Search results for: care pathways

Authors: Reza Ariaeinejad, Norm Archer

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Self-management is becoming a new emphasis for healthcare systems around the world. But there are many different problems with adoption of new health-related intervention systems. The situation is even more complicated for chronically ill patients with disabilities, illiteracy, and impairment in judgment in addition to their conditions, or having multiple co-morbidities. Providing online decision support to manage patient health and to provide better support for chronically ill patients is a new way of dealing with chronic disease management. In this study, the importance of mobile technology through an m-Health system that supports self-management interventions including the care provider, family and social support, education and training, decision support, recreation, and ongoing patient motivation to promote adherence and sustainability of the intervention are discussed. A proposed theoretical model for adoption and sustainability of system use is developed, based on UTAUT2 and IS Continuance of Use models, both of which have been pre-validated through longitudinal studies. The objective of this paper is to show the importance of using mobile technology in adoption and sustainability of use of an m-Health system which will result in commercially sustainable self-management support for chronically ill patients.

Keywords: M-health, e-health, self-management, disease.

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Authors: Joserra Díez, Ainhoa Meñika, Iñaki Sanz-Azkue, Arritokieta Ortuzar

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Biodiversity provides humans with a great range of ecosystemic services; it is therefore an indispensable resource and a legacy to coming generations. However, in the last decades, the increasing exploitation of the Planet has caused a great loss of biodiversity and its acquaintance has decreased remarkably; especially in urbanized areas, due to the decreasing attachment of humans to nature. Yet, the Primary Education curriculum primes the identification of flora and fauna to guarantee the knowledge of children on their surroundings, so that they care for the environment as well as for themselves. In order to produce effective didactic material that meets the needs of both teachers and pupils, it is fundamental to diagnose the current situation. In the present work, the knowledge on biodiversity of 3^rd cycle Primary Education students in Biscay (n=98) and its relation to the size of the town/city of their school is discussed. Two tests have been used with such aim: one for tree identification and the other one so that the students enumerated the species of trees and animals they knew. Results reveal that knowledge of students on tree identification is scarce regardless the size of the city/town and of their school. On the other hand, animal species are better known than tree species.

Keywords: Biodiversity, population, tree identification, animal identification.

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Authors: Chang, Chun-Lang, Liu, Chun-Kai

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This study, for its research subjects, uses patients who had undergone total knee replacement surgery from the database of the National Health Insurance Administration. Through the review of literatures and the interviews with physicians, important factors are selected after careful screening. Then using Cross Entropy Method, Genetic Algorithm Logistic Regression, and Particle Swarm Optimization, the weight of each factor is calculated and obtained. In the meantime, Excel VBA and Case Based Reasoning are combined and adopted to evaluate the system. Results show no significant difference found through Genetic Algorithm Logistic Regression and Particle Swarm Optimization with over 97% accuracy in both methods. Both ROC areas are above 0.87. This study can provide critical reference to medical personnel as clinical assessment to effectively enhance medical care quality and efficiency, prevent unnecessary waste, and provide practical advantages to resource allocation to medical institutes.

Keywords: Total knee replacement, Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization.

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Authors: J. Kolář, V. Dvořák

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In this work, we try to find the best setting of Computational Fluid Dynamic solver available for the problems in the field of supersonic internal flows. We used the supersonic air-toair ejector to represent the typical problem in focus. There are multiple oblique shock waves, shear layers, boundary layers and normal shock interacting in the supersonic ejector making this device typical in field of supersonic inner flows. Modeling of shocks in general is demanding on the physical model of fluid, because ordinary conservation equation does not conform to real conditions in the near-shock region as found in many works. From these reasons, we decided to take special care about solver setting in this article by means of experimental approach of color Schlieren pictures and pneumatic measurement. Fast pressure transducers were used to measure unsteady static pressure in regimes with normal shock in mixing chamber. Physical behavior of ejector in several regimes is discussed. Best choice of eddy-viscosity setting is discussed on the theoretical base. The final verification of the k-ω SST is done on the base of comparison between experiment and numerical results.

Keywords: CFD simulations, color Schlieren, k-ω SST, supersonic flows, shock waves.

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Authors: Okolie Uchenna, Ehiemere Ijeoma, Ezenduka Pauline, Ogbu Sylvester

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A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Keywords: Behavior change, diabetes mellitus, dietarymanagement, diet adherence.

