Search results for: Elderly care.

Authors: H. Ashrafi, S. Ebrahimi, H. Kamalzadeh

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With the development of business competition, it is important for healthcare providers to improve their service qualities. In order to improve service quality of a clinic, four important dimensions are defined: tangibles, responsiveness, empathy, and reliability. Moreover, there are several service stages in hospitals such as financial screening and examination. One of the most challenging limitations for improving service quality is budget which impressively affects the service quality. In this paper, we present an approach to address budget uncertainty and provide guidelines for service resource allocation. In this paper, a service quality improvement approach is proposed which can be adopted to multistage service processes to improve service quality, while controlling the costs. A multi-objective function based on the importance of each area and dimension is defined to link operational variables to service quality dimensions. The results demonstrate that our approach is not ultra-conservative and it shows the actual condition very well. Moreover, it is shown that different strategies can affect the number of employees in different stages.

Keywords: Service quality assessment, healthcare resource allocation, robust optimization, budget uncertainty.

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Authors: Inas S. Khayal, Weiping Zhou, Jonathan Skinner

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Healthcare delivery systems around the world are in crisis. The need to improve health outcomes while decreasing healthcare costs have led to an imminent call to action to transform the healthcare delivery system. While Bioinformatics and Biomedical Engineering have primarily focused on biological level data and biomedical technology, there is clear evidence of the importance of the delivery of care on patient outcomes. Classic singular decomposition approaches from reductionist science are not capable of explaining complex systems. Approaches and methods from systems science and systems engineering are utilized to structure healthcare delivery system data. Specifically, systems architecture is used to develop a multi-scale and multi-dimensional characterization of the healthcare delivery system, defined here as the Healthcare Delivery System Knowledge Base. This paper is the first to contribute a new method of structuring and visualizing a multi-dimensional and multi-scale healthcare delivery system using systems architecture in order to better understand healthcare delivery.

Keywords: Health informatics, systems thinking, systems architecture, healthcare delivery system, data analytics.

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Authors: C. Papapicco

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Motherhood is an existential human relationship that lasts for the whole life and is always interwoven with subjectivity and culture. As a result of the brain drain, the motherhood becomes motherhood at distance. Starting from the hypothesis that re-signification of the mother at distance practices is culturally relevant; the research aims to understand the experience of mother at a distance in order to extrapolate the strategies of management of the empty nest. Specifically, the research aims to evaluate the experience of a brain drain’s mother, who created a blog that intends to take care of other parents at a distance. Actually, the blog is the only artifact symbol of the Italian culture of motherhood at distance. In the research, a Netnographic Analysis of the blog mammedicervelliinfuga.com is offered with the aim of understanding if the online world becomes an opportunity to manage the role of mother at a distance. A narrative interview with the blog creator was conducted and then the texts were analyzed by means of a Diatextual Analysis approach. It emerged that the migration projects of talented children take on different meanings and representations for parents. Thus, it is shown that the blog becomes a new form of understanding and practicing motherhood at a distance.

Keywords: Brain drain, diatextual analysis, distance motherhood blog, online and offline narrations.

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Authors: Tahvilian R., Siahi Shadbad MR., Hamishehkar H., Aghababa Gharehbagh V.

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Nowadays pharmaceutical care departments located in hospitals are amongst the important pillars of the healthcare system. The aim of this study was to evaluate quality of hospital drugstores affiliated with Kermanshah University of Medical Sciences. In this cross-sectional study a validated questionnaire was used. The questionnaire was filled in by the one of the researchers in all seventeen hospital drugstores located in the teaching and nonteaching hospitals affiliated with Kermanshah University of Medical Sciences. The results shows that in observed hospitals,24% of pharmacy environments, 25% of pharmacy store and storage conditions, 49% of storage procedure, 25% of ordering drugs and supplies, 73% of receiving supplies (proper procedure are fallowed for receiving supplies), 35% of receiving supplies (prompt action taken if deterioration of drugs received is suspected), 23.35% of drugs delivery to patients and finally 0% of stock cards are used for proper inventory control have full compliance with standards.

