Search results for: geriatric hospital care

Authors: Nasir Baba Ahmed, Nicolas Daclin, Marc Olivaux, Gilles Dusserre

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The Mobile field hospital is critical in terms of managing emergencies in crisis. It is a sub-section of the main hospitals and the health sector, tasked with delivering responsive, immediate, and efficient medical services during a crisis. With the aim to prevent further crisis, the assessment of the cyber assets follows different methods, to distinguish its strengths and weaknesses, and in turn achieve cyber resiliency. The work focuses on assessments of cyber resilience in field hospitals with trends growing in both the field hospital and the health sector in general. This creates opportunities for the adverse attackers and the response improvement objectives for attaining cyber resilience, as the assessments allow users and stakeholders to know the level of risks with regards to its cyber assets. Thus, the purpose is to show the possible threat vectors which open up opportunities, with contrast to current trends in the assessment of the mobile field hospitals’ cyber assets.

Keywords: Assessment framework, cyber resilience, cyber security, Mobile Field Hospital.

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Authors: Nareelux Suwannobol, JintanaTapin, Khuanchanok Narachan

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The objective of this study was to determine the accuracy to estimation fetal weight by Johnson-s method and compares it with actual birth weight. The sample group was 126 infants delivered in Dan KhunThot hospital from January March 2012. Fetal weight was estimated by measuring fundal height according to Johnson-s method. The information was collected by studying historical delivery records and then analyzed by using the statistics of frequency, percentage, mean, and standard deviation. Finally, the difference was analyzed by a paired t-test.The results showed had an average birth weight was 3093.57 ± 391.03 g (mean ± SD) and 3,455 ± 454.55 g average estimated fetal weight by Johnson-s method higher than average actual birth weight was 384.09 grams. When classifying the infants according to birth weight found that low birth weight (<2500 g) and the appropriate birth weight (2500-3999g) actual birth weight less than estimate fetal weight . But the high birth weight (> 4000 g) actual birth weight was more than estimated fetal weight. The difference was found between actual birth weight and estimation fetal weight of the minimum weight in high birth weight ( > 4000 g) , the appropriate birth weight (2500-3999g) and low birth weight (<2500 g) respectively. The rate of estimates fetal weight within 10% of actual birth weight was 35.7%. Actual birth weight were compared with the found that the difference is statistically significant (p <.000). Employing Johnson-s method to estimate fetal weight can estimate initial fetal weight before passing to special examinations, which may require excessive high cost. A variety of methods should be employed to estimate fetal weight more precisely, which will help plan care for mother-s and infant-s safety.

Keywords: Johnson's method, Fetal weight estimate, Delivery Room, Student nurse.

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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Authors: Wei-Wen Liu, Feng-Chuan Pan, Pei-Chi Wen, Sen-Ji Chen, Su-Hui Lin

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Nurses in an Armed Force Hospital (AFH) expose to stronger stress than those in a civil hospital, especially in an emergency department (ED). Ironically, stresses of these nurses received few if any attention in academic research in the past. This study collects 227 samples from the emergency departments of four armed force hospitals in central and southern Taiwan. The research indicates that the top five stressors are a massive casualty event, delayed physician support, overloads of routine work, overloads of assignments, and annoying paper work. Excessive work loading was found to be the primary source of stress. Nurses who were perceived to have greater stress levels were more inclined to deploy emotion-oriented approaches and more likely to seek job rotations. Professional stressors and problem-oriented approaches were positively correlated. Unlike other local studies, this study concludes that the excessive work-loading is more stressful in an AFH.

Keywords: Emergency nurse, Job stressor, Coping behavior, Armed force hospital.

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Authors: Laurent Letrilliart, Anne-Katty Bacis, François Mennerat, Cyrille Colin

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The International Classification of Primary Care (ICPC), which belongs to the WHO Family of International Classifications (WHO-FIC), has a low granularity, which is convenient for describing general medical practice. However, its lack of specificity makes it useful to be used along with an interface terminology. An international survey has been performed, using a questionnaire sent by email to experts from 25 countries, in order to describe the terminologies interfacing with ICPC. Eleven interface terminologies have been identified, developed in Argentina, Australia, Belgium (2), Canada, Denmark, France, Germany, Norway, South Africa, and The Netherlands. Globally, these systems have been poorly assessed until now.

