Search results for: Health Care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1366

Search results for: Health Care

1126 High-Value Health System for All: Technologies for Promoting Health Education and Awareness

Authors: M. P. Sebastian

Abstract:

Health for all is considered as a sign of well-being and inclusive growth. New healthcare technologies are contributing to the quality of human lives by promoting health education and awareness, leading to the prevention, early diagnosis and treatment of the symptoms of diseases. Healthcare technologies have now migrated from the medical and institutionalized settings to the home and everyday life. This paper explores these new technologies and investigates how they contribute to health education and awareness, promoting the objective of high-value health system for all. The methodology used for the research is literature review. The paper also discusses the opportunities and challenges with futuristic healthcare technologies. The combined advances in genomics medicine, wearables and the IoT with enhanced data collection in electronic health record (EHR) systems, environmental sensors, and mobile device applications can contribute in a big way to high-value health system for all. The promise by these technologies includes reduced total cost of healthcare, reduced incidence of medical diagnosis errors, and reduced treatment variability. The major barriers to adoption include concerns with security, privacy, and integrity of healthcare data, regulation and compliance issues, service reliability, interoperability and portability of data, and user friendliness and convenience of these technologies.

Keywords: Bigdata, education, healthcare, ICT, patients, technologies.

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1125 A Study on the Assessment of Prosthetic Infection after Total Knee Replacement Surgery

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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1124 Hypertension and Its Association with Oral Health Status in Adults: A Pilot Study in Padusunan Adults Community

Authors: Murniwati, Nurul Khairiyah, Putri Ovieza Maizar

Abstract:

The association between general and oral health is clearly important, particularly in adults with medical conditions. Many of the medical systemic conditions are either caused or aggravated by poor oral hygiene and vice versa. Hypertension is one of common medical systemic problem which has been a public health concern worldwide due to its known consequences. Those consequences must be related to oral health status as well, whether it may cause or worsen the oral health conditions. The objective of this study was to find out the association between hypertension and oral health status in adults. This study was an analytical observational study by using cross-sectional method. A total of 42 adults both male and female in Padusunan Village, Pariaman, West Sumatra, Indonesia were selected as subjects by using purposive sampling. Manual sphygmomanometer was used to measure blood pressure and dental examination was performed to calculate the decayed, missing, and filled teeth (DMFT) scores in order to represent oral health status. The data obtained was analyzed statistically using One Way ANOVA to determine the association between hypertensive adults and their oral health status. The result showed that majority age of the subjects was ranging from 51-70 years (40.5%). Based on blood pressure examination, 57.1% of subjects were classified to prehypertension. Overall, the mean of DMFT score calculated in normal, prehypertension and hypertension group was not considered statistically significant. There was no significant association (p>0.05) between hypertension and oral health status in adults.

Keywords: Blood pressure, hypertension, DMFT, oral health status.

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1123 Internet of Health Things as a Win-Win Solution for Mitigating the Paradigm Shift inside Senior Patient-Physician Shared Health Management

Authors: Marilena Ianculescu, Adriana Alexandru

Abstract:

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

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

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1122 Factors Influencing Intention to Engage in Long-term Care Services among Nursing Aide Trainees and the General Public

Authors: Ju-Chun Chien

Abstract:

Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.

Keywords: Long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior.

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1121 ME/CFS Health Outcomes: The Interaction of Mode of Illness Onset and Psychiatric Comorbidity

Authors: Mary Gloria C. Njoku, Leonard A. Jason, Nicole Porter, Molly Brown

Abstract:

The objective of this study was to examine the interaction between mode of illness onset and psychiatric comorbidity on the health outcomes of persons with ME/CFS. A total of 114 individuals with ME/CFS participated in this study. Individuals completed a battery of baseline measures including the fatigue severity scale and measures of disability. Findings indicated that those with sudden illness onset had more impaired physical health functioning. In addition, among individuals with sudden onset, those without psychiatric comorbidity had greater fatigue severity and lower overall physical health than those with psychiatric comordibity. In contrast, among individuals with gradual illness onset, those with psychiatric comorbity had higher fatigue severity than those without comorbid psychiatric disorders. The health outcomes of individuals who have ME/CFS with or without psychiatric comorbidity are impacted by the mode of illness onset and this suggest that it is important to examine these factors in future research.

Keywords: Health Outcomes, ME/CFS, Mode of Illness Onset, Psychiatric Comorbidity.