Keywords: Hospital pharmacy standards, Kermanshah, pharmacy management

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Authors: Qin Wei

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There has been an increased number of immigrants arriving in Canada and a concurrent rise in the number of immigrant youth suffering from drug abuse. Immigrant youths’ drug abuse has become a significant social and public health concern for researchers. This paper explores the nature of immigrant youths’ drug abuse by examining the factors influencing the onset of substance misuse, the barriers that discourage youth to seek out treatment, and how to resolve addictions amidst immigrant youth. Findings demonstrate that diminished parental supervision, acculturation challenges, peer conformity, discrimination, and ethnic marginalization are all significant factors influencing youth to use drugs as an outlet for their pain, while culturally incompetent care and fear of family and culture-based addiction stigma act as barriers discouraging youth from seeking out addiction support. To resolve addiction challenges amidst immigrant youth, future research should focus on promoting and implementing culturally sensitive practices and psychoeducational initiatives into immigrant communities and within public health policies.

Keywords: Approaches, barriers, drug abuse, Canada, immigrant youth.

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Authors: Samir Abdelhamid, Noureddine Bouguechal

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We report in this paper the model adopted by our system of continuous speech recognition in Arab language SySRA and the results obtained until now. This system uses the database Arabdic-10 which is a corpus of word for the Arab language and which was manually segmented. Phonetic decoding is represented by an expert system where the knowledge base is translated in the form of production rules. This expert system transforms a vocal signal into a phonetic lattice. The higher level of the system takes care of the recognition of the lattice thus obtained by deferring it in the form of written sentences (orthographical Form). This level contains initially the lexical analyzer which is not other than the module of recognition. We subjected this analyzer to a set of spectrograms obtained by dictating a score of sentences in Arab language. The rate of recognition of these sentences is about 70% which is, to our knowledge, the best result for the recognition of the Arab language. The test set consists of twenty sentences from four speakers not having taken part in the training.

Keywords: Continuous speech recognition, lexical analyzer, phonetic decoding, phonetic lattice, vocal signal.

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Authors: Amit Kumar, Himanshu Singal, Arnav Bhavsar

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In this modern era of automation, most of the academic exams and competitive exams are Multiple Choice Questions (MCQ). The responses of these MCQ based exams are recorded in the Optical Mark Reader (OMR) sheet. Evaluation of the OMR sheet requires separate specialized machines for scanning and marking. The sheets used by these machines are special and costs more than a normal sheet. Available process is non-economical and dependent on paper thickness, scanning quality, paper orientation, special hardware and customized software. This study tries to tackle the problem of evaluating the OMR sheet without any special hardware and making the whole process economical. We propose an image processing based algorithm which can be used to read and evaluate the scanned OMR sheets with no special hardware required. It will eliminate the use of special OMR sheet. Responses recorded in normal sheet is enough for evaluation. The proposed system takes care of color, brightness, rotation, little imperfections in the OMR sheet images.

Keywords: OMR, image processing, hough circle transform, interpolation, detection, Binary Thresholding.

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Authors: A. M. Tarola, R. Preti, A. M. Girelli, P. Campana

