Search results for: lean healthcare
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 307

Search results for: lean healthcare

67 Barriers and Drivers towards the Use of Childhood Vaccination Services by Undocumented Migrant Caregivers in Sabah, Malaysia: A Qualitative Analysis

Authors: Michal Christina Steven, Mohd. Yusof Hj Ibrahim, Haryati Abdul Karim, Prabakaran Dhanaraj, Kelly Alexius Mansin

Abstract:

After 27 years, Malaysia reported polio cases in 2019 involving the children of the undocumented migrants living in Sabah. These undocumented migrants present a significant challenge in achieving the elimination of vaccine-preventable diseases (VPD). Due to the recent polio outbreak among the undocumented migrant children in Sabah, an in-depth interview was conducted among the caregivers of undocumented migrant children to identify the barriers and drivers towards vaccinating their children. Financial barriers, legal citizenship status, language barrier, the COVID-19 pandemic, and physical barriers have been the barriers to access vaccination services by undocumented migrants. Five significant drivers for undocumented migrants to vaccinate their children are social influence, fear of disease, parental trust in healthcare providers, good support, and vaccine availability. Necessary action should be taken immediately to address the problems of vaccinating the children of undocumented migrants to prevent the re-emergence of VPD.

Keywords: Malaysia, polio, Sabah, undocumented migrants.

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66 A Study on the Relation among Primary Care Professionals Serving the Disadvantaged Community, Socioeconomic Status, and Adverse Health Outcome

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

Abstract:

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

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

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65 Seismic Vulnerability Mitigation of Non-Engineered Buildings

Authors: Muhammad Tariq A. Chaudhary

Abstract:

The tremendous loss of life that resulted in the aftermath of recent earthquakes in developing countries is mostly due to the collapse of non-engineered and semi-engineered building structures. Such structures are used as houses, schools, primary healthcare centers and government offices. These building are classified structurally into two categories viz. non-engineered and semi-engineered. Non-engineered structures include: adobe, unreinforced masonry (URM) and wood buildings. Semi-engineered buildings are mostly low-rise (up to 3 story) light concrete frame structures or masonry bearing walls with reinforced concrete slab. This paper presents an overview of the typical damage observed in non-engineered structures and their most likely causes in the past earthquakes with specific emphasis on the performance of such structures in the 2005 Kashmir earthquake. It is demonstrated that seismic performance of these structures can be improved from life-safety viewpoint by adopting simple low-cost modifications to the existing construction practices. Incorporation of some of these practices in the reconstruction efforts after the 2005 Kashmir earthquake are examined in the last section for mitigating seismic risk hazard.

Keywords: Kashmir earthquake, non-engineered buildings, seismic hazard, structural details, structural strengthening.

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64 Two States Mapping Based Neural Network Model for Decreasing of Prediction Residual Error

Authors: Insung Jung, lockjo Koo, Gi-Nam Wang

Abstract:

The objective of this paper is to design a model of human vital sign prediction for decreasing prediction error by using two states mapping based time series neural network BP (back-propagation) model. Normally, lot of industries has been applying the neural network model by training them in a supervised manner with the error back-propagation algorithm for time series prediction systems. However, it still has a residual error between real value and prediction output. Therefore, we designed two states of neural network model for compensation of residual error which is possible to use in the prevention of sudden death and metabolic syndrome disease such as hypertension disease and obesity. We found that most of simulations cases were satisfied by the two states mapping based time series prediction model compared to normal BP. In particular, small sample size of times series were more accurate than the standard MLP model. We expect that this algorithm can be available to sudden death prevention and monitoring AGENT system in a ubiquitous homecare environment.

Keywords: Neural network, U-healthcare, prediction, timeseries, computer aided prediction.

