Search results for: Physician.

Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

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

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

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Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: Health management, Internet of Health Things, remote monitoring, senior patient.

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Authors: K. Amudha, C. Nelson Kennedy Babu, S. Balu

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The security of the medical images and its related data is the major research area which is to be concentrated in today’s era. Security in the medical image indicates that the physician may hide patients’ related data in the medical image and transfer it safely to a defined location using reversible watermarking. Many reversible watermarking methods had proposed over the decade. This paper enhances the security level in brain tumor images to hide the patient’s detail, which has to be conferred with other physician’s suggestions. The details or the information will be hidden in Non-ROI area of the image by using the block cipher algorithm. The block cipher uses different keys to extract the details that are difficult for the intruder to detect all the keys and to spot the details, which are the key advantage of this method. The ROI is the tumor area and Non-ROI is the area rest of ROI. The Non-ROI should not be spoiled in any cause and the details in the Non-ROI should be extracted correctly. The reversible watermarking method proposed in this paper performs well when compared to existing methods in the process of extraction of an original image and providing information security.

Keywords: Brain tumor images, Block Cipher, Reversible watermarking, ROI.

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Authors: Marina Gorunescu, Florin Gorunescu, Kenneth Revett

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Hepatocellular carcinoma, also called hepatoma, most commonly appears in a patient with chronic viral hepatitis. In patients with a higher suspicion of HCC, such as small or subtle rising of serum enzymes levels, the best method of diagnosis involves a CT scan of the abdomen, but only at high cost. The aim of this study was to increase the ability of the physician to early detect HCC, using a probabilistic neural network-based approach, in order to save time and hospital resources.

Keywords: Early HCC diagnosis, probabilistic neural network.

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Authors: M. Bastanfard, B. Jalaeian, S. Jafari

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Sonogram images of normal and lymphocyte thyroid tissues have considerable overlap which makes it difficult to interpret and distinguish. Classification from sonogram images of thyroid gland is tackled in semiautomatic way. While making manual diagnosis from images, some relevant information need not to be recognized by human visual system. Quantitative image analysis could be helpful to manual diagnostic process so far done by physician. Two classes are considered: normal tissue and chronic lymphocyte thyroid (Hashimoto's Thyroid). Data structure is analyzed using K-nearest-neighbors classification. This paper is mentioned that unlike the wavelet sub bands' energy, histograms and Haralick features are not appropriate to distinguish between normal tissue and Hashimoto's thyroid.

Keywords: Sonogram, thyroid, Haralick feature, wavelet.

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Authors: Weidong Xia, Malgorzata Kolotylo, Xuan Tan

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This study examines the key factors that influence general practitioners’ learning and transfer of specialized arthritis knowledge and self-care techniques to patients during normal patient visits. Drawing on the theory of planed behavior and using matched survey data collected from general practitioners before and after training sessions provided by specialized orthopedic physicians, the study suggests that the general practitioner’s intention to use and transfer learned knowledge was influenced mainly by intrinsic motivation, organizational learning culture and absorptive capacity, but was not influenced by extrinsic motivation. The results provide both theoretical and practical implications.

Keywords: Empirical study, healthcare knowledge management, patient self-care, physician knowledge transfer.

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Authors: Saleem Ahmed Aladhrai, Pier Luigi Ingrassia, Nahid K. El- Bakri

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Objective: The objective of this paper is to assess the hospitals preparedness for emergency using WHO standards. Method: This is a cross-sectional study, consisted of site visit, questionnaire survey, 16 health facilities were included. The WHO standard for emergency preparedness of health facilities was used to evaluate and assess the hospitals preparedness of health facilities. Result: 13 hospitals were responded. They scored below average in all measure >75%), while above average score was in 7 out 9 nine measure with a range of 8%-25%. Un acceptable below average was noted in two measures only. Discussion: The biggest challenge facing the hospitals in their emergency intervention is the lack of pre-emergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. Conclusion: The studied hospitals presently are far from international disasters preparedness protocols. That necessitates improvements in emergency preparedness, as well as in physician skills for injury management.

Keywords: Arab Spring, Yemen, Hospital Preparedness, Disaster.

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Authors: Wei-Wen Liu, Feng-Chuan Pan, Pei-Chi Wen, Sen-Ji Chen, Su-Hui Lin

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Nurses in an Armed Force Hospital (AFH) expose to stronger stress than those in a civil hospital, especially in an emergency department (ED). Ironically, stresses of these nurses received few if any attention in academic research in the past. This study collects 227 samples from the emergency departments of four armed force hospitals in central and southern Taiwan. The research indicates that the top five stressors are a massive casualty event, delayed physician support, overloads of routine work, overloads of assignments, and annoying paper work. Excessive work loading was found to be the primary source of stress. Nurses who were perceived to have greater stress levels were more inclined to deploy emotion-oriented approaches and more likely to seek job rotations. Professional stressors and problem-oriented approaches were positively correlated. Unlike other local studies, this study concludes that the excessive work-loading is more stressful in an AFH.

