Search results for: patient engagement.

Authors: A. Vassila, D. Kalogeropoulos, R. Rawashdeh, N. Hall, N. Rahman, M. Fabian, S. Thulasidharan, H. Parwez

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Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. This is a retrospective analysis, which examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750 mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications.

Keywords: Scleritis, necrotizing scleritis, scleroderma, autoimmune disease.

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of COVID-19 infection. Understanding novel treatment approaches is important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with VR included. This game-based VR technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with COVID-19 related CVA. The safety of developed instruments for such cases provides approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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Authors: Jiakai Li, Gursel Serpen, Steven Selman, Matt Franchetti, Mike Riesen, Cynthia Schneider

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This paper presents the development of a Bayesian belief network classifier for prediction of graft status and survival period in renal transplantation using the patient profile information prior to the transplantation. The objective was to explore feasibility of developing a decision making tool for identifying the most suitable recipient among the candidate pool members. The dataset was compiled from the University of Toledo Medical Center Hospital patients as reported to the United Network Organ Sharing, and had 1228 patient records for the period covering 1987 through 2009. The Bayes net classifiers were developed using the Weka machine learning software workbench. Two separate classifiers were induced from the data set, one to predict the status of the graft as either failed or living, and a second classifier to predict the graft survival period. The classifier for graft status prediction performed very well with a prediction accuracy of 97.8% and true positive values of 0.967 and 0.988 for the living and failed classes, respectively. The second classifier to predict the graft survival period yielded a prediction accuracy of 68.2% and a true positive rate of 0.85 for the class representing those instances with kidneys failing during the first year following transplantation. Simulation results indicated that it is feasible to develop a successful Bayesian belief network classifier for prediction of graft status, but not the graft survival period, using the information in UNOS database.

Keywords: Bayesian network classifier, renal transplantation, graft survival period, United Network for Organ Sharing

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Authors: Asia Majeed

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This paper will investigate a form of learning mathematics by integrating technology in mathematics specifically for the university first-year calculus class to support students’ engagement in learning which influences students' conceptual and procedural understanding of the calculus content in a better way. The students with good grades in high school calculus generally struggle in first-year university calculus classes in learning mathematical analysis concepts. This problem has to be addressed. If this problem is not resolved, then most likely students with less ability to do mathematics might not able to complete their degrees. In this work, MATLAB is used to help students in learning and in improving calculus concepts.

Keywords: Calculus, first-year university students, teaching strategies, MATLAB.

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Authors: Omar Farshad Jeelani, Makaire Njie, Viktoriia M. Korzhuk

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Recently, the application of AI-powered algorithms in healthcare continues to flourish. Particularly, access to healthcare information, including patient health history, diagnostic data, and PII (Personally Identifiable Information) is paramount in the delivery of efficient patient outcomes. However, as the exchange of healthcare information between patients and healthcare providers through AI-powered solutions increases, protecting a person’s information and their privacy has become even more important. Arguably, the increased adoption of healthcare AI has resulted in a significant concentration on the security risks and protection measures to the security and privacy of healthcare data, leading to escalated analyses and enforcement. Since these challenges are brought by the use of AI-based healthcare solutions to manage healthcare data, AI-based data protection measures are used to resolve the underlying problems. Consequently, these projects propose AI-powered safeguards and policies/laws to protect the privacy of healthcare data. The project present the best-in-school techniques used to preserve data privacy of AI-powered healthcare applications. Popular privacy-protecting methods like Federated learning, cryptography techniques, differential privacy methods, and hybrid methods are discussed together with potential cyber threats, data security concerns, and prospects. Also, the project discusses some of the relevant data security acts/laws that govern the collection, storage, and processing of healthcare data to guarantee owners’ privacy is preserved. This inquiry discusses various gaps and uncertainties associated with healthcare AI data collection procedures, and identifies potential correction/mitigation measures.

Keywords: Data privacy, artificial intelligence, healthcare AI, data sharing, healthcare organizations.

