Search results for: Patient Safety

Authors: Gorazd Karer

Abstract:

When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents is one of the main tasks of the anesthesiologist. That being said, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. This paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a User-Datagram-Protocol-based (UDP-based) communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of medical-device manufacturer and is implemented in MATLAB-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: Closed-loop control, Depth of Anesthesia, DoA, optical signal acquisition, Patient State index, PSi, UDP communication protocol.

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Authors: A. Gutiérrez, A. Castillo, J. M. Gómez, J. M. Gutiérrez, A. García-Cabot

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Road signs are the elements of roads with a lot of influence in driver-s behavior. So that signals can fulfill its function, they must overcome visibility and durability requirements, particularly needed at night, when the coefficient of retroreflection becomes a decisive factor in ensuring road safety. Accepting that the visibility of the signage has implications for people-s safety, we understand the importance to fulfill its function: to foster the highest standards of service and safety in drivers. The usual conditions of perception of any sign are determined by: age of the driver, reflective material, luminosity, vehicle speed and emplacement. In this way, this paper evaluates the different signals to increase the safety road.

Keywords: Luminosity, orientation, retroreflection, traffic signs.

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Authors: J. Bartnicka

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Surgical team consists of variety types of medical specialists possessing different kind of knowledge, motivations, personalities or abilities. This together with poor knowledge transfer, lack of information and communication technologies (ICT) implementations in hospitals can cause protraction of patient care processes and even jeopardize patient safety. There is presented in the article the outcomes of studies on communication and workflow in surgical team in the background of different collaboration levels in healthcare system. As a result the five determinants of improving workflow and communication within surgical team were indicated as well as knowledge-based tools and supporting information technology were proposed.

Keywords: Knowledge transfer, absorption abilities, knowledge representation, information and communication technologies, cooperation.

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Authors: Kevin Wongleedee

Abstract:

Culinary culture differences can cause health problems for international tourists in Thailand. This paper drew upon data collected from an international tourist survey conducted in Bangkok, Thailand during summer of 2012. Summer is the period that a variety food safety issues and incidents are often publicized in Thailand. The survey targeted European Union tourists- concerns toward a variety of food safety issues that they encountered during their trip in Thailand. A total of 400 respondents were elicited as data input for t-test, and one way ANOVA test. The findings revealed an astonishing result that up to 46.5 percent of respondents were sick at least one time or more in Thailand. However, the majority of respondents trusted that the Thai hotel and Thai restaurants would ensure food safety, but they did not trust street vendors to ensure food safety. The level of food safety concern can be ranked from most concern to least concern by using the value of mean scores as follows: 1) artificial coloring, 2) use of preservatives, 3) antibiotics, 4) growth hormones, 5) chemical residues, and 6) bacterial contamination. The overall mean score for level of concerns was 3.493 with standard deviation of 1.677 which did not indicate a very high level of concern. In addition, the result for t-test and one way ANOVA test revealed that there was not much effect from the demographic differences to level of food safety concerns.

Keywords: Concerns, European Union Tourists, Food Safety Management.

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Authors: Petr Vcelak, Jana Kleckova

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Our Medicine-oriented research is based on a medical data set of real patients. It is a security problem to share patient private data with peoples other than clinician or hospital staff. We have to remove person identification information from medical data. The medical data without private data are available after a de-identification process for any research purposes. In this paper, we introduce an universal automatic rule-based de-identification application to do all this stuff on an heterogeneous medical data. A patient private identification is replaced by an unique identification number, even in burnedin annotation in pixel data. The identical identification is used for all patient medical data, so it keeps relationships in a data. Hospital can take an advantage of a research feedback based on results.

Keywords: DASTA, De-identification, DICOM, Health Level Seven, Medical data, OCR, Personal data

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Authors: A. Hellany, M.Nagrial, M. Nassereddine, J. Rizk

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As new challenges emerge in power electrical workplace safety, it is the responsibility of the systems designer to seek out new approaches and solutions that address them. Design decisions made today will impact cost, safety and serviceability of the installed systems for 40 or 50 years during the useful life for the owner. Studies have shown that this cost is an order of magnitude of 7 to 10 times the installed cost of the power distribution equipment. This paper reviews some aspects of earthing system design in power substation surrounded by residential houses. The electrical potential rise and split factors are discussed and a few recommendations are provided to achieve a safety voltage in the area beyond the boundary of the substation.

