Search results for: Baby care system

Authors: R. Pääkkönen, L. Korpinen, T. Kava, I. Salmi

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This study evaluates obstructive sleep apnea treatment through a case study involving a 67-year-old male driver who had a successful continuous positive airway pressure (CPAP) treatment at home but experienced difficulties with traveling and dental care. There are many cheap sleep apnea and snoring devices available, but there is little professional advice on what kind of devices can help. Professional drivers receive yearly specialized medical care follow-up.

Keywords: Sleep, apnea patient, CPAP, professional driver.

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Authors: Baby Joseph, Sankarganesh Palaniyandi

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The enzyme alkaline protease production was determined under solid state fermentation using the soil bacteria Serratia marcescens sp7. The maximum production was obtained from wheat bran medium than ground nut shell and chemically defined medium. The physiological fermentation factors such as pH of the medium (pH 8), Temperature (40oC) and incubation time (48 hrs) played a vital role in alkaline protease production in all the above. 100Mm NaCl has given better resolution during elution of the enzymes. The enzyme production was found to be associated with growth of the bacterial culture.

Keywords: Alkaline protease, Wheat bran, Ground nut shell, Serratia marcescens

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Authors: Akekaluck Hemtanon, Bunyarit Uyyanonvara

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This research explores on the development of the structure of Carbon Credit Registry System those accords to the need of future events in Thailand. This research also explores the big picture of every connected system by referring to the design of each system, the Data Flow Diagram, and the design in term of the system-s data using DES standard. The purpose of this paper is to show how to design the model of each system. Furthermore, this paper can serve as guideline for designing an appropriate Carbon Credit Registry System.

Keywords: CDM, CDM BE, Annex I County, Non-Annex I country, CERs, Kyoto Protocol.

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Authors: M. Soyaslan, A. Fenercioglu, C. Kozkurt

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Automated storage and retrieval systems (AS/RS) become frequently used systems in warehouses. There has been a transition from human based forklift applications to fast and safe AS/RS applications in firm-s warehouse systems. In this study, basic components and automation systems of the AS/RS are examined. Proposed system's automation components and their tasks in the system control algorithm were stated. According to this control algorithm the control system structure was obtained.

Keywords: AS/RS, Automatic Storage and Retrieval System, Warehouse Control System

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Authors: Satien Janpla, Kunyanuth Kularbphettong

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This paper aims to present the development of a web‑based system to serve the need of selling OTOP products in Samut Songkhram, Thailand. This system was designed to promote and sell OTOP products on Web site. We describe the design approaches and functional components of this system. The system was developed by PHP and JavaScript and MySQL database System. To evaluate the system performance, questionnaires were used to measure user satisfaction with system usability by specialists and users. The results were satisfactory as followed: Means for specialists and users were 4.05 and 3.97, and standard deviation for specialists and users were 0.563 and 0.644 respectively. Further analysis showed that the quality of One Tambon One Product (OTOP) Website was also at a good level as well.

Keywords: Web-based system, OTOP, product.

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Authors: Cheika Jahangeer, Naushad Mamode Khan, Maleika Heenaye-Mamode Khan

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Exclusive breastfeeding is the feeding of a baby on no other milk apart from breast milk. Exclusive breastfeeding during the first 6 months of life is of fundamental importance because it supports optimal growth and development during infancy and reduces the risk of obliterating diseases and problems. Moreover, in developed countries, exclusive breastfeeding has decreased the incidence and/or severity of diarrhea, lower respiratory infection and urinary tract infection. In this paper, we study the factors that influence exclusive breastfeeding and use the Generalized Poisson regression model to analyze the practices of exclusive breastfeeding in Mauritius. We develop two sets of quasi-likelihood equations (QLE)to estimate the parameters.

Keywords: Exclusive breastfeeding, Regression model, Quasilikelihood.

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Authors: Naushad Mamode Khan, Cheika Jahangeer, Maleika Heenaye-Mamode Khan

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Exclusive breastfeeding is the feeding of a baby on no other milk apart from breast milk. Exclusive breastfeeding during the first 6 months of life is very important as it supports optimal growth and development during infancy and reduces the risk of obliterating diseases and problems. Moreover, it helps to reduce the incidence and/or severity of diarrhea, lower respiratory infection and urinary tract infection. In this paper, we make a survey of the factors that influence exclusive breastfeeding and use two dispersed statistical models to analyze data. The models are the Generalized Poisson regression model and the Com-Poisson regression models.

