Search results for: Humanized care service

Authors: Zhankun Wang, Timothy Makubuya

Abstract:

The efficiency of public sports service of prefecture-level cities in Zhejiang from 2008 to 2012 was evaluated by applying the DEA method, then its influencing factors were also analyzed through Tobit model. Upon analysis, the results revealed the following; (i) the change in average efficiency of public sports service in Zhejiang present a smooth uptrend and at a relatively high level from 2008 to 2012 (ii) generally, the productivity of public sports service in Zhejiang improved from 2008 to 2012, the productivity efficiency varied greatly in different years, and the regional difference of production efficiency increased. (iii) The correlations for urbanization rate, aging rate, per capita GDP and the population density were significantly positive with the public sports service efficiency in Zhejiang, of which the most significant was the aging rate. However, the population density and per capita GDP had less impact on the efficiency of public sports service in Zhejiang. In addition, whether the efficiency of public sports services in different areas in Zhejiang reciprocates to overall benefits in public wellbeing in both rural and urban settings is still arguable.

Keywords: DEA Model, public sports service, efficiency, Tobit model, Malmquist productivity index, Zhejiang.

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Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

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Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: Multidisciplinary approach, neuropalliative care, research, quality of life.

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Authors: Nan Li, Ying Wang

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Using entropy weight and TOPSIS method, a comprehensive evaluation is done on the development level of Chinese regional service industry in this paper. Firstly, based on existing research results, an evaluation index system is constructed from the scale of development, the industrial structure and the economic benefits. An evaluation model is then built up based on entropy weight and TOPSIS, and an empirical analysis is conducted on the development level of service industries in 31 Chinese provinces during 2006 and 2009 from the two dimensions or time series and cross section, which provides new idea for assessing regional service industry. Furthermore, the 31 provinces are classified into four categories based on the evaluation results, and deep analysis is carried out on the evaluation results.

Keywords: Chinese regional service industry, Development level, Entropy weight, TOPSIS Evaluation Method

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Authors: Germán Santos-Boada, Jordi Domingo-Pascual

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Recently, in some places, optical-fibre access networks have been used with GPON technology belonging to organizations (in most cases public bodies) that act as neutral operators. These operators simultaneously provide network services to various telecommunications operators that offer integrated voice, data and television services. This situation creates new problems related to quality of service, since the interests of the users are intermingled with the interests of the operators. In this paper, we analyse this problem and consider solutions that make it possible to provide guaranteed quality of service for voice over IP, data services and interactive digital television.

Keywords: GPON networks, multioperator, quality of service, triple-play services.

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Authors: Dawei Cai

Abstract:

This paper describes a design of earphone style wearable device that may provide an automatic guidance service for visitors. With both position information and orientation information obtained from NFC and terrestrial magnetism sensor, a high level automatic guide service may be realized. To realize the service, a algorithm for position detection using the packet from NFC tags, and developed an algorithm to calculate the device orientation based on the data from acceleration and terrestrial magnetism sensors called as MEMS. If visitors want to know some explanation about an exhibit in front of him, what he has to do is only move to the object and stands for a moment. The identification program will automatically recognize the status based on the information from NFC and MEMS, and start playing explanation content about the exhibit. This service should be useful for improving the understanding of the exhibition items and bring more satisfactory visiting experience without less burden.

Keywords: Wearable device, MEMS sensor, NFC, ubiquitous computing, guide system.

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Authors: Adekunle O. Afolabi, Pekka Toivanen

Abstract:

The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: Recommendation systems, healthcare, internet of things, real-time, homecare.

