Search results for: Evidence based treatment

Authors: B. Bergström, A. Ladd, A. Jones, L. Rosso, P. Michael

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Attitudes toward treatment manuals serve as a meaningful predictor of general attitudes toward evidence-based practice. Despite demonstrating high effectiveness in treating many mental disorders, manualized treatments have been underutilized by practitioners. Thus, one can assess the state of the field regarding the adoption of evidence-based practices by surveying practitioner attitudes towards manualized treatments. This study is an adapted replication that assesses psychology graduate student attitudes towards manualized treatments, as a general marker for attitudes towards evidence-based practice. Training programs provide future clinicians with the foundation for critical skills in clinical practice. Research demonstrates that post-graduate continuing education has little to no effect on clinical practice; thus, graduate programs serve as the primary, and often final platform for all future practice. However, there are little empirical data identifying the attitudes and training of graduate students in utilizing manualized treatments. The empirical analysis of this study indicates an increase in positive attitudes among graduate student attitudes towards manualized treatments (within the United States), when compared to past surveys of professional psychologists. Findings from this study may inform graduate programs of barriers for students in developing positive attitudes toward manualized treatments and evidence-based practice. This study also serves as a preliminary predictor of the state-of-the field, in regards to professional psychologists attitudes towards evidence-based practice, if attitudes remain stable. This study indicates that the attitudes toward utilizing evidence-based practices, such as treatment manuals, has become more positive since year 2000.

Keywords: Evidence based treatment, Future of clinical science, Manualized treatment, Student attitudes towards evidence based treatments.

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Authors: Jim Meng, Mammo Yewondwossen

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As a part of routine oesophageal HDR Brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms before the 90-minute brachytherapy procedure complete, and the treatment may need to be aborted. A pre-prepared plan generated before patient’s sedation may reduce the brachytherapy procedure time by 40 minutes. This paper reports rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirms that pre-prepared plans would be acceptable for all reviewed patients. The rationality is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. The argument holds for endobronchial HDR brachytherapy too. With the above evidence, pre-prepared plans have been used for all oesophageal and endobronchial HDR brachytherapy cases in our clinic.

Keywords: HDR brachytherapy, treatment planning, oesophageal carcinoma.

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Authors: A. Taqaddas

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Chemotherapy and radiotherapy are one of the major treatment modalities that play important role in the management of a number of different cancers. This study for the first time evaluates the toxicity of these treatment modalities and its impact on quality of life of cancer patients in Pakistan. The study also for the first time determines what cancer patients of different ages and cancer stages believe would be an effective intervention to manage their psychosocial needs and treatment induced toxicity. The article also provides evidence based approach for the use of variety of interventions to mange cancer treatment induced morbidity and toxicity. In light of the present study and reviewed research data, evidence based recommendations are also made for selection of appropriate interventions to manage Pain, Nausea and Vomiting, Anxiety and Depression, Fatigue and Overall QOL of cancer survivors.

Keywords: Chemotherapy Toxicity, Psycho-Social Interventions, Quality of Life, Radiotherapy Toxicity.

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Authors: T. Turan, Ç. Erdoğan

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As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.

Keywords: Children, evidence based practice, nursing, oral care.

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Authors: Nevena Stolba, A Min Tjoa

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Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.

Keywords: data mining, data warehousing, decision-support systems, evidence-based medicine.

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Authors: Ahmed Kadry, Gwyn Dodd

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There has been a growing call globally for police forces to embed evidence-based policing research methods into police interventions in order to better understand and evaluate their impact. This research study highlights the success and challenges that police forces may encounter when trying to embed evidence-based research methods within their organisation. Ten in-depth qualitative interviews were conducted with police officers and staff at Greater Manchester Police (GMP) who were tasked with integrating evidence-based research methods into their operational interventions. The findings of the study indicate that with adequate resources and individual expertise, evidence-based research methods can be applied to operational work, including the testing of initiatives with strict controls in order to fully evaluate the impact of an intervention. However, the findings also indicate that this may only be possible where an operational intervention is heavily resourced with police officers and staff who have a strong understanding of evidence-based policing research methods, attained for example through their own graduate studies. In addition, the findings reveal that ample planning time was needed to trial operational interventions that would require strict parameters for what would be tested and how it would be evaluated. In contrast, interviewees underscored that operational interventions with the need for a speedy implementation were less likely to have evidence-based research methods applied. The study contributes to the wider literature on evidence-based policing by providing considerations for police forces globally wishing to apply evidence-based research methods to more of their operational work in order to understand their impact. The study also provides considerations for academics who work closely with police forces in assisting them to embed evidence-based policing. This includes how academics can provide their expertise to police decision makers wanting to underpin their work through evidence-based research methods, such as providing guidance on how to evaluate the impact of their work with varying research methods that they may otherwise be unaware of.