Keywords: Exclusive breastfeeding, regression model, generalized poisson, com-poisson.

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Authors: Yoshifumi Ishizaki, Naoki Kanatani, Masaki Ito, Toshihiko Sasama, Takao Kawamura, Kazunori Sugahara

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This paper demonstrates the bus location system for the route bus through the experiment in the real environment. A bus location system is a system that provides information such as the bus delay and positions. This system uses actual services and positions data of buses, and those information should match data on the database. The system has two possible problems. One, the system could cost high in preparing devices to get bus positions. Two, it could be difficult to match services data of buses. To avoid these problems, we have developed this system at low cost and short time by using the smart phone with GPS and the bus route system. This system realizes the path planning considering bus delay and displaying position of buses on the map. The bus location system was demonstrated on route buses with smart phones for two months.

Keywords: Route Bus, Path Planning System, GPS, Smart Phone.

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Authors: Yoshitaka Fujiwara, Jun-ichirou Fukushima, Yasunari Maeda

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Keys to high-quality face-to-face education are ensuring flexibility in the way lectures are given, and providing care and responsiveness to learners. This paper describes a face-to-face education support system that is designed to raise the satisfaction of learners and reduce the workload on instructors. This system consists of a lecture adaptation assistance part, which assists instructors in adapting teaching content and strategy, and a Q&A assistance part, which provides learners with answers to their questions. The core component of the former part is a “learning achievement map", which is composed of a Bayesian network (BN). From learners- performance in exercises on relevant past lectures, the lecture adaptation assistance part obtains information required to adapt appropriately the presentation of the next lecture. The core component of the Q&A assistance part is a case base, which accumulates cases consisting of questions expected from learners and answers to them. The Q&A assistance part is a case-based search system equipped with a search index which performs probabilistic inference. A prototype face-to-face education support system has been built, which is intended for the teaching of Java programming, and this approach was evaluated using this system. The expected degree of understanding of each learner for a future lecture was derived from his or her performance in exercises on past lectures, and this expected degree of understanding was used to select one of three adaptation levels. A model for determining the adaptation level most suitable for the individual learner has been identified. An experimental case base was built to examine the search performance of the Q&A assistance part, and it was found that the rate of successfully finding an appropriate case was 56%.

Keywords: Bayesian network, face-to-face education, lecture adaptation, Q&A assistance.

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Authors: Hanieh Jalali, Ahmad Baraani

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Nowaday-s, many organizations use systems that support business process as a whole or partially. However, in some application domains, like software development and health care processes, a normative Process Aware System (PAS) is not suitable, because a flexible support is needed to respond rapidly to new process models. On the other hand, a flexible Process Aware System may be vulnerable to undesirable and fraudulent executions, which imposes a tradeoff between flexibility and security. In order to make this tradeoff available, a genetic-based anomaly detection model for logs of Process Aware Systems is presented in this paper. The detection of an anomalous trace is based on discovering an appropriate process model by using genetic process mining and detecting traces that do not fit the appropriate model as anomalous trace; therefore, when used in PAS, this model is an automated solution that can support coexistence of flexibility and security.

Keywords: Anomaly Detection, Genetic Algorithm, ProcessAware Systems, Process Mining.

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Authors: Antonio Espingardeiro

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It is likely that robots will cross the boundaries of industry into households over the next decades. With demographic challenges worldwide, the future ageing populations will require the introduction of assistive technologies capable of providing, care, human dignity and quality of life through the aging process. Robotics technology has a high potential for being used in the areas of social and healthcare by promoting a wide range of activities such as entertainment, companionship, supervision or cognitive and physical assistance. However such close Human Robotics Interaction (HRI) encompass a rich set of ethical scenarios that need to be addressed before Socially Assistive Robots (SARs) reach the global markets. Such interactions with robots may seem a worthy goal for many technical/financial reasons but inevitably require close attention to the ethical dimensions of such interactions. This article investigates the current HRI benchmark of social success. It revises it according to the ethical principles of beneficence, non-maleficence and justice aligned with social care ethos. An extension of such benchmark is proposed based on an empirical study of HRIs conducted with elderly groups.

Keywords: HRI, SARs, Social Success, Benchmark, Elderly care.

