Search results for: Palliative care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 405

Search results for: Palliative care

105 The Relevance of Data Warehousing and Data Mining in the Field of Evidence-based Medicine to Support Healthcare Decision Making

Authors: Nevena Stolba, A Min Tjoa

Abstract:

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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104 The Coexistence of Dual Form of Malnutrition among Portuguese Institutionalized Elderly People

Authors: C. Caçador, M. J. Reis Lima, J. Oliveira, M. J. Veiga, M. Teixeira Veríssimo, F. Ramos, M. C. Castilho, E. Teixeira-Lemos

Abstract:

In the present study we evaluated the nutritional status of 214 institutionalized elderly residents of both genders, aged 65 years and older of 11 care homes located in the district of Viseu (center of Portugal). The evaluation was based on anthropometric measurements and the Mini Nutritional Assessment (MNA) score.

The mean age of the subjects was 82.3 ± 6.1 years-old. Most of the elderly residents were female (72.0%). The majority had 4 years of formal education (51.9%) and was widowed (74.3%) or married (14.0%).

Men presented a mean age of 81.2±8.5 years-old, weight 69.3±14.5 kg and BMI 25.33±6.5 kg/m2. In women, the mean age was 84.5±8.2 years-old, weight 61.2±14.7 kg and BMI 27.43±5.6 kg/m2.

The evaluation of the nutritional status using the MNA score showed that 24.0% of the residents show a risk of undernutrition and 76.0% of them were well nourished.

There was a high prevalence of obese (24.8%) and overweight residents (33.2%) according to the BMI. 7.5% were considered underweight.

We also found that according to their waist circumference measurements 88.3% of the residents were at risk for cardiovascular disease (CVD) and 64.0% of them presented very high risk for CVD (WC≥88 cm for women and WC ≥102 cm for men).

The present study revealed the coexistence of a dual form of malnutrition (undernourished and overweight) among the institutionalized Portuguese concomitantly with an excess of abdominal adiposity. The high prevalence of residents at high risk for CVD should not be overlooked.

Given the vulnerability of the group of institutionalized elderly, our study highlights the importance of the classification of nutritional status based on both instruments: the BMI and the MNA.

Keywords: Nutritional status, MNA, BMI, elderly.

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103 Designing Social Care Policies in the Long Term: A Study Using Regression, Clustering and Backpropagation Neural Nets

Authors: Sotirios Raptis

Abstract:

Linking social needs to social classes using different criteria may lead to social services misuse. The paper discusses using ML and Neural Networks (NNs) in linking public services in Scotland in the long term and advocates, this can result in a reduction of the services cost connecting resources needed in groups for similar services. The paper combines typical regression models with clustering and cross-correlation as complementary constituents to predict the demand. Insurance companies and public policymakers can pack linked services such as those offered to the elderly or to low-income people in the longer term. The work is based on public data from 22 services offered by Public Health Services (PHS) Scotland and from the Scottish Government (SG) from 1981 to 2019 that are broken into 110 years series called factors and uses Linear Regression (LR), Autoregression (ARMA) and 3 types of back-propagation (BP) Neural Networks (BPNN) to link them under specific conditions. Relationships found were between smoking related healthcare provision, mental health-related health services, and epidemiological weight in Primary 1(Education) Body Mass Index (BMI) in children. Primary component analysis (PCA) found 11 significant factors while C-Means (CM) clustering gave 5 major factors clusters.

Keywords: Probability, cohorts, data frames, services, prediction.

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102 Reasons for Doing Job outside Household and Difficulties Faced by the Working Women of Bangladesh

Authors: Md. Sayeed Akhter, Md. Akhtar Hossain Mazumder, Syeda Afreena Mamun

Abstract:

Bangladesh is a patriarchal and male dominated country. Traditional, cultural, social, and religious values and practices have reinforced the lower status of women accorded to them in society and have limited their opportunities for education, technical and vocational training, and involvement with earning activities outside their households. After independence numbers of women are doing job outside their households. This study attempts to find out the reasons of engaging in earning activities outside households and difficulties faced by upper and lower class working women in Bangladesh. To explore the objectives and research questions of the study descriptive techniques had been used. Survey was conducted among the women who were working in Rajshahi city of Bangladesh and face-to-face interviews were conducted to collect data. Findings of the study illustrates that most of the upper class working women engaged into job because they wanted to utilized their education and to bring solvency in the family, and they spend their income for meeting the needs of all the members of the family. On the other hand, most of the lower class working women involved into earning activities outside their households because they want to bring solvency in their families and spend their income on household expenditure. Both classes became tensed for their children because they had to stay at their working place for long time. Therefore, day care center should be established besides their working place for their children.