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Authors: Mehran Yazdi, Luc Beaulieu

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Artifact is one of the most important factors in degrading the CT image quality and plays an important role in diagnostic accuracy. In this paper, some artifacts typically appear in Spiral CT are introduced. The different factors such as patient, equipment and interpolation algorithm which cause the artifacts are discussed and new developments and image processing algorithms to prevent or reduce them are presented.

Keywords: CT artifacts, Spiral CT, Artifact removal.

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Authors: Rania Mustafa

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This audit was conducted at Manchester University NHS Foundation Trust, Wythenshawe Hospital Radiology and Accident and Emergency [A&E] Department to assess the appropriateness of clinical information in X-ray requests, specifically in cases of acute ankle injuries. As per the Ottawa Ankle Rules and the recommendations of National Institute for Health and Care Excellence [NICE] and the Royal College of Radiology, we aimed to evaluate the appropriateness of referrals and the thoroughness of clinical information provided by Emergency Department [ED] clinicians for ankle radiography. Our goal was to achieve 100% compliance with these guidelines. The audit involved a comprehensive analysis spanning the period from August 2022 to January 2023, encompassing patient records, radiographic orders, and clinical assessments. Data collection included patient demographics, presenting complaints, clinical assessments, adherence to Ottawa Ankle Rules criteria, and subsequent radiography orders. Here we conducted two audit cycles, involving 38 patients in the first cycle and 86 patients in the second cycle. The data were furtherly filtered to include all patients who were referred from the ED for an ankle Xray with a history of acute trauma and age of more than 18 years. The key finding was that in August 2022, 60% of cases met the Ottawa Ankle Rules criteria accurately, indicating a need for improvement in adherence. However, by January 2023, there was a notable improvement, with 95% of cases accurately meeting the criteria. This significant change reflects an increased alignment with best practices for ankle radiography referrals.

Keywords: Ankle, injuries, Ottawa Ankle Rule, X-rays.

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Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires were returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge; however, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: Gene Profiling, Knowledge, Malaysia, Physician.

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Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

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Dealing with emerging cases of dental malpractice with justifications that stem from the clear rules of dental ethics is a phenomenon with an increasing trend in today's dental practice. Dentists should clearly understand how far the limit of malpractice goes, with or without minimal or major consequences, for the affected patient, which can be justified as a complication of dental treatment, in support of the rules of dental ethics in the dental office. Indeed, malpractice can occur in cases of lack of professionalism, but it can also come as a consequence of anatomical and physiological limitations in the implementation of the dental protocols, predetermined and indicated by the patient in the paragraph of the treatment plan in his personal card. Let this article serve as a short communication between readers and interested parties about the problems that dental malpractice can bring to the community. Malpractice should not be seen only as a professional wrong approach, but also as a phenomenon that can occur during dental practice. The aim of this article is presentation of the latest data published in the literature about malpractice. The combination of keywords is done in such a way with the aim to give the necessary space for collecting the right information in the networks of publications about this field, always first from the point of view of the dentist and not from that of the lawyer or jurist. From the findings included in this article, it was noticed that the diversity of approaches towards the phenomenon depends on the different countries based on the legal basis that these countries have. There is a lack of or a small number of articles that touch on this topic, and these articles are presented with a limited amount of data on the same topic. Dental malpractice should not be hidden under the guise of various dental complications that we justify with the strict rules of ethics for patients treated in the dental chair. The individual experience of dental malpractice must be published with the aim of serving as a source of experience for future generations of dentists.

Keywords: Dental ethics, malpractice, professional protocol, random deviation, dental tourism.

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Authors: Nor Aziati Abdul Hamid, Rajeev SuberamanyNor Aziati Abdul Hamid, Rajeev Suberamany

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Higher education institutions are increasingly opting to outsourcing methods in order to sustain themselves and this creates a gap of literature in terms of how they perceive the relationship. This research paper attempts to identify the behavioral and psychological factors that exist in the engagement thus providing valuable information to practicing and potential clients, and vendors. The determinants were gathered from previous literatures and analyzed to formulate the factors. This study adopts the case study and survey approaches in which interviews and questionnaires are deployed on employees of IT-related department in a Malaysian higher education institution.

