Search results for: home care

Authors: Sheel Chakraborty

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Modern society in developed countries has distanced itself from the earlier norm of joint family living, and with the increase of economic pressure, parents' availability for their children during their infant years has been consistently decreasing over the past three decades. This has been promoted in the US through the legislature and funding. Early care and education may have a positive impact on young minds, but a growing number of kids facing social challenges in making friendships in their teenage years raises serious concerns about its effectiveness. The survey-based primary research presented here shows that a statistically significant number of millennials between the ages of 10 and 25 years prefer to build friendships virtually than face-to-face interactions. Moreover, many teenagers depend more on their virtual friends whom they never met. Contrary to the belief that early social interactions in a non-home setup make the kids confident and more prepared for the real world, many shy-natured kids seem to develop a sense of shakiness in forming social relationships, resulting in loneliness by the time they are young adults. Reflecting on George Mead’s theory of self that is made up of “I” and “Me”, most functioning homes provide the required freedom and forgivable, congenial environment for building the "I" of a toddler; however, daycare or preschools can barely match that. It seems social images created from the “Me” perspective in preschoolers in a daycare environment has interfered and greatly overpowered the formation of a confident "I" thus created a crisis around the inability to form friendships face to face when they grow older. Though the pervasive nature of social media cannot be ignored, the non-parental early care and education practices adopted largely by the urban population have created a favorable platform of teen psychology on which social media popularity thrived, especially providing refuge to shy Gen-Z teenagers. This can explain why young adults today perceive social media as their preferred outlet of expression and a place to form dependable friendships, despite the risk of being cyberbullied.

Keywords: Digital socialization, shyness, developmental psychology, friendship, early education.

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Authors: Maria L. McLeod

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This study examines the ways in which cancer patient narratives are portrayed and framed on the websites of three leading U.S. cancer care centers – The University of Texas MD Anderson Cancer Center in Houston, Memorial Sloan Kettering Cancer Center in New York, and Seattle Cancer Care Alliance. Thirty patient stories, 10 from each cancer center website blog, were analyzed using qualitative and quantitative textual analysis of unstructured data, documenting common themes and other elements of story structure and content. Patient narratives were coded using grounded theory as the basis for conducting emergent qualitative research. As part of a systematic, inductive approach to collecting and analyzing data, recurrent and unique themes were examined and compared in terms of positive and negative framing, patient agency, and institutional praise. All three of these cancer care centers are teaching hospitals, with university affiliations, that emphasize an evidence-based scientific approach to treatment that utilizes the latest research and cutting-edge techniques and technology. The featured cancer stories suggest positive outcomes based on anecdotal narratives as opposed to the science-based treatment models employed by the cancer centers. An analysis of 30 sample stories found skewed representation of the “cancer experience” that emphasizes positive outcomes while minimizing or excluding more negative realities of cancer diagnosis and treatment. The stories also deemphasize patient agency, instead focusing on deference and gratitude toward the cancer care centers, which are cast in the role of savior.  

Keywords: Cancer framing, cancer narratives, survivor stories, patient narratives.

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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, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: Advanced palliative aquatics care, magnetic field therapy, medical device, research design.

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Authors: Hijun Kim, Jungkeun Sung, Seungwoo Kim

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In this paper, a Smart Home Service Robot, McBot II, which performs mess-cleanup function etc. in house, is designed much more optimally than other service robots. It is newly developed in much more practical system than McBot I which we had developed two years ago. One characteristic attribute of mobile platforms equipped with a set of dependent wheels is their omni- directionality and the ability to realize complex translational and rotational trajectories for agile navigation in door. An accurate coordination of steering angle and spinning rate of each wheel is necessary for a consistent motion. This paper develops trajectory controller of 3-wheels omni-directional mobile robot using fuzzy azimuth estimator. A specialized anthropomorphic robot manipulator which can be attached to the housemaid robot McBot II, is developed in this paper. This built-in type manipulator consists of both arms with 3 DOF (Degree of Freedom) each and both hands with 3 DOF each. The robotic arm is optimally designed to satisfy both the minimum mechanical size and the maximum workspace. Minimum mass and length are required for the built-in cooperated-arms system. But that makes the workspace so small. This paper proposes optimal design method to overcome the problem by using neck joint to move the arms horizontally forward/backward and waist joint to move them vertically up/down. The robotic hand, which has two fingers and a thumb, is also optimally designed in task-based concept. Finally, the good performance of the developed McBot II is confirmed through live tests of the mess-cleanup task.

