Search results for: lean healthcare

Authors: Gerrit Alves, Jürgen Roßmann, Roland Wischnewski

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Today, transport and logistic systems are often tightly integrated in the production. Lean production and just-in-time delivering create multiple constraints that have to be fulfilled. As transport networks often have evolved over time they are very expensive to change. This paper describes a discrete-event-simulation system which simulates transportation models using real time resource routing and collision avoidance. It allows for the specification of own control algorithms and validation of new strategies. The simulation is integrated into a virtual reality (VR) environment and can be displayed in 3-D to show the progress. Simulation elements can be selected through VR metaphors. All data gathered during the simulation can be presented as a detailed summary afterwards. The included cost-benefit calculation can help to optimize the financial outcome. The operation of this approach is shown by the example of a timber harvest simulation.

Keywords: Discrete-Event-Simulation, Logistic, Simulation, Virtual Reality.

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Authors: Slim Yacoub, Kosai Raoof

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The aim of this study was to remove the two principal noises which disturb the surface electromyography signal (Diaphragm). These signals are the electrocardiogram ECG artefact and the power line interference artefact. The algorithm proposed focuses on a new Lean Mean Square (LMS) Widrow adaptive structure. These structures require a reference signal that is correlated with the noise contaminating the signal. The noise references are then extracted : first with a noise reference mathematically constructed using two different cosine functions; 50Hz (the fundamental) function and 150Hz (the first harmonic) function for the power line interference and second with a matching pursuit technique combined to an LMS structure for the ECG artefact estimation. The two removal procedures are attained without the use of supplementary electrodes. These techniques of filtering are validated on real records of surface diaphragm electromyography signal. The performance of the proposed methods was compared with already conducted research results.

Keywords: Surface EMG, Adaptive, Matching Pursuit, Powerline interference.

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Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: Malpractice mediation, medical disputes, reconciliation, health litigation, Turkish Health Law.

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Authors: M. Z. Othman, S. Uludag-Demirer, G. N. Demirer

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One of the main challenges for one phase anaerobic digestion processes is the high concentration of NH4+ and PO4 3- ions  in the digested sludge supernatant. This project focuses on enhancing the removal of nutrients during the anaerobic digestion process through fixing both NH4+ and PO4 3- ions in the form of struvite (magnesium ammonium phosphate, MAP, MgNH4PO4.6H2O) within the anaerobic sludge. Batch anaerobic digestion tests showed that Mg2+ concentration in the range 279 – 812 mg/L had insignificant effect on CGP but incurred a slight increase in COD removal. The reactor that had soluble Mg2+:NH4+:PO43- at a molar ratio of 1.28:1:00:1:00 achieved the best performance enhancement of 8% increase in COD removal and 32% reduction in NH4+ in the reactor supernatant. Overall, the results show that there is a potential to optimise conventional anaerobic digestion such that supernatant lean in P and N, and sludge rich in nutrients are obtained. 

Keywords: Anaerobic Digestion, Nutrients, Struvite, Waste Activated Sludge (WAS)

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Authors: Sarbjot Singh Sandhu

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This paper presents the experimental results of a single cylinder Enfield engine using an electronically controlled fuel injection system which was developed to carry out exhaustive tests using neat CNG, and mixtures of hydrogen in compressed natural gas (HCNG) as 0, 5, 10, 15 and 20% by energy. Experiments were performed at 2000 and 2400 rpm with wide open throttle and varying the equivalence ratio. Hydrogen which has fast burning rate, when added to compressed natural gas, enhances its flame propagation rate. The emissions of HC, CO, decreased with increasing percentage of hydrogen but NOx was found to increase. The results indicated a marked improvement in the brake thermal efficiency with the increase in percentage of hydrogen added. The improved thermal efficiency was clearly observed to be more in lean region as compared to rich region. This study is expected to reduce vehicular emissions along with increase in thermal efficiency and thus help in reduction of further environmental degradation.

Keywords: Hydrogen, CNG, HCNG, Emissions.