Keywords: Higher education institution, information technology, outsourcing, relationship

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Authors: Said C. Fares, Mary A. Fares

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It is well documented that introductory computer programming courses are difficult and that failure rates are high. The aim of this project was to reduce the high failure and withdrawal rates in learning to program. This paper presents a number of changes in module organization and instructional delivery system in teaching CS1. Daily out of class help sessions and tutoring services were applied, interactive lectures and laboratories, online resources, and timely feedback were introduced. Five years of data of 563 students in 21 sections was collected and analyzed. The primary results show that the failure and withdrawal rates were cut by more than half. Student surveys indicate a positive evaluation of the modified instructional approach, overall satisfaction with the course and consequently, higher success and retention rates.

Keywords: Failure Rate, Interactive Learning, Student engagement, CS1.

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: Alcohol screening, AUDIT-C, CAGE, Hazardous drinking.

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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: Conradie, P.W., Lombard, A., Moller, M.

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The dramatic effect of information technology on society is undeniable. In education, it is evident in the use of terms like active learning, blended learning, electronic learning and mobile learning (ubiquitous learning). This study explores the perceptions of 54 learners in a higher education institution regarding the use of mobile devices in a third year module. Using semi-structured interviews, it was found that mobile devices had a positive impact on learner motivation, engagement and enjoyment. It also improved the consistency of learning material, and the convenience and flexibility (anywhere, anytime) of learning. User-interfacelimitation, bandwidth and cognitive overload, however, were of concern. The use of cloud based resources like Youtube and Google Docs, through mobile devices, positively influenced learner perceptions, making them prosumers (both consumers and producers) of education content.

Keywords: Active learning, education, mobile learning, pedagogy.

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Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Ahmed A. Khamis, Abeer Kharshid, Nor Azizah Aziz

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The effect of statins dose intensity (SDI) on glycemic control in patients with existing diabetes is unclear. Also, there are many contradictory findings were reported in the literature; thus, it is limiting the possibility to draw conclusions. This project was designed to compare the effect of SDI on glycated hemoglobin (HbA1c%) control in outpatients with Type 2 diabetes in the endocrine clinic at Hospital Pulau Pinang, Malaysia, between July 2015 and August 2016. A prospective cohort study was conducted, where records of 345 patients with Type 2 diabetes (Moderate-SDI group 289 patients and high-SDI cohort 56 patients) were reviewed to identify demographics and laboratory tests. The target of glycemic control (HbA1c < 7% for patient < 65 years, and < 8% for patient ≥ 65 years) was estimated, and the results were presented as descriptive statistics. From 289 moderate-SDI cohorts with a mean age of 57.3 ± 12.4 years, only 86 (29.8%) cases were shown to have controlled glycemia, while there were 203 (70.2%) cases with uncontrolled glycemia with confidence interval (CI) of 95% (6.2–10.8). On the other hand, the high-SDI group of 56 patients with Type 2 diabetes with a mean age 57.7±12.4 years is distributed among 11 (19.6%) patients with controlled diabetes, and 45 (80.4%) of them had uncontrolled glycemia, CI: 95% (7.1–11.9). The study has demonstrated that the relative risk (RR) of uncontrolled glycemia in patients with Type 2 diabetes that used high-SDI is 1.15, and the excessive relative risk (ERR) is 15%. The absolute risk (AR) is 10.2%, and the number needed to harm (NNH) is 10. Outpatients with Type 2 diabetes who use high-SDI of statin have a higher risk of uncontrolled glycemia than outpatients who had been treated with a moderate-SDI.

Keywords: Cohort study, diabetes control, dose intensity, HbA1c, Malaysia, statin, Type 2 diabetes mellitus, uncontrolled glycemia.

