Search results for: Acute care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 539

Search results for: Acute care

389 The Opinions of Nursing Students Regarding Humanized Care through Volunteer Activities at Boromrajonani College of Nursing, Chonburi

Authors: P. Phenpun, S. Wareewan

Abstract:

This qualitative study aimed to describe the opinions in relation to humanized care emerging from the volunteer activities of nursing students at Boromarajonani College of Nursing, Chonburi, Thailand. One hundred and twenty-seven second-year nursing students participated in this study. The volunteer activity model was composed of preparation, implementation, and evaluation through a learning log, in which students were encouraged to write their daily activities after completing practical training at the healthcare center. The preparation content included three main categories: service minded, analytical thinking, and client participation. The preparation process took over three days that accumulates up to 20 hours only. The implementation process was held over 10 days, but with a total of 70 hours only, with participants taking part in volunteer work activities at a healthcare center. A learning log was used for evaluation and data were analyzed using content analysis. The findings were as follows. With service minded, there were two subcategories that emerged from volunteer activities, which were service minded towards patients and within themselves. There were three categories under service minded towards patients, which were rapport, compassion, and empathy service behaviors, and there were four categories under service minded within themselves, which were self-esteem, self-value, management potential, and preparedness in providing good healthcare services. In line with analytical thinking, there were two components of analytical thinking, which were analytical skill for their works and analytical thinking for themselves. There were four subcategories under analytical thinking for their works, which were evidence based thinking, real situational thinking, cause analysis thinking, and systematic thinking, respectively. There were four subcategories under analytical thinking for themselves, which were comparative between themselves, towards their clients that leads to the changing of their service behaviors, open-minded thinking, modernized thinking, and verifying both verbal and non-verbal cues. Lastly, there were three categories under participation, which were mutual rapport relationship; reconsidering client’s needs services and providing useful health care information.

Keywords: Humanized care service, volunteer activity, nursing student, and learning log.

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388 Non-Burn Treatment of Health Care Risk Waste

Authors: Jefrey Pilusa, Tumisang Seodigeng

Abstract:

This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: Autoclave, disposal, fuel, incineration, medical waste.

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387 Influence of Shading on a BIPV System’s Performance in an Urban Context: Case Study of BIPV Systems of the Science Center of Complexity Building of the National and Autonomous University of Mexico in Mexico City

Authors: Viridiana Edith Ardura Perea, José Luis Bermúdez Alcocer

Abstract:

The purpose of this paper is to establish the influence of shading on a Building Integrated Photovoltaic (BIPV) system´s performance in an urban context. The PV systems of the Science Center of Complexity (Centro de Ciencias de la Complejidad) Building based in the Main Campus of the National and Autonomous University of Mexico (UNAM) in Mexico City was taken as case study.  The PV systems are placed on the rooftop and on the south façade of the building.  The south-façade PV system, operating as sunshades, consists of two strings:  one at the ground floor and the other one at the first floor.  According to the building’s facility manager, the south-façade PV system generates 42% less electricity per kilowatt peak (kWp) installed than the one on the roof.  The methods applied in this study were Solar Radiation Analysis (SRA) simulations performed with the Insight 360 Plug-in from Revit 2018® and an on-site measurement using specialized tools.  The results of the SRA simulations showed that the shading casted by the PV system placed on the first floor on top of the PV system of the ground floor decreases its solar incident radiation over 50%.  The simulation outcome was compared and validated to the measured data obtained from the on-site measurement.  In conclusion, the loss factor achieved from the shading of the PVs is due to the surroundings and the PV system´s own design.  The south-façade BIPV system’s deficient design generates critical losses on its performance and decreases its profitability.

Keywords: Building integrated photovoltaics (BIPV) design, energy analysis software, shading losses, solar radiation analysis.