Keywords: Working Women, Reasons for Doing Jobs, Working Environment, Difficulties Faced.

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101 Urban Greenery in the Greatest Polish Cities: Analysis of Spatial Concentration

Authors: Elżbieta Antczak

Abstract:

Cities offer important opportunities for economic development and for expanding access to basic services, including health care and education, for large numbers of people. Moreover, green areas (as an integral part of sustainable urban development) present a major opportunity for improving urban environments, quality of lives and livelihoods. This paper examines, using spatial concentration and spatial taxonomic measures, regional diversification of greenery in the cities of Poland. The analysis includes location quotients, Lorenz curve, Locational Gini Index, and the synthetic index of greenery and spatial statistics tools: (1) To verify the occurrence of strong concentration or dispersion of the phenomenon in time and space depending on the variable category, and, (2) To study if the level of greenery depends on the spatial autocorrelation. The data includes the greatest Polish cities, categories of the urban greenery (parks, lawns, street greenery, and green areas on housing estates, cemeteries, and forests) and the time span 2004-2015. According to the obtained estimations, most of cites in Poland are already taking measures to become greener. However, in the country there are still many barriers to well-balanced urban greenery development (e.g. uncontrolled urban sprawl, poor management as well as lack of spatial urban planning systems).

Keywords: Greenery, urban areas, regional spatial diversification and concentration, spatial taxonomic measure.

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100 Investigation of the Space in Response to the Conditions Caused by the Pandemics and Presenting Five-Scale Design Guidelines to Adapt and Prepare to Face the Pandemics

Authors: Sara Ramezanzadeh, Nashid Nabian

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Historically, pandemics in different periods have caused compulsory changes in human life. In the case of COVID-19, according to the limitations and established care instructions, spatial alignment with the conditions is important. Following the outbreak of COVID-19, the question raised in this study is how to do spatial design in five scales, namely object, space, architecture, city, and infrastructure, in response to the consequences created in the realms under study. From the beginning of the pandemic until now, some changes in the spatial realm have been created spontaneously or by space users. These transformations have been mostly applied in modifiable parts such as furniture arrangement, especially in work-related spaces. To implement other comprehensive requirements, flexibility and adaptation of space design to the conditions resulting from the pandemics are needed during and after the outbreak. Studying the effects of pandemics from the past to the present, this research covers eight major realms, including three categories of ramifications, solutions, and paradigm shifts, and analytical conclusions about the solutions that have been created in response to them. Finally, by the consideration of epidemiology as a modern discipline influencing the design, spatial solutions in the five scales mentioned (in response to the effects of the eight realms for spatial adaptation in the face of pandemics and their following conditions) are presented as a series of guidelines. Due to the unpredictability of possible pandemics in the future, the possibility of changing and updating the provided guidelines is considered.

Keywords: Pandemics, COVID-19, spatial design, ramifications, paradigm shifts, guidelines.

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99 Experimental Study on Strength and Durability Properties of Bio-Self-Cured Fly Ash Based Concrete under Aggressive Environments

Authors: R. Malathy

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High performance concrete is not only characterized by its high strength, workability, and durability but also by its smartness in performance without human care since the first day. If the concrete can cure on its own without external curing without compromising its strength and durability, then it is said to be high performance self-curing concrete. In this paper, an attempt is made on the performance study of internally cured concrete using biomaterials, namely Spinacea pleracea and Calatropis gigantea as self-curing agents, and it is compared with the performance of concrete with existing self-cure chemical, namely polyethylene glycol. The present paper focuses on workability, strength, and durability study on M20, M30, and M40 grade concretes replacing 30% of fly ash for cement. The optimum dosage of Spinacea pleracea, Calatropis gigantea, and polyethylene glycol was taken as 0.6%, 0.24%, and 0.3% by weight of cement from the earlier research studies. From the slump tests performed, it was found that there is a minimum variation between conventional concrete and self-cured concrete. The strength activity index is determined by keeping compressive strength of conventionally cured concrete for 28 days as unity and observed that, for self-cured concrete, it is more than 1 after 28 days and more than 1.15 after 56 days because of secondary reaction of fly ash. The performance study of concretes in aggressive environment like acid attack, sea water attack, and chloride attack was made, and the results are positive and encouraging in bio-self-cured concretes which are ecofriendly, cost effective, and high performance materials.

Keywords: Biomaterials, Calatropis gigantea, polyethylene glycol, Spinacea oleracea, self-curing concrete.