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Goat dairy products are gaining popularity worldwide. In developing countries, but also in many marginal regions of the Mediterranean area, goats represent a great part of the economy and ensure food security. In fact, these small ruminants are able to convert efficiently poor weedy plants and small trees into traditional products of high nutritional quality, showing great resilience to different climatic and environmental conditions. In developed countries, goat milk is appreciated for the presence of health-promoting compounds, bioactive compounds such as conjugated linoleic acids, oligosaccharides, sphingolipids and polyammines. This paper focuses on the recent advances in literature on the nutritional properties of goat milk and on innovative techniques to improve its quality as to become a promising functional food. The environmental sustainability of different methodologies of production has also been examined. Goat milk is valued today as a food of high nutritional value and functional properties as well as small environmental footprint. It is widely consumed in many countries due to high nutritional value, lower allergenic potential, and better digestibility when compared to bovine milk, that makes this product suitable for infants, elderly or sensitive patients. The main differences in chemical composition between a cow and goat milk rely on fat globules that in goat milk are smaller and in fatty acids that present a smaller chain length, while protein, fat, and lactose concentration are comparable. Milk nutritional properties have demonstrated to be strongly influenced by animal diet, genotype, and welfare, but also by season and production systems. Furthermore, there is a growing interest in the dairy industry in goat milk for its relatively high concentration of prebiotics and a good amount of probiotics, which have recently gained importance for their therapeutic potential. Therefore, goat milk is studied as a promising matrix to develop innovative functional foods. In addition to the economic and nutritional value, goat milk is considered a sustainable product for its small environmental footprint, as they require relatively little water and land, and less medical treatments, compared to cow, these characteristics make its production naturally vocated to organic farming. Organic goat milk production has becoming more and more interesting both for farmers and consumers as it can answer to several concerns like environment protection, animal welfare and economical sustainment of rural populations living in marginal lands. These evidences make goat milk an ancient food with novel properties and advantages to be valorized and exploited.

Keywords: Goat milk, nutritional quality, bioactive compounds, sustainable production.

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Authors: Devasis Ghosh

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The main hindrance to total cure of cancer is a) the failure to control continued production of cancer cells, b) its sustenance and c) its metastasis. This review study has tried to address this issue of total cancer cure in a more innovative way. A 10-pronged “CRAB METHOD”, a novel holistic scientific approach of Cancer treatment has been hypothesized in this paper. Apart from available Chemotherapy, Radiotherapy and Oncosurgery, (which shall not be discussed here), seven other points of interference and treatment has been suggested, i.e. 1. Efficient stress management. 2. Dampening of ATF3 expression. 3. Selective inhibition of Platelet Activity. 4. Modulation of serotonin production, metabolism and 5HT receptor antagonism. 5. Auxin, its anti-proliferative potential and its modulation. 6. Melatonin supplementation because of its oncostatic properties. 7. HDAC Inhibitors especially valproic acid use due to its apoptotic role in many cancers. If all the above stated seven steps are thoroughly taken care of at the time of initial diagnosis of cancer along with the available treatment modalities of Chemotherapy, Radiotherapy and Oncosurgery, then perhaps, the morbidity and mortality rate of cancer may be greatly reduced.

Keywords: ATF3 dampening, auxin modulation, cancer, platelet activation, serotonin, stress, valproic acid.

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Authors: Jaipal Bisht, Aditya Goel

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Optical Burst Switching (OBS) is a promising technology for the future generation Internet. Control architecture and Contention resolution are the main issues faced by the Optical Burst Switching networks. In this paper we are only taking care of the Contention problem and to overcome this issue we propose Pre-Deflection Routing with Control Packet Signal Scheme for Contention Resolution in Optical Burst Switch Networks. In this paper Pre-deflection routing approach has been proposed in which routing is carried out in two ways, Shortest Path First (SPF) and Least Hop First (LHF) Routing to forward the clusters and canoes respectively. Hereafter Burst Offset Time Control Algorithm has been proposed where a forward control packet (FCP) collects the congestion price and contention price along its paths. Thereafter a reverse-direction control packet (RCP) sent by destination node which delivers the information of FCP to the source node, and source node uses this information to revise its offset time and burst length.

Keywords: Contention Resolution, FCP, OBS, Offset Time, PST, RCP.

