Search results for: geriatric hospital care

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

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The management of the health-care wastes is one of the most important problems in Istanbul, a city with more than 12 million inhabitants, as it is in most of the developing countries. Negligence in appropriate treatment and final disposal of the healthcare wastes can lead to adverse impacts to public health and to the environment. This paper employs a fuzzy multi-criteria group decision making approach, which is based on the principles of fusion of fuzzy information, 2-tuple linguistic representation model, and technique for order preference by similarity to ideal solution (TOPSIS), to evaluate health-care waste (HCW) treatment alternatives for Istanbul. The evaluation criteria are determined employing nominal group technique (NGT), which is a method of systematically developing a consensus of group opinion. The employed method is apt to manage information assessed using multigranularity linguistic information in a decision making problem with multiple information sources. The decision making framework employs ordered weighted averaging (OWA) operator that encompasses several operators as the aggregation operator since it can implement different aggregation rules by changing the order weights. The aggregation process is based on the unification of information by means of fuzzy sets on a basic linguistic term set (BLTS). Then, the unified information is transformed into linguistic 2-tuples in a way to rectify the problem of loss information of other fuzzy linguistic approaches.

Keywords: Group decision making, health care waste management, multi-criteria decision making, OWA, TOPSIS, 2-tuple linguistic representation

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Authors: Andrea Zielke-Nadkarni

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Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: Pain management, migrants, sociocultural context, palliative care.

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Authors: Anwar Sadat

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Today, the Internet based communication has widen the opportunity of event monitoring system in the medical field. There is always a need of analyzing and designing secure and reliable mobile communication between the hospital and biomedical engineers mobile units. This study has been carried out to find possible solution using SIP-based event notification for alerting the technical staff about the Biomedical Device (BMD) status and Patients treatment session. The Session Initiation Protocol (SIP) can be used to create a medical event notification system. SIP can work on a variety of devices. Its adoption as the protocol of choice for third generation wireless networks allows for a robust and scalable environment. One of the advantages of SIP is that it supports personal mobility through the separation of user addressing and device addressing. The solution for Telemed alert notification system is based on SIP - Specific Event Notification. The aim of this project is to extend mobility service to the hospital technicians who are using Telemedicine system.

Keywords: Biomedical, Mobility Service, Notify, Proxy Server, SIP, Subscribe, Telemedicine.

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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, Jr., James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the United States. The elevated death and disease rates among former slaves were attributable to lack of quality healthcare. To address the paucity of healthcare services, Meharry Medical College, an institution with the mission of educating minority professionals and serving the underserved population, was established in 1876. Purpose: The social ecological framework and partial least squares (PLS) path modeling were used to quantify the impact of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Thus, the study results could demonstrate the accomplishment of the College’s mission of training primary care professionals to serve in underserved areas. Methods: Various statistical methods were used to analyze alumni data from 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates in the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t-test was performed to detect the significant mean differences of respective clustering and criterion variables. Chi-square test was used to test if the proportions of primary care and non-primary care specialists are consistent with those of medical and dental graduates practicing in the designated community clusters. Finally, the PLS path model was constructed to explore the construct validity of analytic model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Results: Approximately 83% (3,192/3,864) of Meharry Medical College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the PLS path modeling demonstrated that alumni served as primary care professionals in communities with significantly lower socioeconomic status and higher adverse health outcome (p < .001). The PLS path modeling exhibited the meaningful interrelation between primary care professionals practicing communities and surrounding environments (socioeconomic statues and adverse health outcome), which yielded model reliability, validity, and applicability. Conclusion: This study applied social ecological theory and analytic modeling approaches to assess the attainment of Meharry Medical College’s mission of training primary care professionals to serve in underserved areas, particularly in communities with low socioeconomic status and high rates of adverse health outcomes. In summary, the majority of medical and dental graduates from Meharry Medical College provided primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcome, which demonstrated that Meharry Medical College has fulfilled its mission. The high reliability, validity, and applicability of this model imply that it could be replicated for comparable universities and colleges elsewhere.