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63 Social Assistive Robots, Reframing the Human Robotics Interaction Benchmark of Social Success

Authors: Antonio Espingardeiro

Abstract:

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

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

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62 The Effects of Extracorporeal Shockwave Therapy on Pain, Function, Range of Motion, and Strength in Patients with Insertional Achilles Tendinosis

Authors: P. Sanzo

Abstract:

Increased physical fitness participation has been paralleled by increasedoveruse injuries such as insertional Achilles tendinosis (AT). Treatment has provided inconsistentresults. The use of extracorporeal shockwave therapy (ECSWT) offers a new treatment consideration.The purpose of this study was to assess the effects of ECSWTon pain, function, range of motion (ROM), joint mobility and strength in patients with AT. Thirty subjects were treated with ECSWT and measures were takenbefore and three months after treatment. There was significant differences in visual analog scale (VAS) scores for pain at rest (p=0.002); after activity (p= 0.0001); overall improvement(p=0.0001); Lower Extremity Functional Scale (LEFS) scores (p=0.002); dorsiflexion range of motion (ROM) (p=0.0001); plantarflexion strength (p=0.025); talocrural joint anterior glide (p=0.046); and subtalar joint medial and lateral glide (p=0.025).ECSWT offers a new intervention that may limit the progression of the disorder and the long term healthcare costs associated with AT.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, Achilles tendinosis, range of motion, strength, joint mobility

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61 Observations of Conformity in the Health Professions

Authors: Tanya N. Beran, Michelle A. Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

Abstract:

Although interprofessional practice is a collaborative approach for problem solving among health professionals, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists can be used to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal strategies to manage the conformity pressures that people face.

Keywords: Conformity, decision-making, interprofessional teams, medical simulation.

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60 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

Abstract:

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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59 Legal Regulation and Critical Analysis for an Effectively Treatment of Pharmaceutical Waste

Authors: Merita Dauti, Edita Alili-Idrizi, Sihana Ahmeti–Lika, Ledjan Malaj

Abstract:

The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people’s health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection.

Keywords: Pharmaceutical waste, legal regulation, proper disposal, environment pollution.

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58 Importance of Mobile Technology in Successful Adoption and Sustainability of a Chronic Disease Support System

Authors: Reza Ariaeinejad, Norm Archer

Abstract:

Self-management is becoming a new emphasis for healthcare systems around the world. But there are many different problems with adoption of new health-related intervention systems. The situation is even more complicated for chronically ill patients with disabilities, illiteracy, and impairment in judgment in addition to their conditions, or having multiple co-morbidities. Providing online decision support to manage patient health and to provide better support for chronically ill patients is a new way of dealing with chronic disease management. In this study, the importance of mobile technology through an m-Health system that supports self-management interventions including the care provider, family and social support, education and training, decision support, recreation, and ongoing patient motivation to promote adherence and sustainability of the intervention are discussed. A proposed theoretical model for adoption and sustainability of system use is developed, based on UTAUT2 and IS Continuance of Use models, both of which have been pre-validated through longitudinal studies. The objective of this paper is to show the importance of using mobile technology in adoption and sustainability of use of an m-Health system which will result in commercially sustainable self-management support for chronically ill patients.

Keywords: M-health, e-health, self-management, disease.

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57 Dry Matter, Moisture, Ash and Crude Fibre Content in Distinct Segments of ‘Durian Kampung’ Husk

Authors: Norhanim Nordin, Rosnah Shamsudin, Azrina Azlan, Mohammad Effendy Ya’acob

Abstract:

An environmental friendly approach for disposal of voluminous durian husk waste could be implemented by substituting them into various valuable commodities, such as healthcare and biofuel products. Thus, the study of composition value in each segment of durian husk was very crucial to determine the suitable proportions of nutrients that need to be added and mixed in the product. A total of 12 ‘Durian Kampung’ fruits from Sg Ruan, Pahang were selected and each fruit husk was divided into four segments and labelled as P-L (thin neck area of white inner husk), P-B (thick bottom area of white inner husk), H (green and thorny outer husk) and W (whole combination of P-B and H). Four experiments have been carried out to determine the dry matter, moisture, ash and crude fibre content. The results show that the H segment has the highest dry matter content (30.47%), while the P-B segment has the highest percentage in moisture (81.83%) and ash (6.95%) content. It was calculated that the ash content of the P-B segment has a higher rate of moisture level which causes the ash content to increase about 2.89% from the P-L segment. These data have proven that each segment of durian husk has a significant difference in terms of composition value, which might be useful information to fully utilize every part of the durian husk in the future.