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Authors: Faizal A. Samman, Thomas Hollstein, Manfred Glesner

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A synchronous network-on-chip using wormhole packet switching and supporting guaranteed-completion best-effort with low-priority (LP) and high-priority (HP) wormhole packet delivery service is presented in this paper. Both our proposed LP and HP message services deliver a good quality of service in term of lossless packet completion and in-order message data delivery. However, the LP message service does not guarantee minimal completion bound. The HP packets will absolutely use 100% bandwidth of their reserved links if the HP packets are injected from the source node with maximum injection. Hence, the service are suitable for small size messages (less than hundred bytes). Otherwise the other HP and LP messages, which require also the links, will experience relatively high latency depending on the size of the HP message. The LP packets are routed using a minimal adaptive routing, while the HP packets are routed using a non-minimal adaptive routing algorithm. Therefore, an additional 3-bit field, identifying the packet type, is introduced in their packet headers to classify and to determine the type of service committed to the packet. Our NoC prototypes have been also synthesized using a 180-nm CMOS standard-cell technology to evaluate the cost of implementing the combination of both services.

Keywords: Network-on-Chip, Parallel Pipeline Router Architecture, Wormhole Switching, Two-Level Priority Service.

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Authors: Souleymane Oumtanaga, Falilu Abudul Kadiri

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Internet is without any doubt the fastest and effective mean of communication making it possible to reach a great number of people in the world. It draws its base from exchange points. Indeed exchange points are used to inter-connect various Internet suppliers and operators in order to allow them to exchange traffic and it is with these interconnections that Internet made its great strides. They thus make it possible to limit the traffic delivered via the operators of transits. This limitation allows a significant improvement of the quality of service, a reduction in the latency time just as a reduction of the cost of connection for the final subscriber. Through this article we will show how the installation of an IXP allows an improvement and a diversification of the services just as a reduction of the Internet connection costs.

Keywords: Quality of service, Exchange point, interconnection, Service providers, bandwidth, traffic, routers, routing table.

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Authors: Daniella Kucsma

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The examination of the Public Service Organization’s performance evaluation includes several steps that help public organizations to develop a more efficient system. Public sector organizations have different characteristics than the competitive sector, so it can be stated that other/new elements become more important in their performance processes. The literature in this area is diverse, so highlighting an indicator system can be useful for introducing a system, but it is also worthwhile to measure the specific elements of the organization. In the case of a public service organization, due to the service obligation, it is usually possible to talk about a high number of users, so compliance is more difficult. For the organization, it is an important target to place great emphasis on the increase of service standards and the development of related processes. In this research, the health sector is given a prominent role, as it is a sensitive area where both organizational and individual performance is important for all participants. As a primary step, the content of the strategy is decisive, as this is important for the efficient structure of the process. When designing any system, it is important to review the expectations of the stakeholders, as this is primary when considering the design. The goal of this paper is to build the foundations of a performance management and indexing framework that can help a hospital to provide effective feedback and a direction that is important in assessing and developing a service and can become a management philosophy.

Keywords: health sector, public sector, performance management, strategy

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Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

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The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: Ethnographic study, health care needs, elderly Malay people, Malaysia, quality of life, residential home.

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Authors: Suparna Karmakar, Ranjan Dasgupta

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Railway Stations are prone to emergency due to various reasons and proper monitor of railway stations are of immense importance from various angles. A Petri-net representation of a web-service-based Emergency management system has been proposed in this paper which will help in monitoring situation of train, track, signal etc. and in case of any emergency, necessary resources can be dispatched.

Keywords: Business process, Petri net, Rail Station Emergency Management, Web service based system

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Authors: Mohammed T. Simsim

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This paper discusses telecominication market developments in Saudi Arabia. Empirical research was carried in the holy city of Makkah to study the customer's preference for mobile cellular service and  
the factor influencing their subscription of the mobile 
phone service. Results indicate that the financial factor sicnificantly influence the customer's selection of the service provider.  


   

  
  



 


  


  




 
 
  



 
 


  
 


 
   

Keywords: Customer, Makkah, Mobile phone, Operator, Saudi Arabia

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Authors: Juhan Kim, Soohyung Kim, Kiyoung Moon

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In this paper, we design an integration security system that provides authentication service, authorization service, and management service of security data and a unified interface for the management service. The interface is originated from XKMS protocol and is used to manage security data such as XACML policies, SAML assertions and other authentication security data including public keys. The system includes security services such as authentication, authorization and delegation of authentication by employing SAML and XACML based on security data such as authentication data, attributes information, assertions and polices managed with the interface in the system. It also has SAML producer that issues assertions related on the result of the authentication and the authorization services.

