Search results for: Medical tourism

Authors: Nahla Ibraheem Jabbar, Monica Mehrotra

Abstract:

This paper used a fuzzy kohonen neural network for medical image segmentation. Image segmentation plays a important role in the many of medical imaging applications by automating or facilitating the diagnostic. The paper analyses the tumor by extraction of the features of (area, entropy, means and standard deviation).These measurements gives a description for a tumor.

Keywords: FCM, features extraction, medical image processing, neural network, segmentation.

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Authors: Mannan Mridha, Mohammad S. Islam

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

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

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Authors: R. Talebi, A. Abdel-Dayem, J. Johnson

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Three-dimensional reconstruction of small objects has been one of the most challenging problems over the last decade. Computer graphics researchers and photography professionals have been working on improving 3D reconstruction algorithms to fit the high demands of various real life applications. Medical sciences, animation industry, virtual reality, pattern recognition, tourism industry, and reverse engineering are common fields where 3D reconstruction of objects plays a vital role. Both lack of accuracy and high computational cost are the major challenges facing successful 3D reconstruction. Fringe projection has emerged as a promising 3D reconstruction direction that combines low computational cost to both high precision and high resolution. It employs digital projection, structured light systems and phase analysis on fringed pictures. Research studies have shown that the system has acceptable performance, and moreover it is insensitive to ambient light. This paper presents an overview of fringe projection approaches. It also presents an experimental study and implementation of a simple fringe projection system. We tested our system using two objects with different materials and levels of details. Experimental results have shown that, while our system is simple, it produces acceptable results.

Keywords: Digital fringe projection, 3D reconstruction, phase unwrapping, phase shifting.

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Authors: J. Mehena, M. C. Adhikary

Abstract:

In this paper, a spatial multiple-kernel fuzzy C-means (SMKFCM) algorithm is introduced for segmentation problem. A linear combination of multiples kernels with spatial information is used in the kernel FCM (KFCM) and the updating rules for the linear coefficients of the composite kernels are derived as well. Fuzzy cmeans (FCM) based techniques have been widely used in medical image segmentation problem due to their simplicity and fast convergence. The proposed SMKFCM algorithm provides us a new flexible vehicle to fuse different pixel information in medical image segmentation and detection of MR images. To evaluate the robustness of the proposed segmentation algorithm in noisy environment, we add noise in medical brain tumor MR images and calculated the success rate and segmentation accuracy. From the experimental results it is clear that the proposed algorithm has better performance than those of other FCM based techniques for noisy medical MR images.

Keywords: Clustering, fuzzy C-means, image segmentation, MR images, multiple kernels.

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Authors: B. Stroetmann, A. Aisenbrey

Abstract:

The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: Bilingual, English, medicine, doctor.

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Authors: T. Gotoh, T. Takayama, M. Ishiki, T. Ikeda

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Recently, majors of doctors are divided into terribly lots of detailed areas. However, it is actually not a rare case that a doctor has a patient who is not in his/her major. He/She must judge an assessment and make a medical treatment plan for this patient. According to our investigation, conventional approaches such as image diagnosis cooperation are insufficient. This paper proposes an 'Assessment / Medical Treatment Plan Consulting System'. We have implemented a pilot system based on our proposition. Its effectiveness is clarified by an evaluation.

Keywords: Application, computational intelligence and telecommunications, medicine, intelligent systems.

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Authors: M. McHugh, D. Lillis

Abstract:

Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: Medical, mobile, applications, software Engineering, FDA, standards, regulations, agile.

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Authors: Manar AlJazzazi, Mohammed Rawashdeh, Tariq Alshawaheen, Aktham Malkawi

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This paper is a part of research, in which the way the biomedical engineers follow in their work is analyzed. The goal of this paper is to present a method for specification of user requirements in the medical devices maintenance process. Data Gathering Methods, Research Model Phases and Descriptive Analysis is presented. These technology and verification rules can be implemented in Medical devices maintenance management process to the maintenance process.

Keywords: Quality Function Deployment (QFD), User - requirements approach.

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Authors: HaeNa Lee, Sun K. Yoo

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Volume rendering is widely used in medical CT image visualization. Applying 3D image visualization to diagnosis application can require accurate volume rendering with high resolution. Interpolation is important in medical image processing applications such as image compression or volume resampling. However, it can distort the original image data because of edge blurring or blocking effects when image enhancement procedures were applied. In this paper, we proposed adaptive tension control method exploiting gradient information to achieve high resolution medical image enhancement in volume visualization, where restored images are similar to original images as much as possible. The experimental results show that the proposed method can improve image quality associated with the adaptive tension control efficacy.

Keywords: Tension control, Interpolation, Ray-casting, Medical imaging analysis.

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Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang

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Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.

Keywords: Acute hepatitis, Medical resource cost, Artificial neural network, Support vector regression.