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Authors: Christopher C. Anyadubalu

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Biological, psychological and social experiences and perceptions of healthcare services in patients medically diagnosed of coronary heart disease were investigated using a sample of 10 participants whose responses to the in-depth interview questions were analyzed based on inter-and-intra-case analyses. The results obtained revealed that advancing age, single status, divorce and/or death of spouse and the issue of single parenting negatively impacted patients- biopsychosocial experiences. The patients- experiences of physical signs and symptoms, anxiety and depression, past serious medical conditions, use of self-prescribed medications, family history of poor mental/medical or physical health, nutritional problems and insufficient physical activities heightened their risk of coronary attack. Collectivist culture served as a big source of relieve to the patients. Patients- temperament, experience of different chronic life stresses/challenges, mood alteration, regular drinking, smoking/gambling, and family/social impairments compounded their health situation. Patients were satisfied with the biomedical services rendered by the healthcare personnel, whereas their psychological and social needs were not attended to. Effective procedural treatment model, a holistic and multidimensional approach to the treatment of heart disease patients was proposed.

Keywords: Biopsychosocial, Coronary Heart Disease, Experience, Patients, Perception, Perspective.

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Authors: M. S. Khurram, S. A. Memon, S. Khan

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Bed voidage behavior among different flow regimes for Geldart A, B, and D particles (fluid catalytic cracking catalyst (FCC), particle A and glass beads) of diameter range 57-872 μm, apparent density 1470-3092 kg/m³, and bulk density range 890-1773 kg/m³ were investigated in a gas-solid circulating fluidized bed of 0.1 m-i.d. and 2.56 m-height of plexi-glass. Effects of variables (gas velocity, particle properties, and static bed height) were analyzed on bed voidage. The axial voidage profile showed a typical trend along the riser: a dense bed at the lower part followed by a transition in the splash zone and a lean phase in the freeboard. Bed expansion and dense bed voidage increased with an increase of gas velocity as usual. From experimental results, a generalized model relationship based on inverse fluidization number for dense bed voidage from bubbling to fast fluidization regimes was presented.

Keywords: Axial voidage, circulating fluidized bed, splash zone, static bed.

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Authors: Ibrahim A. Alkali

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There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: Caregiving, Inpatient setting, Integration, Patient Families.

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Authors: Rujijan Vichivanives

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This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: Developing, Herbs, Knowledge-based system, Medical treatment.

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Authors: Farhan Ismaeel Dakheel, Raoof Smko, K. Negrat, Abdelsalam Almarimi

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In this paper we used data mining techniques to identify outlier patients who are using large amount of drugs over a long period of time. Any healthcare or health insurance system should deal with the quantities of drugs utilized by chronic diseases patients. In Kingdom of Bahrain, about 20% of health budget is spent on medications. For the managers of healthcare systems, there is no enough information about the ways of drug utilization by chronic diseases patients, is there any misuse or is there outliers patients. In this work, which has been done in cooperation with information department in the Bahrain Defence Force hospital; we select the data for Cardiac patients in the period starting from 1/1/2008 to December 31/12/2008 to be the data for the model in this paper. We used three techniques for finding the drug utilization for cardiac patients. First we applied a clustering technique, followed by measuring of clustering validity, and finally we applied a decision tree as classification algorithm. The clustering results is divided into three clusters according to the drug utilization, for 1603 patients, who received 15,806 prescriptions during this period can be partitioned into three groups, where 23 patients (2.59%) who received 1316 prescriptions (8.32%) are classified to be outliers. The classification algorithm shows that the use of average drug utilization and the age, and the gender of the patient can be considered to be the main predictive factors in the induced model.

Keywords: Data Mining, Clustering, Classification, Drug Utilization..

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Authors: Ntokozo C. Mthembu

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The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: Traditional healing system, healers, pluralist healthcare system, post-colonial era.

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Authors: Walid MOUDANI

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The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the Coronary Heart Disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts- knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: Multi-Classifier Decisions Tree, Features Reduction, Dynamic Programming, Rough Sets.