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98 Damage to Strawberries Caused by Simulated Transport

Authors: G. La Scalia, M. Enea, R. Micale, O. Corona, L. Settanni

Abstract:

The quality and condition of perishable products delivered to the market and their subsequent selling prices are directly affected by the care taken during harvesting and handling. Mechanical injury, in fact, occurs at all stages, from pre-harvest operations through post-harvest handling, packing and transport to the market. The main implications of this damage are the reduction of the product’s quality and economical losses related to the shelf life diminution. For most perishable products, the shelf life is relatively short and it is typically dictated by microbial growth related to the application of dynamic and static loads during transportation. This paper presents the correlation between vibration levels and microbiological growth on strawberries and woodland strawberries and detects the presence of volatile organic compounds (VOC) in order to develop an intelligent logistic unit capable of monitoring VOCs using a specific sensor system. Fresh fruits were exposed to vibrations by means of a vibrating table in a temperature-controlled environment. Microbiological analyses were conducted on samples, taken at different positions along the column of the crates. The values obtained were compared with control samples not exposed to vibrations and the results show that different positions along the column influence the development of bacteria, yeasts and filamentous fungi.

Keywords: Microbiological analysis, shelf life, transport damage, volatile organic compounds.

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97 Cultural Practices as a Coping Measure for Women who Terminated a Pregnancy in Adolescence: A Qualitative Study

Authors: Botshelo R. Sebola

Abstract:

Unintended pregnancy often results in pregnancy termination. Most countries have legalised the termination of a pregnancy and pregnant adolescents can visit designated clinics without their parents’ consent. In most African and Asian countries, certain cultural practices are performed following any form of childbirth, including abortion, and such practices are ingrained in societies. The aim of this paper was to understand how women who terminated a pregnancy during adolescence coped by embracing cultural practices. A descriptive multiple case study design was adopted for the study. In-depth, semi-structured interviews and reflective diaries were used for data collection. Participants were 13 women aged 20 to 35 years who had terminated a pregnancy in adolescence. Three women kept their soiled sanitary pads, burned them to ash and waited for the rainy season to scatter the ash in a flowing stream. This ritual was performed to appease the ancestors, ask them for forgiveness and as a send-off for the aborted foetus. Five women secretly consulted Sangoma (traditional healers) to perform certain rituals. Three women isolated themselves to perform herbal cleansings, and the last two chose not to engage in any sexual activity for one year, which led to the loss of their partners. This study offers a unique contribution to understanding the solitary journey of women who terminate a pregnancy. The study challenges healthcare professionals who work in clinics that offer pregnancy termination services to look beyond releasing the foetus to advocating and providing women with the necessary care and support in performing cultural practices.

Keywords: Adolescence, case study, cultural rituals, pregnancy.

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96 Mathematical Description of Functional Motion and Application as a Feeding Mode for General Purpose Assistive Robots

Authors: Martin Leroux, Sylvain Brisebois

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Eating a meal is among the Activities of Daily Living, but it takes a lot of time and effort for people with physical or functional limitations. Dedicated technologies are cumbersome and not portable, while general-purpose assistive robots such as wheelchair-based manipulators are too hard to control for elaborate continuous motion like eating. Eating with such devices has not previously been automated, since there existed no description of a feeding motion for uncontrolled environments. In this paper, we introduce a feeding mode for assistive manipulators, including a mathematical description of trajectories for motions that are difficult to perform manually such as gathering and scooping food at a defined/desired pace. We implement these trajectories in a sequence of movements for a semi-automated feeding mode which can be controlled with a very simple 3-button interface, allowing the user to have control over the feeding pace. Finally, we demonstrate the feeding mode with a JACO robotic arm and compare the eating speed, measured in bites per minute of three eating methods: a healthy person eating unaided, a person with upper limb limitations or disability using JACO with manual control, and a person with limitations using JACO with the feeding mode. We found that the feeding mode allows eating about 5 bites per minute, which should be sufficient to eat a meal under 30min.

Keywords: Assistive robotics, Automated feeding, Elderly care, Trajectory design, Human-Robot Interaction.

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95 Vision-Based Daily Routine Recognition for Healthcare with Transfer Learning

Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan

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We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.

Keywords: Daily activity recognition, healthcare, IoT sensors, transfer learning.

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94 Financial Technology: The Key to Achieving Financial Inclusion in Developing Countries Post COVID-19 from an East African Perspective

Authors: Yosia Mulumba, Klaus Schmidt

Abstract:

Financial Inclusion is considered a key pillar for development in most countries around the world. Access to affordable financial services in a country’s economy can be a driver to overcome poverty and reduce income inequalities, and thus increase economic growth. Nevertheless, the number of financially excluded populations in developing countries continues to be very high. This paper explores the role of Financial Technology (Fintech) as a key driver for achieving financial inclusion in developing countries post the COVID-19 pandemic with an emphasis on four East African countries: Kenya, Tanzania, Uganda, and Rwanda. The research paper is inspired by the positive disruption caused by the pandemic, which has compelled societies in East Africa to adapt and embrace the use of financial technology innovations, specifically Mobile Money Services (MMS), to access financial services. MMS has been further migrated and integrated with other financial technology innovations such as Mobile Banking, Micro Savings, and Loans, and Insurance, to mention but a few. These innovations have been adopted across key sectors such as commerce, health care, or agriculture. The research paper will highlight the Mobile Network Operators (MNOs) that are behind MMS, along with numerous innovative products and services being offered to the customers. It will also highlight the regulatory framework under which these innovations are being governed to ensure the safety of the customers' funds.