Keywords: Disadvantaged Community, K-means Cluster Analysis, PLS Path Modeling, Primary care.

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Authors: L. Nekoozad, M. Salehi Barough, B. Salmasian

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Introduction: Some parameters should be considered to investigate the chronic effects of radiation absorption in radiation workers. Trace elements are parameters which small changes in them can cause significant effects on live systems. The role of trace element concentration in human health is significant. These elements play an important role in the developing and functioning of the immune system, cellular respiration, and oxidation processes. Considering the importance and necessity of this issue and few studies, measurements of concentration changes of these elements due to the absorbed dose are important. Purpose: This study aimed to determine the biological effects of occupational dose absorption on plasma and erythrocyte concentration of Zn and Cu in the radiology staff of Tehran Oil Hospital. Material and methods: In this analytical-comparative study, 72 people have entered. 36 people (18 males and 18 females) were selected as radiology staff in the diagnostic and therapeutic departments of Tehran Oil Hospital. And 36 people (18 males and 18 females) were selected as general section staff in the same hospital as a control group. Radiology and control groups’ age and sex were matched. 10 ml of venous blood was taken from all people.  An atomic absorption spectrometer was used to obtain zinc and copper plasma concentrations. Levine test was used to compare these results validity. Results: The mean concentrations of copper and zinc were measured as 0.951 and 0.754 mg/L in the plasma phase and 3.2  and 0.401 mg/L in the RBC phase for the radiology group.  Copper and zinc average concentrations, respectively 0.976 and 0.813 mg/L in the plasma phase and 2.906 and 0.476 mg/L in the RBC phase, were measured for the control group. These elements Concentrations in the plasma phase were significantly different from that of the control group, but the concentrations in the red blood cell phase did not show a significant difference compared to the control group. In comparison, a separate comparison between men and women in the experimental and control groups showed a significant difference in the values of the elements mentioned. With a significant increase in samples, a better justification than the available statistical results can be extracted. Conclusions: Within this study results, chronic occupational probabilistic absorption destructive effects (even within the permitted range) on blood trace element concentration have been confirmed.

Keywords: Chronic absorption, atomic absorption spectrometry, radiology staff, trace element concentration.

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Authors: Jinn-Yi Yeh, Tai-Hsi Wu

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Hemodialysis patients might suffer from unhealthy care behaviors or long-term dialysis treatments. Ultimately they need to be hospitalized. If the hospitalization rate of a hemodialysis center is high, its quality of service would be low. Therefore, how to decrease hospitalization rate is a crucial problem for health care. In this study we combined temporal abstraction with data mining techniques for analyzing the dialysis patients' biochemical data to develop a decision support system. The mined temporal patterns are helpful for clinicians to predict hospitalization of hemodialysis patients and to suggest them some treatments immediately to avoid hospitalization.

Keywords: Hemodialysis, Temporal abstract, Data mining, Healthcare quality.

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Authors: Paria Soleimani, Arezoo Neshati

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Myocardial infarction is one of the leading causes of death in the world. Some of these deaths occur even before the patient reaches the hospital. Myocardial infarction occurs as a result of impaired blood supply. Because the most of these deaths are due to coronary artery disease, hence the awareness of the warning signs of a heart attack is essential. Some heart attacks are sudden and intense, but most of them start slowly, with mild pain or discomfort, then early detection and successful treatment of these symptoms is vital to save them. Therefore, importance and usefulness of a system designing to assist physicians in early diagnosis of the acute heart attacks is obvious. The main purpose of this study would be to enable patients to become better informed about their condition and to encourage them to seek professional care at an earlier stage in the appropriate situations. For this purpose, the data were collected on 711 heart patients in Iran hospitals. 28 attributes of clinical factors can be reported by patients; were studied. Three logistic regression models were made on the basis of the 28 features to predict the risk of heart attacks. The best logistic regression model in terms of performance had a C-index of 0.955 and with an accuracy of 94.9%. The variables, severe chest pain, back pain, cold sweats, shortness of breath, nausea and vomiting, were selected as the main features.

