Search results for: hospitals
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 122

Search results for: hospitals

62 Determinants of Knowledge-Based Improving Workflow and Communication within Surgical Team

Authors: J. Bartnicka

Abstract:

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

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

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61 Automated Detection of Alzheimer Disease Using Region Growing technique and Artificial Neural Network

Authors: B. Al-Naami, N. Gharaibeh, A. AlRazzaq Kheshman

Abstract:

Alzheimer is known as the loss of mental functions such as thinking, memory, and reasoning that is severe enough to interfere with a person's daily functioning. The appearance of Alzheimer Disease symptoms (AD) are resulted based on which part of the brain has a variety of infection or damage. In this case, the MRI is the best biomedical instrumentation can be ever used to discover the AD existence. Therefore, this paper proposed a fusion method to distinguish between the normal and (AD) MRIs. In this combined method around 27 MRIs collected from Jordanian Hospitals are analyzed based on the use of Low pass -morphological filters to get the extracted statistical outputs through intensity histogram to be employed by the descriptive box plot. Also, the artificial neural network (ANN) is applied to test the performance of this approach. Finally, the obtained result of t-test with confidence accuracy (95%) has compared with classification accuracy of ANN (100 %). The robust of the developed method can be considered effectively to diagnose and determine the type of AD image.

Keywords: Alzheimer disease, Brain MRI analysis, Morphological filter, Box plot, Intensity histogram, ANN.

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60 Comparison of Seismic Retrofitting Methods for Existing Foundations in Seismological Active Regions

Authors: Peyman Amini Motlagh, Ali Pak

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Seismic retrofitting of important structures is essential in seismological active zones. The importance is doubled when it comes to some buildings like schools, hospitals, bridges etc. because they are required to continue their serviceability even after a major earthquake. Generally, seismic retrofitting codes have paid little attention to retrofitting of foundations due to its construction complexity. In this paper different methods for seismic retrofitting of tall buildings’ foundations will be discussed and evaluated. Foundations are considered in three different categories. First, foundations those are in danger of liquefaction of their underlying soil. Second, foundations located on slopes in seismological active regions. Third, foundations designed according to former design codes and may show structural defects under earthquake loads. After describing different methods used in different countries for retrofitting of the existing foundations in seismological active regions, comprehensive comparison between these methods with regard to the above mentioned categories is carried out. This paper gives some guidelines to choose the best method for seismic retrofitting of tall buildings’ foundations in retrofitting projects.

Keywords: Existing foundation, landslide, liquefaction, seismic retrofitting.

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59 Acute Coronary Syndrome Prediction Using Data Mining Techniques- An Application

Authors: Tahseen A. Jilani, Huda Yasin, Madiha Yasin, C. Ardil

Abstract:

In this paper we use data mining techniques to investigate factors that contribute significantly to enhancing the risk of acute coronary syndrome. We assume that the dependent variable is diagnosis – with dichotomous values showing presence or  absence of disease. We have applied binary regression to the factors affecting the dependent variable. The data set has been taken from two different cardiac hospitals of Karachi, Pakistan. We have total sixteen variables out of which one is assumed dependent and other 15 are independent variables. For better performance of the regression model in predicting acute coronary syndrome, data reduction techniques like principle component analysis is applied. Based on results of data reduction, we have considered only 14 out of sixteen factors.

Keywords: Acute coronary syndrome (ACS), binary logistic regression analyses, myocardial ischemia (MI), principle component analysis, unstable angina (U.A.).

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58 Energy Efficient Shading Strategies for Windows of Hospital ICUs in the Desert

Authors: A. Sherif, A. El Zafarany, R. Arafa

Abstract:

Hospitals, everywhere, are considered heavy energy consumers. Hospital Intensive Care Unit spaces pose a special challenge, where design guidelines requires the provision of external windows for daylighting and external view. Window protection strategies could be employed to reduce energy loads without detriment effect on comfort or health care. This paper addresses the effectiveness of using various window strategies on the annual cooling, heating and lighting energy use of a typical Hospital Intensive Unit space. Series of experiments were performed using the EnergyPlus simulation software for a typical Intensive Care Unit (ICU) space in Cairo, located in the Egyptian desert. This study concluded that the use of shading systems is more effective in conserving energy in comparison with glazing of different types, in the Cairo ICUs. The highest energy savings in the West and South orientations were accomplished by external perforated solar screens, followed by overhangs positioned at a protection angle of 45°.