Keywords: Financial inclusion, financial technology, regulatory framework, mobile money services.

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93 The Experiences of Hong Kong Chinese Divorced Wives in Facing the Cancer Death of Their Ex-Husbands

Authors: M. L. Yeung

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With the surge of divorce rate and male cancer onset/death rates, the phenomenon of divorced wives in the facing cancer death of their ex-husbands is not uncommon in Hong Kong. Yet, there is a dearth of study on the experiences of bereaved-divorced wives in the Hong Kong cultural context. This project fills the knowledge gap by conducting a qualitative study for having interviewed four bereaved ex-wives, who returned to ex-husbands’ end-of-life caregiving and eventually grieved for the ex-spousal’s death. From the perspectives of attachment theory and disenfranchised grief in the Hong Kong cultural context, a ‘double-loss’ experience is found in which interviewees suffer from the first loss of divorce and the second loss of ex-husbands’ death. Traumatic childhood experiences, attachment needs, role ambiguity, unresolved emotions and unrecognized grief are found significant in their lived experiences which alert the ‘double-loss’ is worthy of attention. Extending a family-centered end-of-life and bereavement care services to divorced couples is called for, in which validation on the attachment needs, ex-couple reconciliation, and acknowledgement on the disenfranchised grief are essential for social work practice on this group of clienteles specifically in Hong Kong cultural context.

Keywords: Changing family, disenfranchised grief, divorce, ex-spousal death, marriage.

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92 Interpreting Chopin’s Music Today: Mythologization of Art: Kitsch

Authors: Ilona Bala

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The subject of this abstract is related to the notion of 'popular music', a notion that should be treated with extreme care, particularly when applied to Frederic Chopin, one of the greatest composers of Romanticism. By ‘popular music’, we mean a category of everyday music, set against the more intellectual kind, referred to as ‘classical’. We only need to look back to the culture of the nineteenth century to realize that this ‘popular music’ refers to the ‘music of the low’. It can be studied from a sociological viewpoint, or as sociological aesthetics. However, we cannot ignore the fact that, very quickly, this music spread to the wealthiest strata of the European society of the nineteenth century, while likewise the lowest classes often listen to the intellectual classical music, so pleasant to listen to. Further, we can observe that a sort of ‘sacralisation of kitsch’ occurs at the intersection between the classical and popular music. This process is the topic of this contribution. We will start by investigating the notion of kitsch through the study of Chopin’s popular compositions. However, before considering the popularisation of this music in today’s culture, we will have to focus on the use of the word kitsch in Chopin’s times, through his own musical aesthetics. Finally, the objective here will be to negate the theory that art is simply the intellectual definition of aesthetics. A kitsch can, obviously, only work on the emotivity of the masses, as it represents one of the features of culture-language (the words which the masses identify with). All art is transformed, becoming something outdated or even outmoded. Here, we are truly within a process of mythologization of art, through the study of the aesthetic reception of the musical work.

Keywords: F. Chopin, musical work, popular music, romantic music, mythologization of art, kitsch.

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91 A Metric-Set and Model Suggestion for Better Software Project Cost Estimation

Authors: Murat Ayyıldız, Oya Kalıpsız, Sırma Yavuz

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Software project effort estimation is frequently seen as complex and expensive for individual software engineers. Software production is in a crisis. It suffers from excessive costs. Software production is often out of control. It has been suggested that software production is out of control because we do not measure. You cannot control what you cannot measure. During last decade, a number of researches on cost estimation have been conducted. The metric-set selection has a vital role in software cost estimation studies; its importance has been ignored especially in neural network based studies. In this study we have explored the reasons of those disappointing results and implemented different neural network models using augmented new metrics. The results obtained are compared with previous studies using traditional metrics. To be able to make comparisons, two types of data have been used. The first part of the data is taken from the Constructive Cost Model (COCOMO'81) which is commonly used in previous studies and the second part is collected according to new metrics in a leading international company in Turkey. The accuracy of the selected metrics and the data samples are verified using statistical techniques. The model presented here is based on Multi-Layer Perceptron (MLP). Another difficulty associated with the cost estimation studies is the fact that the data collection requires time and care. To make a more thorough use of the samples collected, k-fold, cross validation method is also implemented. It is concluded that, as long as an accurate and quantifiable set of metrics are defined and measured correctly, neural networks can be applied in software cost estimation studies with success

Keywords: Software Metrics, Software Cost Estimation, Neural Network.