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386 Consumption Insurance against the Chronic Illness: Evidence from Thailand

Authors: Yuthapoom Thanakijborisut

Abstract:

This paper studies consumption insurance against the chronic illness in Thailand. The study estimates the impact of household consumption in the chronic illness on consumption growth. Chronic illness is the health care costs of a person or a household’s decision in treatment for the long term; the causes and effects of the household’s ability for smooth consumption. The chronic illnesses are measured in health status when at least one member within the household faces the chronic illness. The data used is from the Household Social Economic Panel Survey conducted during 2007 and 2012. The survey collected data from approximately 6,000 households from every province, both inside and outside municipal areas in Thailand. The study estimates the change in household consumption by using an ordinary least squares (OLS) regression model. The result shows that the members within the household facing the chronic illness would reduce the consumption by around 4%. This case indicates that consumption insurance in Thailand is quite sufficient against chronic illness.

Keywords: Consumption insurance, chronic illness, health care, Thailand.

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385 Environmental and Toxicological Impacts of Glyphosate with Its Formulating Adjuvant

Authors: I. Székács, Á. Fejes, S. Klátyik, E. Takács, D. Patkó, J. Pomóthy, M. Mörtl, R. Horváth, E. Madarász, B. Darvas, A. Székács

Abstract:

Environmental and toxicological characteristics of formulated pesticides may substantially differ from those of their active ingredients or other components alone. This phenomenon is demonstrated in the case of the herbicide active ingredient glyphosate. Due to its extensive application, this active ingredient was found in surface and ground water samples collected in Békés County, Hungary, in the concentration range of 0.54–0.98 ng/ml. The occurrence of glyphosate appeared to be somewhat higher at areas under intensive agriculture, industrial activities and public road services, but the compound was detected at areas under organic (ecological) farming or natural grasslands, indicating environmental mobility. Increased toxicity of the formulated herbicide product Roundup compared to that of glyphosate was observed on the indicator aquatic organism Daphnia magna Straus. Acute LC50 values of Roundup and its formulating adjuvant polyethoxylated tallowamine (POEA) exceeded 20 and 3.1 mg/ml, respectively, while that of glyphosate (as isopropyl salt) was found to be substantially lower (690-900 mg/ml) showing good agreement with literature data. Cytotoxicity of Roundup, POEA and glyphosate has been determined on the neuroectodermal cell line, NE-4C measured both by cell viability test and holographic microscopy. Acute toxicity (LC50) of Roundup, POEA and glyphosate on NE-4C cells was found to be 0.013±0.002%, 0.017±0.009% and 6.46±2.25%, respectively (in equivalents of diluted Roundup solution), corresponding to 0.022±0.003 and 53.1±18.5 mg/ml for POEA and glyphosate, respectively, indicating no statistical difference between Roundup and POEA and 2.5 orders of magnitude difference between these and glyphosate. The same order of cellular toxicity seen in average cell area has been indicated under quantitative cell visualization. The results indicate that toxicity of the formulated herbicide is caused by the formulating agent, but in some parameters toxicological synergy occurs between POEA and glyphosate.

Keywords: Glyphosate, polyethoxylated tallowamine, Roundup, combined aquatic and cellular toxicity, synergy.

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384 Introducing an Image Processing Base Idea for Outdoor Children Caring

Authors: Hooman Jafarabadi

Abstract:

In this paper application of artificial intelligence for baby and children caring is studied. Then a new idea for injury prevention and safety announcement is presented by using digital image processing. The paper presents the structure of the proposed system. The system determines the possibility of the dangers for children and babies in yards, gardens and swimming pools or etc. In the presented idea, multi camera System is used and receiver videos are processed to find the hazardous areas then the entrance of children and babies in the determined hazardous areas are analyzed. In this condition the system does the programmed action capture, produce alarm or tone or send message.

Keywords: Baby and children Care and Nursing, Intelligent Control Systems for Nursing, Electronic Care and Nursing, Dangers and safety for children and babies, Motion detection, Expert danger alarm systems.