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

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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: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: Malpractice mediation, medical disputes, reconciliation, health litigation, Turkish Health Law.

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Authors: Panos Kotsas

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This paper presents the application of a signal intensity independent registration criterion for non-rigid body registration of medical images. The criterion is defined as the weighted ratio image of two images. The ratio is computed on a voxel per voxel basis and weighting is performed by setting the ratios between signal and background voxels to a standard high value. The mean squared value of the weighted ratio is computed over the union of the signal areas of the two images and it is minimized using the Chebyshev polynomial approximation. The geometric transformation model adopted is a local cubic B-splines based model.

Keywords: Medical image, non-rigid, registration.

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Authors: Cristina G. Dascâlu, Corina Dima Cozma, Elena Carmen Cotrutz

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The medical data statistical analysis often requires the using of some special techniques, because of the particularities of these data. The principal components analysis and the data clustering are two statistical methods for data mining very useful in the medical field, the first one as a method to decrease the number of studied parameters, and the second one as a method to analyze the connections between diagnosis and the data about the patient-s condition. In this paper we investigate the implications obtained from a specific data analysis technique: the data clustering preceded by a selection of the most relevant parameters, made using the principal components analysis. Our assumption was that, using the principal components analysis before data clustering - in order to select and to classify only the most relevant parameters – the accuracy of clustering is improved, but the practical results showed the opposite fact: the clustering accuracy decreases, with a percentage approximately equal with the percentage of information loss reported by the principal components analysis.

Keywords: Data clustering, medical data, principal components analysis.

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Authors: Young Kuen Cho, Dae Won Lee, Young-Jin Jung, Sung Kuk Kim, Dong-Hyun Seo, Chang-Yong Ko, Han Sung Kim

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Many medical devices are driven by motor pumps. Some researchers reported that the vibration mainly affected medical devices using a motor pump. The purpose of this study was to examine the effect of stiffness and damping coefficient in a 3-dimensional (3D) model of a motor pump and spring. In the present paper, experimental and mathematical tests for the moments of inertia of the 3D model and the material properties were investigated by an INSTRON machine. The response surfaces could be generated by using 3D multi-body analysis and the design of experiment method. It showed that differences in contours of the response surface were clearly found for the particular area. Displacement of the center of the motor pump was decreased at K≈2000 N/M, C≈12.5 N-sec/M. However, the frequency was increased at K≈2000 N/M, C≈15 N-sec/M. In this study, this study suggested experimental technique for vibration reduction for a motor pump in medical device. The combined method suggested in this study will greatly contribute to design of medical devices concerning vibration and noise intervention.

Keywords: Motor pump, Spring, Vibration reduction, Medicaldevices, Moment of Inertia

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Authors: S. Moein, S. A. Monadjemi, P. Moallem

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In this paper, application of artificial neural networks in typical disease diagnosis has been investigated. The real procedure of medical diagnosis which usually is employed by physicians was analyzed and converted to a machine implementable format. Then after selecting some symptoms of eight different diseases, a data set contains the information of a few hundreds cases was configured and applied to a MLP neural network. The results of the experiments and also the advantages of using a fuzzy approach were discussed as well. Outcomes suggest the role of effective symptoms selection and the advantages of data fuzzificaton on a neural networks-based automatic medical diagnosis system.

Keywords: Artificial Neural Networks, Fuzzy Logic, MedicalDiagnosis, Symptoms, Fuzzification.

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Authors: Shadrack Mambo, Karim Djouani, Yskandar Hamam, Barend van Wyk, Patrick Siarry

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This paper discusses the current trends in medical image registration techniques and addresses the need to provide a solid theoretical foundation for research endeavours. Methodological analysis and synthesis of quality literature was done, providing a platform for developing a good foundation for research study in this field which is crucial in understanding the existing levels of knowledge. Research on medical image registration techniques assists clinical and medical practitioners in diagnosis of tumours and lesion in anatomical organs, thereby enhancing fast and accurate curative treatment of patients. Literature review aims to provide a solid theoretical foundation for research endeavours in image registration techniques. Developing a solid foundation for a research study is possible through a methodological analysis and synthesis of existing contributions. Out of these considerations, the aim of this paper is to enhance the scientific community’s understanding of the current status of research in medical image registration techniques and also communicate to them, the contribution of this research in the field of image processing. The gaps identified in current techniques can be closed by use of artificial neural networks that form learning systems designed to minimise error function. The paper also suggests several areas of future research in the image registration.

Keywords: Image registration techniques, medical images, neural networks, optimisation, transformation.

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Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria

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In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.

Keywords: Healthcare for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device.