Keywords: Durian husk, crude fibre content, dry matter content, moisture content.

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56 Collaboration in Palliative Care Networks in Urban and Rural Regions of Switzerland

Authors: R. Schweighoffer, N. Nagy, E. Reeves, B. Liebig

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Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.

Keywords: Collaboration, healthcare networks, palliative care, Switzerland.

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55 Design Systems and the Need for a Usability Method: Assessing the Fitness of Components and Interaction Patterns in Design Systems Using Atmosphere Methodology

Authors: P. Johansson, S. Mardh

Abstract:

The present study proposes a usability test method, Atmosphere, to assess the fitness of components and interaction patterns of design systems. The method covers the user’s perception of the components of the system, the efficiency of the logic of the interaction patterns, perceived ease of use as well as the user’s understanding of the intended outcome of interactions. These aspects are assessed by combining measures of first impression, visual affordance and expectancy. The method was applied to a design system developed for the design of an electronic health record system. The study was conducted involving 15 healthcare personnel. It could be concluded that the Atmosphere method provides tangible data that enable human-computer interaction practitioners to analyze and categorize components and patterns based on perceived usability, success rate of identifying interactive components and success rate of understanding components and interaction patterns intended outcome.

Keywords: atomic design, atmosphere methodology, design system, expectancy testing, first impression testing, usability testing, visual affordance testing

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54 Data Integrity: Challenges in Health Information Systems in South Africa

Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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53 The Impact of Occupational Stress on Quality of Work Life among the Staff of e-Workspace

Authors: Alireza Bolhari, Ali Rezaeean, Jafar Bolhari, Fatemeh Zare

Abstract:

With the advent of new technologies, factors related to mental health in e-workspaces are taken into consideration more than ever. Studies have revealed that one of the factors affecting the productivity of employees in an organization is occupational stress. Another influential factor is quality of work life which is important in the improvement of work environment conditions and organizational efficiency. In order to uncover the quality of work life level and to investigate the impact of occupational stress on quality of work life among information technology employees in Iran, a cross-sectional study design was applied and data were gathered using a questionnaire validated by a group of experts. The results of the study showed that information technology staffs have average level of both occupational stress and quality of work life. Furthermore, it was found that occupational stress has a negative impact on quality of work life. In addition, the same results were observed for role ambiguity, role conflict, role under-load, work-pace, work repetitiveness and tension toward quality of work life. No significant relation was found between role overload and quality of work life. Finally, directions for future research are proposed and discussed.

Keywords: Information Technology, e-Workspace, Healthcare, IT Staff, Occupational Stress, Quality of Work Life

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52 Urban Resilience: Relation between COVID-19 and Urban Environment in Amman City

Authors: Layla Mujahed

Abstract:

COVID-19 is an exam for all the city’s systems. It shows many gaps in the systems such as healthcare, economic, social, and environment. This pandemic is paving for a new era, an era of technology and it has changed people’s lives, such as physical, and emotional changes, and converting communication into digitalized. The effect of COVID-19 has covered all urban city parts. COVID-19 will not be the last pandemic our cities will face. For that, more researches focus on enhancing the quality of the urban environment. This pandemic encourages a rethinking of the environment’s role, especially in cities. Cities are trying to provide the best suitable strategies and regulations to prevent the spread of COVID-19, and an example of that is Amman city. Amman has a high increment in the number of COVID-19 infected people, while it has controlled the situation for months. For that, this paper studies the relation between COVID-19 and urban environmental studies cases about cities around the world, and learns from their models to face COVID-19. In Amman, people’s behavior has changed towards public transportation and public green spaces. N­ew governmental regulations focus on increasing people’s mental awareness, supporting local businesses, and enhancing neighborhood planning that can help Amman to face any future pandemics.