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383 Poisoning Admission in Children Hospital in Benghazi-Libya, Three Years Review of Medical Record

Authors: Mudafara S Bengleil

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Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Keywords: Children, hospital, poisoning.

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382 Client Satisfaction: Does Private or Public Health Sector Make a Difference? Results from Secondary Data Analysis in Sindh, Pakistan

Authors: Wajiha Javed, Arsalan Jabbar, Nelofer Mehboob, Muhammad Tafseer, Zahid Memon

Abstract:

Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset on 3133 women. Ten different multivariate models were made. to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92, 95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29). Discussion: Public sector has successfully attained substantial satisfaction levels with respect to provision of contraceptives, but it contrasts previous literature from a multi country studies. Our study though in is concordance with a study from Tanzania where public sector was more likely to offer family planning services to clients as compared to private facilities. Conclusion: In majority of the developing countries, public sector is more involved in FP service provision; however, in Pakistan clients’ satisfaction in private sector is more, which opens doors for public-private partnerships and collaboration in the near future. 

Keywords: Client satisfaction, Family Planning, Public private partnership, Quality of care

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381 Directors’ Duties, Civil Liability, and the Business Judgment Rule under the Portuguese Legal Framework

Authors: Marisa Catarina da Conceição Dinis

Abstract:

The commercial companies’ management has suffered an important material and legal transformation in the last years, mainly related to the changes in the Portuguese legal framework and because of the fact they were recently object of great expansion. In fact, next to the smaller family businesses, whose management is regularly assumed by partners, companies with social investment highly scattered, whose owners are completely out from administration, are now arising. In those particular cases, the business transactions are much more complex and require from the companies’ managers a highly technical knowledge and some specific professionals’ skills and abilities. This kind of administration carries a high-level risk that can both result in great success or in great losses. Knowing that the administration performance can result in important losses to the companies, the Portuguese legislator has created a legal structure to impute them some responsibilities and sanctions. The main goal of this study is to analyze the Portuguese law and some jurisprudence about companies’ management rules and about the conflicts between the directors and the company. In order to achieve these purposes we have to consider, on the one hand, the legal duties directly connected to the directors’ functions and on the other hand the disrespect for those same rules. The Portuguese law in this matter, influenced by the common law, determines that the directors’ attitude should be guided by loyalty and honesty. Consequently, we must reflect in which cases the administrators should respond to losses that they might cause to companies as a result of their duties’ disrespect. In this way is necessary to study the business judgment rule wich is a rule that refers to a liability exclusion rule. We intend, in the same way, to evaluate if the civil liability that results from the directors’ duties disrespect can extend itself to those who have elected them ignoring or even knowing that they don´t have the necessary skills or appropriate knowledge to the position they hold. To charge directors’, without ruining entrepreneurship, charging, in the same way, those who select them reinforces the need for more responsible and cautious attitudes which will lead consequently to more confidence in the markets.

Keywords: Duty of loyalty, duty of care, business judgment rule, civil liability of directors.

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380 Green Technologies and Sustainability in the Care and Maintenance of Protective Textiles

Authors: R. Nayak, T. Panwar, R. Padhye

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Protective textiles get soiled, stained and even worn during their use, which may not be usable after a certain period due to the loss of protective performance. They need regular cleaning and maintenance, which helps to extend the durability of the clothing, retains their useful properties and ensures that fresh clothing is ready to wear when needed. Generally, the cleaning processes used for various protective clothing include dry-cleaning (using solvents) or wet cleaning (using water). These cleaning processes can alter the fabric surface properties, dimensions, and physical, mechanical and performance properties. The technology of laundering and dry-cleaning has undergone several changes. Sustainable methods and products are available for faster, safer and improved cleaning of protective textiles. We performed a comprehensive and systematic review of green technologies and eco-friendly products for sustainable cleaning of protective textiles. Special emphasis is given on the care and maintenance procedures of protective textiles for protection from fire, bullets, chemical and other types of protective clothing.