Keywords: EPR, Split Factor, Earthing Design

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Authors: Carine Cridelich, Pablo Juesas Cano, Emmanuel Ramasso, Noureddine Zerhouni, Bernd Weiler

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Safety is one of the most important considerations when buying a new car. While active safety aims at avoiding accidents, passive safety systems such as airbags and seat belts protect the occupant in case of an accident. In addition to legal regulations, organizations like Euro NCAP provide consumers with an independent assessment of the safety performance of cars and drive the development of safety systems in automobile industry. Those ratings are mainly based on injury assessment reference values derived from physical parameters measured in dummies during a car crash test. The components and sub-systems of a safety system are designed to achieve the required restraint performance. Sled tests and other types of tests are then carried out by car makers and their suppliers to confirm the protection level of the safety system. A Knowledge Discovery in Databases (KDD) process is proposed in order to minimize the number of tests. The KDD process is based on the data emerging from sled tests according to Euro NCAP specifications. About 30 parameters of the passive safety systems from different data sources (crash data, dummy protocol) are first analysed together with experts opinions. A procedure is proposed to manage missing data and validated on real data sets. Finally, a procedure is developed to estimate a set of rough initial parameters of the passive system before testing aiming at reducing the number of tests.

Keywords: KDD process, passive safety systems, sled test, dummy injury assessment reference values, frontal impact

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Authors: Omid Adibi, Nategheh Najafpour, Bijan Farhanieh, Hossein Afshin

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Energy transmission pipelines are one of the most vital parts of each country which several strict laws have been conducted to enhance the safety of these lines and their vicinity. One of these laws is the safety distance around high pressure gas pipelines. Safety distance refers to the minimum distance from the pipeline where people and equipment do not confront with serious damages. In the present study, safety distance around high pressure gas transmission pipelines were determined by using numerical methods. For this purpose, gas leakages from cracked pipeline and created jet fires were simulated as continuous ignition, three dimensional, unsteady and turbulent cases. Numerical simulations were based on finite volume method and turbulence of flow was considered using k-ω SST model. Also, the combustion of natural gas and air mixture was applied using the eddy dissipation method. The results show that, due to the high pressure difference between pipeline and environment, flow chocks in the cracked area and velocity of the exhausted gas reaches to sound speed. Also, analysis of the incident radiation results shows that safety distances around 42 inches high pressure natural gas pipeline based on 5 and 15 kW/m² criteria are 205 and 272 meters, respectively.

Keywords: Gas pipelines, incident radiation, numerical simulation, safety distance.

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Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

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Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: Resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan.

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Authors: J. Bouchard, B. Prosperi, G. Bavre, M. Daudé, E. Jeandupeux

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Young patients suffering from Cerebral Palsy are facing difficult choices concerning heavy surgeries. Diagnosis settled by surgeons can be complex and on the other hand decision for patient about getting or not such a surgery involves important reflection effort. Proposed software combining prediction for surgeries and post surgery kinematic values, and from 3D model representing the patient is an innovative tool helpful for both patients and medicine professionals. Beginning with analysis and classification of kinematics values from Data Base extracted from gait analysis in 3 separated clusters, it is possible to determine close similarity between patients. Prediction surgery best adapted to improve a patient gait is then determined by operating a suitable preconditioned neural network. Finally, patient 3D modeling based on kinematic values analysis, is animated thanks to post surgery kinematic vectors characterizing the closest patient selected from patients clustering.

Keywords: Cerebral Palsy, Clustering, Crouch Gait, 3-D Modeling.

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Authors: Zeeshan Hamid, Asher Ramish

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The purpose of this paper is to focus on security and safety issues facing by pharmaceutical industry globally when counterfeit drugs are in question. Hence, there is an intense need to secure and authenticate pharmaceutical products in the emerging counterfeit product market. This paper will elaborate the application of radio frequency identification (RFID) in pharmaceutical industry and to identify its key benefits for patient’s care. The benefits are: help to co-ordinate the stream of supplies, accuracy in chains of supplies, maintaining trustworthy information, to manage the operations in appropriate and timely manners and finally deliver the genuine drug to patient. It is discussed that how RFID supported supply chain information sharing (SCIS) helps to combat against counterfeit drugs. And a solution how to tag pharmaceutical products; since, some products prevent RFID implementation in this industry. In this paper, a proposed model for pharma industry distribution suggested to combat against the counterfeit drugs when they are in supply chain.