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Authors: José A. D. Machuca, Bernabé Escobar-Pérez, Pedro Garrido Vega, Darkys E. Lujan García

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Starting with an analysis of the financial and operational indicators that can be found in the specialised literature, this study aims to contribute to improvements in the performance measurement systems used when the unit of analysis is the manufacturing plant. For this a search was done in the highest impact Journals of Production and Operations Management and Management Accounting , with the aim of determining the financial and operational indicators used to evaluate performance when Advanced Production Practices have been implemented, more specifically when the practices implemented are Total Quality Management, JIT/Lean Manufacturing and Total Productive Maintenance. This has enabled us to obtain a classification of the two types of indicators based on how much each is used. For the financial indicators we have also prepared a proposal that can be adapted to manufacturing plants- accounting features. In the near future we will propose a model that links practices implementation with financial and operational indicators and these two last with each other. We aim to will test this model empirically with the data obtained in the High Performance Manufacturing Project.

Keywords: Advanced Production Practices, Financial Indicators, Non-Financial Indicators

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Authors: Charles Mbohwa, Gift Nyambe

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The paper reviews South Africa’s industrialization, the basis of its formation and to establish whether it can be expanded using technology transfer mechanisms principles. It also seek to draw comparisons from other industrialized countries and as a baseline, and take lessons on how these industrialized countries have achieved their secondary industrialization; hence they are known as the developed countries. It identifies the challenges faced by South Africa’s current industrial base and recommend ways that could be meaningful in assisting it to be expandable. It also seeks to contribute to the existing body of knowledge on industrialization and technology transfer in advancing industry formation. It is also the intention of the paper to look at best principles outlined in operations management theories on how they could be of value in strengthening industrial formation and expansion. These principles include but not limited to the application of lean manufacturing principles, however they are not only applicable to the manufacturing sector but to any business optimization strategy. There will be emphasize on the role of the primary sector in South Africa’s industrialization and the opportunities it ought to bring in strengthening and harnessing the success of the secondary sector formation.

Keywords: Industrialization, Expansion, operations and Technology transfer.

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Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

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Dropout rates in higher educational institutions pose significant challenges for both students and institutions, with poor mental health (MH) emerging as a key risk factor. Healthcare college students, including medical students, are particularly vulnerable to MH issues due to the demanding academic schedules they face. Poor mental health (MH) would be considered as a key risk factor for dropout from higher educational institutions that pose significant challenges for both students and institutions. And, inadequate food access (FA) has been related to poor MH. Given that targeted students may experience multiple risk factors for poor MH and vulnerable FA, the study aims to clarify the relationship between MH and FA to enhance student well-being. A cross-sectional design was used to explore the association between MH status and FA among 421 students (147 male, 274 female). Participants completed two questionnaires assessing MH and FA during winter 2022. The mean MH score was 6.7 ± 4.6, with higher scores indicating worse MH (max. score 27). While year-round FA showed no significant association with MH, FA during winter was significantly associated with MH (p = 0.01). Although car ownership did not directly impact MH, it was significantly associated with FA (p < 0.01), thus indirectly influencing MH. Our findings underscore the importance of FA in promoting MH, particularly during winter. Adopting a lifestyle that facilitates easier FA may be beneficial for MH, given its indirect association with MH outcomes. These insights emphasize the significance of addressing FA-related challenges to enhance student’s mental well-being.

Keywords: Mental health, food access, co-medical students, lifestyle.

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

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: Architectural typology, Developing countries, Local construction techniques, Primary health care.

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

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

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

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Authors: Frank C. Pan, Che-Long Su, Ching-Hsuen Chen

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Background, measuring an individual-s Health Literacy is gaining attention, yet no appropriate instrument is available in Taiwan. Measurement tools that were developed and used in western countries may not be appropriate for use in Taiwan due to a different language system. Purpose of this research was to develop a Health Literacy measurement instrument specific for Taiwan adults. Methods, several experts of clinic physicians; healthcare administrators and scholars identified 125 common used health related Chinese phrases from major medical knowledge sources that easy accessible to the public. A five-point Likert scale is used to measure the understanding level of the target population. Such measurement is then used to compare with the correctness of their answers to a health knowledge test for validation. Samples, samples under study were purposefully taken from four groups of people in the northern Pingtung, OPD patients, university students, community residents, and casual visitors to the central park. A set of health knowledge index with 10 questions is used to screen those false responses. A sample size of 686 valid cases out of 776 was then included to construct this scale. An independent t-test was used to examine each individual phrase. The phrases with the highest significance are then identified and retained to compose this scale. Result, a Taiwan Health Literacy Scale (THLS) was finalized with 66 health-related phrases under nine divisions. Cronbach-s alpha of each division is at a satisfactory level of 89% and above. Conclusions, factors significantly differentiate the levels of health literacy are education, female gender, age, family members of stroke victims, experience with patient care, and healthcare professionals in the initial application in this study..