Keywords: XML, XML Security, XACML.

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Authors: J. Luché-Thayer, C. Perronne, C. Meseko

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We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: Conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent.

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Authors: Fatemeh Afsharnia, Mohammad Amin Asoodar, Abbas Abdeshahi, Afshin Marzban

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A repairable mechanical system (as agricultural tractor) is subject to deterioration or repeated failure and needs a repair shops and also operator’s capability for the repair and maintenance operations. Data are based on field visits and interviews with 48MF 285 tractor operators from 14 villages collected in north of Khouzestan province. The results showed that most operators were lack the technical skill to service and repair tractors due to insufficient training, specific education and work experience. Inadequate repair and maintenance facilities, such as workshops, mechanics and spare parts depots cause delays in repair work in the survey areas. Farmers do not keep accurate service records and most of them disregard proper maintenance and service of their tractors, such as changing engine oil without following the manufacturer’s recommendations. Since, Repair and maintenance facilities should be established in village areas to guarantee timely repair in case of breakdowns and to make spare parts available at low price. The operators should keep service records accurately and adhere to maintenance and service schedules according to the manufacturer’s instructions. They should also be encouraged to do the service and maintain their tractors properly.

Keywords: Operators’ capability, Facilities availability, Repair and maintenance, MF 285 tractors.

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Authors: A.Khaja Kamaluddin, B.Muhammed Yousoof

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Routing places an important role in determining the quality of service in wireless networks. The routing methods adopted in wireless networks have many drawbacks. This paper aims to review the current routing methods used in wireless networks. This paper proposes an innovative solution to overcome the problems in routing. This solution is aimed at improving the Quality of Service. This solution is different from others as it involves the resuage of the part of the virtual circuits. This improvement in quality of service is important especially in propagation of multimedia applications like video, animations etc. So it is the dire need to propose a new solution to improve the quality of service in ATM wireless networks for multimedia applications especially during this era of multimedia based applications.

Keywords: Packet buffering, Routing Table, Virtual Circuits (VC)

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Authors: DongHoon Shin, Yunmook Nah, HoSeong Kim, Gang Shin Lee, Jae-Il Lee

Abstract:

The rapid advance of communication technology is evolving the network environment into the broadband convergence network. Likewise, the IT services operated in the individual network are also being quickly converged in the broadband convergence network environment. VoIP and IPTV are two examples of such new services. Efforts are being made to develop the video phone service, which is an advanced form of the voice-oriented VoIP service. However, the new IT services will be subject to stability and reliability vulnerabilities if the relevant security issues are not answered during the convergence of the existing IT services currently being operated in individual networks within the wider broadband network environment. To resolve such problems, this paper attempts to analyze the possible threats and identify the necessary security measures before the deployment of the new IT services. Furthermore, it measures the quality of the encryption algorithm application example to describe the appropriate algorithm in order to present security technology that will have no negative impact on the quality of the video phone service.

Keywords: BcN, Security Measures, Video Phone.

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Authors: Yoonjung An, Yongtae Park

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Offering a Product-Service System (PSS) is a well-accepted strategy that companies may adopt to provide a set of systemic solutions to customers. PSSs were initially provided in a simple form but now take diversified and complex forms involving multiple services, products and technologies. With the growing interest in the PSS, frameworks for the PSS development have been introduced by many researchers. However, most of the existing frameworks fail to examine various relations existing in a complex PSS. Since designing a complex PSS involves full integration of multiple products and services, it is essential to identify not only product-service relations but also product-product/ service-service relations. It is also equally important to specify how they are related for better understanding of the system. Moreover, as customers tend to view their purchase from a more holistic perspective, a PSS should be developed based on the whole system’s requirements, rather than focusing only on the product requirements or service requirements. Thus, we propose a framework to develop a complex PSS that is coordinated fully with the requirements of both worlds. Specifically, our approach adopts a multi-domain matrix (MDM). A MDM identifies not only inter-domain relations but also intra-domain relations so that it helps to design a PSS that includes highly desired and closely related core functions/ features. Also, various dependency types and rating schemes proposed in our approach would help the integration process.