Keywords: Energy, Hospital, Intensive Care Units, Shading.

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57 A Robust Optimization Method for Service Quality Improvement in Health Care Systems under Budget Uncertainty

Authors: H. Ashrafi, S. Ebrahimi, H. Kamalzadeh

Abstract:

With the development of business competition, it is important for healthcare providers to improve their service qualities. In order to improve service quality of a clinic, four important dimensions are defined: tangibles, responsiveness, empathy, and reliability. Moreover, there are several service stages in hospitals such as financial screening and examination. One of the most challenging limitations for improving service quality is budget which impressively affects the service quality. In this paper, we present an approach to address budget uncertainty and provide guidelines for service resource allocation. In this paper, a service quality improvement approach is proposed which can be adopted to multistage service processes to improve service quality, while controlling the costs. A multi-objective function based on the importance of each area and dimension is defined to link operational variables to service quality dimensions. The results demonstrate that our approach is not ultra-conservative and it shows the actual condition very well. Moreover, it is shown that different strategies can affect the number of employees in different stages.

Keywords: Service quality assessment, healthcare resource allocation, robust optimization, budget uncertainty.

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56 Security Architecture for At-Home Medical Care Using Sensor Network

Authors: S.S.Mohanavalli, Sheila Anand

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

Keywords: data confidentiality, integrity, remotemonitoring, source authentication

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55 The Design of the HL7 RIM-based Sharing Components for Clinical Information Systems

Authors: Wei-Yi Yang, Li-Hui Lee, Hsiao-Li Gien, Hsing-Yi Chu, Yi-Ting Chou, Der-Ming Liou

Abstract:

The American Health Level Seven (HL7) Reference Information Model (RIM) consists of six back-bone classes that have different specialized attributes. Furthermore, for the purpose of enforcing the semantic expression, there are some specific mandatory vocabulary domains have been defined for representing the content values of some attributes. In the light of the fact that it is a duplicated effort on spending a lot of time and human cost to develop and modify Clinical Information Systems (CIS) for most hospitals due to the variety of workflows. This study attempts to design and develop sharing RIM-based components of the CIS for the different business processes. Therefore, the CIS contains data of a consistent format and type. The programmers can do transactions with the RIM-based clinical repository by the sharing RIM-based components. And when developing functions of the CIS, the sharing components also can be adopted in the system. These components not only satisfy physicians- needs in using a CIS but also reduce the time of developing new components of a system. All in all, this study provides a new viewpoint that integrating the data and functions with the business processes, it is an easy and flexible approach to build a new CIS.

Keywords: HL7, Reference Information Model (RIM), web service, process management.

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54 Managing an Acute Pain Unit Based on the Balanced Scorecard

Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho

Abstract:

The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Keywords: Acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal.

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53 Reducing Unplanned Extubation in Psychiatric LTC

Authors: Jih-Rue Pan, Feng-Chuan Pan

Abstract:

Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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52 Design and Performance Evaluation of Hybrid Corrugated-GFRP Infill Panels

Authors: WooYoung Jung, HoYoung Son

Abstract:

This study presented to reduce earthquake damage and emergency rehabilitation of critical structures such as schools, hightech factories, and hospitals due to strong ground motions associated with climate changes. Regarding recent trend, a strong earthquake causes serious damage to critical structures and then the critical structure might be influenced by sequence aftershocks (or tsunami) due to fault plane adjustments. Therefore, in order to improve seismic performance of critical structures, retrofitted or strengthening study of the structures under aftershocks sequence after emergency rehabilitation of the structures subjected to strong earthquakes is widely carried out. Consequently, this study used composite material for emergency rehabilitation of the structure rather than concrete and steel materials because of high strength and stiffness, lightweight, rapid manufacturing, and dynamic performance. Also, this study was to develop or improve the seismic performance or seismic retrofit of critical structures subjected to strong ground motions and earthquake aftershocks, by utilizing GFRP-Corrugated Infill Panels (GCIP).

Keywords: Composite material, GFRP, Infill Panel, Aftershock, Seismic Retrofitting.

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51 Robotic Assistance in Nursing Care: Survey on Challenges and Scenarios

Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

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Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: Robotics and automation, engineering management, engineering in medicine and biology, medical services, public healthcare.

