrence of fault in transmission line is very high which has to be immediately taken care of in order to minimize damage caused by it. In this paper Discrete wavelet transform of voltage signals at the two ends of transmission lines have been analyzed. The transient energy of the detail information of level five is calculated for different fault conditions. It is observed that the variation of transient energy of healthy and faulted line can give important information which can be very useful in classifying and locating the fault.

Keywords: Wavelet, Discrete wavelet transform, Multiresolution analysis, Transient energy

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Authors: Muhammad Hammad Lakhvi

Abstract:

Islam has a general principle of increase in population. But the Muslims are equally obliged to take care of health, education and the provisions etc. for their offspring and wives in the best possible way. The Muslims would have to regulate and manage the number of children, if any situation affects their duties regarding their wives or children. Islam accomplishes permissibility of temporary blockade in human fertility if someone faces any problem regarding health of mother or children. During the life of the Holy Prophet (SAW), Azl (coitus interruptus) was the only way for temporary spacing between the children. In technologically developed environment, the same can be resort through some advanced methodology or instrument of temporary blockade. Solid grounds are available in Islam that the fertility rate should be managed if any of the aspect of human quality is being affected.

Keywords: Islam, Fertility Regulations, Muslims, Qur'an

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Authors: Sung Ho Ha, Seong Hyeon Joo

Abstract:

Data mining techniques have been used in medical research for many years and have been known to be effective. In order to solve such problems as long-waiting time, congestion, and delayed patient care, faced by emergency departments, this study concentrates on building a hybrid methodology, combining data mining techniques such as association rules and classification trees. The methodology is applied to real-world emergency data collected from a hospital and is evaluated by comparing with other techniques. The methodology is expected to help physicians to make a faster and more accurate classification of chest pain diseases.

Keywords: Data mining, medical decisions, medical domainknowledge, chest pain.

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Authors: Zheng Miao, Dennis Fernandez

Abstract:

CRISPR research has the potential to completely transform life science, agriculture, live-stock and the health care industry. The Intellectual Property derived from its research has raised significant attention in the academic as well as the biopharmaceutical industry culminating an urgent need for strategic IP protection. We review the rudimentary concepts and key competitors of CRISPR technologies as well as the paramount strategies for intellectual property protection. Further, we elaborate on prosecution issues related to CRISPR patents as well as possible solutions to various patent laws, interferences and litigation. Finally, we address how the bioinformatics of the CRISPR technology begs an inquiry into issues of privacy and a host of ethical concerns.

Keywords: Bioinformatics, CRISPR, biotechnology, intellectual property.

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Authors: Lina Al-Qatawneh, Abdallah Abdallah, Salam Zalloum

Abstract:

In managing healthcare logistics, cost is not the only factor to be considered. The level of items- criticality used in patient care services plays an important role as well. A stock-out incident of a high critical item could threaten a patient's life. In this paper, the DMAIC (Define-Measure-Analyze-Improve-Control) methodology is used to drive improvement projects based on customer driven critical to quality characteristics at a Jordanian hospital. This paper shows how the application of Six Sigma improves the performance of the case hospital logistics system by reducing the number of stock-out incidents.

Keywords: Criticality level, Healthcare, Logistics, and Six Sigma.

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Authors: P. Prasannakumar, L. Myoung Young, G. Seung Kye, P. Sang Hun, S. Chul Gyu

Abstract:

In this paper, we discussed the coupling medium in the optoacoustic imaging. The coupling medium is placed between the scanned object and the ultrasound transducers. Water with varying temperature was used as the coupling medium. The water temperature is gradually varied between 25 to 40 degrees. This heating process is taken with care in order to avoid the bubble formation. Rise in the photoacoustic signal is noted through an unfocused transducer with frequency of 2.25 MHz as the temperature increases. The temperature rise is monitored using a NTC thermistor and the values in degrees are calculated using an embedded evaluation kit. Also the temperature is transmitted to PC through a serial communication. All these processes are synchronized using a trigger signal from the laser source.

Keywords: Embedded, optoacoustic, ultrasound, unfocused transducer.

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Authors: H. Buluthan Cetintas, M. Nejat Ozupek

Abstract:

Communication is an important factor and a prop in directing corporate activities efficiently, in ensuring the flow of knowledge which is necessary for the continuity of the institution, in creating a common language in the institution, in transferring corporate culture and ultimately in corporate success. The idea of transmitting the knowledge among the workers in a healthy manner has revived knowledge communication. Knowledge communication can be defined as the act of mutual creation and communication of intuitions, assessments, experiences and capabilities, as long as maintained effectively, can provide advantages such as corporate continuity, access to corporate objectives and making true administrative decisions. Although the benefits of the knowledge communication to corporations are known, and the necessary worth and care is given, some hardships may arise which makes it difficult or even block it. In this article, difficulties that prevent knowledge communication will be discussed and solutions will be proposed.