Keywords: Supply chain, RFID, pharmaceutical industry, counterfeit drugs, patients care.

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Authors: Anders Thorsèn, Behrooz Sangchoolie, Peter Folkesson, Ted Strandberg

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As more parts of the power grid become connected to the internet, the risk of cyberattacks increases. To identify the cybersecurity threats and subsequently reduce vulnerabilities, the common practice is to carry out a cybersecurity risk assessment. For safety classified systems and products, there is also a need for safety risk assessments in addition to the cybersecurity risk assessment to identify and reduce safety risks. These two risk assessments are usually done separately, but since cybersecurity and functional safety are often related, a more comprehensive method covering both aspects is needed. Some work addressing this has been done for specific domains like the automotive domain, but more general methods suitable for, e.g., Intelligent Distributed Grids, are still missing. One such method from the automotive domain is the Security-Aware Hazard Analysis and Risk Assessment (SAHARA) method that combines safety and cybersecurity risk assessments. This paper presents an approach where the SAHARA method has been modified to be more suitable for larger distributed systems. The adapted SAHARA method has a more general risk assessment approach than the original SAHARA. The proposed method has been successfully applied on two use cases of an intelligent distributed grid.

Keywords: Intelligent distribution grids, threat analysis, risk assessment, safety, cybersecurity.

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Authors: Bu Seog Ju, Jae Sang Kim, Woo Young Jung

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In recent year, with recent increase of interest towards leisure sports, increased number of Zip-Line or Zip-Wire facilities has built. Many researches have been actively conducted on the emphasis of the cable and the wire at the bridge. However, very limited researches have been conducted on the safety of the Zip-Line structure. In fact, fall accidents from Zip-Line have been reported frequently. Therefore, in this study, the structural safety of Zip-Line under dynamic impact loading condition were evaluated on the previously installed steel cable for leisure (Zip-Line), using 3-dimensional nonlinear Finite Element (FE) model. The result from current study would assist assurance of systematic stability of Zip-Line.

Keywords: Zip-Line, Wire, Cable, 3D FE Model, Safety.

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Authors: Kyung-Jung Lee, Hyun-Sik Ahn

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This paper suggests a design methodology for the hardware and software of the electronic control unit (ECU) of safety-critical vehicle applications such as braking and steering. The architecture of the hardware is a high integrity system such thatit incorporates a high performance 32-bit CPU and a separate peripheral controlprocessor (PCP) together with an external watchdog CPU. Communication between the main CPU and the PCP is executed via a common area of RAM and events on either processor which are invoked by interrupts. Safety-related software is also implemented to provide a reliable, self-testing computing environment for safety critical and high integrity applications. The validity of the design approach is shown by using the hardware-in-the-loop simulation (HILS)for electric power steering(EPS) systemswhich consists of the EPS mechanism, the designed ECU, and monitoring tools.

Keywords: Electronic control unit, electric power steering, functional safety, hardware-in-the-loop simulation.

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Authors: Maznah Abdullah, Mohammed Quaddus

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Bio-demographic diversity which refers to age and gender of members in a team, has been frequently identified to influence team innovation directly. As the theories expanded, biodemographic diversity was suggested to influence team innovation via psychosocial trait and interaction process. This study examines those suggestions, in which psychosocial trait and interaction process were operationalized as 'participation safety climate' and 'team reflexivity' respectively. The role of team reflexivity as a mediator to participation safety climate and team innovation was also assessed. Due to a small number of teams involved in the study, data were analyzed by using a PLS-graph. While the results show only gender is significantly related to the participation safety climate, which in turn influences team reflexivity and team innovation, there is no statistical evidence that team reflexivity mediates the impact of participation safety climate on team innovation.

Keywords: Bio-demographic diversity, participation safetyclimate, team innovation, team reflexivity

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Authors: Erol Karaca

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

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

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Authors: Nadir A. Carreón, Christa Sonderer, Aakarsh Rao, Roman Lysecky