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Authors: Hui Fang Huang Su, Leanne Lai, Pei-Fen Li, Mei-Hwei Ho, Yu-Wen Chiu

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This study aimed to provide a practical, systematic, and comprehensive intervention for children with Autism Spectrum Disorder (ASD). A pilot study of quasi-experimental pre-post intervention with control group design was conducted to evaluate if the mathematical intervention (Project MIND - Math Is Not Difficult) increases the math comprehension of children with ASD Children with ASD in the primary grades (K-1, 2) participated in math interventions to enhance their math comprehension and cognitive ability. The Bracken basic concept scale was used to evaluate subjects’ language skills, cognitive development, and school readiness. The study found that our systemic interventions of Project MIND significantly improved the mathematical and cognitive abilities in children with autism. The results of this study may lead to a major change in effective and adequate health care services for children with ASD and their families. All statistical analyses were performed with the IBM SPSS Statistics Version 25 for Windows. The significant level was set at 0.05 P-value.

Keywords: Young Children, Autism, Mathematics, Curriculum, teaching and learning, children with special needs, Project MIND.

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Authors: E. N. Hasanov, K. Y. Yusifova, M. A. Ali

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Rabies is a zoonotic disease that causes acute encephalitis in domestic and wild carnivores. The goal of this investigation was to analyze the data on oral vaccination of wild canids and stray dogs in Azerbaijan. Before the start of vaccination campaign conducted by the IDEA (International Dialogue for Environmental Action) Animal Care Center (IACC), all rabies cases in Azerbaijan for the period of 2017-2020 were analyzed. So, 30 regions for oral immunization with the Rabadrop vaccine were selected. In total, 95.9 thousand doses of baits were scattered in 30 regions, 970 (0.97%) remained intact. In addition, a campaign to sterilize and vaccinate stray dogs and cats undoubtedly had a positive impact on reducing the dynamics of rabies incidence. During the period 2017-2020, 2,339 dogs and 2,962 cats were sterilized and vaccinated under this program. It can be noted that the risk of rabies infection can be reduced through special preventive measures against disease reservoirs, which include oral immunization of wild and stray animals.

Keywords: Rabies, vaccination, oral immunization, wild canids, stray dogs, vaccine, disease reservoirs.

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Authors: L. Grinis, N. Lubashevsky, Y. Ostrovski

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In wastewater treatment processes, aeration introduces air into a liquid. In these systems, air is introduced by different devices submerged in the wastewater. Smaller bubbles result in more bubble surface area per unit of volume and higher oxygen transfer efficiency. Jet pumps are devices that use air bubbles and are widely used in wastewater treatment processes. The principle of jet pumps is their ability to transfer energy of one fluid, called primary or motive, into a secondary fluid or gas. These pumps have no moving parts and are able to work in remote areas under extreme conditions. The objective of this work is to study experimentally the characteristics of the jet pump and the size of air bubbles in the laboratory water tank. The effect of flow rate ratio on pump performance is investigated in order to have a better understanding about pump behavior under various conditions, in order to determine the efficiency of receiving air bubbles different sizes. The experiments show that we should take care when increasing the flow rate ratio while seeking to decrease bubble size in the outlet flow. This study will help improve and extend the use of the jet pump in many practical applications.

Keywords: Jet pump, air bubbles size, retention time.

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Authors: Turki Alotaibi

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Student counseling programs can provide many benefits to students in schools all around the world. In theory, the government of the Kingdom of Saudi Arabia (Saudi Arabia) has committed itself to school counseling programs in educational institutions throughout the country. Student counselors face a number of burdens and obstacles that impact student counseling programs. It is also widely known that Saudi Arabia has extremely high prevalence rates for overweight and obesity, anxiety and depression, and diabetes in children. It has also been demonstrated that teachers and staff are inadequately prepared when dealing with health issues relating to diabetes in schools in Saudi Arabia. This study will clearly demonstrate how student counselors in Saudi Arabia could become 'New Educators' in Saudi schools in relation to these health issues. This would allow them to leverage their position as student counselor to improve the management of these health issues in Saudi schools, to improve the quality of care provided to school children, and to overcome burdens and obstacles that are currently negatively affecting student counseling in Saudi schools.