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90 Data Mining for Cancer Management in Egypt Case Study: Childhood Acute Lymphoblastic Leukemia

Authors: Nevine M. Labib, Michael N. Malek

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Data Mining aims at discovering knowledge out of data and presenting it in a form that is easily comprehensible to humans. One of the useful applications in Egypt is the Cancer management, especially the management of Acute Lymphoblastic Leukemia or ALL, which is the most common type of cancer in children. This paper discusses the process of designing a prototype that can help in the management of childhood ALL, which has a great significance in the health care field. Besides, it has a social impact on decreasing the rate of infection in children in Egypt. It also provides valubale information about the distribution and segmentation of ALL in Egypt, which may be linked to the possible risk factors. Undirected Knowledge Discovery is used since, in the case of this research project, there is no target field as the data provided is mainly subjective. This is done in order to quantify the subjective variables. Therefore, the computer will be asked to identify significant patterns in the provided medical data about ALL. This may be achieved through collecting the data necessary for the system, determimng the data mining technique to be used for the system, and choosing the most suitable implementation tool for the domain. The research makes use of a data mining tool, Clementine, so as to apply Decision Trees technique. We feed it with data extracted from real-life cases taken from specialized Cancer Institutes. Relevant medical cases details such as patient medical history and diagnosis are analyzed, classified, and clustered in order to improve the disease management.

Keywords: Data Mining, Decision Trees, Knowledge Discovery, Leukemia.

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89 Cloud Enterprise Application Provider Selection Model for the Small and Medium Enterprise: A Pilot Study

Authors: Rowland R. Ogunrinde, Yusmadi Y. Jusoh, Noraini Che Pa, Wan Nurhayati W. Rahman, Azizol B. Abdullah

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Enterprise Applications (EAs) aid the organizations achieve operational excellence and competitive advantage. Over time, most Small and Medium Enterprises (SMEs), which are known to be the major drivers of most thriving global economies, use the costly on-premise versions of these applications thereby making business difficult to competitively thrive in the same market environment with their large enterprise counterparts. The advent of cloud computing presents the SMEs an affordable offer and great opportunities as such EAs can be cloud-hosted and rented on a pay-per-use basis which does not require huge initial capital. However, as there are numerous Cloud Service Providers (CSPs) offering EAs as Software-as-a-Service (SaaS), there is a challenge of choosing a suitable provider with Quality of Service (QoS) that meet the organizations’ customized requirements. The proposed model takes care of that and goes a step further to select the most affordable among a selected few of the CSPs. In the earlier stage, before developing the instrument and conducting the pilot test, the researchers conducted a structured interview with three experts to validate the proposed model. In conclusion, the validity and reliability of the instrument were tested through experts, typical respondents, and analyzed with SPSS 22. Results confirmed the validity of the proposed model and the validity and reliability of the instrument.

Keywords: Cloud service provider, enterprise applications, quality of service, selection criteria, small and medium enterprise.

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88 Helping Others and Youth Mental Health: A Qualitative Study Exploring Perspectives of Youth Engaging in Prosocial Activities

Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

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Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental wellbeing, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behavior. Heavy time commitment, negative behavior from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall wellbeing.

Keywords: Helping others, prosocial behavior, youth, mental wellbeing.

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87 An Overview of Electronic Waste as Aggregate in Concrete

Authors: S. R. Shamili, C. Natarajan, J. Karthikeyan

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Rapid growth of world population and widespread urbanization has remarkably increased the development of the construction industry which caused a huge demand for sand and gravels. Environmental problems occur when the rate of extraction of sand, gravels, and other materials exceeds the rate of generation of natural resources; therefore, an alternative source is essential to replace the materials used in concrete. Now-a-days, electronic products have become an integral part of daily life which provides more comfort, security, and ease of exchange of information. These electronic waste (E-Waste) materials have serious human health concerns and require extreme care in its disposal to avoid any adverse impacts. Disposal or dumping of these E-Wastes also causes major issues because it is highly complex to handle and often contains highly toxic chemicals such as lead, cadmium, mercury, beryllium, brominates flame retardants (BFRs), polyvinyl chloride (PVC), and phosphorus compounds. Hence, E-Waste can be incorporated in concrete to make a sustainable environment. This paper deals with the composition, preparation, properties, classification of E-Waste. All these processes avoid dumping to landfills whilst conserving natural aggregate resources, and providing a better environmental option. This paper also provides a detailed literature review on the behaviour of concrete with incorporation of E-Wastes. Many research shows the strong possibility of using E-Waste as a substitute of aggregates eventually it reduces the use of natural aggregates in concrete.