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1120 A Study on the Leadership Behavior, Safety Culture, and Safety Performance of the Healthcare Industry

Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

Abstract:

Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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1119 Analysing Environmental Risks and Perceptions of Risks to Assess Health and Well-being in Poor Areas of Abidjan

Authors: Kouassi Dongo, Christian Zurbrügg, Gueladio Cissé1, Brigit Obrist, Marcel Tanner, Jean Biémi

Abstract:

This study analyzed environmental health risks and people-s perceptions of risks related to waste management in poor settlements of Abidjan, to develop integrated solutions for health and well-being improvement. The trans-disciplinary approach used relied on remote sensing, a geographic information system (GIS), qualitative and quantitative methods such as interviews and a household survey (n=1800). Mitigating strategies were then developed using an integrated participatory stakeholder workshop. Waste management deficiencies resulting in lack of drainage and uncontrolled solid and liquid waste disposal in the poor settlements lead to severe environmental health risks. Health problems were caused by direct handling of waste, as well as through broader exposure of the population. People in poor settlements had little awareness of health risks related to waste management in their community and a general lack of knowledge pertaining to sanitation systems. This unfortunate combination was the key determinant affecting the health and vulnerability. For example, an increased prevalence of malaria (47.1%) and diarrhoea (19.2%) was observed in the rainy season when compared to the dry season (32.3% and 14.3%). Concerted and adapted solutions that suited all the stakeholders concerned were developed in a participatory workshop to allow for improvement of health and well-being.

Keywords: Abidjan, environmental health risks, informalsettlements, vulnerability, waste management.

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1118 Water, Sanitation and Health in Developing Countries: How Far from Sustainable Development?

Authors: May A. Massoud

Abstract:

The availability of water in adequate quantity and quality is imperative for sustainable development. Worldwide, significant imbalance exists with regards to sustainable development particularly from a water and sanitation perspective. Water is a critical component of public health, and failure to supply safe water will place a heavy burden on the entire population. Although the 21st century has witnessed wealth and advanced development, it has not been realized everywhere. Billions of people are still striving to access the most basic human needs which are food, shelter, safe drinking water and adequate sanitation. The global picture conceals various inequalities particularly with regards to sanitation coverage in rural and urban areas. Currently, water scarcity and in particular water governance is the main challenge which will cause a threat to sustainable development goals. Within the context of water, sanitation and health, sustainable development is a confusing concept primarily when examined from the viewpoint of policy options for developing countries. This perspective paper aims to summarize and critically evaluate evidence of published studies in relation to water, sanitation and health and to identify relevant solutions to reduce public health impacts. Evidently, improving water and sanitation services will result in significant and lasting gains in health and economic development.

Keywords: developing countries, health, sanitation, sustainability, water

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1117 Optimal Rest Interval between Sets in Robot-Based Upper-Arm Rehabilitation

Authors: Virgil Miranda, Gissele Mosqueda, Pablo Delgado, Yimesker Yihun

Abstract:

Muscular fatigue affects the muscle activation that is needed for producing the desired clinical outcome. Integrating optimal muscle relaxation periods into a variety of health care rehabilitation protocols is important to maximize the efficiency of the therapy. In this study, four muscle relaxation periods (30, 60, 90 and 120 seconds) and their effectiveness in producing consistent muscle activation of the muscle biceps brachii between sets of an elbow flexion and extension task were investigated among a sample of 10 subjects with no disabilities. The same resting periods were then utilized in a controlled exoskeleton-based exercise for a sample size of 5 subjects and have shown similar results. On average, the muscle activity of the biceps brachii decreased by 0.3% when rested for 30 seconds, and it increased by 1.25%, 0.76% and 0.82% when using muscle relaxation periods of 60, 90 and 120 seconds, respectively. The preliminary results suggest that a muscle relaxation period of about 60 seconds is needed for optimal continuous muscle activation within rehabilitation regimens. Robot-based rehabilitation is good to produce repetitive tasks with the right intensity and knowing the optimal resting period will make the automation more effective.

Keywords: Rest intervals, muscle biceps brachii, robot rehabilitation, muscle fatigue.

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1116 COVID_ICU_BERT: A Fine-tuned Language Model for COVID-19 Intensive Care Unit Clinical Notes

Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

Abstract:

Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as physiological vital signs, images and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful to influence the judgement of clinical sentiment in ICU clinical notes. This paper presents two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of a clinical transformer model that can reliably predict clinical sentiment for notes of COVID patients in ICU. We train the model on clinical notes for COVID-19 patients, ones not previously seen by Bio_ClinicalBERT or Bio_Discharge_Summary_BERT. The model which was based on Bio_ClinicalBERT achieves higher predictive accuracy than the one based on Bio_Discharge_Summary_BERT (Acc 93.33%, AUC 0.98, and Precision 0.96). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and Precision 0.92).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation.