Keywords: Anxiety, depression, diabetes, overweight, obesity, policy recommendations, student counseling, The Kingdom of Saudi Arabia.

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Authors: I-En Lin, Feng-Jung Yang

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In addition to kidney transplant, renal replacement therapy involves hemodialysis and peritoneal dialysis (PD). PD possesses advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home dialysis treatment. However, potential danger still exists despite the numerous advantages of PD, particularly when patients require dialysis exchange four to five times a day, during which improper operation can easily lead to peritonitis. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. Connecting the transfer set requires sterile technique. Transfer set may require a new cap each time that it disconnects from the bag after an exchange. There are many chances to get infection due to unsafe behavior (ex: hand tremor, poor eyesight and weakness, cap fall-down). The proposed semi-automatic connection mechanism used in the PD can greatly reduce infection chances. This light-weight connection device is portable. The device also does not require using throughout the entire process. It is capable of significantly improving quality of life. Therefore, it is very promising to adopt in home care application.

Keywords: Automatic connection, catheter, glomerulonephritis, peritoneal dialysis.

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Authors: Meriem Benzarti, Mohamed Ben Tkaya, Cyril Pailler Mattei, Hassan Zahouani

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Hair is a non homogenous complex material which can be associated with a polymer. It is made up 95% of Keratin. Hair has a great social significance for human beings. In the High Middle Ages, for example, long hairs have been reserved for kings and nobles. Most common interest in hair is focused on hair growth, hair types and hair care, but hair is also an important biomaterial which can vary depending on ethnic origin or on age, hair colour for example can be a sign of ethnic ancestry or age (dark hair for Asiatic, blond hair for Caucasian and white hair for old people in general). In this context, different approaches have been conducted to determine the differences in mechanical properties and characterize the fracture topography at the surface of hair depending on its type and its age. A tensile testing machine was especially designed to achieve tensile tests on hair. This device is composed of a microdisplacement system and a force sensor whose peak load is limited to 3N. The curves and the values extracted from each experiment, allow us to compare the evolution of the mechanical properties from one hair to another. Observations with a Scanning Electron Microscope (SEM) and with an interferometer were made on different hairs. Thus, it is possible to access the cuticle state and the fracture topography for each category.

Keywords: Hair, relaxation test, SEM, interferometer, mechanical properties.

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Authors: Sheetal Chavan, P. J. Kulkarni, Vivek Shanbhag

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Although achieving zero-defect software release is practically impossible, software industries should take maximum care to detect defects/bugs well ahead in time allowing only bare minimums to creep into released version. This is a clear indicator of time playing an important role in the bug detection. In addition to this, software quality is the major factor in software engineering process. Moreover, early detection can be achieved only through static code analysis as opposed to conventional testing. BugCatcher.Net is a static analysis tool, which detects bugs in .NET® languages through MSIL (Microsoft Intermediate Language) inspection. The tool utilizes a Parser based on Finite State Automata to carry out bug detection. After being detected, bugs need to be corrected immediately. BugCatcher.Net facilitates correction, by proposing a corrective solution for reported warnings/bugs to end users with minimum side effects. Moreover, the tool is also capable of analyzing the bug trend of a program under inspection.

Keywords: Dependence, Early solution, Finite State Automata, Grammar, Late solution, Parser State Transition Diagram, StaticProgram Analysis.