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Authors: N. Rugthaicharoencheep, T. Langtharthong

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This paper presents the optimal placement and sizing of distributed generation (DG) in a distribution system. The problem is to reliability improvement of distribution system with distributed generations. The technique employed to solve the minimization problem is based on a developed Tabu search algorithm and reliability worth analysis. The developed methodology is tested with a distribution system of Roy Billinton Test System (RBTS) bus 2. It can be seen from the case study that distributed generation can reduce the customer interruption cost and therefore improve the reliability of the system. It is expected that our proposed method will be utilized effectively for distribution system operator.

Keywords: Distributed generation Optimization technique Reliability improvement, Distribution system.

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Authors: Juan L. Castro, Maria I. NavarroVictor Lopez, Eduardo M. Eisman, Jose M. Zurita

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This paper describes the Multilingual Virtual Simulated Patient framework. It has been created to train the social skills and testing the knowledge of primary health care medical students. The framework generates conversational agents which perform in serveral languages as virtual simulated patients that help to improve the communication and diagnosis skills of the students complementing their training process.

Keywords: Medical training, conversational agents, patient modeling.

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Authors: Ryuji Yamazaki, Masahiro Kochi, Weiran Zhu, Hiroko Kase

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In care for older adults, behavioral and psychological symptoms of dementia (BPSD) like agitation and aggression are distressing for patients and their caretakers, often resulting in premature institutionalization with increased costs of care. To improve mood and mitigate symptoms, as a non-pharmaceutical approach, emotion-oriented therapy like reminiscence work is adopted in face-to-face communication. Telecommunication support is expected to be provided by robotic media as a bridge for digital divide for those with dementia and facilitate social interaction both verbally and nonverbally. The purpose of this case study is to explore the conditions in which robotic media can effectively attract attention from older adults with dementia and promote their well-being. As a pilot study, we introduced the pillow-phone Hugvie^®, a huggable humanly shaped communication medium to five residents with dementia at a care facility, to investigate how the following conditions work for the elderly when they use the medium; 1) no sound, 2) radio, non-interactive, 3) daily conversation, and 4) reminiscence work. As a result, under condition 4, reminiscence work, the five participants kept concentration in interacting with the medium for a longer duration than other conditions. In condition 4, they also showed larger amount of utterances than under other conditions. These results indicate that providing topics related to personal histories through robotic media could affect communication positively and should, therefore, be further investigated. In addition, the issue of ethical implications by using persuasive technology that affects emotions and behaviors of older adults is also discussed.

Keywords: BPSD, reminiscence, tactile telecommunication, utterances.

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Authors: Raju Kaduru, Narsaiah Srinivas Gondlala

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This paper presents an analytical approach for evaluating distribution system reliability indices in the presence of distributed generation. Modeling distributed generation and evaluation of distribution system reliability indices using the frequency duration technique. Using model implements and case studies are discussed. Results showed that location of DG and its effect in distribution reliability indices. In this respect, impact of DG on distribution system is investigated using the IEEE Roy Billinton test system (RBTS2) included feeder 1. Therefore, it will help to the distribution system planners in the DG resource placement.

Keywords: Distributed Generation, DG Location, Distribution System, Reliability Indices.

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Authors: Kalinga Ellen A., Bagile Burchard B.

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Tanzania Secondary Schools e-Learning (TanSSe-L) system is a customized learning management system (LMS) developed to enable ICT support in teaching and learning functions. Methodologies involved in the development of TanSSe-L system are Object oriented system analysis and design with UML to create and model TanSSe-L system database structure in the form of a design class diagram, Model Driven Architecture (MDA) to provide a well defined process in TanSSe-L system development, where MDA conceptual layers were integrated with system development life cycle and customization of open source learning management system which was used during implementation stage to create a timely functional TanSSe-L system. Before customization, a base for customization was prepared. This was the manual transformation from TanSSe-L system platform independent models (PIM) to TanSSe-L system specific PIM. This paper presents how Moodle open source LMS was analyzed and prepared to be the TanSSe-L system specific PIM as applied by MDA.

Keywords: Customization, e-Learning, MDA Transformation, Moodle, Secondary Schools, Tanzania.

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

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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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Authors: Vicky Suri, Monika Suri Grover, Raghav Gupta, Shipra Asija, Sulabh Arya, Sushant Jain

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With today's fast lifestyles and busy schedule, nuclear families are becoming popular. Thus, the elderly members of these families are often neglected. This has lead to the popularity of the concept of Community living for the aged. The elders reside at a centre, which is controlled by the MANAGER. The manager takes responsibility of the functioning of the centre which includes taking care of 'residents' at the centre along with managing the daily chores of the centre, which he accomplishes with the help of a number of staff members and volunteers Often the Manager is not an employee but a volunteer. In such cases especially, time is an important constraint. A system, which provides an easy and efficient manner of managing the working of an old age home in detail, will prove to be of great benefit. We have developed a P.C. based organizer used to monitor the various activities of an old age home. It is an effective and easy-to-use system which will enable the manager to keep an account of all the residents, their accounts, staff members, volunteers, the centre-s logistic requirements etc. It is thus, a comprehensive 'Organizer' for Old Age Homes.