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1115 Medical Knowledge Management in Healthcare Industry

Authors: B. Stroetmann, A. Aisenbrey

Abstract:

The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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1114 Dialogue Meetings as an Arena for Collaboration and Reflection among Researchers and Practitioners

Authors: Kerstin Grunden, Ann Svensson, Berit Forsman, Christina Karlsson, Ayman Obeid

Abstract:

The research question of the article is to explore whether the dialogue meetings method could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in municipalities, or not. A testbed was planned to be implemented in a retirement home in a Swedish municipality, and the practitioners worked with a pre-study of that testbed. In the article, the dialogue between the researchers and the practitioners in the dialogue meetings is described and analyzed. The potential of dialogue meetings as an arena for learning and reflection among researchers and practitioners is discussed. The research methodology approach is participatory action research with mixed methods (dialogue meetings, focus groups, participant observations). The main findings from the dialogue meetings were that the researchers learned more about the use of traditional research methods, and the practitioners learned more about how they could improve their use of the methods to facilitate change processes in their organization. These findings have the potential both for the researchers and the practitioners to result in more relevant use of research methods in change processes in organizations. It is concluded that dialogue meetings could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in a health care organization.

Keywords: Dialogue meetings, implementation, reflection, test bed, welfare technology, participatory action research.

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1113 Establishment and Evaluation of Information System for Chemotherapy Care

Authors: Yi-Ting Liu, Pei-Ying Wen

Abstract:

In order to improve the overall safety of chemotherapy, safety-protecting netwas established for the whole process from prescribing by physicians, transcribing by nurses, dispensing by pharmacists to administering by nurses. The information system was used to check and monitorwhole process of administration and related sheets were computerized to simplify the paperwork.

Keywords: Chemotherapy, Bar Code Medication Administration (BCMA), Medication Safety.

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1112 The Impact of Hospital Intensive Care Unit Window Design on Daylighting and Energy Performance in Desert Climate

Authors: A. Sherif, H. Sabry, A. Elzafarany, M. Gadelhak, R. Arafa, M. Aly

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This paper addresses the design of hospital Intensive Care Unit windows for the achievement of visual comfort and energy savings. The aim was to identify the window size and shading system configurations that could fulfill daylighting adequacy, avoid glare and reduce energy consumption. The study focused on addressing the effect of utilizing different shading systems in association with a range of Window-to-Wall Ratios (WWR) in different orientations under the desert clear-sky of Cairo, Egypt. The results of this study demonstrated that solar penetration is a critical concern affecting the design of ICU windows in desert locations, as in Cairo, Egypt. Use of shading systems was found to be essential in providing acceptable daylight performance and energy saving. Careful positioning of the ICU window towards a proper orientation can dramatically improve performance. It was observed that ICU windows facing the north direction enjoyed the widest range of successful window configuration possibilities at different WWRs. ICU windows facing south enjoyed a reasonable number of configuration options as well. By contrast, the ICU windows facing the east orientation had a very limited number of options that provide acceptable performance. These require additional local shading measures at certain times due to glare incidence. Moreover, use of horizontal sun breakers and solar screens to protect the ICU windows proved to be more successful than the other alternatives in a wide range of Window to Wall Ratios. By contrast, the use of light shelves and vertical shading devices seemed questionable.

Keywords: Daylighting, Desert, Energy Efficiency, Shading.

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1111 Sociodemographic Risk Factors of Cervical Cancer in Imphal, Manipur

Authors: Arundhati Devi Maibam, K. Ingocha Singh

Abstract:

Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: Cervical cancer, Manipuri women, RIIMS, Socio-demographic risk factors.