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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: Miroslava Šidlovská, Ida Petrovičová, Tomáš Pilka, Branislav Kolena

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Phthalates are ubiquitous environmental pollutants well known because of their endocrine disrupting activity in human organism. The aim of our study was, by biological monitoring, investigate exposure to phthalates of Roma ethnicity group i.e. children and adults from 5 families (n=29, average age 11.8 ± 7.6 years) living in western Slovakia. Additionally, we analysed some associations between anthropometric measures, questionnaire data i.e. socio-economic status, eating and drinking habits, practise of personal care products and household conditions in comparison with concentrations of phthalate metabolites. We used for analysis of urine samples high performance liquid chromatography and tandem mass spectrometry (HPLC-MS/MS) to determine concentrations of phthalate metabolites monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-iso-butyl phthalate (MiBP), mono(2-ethyl- 5-hydroxyhexyl) phthalate (5OH-MEHP), mono(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP) and mono(2-etylhexyl) phthalate (MEHP). Our results indicate that ethnicity, lower socioeconomic status and different housing conditions in Roma population can affect urinary concentration of phthalate metabolites.

Keywords: Biomonitoring, ethnicity, human exposure, phthalate metabolites.

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Authors: Sotirios Raptis

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Health and Social care (HSc) services planning and scheduling are facing unprecedented challenges, due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven approaches can help to improve policies, plan and design services provision schedules using algorithms that assist healthcare managers to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as Classification and Regression Trees (CART), Random Forests (RF), and Logistic Regression (LGR). The significance tests Chi-Squared and Student’s test are used on data over a 39 years span for which data exist for services delivered in Scotland. The demands are associated using probabilities and are parts of statistical hypotheses. These hypotheses, as their NULL part, assume that the target demand is statistically dependent on other services’ demands. This linking is checked using the data. In addition, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus, groups of services. Statistical tests confirmed ML coupling and made the prediction statistically meaningful and proved that a target service can be matched reliably to other services while ML showed that such marked relationships can also be linear ones. Zero padding was used for missing years records and illustrated better such relationships both for limited years and for the entire span offering long-term data visualizations while limited years periods explained how well patients numbers can be related in short periods of time or that they can change over time as opposed to behaviours across more years. The prediction performance of the associations were measured using metrics such as Receiver Operating Characteristic (ROC), Area Under Curve (AUC) and Accuracy (ACC) as well as the statistical tests Chi-Squared and Student. Co-plots and comparison tables for the RF, CART, and LGR methods as well as the p-value from tests and Information Exchange (IE/MIE) measures are provided showing the relative performance of ML methods and of the statistical tests as well as the behaviour using different learning ratios. The impact of k-neighbours classification (k-NN), Cross-Correlation (CC) and C-Means (CM) first groupings was also studied over limited years and for the entire span. It was found that CART was generally behind RF and LGR but in some interesting cases, LGR reached an AUC = 0 falling below CART, while the ACC was as high as 0.912 showing that ML methods can be confused by zero-padding or by data’s irregularities or by the outliers. On average, 3 linear predictors were sufficient, LGR was found competing well RF and CART followed with the same performance at higher learning ratios. Services were packed only when a significance level (p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, low birth weights, alcoholism, drug abuse, and emergency admissions. The work found  that different HSc services can be well packed as plans of limited duration, across various services sectors, learning configurations, as confirmed by using statistical hypotheses.

Keywords: Class, cohorts, data frames, grouping, prediction, probabilities, services.

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Authors: Tanya N. Beran, Michelle A. Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

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Although interprofessional practice is a collaborative approach for problem solving among health professionals, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists can be used to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal strategies to manage the conformity pressures that people face.

Keywords: Conformity, decision-making, interprofessional teams, medical simulation.

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Authors: Noor Azlina Mohd Salleh, Salmiah Kasolang, Ahmed Jaffar

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Green Lean Total Quality Management (TQM) System is a system comprises of Environmental Management System (EMS) practices which is integrated to TQM with Lean Manufacturing (LM) principles. The ultimate goal of this system is to focus on achieving total customer satisfaction and environmental care by removing eight wastes available in any process in an organization. A survey questionnaire was developed and distributed to 30 highly active automotive vendors in Malaysia and analyzed by SPSS v.17. It was found out that some vendors have been practicing TQM and LM while some have started to implement EMS. This study is only focusing on highly active companies that have been involved in MAJAICO Program and Proton Vendor Development Program. This is the first study conducted to know the current status of TQM, LM and EMS practices in highly active automotive companies in Malaysia. It was found out that EMS has been practiced by 16 companies out of 30. Within these 16 companies the approach is more holistic and green. This is a preliminary study that combined 4 awards practices, ISO/TS16949, Toyota Production System SAEJ4000, MAJAICO Lean Production System and EMS.