Keywords: Sustainable cleaning, protective textiles, eco-friendly cleaning, ozone laundering, ultrasonic cleaning.

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379 Understanding Help Seeking among Black Women with Clinically Significant Posttraumatic Stress Symptoms

Authors: Glenda Wrenn, Juliet Muzere, Meldra Hall, Allyson Belton, Kisha Holden, Chanita Hughes-Halbert, Martha Kent, Bekh Bradley

Abstract:

Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.

Keywords: Culture, help-seeking, integrated care, PTSD.

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378 A Review of Pharmacological Prevention of Peri-and Post-Procedural Myocardial Injury after Percutaneous Coronary Intervention

Authors: Syed Dawood Md. Taimur, Md. Hasanur Rahman, Syeda Fahmida Afrin, Farzana Islam

Abstract:

The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.

Keywords: Coronary artery disease, Percutaneous coronary intervention, Myocardial injury, Pharmacology.

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377 Consumption Pattern and Dietary Practices of Pregnant Women in Odeda Local Government Area of Ogun State

Authors: Ademuyiwa, M. O., Sanni, S. A.

Abstract:

The importance of maternal nutritional practices during pregnancy cannot be overemphasized. This paper assessed the consumption pattern and dietary practices of 50 pregnant women selected using purposive sampling technique from three health care centres (Primary Health Care Centre, Obantoko; Primary Health Care Centre Alabata; and the General Hospital, Odeda) in Odeda Local Government Area of Ogun State, Nigeria. Structured questionnaire was used to elicit information on socioeconomic status, consumption pattern and dietary practices. Data were analyzed using the Statistical Package for Social Sciences (SPSS, 17). The results indicated that about 58% of the pregnant women were below the age of 30 while 42% were ages 28-40 years. Only 16% had tertiary education while (38%) had secondary education, 52% earn income through petty trading. On food intake, 52% got their energy source from rice on a daily basis, followed by pap (38%) and eko (34%). For protein intake, 36% consumed bean cake on a daily basis while 66% consumed moinmoin 2-3 times a week. Orange (48%) and Green Leafy vegetable (40%) accounted for the mostly consumed fruit and vegetable on daily basis. In terms of animal origin, fish (76%), meat (58%) and eggs (30%) were consumed daily, while chicken and snail were consumed occasionally by 54% and 42%, respectively. Forty-six percent (46%) of the pregnant women eat more than three times daily; while 60% of the women eat outside their homes with 42% respondents eat out lunch and only two percent least eaten out dinner. It is important to increase in awareness campaign to sensitize the pregnant women on the importance of good nutrition especially fruits, vegetables and dairy products. 

Keywords: Consumption Pattern, Dietary Practices, Pregnant, Women, Nigeria.

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376 The Integrated Management of Health Care Strategies and Differential Diagnosis by Expert System Technology: A Single-Dimensional Approach

Authors: A. B. Adehor, P. R. Burrell

Abstract:

The Integrated Management of Child illnesses (IMCI) and the surveillance Health Information Systems (HIS) are related strategies that are designed to manage child illnesses and community practices of diseases. However, both strategies do not function well together because of classification incompatibilities and, as such, are difficult to use by health care personnel in rural areas where a majority of people lack the basic knowledge of interpreting disease classification from these methods. This paper discusses a single approach on how a stand-alone expert system can be used as a prompt diagnostic tool for all cases of illnesses presented. The system combines the action-oriented IMCI and the disease-oriented HIS approaches to diagnose malaria and typhoid fever in the rural areas of the Niger-delta region.

Keywords: Differential diagnosis, Health Information System(HIS), Integrated Management of Child Illnesses (IMCI), Malaria andTyphoid fever.