Keywords: COVID-19, urban environment, urban planning, urban resilience.

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51 Protein Profiling in Alanine Aminotransferase Induced Patient cohort using Acetaminophen

Authors: Gry M, Bergström J, Lengquist J, Lindberg J, Drobin K, Schwenk J, Nilsson P, Schuppe-Koistinen I.

Abstract:

Sensitive and predictive DILI (Drug Induced Liver Injury) biomarkers are needed in drug R&D to improve early detection of hepatotoxicity. The discovery of DILI biomarkers that demonstrate the predictive power to identify individuals at risk to DILI would represent a major advance in the development of personalized healthcare approaches. In this healthy volunteer acetaminophen study (4g/day for 7 days, with 3 monitored nontreatment days before and 4 after), 450 serum samples from 32 subjects were analyzed using protein profiling by antibody suspension bead arrays. Multiparallel protein profiles were generated using a DILI target protein array with 300 antibodies, where the antibodies were selected based on previous literature findings of putative DILI biomarkers and a screening process using pre dose samples from the same cohort. Of the 32 subjects, 16 were found to develop an elevated ALT value (2Xbaseline, responders). Using the plasma profiling approach together with multivariate statistical analysis some novel findings linked to lipid metabolism were found and more important, endogenous protein profiles in baseline samples (prior to treatment) with predictive power for ALT elevations were identified.

Keywords: DILI, Plasma profiling, PLSDA, Randomforest.

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50 Influence of Environmental Temperature on Dairy Herd Performance and Behaviour

Authors: L. Krpalkova, N. O' Mahony, A. Carvalho, S. Campbell, S. Harapanahalli, J. Walsh

Abstract:

The objective of this study was to determine the effects of environmental stressors on the performance of lactating dairy cows and discuss some future trends. There exists a relationship between the meteorological data and milk yield prediction accuracy in pasture-based dairy systems. New precision technologies are available and are being developed to improve the sustainability of the dairy industry. Some of these technologies focus on welfare of individual animals on dairy farms. These technologies allow the automatic identification of animal behaviour and health events, greatly increasing overall herd health and yield while reducing animal health inspection demands and long-term animal healthcare costs. The data set consisted of records from 489 dairy cows at two dairy farms and temperature measured from the nearest meteorological weather station in 2018. The effects of temperature on milk production and behaviour of animals were analyzed. The statistical results indicate different effects of temperature on milk yield and behaviour. The “comfort zone” for animals is in the range 10 °C to 20 °C. Dairy cows out of this zone had to decrease or increase their metabolic heat production, and it affected their milk production and behaviour.

Keywords: Behaviour, milk yield, temperature, precision technologies.

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49 Improving the Elder-s Quality of Life with Smart Television Based Services

Authors: Van-Quang Trinh, Gi-Soo Chung, Hee-Cheol Kim

Abstract:

The increasing number of senior population gradually causes to demand the use of information and communication technology for their satisfactory lives. This paper presents the development of an integrated TV based system which offers an opportunity to provide value added services to a large number of elderly citizens, and thus helps improve their quality of life. The design philosophy underlying this paper is to fulfill both technological and human aspects. The balance between these two dimensions has been currently stressed as a crucial element for the design of usable systems in real use, particularly to the elderly who have physical and mental decline. As the first step to achieve it, we have identified human and social factors that affect the elder-s quality of life by a literature review, and based on them, build four fundamental services: information, healthcare, learning and social network services. Secondly, the system architecture, employed technologies and the elderly-friendly system design considerations are presented. This reflects technological and human perspectives in terms of the system design. Finally, we describe some scenarios that illustrate the potentiality of the proposed system to improve elderly people-s quality of life.