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50 A Multimedia Telemonitoring Network for Healthcare

Authors: Hariton N. Costin, Sorin Puscoci, Cristian Rotariu, Bogdan Dionisie, Marinela C. Cimpoesu

Abstract:

TELMES project aims to develop a securized multimedia system devoted to medical consultation teleservices. It will be finalized with a pilot system for a regional telecenters network that connects local telecenters, having as support multimedia platforms. This network will enable the implementation of complex medical teleservices (teleconsulations, telemonitoring, homecare, urgency medicine, etc.) for a broader range of patients and medical professionals, mainly for family doctors and those people living in rural or isolated regions. Thus, a multimedia, scalable network, based on modern IT&C paradigms, will result. It will gather two inter-connected regional telecenters, in Iaşi and Piteşti, Romania, each of them also permitting local connections of hospitals, diagnostic and treatment centers, as well as local networks of family doctors, patients, even educational entities. As communications infrastructure, we aim to develop a combined fixmobile- internet (broadband) links. Other possible communication environments will be GSM/GPRS/3G and radio waves. The electrocardiogram (ECG) acquisition, internet transmission and local analysis, using embedded technologies, was already successfully done for patients- telemonitoring.

Keywords: Healthcare, telemedicine, telemonitoring, ECG analysis.

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49 Development of Soft-Core System for Heart Rate and Oxygen Saturation

Authors: Caje F. Pinto, Jivan S. Parab, Gourish M. Naik

Abstract:

This paper is about the development of non-invasive heart rate and oxygen saturation in human blood using Altera NIOS II soft-core processor system. In today's world, monitoring oxygen saturation and heart rate is very important in hospitals to keep track of low oxygen levels in blood. We have designed an Embedded System On Peripheral Chip (SOPC) reconfigurable system by interfacing two LED’s of different wavelengths (660 nm/940 nm) with a single photo-detector to measure the absorptions of hemoglobin species at different wavelengths. The implementation of the interface with Finger Probe and Liquid Crystal Display (LCD) was carried out using NIOS II soft-core system running on Altera NANO DE0 board having target as Cyclone IVE. This designed system is used to monitor oxygen saturation in blood and heart rate for different test subjects. The designed NIOS II processor based non-invasive heart rate and oxygen saturation was verified with another Operon Pulse oximeter for 50 measurements on 10 different subjects. It was found that the readings taken were very close to the Operon Pulse oximeter.

Keywords: Heart rate, NIOS II, Oxygen Saturation, photoplethysmography, soft-core, SOPC.

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48 Building an Inferential Model between Caregivers and Patients by using RFID

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

Abstract:

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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47 The Use of SD Bioline TB AgMPT64® Detection Assay for Rapid Characterization of Mycobacteria in Nigeria

Authors: S. Ibrahim, U. B. Abubakar, S. Danbirni, A. Usman, F. M. Ballah, C. A. Kudi, L. Lawson, G. H. Abdulrazak, I. A. Abdulkadir

Abstract:

Performing culture and characterization of mycobacteria in low resource settings like Nigeria is a very difficult task to undertake because of the very few and limited laboratories carrying out such an experiment; this is a largely due to stringent and laborious nature of the tests. Hence, a rapid, simple and accurate test for characterization is needed. The “SD BIOLINE TB Ag MPT 64 Rapid ®” is a simple and rapid immunochromatographic test used in differentiating Mycobacteria into Mycobacterium tuberculosis (NTM). The 100 sputa were obtained from patients suspected to be infected with tuberculosis and presented themselves to hospitals for check-up and treatment were involved in the study. The samples were cultured in a class III Biosafety cabinet and level III biosafety practices were followed. Forty isolates were obtained from the cultured sputa, and there were identified as Acid-fast bacilli (AFB) using Zeihl-Neelsen acid-fast stain. All the isolates (AFB positive) were then subjected to the SD BIOLINE Analyses. A total of 31 (77.5%) were characterized as MTBC, while nine (22.5%) were NTM. The total turnaround time for the rapid assay was just 30 minutes as compared to a few days of phenotypic and genotypic method. It was simple, rapid and reliable test to differentiate MTBC from NTM.

Keywords: Culture, mycobacteria, non-tuberculous mycobacteria, SD bioline.