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Authors: Manal Rauf

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Trained medical practitioners are produced from medical colleges serving in public and private sectors. Prime responsibility of teaching faculty is to inculcate required work ethic among the students by serving as role models for them. It is an observed fact that classroom incivility behaviours are providing a friction in achieving these targets. Present study aimed at identification of classroom incivility behaviours observed by teachers and students of public and private medical colleges as per Glasser’s Choice Theory, making a comparison and investigating the strategies being adopted by teachers of both sectors to control undesired class room behaviours. Findings revealed that a significant difference occurs between teacher and student incivility behaviours. Public sector teacher focussed on survival as a strong factor behind in civil behaviours whereas private sector teachers considered power as the precedent for incivility. Teachers of both sectors are required to use verbal as well as non-verbal immediacy to reach a healthy leaning environment.

Keywords: Classroom incivility behaviour, Glasser choice theory, Mehrabian immediacy theory, medical student.

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Authors: Rita C. Ramos

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Medical Surgical Nursing is one of the major subjects in nursing. This study examined the validity and reliability of the achievement examination utilizing the Classical Test Theory and Item Response Theory. The study answered the following objectives specifically : ( a) To establish the validity and reliability of the achievement examination utilizing Classical Test Theory and Item Response Theory ; ( b ) To determine the dimensionality measure of items and ( c ) to compare the item difficulty and item discrimination of the Medical Surgical Nursing Achievement examination using Classical Test Theory ( CTT ) and Item Response Theory ( IRT ). The developed instrument was administered to fourth year nursing students (N= 136) of a private university in Manila. The findings yielded the following results: The achievement examination is reliable both using CTT and IRT. The findings indicate person and item statistics from two frameworks are quite alike. The achievement examination formed a unidimensional construct.

Keywords: Achievement Examination, Item Response Theory, Medical Surgical, Nursing.

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Authors: A. Halim Sahelan, Mohd Halid Abu, Jamaluddin Hashim, Zulisman Maksom, Mohd Afif Md Nasir

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This study aims to assess the students' needs for the tour planning e-guide. The study is developing on the contribution and importance of the Educational Tour Planning Guide (ETP) is a multimedia course ware as one of the effective methods in teaching and learning of environmental science among the students in primary schools of the Ministry of Education, Malaysia. It is to provide the student with knowledge and experience about tourism, environmental science activities and process. E-guide to ETP also hopes to strengthen the student understanding toward the subject learn in the tourism environmental science. In order to assess the student's needs on the e-Guide to Educational Tour Planning in Environmental Science, the study has produced a similar e-Guide to ETP in the form as a course ware to be tested during the study. The study has involved several steps in order to be completed. It is such as the formulation of the problem, the review of the literature, the formulation of the study methodology, the production of the e-Guide to ETP, field survey and finally the analyses and discussion made on the data gathered during the study. The survey has involved 100 respondents among the students in standard six primary schools in Kluang Johor. Through the findings, the study indicates that the current tested product is acceptable among the students in learning environmental science as a guide to plan for the tour. The findings also show a slight difference between the respondents who are using the e-Guide to ETP, and those who are not on the basis of the e-Guide to ETP results. Due the important for the study, the researcher hopes to be having a fair discussion and excellence, recommendation for the development of the product of the current study. This report is written also important to provide a written reference for the future related study.

Keywords: Tour planning e-guide, educational tour planning guide, environmental science, multimedia course ware.

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Authors: M. Das Gupta, S. Banerjee

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Content Based Image Retrieval (CBIR) coupled with Case Based Reasoning (CBR) is a paradigm that is becoming increasingly popular in the diagnosis and therapy planning of medical ailments utilizing the digital content of medical images. This paper presents a survey of some of the promising approaches used in the detection of abnormalities in retina images as well in mammographic screening and detection of regions of interest in MRI scans of the brain. We also describe our proposed algorithm to detect hard exudates in fundus images of the retina of Diabetic Retinopathy patients.

Keywords: Case based reasoning, Exudates, Retina image, Similarity based retrieval.

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Authors: Gurung S., Yadav B. N., Budhathoki SS.

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Problem based learning is one of the highly acclaimed learning methods in medical education since its first introduction at Mc-Master University in Canada in the 1960s. It has now been adopted as a teaching learning method in many medical colleges of Nepal. B.P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university is the second institute in Nepal to establish problem-based learning academic program and need-based teaching approach hence minimizing teaching through lectures since its inception. During the first two years of MBBS course, the curriculum is divided into various organ-systems incorporated with problem-based learning exercise each of one week duration.

Keywords: PBL, medical education.