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1110 Design and Simulation of Heartbeat Measurement System Using Arduino Microcontroller in Proteus

Authors: Muhibul H. Bhuyan, Mafujul Hasan

Abstract:

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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1109 The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

Abstract:

Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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1108 Absence of Leave and Job Morality in the ICU

Authors: Li-Ping Hsiao, Feng-Chuan Pan

Abstract:

Leave of absence is important in maintaining a good status of human resource quality. Allowing the employees temporarily free from the routine assignments can vitalize the workers- morality and productivity. This is particularly critical to secure a satisfactory service quality for healthcare professionals of which were typically featured with labor intensive and complicated works to perform. As one of the veteran hospitals that were found and operated by the Veteran Department of Taiwan, the nursing staff of the case hospital was squeezed to an extreme minimum level under the pressure of a tight budgeting. Leave of absence on schedule became extremely difficult, especially for the intensive care units (ICU), in which required close monitoring over the cared patients, and that had more easily driven the ICU nurses nervous. Even worse, the deferred leaves were more than 10 days at any time in the ICU because of a fluctuating occupancy. As a result, these had brought a bad setback to this particular nursing team, and consequently defeated the job performance and service quality. To solve this problem and accordingly to strengthen their morality, a project team was organized across different departments specific for this. Sufficient information regarding jobs and positions requirements, labor resources, and actual working hours in detail were collected and analyzed in the team meetings. Several alternatives were finalized. These included job rotating, job combination, leave on impromptu and cross-departmental redeployment. Consequently, the deferred leave days sharply reduced 70% to a level of 3 or less days. This improvement had not only provided good shelter for the ICU nurses that improved their job performance and patient safety but also encouraged the nurses active participating of a project and learned the skills of solving problems with colleagues.

Keywords: Information, job rotating, human resource, intensive care unit.

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1107 Analyzing the Fiscal Health of Local Governments in Taiwan: Evidence from Quantile Analysis

Authors: Chiung-Ju Huang, Yuan-Hong Ho

Abstract:

This paper develops the fiscal health index of 21 local governments in Taiwan over the 1984 to 2010 period. A quantile regression analysis was used to explore the extent that economic variables, political budget cycles, and legislative checks and balances, impact different quantiles of fiscal health index for a country over a sample period of time. Our findings suggest that local governments at the lower quantile are significantly benefited from political budget cycles and the increase in central government revenues, while legislative effective checks and balances and the increase in central government expenditures have a significantly negative effect on local fiscal health. When local governments are in the upper tail of the distribution, legislative checks and balances and growth in macroeconomics have significant and adverse effects on the fiscal health of local governments. However, increases in central government revenues have significant and positive effects on the health status of local government in Taiwan.

Keywords: Fiscal health, political budget cycles, legislative checks and balances, quantile regression.

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1106 The Role of Medical Expert Systems in Pakistan

Authors: Fahad Shahbaz Khan, Fahad Maqbool, Saad Razzaq, Kashif Irfan, Tehseen Zia

Abstract:

Expert systems are used extensively in many domains. This paper discusses the use of medical expert systems in Pakistan. Countries all over the world pay special attention on health facilities. A country like Pakistan faces a lot of trouble in health sector. Several attempts have been made in Pakistan to improve the health conditions of the people but the situation is still not encouraging. There is a shortage of doctors and other trained personnel in Pakistan. Expert systems can play a vital role in such cases where the medical expert is not readily available. The purpose of this paper is to analyze the role that such systems can play in improving the health conditions of the people in Pakistan.

Keywords: Medical Diagnostics, Expert Systems, Pakistan.

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1105 Health Risk Assessment of Heavy Metals in the Contaminated and Uncontaminated Soils

Authors: S. A. Nta

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Application of health risk assessment methods is important in order to comprehend the risk of human exposure to heavy metals and other dangerous pollutants. Four soil samples were collected at distances of 10, 20, 30 m and the control 100 m away from the dump site at depths of 0.3, 0.6 and 0.9 m. The collected soil samples were examined for Zn, Cu, Pb, Cd and Ni using standard methods. The health risks via the main pathways of human exposure to heavy metal were detected using relevant standard equations. Hazard quotient was calculated to determine non-carcinogenic health risk for each individual heavy metal. Life time cancer risk was calculated to determine the cumulative life cancer rating for each exposure pathway. The estimated health risk values for adults and children were generally lower than the reference dose. The calculated hazard quotient for the ingestion, inhalation and dermal contact pathways were less than unity. This means that there is no detrimental concern to the health on human exposure to heavy metals in contaminated soil. The life time cancer risk 5.4 × 10-2 was higher than the acceptable threshold value of 1 × 10-4 which is reflected to have significant health effects on human exposure to heavy metals in contaminated soil. Good hygienic practices are recommended to ease the potential risk to children and adult who are exposed to contaminated soils. Also, the local authorities should be made aware of such health risks for the purpose of planning the management strategy accordingly.

Keywords: Health risk assessment, pollution, heavy metals, soil.