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Authors: Surajit Debnath, Soma Addya

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Human genome is not only the evolutionary summation of all advantageous events, but also houses lesions of deleterious foot prints. A single gene mutation sometimes may express multiple consequences in numerous tissues and a linear relationship of the genotype and the phenotype may often be obscure. ß Thalassemia minor, a transfusion independent mild anaemia, coupled with environment among other factors may articulate into phenotypic pleotropy with Hypocholesterolemia, Vitamin D deficiency, Tissue hypoxia, Hyper-parathyroidism and Psychological alterations. Occurrence of Pancreatic insufficiency, resultant steatorrhoea, Vitamin-D (25-OH) deficiency (13.86 ngm/ml) with Hypocholesterolemia (85mg/dl) in a 30 years old male ß Thal-minor patient (Hemoglobin 11mg/dl with Fetal Hemoglobin 2.10%, Hb A2 4.60% and Hb Adult 84.80% and altered Hemogram) with increased Para thyroid hormone (62 pg/ml) & moderate Serum Ca+2 (9.5mg/ml) indicate towards a cascade of phenotypic pleotropy where the ß Thalassemia mutation ,be it in the 5’ cap site of the mRNA , differential splicing etc in heterozygous state is effecting several metabolic pathways. Compensatory extramedulary hematopoiesis may not coped up well with the stressful life style of the young individual and increased erythropoietic stress with high demand for cholesterol for RBC membrane synthesis may have resulted in Hypocholesterolemia.Oxidative stress and tissue hypoxia may have caused the pancreatic insufficiency, leading to Vitamin D deficiency. This may in turn have caused the secondary hyperparathyroidism to sustain serum Calcium level. Irritability and stress intolerance of the patient was a cumulative effect of the vicious cycle of metabolic compromises. From these findings we propose that the metabolic deficiencies in the ß Thalassemia mutations may be considered as the phenotypic display of the pleotropy to explain the genetic epidemiology. According to the recommendations from the NIH Workshop on Gene-Environment Interplay in Common Complex Diseases: Forging an Integrative Model, study design of observations should be informed by gene-environment hypotheses and results of a study (genetic diseases) should be published to inform future hypotheses. Variety of approaches is needed to capture data on all possible aspects, each of which is likely to contribute to the etiology of disease. Speakers also agreed that there is a need for development of new statistical methods and measurement tools to appraise information that may be missed out by conventional method where large sample size is needed to segregate considerable effect. A meta analytic cohort study in future may bring about significant insight on to the title comment.

Keywords: Genetic disease, Genetic epidemiology, Heterozygous, Phenotype, Pleotropy, ß Thalassemia minor, Metabolic compromises.

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Authors: Abdul Baqi, Zaid Mohammad

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Reinforced concrete stair slabs with mid landings i.e. Dog-legged shaped are conventionally designed as per specifications of standard codes of practices which guide about the effective span according to the varying support conditions. Presently, the behavior of such slabs has been investigated using Finite Element method. A single flight stair slab with landings on both sides and supported at ends on wall, and a multi flight stair slab with landings and six different support arrangements have been analyzed. The results obtained for stresses, strains and deflections are used to describe the behavior of such stair slabs, including locations of critical moments and deflections. Values of critical moments obtained by F.E. analysis have also have been compared with that obtained from conventional analysis. Analytical results show that the moments are also critical near the kinks i.e. junction of mid-landing and inclined waist slab. This change in the behavior of dog-legged stair slab may be due to continuity of the material in transverse direction in two landings adjoining the waist slab, hence additional stiffness achieved. This change in the behavior is generally not taken care of in conventional method of design.

Keywords: Dog-legged, Stair slab, F.E. Analysis, Landing, Reinforced concrete.

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Authors: Z. Karakus, Z. Ozer

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Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: E-Learning, Medication Administration, Nursing, Nursing Students.

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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Authors: Y. Lacroix, J.-F. Malbranque

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We present a chronological evolution for naval telecommunication networks. We distinguish periods: with or without multiplexers, with switch systems, with federative systems, with medium switching, and with medium switching with wireless networks. This highlights the introduction of new layers and technology in the architecture. These architectures are presented using layer models of transmission, in a unified way, which enables us to integrate pre-existing models. A ship of a naval fleet has internal communications (i.e. applications' networks of the edge) and external communications (i.e. the use of the means of transmission between edges). We propose architectures, deduced from the layer model, which are the point of convergence between the networks on board and the HF, UHF radio, and satellite resources. This modelling allows to consider end-to-end naval communications, and in a more global way, that is from the user on board towards the user on shore, including transmission and networks on the shore side. The new architectures need take care of quality of services for end-to-end communications, the more remote control develops a lot and will do so in the future. Naval telecommunications will be more and more complex and will use more and more advanced technologies, it will thus be necessary to establish clear global communication schemes to grant consistency of the architectures. Our latest model has been implemented in a military naval situation, and serves as the basic architecture for the RIFAN2 network.