Keywords: Disposal, electronic waste, landfill, toxic chemicals.

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86 Evaluation of State of the Art IDS Message Exchange Protocols

Authors: Robert Koch, Mario Golling, Gabi Dreo

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During the last couple of years, the degree of dependence on IT systems has reached a dimension nobody imagined to be possible 10 years ago. The increased usage of mobile devices (e.g., smart phones), wireless sensor networks and embedded devices (Internet of Things) are only some examples of the dependency of modern societies on cyber space. At the same time, the complexity of IT applications, e.g., because of the increasing use of cloud computing, is rising continuously. Along with this, the threats to IT security have increased both quantitatively and qualitatively, as recent examples like STUXNET or the supposed cyber attack on Illinois water system are proofing impressively. Once isolated control systems are nowadays often publicly available - a fact that has never been intended by the developers. Threats to IT systems don’t care about areas of responsibility. Especially with regard to Cyber Warfare, IT threats are no longer limited to company or industry boundaries, administrative jurisdictions or state boundaries. One of the important countermeasures is increased cooperation among the participants especially in the field of Cyber Defence. Besides political and legal challenges, there are technical ones as well. A better, at least partially automated exchange of information is essential to (i) enable sophisticated situational awareness and to (ii) counter the attacker in a coordinated way. Therefore, this publication performs an evaluation of state of the art Intrusion Detection Message Exchange protocols in order to guarantee a secure information exchange between different entities.

Keywords: Cyber Defence, Cyber Warfare, Intrusion Detection Information Exchange, Early Warning Systems, Joint Intrusion Detection, Cyber Conflict

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85 Hybrid Advanced Oxidative Pretreatment of Complex Industrial Effluent for Biodegradability Enhancement

Authors: K. Paradkar, S. N. Mudliar, A. Sharma, A. B. Pandit, R. A. Pandey

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The study explores the hybrid combination of Hydrodynamic Cavitation (HC) and Subcritical Wet Air Oxidation-based pretreatment of complex industrial effluent to enhance the biodegradability selectively (without major COD destruction) to facilitate subsequent enhanced downstream processing via anaerobic or aerobic biological treatment. Advanced oxidation based techniques can be less efficient as standalone options and a hybrid approach by combining Hydrodynamic Cavitation (HC), and Wet Air Oxidation (WAO) can lead to a synergistic effect since both the options are based on common free radical mechanism. The HC can be used for initial turbulence and generation of hotspots which can begin the free radical attack and this agitating mixture then can be subjected to less intense WAO since initial heat (to raise the activation energy) can be taken care by HC alone. Lab-scale venturi-based hydrodynamic cavitation and wet air oxidation reactor with biomethanated distillery wastewater (BMDWW) as a model effluent was examined for establishing the proof-of-concept. The results indicated that for a desirable biodegradability index (BOD: COD - BI) enhancement (up to 0.4), the Cavitation (standalone) pretreatment condition was: 5 bar and 88 min reaction time with a COD reduction of 36 % and BI enhancement of up to 0.27 (initial BI - 0.17). The optimum WAO condition (standalone) was: 150oC, 6 bar and 30 minutes with 31% COD reduction and 0.33 BI. The hybrid pretreatment (combined Cavitation + WAO) worked out to be 23.18 min HC (at 5 bar) followed by 30 min WAO at 150oC, 6 bar, at which around 50% COD was retained yielding a BI of 0.55. FTIR & NMR analysis of pretreated effluent indicated dissociation and/or reorientation of complex organic compounds in untreated effluent to simpler organic compounds post-pretreatment.

Keywords: BI, hybrid, hydrodynamic cavitation, wet air oxidation.

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84 Patient’s Knowledge and Use of Sublingual Glyceryl Trinitrate Therapy in Taiping Hospital, Malaysia

Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md Saad

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Background: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self-administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: Glyceryl trinitrate, knowledge, adherence.