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With the advent of complex software and increased connectivity, security of life-critical medical devices is becoming an increasing concern, particularly with their direct impact to human safety. Security is essential, but it is impossible to develop completely secure and impenetrable systems at design time. Therefore, it is important to assess the potential impact on security and safety of exploiting a vulnerability in such critical medical systems. The common vulnerability scoring system (CVSS) calculates the severity of exploitable vulnerabilities. However, for medical devices, it does not consider the unique challenges of impacts to human health and privacy. Thus, the scoring of a medical device on which a human life depends (e.g., pacemakers, insulin pumps) can score very low, while a system on which a human life does not depend (e.g., hospital archiving systems) might score very high. In this paper, we present a Medical Vulnerability Scoring System (MVSS) that extends CVSS to address the health and privacy concerns of medical devices. We propose incorporating two new parameters, namely health impact and sensitivity impact. Sensitivity refers to the type of information that can be stolen from the device, and health represents the impact to the safety of the patient if the vulnerability is exploited (e.g., potential harm, life threatening). We evaluate 15 different known vulnerabilities in medical devices and compare MVSS against two state-of-the-art medical device-oriented vulnerability scoring system and the foundational CVSS.

Keywords: Common vulnerability system, medical devices, medical device security, vulnerabilities.

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Authors: Abeer K. Jameel, Harry Evdorides

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Iraq is a middle income country where the road safety issue is considered one of the leading causes of deaths. To control the road risk issue, the Iraqi Ministry of Planning, General Statistical Organization started to organise a collection system of traffic accidents data with details related to their causes and severity. These data are published as an annual report. In this paper, a review of the available crash data in Iraq will be presented. The available data represent the rate of accidents in aggregated level and classified according to their types, road users’ details, and crash severity, type of vehicles, causes and number of causalities. The review is according to the types of models used in road safety studies and research, and according to the required road safety data in the road constructions tasks. The available data are also compared with the road safety dataset published in the United Kingdom as an example of developed country. It is concluded that the data in Iraq are suitable for descriptive and exploratory models, aggregated level comparison analysis, and evaluation and monitoring the progress of the overall traffic safety performance. However, important traffic safety studies require disaggregated level of data and details related to the factors of the likelihood of traffic crashes. Some studies require spatial geographic details such as the location of the accidents which is essential in ranking the roads according to their level of safety, and name the most dangerous roads in Iraq which requires tactic plan to control this issue. Global Road safety agencies interested in solve this problem in low and middle-income countries have designed road safety assessment methodologies which are basing on the road attributes data only. Therefore, in this research it is recommended to use one of these methodologies.

Keywords: Data availability, Iraq, road safety.

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Authors: T. Gotoh, T. Takayama, M. Ishiki, T. Ikeda

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Recently, majors of doctors are divided into terribly lots of detailed areas. However, it is actually not a rare case that a doctor has a patient who is not in his/her major. He/She must judge an assessment and make a medical treatment plan for this patient. According to our investigation, conventional approaches such as image diagnosis cooperation are insufficient. This paper proposes an 'Assessment / Medical Treatment Plan Consulting System'. We have implemented a pilot system based on our proposition. Its effectiveness is clarified by an evaluation.

Keywords: Application, computational intelligence and telecommunications, medicine, intelligent systems.

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Authors: Muhammad Tufail, Jawad Hussain, Hammad Hussain, Imran Hafeez, Naveed Ahmad

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Road safety performance index is a composite index which combines various indicators of road safety into single number. Development of a road safety performance index using appropriate safety performance indicators is essential to enhance road safety. However, a road safety performance index in developing countries has not been given as much priority as needed. The primary objective of this research is to develop a general Road Safety Performance Index (RSPI) for developing countries based on the facility as well as behavior of road user. The secondary objectives include finding the critical inputs in the RSPI and finding the better method of making the index. In this study, the RSPI is developed by selecting four main safety performance indicators i.e., protective system (seat belt, helmet etc.), road (road width, signalized intersections, number of lanes, speed limit), number of pedestrians, and number of vehicles. Data on these four safety performance indicators were collected using observation survey on a 20 km road section of the National Highway N-125 road Taxila, Pakistan. For the development of this composite index, two methods are used: a) Principal Component Analysis (PCA) and b) Equal Weighting (EW) method. PCA is used for extraction, weighting, and linear aggregation of indicators to obtain a single value. An individual index score was calculated for each road section by multiplication of weights and standardized values of each safety performance indicator. However, Simple Average technique was used for weighting and linear aggregation of indicators to develop a RSPI. The road sections are ranked according to RSPI scores using both methods. The two weighting methods are compared, and the PCA method is found to be much more reliable than the Simple Average Technique.

Keywords: Aggregation, index score, indicators, principal component analysis, weighting.