Keywords: Automotive Industry, Lean Manufacturing, Operational Engineering Management, Total Quality Management. Environmental Management System.

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Authors: R. F. Ajayi, U. Sidwaba, U. Feleni, S. F. Douman, E. Nxusani, L. Wilson, C. Rassie, O. Tovide, P. G. L. Baker, S. L. Vilakazi, R. Tshikhudo, E. I. Iwuoha

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Pyrazinamide (PZA) is among the first-line pro-drugs  in the tuberculosis (TB) combination chemotherapy used to treat  Mycobacterium tuberculosis. Numerous reports have suggested that  hepatotoxicity due to pyrazinamide in patients is due to inappropriate  dosing. It is, therefore necessary to develop sensitive and reliable  techniques for determining the PZA metabolic profile of diagnosed  patients promptly and at point-of-care. This study reports the  determination of PZA based on nanobiosensor systems developed  from disuccinimidyl octanedioate modified Cytochrome P450-2E1  (CYP2E1) electrodeposited on gold substrates derivatised with  (poly(8-anilino-1-napthalene sulphonic acid) PANSA/PVP-AgNPs  nanocomposites. The rapid and sensitive amperometric PZA  detection gave a dynamic linear range of 2µM to 16µM revealing a  limit of detection of 0.044µM and a sensitivity of 1.38µA/µM. The  Michaelis-Menten parameters; KM, KM app and IMAX were calculated to  be 6.0µM, 1.41µM and 1.51x10-6 A, respectively, indicating a  nanobiosensor suitable for use in serum.

Keywords: Cytochrome P450-2E1, Disuccinimidyl octanedioate, Pyrazinamide, Tuberculosis.

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Authors: Reza Ariaeinejad, Norm Archer

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Self-management is becoming a new emphasis for healthcare systems around the world. But there are many different problems with adoption of new health-related intervention systems. The situation is even more complicated for chronically ill patients with disabilities, illiteracy, and impairment in judgment in addition to their conditions, or having multiple co-morbidities. Providing online decision support to manage patient health and to provide better support for chronically ill patients is a new way of dealing with chronic disease management. In this study, the importance of mobile technology through an m-Health system that supports self-management interventions including the care provider, family and social support, education and training, decision support, recreation, and ongoing patient motivation to promote adherence and sustainability of the intervention are discussed. A proposed theoretical model for adoption and sustainability of system use is developed, based on UTAUT2 and IS Continuance of Use models, both of which have been pre-validated through longitudinal studies. The objective of this paper is to show the importance of using mobile technology in adoption and sustainability of use of an m-Health system which will result in commercially sustainable self-management support for chronically ill patients.

Keywords: M-health, e-health, self-management, disease.

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Authors: Joserra Díez, Ainhoa Meñika, Iñaki Sanz-Azkue, Arritokieta Ortuzar

Abstract:

Biodiversity provides humans with a great range of ecosystemic services; it is therefore an indispensable resource and a legacy to coming generations. However, in the last decades, the increasing exploitation of the Planet has caused a great loss of biodiversity and its acquaintance has decreased remarkably; especially in urbanized areas, due to the decreasing attachment of humans to nature. Yet, the Primary Education curriculum primes the identification of flora and fauna to guarantee the knowledge of children on their surroundings, so that they care for the environment as well as for themselves. In order to produce effective didactic material that meets the needs of both teachers and pupils, it is fundamental to diagnose the current situation. In the present work, the knowledge on biodiversity of 3^rd cycle Primary Education students in Biscay (n=98) and its relation to the size of the town/city of their school is discussed. Two tests have been used with such aim: one for tree identification and the other one so that the students enumerated the species of trees and animals they knew. Results reveal that knowledge of students on tree identification is scarce regardless the size of the city/town and of their school. On the other hand, animal species are better known than tree species.

