Search results for: obstacles to healthcare accessibility

Authors: Aya Salama

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Digital Twin has emerged as a compelling research area, capturing the attention of scholars over the past decade. It finds applications across diverse fields, including smart manufacturing and healthcare, offering significant time and cost savings. Notably, it often intersects with other cutting-edge technologies such as Data Mining, Artificial Intelligence, and Machine Learning. However, the concept of a Human Digital Twin (HDT) is still in its infancy and requires further demonstration of its practicality. HDT takes the notion of Digital Twin a step further by extending it to living entities, notably humans, who are vastly different from inanimate physical objects. The primary objective of this research was to create an HDT capable of automating real-time human responses by simulating human behavior. To achieve this, the study delved into various areas, including clustering, supervised classification, topic extraction, and sentiment analysis. The paper successfully demonstrated the feasibility of HDT for generating personalized responses in social messaging applications. Notably, the proposed approach achieved an overall accuracy of 63%, a highly promising result that could pave the way for further exploration of the HDT concept. The methodology employed Random Forest for clustering the question database and matching new questions, while K-nearest neighbor was utilized for sentiment analysis.

Keywords: Human Digital twin, sentiment analysis, topic extraction, supervised machine learning, unsupervised machine learning, classification and clustering.

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Authors: Cheryl Marie Cordeiro

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Although fisheries and aquaculture studies might seem marginal to international business (IB) studies in general, fisheries and aquaculture IB (FAIB) management is currently facing increasing pressure to meet global demand and consumption for fish in the next coming decades. In part address to this challenge, the purpose of this systematic review of literature (SLR) study is to investigate the use of the term ‘market access’ in its context of use in the generic literature and business sector discourse, in comparison to the more specific literature and discourse in fisheries, aquaculture and seafood. This SLR aims to uncover the knowledge/interest gaps between the academic subject discourses and business sector practices. Corpus driven in methodology and using a triangulation method of three different text analysis software including AntConc, VOSviewer and Web of Science (WoS) analytics, the SLR results indicate a gap in conceptual knowledge and business practices in how ‘market access’ is conceived and used in the context of the pharmaceutical healthcare industry and FAIB research and practice. While it is acknowledged that the product orientation of different business sectors might differ, this SLR study works with the assumption that both business sectors are global in orientation. These business sectors are complex in their operations from product to market. This SLR suggests a conceptual model in understanding the challenges, the potential barriers as well as avenues for solutions to developing market access for FAIB.

Keywords: Market access, fisheries and aquaculture, international business, systematic literature review.

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Authors: Petri Kouvo, Aino Kainulainen, Kimmo Koivunen

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Separate collection system for recyclable wastes in the Helsinki region was ranked second best of European capitals. The collection system includes paper, cardboard, glass, metals and biowaste. Residual waste is collected and used in energy production. The collection system excluding paper is managed by the Helsinki Region Environmental Services HSY, a public organization owned by four municipalities (Helsinki, Espoo, Kauniainen and Vantaa). Paper collection is handled by the producer responsibility scheme. The efficiency of the collection system in the Helsinki region relies on a good coverage of door-to-door-collection. All properties with 10 or more dwelling units are required to source separate biowaste and cardboard. This covers about 75% of the population of the area. The obligation is extended to glass and metal in properties with 20 or more dwelling units. Other success factors include public awareness campaigns and a fee system that encourages recycling. As a result of waste management regulations for source separation of recyclables and biowaste, nearly 50 percent of recycling rate of household waste has been reached. For households and small and medium size enterprises, there is a sorting station fleet of five stations available. More than 50 percent of wastes received at sorting stations is utilized as material. The separate collection of plastic packaging in Finland will begin in 2016 within the producer responsibility scheme. HSY started supplementing the national bring point system with door-to-door-collection and pilot operations will begin in spring 2016. The result of plastic packages pilot project has been encouraging. Until the end of 2016, over 3500 apartment buildings have been joined the piloting, and more than 1800 tons of plastic packages have been collected separately. In the summer 2015 a novel partial flow digestion process combining digestion and tunnel composting was adopted for source separated household and commercial biowaste management. The product gas form digestion process is converted in to heat and electricity in piston engine and organic Rankine cycle process with very high overall efficiency. This paper describes the efficient collection system and discusses key success factors as well as main obstacles and lessons learned as well as the partial flow process for biowaste management.