Keywords: Terminology, controlled vocabulary, thesaurus, classification, International Classification of Primary Care.

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Authors: Chia-Jou Hsieh, Feng-Chuan Pan

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Oral health is particular important to the hospitalized patients with chronic schizophrenia for an extreme high potential of the respiratory infections. Due to the degeneration of physical capability, patients of this kind typically fall dependent in the activity of daily living (ADL). A very high percentage of patients had dental problems of which mostly could be easily avoid by easy regular tooth brushing. Purpose of the project is to develop a mechanism in helping the schizophrenia patients in rebuilding a tooth-cleaning habit. The project observed and evaluated the tooth-cleaning behavior of 100 male patients in a psychiatric hospital, and found the majority of them ignored such an activity in a three-month period of time. In the meantime, the primary care-givers were not aware or not convinced the importance of such a need of dental hygiene, and thus few if any tooth cleaning training or knowledge on dental hygiene were given to the patients. The project then developed a program based on the numerous observations and discussions. The improvement program included patients- group education, care-givers- training, and a tool-kit for tooth-brush holding was erected. The project launched with some incentive package. The outcomes were encouraging with 87% of the patients had rebuilt their tooth-brushing habits against previous 22%, and the tooth cleaning kits were 100% kept against 22% in the past. This project had significantly improved the oral health of the patients. The project, included the procedure and the tool-kit holder specific for this purpose, was a good examples for psychiatric hospitals.

Keywords: Schizophrenia, dental hygiene, tool-kit holder, health education

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Authors: Ayman M. Mansour

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In this paper, we propose an intelligent system that is used for monitoring the health conditions of patients. Monitoring the health condition of patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The ability of making medical decisions, the quality of medical is expected to be improved.

Keywords: GSM, SMS, Patient, Monitoring system, Fuzzy Logic, Multi-agent system.

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Authors: L. Korpinen, T. Kava, I. Salmi

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This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: Sleep, apnea patient, operating model, hospital.

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Authors: Mehtap Dursun, E. Ertugrul Karsak, Melis Almula Karadayi

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Disposal of health-care waste (HCW) is considered as an important environmental problem especially in large cities. Multiple criteria decision making (MCDM) techniques are apt to deal with quantitative and qualitative considerations of the health-care waste management (HCWM) problems. This research proposes a fuzzy multi-criteria group decision making approach with a multilevel hierarchical structure including qualitative as well as quantitative performance attributes for evaluating HCW disposal alternatives for Istanbul. Using the entropy weighting method, objective weights as well as subjective weights are taken into account to determine the importance weighting of quantitative performance attributes. The results obtained using the proposed methodology are thoroughly analyzed.

Keywords: Entropy weighting method, group decision making, health-care waste management, hierarchical fuzzy multi-criteriadecision making

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Authors: Amir Mohammad Fathollahi Fard, Mostafa Hajiaghaei-Keshteli, Mohammad Mahdi Paydar

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With increasing life expectancy in developed countries, the role of home care services is highlighted by both academia and industrial contributors in Home Health Care Supply Chain (HHCSC) companies. The main decisions in such supply chain systems are the location of pharmacies, the allocation of patients to these pharmacies and also the routing and scheduling decisions of nurses to visit their patients. In this study, for the first time, an integrated model is proposed to consist of all preliminary and necessary decisions in these companies, namely, location-allocation-routing model. This model is a type of NP-hard one. Therefore, an Imperialist Competitive Algorithm (ICA) is utilized to solve the model, especially in large sizes. Results confirm the efficiency of the developed model for HHCSC companies as well as the performance of employed ICA.

Keywords: Home health care supply chain, location-allocation-routing problem, imperialist competitive algorithm, optimization.