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Authors: Fahad Shahbaz Khan, Rao Muhammad Anwer, Olof Torgersson

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The vast amount of information hidden in huge databases has created tremendous interests in the field of data mining. This paper examines the possibility of using data clustering techniques in oral medicine to identify functional relationships between different attributes and classification of similar patient examinations. Commonly used data clustering algorithms have been reviewed and as a result several interesting results have been gathered.

Keywords: Oral Medicine, Cluto, Data Clustering, Data Mining.

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Authors: M. K. Zholdassova, G. Matthews, A. M. Kustubayeva, S. M. Jakupov

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The aim of this study was to test whether the Attention Networks Test (ANT) showed temporal decrements in performance. Vigilance tasks typically show such decrements, which may reflect impairments in executive control resulting from cognitive fatigue. The ANT assesses executive control, as well as alerting and orienting. Thus, it was hypothesized that ANT executive control would deteriorate over time. Manipulations including task condition (trial composition) and masking were included in the experimental design in an attempt to increase performance decrements. However, results showed that there is no temporal decrement on the ANT. The roles of task demands, cognitive fatigue and participant motivation in producing this result are discussed. The ANT may not be an effective tool for investigating temporal decrement in attention.

Keywords: ANT, executive control, task engagement, vigilancedecrement

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Authors: N.B. Adams

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This article discusses the concept of student ownership of knowledge and seeks to determine how to move students from knowledge acquisition to knowledge application and ultimately to knowledge generation in a virtual setting. Instructional strategies for fostering student engagement in a virtual environment are critical to the learner-s strategic ownership of the knowledge. A number of relevant theories that focus on learning, affect, needs and adult concerns are presented to provide a basis for exploring the transfer of knowledge from teacher to learner. A model under development is presented that combines the dimensions of knowledge approach, the teacher-student relationship with regards to knowledge authority and teaching approach to demonstrate the recursive and scaffolded design for creation of virtual learning environments.

Keywords: Virtual learning environments, learning theory, teaching model, online learning.

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Authors: Valentina Piric, Maja Martinovic, Zoran Barac

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The application of marketing to the domain of politics has become relevant in recent times. With this article the authors wanted to explore the issue of the current political engagement among young people in Croatia. The question is what makes young people (age 18-30) politically active in young democracies such as that of the Republic of Croatia. Therefore, the objective of this study was to discover the real or hidden motivations behind the decision to actively participate in politics among young members of the two largest political parties in the country – the Croatian Democratic Union and the Social Democratic Party of Croatia. The study expected to find that the motivation for political engagement of young people is often connected with a possible achievement of individual goals and egoistic needs such as: self-acceptance, social success, financial success, prestige, reputation, status, recognition from the others etc. It was also expected that, due to the poor economic and social situation in the country, young people feel an increasing disconnection from politics. Additionally, the authors expected to find that there is a huge potential to engage young people in the political life of the country through a proper and more interactive use of marketing communication campaigns and social media platforms, with an emphasis on highly ethical motives of political activity and their benefits to society. All respondents included in the quantitative survey (sample size [N=100]) are active in one of the two largest political parties in Croatia. The sampling and distribution of the survey occurred in the field in September 2016. The results of the survey demonstrate that in Croatia, the way young people feel about politics and act accordingly, are in fact similar to what the theory describes. The research findings reveal that young people are politically active; however, the challenge is to find a way to motivate even more young people in Croatia to actively participate in the political and democratic processes in the country and to encourage them to see additional benefits out of this practice, not only related to their individual motives, but related more to the well-being of Croatia as a country and of every member of society. The research also discovered a huge potential for political marketing communication possibilities, especially related to interactive social media. It is possible that the social media channels have a stronger influence on the decision-making process among young people when compared to groups of reference. The level of interest in politics among young Croatians varies; some of them are almost indifferent, whilst others express a serious interest in different ways to actively contribute to the political life of the country, defining a participation in the political life of their country almost as their moral obligation. However, additional observations and further research need to be conducted to get a clearer and more precise picture about the interest in politics among young people in Croatia and their social potential.

Keywords: Croatia, marketing communication, motivation, politics, young people.