Keywords: Old Age Home Organizer, HelpAge India.

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Authors: Yu-Chi Shiue, Jyong Lin, Shih-Chang Chen

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With the increase of economic behavior and the upgrade of living standar, the ratio for people in Taiwan who own automobiles and motorcycles have recently increased with multiples. Therefore, parking issues will be a big challenge to facilitate traffic network and ensure urban life quality. The Parking Guidance and Information System is one of important systems for Advanced Traveler Information Services (ATIS). This research proposes a parking guidance and information system which integrates GPS and 3G network for a map on the Geographic Information System to solution inadequate of roadside information kanban. The system proposed in this study mainly includes Parking Host, Parking Guidance and Information Server, Geographic Map and Information System as well as Parking Guidance and Information Browser. The study results show this system can increase driver-s efficiency to find parking space and efficiently enhance parking convenience in comparison with roadside kanban system.

Keywords: Geographic Information System, 3G, GPS, parkinginformation

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Authors: Jenny K. Ubaque, Edward P. Guillen, Juan S. Solórzano, Leonardo J. Ramírez

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The health care must be a right for people around the world, but in order to guarantee the access to all, it is necessary to overcome geographical barriers. Telemedicine take advantage of Information Communication Technologies to deploy health care services around the world. To achieve those goals, it is necessary to use existing last mile solution to create access for home users, which is why is necessary to establish the channel characteristics for those kinds of services. This paper presents an analysis of network performance of last mile solution for the use of IPTV broadcasting with the application of streaming for telemedicine apps.

Keywords: Telemedicine, IPTV, GPON, ADSL2+, COAXIAL, Jumbogram.

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Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: Average run length, Bernoulli CUSUM chart, beta binomial posterior predictive distribution, clinical indicator, health care organization, highest posterior density interval.

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Authors: Muhibul H. Bhuyan, Mafujul Hasan

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If a person can monitor his/her heart rate regularly then he/she can detect heart disease early and thus he/she can enjoy longer life span. Therefore, this disease should be taken seriously. Hence, many health care devices and monitoring systems are being designed to keep track of the heart disease. This work reports a design and simulation processes of an Arduino microcontroller based heart rate measurement and monitoring system in Proteus environment. Clipping sensors were utilized to sense the heart rate of an individual from the finger tips. It is a digital device and uses mainly infrared (IR) transmitter (mainly IR LED) and receiver (mainly IR photo-transistor or IR photo-detector). When the heart pumps the blood and circulates it among the blood vessels of the body, the changed blood pressure is detected by the transmitter and then reflected back to the receiver accordingly. The reflected signals are then processed inside the microcontroller through a software written assembly language and appropriate heart rate (HR) is determined by it in beats per minute (bpm) from the detected signal for a duration of 10 seconds and display the same in bpm on the LCD screen in digital format. The designed system was simulated on several persons with varying ages, for example, infants, adult persons and active athletes. Simulation results were found very satisfactory.

Keywords: Heart rate measurement, design, simulation, Proteus, Arduino Uno microcontroller.

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Authors: Amjaad Alsalamah, Liyakathunsia Syed

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Transportation is an essential need for many people to go to their work, school, and home. In particular, the main common method inside many cities is to drive the car. Driving a car can be an easy job to reach the destination and load all stuff in a reasonable time. However, deciding to find a parking lot for a car can take a long time using the traditional system that can issue a paper ticket for each customer. The old system cannot guarantee a parking lot for all customers. Also, payment methods are not always available, and many customers struggled to find their car among a numerous number of cars. As a result, this research focuses on providing an online smart parking system in order to save time and budget. This system provides a flexible management system for both parking owner and customers by receiving all request via the online system and it gets an accurate result for all available parking and its location.

Keywords: Smart parking system, IoT, tracking system, process model, cost, time.