Keywords: Inter-domain relations, intra-domain relations, multi-domain matrix, product-service system design.

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Authors: Abdallah Al Sabbagh

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Next Generation Wireless Network (NGWN) is expected to be a heterogeneous network which integrates all different Radio Access Technologies (RATs) through a common platform. A major challenge is how to allocate users to the most suitable RAT for them. An optimized solution can lead to maximize the efficient use of radio resources, achieve better performance for service providers and provide Quality of Service (QoS) with low costs to users. Currently, Radio Resource Management (RRM) is implemented efficiently for the RAT that it was developed. However, it is not suitable for a heterogeneous network. Common RRM (CRRM) was proposed to manage radio resource utilization in the heterogeneous network. This paper presents a user level Markov model for a three co-located RAT networks. The load-balancing based and service based CRRM algorithms have been studied using the presented Markov model. A comparison for the performance of load-balancing based and service based CRRM algorithms is studied in terms of traffic distribution, new call blocking probability, vertical handover (VHO) call dropping probability and throughput.

Keywords: Heterogeneous Wireless Network, Markov chain model, load-balancing based and service based algorithm, CRRM algorithms, Beyond 3G network.

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Authors: P. Vel, H. Mubarak, M. A. Malak

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The elements for success in the service industry for many organizations have been studied and quantified. They range from effective performance evaluation and management to adequately implementing seven P’s. However, the success story of every organization is unique. What might work for one organization might not for another as every company is inherently distinctive. In this paper, the strategic framework behind the success of Liberty Automobiles Dubai is captured. The primary data necessary for this paper was collected through in-depth interviews with the managers for sales, service and marketing as well as the group general manager. Subsequently, the key areas that led to the success of Liberty Autos will be discussed in this paper.

Keywords: Services marketing, automotive retailing, and retailer success.

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Authors: Jieun Song, Taesung Kim, Sokjoon Lee, Howon Kim

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Recently, the RFID (Radio Frequency Identification) technology attracts the world market attention as essential technology for ubiquitous environment. The RFID market has focused on transponders and reader development. But that concern has shifted to RFID software like as high-valued e-business applications, RFID middleware and related development tools. However, due to the high sensitivity of data and service transaction within the RFID network, security consideration must be addressed. In order to guarantee trusted e-business based on RFID technology, we propose a security enhanced RFID middleware system. Our proposal is compliant with EPCglobal ALE (Application Level Events), which is standard interface for middleware and its clients. We show how to provide strengthened security and trust by protecting transported data between middleware and its client, and stored data in middleware. Moreover, we achieve the identification and service access control against illegal service abuse. Our system enables secure RFID middleware service and trusted e-business service.

Keywords: RFID Middleware, ALE (Application Level Events), Security.

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Authors: M. Susithra, R. Gnanadass

Abstract:

Ancillary services are support services which are essential for humanizing and enhancing the reliability and security of the electric power system. Reactive power ancillary service is one of the important ancillary services in a restructured electricity market which determines the cost of supplying ancillary services and finding of how this cost would change with respect to operating decisions. This paper presents a new formation that can be used to minimize the Independent System Operator (ISO)’s total payment for reactive power ancillary service. The modified power flow tracing algorithm estimates the availability of reserve reactive power for ancillary service. In order to find optimum reactive power dispatch, Biogeography based optimization method (BPO) is proposed. Market Reactive Clearing Price (MRCP) is then estimated and it encourages generator companies (GENCOs) to participate in an ancillary service. Finally, optimal weighting factor and real time utilization factor of reactive power give the minimum ISO’s total payment. The effectiveness of proposed design is verified using IEEE 30 bus system.