Keywords: Equilibrium beach profile, eastern tombolo of Giens, potential function, erosion.

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Authors: Osamah M. Al-Qershi, Khoo Bee Ee

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In recent years image watermarking has become an important research area in data security, confidentiality and image integrity. Many watermarking techniques were proposed for medical images. However, medical images, unlike most of images, require extreme care when embedding additional data within them because the additional information must not affect the image quality and readability. Also the medical records, electronic or not, are linked to the medical secrecy, for that reason, the records must be confidential. To fulfill those requirements, this paper presents a lossless watermarking scheme for DICOM images. The proposed a fragile scheme combines two reversible techniques based on difference expansion for patient's data hiding and protecting the region of interest (ROI) with tamper detection and recovery capability. Patient's data are embedded into ROI, while recovery data are embedded into region of non-interest (RONI). The experimental results show that the original image can be exactly extracted from the watermarked one in case of no tampering. In case of tampered ROI, tampered area can be localized and recovered with a high quality version of the original area.

Keywords: DICOM, reversible, ROI-based, watermarking.

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Authors: K. Shiba, T. Kobayashi, T. Kaburagi, Y. Kurihara

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Elderly population in the world is increasing, and consequently, their nursing burden is also increasing. In such situations, monitoring and evaluating their daily action facilitates efficient nursing care. Especially, we focus on an unconscious activity during sleep, i.e. turnover. Monitoring turnover during sleep is essential to evaluate various conditions related to sleep. Bedsores are considered as one of the monitoring conditions. Changing patient’s posture every two hours is required for caregivers to prevent bedsore. Herein, we attempt to develop an unconstrained nocturnal monitoring system using a sensing device based on piezoelectric ceramics that can detect the vibrations owing to human body movement on the bed. In the proposed method, in order to construct a multi-points sensing, we placed two sensing devices under the right and left legs at the head-side of an ordinary bed. Using this equipment, when a subject lies on the bed, feature is calculated from the output voltages of the sensing devices. In order to evaluate our proposed method, we conducted an experiment with six healthy male subjects. Consequently, the period during which turnover occurs can be correctly classified as the turnover period with 100% accuracy.

Keywords: Turnover, piezoelectric ceramics, multi-points sensing, unconstrained monitoring system.

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Authors: Alexander V. Libin, Manon Schladen, Assya Pascalev, Nawar Shara, Miriam Philmon, Yuri Millo, Joseph Verbalis

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Chronic conditions carry with them strong emotions and often lead to charged relationships between patients and their health providers and, by extension, patients and health researchers. Persons are both autonomous and relational and a purely cognitive model of autonomy neglects the social and relational basis of chronic illness. Ensuring genuine informed consent in research requires a thorough understanding of how participants perceive a study and their reasons for participation. Surveys may not capture the complexities of reasoning that underlies study participation. Contradictory reasons for participation, for instance an initial claim of altruism as rationale and a subsequent claim of personal benefit (therapeutic misconception), affect the quality of informed consent. Individuals apply principles through the filter of personal values and lived experience. Authentic autonomy, and hence authentic consent to research, occurs within the context of patients- unique life narratives and illness experiences.

Keywords: ethical dilemmas, open source technology, patient education, psychology of decision making

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Authors: Anna Słupik, Anna Mosiołek, Sebastian Wójtowicz, Dariusz Białoszewski