Keywords: Coronary heart disease, acute heart attacks, prediction, logistic regression.

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Authors: Viviane Nascimento, Dania Mehmod

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Introduction: The Coronavirus (COVID-19) disease was firstly reported in Asia at the end of 2019 and became a pandemic at the beginning of 2020. It resulted in a significant impact over the global economy and the health care systems around the world. The immediate measure adopted worldwide to contain the virus was mainly the lockdown and curfews. This certainly had an important impact on expats workers due to the financial insecurity, culture barrier and distance from the family. Saudi Arabia has one of the largest flows of foreign workers in the world and expats are the majority of the workforce. The aim of this essay was assessing the psychological impact of COVID-19 in non-health care expats living in Saudi Arabia. Methods: The study was conducted in a construction company in Riyadh with non-health care employees. The cross-sectional study protocol was approved by the company's executive management. Employees who verbally agreed to participate in the study were asked to anonymously answer a questionnaire validated for behavioral research (DASS-21). In addition, a second questionnaire was created to assess feelings and emotions. Results: More than a third of participants screened positive for one or more psychological symptoms (depression, anxiety and stress) on the DASS-21 scale. Moreover, it was observed an increase on negative feelings on the additional questionnaire. Conclusion: This study reveals an increase on negative feelings and psychological symptoms among non-health care migrant workers during the COVID-19 pandemic. In light of this, it is crucial to understand the emotional effects caused by the pandemic on migrant workers in order to create supportive and informative strategies minimizing the emotional impact on this vulnerable group.

Keywords: COVID-19 pandemic, Saudi Arabia, psychological effects, migrant workers.

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Authors: Siriwan Saksiriruthai

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This paper develops models to analyze the relationship between leisure time and wage change. Using Thailand-s Time Use Survey and Labor Force Survey data, the estimation of wage changes in response to leisure time change indicates that media receiving, personal care and social participation and volunteer activities are the ones that significantly raise hourly wages. Thus, the finding suggests the stimulation in time use for media access to enhance knowledge and productivity, personal care for attractiveness and healthiness in order to raise productivity, and social activities to develop connections for possible future opportunities including wage increase. These activities should be promoted for productive leisure time and for welfare improvement.

Keywords: Leisure, wage, time use, Thailand.

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Authors: Antonio Di Leva, Carla Reyneri, Michele Sonnessa

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PARADIGMA (PARticipative Approach to DIsease Global Management) is a pilot project which aims to develop and demonstrate an Internet based reference framework to share scientific resources and findings in the treatment of major diseases. PARADIGMA defines and disseminates a common methodology and optimised protocols (Clinical Pathways) to support service functions directed to patients and individuals on matters like prevention, posthospitalisation support and awareness. PARADIGMA will provide a platform of information services - user oriented and optimised against social, cultural and technological constraints - supporting the Health Care Global System of the Euro-Mediterranean Community in a continuous improvement process.

Keywords: Decision Support Systems, Ontology, Healt Care, Clinical Pathway

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Authors: Nami Matsumoto

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This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.

Keywords: Health care, Japanese-English medical encounters, language barriers, trust.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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Authors: Fadzilah Abdul Rahman

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Emotional development is developed between the parents and their child. Behavioural development is also developed between the parents and their child. Social Development is how parents can help their special needs child to adapt to society and to face challenges. In promoting a lifelong learning mindset, enhancing skill sets and readiness to face challenges, parents would be able to counter balance these challenges during their care giving process and better manage their expectations through understanding the hierarchy of needs modality towards a positive attitude, and in turn, improve their quality of life and participation in society. This paper aims to demonstrate how the hierarchy of needs can be applied in various situations of caregiving for parents with a special needs child.

Keywords: Hierarchy of needs, parents, special needs, care-giving.