Keywords: Holonomic Omni-wheeled Mobile Robot, Special-purpose, Manipulation, Home Service Robot

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Authors: Muhammad Mehran Arshad Khan, Chengliang Wang, Zou Minhui, Danyal Badar Soomro

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Security of the smart home in terms of behavior activity pattern recognition is a totally dissimilar and unique issue as compared to the security issues of other scenarios. Sensor devices (low capacity and high capacity) interact and negotiate each other by detecting the daily behavior activity of individuals to execute common tasks. Once a device (e.g., surveillance camera, smart phone and light detection sensor etc.) is compromised, an adversary can then get access to a specific device and can damage daily behavior activity by altering the data and commands. In this scenario, a group of common instruction processes may get involved to generate deadlock. Therefore, an effective suitable security solution is required for smart home architecture. This paper proposes seamless distributed Scheme which fortifies low computational wireless devices for secure communication. Proposed scheme is based on lightweight key-session process to upheld cryptic-link for trajectory by recognizing of individual’s behavior activities pattern. Every device and service provider unit (low capacity sensors (LCS) and high capacity sensors (HCS)) uses an authentication token and originates a secure trajectory connection in network. Analysis of experiments is revealed that proposed scheme strengthens the devices against device seizure attack by recognizing daily behavior activities, minimum utilization memory space of LCS and avoids network from deadlock. Additionally, the results of a comparison with other schemes indicate that scheme manages efficiency in term of computation and communication.

Keywords: Authentication, key-session, security, wireless sensors.

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

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

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

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Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Piero Favino, Luca Preis

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A settlement strategy is to anticipate and respond the needs of existing and future communities through the provision of primary health care facilities in marginalized areas. Access to a health care network is important to improving healthcare coverage, often lacking, in developing countries. The study explores that a good sanitary system strategy of rural contexts brings advantages to an existing settlement: improving transport, communication, water and social facilities. The objective of this paper is to define a possible methodology to implement primary health care facilities in disadvantaged areas of emerging countries. In this research, we analyze the case study of Lauro de Freitas, a municipality in the Brazilian state of Bahia, part of the Metropolitan Region of Salvador, with an area of 57,662 km² and 194.641 inhabitants. The health localization system in Lauro de Freitas is an integrated process that involves not only geographical aspects, but also a set of factors: population density, epidemiological data, allocation of services, road networks, and more. Data were collected also using semi-structured interviews and questionnaires to the local population. Synthesized data suggest that moving away from the coast where there is the greatest concentration of population and services, a network of primary health care facilities is able to improve the living conditions of small-dispersed communities. Based on the health service needs of populations, we have developed a methodological approach that is particularly useful in rural and remote contexts in emerging countries.

Keywords: Primary health care, developing countries, policy health planning, settlement strategy.

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Authors: Aimen Batool Bint-E-Rashid, Syed Muhammad Dawood Ali Shah, Muhammad Usman Farooq, Mahgul Anwar

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As the world is progressing, the needs and demands of the consumer market are also changing. Nowadays the trends of consumer purchase decisions are dependent upon multiple factors. This study aims to identify the influential impact of country of origin over the perception and devotion towards daily personal care products specifically in reference to the knowledge and awareness regarding that particular brand in Pakistan. To corroborate this study, a 30-item brand origin questionnaire has been used with 300 purchase decision makers belonging to different age groups. To illustrate this study, a model has been developed based on brand origin, brand awareness and brand loyalty. Correlation and regression analysis have been used to find out the results which conclude the findings on the perspective of Pakistan’s consumer market as that brand origin has a direct relationship with brand loyalty provided that the consumer has a positive brand awareness. Support for the fact that brand origin impacts brand loyalty through brand awareness has been presented in this study.

Keywords: Brand awareness, brand loyalty, brand origin, personal care products, P&G, Unilever.