Keywords: Emergency nurse, Job stressor, Coping behavior, Armed force hospital.

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Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

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Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: Image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality.

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Authors: Faith-Michael E. Uzoka, Boluwaji A. Akinnuwesi, Taiwo Amoo, Flora Aladi, Stephen Fashoto, Moses Olaniyan, Joseph Osuji

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The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

Keywords: Medical diagnosis, tropical diseases, fuzzy cognitive map, decision support filters, malaria differential diagnosis.

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Authors: Jia-Rong Yeh, Ai-Hsien Li, Jiann-Shing Shieh, Yen-An Su, Chi-Yu Yang

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In this paper, an automatic detecting algorithm for QRS complex detecting was applied for analyzing ECG recordings and five criteria for dangerous arrhythmia diagnosing are applied for a protocol type of automatic arrhythmia diagnosing system. The automatic detecting algorithm applied in this paper detected the distribution of QRS complexes in ECG recordings and related information, such as heart rate and RR interval. In this investigation, twenty sampled ECG recordings of patients with different pathologic conditions were collected for off-line analysis. A combinative application of four digital filters for bettering ECG signals and promoting detecting rate for QRS complex was proposed as pre-processing. Both of hardware filters and digital filters were applied to eliminate different types of noises mixed with ECG recordings. Then, an automatic detecting algorithm of QRS complex was applied for verifying the distribution of QRS complex. Finally, the quantitative clinic criteria for diagnosing arrhythmia were programmed in a practical application for automatic arrhythmia diagnosing as a post-processor. The results of diagnoses by automatic dangerous arrhythmia diagnosing were compared with the results of off-line diagnoses by experienced clinic physicians. The results of comparison showed the application of automatic dangerous arrhythmia diagnosis performed a matching rate of 95% compared with an experienced physician-s diagnoses.

Keywords: Signal processing, electrocardiography (ECG), QRS complex, arrhythmia.

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Authors: Adekunle O. Afolabi, Pekka Toivanen

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The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: Recommendation systems, healthcare, internet of things, real-time, homecare.

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Authors: A. G. Margaryan

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Ability of adaptation of the organism is considered as an important component of health in maintaining relative dynamic constancy of the hemostasis and functioning of all organs and systems. Among the various forms of adaptation (individual, species and mental), social adaptation of the organism has a particular role. The aim of this study was to evaluate the subjective perception of social factors, social welfare and the level of adaptability of Armenian physicians. The survey involved 2,167 physicians (592 men and 1,575 women). According to the survey, most physicians (75.1%) were married. It was found that 88.6% of respondents had harmonious family relationships, 7.6% of respondents – tense relationships, and 1.0% – marginal relationships. The results showed that the average monthly salary with all premium payments amounted to 88 263.6±5.0 drams, and 16.7% of physicians heavily relied on the material support of parents or other relatives. Low material welfare was also confirmed by the analysis of the living conditions. Analysis of the results showed that the degree of subjective perception of social factors of different specialties averaged 11.3±3.1 points, which corresponds to satisfactory results (a very good result – 4.0 points). The degree of social adaptation of physicians on average makes 4.13±1.9 points, which corresponds to poor results (allowable less than 3.0 points). The distribution of the results of social adaptation severity revealed that the majority of physicians (58.6%) showed low social adaptation, average social adaptation is observed in 22.4% of the physicians and high adaptation – in only 17.4% of physicians. In conclusions, the findings of this study suggest that the degree of social adaptation of currently practicing physicians is low.

Keywords: Physician's health, social adaptation, social factor, social health.

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Authors: Insung Jung, Gi-Nam Wang

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In this paper, we present user pattern learning algorithm based MDSS (Medical Decision support system) under ubiquitous. Most of researches are focus on hardware system, hospital management and whole concept of ubiquitous environment even though it is hard to implement. Our objective of this paper is to design a MDSS framework. It helps to patient for medical treatment and prevention of the high risk patient (COPD, heart disease, Diabetes). This framework consist database, CAD (Computer Aided diagnosis support system) and CAP (computer aided user vital sign prediction system). It can be applied to develop user pattern learning algorithm based MDSS for homecare and silver town service. Especially this CAD has wise decision making competency. It compares current vital sign with user-s normal condition pattern data. In addition, the CAP computes user vital sign prediction using past data of the patient. The novel approach is using neural network method, wireless vital sign acquisition devices and personal computer DB system. An intelligent agent based MDSS will help elder people and high risk patients to prevent sudden death and disease, the physician to get the online access to patients- data, the plan of medication service priority (e.g. emergency case).