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375 Counterfeit Drugs Prevention in Pharmaceutical Industry with RFID: A Framework Based On Literature Review

Authors: Zeeshan Hamid, Asher Ramish

Abstract:

The purpose of this paper is to focus on security and safety issues facing by pharmaceutical industry globally when counterfeit drugs are in question. Hence, there is an intense need to secure and authenticate pharmaceutical products in the emerging counterfeit product market. This paper will elaborate the application of radio frequency identification (RFID) in pharmaceutical industry and to identify its key benefits for patient’s care. The benefits are: help to co-ordinate the stream of supplies, accuracy in chains of supplies, maintaining trustworthy information, to manage the operations in appropriate and timely manners and finally deliver the genuine drug to patient. It is discussed that how RFID supported supply chain information sharing (SCIS) helps to combat against counterfeit drugs. And a solution how to tag pharmaceutical products; since, some products prevent RFID implementation in this industry. In this paper, a proposed model for pharma industry distribution suggested to combat against the counterfeit drugs when they are in supply chain.

Keywords: Supply chain, RFID, pharmaceutical industry, counterfeit drugs, patients care.

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374 Synchronization between the Slow Oscillations in the Human Cardiovascular System

Authors: M. D. Prokhorov, V. I. Ponomarenko, A. S. Karavaev, A. R. Kiselev, V. I. Gridnev

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Synchronization between the slow oscillations of heart rate and blood pressure having in humans a basic frequency close to 0.1 Hz is investigated. A method is proposed for quantitative estimation of synchronization between these oscillating processes based on calculation of relative time of phase synchronization of oscillations. It is shown that healthy subjects exhibit in average substantially longer epochs of synchronization between the slow oscillations in heart rate and blood pressure than patients after acute myocardial infarction

Keywords: Cardiovascular system, slow oscillating processes, synchronization.

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373 Toxicity of Copper and Cadmium to Freshwater Fishes

Authors: M. Shuhaimi-Othman, Y. Nadzifah, A.K. Ahmad

Abstract:

Two freshwater fishes, Rasbora sumatrana (Cyprinidae) and Poecilia reticulata (guppy) (Poeciliidae) were exposed for a four-day period in the laboratory condition to a range of copper (Cu) and cadmium (Cd) concentrations. Mortality was assessed and median lethal concentrations (LC50) were calculated. LC50 increased with decrease in mean exposure times for both metals. For R. sumatrana, LC50s for 24, 48, 72 and 96 hours for Cu were 54.2, 30.3, 18.9 and 5.6 μg/L and for Cd 1440.2, 459.3, 392.3 and 101.6 μg/L respectively. For P. reticulata, LC50s for 24, 48, 72 and 96 hours for Cu were 348.9, 145.4, 61.3 and 37.9 μg/L and for Cd 8205.6, 2827.1, 405.8 and 168.1 μg/L, respectively. Results indicated that the Cu was more toxic than Cd to both fishes (Cu>Cd) and R. sumatrana was more sensitive than P. reticulata to the metals.

Keywords: Acute, heavy metals, LT50, toxicity

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372 Computer Based Medicine: I - The Future

Authors: Essam Abd-Elrazek

Abstract:

With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.

Keywords: Medical Informatics, telemedicine, e-health systems.

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371 Classification of Health Risk Factors to Predict the Risk of Falling in Older Adults

Authors: L. Lindsay, S. A. Coleman, D. Kerr, B. J. Taylor, A. Moorhead

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Cognitive decline and frailty is apparent in older adults leading to an increased likelihood of the risk of falling. Currently health care professionals have to make professional decisions regarding such risks, and hence make difficult decisions regarding the future welfare of the ageing population. This study uses health data from The Irish Longitudinal Study on Ageing (TILDA), focusing on adults over the age of 50 years, in order to analyse health risk factors and predict the likelihood of falls. This prediction is based on the use of machine learning algorithms whereby health risk factors are used as inputs to predict the likelihood of falling. Initial results show that health risk factors such as long-term health issues contribute to the number of falls. The identification of such health risk factors has the potential to inform health and social care professionals, older people and their family members in order to mitigate daily living risks.