Keywords: evidence based policing, evidence-based practice, operational policing, organisational change

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Authors: M. Caramihai, Irina Severin, H. Balan, A. Blidaru, V. Balanica

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Accurate assessment of the primary tumor response to treatment is important in the management of breast cancer. This paper introduces a new set of treatment evaluation indicators for breast cancer cases based on the computational process of three known metrics, the Euclidian, Hamming and Levenshtein distances. The distance principals are applied to pairs of mammograms and/or echograms, recorded before and after treatment, determining a reference point in judging the evolution amount of the studied carcinoma. The obtained numerical results are indeed very transparent and indicate not only the evolution or the involution of the tumor under treatment, but also a quantitative measurement of the benefit in using the selected method of treatment.

Keywords: Breast cancer, Distance metrics, Cancer treatment evaluation.

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Authors: M. Kaya, M. Eris

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Internet use, intelligent communication tools, and social media have all become an integral part of our daily life as a result of rapid developments in information technology. However, this widespread use increases crimes committed in the digital environment. Therefore, digital forensics, dealing with various crimes committed in digital environment, has become an important research topic. It is in the research scope of digital forensics to investigate digital evidences such as computer, cell phone, hard disk, DVD, etc. and to report whether it contains any crime related elements. There are many software and hardware tools developed for use in the digital evidence acquisition process. Today, the most widely used digital evidence investigation tools are based on the principle of finding all the data taken place in digital evidence that is matched with specified criteria and presenting it to the investigator (e.g. text files, files starting with letter A, etc.). Then, digital forensics experts carry out data analysis to figure out whether these data are related to a potential crime. Examination of a 1 TB hard disk may take hours or even days, depending on the expertise and experience of the examiner. In addition, it depends on examiner’s experience, and may change overall result involving in different cases overlooked. In this study, a hash-based matching and digital evidence evaluation method is proposed, and it is aimed to automatically classify the evidence containing criminal elements, thereby shortening the time of the digital evidence examination process and preventing human errors.

Keywords: Block matching, digital evidence, hash list.

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Authors: Lilian Noronha Nassif

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Cybercrime investigation demands an appropriated evidence collection mechanism. If the investigator does not acquire digital proofs in a forensic sound, some important information can be lost, and judges can discard case evidence because the acquisition was inadequate. The correct digital forensic seizing involves preparation of professionals from fields of law, police, and computer science. This paper presents important challenges faced during evidence collection in different perspectives of places. The crime scene can be virtual or real, and technical obstacles and privacy concerns must be considered. All pointed challenges here highlight the precautions to be taken in the digital evidence collection and the suggested procedures contribute to the best practices in the digital forensics field.

Keywords: Digital evidence, digital forensic processes and procedures, mobile forensics, cloud forensics.

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Authors: Altayeb Qasem, Tarek Zayed, Zhi Chen

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Statistics Canada stated that the wastewater treatment facilities in most provinces are aging and passes 63% of their useful life in 2007 the highest ratio among public infrastructure assets. Currently, there is no standard condition rating system for wastewater treatment plants that give a specific rating index that describe the physical integrity of different infrastructure elements in the treatment plant and its environmental performance. The main objective of this study is to develop a condition-rating index for wastewater treatment plants mainly activated sludge systems. The proposed WWTP CRI, is based on dividing the treatment plant into its three treatment phases; primary phase, secondary phase and the tertiary phase. The condition-rating index will reflect the infrastructures state for each phase, mainly tanks, pipes, blowers and pumps.

Keywords: Condition rating index, Wastewater treatment plants, AHP- MUAT.