Keywords: Health literacy, health knowledge, REALM, THLS.

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

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

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

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Authors: Makkia, Ahmad, Al-Falahi, Abdullah Abdelaziz Muharram

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Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. The current study aimed to assess sng the prevalence of ‎occupational health hazards among Health care workers and associated ‎risk factors in public hospitals in Sana'a City, Yemen. Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. More the half (60.6%) of HCWs were aged between 20-30 years, 50.8% were males, 56.3% were married, and 45.5% had a diploma qualification, while 65.2% of HCWs had less than 6 years of experience. The results show a high prevalence of occupational hazards (99%); ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p > 0.05). The study revealed that occupational hazards were highly prevalent among the participants. The most common biological hazard was exposure to sharp-related injuries, while the predominant physical hazard was slip, trip, and fall incidents. Ergonomic hazards manifested as back or neck pain during work. Chemical hazards were represented by allergic reactions to medical gloves powder. Psychosocial hazards included experiencing verbal and physical harassment. In conclusion, the study emphasized the importance of raising awareness among HCWs and conducting training courses to prevent occupational hazards.

Keywords: Health workers, occupational hazard, prevalence, risk factors.

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Authors: D. Gåsvaer, L. Stålberg, A. Fundin, M. Jackson, P. Johansson

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Exploration and exploitation capabilities are both important within Operations as means for improvement when managed separately, and for establishing dynamic improvement capabilities when combined in balance. However, it is unclear what exploration and exploitation capabilities imply in improvement and development work within an Operations context. So, in order to better understand how to develop exploration and exploitation capabilities within Operations, the main characteristics of these constructs needs to be identified and further understood. Thus, the objective of this research is to increase the understanding about exploitation and exploration characteristics, to concretize what they translates to within the context of improvement and development work in an Operations unit, and to identify practical challenges. A literature review and a case study are presented. In the literature review, different interpretations of exploration and exploitation are portrayed, key characteristics have been identified, and a deepened understanding of exploration and exploitation characteristics is described. The case in the study is an Operations unit, and the aim is to explore to what extent and in what ways exploration and exploitation activities are part of the improvement structures and processes. The contribution includes an identification of key characteristics of exploitation and exploration, as well as an interpretation of the constructs. Further, some practical challenges are identified. For instance, exploration activities tend to be given low priority, both in daily work as in the manufacturing strategy. Also, the overall understanding about the concepts of exploitation and exploration (or any similar aspect of dynamic improvement capabilities) is very low.

Keywords: Exploitation, Exploration, Improvement, Lean production, Manufacturing.

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Authors: Chi-Shan Chen, Mao-Chou Hsu, Feng-Chuan Pan

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The incidence of oral cancer in Taiwan increased year by year. It replaced the nasopharyngeal as the top incurrence among head and neck cancers since 1994. Early examination and earlier identification for earlier treatment is the most effective medical treatment for these cancers. Although the government fully subsidized the expenses with tremendous promotion program for oral cancer screening, the citizen-s participation remained low. Purpose of this study is to understand the factors affecting the citizens- behavior intensions of taking an oral cancer screening. Based on the Theory of Planned Behavior, this study adopted four distinctive variables in explaining the captioned behavior intentions.700 questionnaires were dispatched with 500 valid responses or 71.4% returned by the citizens with an age 30 or above from the eastern counties of Taiwan. Test results has shown that attitude toward, subjective norms of, and perceived behavioral control over the oral cancer screening varied from some demographic factors to another. The study proofed that attitude toward, subjective norms of, and perceived behavioral control over the oral cancer screening had positive impacts on the corresponding behavior intention. The test concluded that the theory of planned behavior was appropriate as a theoretical framework in explaining the influencing factors of intentions of taking oral cancer screening. This study suggested the healthcare professional should provide high accessibility of screening services other than just delivering knowledge on oral cancer to promote the citizens- intentions of taking the captioned screening. This research also provided a practical implication to the healthcare professionals when formulating and implementing promotion instruments for lifting the screening rate of oral cancer.