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Authors: S.S.Mohanavalli, Sheila Anand

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This paper proposes a novel architecture for At- Home medical care which enables senior citizens, patients with chronic ailments and patients requiring post- operative care to be remotely monitored in the comfort of their homes. This architecture is implemented using sensors and wireless networking for transmitting patient data to the hospitals, health- care centers for monitoring by medical professionals. Patients are equipped with sensors to measure their physiological parameters, like blood pressure, pulse rate etc. and a Wearable Data Acquisition Unit is used to transmit the patient sensor data. Medical professionals can be alerted to any abnormal variations in these values for diagnosis and suitable treatment. Security threats and challenges inherent to wireless communication and sensor network have been discussed and a security mechanism to ensure data confidentiality and source authentication has been proposed. Symmetric key algorithm AES has been used for encrypting the data and a patent-free, two-pass block cipher mode CCFB has been used for implementing semantic security.

Keywords: data confidentiality, integrity, remotemonitoring, source authentication

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Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria

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In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.

Keywords: Healthcare for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device.

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Authors: Eun-Jung Ko, Hyung-Jik Lee, Jeun-Woo Lee

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In ubiqutious healthcare environment, user's health data are transfered to the remote healthcare server by the user's wearable system or mobile phone. These collected user's health data should be managed and analyzed in the healthcare server, so that care giver or user can monitor user's physiological state. In this paper, we designed and developed the intelligent Healthcare Server to manage the user's health data using CDSS and ontology. Our system can analyze user's health data semantically using CDSS and ontology, and report the result of user's physiological raw data to the user and care giver.

Keywords: u-healthcare, CDSS, healthcare server, health data, ontology.

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Authors: Bill D. Geis, Frederick Newman

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Suicide and wrongful death forensic cases are the fastest rising tort in mental health law. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from US state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. But suicide ideation, in the matter of suicide risk determination, may be a necessary but insufficient target of lethal suicide risk assessment. Assessment of near-term suicide risk—assessment that goes beyond verbalized suicide ideation and relates to acute crisis variables—is likely needed. Specifically, such other or additional suicide risk variable assessment may be required in the context of lethal suicide risk situations, as opposed to the discernment of general, nonlethal suicide behavior as a standard of practice (whether a patient is having suicidal thoughts or exhibiting an ambivalent suicide attempt potential). In the current study, verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The Lethal Suicide Risk Assessment, Acute Model, and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training and become the legal standard of care for expected clinical behavior. Without this expanded clinical assessment perspective, the standard of care for suicide assessment is out of sync with current knowledge—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: Forensic evaluation, standard of care, suicide, suicide assessment, wrongful death.

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Authors: Weidong Xia, Malgorzata Kolotylo, Xuan Tan

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This study examines the key factors that influence general practitioners’ learning and transfer of specialized arthritis knowledge and self-care techniques to patients during normal patient visits. Drawing on the theory of planed behavior and using matched survey data collected from general practitioners before and after training sessions provided by specialized orthopedic physicians, the study suggests that the general practitioner’s intention to use and transfer learned knowledge was influenced mainly by intrinsic motivation, organizational learning culture and absorptive capacity, but was not influenced by extrinsic motivation. The results provide both theoretical and practical implications.

Keywords: Empirical study, healthcare knowledge management, patient self-care, physician knowledge transfer.

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Authors: R. Poonsuph

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Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: A. A. AlRasheed, A. Atkins, R. Campion

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This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: Knowledge management, visualisation, patients, hospitals, healthcare workers, workflow, improvements.

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Authors: Li-Ping Hsiao, Feng-Chuan Pan

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

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

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Authors: Norman Wu, Darren Sun

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Key performance indicators (KPIs) are used for post result evaluation in the construction industry, and they normally do not have provisions for changes. This paper proposes a set of dynamic key performance indicators (d-KPIs) which predicts the future performance of the activity being measured and presents the opportunity to change practice accordingly. Critical to the predictability of a construction project is the ability to achieve automated data collection. This paper proposes an effective way to collect the process and engineering management data from an integrated construction management system. The d-KPI matrix, consisting of various indicators under seven categories, developed from this study can be applied to close monitoring of the development projects of aged-care facilities. The d-KPI matrix also enables performance measurement and comparison at both project and organization levels.