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1104 Building an Integrated Relational Database from Swiss Nutrition National Survey and Swiss Health Datasets for Data Mining Purposes

Authors: Ilona Mewes, Helena Jenzer, Farshideh Einsele

Abstract:

Objective: The objective of the study was to integrate two big databases from Swiss nutrition national survey (menuCH) and Swiss health national survey 2012 for data mining purposes. Each database has a demographic base data. An integrated Swiss database is built to later discover critical food consumption patterns linked with lifestyle diseases known to be strongly tied with food consumption. Design: Swiss nutrition national survey (menuCH) with approx. 2000 respondents from two different surveys, one by Phone and the other by questionnaire along with Swiss health national survey 2012 with 21500 respondents were pre-processed, cleaned and finally integrated to a unique relational database. Results: The result of this study is an integrated relational database from the Swiss nutritional and health databases.

Keywords: Health informatics, data mining, nutritional and health databases, nutritional and chronical databases.

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1103 The Environmental Conservation Behavior of the Applied Health Science Students of Green and Clean University

Authors: Nareelux Suwannobol, Plernpit Promrak, Kiattisak Batsungnoen

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The aim of this study was to investigate the environmental conservation behavior of the Applied Health Science students of Suranaree University of Technology, a green and clean university. The sample group was 184 Applied Health Science students (medical, nursing, and public health). A questionnaire was used to collect information. The result of the study found that the students had more negative than positive behaviors towards energy, water, and forest conservation. This result can be used as basic information for designing long-term behavior modification activities or research projects on environmental conservation. Thus Applied Health Science students will be encouraged to be conscious and also be a good example of environmental conservation behavior.

Keywords: Energy conservation behavior, Water conservationbehavior, Forest conservation behavior, Green and clean University.

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1102 A Bio-Ecological Perspective on Risk Awareness and Factors Associated with Substance Use during Pregnancy in Communities of the Western Cape Province, South Africa

Authors: Mutshinye Manguvhewa, Maria Florence, Mansoo Yu

Abstract:

Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential elements related with substance use among women of childbearing-age. Factors associated with substance use during pregnancy were explored using qualitative research approach and bio-ecological theoretical framework was utilised to guide the study. Participants were selected using purposive sampling. Participants accessed from the Department of Social Development who met the inclusion criteria of the study were interviewed using semi structured interviews. Participants were referred for psychological intervention during the interview if deemed necessary. Braun and Clarke’s six phases of thematic analysis were used to analyse the data. The study adhered to ethical measures for the participants’ protection. Participants had been knowledgeable about the study earlier than the initiation of the interviews and the important points of their voluntary participation had been explained. The key findings from this study illustrate that social factors, individual area and romantic relationship are the major contributing factors to substance use among pregnant ladies in this sample. Recommendations arising from the study encompass that the stakeholders, rehabilitation centers, Department of Health and future researchers ought to act proactively against substance use all through pregnancy.

Keywords: Bio-ecological factors, pregnancy risk awareness, antenatal care, substance use.

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1101 Evaluation of Fluoride Contents of Kirkuk City's Drinking Water and Its Source: Lesser Zab River and Its Effect on Human Health

Authors: Abbas R. Ali, Safa H. Abdulrahman

Abstract:

In this study, forty samples had been collected from water of Lesser Zab River and drinking water to determine fluoride concentration and show the impact of fluoride on general health of society of Kirkuk city. Estimation of fluoride concentration and determination of its proportion in water samples were performed attentively using a fluoride ion selective electrode. The fluoride concentrations in the Lesser Zab River samples were between 0.0265 ppm and 0.0863 ppm with an average of 0.0451 ppm, whereas the average fluoride concentration in drinking water samples was 0.102 ppm and ranged from 0.010 to 0.289 ppm. A comparison between results obtained with World Health Organization (WHO) show a low concentration of fluoride in the samples of the study. Thus, for health concerns we should increase the concentration of this ion in water of Kirkuk city at least to about (1.0 ppm) and this will take place after fluorination process.

Keywords: Fluoride concentration, Lesser Zab River, drinking water, health society, Kirkuk city.