Keywords: Theory of planned behavior, oral cancer, cancer screening

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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Authors: Ali Ghaffari, A. Hosein Shamekhi, Akbar Saki, Ehsan Kamrani

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In order to meet the limits imposed on automotive emissions, engine control systems are required to constrain air/fuel ratio (AFR) in a narrow band around the stoichiometric value, due to the strong decay of catalyst efficiency in case of rich or lean mixture. This paper presents a model of a sample spark ignition engine and demonstrates Simulink-s capabilities to model an internal combustion engine from the throttle to the crankshaft output. We used welldefined physical principles supplemented, where appropriate, with empirical relationships that describe the system-s dynamic behavior without introducing unnecessary complexity. We also presents a PID tuning method that uses an adaptive fuzzy system to model the relationship between the controller gains and the target output response, with the response specification set by desired percent overshoot and settling time. The adaptive fuzzy based input-output model is then used to tune on-line the PID gains for different response specifications. Experimental results demonstrate that better performance can be achieved with adaptive fuzzy tuning relative to similar alternative control strategies. The actual response specifications with adaptive fuzzy matched the desired response specifications.

Keywords: Modelling, Air–fuel ratio control, SI engine, Adaptive fuzzy Control.

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Authors: Zare Aliabad, H., Mirzaei, S.

Abstract:

This work presents a theoretical investigation of the simultaneous absorption of CO2 and H2S into aqueous solutions of MDEA and DEA. In this process the acid components react with the basic alkanolamine solution via an exothermic, reversible reaction in a gas/liquid absorber. The use of amine solvents for gas sweetening has been investigated using process simulation programs called HYSYS and ASPEN. We use Electrolyte NRTL and Amine Package and Amines (experimental) equation of state. The effects of temperature and circulation rate and amine concentration and packed column and murphree efficiency on the rate of absorption were studied. When lean amine flow and concentration increase, CO2 and H2S absorption increase too. With the improvement of inlet amine temperature in absorber, CO2 and H2S penetrate to upper stages of absorber and absorption of acid gases in absorber decreases. The CO2 concentration in the clean gas can be greatly influenced by the packing height, whereas for the H2S concentration in the clean gas the packing height plays a minor role. HYSYS software can not estimate murphree efficiency correctly and it applies the same contributions in all diagrams for HYSYS software. By improvement in murphree efficiency, maximum temperature of absorber decrease and the location of reaction transfer to the stages of bottoms absorber and the absorption of acid gases increase.

Keywords: Absorber, DEA, MDEA, Simulation.

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Authors: María Araya Léon, Ainoa Abella, Aura Murillo, Ricardo Guasch, Laura Clèries

Abstract:

This article aims to examine scientific theory framed within the term hospitals of the future from a multidisciplinary and cross-sectional perspective. To understand the connection that the various cross-sectional areas, we studied have with architectural spaces and to determine the future outlook of the works examined and how they can be classified into the categories of need/solution, evolution/revolution, collective/individual, and preventive/corrective. The changes currently taking place within the context of healthcare demonstrate how important these projects are and the need for companies to face future changes. A systematic review has been carried out focused on what will the hospitals of the future be like in relation to the elements that form part of their use, design, and architectural space experience, using the WOS database from 2016 to 2019. The large number of works about sensoring & big data and the scarce amount related to the area of materials is worth highlighting. Furthermore, no growth concerning future issues is envisaged over time. Regarding classifications, the articles we reviewed address evolutionary and collective solutions more, and in terms of preventive and corrective solutions, they were found at a similar level. Although our research focused on the future of hospitals, there is little evidence representing this approach. We also detected that, given the relevance of the research on how the built environment influences human health and well-being, these studies should be promoted within the context of healthcare. This article allows to find evidence on the future perspective from within the domain of hospital architecture, in order to create bridges between the productive sector of architecture and scientific theory. This will make it possible to detect R&D opportunities in each analyzed cross-section.

Keywords: Hospitals, trends, architectural space, disruptive approach.