Keywords: Biogeography based optimization method, Power flow tracing method, Reactive generation capability curve and Reactive power ancillary service.

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Authors: Lars Steiner, Zahra Ahmadi

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

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

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Authors: Anthony Vandarakis

Abstract:

Today’s International Service Learning practices require an update: modern technologies, fresh educational frameworks, and a new operating system to accountably prosper. This paper describes a model of International Service Learning (ISL), which combines current technological hardware, electronic platforms, and asynchronous communications that are grounded in inclusive pedagogy. This model builds on the work around collaborative field trip learning, extending the reach to international partnerships across continents. Mobile technology, 21^st century skills and summit-basecamp modeling intersect to support novel forms of learning that tread lightly on fragile natural ecosystems, affirm local reciprocal partnership in projects, and protect traveling participants from common yet avoidable cultural pitfalls.

Keywords: International Service Learning, ISL, field experiences, mobile technology, ‘out there in here’, summit basecamp pedagogy.

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Authors: Khaja Kamaluddin, Muhammed Yousoof

Abstract:

Available Bit Rate Service (ABR) is the lower priority service and the better service for the transmission of data. On wireline ATM networks ABR source is always getting the feedback from switches about increase or decrease of bandwidth according to the changing network conditions and minimum bandwidth is guaranteed. In wireless networks guaranteeing the minimum bandwidth is really a challenging task as the source is always in mobile and traveling from one cell to another cell. Re establishment of virtual circuits from start to end every time causes the delay in transmission. In our proposed solution we proposed the mechanism to provide more available bandwidth to the ABR source by re-usage of part of old Virtual Channels and establishing the new ones. We want the ABR source to transmit the data continuously (non-stop) inorderto avoid the delay. In worst case scenario at least minimum bandwidth is to be allocated. In order to keep the data flow continuously, priority is given to the handoff ABR call against new ABR call.

Keywords: Bandwidth allocation, Virtual Channel (VC), CBR, ABR, MCR and QOS.

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Authors: Jieun Kim, Yongtae Park, Hakyeon Lee

Abstract:

The emergence of mobile application services and App Store has led to the explosive growth of user innovation, which users voluntarily contribute to. User innovation communities where end users freely reveal innovative ideas and needs with other community members are becoming increasingly influential in this area. However, user-s ideas in user innovation community are not enough to be new service opportunity, because some of them can already developed as existing services in App Store. Moreover, the existing services similar to new service opportunity can be significant references to apply analogy to develop service concept. In response, this research proposes Case-Based Reasoning approach to matching the user needs and existing services, identifying unmet opportunistic user needs, and retrieving similar services with opportunity. Due to its intuitive and transparent algorithm, users related to App Store innovation communities can easily employ Case-Based Reasoning based approach to their innovation.

Keywords: App Store, Case-Based Reasoning, Mobile Application Service, User innovation community.

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Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: Emergency nurses, nursing care, workload, work sampling.

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Authors: Sayantan Khanra, Rojers P. Joseph

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This study attempts to analyze the impact of demography and service quality on the adoption and diffusion of e-Government services in the context of India. The objective of this paper is to study the users' perception about e-Government services and investigate the key variables that are most salient to the Indian populace. At the completion of this study, a research model that would help to understand the relationship involving the demographic variables and service quality dimensions, and the willingness to adopt e-Government services is expected to be developed. Dedicated authorities, particularly those in developing economies, may use that model or its augmented versions to design and update e-Government services and promote their use among citizens. After all, enhanced public participation is required to improve efficiency, engagement and transparency in the implementation of the aforementioned services.

Keywords: Adoption and diffusion of e-Government services, demographic variables, hierarchical regression analysis, service quality dimensions.

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Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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Authors: Noda L. M., Salvador I. C, C. M. L. G. Parada, Fonseca C. R. B.

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In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Keywords: Fetal Mortality, Infant Mortality, Maternal-Child Health Services, Program Evaluation.

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