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Introduction: Whole-Body Vibration (WBV) uses high frequency mechanical stimuli generated by a vibration plate and transmitted through bone, muscle and connective tissues to the whole body. Research has shown that long-term vibration-plate training improves neuromuscular facilitation, especially in afferent neural pathways, responsible for the conduction of vibration and proprioceptive stimuli, muscle function, balance and proprioception. Some researchers suggest that the vibration stimulus briefly inhibits the conduction of afferent signals from proprioceptors and can interfere with the maintenance of body balance. The aim of this study was to evaluate the influence of a single set of exercises associated with whole-body vibration on the joint position sense and body balance. Material and methods: The study enrolled 55 people aged 19-24 years. These individuals were randomly divided into a test group (30 persons) and a control group (25 persons). Both groups performed the same set of exercises on a vibration plate. The following vibration parameters: frequency of 20Hz and amplitude of 3mm, were used in the test group. The control group performed exercises on the vibration plate while it was off. All participants were instructed to perform six dynamic exercises lasting 30 seconds each with a 60-second period of rest between them. The exercises involved large muscle groups of the trunk, pelvis and lower limbs. Measurements were carried out before and immediately after exercise. Joint position sense (JPS) was measured in the knee joint for the starting position at 45° in an open kinematic chain. JPS error was measured using a digital inclinometer. Balance was assessed in a standing position with both feet on the ground with the eyes open and closed (each test lasting 30 sec). Balance was assessed using Matscan with FootMat 7.0 SAM software. The surface of the ellipse of confidence and front-back as well as right-left swing were measured to assess balance. Statistical analysis was performed using Statistica 10.0 PL software. Results: There were no significant differences between the groups, both before and after the exercise (p> 0.05). JPS did not change in both the test (10.7° vs. 8.4°) and control groups (9.0° vs. 8.4°). No significant differences were shown in any of the test parameters during balance tests with the eyes open or closed in both the test and control groups (p> 0.05). Conclusions: 1. Deterioration in proprioception or balance was not observed immediately after the vibration stimulus. This suggests that vibrationinduced blockage of proprioceptive stimuli conduction can have only a short-lasting effect that occurs only as long as a vibration stimulus is present. 2. Short-term use of vibration in treatment does not impair proprioception and seems to be safe for patients with proprioceptive impairment. 3. These results need to be supplemented with an assessment of proprioception during the application of vibration stimuli. Additionally, the impact of vibration parameters used in the exercises should be evaluated.

Keywords: Balance, joint position sense, proprioception, whole body vibration.

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

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

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

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Authors: M. Dahiru, O. I. Enabulele

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The research aims to investigate the occurrence of multidrug-resistant Acinetobacter, in carrot and estimate the role of carrot in its transmission in a rapidly growing urban population. Thus, 50 carrot samples were collected from Jakara wastewater irrigation farms and are analyzed on MacConkey agar and screened by Microbact 24E (Oxoid) and susceptibility of isolates is tested against 10 commonly used antibiotics. Acinetobacter baumannii and A. lwoffii were isolated in 22.00% and 16% of samples respectively. Resistance to ceporex and penicillin of 36.36% and 27.27% in A. baumannii, and sensitivity to ofloxacin, pefloxacin, gentimycin and co-trimoxazole were observed. However, for A. lwoffii apart from 37.50% resistance to ceporex, it was also resistant to all other drugs tested. There were similarities in the resistances shown by A. baumannii and A. lwoffii to fluoroquinolones and β- lactame drug families in addition to between sulfonamide and animoglycoside demonstrated by A. lwoffii. Significant correlation in similarities were observed at P < 0.05 to CPX to NA (46.2%), and SXT to AU (52.6%) A. baumannii and A. lwoffii respectively and high multi drug resistance (MDR) of 27.27% and 62.50% by A. baumannii and A. lwoffii respectively. The occurrence of multidrug-resistance pathogen in carrot is a serious challenge to public health care, especially in a rapidly growing urban population where subsistence agriculture contributes greatly to urban livelihood and source of vegetables.

Keywords: Urban agriculture, Public health, Fluoroquinolone, Sulfonamide, Multidrug-resistance.

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Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

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Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: Cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma.

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

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

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

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Authors: I. Kočvarová, E. Machů, N. Bártlová

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The issue of inclusion - segregation in the current Czech educational system is highly actual due to changes in legislation. It applies primarily to pupils with special educational needs, but it should also apply to pupils with giftedness. The paper presents chosen results of an exploratory survey that was carried out on a convenience sample of 1101 Czech teachers working in lower secondary education (ISCED2). The rate of teachers´ agreement with segregation of gifted pupils in the education system was monitored during this investigation. A validated questionnaire of our own design was used for the purpose of this investigation. The results were compared across groups of teachers in terms of selected variables. Results show that 36,3 % of teachers incline to segregation (rather than inclusion) of gifted pupils. Teachers who are not educated in this field and have no experience in teaching gifted pupils tend to support their segregation more in comparison with other teachers. Teachers of specialized schools for gifted pupils paradoxically agree with segregation to a slightly lesser extent than teachers from traditional schools, but they also manifest the most hesitant attitude in this issue. Preferences for segregation of gifted pupils are not related to attitudes toward gifted pupils or teachers' self-evaluation in terms of care for the gifted. Investigation indicates that the issue of education of gifted children and their inclusion in the educational system needs more space within the further education of teachers.