Keywords: Corporate knowledge communication, knowledge communication, knowledge communication barriers

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Authors: Somorjeet Sharma Shamurailatpam, Rabindra Das, A. Suchitra Devi

Abstract:

Computer and video display users might complain about Asthenopia, burning, dry eyes etc. The management of dry eyes is often not in the lines of severity. Following systematic evaluation and grading, dry eye disease is one condition that can be practiced at all levels of ophthalmic care. In the present study, different spectrum causing dry eye and prevalence of dry eye disease in computer users of Manipur, India are determined with 600 individuals (300 cases and 300 control). Individuals between 15 and 50 years who used computers for more than 3 hrs a day for 1 year or more were included. Tear break up time (TBUT) and Schirmer’s test were conducted. It shows that 33 (20.4%) out of 164 males and 47 (30.3%) out of 136 females have dry eye. Possible explanation for the observed result is discussed.

Keywords: Asthenopia, computer vision syndrome, dry eyes, Schirmer’s test, tear breakup time.

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Authors: N. R. Harris, J. Curry

Abstract:

This paper describes the construction and operation of an experimental LoRaWAN network surrounding the University of Southampton in the United Kingdom. Following successful installation, an experimental node design is built and characterised, with particular emphasis on radio range. Several configurations are investigated, including different data rates, and varying heights of node. It is concluded that although range can be great (over 8 km in this case), environmental topology is critical. However, shorter range implementations, up to about 2 km in an urban environment, are relatively insensitive although care is still needed. The example node and the relatively simple base station reported demonstrate that LoraWan can be a very low cost and practical solution to Internet of Things type applications for distributed monitoring systems with sensors spread over distances of several km.

Keywords: Wireless sensor network, LoRa, internet of things, propagation.

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Authors: P. Prudtikul, S. Pathomsiri

Abstract:

Most, if not all, public hospitals in Thailand have encountered a common problem regarding the increasing demand for medical services. The increasing number of patients causes so much strain on the hospital-s services, over-crowded, overloaded working hours, staff fatigue, medical error and long waiting time. This research studied the characteristics of operational processes of the medical care services at the medicine department in a large public university hospital. The research focuses on details regarding methods, procedures, processes, resources, and time management in overall processes. The simulation model is used as a tool to analyze the impact of various improvement strategies.

Keywords: Patient flow, medicine department, simulation, outpatient department.

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Authors: Lalit Garg, Sally McClean, Maria Barton

Abstract:

Healthcare issues continue to pose huge problems and incur massive costs. As a result there are many challenging problems still unresolved. In this paper, we will carry out an extensive scientific survey of different areas of management and planning in an attempt to identify where there has already been a substantial contribution from management science methods to healthcare problems and where there is a clear potential for more work to be done. The focus will be on the read-across to the healthcare domain from such approaches applied generally to management and planning and how the methods can be used to improvement patient care. We conclude that, since the healthcare domain significantly differs from traditional areas of management and planning, in some cases there is a need to modify the approaches so as to incorporate the complexities of healthcare, and fully exploit the potential for improvement.

Keywords: Management science, management and planning, transforming services, healthcare.

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Authors: Pressca Neging, Rosidah Musa, Rabiah Abdul Wahab

Abstract:

The rapid adoption of Internet has turned the Millennial Teens- life like a lightning speed. Empirical evidence has illustrated that Pathological Internet Use (PIU) among them ensure long-term success to the market players in the children industry. However, it creates concerns among their care takers as it generates mental disorder among some of them. The purpose of this paper is to examine the determinants of PIU and identify its outcomes among urban Millennial Teens. It aims to develop a theoretical framework based on a modified Media System Dependency (MSD) Theory that integrates important systems and components that determine and resulted from PIU.

Keywords: Internet, media system dependency theory, millennial, pathological internet use.

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Authors: Naeleh Motamedi, Masoud Mahmoudkhan Shirazi, Nima Nouraei

Abstract:

Natural disasters, including earthquake, kill many people around the world every year. Society rescue actions, which start after the earthquake and are called LAST in abbreviation, include locating, access, stabilization and transportation. In the present article, we have studied the process of local accessibility to the injured and transporting them to health care centers. With regard the heavy traffic load due to earthquake, the destruction of connecting roads and bridges and the heavy debris in alleys and street, which put the lives of the injured and the people buried under the debris in danger, accelerating the rescue actions and facilitating the accessibilities are of great importance, obviously. Tehran, the capital of Iran, is among the crowded cities in the world and is the center of extensive economic, political, cultural and social activities. Tehran has a population of about 9.5 millions and because of the immigration of people from the surrounding cities. Furthermore, considering the fact that Tehran is located on two important and large faults, a 6 Richter magnitude earthquake in this city could lead to the greatest catastrophe during the entire human history. The present study is a kind of review and a major part of the required information for it, has been obtained from libraries all of the rescue vehicles around the world, including rescue helicopters, ambulances, fire fighting vehicles and rescue boats, and their applied technology, and also the robots specifically designed for the rescue system and the advantages and disadvantages of them, have been investigated. The studies show that there is a significant relationship between the rescue team-s arrival time at the incident zone and the number of saved people; so that, if the duration of burial under debris 30 minutes, the probability of survival is %99.3, after a day is %81, after 2days is %19 and after 5days is %7.4. The exiting transport systems all have some defects. If these defects are removed, more people could be saved each hour and the preparedness against natural disasters is increased. In this study, transport system has been designed for the rescue team and the injured; which could carry the rescue team to the incident zone and the injured to the health care centers. In addition, this system is able to fly in the air and move on the earth as well; so that the destruction of roads and the heavy traffic load could not prevent the rescue team from arriving early at the incident zone. The system also has the equipment required firebird for debris removing, optimum transport of the injured and first aid.

Keywords: earthquake, accelerating, accessibilities transportation, rescue system

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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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Authors: Proud Arunrangsiwed

Abstract:

Crisis management strategies could be found in various curriculums, not only in schools of business, but also schools of communication. Young students, such as freshmen and sophomores of undergraduate schools, may not care about learning crisis management strategies. Moreover, crisis management strategies are not a topic art students are familiar with. The current paper discusses a way to adapt entertainment media into a crisis management lesson, and the importance of learning crisis management strategies in the school of animation. Students could learn crisis management strategies by watching movies with content about a crisis and responding to crisis responding. The students should then participate in follow up discussions related to the strategies that were used to address the crisis, as well as their success in solving the crisis.

Keywords: Situational crisis communication theory, crisis response strategies, media effect, unintentional effect.

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Authors: Rooholah Hasanizadeh, Saadan Zokaei

Abstract:

Energy efficient protocol design is the aim of current researches in the area of sensor networks where limited power resources impose energy conservation considerations. In this paper we care for Medium Access Control (MAC) protocols and after an extensive literature review, two adaptive schemes are discussed. Of them, adaptive-rate MACs which were introduced for throughput enhancement show the potency to save energy, even more than adaptive-power schemes. Then we propose an allocation algorithm for getting accurate and reliable results. Through a simulation study we validated our claim and showed the power saving of adaptive-rate protocols.

Keywords: Adaptive-rate, adaptive-power, MAC protocol, energy efficiency, sensor networks.

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Authors: H. E. Michail, V. N. Thanasoulis, G. A. Panagiotakopoulos, A. P. Kakarountas, C. E. Goutis

Abstract:

In this paper an efficient implementation of Ripemd- 160 hash function is presented. Hash functions are a special family of cryptographic algorithms, which is used in technological applications with requirements for security, confidentiality and validity. Applications like PKI, IPSec, DSA, MAC-s incorporate hash functions and are used widely today. The Ripemd-160 is emanated from the necessity for existence of very strong algorithms in cryptanalysis. The proposed hardware implementation can be synthesized easily for a variety of FPGA and ASIC technologies. Simulation results, using commercial tools, verified the efficiency of the implementation in terms of performance and throughput. Special care has been taken so that the proposed implementation doesn-t introduce extra design complexity; while in parallel functionality was kept to the required levels.

Keywords: Hardware implementation, hash functions, Ripemd-160, security.

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Authors: Roman Knizek, Denisa Karhankova, Ludmila Fridrichova

Abstract:

For their exceptional properties nanofibers, respectively, nanofiber layers are achieving an increasingly wider range of uses. Nowadays nanofibers are used mainly in the field of air filtration where they are removing submicron particles, bacteria, and viruses. Their efficiency is not changed in time, and the power consumption is much lower than that of electrically charged filters. Nanofibers are primarily used for converting and storage of energy in both air and liquid filtration, in food and packaging, protecting the environment, but also in health care which is made possible by their newly discovered properties. However, a major problem of the nanofiber layer is practically zero abrasion resistance; it is, therefore, necessary to laminate the nanofiber layer with another suitable material. Unfortunately, lamination of nanofiber layers is a major problem since the nanofiber layer contains small pores through which it is very difficult for adhesion to pass through. Therefore, there is still only a small percentage of products with these unique fibers 5.

Keywords: Nanofiber layer, nanomembrane, lamination, electrospinning.

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

Abstract:

The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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Authors: Åsa Smedberg

Abstract:

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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