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Authors: N. Manavizadeh, M. Hosseini, M. Rabbani

Abstract:

In the last decades to supply the various and different demands of clients, a lot of manufacturers trend to use the mixedmodel assembly line (MMAL) in their production lines, since this policy make possible to assemble various and different models of the equivalent goods on the same line with the MTO approach. In this article, we determine the sequence of (MMAL) line, with applying the kitting approach and planning of rest time for general workers to reduce the wastages, increase the workers effectiveness and apply the sector of lean production approach. This Multi-objective sequencing problem solved in small size with GAMS22.2 and PSO meta heuristic in 10 test problems and compare their results together and conclude that their results are very similar together, next we determine the important factors in computing the cost, which improving them cost reduced. Since this problem, is NPhard in large size, we use the particle swarm optimization (PSO) meta-heuristic for solving it. In large size we define some test problems to survey it-s performance and determine the important factors in calculating the cost, that by change or improved them production in minimum cost will be possible.

Keywords: Mixed-Model Assembly Line, particle swarmoptimization, Multi-objective sequencing problem, MTO system, kitto-assembly, rest time

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Authors: Osa D Egonwa

Abstract:

In the 21^st century, the disciplinary boundaries of past centuries that we often create through mainstream art historical classification, techniques and sources may have been eroded by visual culture, which seems to provide a more inclusive umbrella for the new ways artists go about the creative process and its resultant commodities. Over the past four decades, artists in Africa have resorted to new materials, techniques and themes which have affected our ways of research on these artists and their art. Frontline artists such as El Anatsui, Yinka Shonibare, Erasmus Onyishi are demonstrating that any material is just suitable for artistic expression. Most of times, these materials come with their own techniques/effects and visual syntax: a combination of materials compounds techniques, formal aesthetic indexes, halo effects, and iconography. This tends to challenge the categories and we lean on to view, think and talk about them. This renders our main stream art historical research methods inadequate, thus suggesting new discursive concepts, terms and theories. This paper proposed the Africanist eclectic methods derived from the dual framework of Masquerade Theory and What Comes Behind Six is More Than Seven. This paper shares thoughts/research on art historical methods, terminological re-alignments on classification/source data, presentational format and interpretation arising from the emergent trends in our subject. The outcome provides useful tools to mediate new thoughts and experiences in recent African art and visual culture.

Keywords: Art Historical Methods, Classifications, Concepts , Re-alignment.

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Authors: Yi-Yun Ko, Der-Ming Liou

Abstract:

The Electronic Health Record (EHR) system is very general and we should pay more attention to a patient-s privacy. The patient-s consent is one of the elements when dealing with privacy topics. This study focuses on the creating and managing of patient consent. The integration of the HL7 standards and the IHE BPPC profile provides a base for the creation of patient consent. Establishing the platform offers the patients a way to create, revoke or update their consents. Through this platform, they can manage their consents in an easier manner.

Keywords: consent, EHR, HL7, IHE

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Authors: Man Young Kim

Abstract:

Catalytic combustion is generally accepted as an environmentally preferred alternative for the generation of heat and power from fossil fuels mainly due to its advantages related to the stable combustion under very lean conditions with low emissions of NOx, CO, and UHC at temperatures lower than those occurred in conventional flame combustion. Despite these advantages, the commercial application of catalytic combustion has been delayed because of complicated reaction processes and the difficulty in developing appropriate catalysts with the required stability and durability. To develop the catalytic combustors, detailed studies on the combustion characteristics of catalytic combustion should be conducted. To the end, in current research, quantitative studies on the combustion characteristics of the catalytic combustors, with a Pd-based catalyst for MCFC power generation systems, relying on numerical simulations have been conducted. In addition, data from experimental studies of variations in outlet temperatures and fuel conversion, taken after operating conditions have been used to validate the present numerical approach. After introducing the governing equations for mass, momentum, and energy equations as well as a description of catalytic combustion kinetics, the effects of the excess air ratio, space velocity, and inlet gas temperature on the catalytic combustion characteristics are extensively investigated. Quantitative comparisons are also conducted with previous experimental data. Finally, some concluding remarks are presented.

Keywords: Catalytic combustion, Methane, BOP, MCFC power generation system, Inlet temperature, Excess air ratio, Space velocity.

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