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83 Patient Support Program in Pharmacovigilance: Foster Patient Confidence and Compliance

Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

Abstract:

The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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82 Child Homicide Victimization and Community Context: A Research Note

Authors: Bohsiu Wu

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Among serious crimes, child homicide is a rather rare event. However, the killing of children stirs up a special type of emotion in society that pales other criminal acts. This study examines the relevancy of three possible community-level explanations for child homicide: social deprivation, female empowerment, and social isolation. The social deprivation hypothesis posits that child homicide results from lack of resources in communities. The female empowerment hypothesis argues that a higher female status translates into a higher level of capability to prevent child homicide. Finally, the social isolation hypothesis regards child homicide as a result of lack of social connectivity. Child homicide data, aggregated by US postal ZIP codes in California from 1990 to 1999, were analyzed with a negative binomial regression. The results of the negative binomial analysis demonstrate that social deprivation is the most salient and consistent predictor among all other factors in explaining child homicide victimization at the ZIP-code level. Both social isolation and female labor force participation are weak predictors of child homicide victimization across communities. Further, results from the negative binomial regression show that it is the communities with a higher, not lower, degree of female labor force participation that are associated with a higher count of child homicide. It is possible that poor communities with a higher level of female employment have a lesser capacity to provide the necessary care and protection for the children. Policies aiming at reducing social deprivation and strengthening female empowerment possess the potential to reduce child homicide in the community.

Keywords: Child homicide, deprivation, empowerment, isolation.

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81 Chronic Patients- Prescription Refill Intentions

Authors: Ching - Yi Lee, I-Hsiung Tseng, Feng-Chuan Pan

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Environment today is featured with aging population, increasing prevalence of chronic disease and complex of medical treatment. Safe use of pharmaceutics relied very much on the efforts made by both the health- related organizations and as well as the government agencies. As far as the specialization concern in providing health services to the patients, the government actively issued and implemented the divisions of medical treatment and pharmaceutical to improve the quality of care and to reduce medication errors and ensure public health. Pharmaceutical sub-sector policy has been implemented for 13 years. This study attempts to explore the factors that affect the patients- behavior intention of refilling a prescription from a NHIB pharmacy. Samples were those patients refilling their prescriptions with the case NHIB pharmacies. A self-administered questionnaire was used to collect respondents- information while the patients or family members visit the pharmacy for the refilling. 1,200 questionnaires were dispatched in 37 pharmacies that randomly selected from Pingtung City, Dongkang, Chaozhou, Hengchun areas. 732 responses were gained with 604 valid samples for further analyses. Results of data analyses indicated that respondents- attitude, subjective norm, perceived behavior control and behavior intentions toward refilling behavior varied from some demographic variables to another. This research also suggested adding actual behavior, either by a self-report or observed, into the research.

Keywords: Separation of dispensing and prescribing, prescriptions refill slip, NHIB contracted pharmacy, drug safety, theory of planned behavior.

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80 Applications of Support Vector Machines on Smart Phone Systems for Emotional Speech Recognition

Authors: Wernhuar Tarng, Yuan-Yuan Chen, Chien-Lung Li, Kun-Rong Hsie, Mingteh Chen

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An emotional speech recognition system for the applications on smart phones was proposed in this study to combine with 3G mobile communications and social networks to provide users and their groups with more interaction and care. This study developed a mechanism using the support vector machines (SVM) to recognize the emotions of speech such as happiness, anger, sadness and normal. The mechanism uses a hierarchical classifier to adjust the weights of acoustic features and divides various parameters into the categories of energy and frequency for training. In this study, 28 commonly used acoustic features including pitch and volume were proposed for training. In addition, a time-frequency parameter obtained by continuous wavelet transforms was also used to identify the accent and intonation in a sentence during the recognition process. The Berlin Database of Emotional Speech was used by dividing the speech into male and female data sets for training. According to the experimental results, the accuracies of male and female test sets were increased by 4.6% and 5.2% respectively after using the time-frequency parameter for classifying happy and angry emotions. For the classification of all emotions, the average accuracy, including male and female data, was 63.5% for the test set and 90.9% for the whole data set.

Keywords: Smart phones, emotional speech recognition, socialnetworks, support vector machines, time-frequency parameter, Mel-scale frequency cepstral coefficients (MFCC).

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79 Remittances and the Changing Roles of Women in Laos

Authors: N. Southiseng, J. Walsh

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Prior to 1975, women in Laos suffered from having reduced levels of power over decision-making in their families and in their communities. This has had a negative impact on their ability to develop their own identities. Their roles were identified as being responsible for household activities and making preparations for their marriage. Many women lost opportunities to get educated and access the outdoor work that might have empowered them to improve their situations. So far, no accurate figures of either emigrants or return migrants have been compiled but it appears that most of them were women, and it was women who most and more frequently remitted money home. However, very few recent studies have addressed the relationship between remittances and the roles of women in Laos. This study, therefore, aims at redressing to some extent the deficiencies in knowledge. Qualitative techniques were used to gather data, including individual in-depth interviews and direct observation in combination with the content analysis method. Forty women in Vientiane Municipality and Savannakhet province were individually interviewed. It was found that the monetary remittance was typically used for family security and well-being; on fungible activities; on economic and business activities; and on community development, especially concerning hospitality and providing daily household necessities. Remittances played important roles in improving many respondents- livelihoods and positively changed their identities in families and communities. Women became empowered as they were able to start commercial businesses, rather than taking care of (just) housework, children and elders. Interviews indicated that 92.5% of the respondents their quality of lives improved, 90% felt happier in their families and 82.5% felt conflicts in their families were reduced.