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Authors: P. Murphy, D. Vasic, A. W. Gunaratne, T. Tugonon, M. Ison, C. Pagonis, E. T. Sitchon, A. Le Busque, T. J. Borody

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Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by an alteration in bowel movements. There are three different types of IBS: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). Antimicrobials are increasingly being used as treatment for all types of IBS. Due to this increased use and subsequent success, the gut microbiome as a factor in the etiology of IBS is becoming more apparent. Accepted standard treatment has focused on IBS-C and involves either vancomycin or rifaximin. Here, we report on a cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients were aged between 24-74 years (mean 44 years) and nine were female. At baseline all patients had diarrhea, four with mucus and one with blood. Other reported symptoms include abdominal pain (n = 11) bloating (n = 9), flatulence (n = 7), fatigue (n = 4) and nausea (n = 3). Patient’s treatments were personalized according to their symptom severity and tolerability and were treated with a combination of rifaximin (500-3000 mg/d) and vancomycin (500 mg-1500 mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks. Of all patients, 89% reported improvement of at least 1 symptom, one reported no change and one patient’s symptoms got worse. The success of this combination treatment could be due to the different mechanisms of action undertaken by each medication. Vancomycin works by inhibiting the cell wall of the bacteria and rifaximin by inhibiting protein synthesis. This success in treatment validates the idea that IBS-D may be driven by a bacterial infection of the gastrointestinal microbiome. As IBS-D presents similarly to Clostridium difficile and symptom improvement can occur with the same treatment as Clostridium difficile of rifaximin and vancomycin, there is reason to suggest that the infectious agent could be an unidentified strain of Clostridium. Although these results offer some validity to the theory, more research is required.

Keywords: Clostridium difficile infection, diarrhea predominant irritable bowel syndrome, microbiome, vancomycin/rifaximin combination.

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Authors: S. S. Ngu, L. C. Kho, T. P. Tan, M. S. Osman

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This work deals with the design of the robotic assembly system for the roller clamps. The task is characterized by high speed, high yield and safety engagement. This paper describes the design of different parts of an automated high speed machine to assemble the parts of roller clamps. The roller clamp robotic assembly system performs various processes in the assembly line which include clamp body and roller feeding, inserting the roller into the clamp body, and dividing the rejected clamp and successfully assembled clamp into their own tray. The electrical/electronics design of the machine is discussed. The target is to design a cost effective, minimum maintenance and high speed machine for the industry applications.

Keywords: Machine design, assembly machine, roller clamp, industry applications.

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Authors: Irene Winkler, Mark Jager, Vojkan Mihajlovic, Tsvetomira Tsoneva

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In this work we evaluate the possibility of predicting the emotional state of a person based on the EEG. We investigate the problem of classifying valence from EEG signals during the presentation of affective pictures, utilizing the "frontal EEG asymmetry" phenomenon. To distinguish positive and negative emotions, we applied the Common Spatial Patterns algorithm. In contrast to our expectations, the affective pictures did not reliably elicit changes in frontal asymmetry. The classifying task thereby becomes very hard as reflected by the poor classifier performance. We suspect that the masking of the source of the brain activity related to emotions, coming mostly from deeper structures in the brain, and the insufficient emotional engagement are among main reasons why it is difficult to predict the emotional state of a person.

Keywords: Emotion, Valence, EEG, Common Spatial Patterns(CSP).

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Authors: Erisasadat Sahebzamani, Núria Forcada, Francisco Lendinez

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Global climate change has become increasingly problematic over the past few decades. The construction industry has contributed to greenhouse gas emissions in recent decades. Considering these issues and the high demand for materials in the construction industry, Circular Economy (CE) is considered necessary to keep materials in the loop and extend their useful lives. By providing tangible benefits, Construction 4.0 facilitates the adoption of CE by reducing waste, updating standard work, sharing knowledge, and increasing transparency and stability. This study aims to present a framework for integrating CE and digital tools like Building Information Modeling (BIM) and Virtual Reality (VR) to examine the impact on the construction industry based on stakeholders' perspectives.