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Authors: Beatriz López, Joaquim Meléndez, Heiko Wissel, Henning Haase, Kathleen Laatz, Oliver S. Grosser

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Concerning the inpatient care the present situation is characterized by intense charges of medical technology into the clinical daily routine and an ever stronger integration of special techniques into the clinical workflow. Medical technology is by now an integral part of health care according to consisting general accepted standards. Purchase and operation thereby represent an important economic position and both are subject of everyday optimisation attempts. For this purpose by now exists a huge number of tools which conduce more likely to a complexness of the problem by a comprehensive implementation. In this paper the advantages of an integrative information-workflow on the life-cycle-management in the region of medical technology are shown.

Keywords: Medical equipment maintenance, maintenanceworkflow, medical equipment management, optimisation ofworkflow.

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Authors: Cherryl Lowe

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Background - The TrendCare Patient Dependency System is currently used by a large number of maternity Services across Australia, New Zealand and Singapore. In 2012, 2013 and 2014 validation studies were initiated in all three countries to validate the acuity tools used for women in labour, and postnatal mothers and babies. This paper will present the findings of the validation study. Aim - The aim of this study was to; identify if the care hours provided by the TrendCare acuity system was an accurate reflection of the care required by women and babies; obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of maternity care models in three countries. Method - A non-experimental action research methodology was used across maternity services in four District Health Boards in New Zealand, a large tertiary and a large secondary maternity service in Singapore and a large public maternity service in Australia. Standardised data collection forms and timing devices were used to collect midwife contact times, with women and babies included in the study. Rejection processes excluded samples when care was not completed/rationed, and contact timing forms were incomplete. The variances between actual timed midwife/mother/baby contact and the TrendCare acuity category times were identified and investigated. Results - Thirty two (88.9%) of the 36 TrendCare acuity category timings, fell within the variance tolerance levels when compared to the actual timings recorded for midwifery care. Four (11.1%) TrendCare categories provided less minutes of care than the actual timings and exceeded the variance tolerance level. These were all night shift category timings. Nine postnatal categories were not able to be compared as the sample size for these categories was statistically insignificant. 100% of labour ward TrendCare categories matched actual timings for midwifery care, all falling within the variance tolerance levels. The actual time provided by core midwifery staff to assist lead maternity carer (LMC) midwives in New Zealand labour wards showed a significant deviation to previous studies. The findings of the study demonstrated the need for additional time allocations in TrendCare to accommodate an increased level of assistance given to LMC midwives. Conclusion - The results demonstrated the importance of regularly validating the TrendCare category timings with actual timings of the care hours provided. It was evident from the findings that variances to models of care and length of stay in maternity units have increased midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the LMC midwife has increased substantially. Outcomes - As a consequence of this study, changes were made to the night duty TrendCare maternity categories, additional acuity indicators were developed and times for assisting LMC midwives in labour ward increased. The updated TrendCare version was delivered to maternity services in 2014.

Keywords: Maternity, acuity, midwifery research, midwifery workloads.

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Authors: Wenhsuan Lee, Yachi Chang, Yingyih Shih

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In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

Keywords: Palliative care, breathing training, bio-psycho-social Model, heart rate variability.

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Authors: S. Abed, S. O’Neill

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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: Health care, nurse education, nurse leadership, nursing in Iraq, transformational leadership.

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Authors: A. Seham A. Elgamal, Reham H. Saleh

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Chronic kidney disease became a global health problem worldwide. Therefore, in order to maintain a patient’s life and improve the survival rate, hemodialysis is essential to replace the function of their kidneys. However, those patients may complain about multiple physical and psychological stressors due to the nature of the disease and the need for frequent hemodialysis sessions. So, those patients use various strategies to cope with the stressors related to their disease and the treatment procedures. Cross-sectional, descriptive study was carried out to achieve the aim of the study. A convenient sample including all adult patients was recruited for this study. Hemodialysis Stressors Scale (HSS) and Jalowiec Coping Scale (JCS) were used to investigate the stressors and coping strategies of 89 hemodialysis patients, at a governmental hospital (King Khalid Hospital-Jeddah). Results of the study revealed that 50.7% experienced physiological stressors and 38% experienced psychosocial stressors. Also, optimistic, fatalistic, and supportive coping strategies were the most common coping strategies used by the patients with mean scores (2.88 + 0.75, 2.87 + 0.75, and 1.82 + 0.71), respectively. In conclusion, being familiar with the types of stressors and the effective coping strategies of hemodialysis patients and their families are important in order to enhance their adaptation with chronic kidney diseases.