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Authors: Pedro Padilha Gonçalves, Doris C. C. K. Kowaltowski, Benjamin Cleveland

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Trends in education affect schooling, needing incorporation into design concepts to support desired learning processes with appropriate and stimulating environments. A design process for school architecture demands research, debates, reflections, and efficient decision-making methods. This paper presents research on evidence-based design, related to middle schools, based on a systematic literature review and the elaboration of a set of architectural design patterns, through a graphic translation of new concepts for classroom configurations, to support programming debates and the synthesis phase of design. The investigation resulted in nine patterns that configure the concepts of boundaries, flexibility, levels of openness, mindsets, neighborhoods, movement and interaction, territories, opportunities for learning, and sightlines for classrooms. The research is part of a continuous investigation of design methods, on contemporary school architecture to produce an architectural pattern matrix based on scientific information translated into an insightful graphic design language.

Keywords: School architecture, design process, design patterns, evidence-based design.

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Authors: J. Bolobajev, M. Trapido, A. Goi

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The practical application of the Fenton-based treatment method for organic compounds-contaminated water purification is limited mainly because of the large amount of ferric sludge formed during the treatment, where ferrous iron (Fe(II)) is used as the activator of the hydrogen peroxide oxidation processes. Reuse of ferric sludge collected from clarifiers to substitute Fe(II) salts allows reducing the total cost of Fenton-type treatment technologies and minimizing the accumulation of hazardous ferric waste. Dissolution of ferric iron (Fe(III)) from the sludge to liquid phase at acidic pH and autocatalytic transformation of Fe(III) to Fe(II) by phenolic compounds (tannic acid, lignin, phenol, catechol, pyrogallol and hydroquinone) added or present as water/wastewater constituents were found to be essentially involved in the Fenton-based oxidation mechanism. Observed enhanced formation of highly reactive species, hydroxyl radicals, resulted in a substantial organic contaminant degradation increase. Sludge reuse at acidic pH and in the presence of ferric iron reductants is a novel strategy in the Fenton-based treatment application for organic compounds-contaminated water purification.

Keywords: Ferric sludge reuse, ferric iron reductant, water treatment, organic pollutant.

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Authors: Monika Nuffer, Wesley Nuffer

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The problem of obesity is one that continues to be faced in the United States health care system and across the developing world. Prescription medications are available, but are often very expensive with minimal insurance coverage. The over-the-counter diet aid industry is a robust one, selling billions of dollars in products every year. It is important for clinicians to understand the myriad of different nutritional supplements marketed for obesity, and to weigh the evidence behind these products. This manuscript outlines the most commonly used nutritional supplements currently marketed for weight loss, reviewing the evidence with a focus on the efficacy and safety of these products.

Keywords: Obesity, weight loss, herbal products, nutritional supplements

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Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: Cancer Patients, E-Learning, Nursing, Web Based Education.

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Authors: Santirat Nansaarng, Sittichai Kaewkuekool, Supreeya Siripattanakunkajorn

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The purpose of this research was to study the inspector performance by using computer based training (CBT). Visual inspection task was printed circuit board (PCB) simulated on several types of defects. Subjects were 16 undergraduate randomly selected from King Mongkut-s University of Technology Thonburi and test for 20/20. Then, they were equally divided on performance into two groups (control and treatment groups) and were provided information before running the experiment. Only treatment group was provided feedback information after first experiment. Results revealed that treatment group was showed significantly difference at the level of 0.01. The treatment group showed high percentage on defects detected. Moreover, the attitude of inspectors on using the CBT to inspection was showed on good. These results have been showed that CBT could be used for training to improve inspector performance.

Keywords: Training, Feedback, Computer based Training (CBT)

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Authors: Rossi A. Hassad

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There is widespread emphasis on reform in the teaching of introductory statistics at the college level. Underpinning this reform is a consensus among educators and practitioners that traditional curricular materials and pedagogical strategies have not been effective in promoting statistical literacy, a competency that is becoming increasingly necessary for effective decision-making and evidence-based practice. This paper explains the historical context of, and rationale for reform-oriented teaching of introductory statistics (at the college level) in the health, social and behavioral sciences (evidence-based disciplines). A firm understanding and appreciation of the basis for change in pedagogical approach is important, in order to facilitate commitment to reform, consensus building on appropriate strategies, and adoption and maintenance of best practices. In essence, reform-oriented pedagogy, in this context, is a function of the interaction among content, pedagogy, technology, and assessment. The challenge is to create an appropriate balance among these domains.

Keywords: Reform-oriented, reform, introductory statistics, health, behavioral sciences, evidence-based, psychology, teaching, learning.