Keywords: Classification, falls, health risk factors, machine learning, older adults.

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370 Proposing Enterprise Wide Information Systems Business Performance Model

Authors: Vineet Kansal

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Enterprise Wide Information Systems (EWIS) implementation involves the entire business and will require changes throughout the firm. Because of the scope, complexity and continuous nature of ERP, the project-based approach to managing the implementation process resulted in failure rates of between 60% and 80%. In recent years ERP systems have received much attention. The organizational relevance and risk of ERP projects make it important for organizations to focus on ways to make ERP implementation successful. Once these systems are in place, however, their performance depends on the identified macro variables viz. 'Business Process', 'Decision Making' and 'Individual / Group working'. The questionnaire was designed and administered. The responses from 92 organizations were compiled. The relationship of these variables with EWIS performance is analyzed using inferential statistical measurements. The study helps to understand the performance of model presented. The study suggested in keeping away from the calamities and thereby giving the necessary competitive edge. Whenever some discrepancy is identified during the process of performance appraisal care has to be taken to draft necessary preventive measures. If all these measures are taken care off then the EWIS performance will definitely deliver the results.

Keywords: Enterprise Systems, performance, technology

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369 Analysis of Pharmaceuticals in Influents of Municipal Wastewater Treatment Plants in Jordan

Authors: O. A. Al-Mashaqbeh, A. M. Ghrair, D. Alsafadi, S. S. Dalahmeh, S. L. Bartelt-Hunt, D. D. Snow

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Grab samples were collected in the summer to characterize selected pharmaceuticals and personal care products (PPCPs) in the influent of two wastewater treatment plants (WWTPs) in Jordan. Liquid chromatography tandem mass spectrometry (LC–MS/MS) was utilized to determine the concentrations of 18 compounds of PPCPs. Among all of the PPCPs analyzed, eight compounds were detected in the influent samples (1,7-dimethylxanthine, acetaminophen, caffeine, carbamazepine, cotinine, morphine, sulfamethoxazole and trimethoprim). However, five compounds (amphetamine, cimetidine, diphenhydramine, methylenedioxyamphetamine (MDA) and sulfachloropyridazine) were not detected in collected samples (below the detection limits <0.005 ng/l). Moreover, the results indicated that the highest concentration levels detected in collected samples were caffeine, acetaminophen, 1,7-dimethylxanthine, cotinine and carbamazepine at concentration of 182.5 µg/L, 28.7 µg/l, 7.47 µg/l, 4.67 µg/l and 1.54 µg/L, respectively. In general, most of compounds concentrations measured in wastewater in Jordan are within the range for wastewater previously reported in India wastewater except caffeine.

Keywords: Pharmaceuticals and personal care products, wastewater, Jordan.

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368 Family Carers' Experiences in Striving for Medical Care and Finding Their Solutions for Family Members with Mental Illnesses

Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

Abstract:

Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: Family carers, coercive treatment, independent living, mental health crisis, persons with mental illness.

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367 Colorectal Cancer Screening by a CEACAM-6 Immunosensor

Authors: C. T. S. Ching, P. W. C hen, T. P. Sun, H. L. Shieh

Abstract:

The biomarker for colorectal cancer (CRC) is CEACAM-6 antigen (C6AG). Therefore, this study aims to develop a novel, simple and low-cost CEACAM-6 antigen immumosensor (C6AG-IMS), based on electrical impedance measurement, for precise determination of C6AG. A low-cost screen-printed graphite electrode was constructed and used as the sensor, with CEACAM-6 antibody (C6AB) immobilized on it. The procedures of sensor fabrication and antibody immobilization are simple and low-cost. Measurement of the electrical impedance at a definite frequency ranges (0.43 – 1.26 MHz) showed that the C6AG-IMS has an excellent linear (r2>0.9) response range (8.125 – 65 pg/mL), covering the normal physiological and pathological ranges of blood C6AG levels. Also, the C6AG-IMS has excellent reliability and validity, with the intraclass correlation coefficient being 0.97. In conclusion, a novel, simple, low-cost and reliable C6AG-IMS was designed and developed, being able to accurately determine blood C6AG levels in the range of pathological and normal physiological regions. The C6AG-IMS can provide a point-of-care and immediate screening results to the user at home.