Keywords: Coping strategies, hemodialysis, physiological stressors, psychological stressors.

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Authors: F. Lievens, M. Jordanova

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Telemedicine is brought to life by contemporary changes of our world and summarizes the entire range of services that are at the crossroad of traditional healthcare and information technology. It is believed that eHealth can help in solving critical issues of rising costs, care for ageing and housebound population, staff shortage. It is a feasible tool to provide routine as well as specialized health service as it has the potential to improve both the access to and the standard of care. eHealth is no more an optional choice. It has already made quite a way but it still remains a fantastic challenge for the future requiring cooperation and coordination at all possible levels. The strategic objectives of this paper are: 1. To start with an attempt to clarify the mass of terms used nowadays; 2. To answer the question “Who needs eHealth"; 3. To focus on the necessity of bridging telemedicine and medical (health) informatics as well as on the dual relationship between them; as well as 4. To underline the need of networking in understanding, developing and implementing eHealth.

Keywords: E-Health/telemedicine, networking, medical informatics.

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Authors: C. Asarkaya, S. Z. Siretioglu Girgin

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Turkish migrants constitute the largest group among people with migration background living in Germany. Turkish women’s labor market participation is of significant importance for their social and economic integration to the German society. This paper thus aims to investigate their labor market positions. Turkish migrant women participate less in the labor market compared to men, and are responsible for most of the housework, child care, and elderly care. This is due to their traditional roles in the family, educational level, insufficient knowledge of German language, and insufficient professional experience. We strongly recommend that wide-reaching integration policies for women are formulated, so as to encourage participation of not only migrant women but also their husbands, fathers and/or brothers, and natives.

Keywords: Empowerment, Germany, Labor Market, Migration, Turkish, Women.

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Authors: Randa M. Ali, Naguiba F. Loutfy, Osama M. Awad

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Leishmaniasis is the collective name for a number of diseases caused by protozoan flagellates of the genus Leishmania, which is transmitted by Phlebotomine sandfly, the disease has diverse clinical manifestations and found in many areas of the world, particularly in Africa, Latin America, South and Central Asia, the Mediterranean basin and the Middle East. This study was done to assess primary health care physicians’ knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. It is a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study; only 20 PHP completed the questionnaire. 60 local inhabitants were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results showed that 11 (55%) percent of the physicians had satisfactory knowledge; they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. On the other hand when attitude of the primary health care physicians about leishmaniasis was measured, results showed that 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandfly as a vector of the disease is poor and needs to be corrected. (90%) of the interviewed inhabitants had not heard about leishmaniasis, Only 3 (5%) of them said they know sandfly and its role in transmission of leishmaniasis. Thus we conclude that knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of leishmaniasis, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that for inhabitants to take enough protective measures against the vector, they should perceive that it is responsible for causing a disease.

Keywords: Attitude, knowledge, PHP, leishmaniasis, sandfly, local inhabitants, inside and outside housing conditions.

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Authors: Chanisada Choosuk, Napisporn Memongkol Runchana Sinthavalai, Fareeda Lambensah

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The objective of this research is to explore the role of actors at the local level in managing the Pre-hospital Emergency Medical Service (EMS) system in Thailand. The research method was done through documentary research, individual interviews, and one forum conducted in each province. This paper uses the case of three provinces located in three regions in Thailand including; Ubon Ratchathani (North-eastern region), Lampang (Northern Region), and Songkhla (Southern Region). The result shows that, recently, the role of the local government in being the service provider for their local people is increasingly concerned. In identifying the key success factors towards the EMS system, it includes; (i) the local executives- vision and influence that the decisions made by them, for both PAO (Provincial Administration Organisation (PAO) and TAO (Tambon Administration Organisation), is vital to address the overall challenges in EMS development, (ii) the administrative system through reforming their working style create the flexibility in running the EMS task, (iii) the network-based management among different agencies at the local level leads to the better EMS practices, and (iv) the development in human resource is very vital in delivering the effective services.