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Authors: Maria L. McLeod

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This study examines the ways in which cancer patient narratives are portrayed and framed on the websites of three leading U.S. cancer care centers – The University of Texas MD Anderson Cancer Center in Houston, Memorial Sloan Kettering Cancer Center in New York, and Seattle Cancer Care Alliance. Thirty patient stories, 10 from each cancer center website blog, were analyzed using qualitative and quantitative textual analysis of unstructured data, documenting common themes and other elements of story structure and content. Patient narratives were coded using grounded theory as the basis for conducting emergent qualitative research. As part of a systematic, inductive approach to collecting and analyzing data, recurrent and unique themes were examined and compared in terms of positive and negative framing, patient agency, and institutional praise. All three of these cancer care centers are teaching hospitals, with university affiliations, that emphasize an evidence-based scientific approach to treatment that utilizes the latest research and cutting-edge techniques and technology. The featured cancer stories suggest positive outcomes based on anecdotal narratives as opposed to the science-based treatment models employed by the cancer centers. An analysis of 30 sample stories found skewed representation of the “cancer experience” that emphasizes positive outcomes while minimizing or excluding more negative realities of cancer diagnosis and treatment. The stories also deemphasize patient agency, instead focusing on deference and gratitude toward the cancer care centers, which are cast in the role of savior.  

Keywords: Cancer framing, cancer narratives, survivor stories, patient narratives.

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Authors: Karel Frydrýšek, Pavel Koštial, Karla Barabaszová, Jana Kukutschová

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This paper deals with a new way for designing external fixators applied in traumatology and orthopaedics. These fixators can be applied in the treatment of open and unstable fractures or for lengthening human or animal bones etc. The new design is based on the development of Ilizarov and other techniques (i.e. shape and weight optimalization based on composite materials, application of smart materials, nanotechnology, low x-ray absorption, antibacterial protection, patient's comfort, reduction in the duration of the surgical treatment, and cost).

Keywords: biomechanics, design, external fixators, newmaterials, traumatology

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Authors: V. Spaeth, A. Djerbi-Tegguer

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The recycling of concrete, bricks and masonry rubble as concrete aggregates is an important way to contribute to a sustainable material flow. However, there are still various uncertainties limiting the widespread use of Recycled Concrete Aggregates (RCA). The fluctuations in the composition of grade recycled aggregates and their influence on the properties of fresh and hardened concrete are of particular concern regarding the use of RCA. Most of problems occurring while using recycled concrete aggregates as aggregates are due to higher porosity and hence higher water absorption, lower mechanical strengths, residual impurities on the surface of the RCA forming weaker bond between cement paste and aggregate. So, the reuse of RCA is still limited. Efficient polymer based treatment is proposed in order to reuse RCA easier. The silicon-based polymer treatments of RCA were carried out and were compared. This kind of treatment can improve the properties of RCA such as the rate of water absorption on treated RCA is significantly reduced.

Keywords: Recycled concrete aggregates, water absorption, silicon-based agent and polymer.

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Authors: Sirimanee Banjong

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This study aimed to 1) develop pre-service teachers’ leadership skills through camp-based learning, and 2) develop preservice teachers’ teamwork skills through camp-based learning. An applied research methodology was used. The target group was derived from a purposive selection. It involved 32 fourth-year students in Early Childhood Education Program enrolling a course entitled Seminar in Early Childhood Education provided during second semester of academic year 2013. The treatment was camp-based learning activities which applied a PDCA process including four stages: 1) plan, 2) do, 3) check, and 4) act. Research instruments were a learning camp program, a camp-based learning management plan, a 5-level assessment form for leadership skills and a 5-level assessment form for assessing teamwork skills. Data were analyzed using descriptive statistics. Results were: 1) pre-service teachers’ leadership skills yielded the before treatment average score at x= 3.4, S.D.=0.6 2and the after-treatment average score at x 4.29 , S.D.=0.66 pre-service teachers’ teamwork skills yielded the before-treatment average score at x=3.31, S.D.=0.60 and the after-treatment average score at x=4.42, S.D.=0.66 Both differences were statistically significant at the .05 level. Thus, the pre-service teachers’ leadership and teamwork skills were significantly improved through the camp-based learning approach.

Keywords: Learning camp, leadership skills, teamwork skills.