Keywords: Elderly people, human computer interaction, quality of life, smart television, user-centered system design

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48 Designing a Patient Monitoring System Using Cloud and Semantic Web Technologies

Authors: Chryssa Thermolia, Ekaterini S. Bei, Stelios Sotiriadis, Kostas Stravoskoufos, Euripides G.M. Petrakis

Abstract:

Moving into a new era of healthcare, new tools and devices are developed to extend and improve health services, such as remote patient monitoring and risk prevention. In this concept, Internet of Things (IoT) and Cloud Computing present great advantages by providing remote and efficient services, as well as cooperation between patients, clinicians, researchers and other health professionals. This paper focuses on patients suffering from bipolar disorder, a brain disorder that belongs to a group of conditions called affective disorders, which is characterized by great mood swings. We exploit the advantages of Semantic Web and Cloud Technologies to develop a patient monitoring system to support clinicians. Based on intelligently filtering of evidence-knowledge and individual-specific information we aim to provide treatment notifications and recommended function tests at appropriate times or concluding into alerts for serious mood changes and patient’s nonresponse to treatment. We propose an architecture as the back-end part of a cloud platform for IoT, intertwining intelligence devices with patients’ daily routine and clinicians’ support.

Keywords: Bipolar disorder, intelligent systems patient monitoring, semantic web technologies, IoT.

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47 Clique and Clan Analysis of Patient-Sharing Physician Collaborations

Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

Abstract:

The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: Clique, clan, electronic health records, physician collaboration.

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46 Leveraging Li-Fi to Enhance Security and Performance of Medical Devices

Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

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The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: Hospital, light fidelity, Li-Fi, medical devices, security.

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45 Evaluation of the Hepatitis C Virus and Classical and Modern Immunoassays Used Nowadays to Diagnose It in Tirana

Authors: Stela Papa, Klementina Puto, Migena Pllaha

Abstract:

HCV is a hepatotropic RNA virus, transmitted primarily via the blood route, which causes progressive disease such as chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma. HCV nowadays is a global healthcare problem. A variety of immunoassays including old and new technologies are being applied to detect HCV in our country. These methods include Immunochromatography assays (ICA), Fluorescence immunoassay (FIA), Enzyme linked fluorescent assay (ELFA), and Enzyme linked immunosorbent assay (ELISA) to detect HCV antibodies in blood serum, which lately is being slowly replaced by more sensitive methods such as rapid automated analyzer chemiluminescence immunoassay (CLIA). The aim of this study is to estimate HCV infection in carriers and chronic acute patients and to evaluate the use of new diagnostic methods. This study was realized from September 2016 to May 2018. During this study period, 2913 patients were analyzed for the presence of HCV by taking samples from their blood serum. The immunoassays performed were ICA, FIA, ELFA, ELISA, and CLIA assays. Concluding, 82% of patients taken in this study, resulted infected with HCV. Diagnostic methods in clinical laboratories are crucial in the early stages of infection, in the management of chronic hepatitis and in the treatment of patients during their disease.

Keywords: CLIA, ELISA, hepatitis C virus, immunoassay.

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44 Optimizing Usability Testing with Collaborative Method in an E-Commerce Ecosystem

Authors: Markandeya Kunchi

Abstract:

Usability testing (UT) is one of the vital steps in the User-centred design (UCD) process when designing a product. In an e-commerce ecosystem, UT becomes primary as new products, features, and services are launched very frequently. And, there are losses attached to the company if an unusable and inefficient product is put out to market and is rejected by customers. This paper tries to answer why UT is important in the product life-cycle of an E-commerce ecosystem. Secondary user research was conducted to find out work patterns, development methods, type of stakeholders, and technology constraints, etc. of a typical E-commerce company. Qualitative user interviews were conducted with product managers and designers to find out the structure, project planning, product management method and role of the design team in a mid-level company. The paper tries to address the usual apprehensions of the company to inculcate UT within the team. As well, it stresses upon factors like monetary resources, lack of usability expert, narrow timelines, and lack of understanding of higher management as some primary reasons. Outsourcing UT to vendors is also very prevalent with mid-level e-commerce companies, but it has its own severe repercussions like very little team involvement, huge cost, misinterpretation of the findings, elongated timelines, and lack of empathy towards the customer, etc. The shortfalls of the unavailability of a UT process in place within the team and conducting UT through vendors are bad user experiences for customers while interacting with the product, badly designed products which are neither useful and nor utilitarian. As a result, companies see dipping conversions rates in apps and websites, huge bounce rates and increased uninstall rates. Thus, there was a need for a more lean UT system in place which could solve all these issues for the company. This paper highlights on optimizing the UT process with a collaborative method. The degree of optimization and structure of collaborative method is the highlight of this paper. Collaborative method of UT is one in which the centralised design team of the company takes for conducting and analysing the UT. The UT is usually a formative kind where designers take findings into account and uses in the ideation process. The success of collaborative method of UT is due to its ability to sync with the product management method employed by the company or team. The collaborative methods focus on engaging various teams (design, marketing, product, administration, IT, etc.) each with its own defined roles and responsibility in conducting a smooth UT with users In-house. The paper finally highlights the positive results of collaborative UT method after conducting more than 100 In-lab interviews with users across the different lines of businesses. Some of which are the improvement of interaction between stakeholders and the design team, empathy towards users, improved design iteration, better sanity check of design solutions, optimization of time and money, effective and efficient design solution. The future scope of collaborative UT is to make this method leaner, by reducing the number of days to complete the entire project starting from planning between teams to publishing the UT report.

Keywords: Usability testing, collaborative method, e-commerce, product management method.

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43 An FPGA Implementation of Intelligent Visual Based Fall Detection

Authors: Peng Shen Ong, Yoong Choon Chang, Chee Pun Ooi, Ettikan K. Karuppiah, Shahirina Mohd Tahir

Abstract:

Falling has been one of the major concerns and threats to the independence of the elderly in their daily lives. With the worldwide significant growth of the aging population, it is essential to have a promising solution of fall detection which is able to operate at high accuracy in real-time and supports large scale implementation using multiple cameras. Field Programmable Gate Array (FPGA) is a highly promising tool to be used as a hardware accelerator in many emerging embedded vision based system. Thus, it is the main objective of this paper to present an FPGA-based solution of visual based fall detection to meet stringent real-time requirements with high accuracy. The hardware architecture of visual based fall detection which utilizes the pixel locality to reduce memory accesses is proposed. By exploiting the parallel and pipeline architecture of FPGA, our hardware implementation of visual based fall detection using FGPA is able to achieve a performance of 60fps for a series of video analytical functions at VGA resolutions (640x480). The results of this work show that FPGA has great potentials and impacts in enabling large scale vision system in the future healthcare industry due to its flexibility and scalability.

Keywords: Fall detection, FPGA, hardware implementation.

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42 On The Analysis of a Compound Neural Network for Detecting Atrio Ventricular Heart Block (AVB) in an ECG Signal

Authors: Salama Meghriche, Amer Draa, Mohammed Boulemden

Abstract:

Heart failure is the most common reason of death nowadays, but if the medical help is given directly, the patient-s life may be saved in many cases. Numerous heart diseases can be detected by means of analyzing electrocardiograms (ECG). Artificial Neural Networks (ANN) are computer-based expert systems that have proved to be useful in pattern recognition tasks. ANN can be used in different phases of the decision-making process, from classification to diagnostic procedures. This work concentrates on a review followed by a novel method. The purpose of the review is to assess the evidence of healthcare benefits involving the application of artificial neural networks to the clinical functions of diagnosis, prognosis and survival analysis, in ECG signals. The developed method is based on a compound neural network (CNN), to classify ECGs as normal or carrying an AtrioVentricular heart Block (AVB). This method uses three different feed forward multilayer neural networks. A single output unit encodes the probability of AVB occurrences. A value between 0 and 0.1 is the desired output for a normal ECG; a value between 0.1 and 1 would infer an occurrence of an AVB. The results show that this compound network has a good performance in detecting AVBs, with a sensitivity of 90.7% and a specificity of 86.05%. The accuracy value is 87.9%.

Keywords: Artificial neural networks, Electrocardiogram(ECG), Feed forward multilayer neural network, Medical diagnosis, Pattern recognitionm, Signal processing.