Keywords: Colorectal Cancer, Immunosensor, Electrical Impedance, CEACAM-6, Measurement, Point-of-Care

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366 Renewal of The Swedish Million Dwelling Program, the Public Housing Company and the Local Community, Hindrances and Mutual Aid

Authors: Lars Steiner, Zahra Ahmadi

Abstract:

Public housing is a vital factor in community development. Successful city, housing and eco system regeneration design is essential in providing positive community development. This concerns work places, nice dwellings, providing premises for child care, care of the elderly, providing qualitative premises for different kinds of commercial service, providing a nice built environment and housing areas and not the least activating tenants. The public housing companies give value to society by stimulating people, renovating socially and economically sustainable as well as being partners to local business and authorities. By their activities the housing companies contribute to sustainable local and regional growth and the identity and reputation of cities. A Social, Economic and Ecological Reputation Effect (SEERE) model for actions to promote housing and community reputation is presented. The model emphasizes regenerative actions to restore natural eco systems as part of housing renewal strategies and to strengthen municipality reputation.

Keywords: Community Development, Image and Reputation, Public Housing, Renewal Strategies.

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365 An Exploratory Approach of the Latin American Migrants’ Urban Space Transformation of Antofagasta City, Chile

Authors: Carolina Arriagada, Yasna Contreras

Abstract:

Since mid-2000, the migratory flows of Latin American migrants to Chile have been increasing constantly. There are two reasons that would explain why Chile is presented as an attractive country for the migrants. On the one hand, traditional centres of migrants’ attraction such as the United States and Europe have begun to close their borders. On the other hand, Chile exhibits relative economic and political stability, which offers greater job opportunities and better standard of living when compared to the migrants’ origin country. At the same time, the neoliberal economic model of Chile, developed under an extractive production of the natural resources, has privatized the urban space. The market regulates the growth of the fragmented and segregated cities. Then, the vulnerable population, most of the time, is located in the periphery and in the marginal areas of the urban space. In this aspect, the migrants have begun to occupy those degraded and depressed areas of the city. The problem raised is that the increase of the social spatial segregation could be also attributed to the migrants´ occupation of the marginal urban places of the city. The aim of this investigation is to carry out an analysis of the migrants’ housing strategies, which are transforming the marginal areas of the city. The methodology focused on the urban experience of the migrants, through the observation of spatial practices, ways of living and networks configuration in order to transform the marginal territory. The techniques applied in this study are semi–structured interviews in-depth interviews. The study reveals that the migrants housing strategies for living in the marginal areas of the city are built on a paradox way. On the one hand, the migrants choose proximity to their place of origin, maintaining their identity and customs. On the other hand, the migrants choose proximity to their social and familiar places, generating sense of belonging. In conclusion, the migration as international displacements under a globalized economic model increasing socio spatial segregation in cities is evidenced, but the transformation of the marginal areas is a fundamental resource of their integration migratory process. The importance of this research is that it is everybody´s responsibility not only the right to live in a city without any discrimination but also to integrate the citizens within the social urban space of a city.

Keywords: Inhabit, migrations, social spatial segregation.