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46 A Real Time Ultra-Wideband Location System for Smart Healthcare

Authors: Mingyang Sun, Guozheng Yan, Dasheng Liu, Lei Yang

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Driven by the demand of intelligent monitoring in rehabilitation centers or hospitals, a high accuracy real-time location system based on UWB (ultra-wideband) technology was proposed. The system measures precise location of a specific person, traces his movement and visualizes his trajectory on the screen for doctors or administrators. Therefore, doctors could view the position of the patient at any time and find them immediately and exactly when something emergent happens. In our design process, different algorithms were discussed, and their errors were analyzed. In addition, we discussed about a , simple but effective way of correcting the antenna delay error, which turned out to be effective. By choosing the best algorithm and correcting errors with corresponding methods, the system attained a good accuracy. Experiments indicated that the ranging error of the system is lower than 7 cm, the locating error is lower than 20 cm, and the refresh rate exceeds 5 times per second. In future works, by embedding the system in wearable IoT (Internet of Things) devices, it could provide not only physical parameters, but also the activity status of the patient, which would help doctors a lot in performing healthcare.

Keywords: Intelligent monitoring, IoT devices, real-time location, smart healthcare, ultra-wideband technology.

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45 Multi-Agent Simulation of Wayfinding for Rescue Operation during Building Fire

Authors: G. Sokhansefat, M. Delavar, M. Banedj-Schafii

Abstract:

Recently research on human wayfinding has focused mainly on mental representations rather than processes of wayfinding. The objective of this paper is to demonstrate the rationality behind applying multi-agent simulation paradigm to the modeling of rescuer team wayfinding in order to develop computational theory of perceptual wayfinding in crisis situations using image schemata and affordances, which explains how people find a specific destination in an unfamiliar building such as a hospital. The hypothesis of this paper is that successful navigation is possible if the agents are able to make the correct decision through well-defined cues in critical cases, so the design of the building signage is evaluated through the multi-agent-based simulation. In addition, a special case of wayfinding in a building, finding one-s way through three hospitals, is used to demonstrate the model. Thereby, total rescue time for rescue operation during building fire is computed. This paper discuses the computed rescue time for various signage localization and provides experimental result for optimization of building signage design. Therefore the most appropriate signage design resulted in the shortest total rescue time in various situations.

Keywords: Multi-Agent system (MAS), Spatial Cognition, Wayfinding, Indoor Environment, Geospatial Information System (GIS).

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44 Blood Glucose Level Measurement from Breath Analysis

Authors: Tayyab Hassan, Talha Rehman, Qasim Abdul Aziz, Ahmad Salman

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The constant monitoring of blood glucose level is necessary for maintaining health of patients and to alert medical specialists to take preemptive measures before the onset of any complication as a result of diabetes. The current clinical monitoring of blood glucose uses invasive methods repeatedly which are uncomfortable and may result in infections in diabetic patients. Several attempts have been made to develop non-invasive techniques for blood glucose measurement. In this regard, the existing methods are not reliable and are less accurate. Other approaches claiming high accuracy have not been tested on extended dataset, and thus, results are not statistically significant. It is a well-known fact that acetone concentration in breath has a direct relation with blood glucose level. In this paper, we have developed the first of its kind, reliable and high accuracy breath analyzer for non-invasive blood glucose measurement. The acetone concentration in breath was measured using MQ 138 sensor in the samples collected from local hospitals in Pakistan involving one hundred patients. The blood glucose levels of these patients are determined using conventional invasive clinical method. We propose a linear regression classifier that is trained to map breath acetone level to the collected blood glucose level achieving high accuracy.

Keywords: Blood glucose level, breath acetone concentration, diabetes, linear regression.

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43 Hybrid Authentication System Using QR Code with OTP

Authors: Salim Istyaq

Abstract:

As we know, number of Internet users are increasing drastically. Now, people are using different online services provided by banks, colleges/schools, hospitals, online utility, bill payment and online shopping sites. To access online services, text-based authentication system is in use. The text-based authentication scheme faces some drawbacks with usability and security issues that bring troubles to users. The core element of computational trust is identity. The aim of the paper is to make the system more compliable for the imposters and more reliable for the users, by using the graphical authentication approach. In this paper, we are using the more powerful tool of encoding the options in graphical QR format and also there will be the acknowledgment which will send to the user’s mobile for final verification. The main methodology depends upon the encryption option and final verification by confirming a set of pass phrase on the legal users, the outcome of the result is very powerful as it only gives the result at once when the process is successfully done. All processes are cross linked serially as the output of the 1st process, is the input of the 2nd and so on. The system is a combination of recognition and pure recall based technique. Presented scheme is useful for devices like PDAs, iPod, phone etc. which are more handy and convenient to use than traditional desktop computer systems.