Keywords: Educational system, evaluation, gifted pupil, inclusion, segregation, teacher.

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Authors: B. Stroetmann, A. Aisenbrey

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

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

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

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

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

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Authors: Ghias ul Hassan, Bilal Nasir, Israr ul Haque, ShafiqAwan, Ghias Un NabiTayyab, S. Hassan Akhtar Bokhari, Khawar Saeed, Qazi Masroor

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Introduction: Pegylated Interferon and Ribavirin combination is standard of care in the management of chronic HCV infected patients. Efficacy of the therapy is judged by the ability to achieve biochemical and virological response as judged by RVR, EVR, ETR and SVR.Objective: To evaluate the efficacy of newly marketed biosimilar Pegylated Interferon Alpha 40KD (Peg INF) in chronic HCV patients. Materials and methods: This was observational, prospective multicentre study to evaluate the ability of biosimilar pegylated interferon alfa 2a (40KD) along with Ribavirin (weight based) to achieve SVR. The enrolled patients were separated into Naïve (A), Relapsers (B) and Non Responders(C) based on the previous history of interferon exposure and its response. The RGT was followed on ALT and RVR, EVR, ETR and SVR.Results:As per protocol analysis estimated SVR for three groups is 86.6% for naïve, 89.4% for relapsers and 52.4% for non-responders to standard interferon. Conclusion: It is concluded that Bio-similar pegylated interferon alfa-2a (40kD) along with Ribavirin has good anti-viral efficacy in Naïve, Relapsers and Non-responders to standard IFN of chronic HCV infected patients requiring treatment.

Keywords: SVR (Sustained virological response), NR (Nonresponders), Pegylated Interferon.

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Authors: Dimitrios Koukopoulos, Yiannis Stamatiou

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In this work, we present for the first time in our perception an efficient digital watermarking scheme for mpeg audio layer 3 files that operates directly in the compressed data domain, while manipulating the time and subband/channel domain. In addition, it does not need the original signal to detect the watermark. Our scheme was implemented taking special care for the efficient usage of the two limited resources of computer systems: time and space. It offers to the industrial user the capability of watermark embedding and detection in time immediately comparable to the real music time of the original audio file that depends on the mpeg compression, while the end user/audience does not face any artifacts or delays hearing the watermarked audio file. Furthermore, it overcomes the disadvantage of algorithms operating in the PCMData domain to be vulnerable to compression/recompression attacks, as it places the watermark in the scale factors domain and not in the digitized sound audio data. The strength of our scheme, that allows it to be used with success in both authentication and copyright protection, relies on the fact that it gives to the users the enhanced capability their ownership of the audio file not to be accomplished simply by detecting the bit pattern that comprises the watermark itself, but by showing that the legal owner knows a hard to compute property of the watermark.

Keywords: Audio watermarking, mpeg audio layer 3, hardinstance generation, NP-completeness.

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Authors: Okwan Frank

Abstract:

Maternal health outcome is one of the major population development challenges in Sub-Saharan Africa. The region has the highest maternal mortality ratio, despite the progressive economic growth in the region during the global economic crisis. It has been hypothesized that increase in economic growth will reduce the level of maternal mortality. The purpose of this study is to investigate the existence of the negative relationship between health outcome proxy by maternal mortality ratio and economic growth in Sub-Saharan Africa. The study used the Pooled Mean Group estimator of ARDL Autoregressive Distributed Lag (ARDL) and the Kao test for cointegration to examine the short-run and long-run relationship between maternal mortality and economic growth. The results of the cointegration test showed the existence of a long-run relationship between the variables considered for the study. The long-run result of the Pooled Mean group estimates confirmed the hypothesis of an inverse relationship between maternal health outcome proxy by maternal mortality ratio and economic growth proxy by Gross Domestic Product (GDP) per capita. Thus increasing economic growth by investing in the health care systems to reduce pregnancy and childbirth complications will help reduce maternal mortality in the sub-region.

Keywords: Economic growth, maternal mortality, pool mean group, Sub-Saharan Africa.