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Authors: Erin Lynne Plettenberg, Jeremy Vickery

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In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: Ontology, logic modeling, electronic medical records, information extraction, vetted web mining.

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Authors: Hossam el-ddin Mostafa, Pavel Čičak

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The mobile users with Laptops need to have an efficient access to i.e. their home personal data or to the Internet from any place in the world, regardless of their location or point of attachment, especially while roaming outside the home subnet. An efficient interpretation of packet losses problem that is encountered from this roaming is to the centric of all aspects in this work, to be over-highlighted. The main previous works, such as BER-systems, Amigos, and ns-2 implementation that are considered to be in conjunction with that problem under study are reviewed and discussed. Their drawbacks and limitations, of stopping only at monitoring, and not to provide an actual solution for eliminating or even restricting these losses, are mentioned. Besides that, the framework around which we built a Triple-R sequence as a costeffective solution to eliminate the packet losses and bridge the gap between subnets, an area that until now has been largely neglected, is presented. The results show that, in addition to the high bit error rate of wireless mobile networks, mainly the low efficiency of mobile-IP registration procedure is a direct cause of these packet losses. Furthermore, the output of packet losses interpretation resulted an illustrated triangle of the registration process. This triangle should be further researched and analyzed in our future work.

Keywords: Amigos, BER-systems, ns-2 implementation, packetlosses, registration process, roaming.

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Authors: Kaibalya Prasad Panda, Nirakar Behera, Kamal Lochan Biswal

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The aim of this paper is to combine the concept of wireless power transfer and GSM controlled robot for the application of home automation. The wireless power transfer concept can be well utilized to charge battery of the GSM controlled robot. When the robot has completed its task, it can come to the origin where it can charge itself. Robot can be charged wirelessly, when it is not performing any task. Combination of GSM controlled robot and wireless power transfer provides greater advantage such as; no wastage of charge stored in the battery when the robot is not doing any task. This provides greater reliability that at any instant, robot can do its work once it receives a message through GSM module. GSM module of the robot and user mobile phone must be interfaced properly, so that robot can do task when it receives message from same user mobile phone, not from any other phone. This paper approaches a robotic movement control through the smart phone and control of GSM robot is done by programming in Arduino environment. The commands used in controlling the robot movement are also explained.

Keywords: Arduino, automation, GSM controlled robot, GSM module, wireless power transfer.

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Authors: Darshana Thomas, Edward Wilkie, James Irvine

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The Internet of things (IoT) is currently a highly researched topic, especially within the context of the smart home. These are small sensors that are capable of gathering data and transmitting it to a server. The majority of smart home products use protocols such as ZigBee or Bluetooth Low Energy (BLE). As these small sensors are increasing in number, the need to implement these with much more capable and ubiquitous transmission technology is necessary. The high power consumption is the reason that holds these small sensors back from using other protocols such as the most ubiquitous form of communication, WiFi. Comparing the power consumption of existing transmission technologies to one with WiFi inbuilt, would provide a better understanding for choosing between these technologies. We have developed a small IoT device with WiFi capability and proven that it is much more efficient than the first protocol, 433 MHz. We extend our work in this paper and compare WiFi power consumption with the other most widely used protocol BLE. The experimental results in this paper would conclude whether the developed prototype is capable in terms of power consumption to replace the existing protocol BLE with WiFi.

Keywords: Bluetooth, internet of things, power consumption, WiFi.

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization.

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Authors: Taisuke Sakaki, Toshihiko Shimokawa, Nobuhiro Ushimi, Koji Murakami, Yong-Kwun Lee, Kazuhiro Tsuruta, Kanta Aoki, Kaoru Fujiie, Ryuji Katamoto, Atsushi Sugyo

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Recently attention has been focused on incomplete spinal cord injuries (SCI) to the central spine caused by pressure on parts of the white matter conduction pathway, such as the pyramidal tract. In this paper, we focus on a training robot designed to assist with primary walking-pattern training. The target patient for this training robot is relearning the basic functions of the usual walking pattern; it is meant especially for those with incomplete-type SCI to the central spine, who are capable of standing by themselves but not of performing walking motions. From the perspective of human engineering, we monitored the operator’s actions to the robot and investigated the movement of joints of the lower extremities, the circumference of the lower extremities, and exercise intensity with the machine. The concept of the device was to provide mild training without any sudden changes in heart rate or blood pressure, which will be particularly useful for the elderly and disabled. The mechanism of the robot is modified to be simple and lightweight with the expectation that it will be used at home.