Keywords: Circular Economy, Building Information Modeling, Virtual Reality, stakeholder engagement.

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Authors: Lynn. J. MacFarlane. A

Abstract:

Within the healthcare system, training and continued professional development although essential, can be effected by cost and logistical restraints due to the nature of healthcare provision e.g employee shift patterns, access to expertise, cost factors in releasing staff to attend training etc. The use of multimedia technology for the development of e-learning applications is also a major cost consideration for healthcare management staff, and this type of media whether optical or on line requires careful planning in order to remain inclusive of all staff with potentially varied access to multimedia computing. This paper discusses a project in which the use of DVD authoring technology has been successfully implemented to meet the needs of distance learning and user considerations, and is based on film production techniques and reduced product turnaround deadlines.

Keywords: DVD, healthcare, distance learning, cost.

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Authors: Sayantan Khanra, Rojers P. Joseph

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This study attempts to analyze the impact of demography and service quality on the adoption and diffusion of e-Government services in the context of India. The objective of this paper is to study the users' perception about e-Government services and investigate the key variables that are most salient to the Indian populace. At the completion of this study, a research model that would help to understand the relationship involving the demographic variables and service quality dimensions, and the willingness to adopt e-Government services is expected to be developed. Dedicated authorities, particularly those in developing economies, may use that model or its augmented versions to design and update e-Government services and promote their use among citizens. After all, enhanced public participation is required to improve efficiency, engagement and transparency in the implementation of the aforementioned services.

Keywords: Adoption and diffusion of e-Government services, demographic variables, hierarchical regression analysis, service quality dimensions.

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Authors: Lynette Drevin, Günther R. Drevin

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Numerous threats have been identified when using social networks. The question is whether young people are aware of these negative impacts of online and mobile technologies. Will they identify threats when needed? Will they know where to get help? Students and school children were part of a survey where their behavior and use of Facebook and an instant messaging application - MXit were studied. This paper presents some of the results. It can be concluded that awareness on security and privacy issues should be raised. The benefit of doing such a survey is that it may help to direct educational efforts from a young age. In this way children – with their parents – can strive towards more secure behavior. Educators can focus their lessons towards the areas that need attention resulting in safer cyber interaction and ultimately more responsible online use.

Keywords: Facebook, Instant messaging, MXit, Privacy, Social networks Information Security awareness education, Trust.

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Authors: Byron Malaela Sotiata Seiuli

Abstract:

Sexual violation is any form of sexual violence, including rape, child molestation, incest, and similar forms of non-consensual sexual contact. Much of these acts of violation are perpetuated, but not entirely, by men against women and children. Moetolo is a Samoan term that is used to describe a person who sexually violates another while they or their family are asleep. This paper presents and discusses sexual abuse from a Samoan viewpoint. Insights are drawn from the authors’ counseling engagement with a Samoan sex offender as part of his probation review process. Relevant literature is also engaged to inform and provide interpretation to the therapeutic work carried out. This article seeks to contribute new understanding to patterned responses of some Samoan people to sexual abuse behaviors, and steps to remedy arising concerns with perpetrators seeking reintegration back into their communities.

Keywords: Fa’asamoa, Samoan cultural identity, sexual abuse and recovery, Uputāua therapeutic approach.

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Authors: Sheng-Chi Tseng, Der-Ming Liou

Abstract:

The health record in the Electronic Health Record (EHR) system is more sensitive than demographic. It raises the important issue for the EHR requirement in privacy, security, audit trail, patient access, and archiving and data retention. The studies about the EHR system security are deficient. The aim of this study is to build a security environment for the EHR system by Integrating the Healthcare Enterprise (IHE) Audit Trail and Node Authentication Security (ATNA) profile. The CDAs can be access in a secure EHR environment.

Keywords: IHE ATNA, EHR security.

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Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

Abstract:

In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: Early stage prediction, heart rate variability, linear and non linear analysis, sudden cardiac death.

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