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Authors: Somenath Mukherjee, Rajdeep Ray, Raj Kumar Samanta, Mofazzal H. Khondekar, Gautam Sanyal

Abstract:

In next generation wireless networks (i.e., 4G and beyond), one of the main objectives is to ensure highest level of customer satisfaction in terms of data transfer speed, decrease in cost and delay, non-rejection and no drop of calls, availability of ‘always-on’ connectivity and services, continuity of connected services, hastle-free roaming in addition to the convenience of use of network services from anywhere and anytime. To take care of these requirements effectively, internet service providers (ISPs) and network planners have to go for major capacity enhancement of network resources and at the same time these resources are to be used effectively and efficiently to reduce cost and to increase revenue. In this work, the effective bandwidth available in a Mobile Switching Center (MSC) of a wireless network providing multi-class multimedia services is analyzed. Bandwidth requirement of the users for a customized Quality of Service (QoS) is estimated. The findings of the QoS estimation are applied for the capacity planning and admission control of the multi-class traffic flows coming into the MSC.

Keywords: Next generation wireless network, mobile switching center, multi-class traffic, quality of service, admission control, effective bandwidth.

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Authors: Pennapa Palapin

Abstract:

This study aimed to examine the management and development of forest tourism Kamchanoad. Ban Dung, Udon Thani sustainability. Data were collected by means of qualitative research including in-depth interviews, semi- structured, and then the data were summarized and discussed in accordance with the objectives. And make a presentation in the form of lectures. The target population for the study consisted of 16 people, including representatives from government agencies, community leaders and the community. The results showed that Guidelines for the Management and Development of Forest Tourism Kamchanoad include management of buildings and infrastructure such as roads, water, electricity, toilets. Other developments are the establishment of a service center that provides information and resources to facilitate tourists.; nature trails and informative signage to educate visitors on the path to the jungle Kamchanoad; forest activities for tourists who are interested only in occasional educational activities such as vegetation, etc.; disseminating information on various aspects of tourism through various channels in both Thailand and English, as well as a web site to encourage community involvement in the planning and management of tourism together with the care and preservation of natural resources and preserving the local cultural tourist area of Kamchanoad.

Keywords: Management and Development Guidelines, Tourist site, Sustainability.

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Authors: Arundhati Devi Maibam, K. Ingocha Singh

Abstract:

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

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

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Authors: Muhibul H. Bhuyan, Mafujul Hasan

Abstract:

If a person can monitor his/her heart rate regularly then he/she can detect heart disease early and thus he/she can enjoy longer life span. Therefore, this disease should be taken seriously. Hence, many health care devices and monitoring systems are being designed to keep track of the heart disease. This work reports a design and simulation processes of an Arduino microcontroller based heart rate measurement and monitoring system in Proteus environment. Clipping sensors were utilized to sense the heart rate of an individual from the finger tips. It is a digital device and uses mainly infrared (IR) transmitter (mainly IR LED) and receiver (mainly IR photo-transistor or IR photo-detector). When the heart pumps the blood and circulates it among the blood vessels of the body, the changed blood pressure is detected by the transmitter and then reflected back to the receiver accordingly. The reflected signals are then processed inside the microcontroller through a software written assembly language and appropriate heart rate (HR) is determined by it in beats per minute (bpm) from the detected signal for a duration of 10 seconds and display the same in bpm on the LCD screen in digital format. The designed system was simulated on several persons with varying ages, for example, infants, adult persons and active athletes. Simulation results were found very satisfactory.

Keywords: Heart rate measurement, design, simulation, Proteus, Arduino Uno microcontroller.

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Authors: Muntanavadee Maytapattana

Abstract:

The purposes of the study were to evaluate the effectiveness of the Parent Training Program for Obesity Reduction (PTPOR) on health behaviors of school-age children. An Ecological Systems Theory (EST) was approached the study and a randomized control trial was used in this study. Participants were school-age overweight or obese children and their parents. One hundred and one parent-child dyads were recruited and random assigned into the PTPOR (N=30), Educational Intervention or EI (N=32), and control group (N=39). The parents in the PTPOR group participated in five sessions including an educational session, a cooking session, aerobic exercise training, 2-time group discussion sessions, and 4-time telephoned counseling sessions. Repeated Measure ANCOVA was used to analyze data. The results presented that the outcomes of the PTPOR group were better than the EI and the control groups at 1^st, 8^th, and 32^nd weeks after finishing the program such as child exercise behavior (F_(2,97) = 3.98, p = .02) and child dietary behavior (F_(2,97) = 9.42, p = .00). The results suggest that nurses and health care providers should utilize the PTPOR for child weight reduction and for the health promotion of a lifestyle among overweight and obese children.

Keywords: Parent training program for obesity reduction, child health behaviors, school-age children.

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Authors: Salma Ainine, Colin Ritchie, Tracey McFee

Abstract:

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

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

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