Keywords: Local governments, Management, Emergency Medical Services (EMS), Thailand

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Authors: Alisha Fisher

Abstract:

Survivors of sex trafficking often report extensive harm not just from the violence itself, but multiple levels such as internalized shame, societal misunderstandings, and the process of reporting, exiting, and healing. The aim of this article is to examine the multi-layered approach to supporting survivors who are exiting sex trafficking through immediate, short-term, and long-term care approaches. We present a systematic review of the current barriers structurally, psychosocially, and psychologically through a Canadian perspective, and apply them to the interventions within the service continuum, basic needs, and further needs and supports to consider. This article suggests that ongoing and additional funding to survivor’s support services, specialized police and heath care training, and increased prevention and public education on the realities of sex trafficking in Canada is a necessity for survivor healing, and the prevention of further harm.

Keywords: Canada Sex Trafficking, exiting sex trafficking, sex trafficking survivors, sex trafficking supports.

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Authors: S. Karthikeyan, Naveen Bindra

Abstract:

Introduction: To update ourselves and understand the concept of latest electronic formats available for Health care providers and how it could be used and developed as per standards. The idea is to correlate between the patients Manual Medical Records keeping and maintaining patients Electronic Information in a Health care setup in this world. Furthermore, this stands with adapting to the right technology depending upon the organization and improve our quality and quantity of Healthcare providing skills. Objective: The concept and theory is to explain the terms of Electronic Medical Record (EMR), Electronic Health Record (EHR) and Personal Health Record (PHR) and selecting the best technical among the available Electronic sources and software before implementing. It is to guide and make sure the technology used by the end users without any doubts and difficulties. The idea is to evaluate is to admire the uses and barriers of EMR-EHR-PHR. Aim and Scope: The target is to achieve the health care providers like Physicians, Nurses, Therapists, Medical Bill reimbursements, Insurances and Government to assess the patient’s information on easy and systematic manner without diluting the confidentiality of patient’s information. Method: Health Information Technology can be implemented with the help of Organisations providing with legal guidelines and help to stand by the health care provider. The main objective is to select the correct embedded and affordable database management software and generating large-scale data. The parallel need is to know how the latest software available in the market. Conclusion: The question lies here is implementing the Electronic information system with healthcare providers and organization. The clinicians are the main users of the technology and manage us to “go paperless”. The fact is that day today changing technologically is very sound and up to date. Basically, the idea is to tell how to store the data electronically safe and secure. All three exemplifies the fact that an electronic format has its own benefit as well as barriers.

Keywords: Medical records, digital records, health information, electronic record system.

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Authors: Meenakshi Bheevgade, Rajendra M. Patrikar

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In today-s new technology era, cluster has become a necessity for the modern computing and data applications since many applications take more time (even days or months) for computation. Although after parallelization, computation speeds up, still time required for much application can be more. Thus, reliability of the cluster becomes very important issue and implementation of fault tolerant mechanism becomes essential. The difficulty in designing a fault tolerant cluster system increases with the difficulties of various failures. The most imperative obsession is that the algorithm, which avoids a simple failure in a system, must tolerate the more severe failures. In this paper, we implemented the theory of watchdog timer in a parallel environment, to take care of failures. Implementation of simple algorithm in our project helps us to take care of different types of failures; consequently, we found that the reliability of this cluster improves.

Keywords: Cluster, Fault tolerant, Grid, Grid ComputingSystem, Meta-computing.