Keywords: Biowaste, HSY, MSW, plastic packages, recycling, separate collection.

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Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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Authors: Naeleh Motamedi, Masoud Mahmoudkhan Shirazi, Nima Nouraei

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Natural disasters, including earthquake, kill many people around the world every year. Society rescue actions, which start after the earthquake and are called LAST in abbreviation, include locating, access, stabilization and transportation. In the present article, we have studied the process of local accessibility to the injured and transporting them to health care centers. With regard the heavy traffic load due to earthquake, the destruction of connecting roads and bridges and the heavy debris in alleys and street, which put the lives of the injured and the people buried under the debris in danger, accelerating the rescue actions and facilitating the accessibilities are of great importance, obviously. Tehran, the capital of Iran, is among the crowded cities in the world and is the center of extensive economic, political, cultural and social activities. Tehran has a population of about 9.5 millions and because of the immigration of people from the surrounding cities. Furthermore, considering the fact that Tehran is located on two important and large faults, a 6 Richter magnitude earthquake in this city could lead to the greatest catastrophe during the entire human history. The present study is a kind of review and a major part of the required information for it, has been obtained from libraries all of the rescue vehicles around the world, including rescue helicopters, ambulances, fire fighting vehicles and rescue boats, and their applied technology, and also the robots specifically designed for the rescue system and the advantages and disadvantages of them, have been investigated. The studies show that there is a significant relationship between the rescue team-s arrival time at the incident zone and the number of saved people; so that, if the duration of burial under debris 30 minutes, the probability of survival is %99.3, after a day is %81, after 2days is %19 and after 5days is %7.4. The exiting transport systems all have some defects. If these defects are removed, more people could be saved each hour and the preparedness against natural disasters is increased. In this study, transport system has been designed for the rescue team and the injured; which could carry the rescue team to the incident zone and the injured to the health care centers. In addition, this system is able to fly in the air and move on the earth as well; so that the destruction of roads and the heavy traffic load could not prevent the rescue team from arriving early at the incident zone. The system also has the equipment required firebird for debris removing, optimum transport of the injured and first aid.

Keywords: earthquake, accelerating, accessibilities transportation, rescue system

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Authors: Insung Jung, Gi-Nam Wang

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In this paper, we present user pattern learning algorithm based MDSS (Medical Decision support system) under ubiquitous. Most of researches are focus on hardware system, hospital management and whole concept of ubiquitous environment even though it is hard to implement. Our objective of this paper is to design a MDSS framework. It helps to patient for medical treatment and prevention of the high risk patient (COPD, heart disease, Diabetes). This framework consist database, CAD (Computer Aided diagnosis support system) and CAP (computer aided user vital sign prediction system). It can be applied to develop user pattern learning algorithm based MDSS for homecare and silver town service. Especially this CAD has wise decision making competency. It compares current vital sign with user-s normal condition pattern data. In addition, the CAP computes user vital sign prediction using past data of the patient. The novel approach is using neural network method, wireless vital sign acquisition devices and personal computer DB system. An intelligent agent based MDSS will help elder people and high risk patients to prevent sudden death and disease, the physician to get the online access to patients- data, the plan of medication service priority (e.g. emergency case).

Keywords: Neural network, U-healthcare, MDSS, CAP, DSS.