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41 Application of Systems Engineering Tools and Methods to Improve Healthcare Delivery Inside the Emergency Department of a Mid-Size Hospital

Authors: Mohamed Elshal, Hazim El-Mounayri, Omar El-Mounayri

Abstract:

Emergency department (ED) is considered as a complex system of interacting entities: patients, human resources, software and hardware systems, interfaces, and other systems. This paper represents a research for implementing a detailed Systems Engineering (SE) approach in a mid-size hospital in central Indiana. This methodology will be applied by “The Initiative for Product Lifecycle Innovation (IPLI)” institution at Indiana University to study and solve the crowding problem with the aim of increasing throughput of patients and enhance their treatment experience; therefore, the nature of crowding problem needs to be investigated with all other problems that leads to it. The presented SE methods are workflow analysis and systems modeling where SE tools such as Microsoft Visio are used to construct a group of system-level diagrams that demonstrate: patient’s workflow, documentation and communication flow, data systems, human resources workflow and requirements, leadership involved, and integration between ER different systems. Finally, the ultimate goal will be managing the process through implementation of an executable model using commercialized software tools, which will identify bottlenecks, improve documentation flow, and help make the process faster.

Keywords: Systems modeling, ED operation, workflow modeling, systems analysis.

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40 Designing Social Care Policies in the Long Term: A Study Using Regression, Clustering and Backpropagation Neural Nets

Authors: Sotirios Raptis

Abstract:

Linking social needs to social classes using different criteria may lead to social services misuse. The paper discusses using ML and Neural Networks (NNs) in linking public services in Scotland in the long term and advocates, this can result in a reduction of the services cost connecting resources needed in groups for similar services. The paper combines typical regression models with clustering and cross-correlation as complementary constituents to predict the demand. Insurance companies and public policymakers can pack linked services such as those offered to the elderly or to low-income people in the longer term. The work is based on public data from 22 services offered by Public Health Services (PHS) Scotland and from the Scottish Government (SG) from 1981 to 2019 that are broken into 110 years series called factors and uses Linear Regression (LR), Autoregression (ARMA) and 3 types of back-propagation (BP) Neural Networks (BPNN) to link them under specific conditions. Relationships found were between smoking related healthcare provision, mental health-related health services, and epidemiological weight in Primary 1(Education) Body Mass Index (BMI) in children. Primary component analysis (PCA) found 11 significant factors while C-Means (CM) clustering gave 5 major factors clusters.

Keywords: Probability, cohorts, data frames, services, prediction.

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39 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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38 Cultural Practices as a Coping Measure for Women who Terminated a Pregnancy in Adolescence: A Qualitative Study

Authors: Botshelo R. Sebola

Abstract:

Unintended pregnancy often results in pregnancy termination. Most countries have legalised the termination of a pregnancy and pregnant adolescents can visit designated clinics without their parents’ consent. In most African and Asian countries, certain cultural practices are performed following any form of childbirth, including abortion, and such practices are ingrained in societies. The aim of this paper was to understand how women who terminated a pregnancy during adolescence coped by embracing cultural practices. A descriptive multiple case study design was adopted for the study. In-depth, semi-structured interviews and reflective diaries were used for data collection. Participants were 13 women aged 20 to 35 years who had terminated a pregnancy in adolescence. Three women kept their soiled sanitary pads, burned them to ash and waited for the rainy season to scatter the ash in a flowing stream. This ritual was performed to appease the ancestors, ask them for forgiveness and as a send-off for the aborted foetus. Five women secretly consulted Sangoma (traditional healers) to perform certain rituals. Three women isolated themselves to perform herbal cleansings, and the last two chose not to engage in any sexual activity for one year, which led to the loss of their partners. This study offers a unique contribution to understanding the solitary journey of women who terminate a pregnancy. The study challenges healthcare professionals who work in clinics that offer pregnancy termination services to look beyond releasing the foetus to advocating and providing women with the necessary care and support in performing cultural practices.

Keywords: Adolescence, case study, cultural rituals, pregnancy.

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