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Authors: B. Mahmoud, M.H. Bedoui, R. Raychev, H. Essabbah

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We present in this paper an acquisition and treatment system designed for semi-analog Gamma-camera. It consists of a nuclear medical Image Acquisition, Treatment and Display chain(IATD) ensuring the acquisition, the treatment of the signals(resulting from the Gamma-camera detection head) and the scintigraphic image construction in real time. This chain is composed by an analog treatment board and a digital treatment board. We describe the designed systems and the digital treatment algorithms in which we have improved the performance and the flexibility. The digital treatment algorithms are implemented in a specific reprogrammable circuit FPGA (Field Programmable Gate Array).interface for semi-analog cameras of Sopha Medical Vision(SMVi) by taking as example SOPHY DS7. The developed system consists of an Image Acquisition, Treatment and Display (IATD) ensuring the acquisition and the treatment of the signals resulting from the DH. The developed chain is formed by a treatment analog board and a digital treatment board designed around a DSP [2]. In this paper we have presented the architecture of a new version of our chain IATD in which the integration of the treatment algorithms is executed on an FPGA (Field Programmable Gate Array)

Keywords: Nuclear medical image, scintigraphic image, digitaltreatment, linearity, spectrometry, FPGA.

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Authors: Mohd. A. M. Rahim, Yahaya Hassan, Mathumalar L. Fahrni

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Second line antiretroviral therapy (ART) regimen is used when patients fail their first line regimen. There are many factors such as non-adherence, drug resistance as well as virological and immunological failure that lead to second line highly active antiretroviral therapy (HAART) regimen treatment failure. This study was aimed at determining predictor factors to treatment failure with second line HAART and analyzing median survival time. An observational, retrospective study was conducted in Sungai Buloh Hospital (HSB) to assess current status of HIV patients treated with second line HAART regimen. Convenience sampling was used and 104 patients were included based on the study’s inclusion and exclusion criteria. Data was collected for six months i.e. from July until December 2013. Data was then analysed using SPSS version 18. Kaplan-Meier and Cox regression analyses were used to measure median survival times and predictor factors for treatment failure. The study population consisted mainly of male subjects, aged 30- 45 years, who were heterosexual, and had HIV infection for less than 6 years. The most common second line HAART regimen given was lopinavir/ritonavir (LPV/r)-based combination. Kaplan-Meier analysis showed that patients on LPV/r demonstrated longer median survival times than patients on indinavir/ritonavir (IDV/r) based combination (p<0.001). The commonest reason for a treatment to fail with second line HAART was non-adherence. Based on Cox regression analysis, other predictor factors for treatment failure with second line HAART regimen were age and mode of HIV transmission.

Keywords: Adherence, antiretroviral therapy, second line, treatment failure.

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Authors: J. Pawłat, H. Stryczewska

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Shortening of natural resources will impose greater limitations of electric energy consumption in various fields including water treatment technologies. Small water treatment installations supplied with electric energy from solar sources are perfect example of zero-emission technology. Possibility of solar energy application, as one of the alternative energy resources for decontamination processes is strongly dependent on geographical location. Various examples of solar driven water purification systems are given and design of solar-water treatment installation based on ozone for the geographical conditions in Poland are presented.

Keywords: solar energy, water purification, ozone water treatment

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Authors: D.M. Weeraddana, K.S. Walgama, E.C. Kulasekere

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A framework to estimate the state of dynamically varying environment where data are generated from heterogeneous sources possessing partial knowledge about the environment is presented. This is entirely derived within Dempster-Shafer and Evidence Filtering frameworks. The belief about the current state is expressed as belief and plausibility functions. An addition to Single Input Single Output Evidence Filter, Multiple Input Single Output Evidence Filtering approach is introduced. Variety of applications such as situational estimation of an emergency environment can be developed within the framework successfully. Fire propagation scenario is used to justify the proposed framework, simulation results are presented.

Keywords: Dempster-Shafer Belief theory, Evidence Filtering, Evidence Fusion, Sensor Modalities, Wireless Sensor Networks

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Authors: Chidera G. Eze, Kennedy K. Abrokwa, Chimaobi V. Okolo

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This paper empirically examines the dynamic relationship between financial deepening and economic growth in a monetary union. We find positive but weak evidence of impacts of financial deepening on growth for Gambia, Gabon and Sierra Leone. There is no evidence of any positive significant impact for Ghana and Nigeria. We argue that, the weak evidence between financial deepening and economic growth can be a consequence of the inability of assessing credit (long-term loans), credit worthiness, lack of information and low level of bank deposits by the private sector despite the improvement in the financial sector.