Keywords: Aged-care project, construction, dynamic KPI, healthcare system.

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Authors: Dimas T. Anantyo, Zsa-Zsa A. Laksmi, Adhie N. Radityo, Arsita E. Rini, Gatot I. Sarosa

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A six-point-two-magnitude earthquake rocked Mamuju District, West Sulawesi Province, Indonesia, on 15 January 2021, causing significant health issues for the affected community, particularly among vulnerable populations such as neonates and children. The aim of this study is to examine and describe the diseases diagnosed in the pediatric population in Mamuju 14 days after the earthquake. This study uses a prospective observational study of the pediatric population presenting at West Sulawesi Regional Hospital, Mamuju Regional Public Hospital, and Bhayangkara Hospital for the period of 14 days after the earthquake. Demographic and clinical information was recorded. 153 children were admitted to the health center. Children younger than six years old were the highest proportion (78%). Out of 153 children, 82 of them were male (54%). The most frequently diagnosed disease during the first and second weeks after the earthquake was respiratory problems, followed by gastrointestinal problems that showed an increase in incidence in the second week. This study found that age has a correlation with common disease in children after an earthquake. Respiratory and gastrointestinal problems were found to be the most common diseases among the pediatric population in Mamuju after the earthquake.

Keywords: Health outcomes, pediatric population, earthquake, Mamuju.

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Authors: S. Sowmyayani, P. Arockia Jansi Rani

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Fall detection is one of the challenging problems in elderly care system. The objective of this paper is to identify falls in elderly care system. In this paper, an efficient fall detection method is proposed to identify falls using correlation factor and Motion History Image (MHI). The proposed method is tested on URF (University of Rzeszow Fall detection) dataset and evaluated with some efficient measures like sensitivity, specificity, precision and classification accuracy. It is compared with other recent methods. The experimental results substantially proved that the proposed method achieves 1.5% higher sensitivity when compared to other methods.

Keywords: Pearson correlation coefficient, motion history image, human shape identification.

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

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Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: Antenatal care, knowledge, practice, attitude, pregnant women.

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Authors: Paulo Rocha

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Once in touch with the Criminal Justice System, offenders with mental disorder tend to return to custody more often than nondisordered individuals, which suggests they have not been receiving appropriate treatment in prison. In this scenario, diverting individuals into care as early as possible in their trajectory seems to be the appropriate approach to rehabilitate mentally unwell offenders and alleviate overcrowded prisons. This paper builds on an ethnographic research investigating the challenges encountered by practitioners working to divert offenders into care while attempting to establish cross-boundary interactions with professionals in the Criminal Justice System and Mental Health Services in the UK. Drawing upon the findings of the study, this paper suggests the development of adequate tools to enable liaison between agencies which ultimately results in successful interventions.

Keywords: Criminogenic needs, interagency collaboration, liaison and diversion, recidivism.

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Authors: R. Miniati, F. Dori, E. Iadanza, M. Fregonara Medici

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management of medical devices in hospitals includes the planning of medical equipment acquisition and maintenance. The presence of critical and non-critical areas together with technological proliferation render the management of medical devices very complex. This study creates an easy and objective methodology for the analysis of medical equipment maintenance, that makes the management of medical devices more feasible. The study has been carried out at Florence Hospital Careggi and it aims to help the clinical engineering department to manage medical equipment by clarifying the hospital situation through a characterization of the different areas, technologies and fault typologies.

Keywords: Clinical Engineering, Maintenance, Medical DevicesManagement, Key Performance Indicators.

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: Sickle cell disease, quality of life, anxiety, depression, socio-demographic characteristics, Ghana.