Keywords: Training, rehabilitation, SCI patient, welfare, robot.

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Authors: Antonio Espingardeiro

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It is likely that robots will cross the boundaries of industry into households over the next decades. With demographic challenges worldwide, the future ageing populations will require the introduction of assistive technologies capable of providing, care, human dignity and quality of life through the aging process. Robotics technology has a high potential for being used in the areas of social and healthcare by promoting a wide range of activities such as entertainment, companionship, supervision or cognitive and physical assistance. However such close Human Robotics Interaction (HRI) encompass a rich set of ethical scenarios that need to be addressed before Socially Assistive Robots (SARs) reach the global markets. Such interactions with robots may seem a worthy goal for many technical/financial reasons but inevitably require close attention to the ethical dimensions of such interactions. This article investigates the current HRI benchmark of social success. It revises it according to the ethical principles of beneficence, non-maleficence and justice aligned with social care ethos. An extension of such benchmark is proposed based on an empirical study of HRIs conducted with elderly groups.

Keywords: HRI, SARs, Social Success, Benchmark, Elderly care.

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Authors: Yenni Anggrayni

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The lack of awareness of the significant prevalence of school absenteeism in Indonesia, which ultimately results in high rates of school dropouts, is an unresolved issue. Therefore, this study aims to investigate the root causes of chronic absenteeism qualitatively and quantitatively using the bioecological systems paradigm in secondary schools for any reason. This study used an open-ended questionnaire to collect data from 1,148 students in six West Java Province districts/cities. Univariate and stepwise multiple logistic regression analyses produced a prediction model for the components. Analysis results show that poor teacher-student relationships, bullying by peers or teachers, negative perception of education, and lack of parental involvement in learning activities are the leading causes of chronic absenteeism. Another finding is to promote home-school partnerships to improve school climate and parental involvement in learning to address chronic absenteeism.

Keywords: Bullying, chronic absenteeism, dropout of school, home-school partnerships, parental involvement.

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

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

Keywords: Medical training, conversational agents, patient modeling.

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Authors: Ryuji Yamazaki, Masahiro Kochi, Weiran Zhu, Hiroko Kase

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In care for older adults, behavioral and psychological symptoms of dementia (BPSD) like agitation and aggression are distressing for patients and their caretakers, often resulting in premature institutionalization with increased costs of care. To improve mood and mitigate symptoms, as a non-pharmaceutical approach, emotion-oriented therapy like reminiscence work is adopted in face-to-face communication. Telecommunication support is expected to be provided by robotic media as a bridge for digital divide for those with dementia and facilitate social interaction both verbally and nonverbally. The purpose of this case study is to explore the conditions in which robotic media can effectively attract attention from older adults with dementia and promote their well-being. As a pilot study, we introduced the pillow-phone Hugvie^®, a huggable humanly shaped communication medium to five residents with dementia at a care facility, to investigate how the following conditions work for the elderly when they use the medium; 1) no sound, 2) radio, non-interactive, 3) daily conversation, and 4) reminiscence work. As a result, under condition 4, reminiscence work, the five participants kept concentration in interacting with the medium for a longer duration than other conditions. In condition 4, they also showed larger amount of utterances than under other conditions. These results indicate that providing topics related to personal histories through robotic media could affect communication positively and should, therefore, be further investigated. In addition, the issue of ethical implications by using persuasive technology that affects emotions and behaviors of older adults is also discussed.

Keywords: BPSD, reminiscence, tactile telecommunication, utterances.