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Authors: Ramón Cruzat, Sergio F. Ochoa, Ignacio Casas, Luis A. Guerrero, José Bravo

Abstract:

Patients under health treatments that involve long  stays at a hospital or health center (e.g. cancer, organ transplants and  severe burns), tend to get bored or depressed because of the lack of  social interaction with family and friends. Such a situation also  affects the evolution and effectiveness of their treatments. In many  cases, the solution to this problem involves extra challenges, since  many patients need to rest quietly (or remain in bed) to their being  contagious. Considering the weak health condition in which usually  are these kinds, keeping them motivated and quiet represents an  important challenge for nurses and caregivers. This article presents a  mobile ubiquitous game called MagicRace, which allows hospitalized  kinds to interact socially with one another without putting to risk  their sensitive health conditions. The game does not require a  communication infrastructure at the hospital, but instead, it uses a  mobile ad hoc network composed of the handheld devices used by  the kids to play. The usability and performance of this application  was tested in two different sessions. The preliminary results show  that users experienced positive feelings from this experience.

 

Keywords: Ubiquitous game, children's emotional support, social isolation, mobile collaborative interactions.

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Authors: Armin Samarghandi, Amirreza Jafari, Mohamad Ghiasi

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Since individuals spend the majority of their time indoors, this immediately affects their productivity and health. An essential factor in occupational health and public health is the influence of indoor environmental quality (IEQ) in buildings on occupant welfare and productivity. Since then, empirical data have been equivocal, indicating either that the studies are inaccurate or that the research has just scratched the surface of green buildings in offices, accommodation, and hospital settings and not taken the aforementioned holistically. This study compared three green-certified buildings — a residential green building, a green hospital, and a green school — with conventional structures in Tehran, Iran by means of a questionnaire spread among those utilizing these buildings, and assessing their productivity and health rate as opposed to the time they resided, worked in conventional buildings. The results demonstrated higher scores pertaining to productivity, physical and mental wellness as a consequence of better indoor environmental quality (IEQ), natural lighting, design, and sustainability of these building against non-green buildings. In addition, ancillary matters — environmental, financial, intellectual, emotional, social, spiritual dimensions of participants — were indirectly evaluated, and the same results are produced.

Keywords: Green building, Iran, productivity, physical and mental health, Tehran.

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Authors: P. Phenpun, S. Wareewan

Abstract:

This qualitative study aimed to describe the opinions in relation to humanized care emerging from the volunteer activities of nursing students at Boromarajonani College of Nursing, Chonburi, Thailand. One hundred and twenty-seven second-year nursing students participated in this study. The volunteer activity model was composed of preparation, implementation, and evaluation through a learning log, in which students were encouraged to write their daily activities after completing practical training at the healthcare center. The preparation content included three main categories: service minded, analytical thinking, and client participation. The preparation process took over three days that accumulates up to 20 hours only. The implementation process was held over 10 days, but with a total of 70 hours only, with participants taking part in volunteer work activities at a healthcare center. A learning log was used for evaluation and data were analyzed using content analysis. The findings were as follows. With service minded, there were two subcategories that emerged from volunteer activities, which were service minded towards patients and within themselves. There were three categories under service minded towards patients, which were rapport, compassion, and empathy service behaviors, and there were four categories under service minded within themselves, which were self-esteem, self-value, management potential, and preparedness in providing good healthcare services. In line with analytical thinking, there were two components of analytical thinking, which were analytical skill for their works and analytical thinking for themselves. There were four subcategories under analytical thinking for their works, which were evidence based thinking, real situational thinking, cause analysis thinking, and systematic thinking, respectively. There were four subcategories under analytical thinking for themselves, which were comparative between themselves, towards their clients that leads to the changing of their service behaviors, open-minded thinking, modernized thinking, and verifying both verbal and non-verbal cues. Lastly, there were three categories under participation, which were mutual rapport relationship; reconsidering client’s needs services and providing useful health care information.

Keywords: Humanized care service, volunteer activity, nursing student, and learning log.

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Authors: Hind Bouami, Patrick Millot

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Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, hospitals, human-centered automated system, risk management.

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Authors: Lucy Ampaw-Asiedu, Terri R. Norton

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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: Disaster management, safe spaces, structural design, tornado, vulnerability.

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