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Authors: Samy A. Selim, Nashwa I. Hagag

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Abstract–The objectives of the current study are to determine the prevalence, etiological agents, drug susceptibility pattern and plasmid profile of Acinetobacter baumannii isolates from Hospital-Acquired Infections (HAI) at Community Hospital, Al Jouf Province, Saudi Arabia. A total of 1890 patients had developed infection during hospital admission and were included in the study. Among those who developed nosocomial infections, 15(9.4), 10(2.7) and 118 (12.7) had respiratory tract infection (RTI), blood stream infections (BSI) and urinary tract (UTI) respectively. A total of 268 bacterial isolates were isolated from nosocomial infection. S. aureus was reported in 23.5% for of the total isolates followed by Klebsiella pneumoniae (17.5%), E. coli (17.2%), P. aeruginosa (11.9%), coagulase negative staphylococcus (9%), A. baumannii (7.1%), Enterobacter spp. (3.4%), Citrobacter freundii (3%), Proteus mirabilis (2.6%), and Proteus vulgaris and Enterococcous faecalis (0.7%). Isolated organisms are multi-drug resistant, predominantly Gram-positive pathogens with a high incidence of methicillin-resistant S. aureus, extended spectrum beta lactamase and vancomycin resistant enterococci organisms. The RFLP (Fragment Length Polymorphisms) patterns of plasmid preparations from isolated A. baumannii isolates had altered RFLP patterns, possibly due to the presence of plasmid(s). Five A. baumannii isolates harbored plasmids all of which were not less than 2.71kbp in molecular weight. Hence, it showed that the gene coding for the isolates were located on the plasmid DNA while the remaining isolates which have no plasmid might showed gene coding for antibiotic resistance being located on chromosomal DNA. Nosocomial infections represent a current problem in Community Hospital, Al Jouf Province, Saudi Arabia. Problems associated with SSI include infection with multidrug resistant pathogens which are difficult to treat and are associated with increased mortality.

Keywords: Hospital-Acquired Infections, Acinetobacter baumannii, antibiotic resistance, plasmid profile, RFLP patterns, Al Jouf Province, Saudi Arabia

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Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: Skeletal scintigraphy, SPECT/CT, imaging.

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Authors: Kaan Yamanturk, Cihan Dogruoz

Abstract:

Seismic isolators have been utilized around the world to protect the structures, nonstructural components and contents from the damaging effects of earthquakes. In Structural Engineering, seismic isolation is used for protecting buildings and its vibration-sensitive contents from earthquakes. Seismic isolation is a passive control system that lowers effective earthquake forces by utilizing flexible bearings. One of the most significant isolation systems is seismic isolators. In this paper, double pendulum type Teflon coated seismic isolators utilized in a city hospital project by Guris Construction and Engineering Co. Inc, located in Kutahya, Turkey, have been investigated. Totally, 498 seismic isolators were applied in the project. These isolators are double friction pendulum type seismic isolation devices. The review of current practices is also examined in this study. The focus of this study is related to the application of passive seismic isolation systems for buildings as practiced in Kutahya City Hospital Project. Based on the study, the acceleration at the top floor will be 0.18 g and it will decrease 0.01 g in every floor. Therefore, seismic isolators are very important for buildings located in earthquake zones.

Keywords: Maximum considered earthquake, moment resisting frame, seismic isolator, seismic design.

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Authors: Petr Vcelak, Jana Kleckova

Abstract:

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: Madiajagan Muthaiyan, Neha Goel, Deepti Sunder Prakash

Abstract:

This paper discusses about an intelligent system to be installed in ambulances providing professional support to the paramedics on board. A video conferencing device over mobile 4G services enables specialists virtually attending the patient being transferred to the hospital. The data centre holds detailed databases on the patients past medical history and hospitals with the specialists. It also hosts various software modules that compute the shortest traffic –less path to the closest hospital with the required facilities, on inputting the symptoms of the patient, on a real time basis.

Keywords: 4G mobile services, cloud computing, data centre, intelligent system, optimization, real time traffic reporting, SaaS, video conferencing.

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