Keywords: Biodiversity, population, tree identification, animal identification.

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Authors: Chang, Chun-Lang, Liu, Chun-Kai

Abstract:

This study, for its research subjects, uses patients who had undergone total knee replacement surgery from the database of the National Health Insurance Administration. Through the review of literatures and the interviews with physicians, important factors are selected after careful screening. Then using Cross Entropy Method, Genetic Algorithm Logistic Regression, and Particle Swarm Optimization, the weight of each factor is calculated and obtained. In the meantime, Excel VBA and Case Based Reasoning are combined and adopted to evaluate the system. Results show no significant difference found through Genetic Algorithm Logistic Regression and Particle Swarm Optimization with over 97% accuracy in both methods. Both ROC areas are above 0.87. This study can provide critical reference to medical personnel as clinical assessment to effectively enhance medical care quality and efficiency, prevent unnecessary waste, and provide practical advantages to resource allocation to medical institutes.

Keywords: Total knee replacement, Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization.

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Authors: J. Kolář, V. Dvořák

Abstract:

In this work, we try to find the best setting of Computational Fluid Dynamic solver available for the problems in the field of supersonic internal flows. We used the supersonic air-toair ejector to represent the typical problem in focus. There are multiple oblique shock waves, shear layers, boundary layers and normal shock interacting in the supersonic ejector making this device typical in field of supersonic inner flows. Modeling of shocks in general is demanding on the physical model of fluid, because ordinary conservation equation does not conform to real conditions in the near-shock region as found in many works. From these reasons, we decided to take special care about solver setting in this article by means of experimental approach of color Schlieren pictures and pneumatic measurement. Fast pressure transducers were used to measure unsteady static pressure in regimes with normal shock in mixing chamber. Physical behavior of ejector in several regimes is discussed. Best choice of eddy-viscosity setting is discussed on the theoretical base. The final verification of the k-ω SST is done on the base of comparison between experiment and numerical results.

Keywords: CFD simulations, color Schlieren, k-ω SST, supersonic flows, shock waves.

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Authors: Okolie Uchenna, Ehiemere Ijeoma, Ezenduka Pauline, Ogbu Sylvester

Abstract:

A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Keywords: Behavior change, diabetes mellitus, dietarymanagement, diet adherence.

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Authors: Abdul Baqi, Zaid Mohammad

Abstract:

Reinforced concrete stair slabs with mid landings i.e. Dog-legged shaped are conventionally designed as per specifications of standard codes of practices which guide about the effective span according to the varying support conditions. Presently, the behavior of such slabs has been investigated using Finite Element method. A single flight stair slab with landings on both sides and supported at ends on wall, and a multi flight stair slab with landings and six different support arrangements have been analyzed. The results obtained for stresses, strains and deflections are used to describe the behavior of such stair slabs, including locations of critical moments and deflections. Values of critical moments obtained by F.E. analysis have also have been compared with that obtained from conventional analysis. Analytical results show that the moments are also critical near the kinks i.e. junction of mid-landing and inclined waist slab. This change in the behavior of dog-legged stair slab may be due to continuity of the material in transverse direction in two landings adjoining the waist slab, hence additional stiffness achieved. This change in the behavior is generally not taken care of in conventional method of design.

Keywords: Dog-legged, Stair slab, F.E. Analysis, Landing, Reinforced concrete.

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Authors: Z. Karakus, Z. Ozer

Abstract:

Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: E-Learning, Medication Administration, Nursing, Nursing Students.

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