Keywords: Graphical Password, OTP, QR Codes, Recognition based graphical user authentication, usability and security.

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42 Bioclimatic Design, Evaluation of Energy Behavior and Energy-Saving Interventions at the Theagenio Cancer Hospital

Authors: Emmanouel Koumoulas, Aikaterini Rokkou, Marios Moschakis

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Theagenio" in Thessaloniki exists and works for three centuries now as a hospital. Since 1975, it has been operating as an Integrated Special Cancer Hospital and since 1985 it has been integrated into the National Health System. "Theagenio" Cancer Hospital is located at the central web of Thessaloniki residential complex and consists of two buildings, the "Symeonidio Research Center", which was completed in 1962 and the Nursing Ward, a project that was later completed in 1975. This paper examines the design of the Hospital Unit according to the requirements of the energy design of buildings. Initially, the energy characteristics of the Hospital are recorded, followed by a detailed presentation of the electromechanical installations. After the existing situation has been captured and with the help of the software TEE-KENAK, different scenarios for the energy upgrading of the buildings have been studied. Proposals for upgrading concern both the shell, e.g. installation of external thermal insulation, replacement of frames, addition of shading systems, etc. as well as electromechanical installations, e.g. use of ceiling fans, improvements in heating and cooling systems, interventions in lighting, etc. The simulation calculates the future energy status of the buildings and presents the economic benefits of the proposed interventions with reference to the environmental profits that arise.

Keywords: Energy consumption in hospitals, energy saving interventions, energy upgrading, hospital facilities.

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41 Nurses’ Views on ‘Effective Nurse Leader’ Characteristics in Iraq

Authors: S. Abed, S. O’Neill

Abstract:

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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40 High Speed Video Transmission for Telemedicine using ATM Technology

Authors: J. P. Dubois, H. M. Chiu

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In this paper, we study statistical multiplexing of VBR video in ATM networks. ATM promises to provide high speed realtime multi-point to central video transmission for telemedicine applications in rural hospitals and in emergency medical services. Video coders are known to produce variable bit rate (VBR) signals and the effects of aggregating these VBR signals need to be determined in order to design a telemedicine network infrastructure capable of carrying these signals. We first model the VBR video signal and simulate it using a generic continuous-data autoregressive (AR) scheme. We carry out the queueing analysis by the Fluid Approximation Model (FAM) and the Markov Modulated Poisson Process (MMPP). The study has shown a trade off: multiplexing VBR signals reduces burstiness and improves resource utilization, however, the buffer size needs to be increased with an associated economic cost. We also show that the MMPP model and the Fluid Approximation model fit best, respectively, the cell region and the burst region. Therefore, a hybrid MMPP and FAM completely characterizes the overall performance of the ATM statistical multiplexer. The ramifications of this technology are clear: speed, reliability (lower loss rate and jitter), and increased capacity in video transmission for telemedicine. With migration to full IP-based networks still a long way to achieving both high speed and high quality of service, the proposed ATM architecture will remain of significant use for telemedicine.

Keywords: ATM, multiplexing, queueing, telemedicine, VBR.

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39 Applying the Regression Technique for Prediction of the Acute Heart Attack

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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38 Calibration of Syringe Pumps Using Interferometry and Optical Methods

Authors: E. Batista, R. Mendes, A. Furtado, M. C. Ferreira, I. Godinho, J. A. Sousa, M. Alvares, R. Martins

Abstract:

Syringe pumps are commonly used for drug delivery in hospitals and clinical environments. These instruments are critical in neonatology and oncology, where any variation in the flow rate and drug dosing quantity can lead to severe incidents and even death of the patient. Therefore it is very important to determine the accuracy and precision of these devices using the suitable calibration methods. The Volume Laboratory of the Portuguese Institute for Quality (LVC/IPQ) uses two different methods to calibrate syringe pumps from 16 nL/min up to 20 mL/min. The Interferometric method uses an interferometer to monitor the distance travelled by a pusher block of the syringe pump in order to determine the flow rate. Therefore, knowing the internal diameter of the syringe with very high precision, the travelled distance, and the time needed for that travelled distance, it was possible to calculate the flow rate of the fluid inside the syringe and its uncertainty. As an alternative to the gravimetric and the interferometric method, a methodology based on the application of optical technology was also developed to measure flow rates. Mainly this method relies on measuring the increase of volume of a drop over time. The objective of this work is to compare the results of the calibration of two syringe pumps using the different methodologies described above. The obtained results were consistent for the three methods used. The uncertainties values were very similar for all the three methods, being higher for the optical drop method due to setup limitations.