Keywords: Laos, Monetary Remittances, Social Remittance, Women's Empowerment.

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78 Effect of Jatropha curcas Leaf Extract on Castor Oil Induced Diarrhea in Albino Rats

Authors: Fatima U. Maigari, Musa Halilu, M. Maryam Umar, Rabiu Zainab

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Plants as therapeutic agents are used as drug in many parts of the world. Medicinal plants are mostly used in developing countries due to culture acceptability, belief or due to lack of easy access to primary health care services. Jatropha curcas is a plant from the Euphorbiaceae family which is widely used in Northern Nigeria as an anti-diarrheal agent. This study was conducted to determine the anti-diarrheal effect of the leaf extract on castor oil induced diarrhea in albino rats. The leaves of J. curcas were collected from Balanga Local government in Gombe State, north-eastern Nigeria; due to its bioavailability. The leaves were air-dried at room temperature and ground to powder. Phytochemical screening was done and different concentrations of the extract was prepared and administered to the different categories of experimental animals. From the results, aqueous leaf extract of Jatropha curcas at doses of 200mg/Kg and 400mg/Kg was found to reduce the mean stool score as compared to control rats, however, maximum reduction was achieved with the standard drug of Loperamide (5mg/Kg). Treatment of diarrhea with 200mg/Kg of the extract did not produce any significant decrease in stool fluid content but was found to be significant in those rats that were treated with 400mg/Kg of the extract at 2hours (0.05±0.02) and 4hours (0.01±0.01). A significant reduction of diarrhea in the experimental animals signifies it to possess some anti-diarrheal activity.

Keywords: Anti-diarrhea, Diarrhea, Jatropha curcas, Loperamide.

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77 An Extensible Software Infrastructure for Computer Aided Custom Monitoring of Patients in Smart Homes

Authors: Ritwik Dutta, Marilyn Wolf

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This paper describes the tradeoffs and the design from scratch of a self-contained, easy-to-use health dashboard software system that provides customizable data tracking for patients in smart homes. The system is made up of different software modules and comprises a front-end and a back-end component. Built with HTML, CSS, and JavaScript, the front-end allows adding users, logging into the system, selecting metrics, and specifying health goals. The backend consists of a NoSQL Mongo database, a Python script, and a SimpleHTTPServer written in Python. The database stores user profiles and health data in JSON format. The Python script makes use of the PyMongo driver library to query the database and displays formatted data as a daily snapshot of user health metrics against target goals. Any number of standard and custom metrics can be added to the system, and corresponding health data can be fed automatically, via sensor APIs or manually, as text or picture data files. A real-time METAR request API permits correlating weather data with patient health, and an advanced query system is implemented to allow trend analysis of selected health metrics over custom time intervals. Available on the GitHub repository system, the project is free to use for academic purposes of learning and experimenting, or practical purposes by building on it.

Keywords: Flask, Java, JavaScript, health monitoring, long term care, Mongo, Python, smart home, software engineering, webserver.

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76 Evaluation of the Effect of Nursing Services Provided in a Correctional Institution on the Physical Health Levels and Health Behaviors of Female Inmates

Authors: Şenay Pehli̇van, Gülümser Kublay

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Female inmates placed in a Correctional Institution (CI) have more physical health problems than other women and their male counterparts. Thus, they require more health care services in the CI and nursing services in particular. CI nurses also have the opportunity to teach behaviors which will protect and improve their health to these women who are difficult to reach in the community. The aim of this study was to evaluate effect of nursing services provided in a CI on the physical health levels and health behaviors of female inmates. The study has a quasi-experimental design. The study was done in Female Closed CI in Ankara, Turkey. The study was conducted on 30 female inmates. Before the implementation of nursing interventions in the initial phase of the study, female inmates were evaluated in terms of physical health problems and health behavior using forms, a physical examination, medical history, health files (file containing medical information related to prisons) and the Omaha System (OS). Findings obtained from evaluations were grouped and symptoms-findings were expressed with OS diagnosis codes. Knowledge, behavior and status scores of prisoners in relation to health problems were determined. After the implementation of the nursing interventions, female inmates were evaluated in terms of physical health problems and health behavior using OS. The research data were collected using the Female Evaluation Form developed by the researcher and the OS. It was found that knowledge, behavior and status scores of prisoners significantly increased after the implementation of nursing interventions (p < 0.05).

Keywords: Correctional institution, correctional nursing, prison nursing, female inmates, physical health problems, health behaviors.

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