Keywords: Financial deepening, economic growth, dynamics, innovation accounting.

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Authors: Mairwen K. Jones, Bethany M. Wootton, Lisa D. Vaccaro

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While OCD is one of the most commonly occurring psychiatric conditions experienced by older adults, there is a paucity of research conducted into the treatment of older adults with OCD. This case study represents the first published investigation of a cognitive treatment for geriatric OCD. It describes the successful treatment of an 86-year old man with a 63-year history of OCD using Danger Ideation Reduction Therapy (DIRT). The client received 14 individual, 50-minute treatment sessions of DIRT over 13 weeks. Clinician-based Y-BOCS scores reduced 84% from 25 (severe) at pre-treatment, to 4 (subclinical) at 6-month post-treatment follow-up interview, demonstrating the efficacy of DIRT for this client. DIRT may have particular advantages over ERP and pharmacological approaches, however further research is required in older adults with OCD.

Keywords: Cognitive Therapy, Danger Ideation Reduction Therapy, Obsessive-Compulsive Disorder, Older adults, Psychogeriatrics

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Authors: Sun K. Yoo, Ki-Chang Nam, Hyun-Young Shin, Ho-Seong Moon, Hee Cheol Kang

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Automated intelligent, clinical decision support systems generally promote to help or to assist physicians and patients regarding to prevention of diseases or treatment of illnesses using computer represented knowledge and information. In this paper, assessment factors affecting the proper design of clinical decision support system were investigated. The required procedure steps for gathering the data from clinical trial and extracting the information from large volume of healthcare repositories were listed, which are necessary for validation and verification of evidence-based implementation of clinical decision support system. The goal of this paper is to extract useful evaluation factors affecting the quality of the clinical decision support system in the design, development, and implementation of a computer-based decision support system.

Keywords: Evaluation, Clinical Decision Support System.

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Authors: Haji Ali Haji, Hussein Suleman, Ulrike Rivett

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This paper presents the design, development and evaluation of an application prototype developed to support tuberculosis (TB) patients’ treatment adherence. The system makes use of graphics and voice reminders as opposed to text messaging to encourage patients to follow their medication routine. To evaluate the effect of the prototype applications, participants were given mobile phones on which the reminder system was installed. Thirty-eight people, including TB health workers and patients from Zanzibar, Tanzania, participated in the evaluation exercises. The results indicate that the participants found the mobile image-based application is useful to support TB treatment. All participants understood and interpreted the intended meaning of every image correctly. The study findings revealed that the use of a mobile visualbased application may have potential benefit to support TB patients (both literate and illiterate) in their treatment processes.

Keywords: ICT4D, mobile technology, tuberculosis, visualbased reminder.

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of COVID-19 infection. Understanding novel treatment approaches is important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with VR included. This game-based VR technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with COVID-19 related CVA. The safety of developed instruments for such cases provides approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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Authors: Nassier A. Nassir, Robert Birch, D. Rico Sierra, S. P. Edwardson, G. Dearden, Zhongwei Guan

Abstract:

The effect of laser surface treatment parameters on the residual strength of titanium alloy has been investigated. The influence of the laser surface treatment on the bonding strength between the titanium and poly-ether-ketone-ketone (PEKK) surfaces was also evaluated and compared to those offered by titanium foils without surface treatment to optimize the laser parameters. Material characterization using an optical microscope was carried out to study the microstructure and to measure the mean roughness value of the titanium surface. The results showed that the surface roughness shows a significant dependency on the laser power parameters in which surface roughness increases with the laser power increment. Moreover, the results of the tensile tests have shown that there is no significant dropping in tensile strength for the treated samples comparing to the virgin ones. In order to optimize the laser parameter as well as the corresponding surface roughness, single-lap shear tests were conducted on pairs of the laser treated titanium stripes. The results showed that the bonding shear strength between titanium alloy and PEKK film increased with the surface roughness increment to a specific limit. After this point, it is interesting to note that there was no significant effect for the laser parameter on the bonding strength. This evidence suggests that it is not necessary to use very high power of laser to treat titanium surface to achieve a good bonding strength between titanium alloy and the PEKK film.

Keywords: Bonding strength, laser surface treatment, PEKK, titanium alloy.

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