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Authors: Ahmed Kamil Hasan Al-Ali, Bouchra Senadji, Ganesh Naik

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We propose a system to real environmental noise and channel mismatch for forensic speaker verification systems. This method is based on suppressing various types of real environmental noise by using independent component analysis (ICA) algorithm. The enhanced speech signal is applied to mel frequency cepstral coefficients (MFCC) or MFCC feature warping to extract the essential characteristics of the speech signal. Channel effects are reduced using an intermediate vector (i-vector) and probabilistic linear discriminant analysis (PLDA) approach for classification. The proposed algorithm is evaluated by using an Australian forensic voice comparison database, combined with car, street and home noises from QUT-NOISE at a signal to noise ratio (SNR) ranging from -10 dB to 10 dB. Experimental results indicate that the MFCC feature warping-ICA achieves a reduction in equal error rate about (48.22%, 44.66%, and 50.07%) over using MFCC feature warping when the test speech signals are corrupted with random sessions of street, car, and home noises at -10 dB SNR.

Keywords: Noisy forensic speaker verification, ICA algorithm, MFCC, MFCC feature warping.

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Authors: Ali Hajiesmaeili, Mehdi Rahimi, Ehsan Jaberi, Amir Abbas Hosseini

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The purpose of this study is investigating the influences of logistics performance on organizational performance including both marketing & financial aspects, and showing the financial impacts of selecting the right marketing and logistics priorities in line with their supply chain type, and also giving the practitioners an advance identification of their priorities and participation types of supply chain, and the best combination of their strategies and resources in this regard. We made use of the original model’s questionnaire to gather all expert’s data and also SPSS and AMOS Ver.22 to analyze the gathered data. CFA method was also used to test whether a relationship between observed variables and their underlying latent constructs exists. Supply chain strategy implementation leads to logistics performance improvement, and marketing performance will be affected as well. Logistics service providers should focus on enhancement of supply chain performance, since logistics performance has been considered as a basis of evaluation of supply chain management strategy. Consequently, performance of the organization will be enhanced. This case is the first research made in Iran that analyzes the relationship between Logistics & Organizational performance in Home Appliances and Home Entertainment companies.

Keywords: Logistics, organizational performance, supply chain, supply chain strategy.

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Authors: M. R. Akshaya, Veena Rao

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Pet population in India is increasing phenomenally owing to the changes in urban lifestyle with increasing number of single professionals, single parents, delayed parenthood etc. The animal companionship as a means of reducing stress levels, deriving emotional support, and unconditional love provided by dogs are a few reasons attributed for increasing pet ownership. The consequence is the booming of the pet care products and dog care centers catering to the different requirements of rearing the pets. Dog care centers quite popular in tier 1 metros of India cater to the requirement of the dog owners providing space for the dogs in absence of the owner. However, it is often reported that the absence of the owner leads to destructive and exploratory behavior issues; the main being the anxiety disorders. In the above context, it becomes imperative for a designer to design dog boarding centers that help in reducing the separation anxiety in dogs keeping in mind the different interior design parameters. An exploratory research with focus group discussion is employed involving a group of dog owners, behaviorists, proprietors of day care as well as boarding centers, and veterinarians to understand their perception on the significance of different interior parameters of color, texture, ventilation, aroma therapy and acoustics as a means of reducing the stress levels in dogs sent to the boarding centers. The data collected is organized as thematic networks thus enabling the listing of the interior design parameters that needs to be considered in designing dog boarding centers. 

Keywords: Behavioral response, design parameters, dog boarding centers, interior environment.

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Authors: Yung-Ting Chang, Chung-You Tsai, Yu-Chuan Li

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Nosocomial (i.e., hospital-acquired) infections (NI) is a major cause of morbidity and mortality in hospitals. NI rate is higher in intensive care units (ICU) than in the general ward due to patients with severe symptoms, poor immunity, and accepted many invasive therapies. Contact behaviors between health caregivers and patients is one of the infect factors. It is difficult to obtain complete contact records by traditional method of retrospective analysis of medical records. This paper establishes a contact history inferential model (CHIM) intended to extend the use of Proximity Sensing of rapid frequency identification (RFID) technology to transferring all proximity events between health caregivers and patients into clinical events (close-in events, contact events and invasive events).The results of the study indicated that the CHIM can infer proximity care activities into close-in events and contact events. The infection control team could redesign and build optimal workflow in the ICU according to the patient-specific contact history which provided by our automatic tracing system.