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364 Everyday Life in the City of Kyzylorda and Almaty in the 20-30-s of the XX Century (State Health Services)

Authors: Zhalmagambetov Yerlanbek, Assymova Dariya, Tashieva Saltanat, and Aliya Bolatkhan

Abstract:

The relevance of the study of everyday life in Almaty and Kyzylorda are associated with the emergence of the modern trends in historiography and socializing areas of government reform. The relevance is due to the fact that in the early twentieth century Kyzylorda and Almaty began to develop as a city and this period has a special place in the life of the state. An interesting aspect of the everyday life of the inhabitants of the new city, which was built in the era of Stalin's Five-Year Plans, can be examined through the eyes of the Soviet people living in a specific environment, reflecting the life of the citizens. The study of industrialization of the Soviet Union and the attention paid to new developments in the first five years of everyday aspects as the impact of the modernization of the 1930s was one of the decisive factors in the lives of residents. Among these factors, we would like to highlight the medical field, which is the basis of all human life, specifically focusing on the state of medicine in Alma-Ata in the first 20-30-years of the twentieth century, and analyze the different aspects of human life, determining the quality of medical care to the population during this period.

Keywords: Alma Ata, capital, epidemic diseases, health care, Kyzylorda, the USSR, Vernyj.

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363 Three Dimensional MEMS Supercapacitor Fabricated by DRIE on Silicon Substrate

Authors: Wei Sun, Ruilin Zheng, Xuyuan Chen

Abstract:

Micro power sources are required to be used in autonomous microelectromechanical system (MEMS). In this paper,  we designed and fabricated a three dimensional (3D) MEMS supercapacitor, which is consisting of conformal silicon  dioxide/titanium/polypyrrole (PPy) layers on silicon substrate. At first, ''through-structure'' was fabricated on the silicon substrate by high-aspect-ratio deep reactive ion etching (DRIE) method, which enlarges the available surface area significantly. Then the SiO2/Ti/PPy layers grew sequentially on the ³through-structure´. Finally, the supercapacitor was investigated by electrochemical methods.

Keywords: MEMS, Supercapacitor, DRIE, 3D.

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362 Biomarkers in a Post-Stroke Population: Allied to Health Care in Brazil

Authors: M. Ricardo Lang, A. Costa, I. Iesbik, K. Haag, L. Trindade Buffara, O. Reimann Junior, C. Auswaldt Steclan

Abstract:

Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with systemic arterial hypertension (SAH) being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyslipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: Biomarkers, population, stroke, sex, stroke unit.

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361 An Extended Eclectic Paradigm of Dunning: Impact of New International Business Processes

Authors: D. de Matías Batalla

Abstract:

This paper develops and extended eclectic paradigm to fit the firm internationalization process with the real international business world. The approach is based on Dunning´s, introducing new concepts like mode of entry, international joint venture o international mergers and acquisitions. At the same time is presented a model to describe the Spanish international mergers and acquisitions in order to determinate the most important factor that influence in this type of foreign direct investment.

Keywords: Dunning, eclectic paradigm, foreign direct investment, IJV, international business, international management, multinational firms, firm internationalization process, M&A.

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360 Visualizing Imaging Pathways after Anatomy-Specific Follow-Up Imaging Recommendations

Authors: Thusitha Mabotuwana, Christopher S. Hall

Abstract:

Radiologists routinely make follow-up imaging recommendations, usually based on established clinical practice guidelines, such as the Fleischner Society guidelines for managing lung nodules. In order to ensure optimal care, it is important to make guideline-compliant recommendations, and also for patients to follow-up on these imaging recommendations in a timely manner. However, determining such compliance rates after a specific finding has been observed usually requires many time-consuming manual steps. To address some of these limitations with current approaches, in this paper we discuss a methodology to automatically detect finding-specific follow-up recommendations from radiology reports and create a visualization for relevant subsequent exams showing the modality transitions. Nearly 5% of patients who had a lung related follow-up recommendation continued to have at least eight subsequent outpatient CT exams during a seven year period following the recommendation. Radiologist and section chiefs can use the proposed tool to better understand how a specific patient population is being managed, identify possible deviations from established guideline recommendations and have a patient-specific graphical representation of the imaging pathways for an abstract view of the overall treatment path thus far.

Keywords: Follow-up recommendations, care pathways, imaging pathway visualization, follow-up tracking.

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