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Authors: Sangita Pokhrel, Nalinda Somasiri, Rebecca Jeyavadhanam, Swathi Ganesan

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Tourism is a booming industry with huge future potential for global wealth and employment. There are countless data generated over social media sites every day, creating numerous opportunities to bring more insights to decision-makers. The integration of big data technology into the tourism industry will allow companies to conclude where their customers have been and what they like. This information can then be used by businesses, such as those in charge of managing visitor centres or hotels, etc., and the tourist can get a clear idea of places before visiting. The technical perspective of natural language is processed by analysing the sentiment features of online reviews from tourists, and we then supply an enhanced long short-term memory (LSTM) framework for sentiment feature extraction of travel reviews. We have constructed a web review database using a crawler and web scraping technique for experimental validation to evaluate the effectiveness of our methodology. The text form of sentences was first classified through VADER and RoBERTa model to get the polarity of the reviews. In this paper, we have conducted study methods for feature extraction, such as Count Vectorization and Term Frequency – Inverse Document Frequency (TFIDF) Vectorization and implemented Convolutional Neural Network (CNN) classifier algorithm for the sentiment analysis to decide if the tourist’s attitude towards the destinations is positive, negative, or simply neutral based on the review text that they posted online. The results demonstrated that from the CNN algorithm, after pre-processing and cleaning the dataset, we received an accuracy of 96.12% for the positive and negative sentiment analysis.

Keywords: Counter vectorization, Convolutional Neural Network, Crawler, data technology, Long Short-Term Memory, LSTM, Web Scraping, sentiment analysis.

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Authors: G. Gürsel, K. H. Gülkesen, N. Zayim, A. Arifoğlu, O. Saka

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User satisfaction is one of the most used success indicators in the research of information system (IS). Literature shows user expectations have great influence on user satisfaction. Both expectation and satisfaction of users are important for Hospital Information Systems (HIS). Education, IS experience, age, attitude towards change, business title, sex and working unit of the hospital, are examined as the potential determinant of the medical users’ expectations. Data about medical user expectations are collected by the “Expectation Questionnaire” developed for this study. Expectation data are used for calculating the Expectation Meeting Ratio (EMR) with the evaluation framework also developed for this study. The internal consistencies of the answers to the questionnaire are measured by Cronbach´s Alpha coefficient. The multivariate analysis of medical user’s EMRs of HIS is performed by forward stepwise binary logistic regression analysis. Education and business title is appeared to be the determinants of expectations from HIS.

Keywords: Evaluation, Fuzzy Logic, Hospital Information System, User Expectation.

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Authors: P. Prudtikul, S. Pathomsiri

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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: Cleto J. Sauer Jr

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Introduction: Brazil’s new national curriculum guidelines (NCG) for medical education were published in 2014, presenting active learning methodologies as a cornerstone. Simulation was initially applied for aviation pilots’ training and is currently applied in health sciences. The high-fidelity simulator replicates human body anatomy in detail, also reproducing physiological functions and its use is increasing in medical schools. Realistic Simulation (RS) has pedagogical aspects that are aligned with Brazil’s NCG teaching concepts. The main objective of this study is to carry on a narrative review on RS’s aspects that are aligned with Brazil’s new NCG teaching concepts. Methodology: A narrative review was conducted, with search in three databases (PubMed, Embase and BVS) of studies published between 2010 and 2020. Results: After systematized search, 49 studies were selected and divided into four thematic groups. RS is aligned with new Brazilian medical curriculum as it is an active learning methodology, providing greater patient safety, uniform teaching, and student's emotional skills enhancement. RS is based on reflective learning, a teaching concept developed for adult’s education. Conclusion: RS is a methodology aligned with NCG teaching concepts and has potential to assist in the implementation of new Brazilian medical school’s curriculum. It is an immersive and interactive methodology, which provides reflective learning in a safe environment for students and patients.

Keywords: Curriculum, high-fidelity simulator, medical education, realistic simulation.

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Authors: Y. Y. Su, K. T. Win, H. C. Chiu

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This study used Item Analysis, Exploratory Factor Analysis (EFA) and Reliability Analysis (Cronbach-s α value) to exam the Questions which selected by the Delphi method based on the issue of “Socio-technical system (STS)" and user-centered perspective. A structure questionnaire with seventy-four questions which could be categorized into nine dimensions (healthcare environment, organization behaviour, system quality, medical data quality, service quality, safety quality, user usage, user satisfaction, and organization net benefits) was provided to evaluate EMR of the Taiwanese healthcare environment.

Keywords: Instrument development, Reliability test, Validity test, Electronic Medical Record Evaluation.

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Authors: Siau-Chuin Liew, Siau-Way Liew, Jasni Mohd Zain

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Digital watermarking in medical images can ensure the authenticity and integrity of the image. This design paper reviews some existing watermarking schemes and proposes a reversible tamper detection and recovery watermarking scheme. Watermark data from ROI (Region Of Interest) are stored in RONI (Region Of Non Interest). The embedded watermark allows tampering detection and tampered image recovery. The watermark is also reversible and data compression technique was used to allow higher embedding capacity.

Keywords: data compression, medical image, reversible, tamperdetection and recovery, watermark.

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