Keywords: Active Radio Frequency Identification, Intensive Care Unit, Nosocomial Infections

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: Geocoding, chronic disease management, quality of diabetes care, rate ratio.

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Authors: Murat Colak, Berkay Cakir Saridogan

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Since the dawn of modern corporations, almost every single employee has been working in the same loop, which contains three basic steps: going to work, providing the needs for the work, and getting back home. Only a small amount of people was able to break that standard and live outside the box. As the 2019 pandemic hit the Earth and most companies shut down their physical offices, that loop had to change for everyone. This means that the old management styles had to be significantly re-arranged to the "work from home" type of business methods. The methods include online conferences and meetings, time and task tracking using algorithms, globalization of the work, and, most importantly, remote working. After the global epidemic started, even the tech giants were concerned. Now, it can be seen that those technology companies have an incredible step-up in their shares compared to the other companies because they know how to manage such situations even better than every other industry. This study aims to take the old traditional management styles in big companies and compare them with the post-Covid methods (2019-2022). As a result of this comparison made using the annual reports and shared statistics, this study aims to explain why the winners of this crisis are the technology companies.

Keywords: COVID-19, technology companies, business models, remote work.

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Authors: J. A. Batsis, G. G. Boateng, L. M. Seo, C. L. Petersen, K. L. Fortuna, E. V. Wechsler, R. J. Peterson, S. B. Cook, D. Pidgeon, R. S. Dokko, R. J. Halter, D. F. Kotz

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Resistance exercise bands are a core component of any physical activity strengthening program. Strength training can mitigate the development of sarcopenia, the loss of muscle mass or strength and function with aging. Yet, the adherence of such behavioral exercise strategies in a home-based setting are fraught with issues of monitoring and compliance. Our group developed a Bluetooth-enabled resistance exercise band capable of transmitting data to an open-source platform. In this work, we developed an application to capture this information in real-time, and conducted three usability studies in two mixed-aged groups of participants (n=6 each) and a group of older adults with obesity participating in a weight-loss intervention (n=20). The system was favorable, acceptable and provided iterative information that could assist in future deployment on ubiquitous platforms. Our formative work provides the foundation to deliver home-based monitoring interventions in a high-risk, older adult population.

Keywords: Application, mHealth, older adult, resistance exercise band, sarcopenia.

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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: Meenakshi Mahajan, Arun Sharma, Navendu Sharma

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Increasing use of cell phone as a medium of human interaction is playing a vital role in solving riddles of crime as well. A young girl went missing from her home late in the evening in the month of August, 2008 when her enraged relatives and villagers physically assaulted and chased her fiancée who often frequented her home. Two years later, her mother lodged a complaint against the relatives and the villagers alleging that after abduction her daughter was either sold or killed as she had failed to trace her. On investigation, a rusted cell phone with partial visible IMEI number, clothes, bangles, human skeleton etc. recovered from abandoned well in the month of May, 2011 were examined in the lab. All hopes pinned on identity of cell phone, for only linking evidence to fix the scene of occurrence supported by call detail record (CDR) and to dispel doubts about mode of sudden disappearance or death as DNA technology did not help in establishing identity of the deceased. The conventional scientific methods were used without success and international mobile equipment identification number of the cell phone could be generated by using statistical analysis followed by online verification. 

Keywords: Call detail record, Luhn algorithm, stereomicroscope.

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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: Abdulrahim Shamayleh

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In this work, the surgical theater of a local hospital in KSA was analyzed using simulation. The focus was on attempting to answer questions related to how many Operating Rooms (ORs) to open and to analyze the performance of the surgical theater in general and mainly the Post Anesthesia Care Unit (PACU) to assist making decisions regarding PACU staffing. The surgical theater consists of ten operating rooms and the PACU unit which has a maximum capacity of fifteen beds. Different sequencing rules to sequence the surgical cases were tested and the Longest Case First (LCF) were superior to others. The results of the different alternatives developed and tested can be used by the manager as a tool to plan and manage the OR and PACU

Keywords: Operating room, post anesthesia care unit, PACUstaffing, sequencing, healthcare

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