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Authors: M. H. Moradi, S. M. Moosavi, A. R. Reisi

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The main objective of this paper is to investigate the enhancement of power system stability via coordinated tuning of Power System Stabilizers (PSSs) in a multi-machine power system. The design problem of the proposed controllers is formulated as an optimization problem. Chaotic catfish particle swarm optimization (C-Catfish PSO) algorithm is used to minimize the ITAE objective function. The proposed algorithm is evaluated on a two-area, 4- machines system. The robustness of the proposed algorithm is verified on this system under different operating conditions and applying a three-phase fault. The nonlinear time-domain simulation results and some performance indices show the effectiveness of the proposed controller in damping power system oscillations and this novel optimization algorithm is compared with particle swarm optimization (PSO).

Keywords: Power system stabilizer, C-Catfish PSO, ITAE objective function, Power system control, Multi-machine power system

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Authors: Chih-Jian Hu, Chung-Chih Cheng, Hsiao-Yuan Wu., Nien-Tzu Chao

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Increasing user comfort and reducing operation costs have always been primary objectives of lighting control strategies in a building. This paper proposes an architecture of the lighting control system for a daylit office. The system consists of the lighting controller, A/D & D/A converter, dimmable LED lights, and the lighting management software. Verification tests are conducted using the proposed system specialized for the interior lighting of a open-plan office. The results showed the proposed architecture of the lighting system would improve the overall system reliability, lower the system cost, and provide ease of installation and maintenance.

Keywords: control, dimming, LED, lighting.

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Authors: M. R. Akshaya, Veena Rao

Abstract:

Pet population in India is increasing phenomenally owing to the changes in urban lifestyle with increasing number of single professionals, single parents, delayed parenthood etc. The animal companionship as a means of reducing stress levels, deriving emotional support, and unconditional love provided by dogs are a few reasons attributed for increasing pet ownership. The consequence is the booming of the pet care products and dog care centers catering to the different requirements of rearing the pets. Dog care centers quite popular in tier 1 metros of India cater to the requirement of the dog owners providing space for the dogs in absence of the owner. However, it is often reported that the absence of the owner leads to destructive and exploratory behavior issues; the main being the anxiety disorders. In the above context, it becomes imperative for a designer to design dog boarding centers that help in reducing the separation anxiety in dogs keeping in mind the different interior design parameters. An exploratory research with focus group discussion is employed involving a group of dog owners, behaviorists, proprietors of day care as well as boarding centers, and veterinarians to understand their perception on the significance of different interior parameters of color, texture, ventilation, aroma therapy and acoustics as a means of reducing the stress levels in dogs sent to the boarding centers. The data collected is organized as thematic networks thus enabling the listing of the interior design parameters that needs to be considered in designing dog boarding centers. 

Keywords: Behavioral response, design parameters, dog boarding centers, interior environment.

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Authors: Mehtap Dursun, E. Ertugrul Karsak, Melis Almula Karadayi

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The management of the health-care wastes is one of the most important problems in Istanbul, a city with more than 12 million inhabitants, as it is in most of the developing countries. Negligence in appropriate treatment and final disposal of the healthcare wastes can lead to adverse impacts to public health and to the environment. This paper employs a fuzzy multi-criteria group decision making approach, which is based on the principles of fusion of fuzzy information, 2-tuple linguistic representation model, and technique for order preference by similarity to ideal solution (TOPSIS), to evaluate health-care waste (HCW) treatment alternatives for Istanbul. The evaluation criteria are determined employing nominal group technique (NGT), which is a method of systematically developing a consensus of group opinion. The employed method is apt to manage information assessed using multigranularity linguistic information in a decision making problem with multiple information sources. The decision making framework employs ordered weighted averaging (OWA) operator that encompasses several operators as the aggregation operator since it can implement different aggregation rules by changing the order weights. The aggregation process is based on the unification of information by means of fuzzy sets on a basic linguistic term set (BLTS). Then, the unified information is transformed into linguistic 2-tuples in a way to rectify the problem of loss information of other fuzzy linguistic approaches.

Keywords: Group decision making, health care waste management, multi-criteria decision making, OWA, TOPSIS, 2-tuple linguistic representation

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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Authors: Andrea Zielke-Nadkarni

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Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: Pain management, migrants, sociocultural context, palliative care.

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Authors: M. Rozanek, K. Roubik

Abstract:

A mathematical model of the respiratory system is introduced in this study. Geometrical dimensions of the respiratory system were used to compute the acoustic properties of the respiratory system using the electro-acoustic analogy. The effect of the geometrical proportions of the respiratory system is observed in the paper.

Keywords: Electro-acoustic analogy, total lung impedance, mechanical parameters, respiratory system.

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