Keywords: Neural network, U-healthcare, MDSS, CAP, DSS.

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Authors: Orly Sarid, Yana Shraga

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Purpose: To compare attitudes and perceptions of Israeli native born mothers versus former Soviet Union (FSU) immigrant mothers regarding the physical health of their infant. Methodology: cross-sectional design. A convenience sample of 50 participants was recruited by face to face and snowball technique. A questionnaire was constructed according to the instructions of the Ministry of Health for the care and treatment of infants. The main areas explored were: sources of knowledge that the young mother acquired regarding the care of her infant, ways of caring for the infant, hygiene and sanitary habits, and the pattern of referral to health professionals. The last topic relates to emotions mothers might experience towards their infant. Results: Mothers from both cultural groups present some similar caring behaviors, which may express a universal aspect of mothers' behavior towards their infants. However, immigrant mothers differ significantly from native born by relying less on their mothers' and grandmothers' experience, they wean their infants from diapers earlier, they are stricter about hygiene and sanitary habits and they tend to consult a physician when their infant has low fever. Native born and immigrant mothers differ in their expressions of pride and wonder. Immigrant mothers report of a lesser degree of these emotions towards their infants than native born mothers. Conclusion: The theoretical model of socialization and acculturation of immigrant mothers is employed as an explanatory model for the current findings Young immigrant mothers undergo a complex acculturation process and adapt behavioral patterns in various areas to comply with Israeli norms and values, demonstrating assimilation. In other areas they adhere to the norms of their original culture.

Keywords: Attitudes, immigrant mothers, infant, physical health

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Authors: Ghada Abo-Zaid

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Objectives: The main objective of this study was to examine the association between the elevated level of C-reactive protein (CRP) and incidence of hypertension before and after adjustments for age, BMI, gender, SES, smoking, diabetes, cholesterol LDL and cholesterol HDL, and to determine whether the association differs by race. Method: Cross sectional data for participants from aged 17 years to 74 years, included in The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analyzed. The CRP level was classified into three categories (> 3 mg/L, between 1 mg/L and 3 mg/L, and < 3 mg/L). Blood pressure categorization was done using JNC 7 indicator. Hypertension is defined as either systolic blood pressure (SBP) of 140 mmHg or more and diastolic blood pressure (DBP) of 90 mmHg or more, otherwise a self-reported prior diagnosis by a physician. Pre-hypertension was defined as 139 ≥ SBP > 120 or 89 ≥ DBP >80. Multinominal regression model was undertaken to measure the association between CRP level and hypertension. Results: In univariable models, CRP concentrations > 3 mg/L were associated with a 73% greater risk of incident hypertension compared with CRP concentrations < 1 mg/L (Hypertension: odds ratio [OR] = 1.73; 95% confidence interval [CI], 1.50-1.99). Ethnic comparisons showed that American Mexicans had the highest risk of incident hypertension (OR = 2.39; 95% CI, 2.21-2.58). This risk was statistically insignificant after controlling by other variables (Hypertension: OR = 0.75; 95% CI, 0.52-1.08), or categorized by race [American Mexican: OR= 1.58; 95% CI, 0.58-4.26, Other Hispanic: OR = 0.87; 95% CI, 0.19-4.42, Non-Hispanic white: OR = 0.90; 95% CI, 0.50-1.59, Non-Hispanic Black: OR = 0.44; 95% CI, 0.22-0.87. The same results were found for pre-hypertension, and the Non-Hispanic black segment showed the highest significant risk for Pre-Hypertension (OR = 1.60; 95% CI, 1.26-2.03). When CRP concentrations were between 1.0 and 3.0 mg/L in unadjusted models, prehypertension was associated with higher likelihood of elevated CRP (OR = 1.37; 95% CI, 1.15-1.62). The same relationship was maintained in Non-Hispanic white, Non-Hispanic black, and other race (Non-Hispanic white: OR = 1.24; 95% CI, 1.03-1.48, Non-Hispanic black: OR = 1.60; 95% CI, 1.27-2.03, other race: OR = 2.50; 95% CI, 1.32-4.74) while the association was insignificant with American Mexican and other Hispanic. In the adjusted model, the relationship between CRP and prehypertension were no longer available. Contrary, hypertension was not independently associated with elevated CRP, and the results were the same after being grouped by race or adjustments for the possible confounder variables. The same results were obtained when SBP or DBP were on a continuous measure. Conclusions: This study confirmed the existence of an association between hypertension, prehypertension and elevated level of CRP, however this association was no longer available after adjusting by other variables. Ethic group differences were statistically significant at the univariable models, while it disappeared after controlling by other variables. 

Keywords: CRP, hypertension, ethnicity, NHANES, blood pressure.

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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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