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Authors: War War Myint

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Geometric design is an important part of planning process design for physical highway to fill up basic function of roads, to give good traffic service. It is found that most of the road safety problems occur at the horizontal curves and complex-compound curves. In this paper, review on Sagarinn-Myinsain Portion of Nay Pyi Taw - Mandalay highway has been conducted in aspect of geometric design induced road safety condition. Horizontal alignment of geometric features and curve details are reviewed based on (AASHTO) standard and revised by Autodesk Land Desktop Software. Moreover, 85th Percentile Operation Speeds (V85) with driver confidence on horizontal curves is evaluated in order to obtain the range of highway safety factor (FS). The length of the selected highway portion is 13.65 miles and 8 lanes. The results of this study can be used to investigate the possible hazardous locations in advance and to revise how design radius and super elevation should be for better road safety performance for the selected portion. Moreover, the relationship between highway safety and highway geometry characteristics can also be known.

Keywords: Geometric design; horizontal alignment; superelevation; 85th percentile operation speed (V85), safety factor (FS).

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Authors: A. Alrasheed, I. Connerton

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Daily provision of high quality food and hygiene to patients is a challenging goal of the healthcare. In Saudi Arabia, matters related to food safety and hygiene are regulated by the Ministry of Health (MOH) and the Saudi Food and Drugs Authority (SFDA). The purpose of this research is to discuss the food safety management inconsistencies and flaws, in particular the ones related to Hazard Analysis and Critical Control Points (HACCP) in Riyadh’s MOH hospitals. As required by law, written HACCP regulations must be implemented, and food handlers need to receive the training accordingly. However, in Saudi hospitals, this is not a requirement, and the food handlers do not need to hold training certificates in food safety or HACCP. Nowadays, the matter of food safety and hygiene have become increasingly important since the decision makers want to align these regulations with the majority of the world and to implement HACCP fully and for this purpose, the SFDA was established. 

Keywords: Food safety, patients, hospitals, HACCP, Saudi Arabia.

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Authors: Ching Louis Liu, Edmund Kazmierczak, Tim Miller

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Safety analysis for multi-agent systems is complicated by the, potentially nonlinear, interactions between agents. This paper proposes a method for analyzing the safety of multi-agent systems by explicitly focusing on interactions and the accident data of systems that are similar in structure and function to the system being analyzed. The method creates a Bayesian network using the accident data from similar systems. A feature of our method is that the events in accident data are labeled with HAZOP guide words. Our method uses an Ontology to abstract away from the details of a multi-agent implementation. Using the ontology, our methods then constructs an “Interaction Map,” a graphical representation of the patterns of interactions between agents and other artifacts. Interaction maps combined with statistical data from accidents and the HAZOP classifications of events can be converted into a Bayesian Network. Bayesian networks allow designers to explore “what it” scenarios and make design trade-offs that maintain safety. We show how to use the Bayesian networks, and the interaction maps to improve multi-agent system designs.

Keywords: Multi-agent system, safety analysis, safety model.

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Authors: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: Patient education, post-operative pain, patient satisfaction, post-operative outcome.

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Authors: Jiewei Li, Hongyan Cui, Chunqi Chang, Yong Hu

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It was expected to benefit patient with hemiparesis after stroke by extensive arm rehabilitation, to partially regain forearm and hand function. This paper propose a robotic rehabilitation arm in assisting the hemiparetic patient to learn new ways of using and moving their weak arms. In this study, the robotic arm was driven by a somatosensory stimulated brain computer interface (BCI), which is a new modality BCI. The use of somatosensory stimulation is not only an input for BCI, but also a electrical stimulation for treatment of hemiparesis to strengthen the arm and improve its range of motion. A trial of this robotic rehabilitation arm was performed in a stroke patient with pure motor hemiparesis. The initial trial showed a promising result from the patient with great motivation and function improvement. It suggests that robotic rehabilitation arm driven by somatosensory BCI can enhance the rehabilitation performance and progress for hemiparetic patients after stroke.

Keywords: Robotic rehabilitation arm, brain computer interface (BCI), hemiparesis, stroke, somatosensory stimulation.

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Authors: Juan L. Castro, Maria I. NavarroVictor Lopez, Eduardo M. Eisman, Jose M. Zurita

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This paper describes the Multilingual Virtual Simulated Patient framework. It has been created to train the social skills and testing the knowledge of primary health care medical students. The framework generates conversational agents which perform in serveral languages as virtual simulated patients that help to improve the communication and diagnosis skills of the students complementing their training process.