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1100 A Qualitative Study of Health-Related Beliefs and Practices among Vegetarians

Authors: Lorena Antonovici, Maria Nicoleta Turliuc

Abstract:

The process of becoming a vegetarian involves changes in several life aspects, including health. Despite its relevance, however, little research has been carried out to analyze vegetarians' self-perceived health, and even less empirical attention has received in the Romanian population. This study aimed to assess health-related beliefs and practices among vegetarian adults in a Romanian sample. We have undertaken 20 semi-structured interviews (10 males, 10 females) based on a snowball sample with a mean age of 31 years. The interview guide was divided into three sections: causes of adopting the diet, general aspects (beliefs, practices, tensions, and conflicts) and consequences of adopting the diet (significant changes, positive aspects, and difficulties, physical and mental health). Additional anamnestic data were reported by means of a questionnaire. Data analyses were performed using Tropes text analysis software (v. 8.2) and SPSS software (v. 24.0.) Findings showed that most of the participants considered a vegetarian diet as a natural and healthy choice as opposed to meat-eating, which is not healthy, and its consumption should be moderated among omnivores. A higher proportion of participants (65%) had an average body mass index (BMI), and several women even assumed having certain affections that no longer occur after following a vegetarian diet. Moreover, participants admitted having better moods and mental health status, given their self-contentment with the dietary choice. Relatives were perceived as more skeptical about their practices than others, and especially women had this view. This study provides a valuable insight into health-related beliefs and practices and how a vegetarian diet might interact.

Keywords: Health-related beliefs, health, practices, vegetarians.

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1099 Toxicity of Bisphenol-A: Effects on Health and Regulations

Authors: T. Özdal, N. Şahin Yeşilcubuk

Abstract:

Bisphenol-A (BPA) is one of the highest volume chemicals produced worldwide in the plastic industry. This compound is mostly used in producing polycarbonate plastics that are often used for food and beverage storage, and BPA is also a component of epoxy resins that are used to line food and beverage containers. Studies performed in this area indicated that BPA could be extracted from such products while they are in contact with food.  Therefore, BPA exposure is presumed. In this paper, the chemical structure of BPA, factors affecting BPA migration to food and beverages, effects on health, and recent regulations will be reviewed.

Keywords: BPA, health, regulations, toxicity.

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1098 A Trainable Neural Network Ensemble for ECG Beat Classification

Authors: Atena Sajedin, Shokoufeh Zakernejad, Soheil Faridi, Mehrdad Javadi, Reza Ebrahimpour

Abstract:

This paper illustrates the use of a combined neural network model for classification of electrocardiogram (ECG) beats. We present a trainable neural network ensemble approach to develop customized electrocardiogram beat classifier in an effort to further improve the performance of ECG processing and to offer individualized health care. We process a three stage technique for detection of premature ventricular contraction (PVC) from normal beats and other heart diseases. This method includes a denoising, a feature extraction and a classification. At first we investigate the application of stationary wavelet transform (SWT) for noise reduction of the electrocardiogram (ECG) signals. Then feature extraction module extracts 10 ECG morphological features and one timing interval feature. Then a number of multilayer perceptrons (MLPs) neural networks with different topologies are designed. The performance of the different combination methods as well as the efficiency of the whole system is presented. Among them, Stacked Generalization as a proposed trainable combined neural network model possesses the highest recognition rate of around 95%. Therefore, this network proves to be a suitable candidate in ECG signal diagnosis systems. ECG samples attributing to the different ECG beat types were extracted from the MIT-BIH arrhythmia database for the study.

Keywords: ECG beat Classification; Combining Classifiers;Premature Ventricular Contraction (PVC); Multi Layer Perceptrons;Wavelet Transform

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1097 Ceramic Employees’ Occupational Health and Safety Training Expectations in Turkey

Authors: Erol Karaca

Abstract:

This study aims to analyze ceramic employees’ occupational health and safety training expectations. To that general objective, the study tries to examine whether occupational health and safety training expectations of ceramic employees meaningfully differentiate depending on demographic features and professional, social and economic conditions. For this purpose, a questionnaire was developed by the researcher. The research data were collected through this questionnaire called “Questionnaire of Occupational Health and Safety Training Expectation” (QSOHSTE). QSOHSTE was applied to 125 ceramic employees working in Kütahya, Turkey. Data obtained from questionnaire were analyzed via SPSS 21. The findings, obtained from the study, revealed that employees’ agreement level to occupational health and safety training expectation statements is generally high-level. The findings reveal that employees expect professional interest such as increased development and investment, preventive measures for accidents, interventions to evaluate the working conditions, establishment of safe working environments and sustainment of adequate equipment for occupational health and safety training process. Besides these findings, employees’ agreement level to occupational health and safety training expectation statements also varies in terms of educational level, professional seniority, income level and perception of economic condition.

Keywords: Occupational Health and Safety, Occupational Training, Occupational Expectation.

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