Keywords: Calibration, interferometry, syringe pump, optical method, uncertainty.

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37 Impact of Hepatitis C Virus Chronic Infection on Quality of Life in Egypt

Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

Abstract:

The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL), its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know how to cope with having a family member with hepatitis C and more importantly to know what should you say and what shouldn’t you say as a positive hopeful attitude is essential for combating HCV chronic infection.

Keywords: Hepatitis C virus chronic infection, physical health component and mental health component of QoL, total quality of life.

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36 A Profile of Recent Upsurge of Brucellosis of Veterinary Health Care Workers Engaged in Brucella Vaccination Program in West Bengal, India

Authors: Satadal Das, Parthasarathi Sengupta

Abstract:

With millions of livestock wealth in India including cattle, and buffaloes, the National Animal Disease Control Program targeted a massive Brucella vaccination program. As a part of it in the state of West Bengal Veterinary healthcare assistants participated in the program in 2021. The aim of this study was to elucidate the burden of brucellosis in those healthcare assistants and to pinpoint the main causes of such infection. We contacted the healthcare assistants to find out whether they were infected during the vaccination program. Our findings indicated many Veterinary healthcare assistants who participated in the program developed symptoms and signs suggestive of brucellosis. Laboratory tests indicated many confirmed Brucellosis cases. However, this may not include many asymptomatic cases. Detailed analysis revealed that in most of them there was a history of needle prick injury about a month back during the vaccination program, which was mainly due to ferocious or disturbed animals. Few also complained that they were not properly trained or proper personal protective types of equipment were not provided. All of them were treated in referral hospitals following a standard protocol of the Government Health Department and now they are followed up. Thus we conclude that proper care during the vaccination of animals should be followed, prophylactic treatment for needle prick injuries should be given, and training and supply of personal protective equipment should be monitored.

Keywords: Occupational brucellosis, needle prick injury, brucella vaccination, personal protective equipment.

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35 Culture Dimensions of Information Systems Security in Saudi Arabia National Health Services

Authors: Saleh Alumaran, Giampaolo Bella, Feng Chen

Abstract:

The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified a set of cultural and sub-cultural dimensions in SA health information security and services.

Keywords: Behaviour theory, Culture dimensions, Electronic health records, Information security.

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34 Standard Deviation of Mean and Variance of Rows and Columns of Images for CBIR

Authors: H. B. Kekre, Kavita Patil

Abstract:

This paper describes a novel and effective approach to content-based image retrieval (CBIR) that represents each image in the database by a vector of feature values called “Standard deviation of mean vectors of color distribution of rows and columns of images for CBIR". In many areas of commerce, government, academia, and hospitals, large collections of digital images are being created. This paper describes the approach that uses contents as feature vector for retrieval of similar images. There are several classes of features that are used to specify queries: colour, texture, shape, spatial layout. Colour features are often easily obtained directly from the pixel intensities. In this paper feature extraction is done for the texture descriptor that is 'variance' and 'Variance of Variances'. First standard deviation of each row and column mean is calculated for R, G, and B planes. These six values are obtained for one image which acts as a feature vector. Secondly we calculate variance of the row and column of R, G and B planes of an image. Then six standard deviations of these variance sequences are calculated to form a feature vector of dimension six. We applied our approach to a database of 300 BMP images. We have determined the capability of automatic indexing by analyzing image content: color and texture as features and by applying a similarity measure Euclidean distance.

Keywords: Standard deviation Image retrieval, color distribution, Variance, Variance of Variance, Euclidean distance.

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33 Steps towards the Development of National Health Data Standards in Developing Countries: An Exploratory Qualitative Study in Saudi Arabia

Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian R. Murray

Abstract:

The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: Interoperability, Case Study, Health Data Standards, Medical Data Exchange, Saudi Arabia.

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