Keywords: Medical training, conversational agents, patient modeling.

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Authors: Khelood A. Mkalaf, Peter Gibson, John Flanagan

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This study investigates the relationship between the reliability of critical medical equipment (CME) and the effectiveness of CME maintenance management strategies in relation to patient outcomes in 84 public hospitals of a top 20 OECD country. The work has examined the effectiveness of CME maintenance management strategies used by the public hospital system of a large state run health organization. The conceptual framework was designed to examine the significance of the relationship between six variables: (1) types of maintenance management strategies, (2) maintenance services, (3) maintenance practice, (4) medical equipment reliability, (5) maintenance costs and (6) patient outcomes. The results provide interesting insights into the effectiveness of the maintenance strategies used. For example, there appears to be about a 1 in 10 000 probability of failure of anesthesia equipment, but these seem to be confined to specific maintenance situations. There are also some findings in relation to outsourcing of maintenance. For each of the variables listed, results are reported in relation to the various types of maintenance strategies and services. Decision-makers may use these results to evaluate more effective maintenance strategies for their CME and generate more effective patient outcomes.

Keywords: Critical medical equipment, maintenance strategy, patient outcomes, reliability.

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Authors: Siripen Yiamjanya, Kevin Wongleedee

Abstract:

Food safety is an important concern for holiday makers in foreign and unfamiliar tourist destinations. In fact, risk from food in these tourist destinations has an influence on tourist perception. This risk can potentially affect physical health and lead to an inability to pursue planned activities. The objective of this paper was to compare foreign tourists- demographics including gender, age and education level, with the level of perceived risk towards food safety. A total of 222 foreign tourists during their stay at Khao San Road in Bangkok were used as the sample. Independent- samples ttest, analysis of variance, and Least Significant Difference or LSD post hoc test were utilized. The findings revealed that there were few demographic differences in level of perceived risk among the foreign tourists. The post hoc test indicated a significant difference among the old and the young tourists, and between the higher and lower level of education. Ranks of tourists- perceived risk towards food safety unveiled some interesting results. Tourists- perceived risk of food safety in established restaurants can be ranked as i) cleanliness of dining utensils, ii) sanitation of food preparation area, and iii) cleanliness of food seasoning and ingredients. Whereas, the tourists- perceived risk of food safety in street food and drink can be ranked as i) cleanliness of stalls and pushcarts, ii) cleanliness of food sold, and iii) personal hygiene of street food hawkers or vendors.

Keywords: Food Safety, Foreign Tourists, Perceived Risk, Khao San Road.

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Authors: Fares Innal, Yves Dutuit, Mourad Chebila

Abstract:

The object of this work is the probabilistic performance evaluation of safety instrumented systems (SIS), i.e. the average probability of dangerous failure on demand (PFD_avg) and the average frequency of failure (PFH), taking into account the uncertainties related to the different parameters that come into play: failure rate (λ), common cause failure proportion (β), diagnostic coverage (DC)... This leads to an accurate and safe assessment of the safety integrity level (SIL) inherent to the safety function performed by such systems. This aim is in keeping with the requirement of the IEC 61508 standard with respect to handling uncertainty. To do this, we propose an approach that combines (1) Monte Carlo simulation and (2) fuzzy sets. Indeed, the first method is appropriate where representative statistical data are available (using pdf of the relating parameters), while the latter applies in the case characterized by vague and subjective information (using membership function). The proposed approach is fully supported with a suitable computer code.

Keywords: Fuzzy sets, Monte Carlo simulation, Safety instrumented system, Safety integrity level.

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Authors: Boo-Sung Koh, Seung-Eock Kim

Abstract:

In this paper, a direct design using a nonlinear inelastic analysis is suggested. Also, this paper compares the load carrying capacity obtained by a nonlinear inelastic analysis with experiment results to verify the accuracy of the results. The allowable stress design results of a railroad through a plate girder bridge and the safety factor of the nonlinear inelastic analysis were compared to examine the safety performance. As a result, the load safety factor for the nonlinear inelastic analysis was twice as high as the required safety factor under the allowable stress design standard specified in the civil engineering structure design standards for urban magnetic levitation railways, which further verified the advantages of the proposed direct design method.

Keywords: Direct design, nonlinear inelastic analysis, residual stress, initial geometric imperfection.

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