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Authors: Muhammad Fiaz, Baseerat Rizwan, Naqvi Najam Abbas, Yang Naiding

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The aspiration of this research article is to target and focus the gains of university-Industry (U-I) collaborations and exploring those hurdles which are the obstacles for attaining these gains. University-Industry collaborations have attained great importance since 1980 in USA due to its application in all fields of life. U-I collaboration is a bilateral process where academia is a proactive member to make such alliances. Universities want to ameliorate their academic-base with the technicalities of technobabbles. U-I collaboration is becoming an essential lane for achieving innovative goals in this century. Many developed nations have set successful examples to prove this phenomenon as a catalyst to reduce costs, efforts and personnel for R&D projects. This study is exploits amplitudes of UI collaboration incentives in the light of success stories of developed countries. Many universities in USA, UK, Canada and various European Countries have been engaged with enterprises for numerous collaborative agreements. A long list of strategic and short term R&D projects has been executed in developed countries to accomplish their intended purposes. Due to the lack of intentions, genuine research and research-oriented environment, the mentioned field could not grow very well in developing countries. During last decade, a new wave of research has induced the institutes of developing countries to promote R&D culture especially in Pakistan. Higher Education Commission (HEC) has initiated many projects and funding supports for universities which have collaborative intentions with industry. Findings show that rapid innovation, overwhelm the technological complexities and articulated intellectual-base are major incentives which steer both partners to establish faculty-industry alliances. Everchanging technologies, concerned about intellectual property, different research environment and culture, research relevancy (Basic or applied), exposure differences and diversity of knowledge (bookish or practical) are main barriers to establish and retain joint ventures. Findings also concluded that, it is dire need to support and enhance cooperation among academia and industry to promote highly coordinated research behaviors. Author has proposed a roadmap for developing countries to promote R&D clusters among faculty and industry to deal the technological challenges and innovation complexities. Based on our research findings, Model for R&D Collaboration for developing countries also have been proposed to promote articulated R&D environment. If developing countries follow this phenomenon, rapid innovations can be achieved with limited R&D budget heads.

Keywords: University-Industry Collaboration, Academia, Innovation, R&D Barriers

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Authors: Rajvir Kaur, Jeewani Anupama Ginige

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With recent trends in Big Data and advancements in Information and Communication Technologies, the healthcare industry is at the stage of its transition from clinician oriented to technology oriented. Many people around the world die of cancer because the diagnosis of disease was not done at an early stage. Nowadays, the computational methods in the form of Machine Learning (ML) are used to develop automated decision support systems that can diagnose cancer with high confidence in a timely manner. This paper aims to carry out the comparative evaluation of a selected set of ML classifiers on two existing datasets: breast cancer and cervical cancer. The ML classifiers compared in this study are Decision Tree (DT), Support Vector Machine (SVM), k-Nearest Neighbor (k-NN), Logistic Regression, Ensemble (Bagged Tree) and Artificial Neural Networks (ANN). The evaluation is carried out based on standard evaluation metrics Precision (P), Recall (R), F1-score and Accuracy. The experimental results based on the evaluation metrics show that ANN showed the highest-level accuracy (99.4%) when tested with breast cancer dataset. On the other hand, when these ML classifiers are tested with the cervical cancer dataset, Ensemble (Bagged Tree) technique gave better accuracy (93.1%) in comparison to other classifiers.

Keywords: Artificial neural networks, breast cancer, cancer dataset, classifiers, cervical cancer, F-score, logistic regression, machine learning, precision, recall, support vector machine.

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Authors: D. Bheenick, M. Young, M. Elmussareh, A. Ali

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Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. To conduct the study, retrospective data of patients presenting acutely to the urology department were collected between January 13 to March 22, 2020 (pre-lockdown period) and March 23 to May 31, 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Included in the study were 1092 patients. The results show that an overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. The results of the study concluded that the admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Keywords: COVID-19, lockdown, admissions, urology

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Authors: Dalyah Y. Al-Jamal, Maryam H. Eshtaiwi, Liyakathunisa Syed

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Connecting health services with technology has a huge demand as people health situations are becoming worse day by day. In fact, engaging new technologies such as Internet of Things (IOT) into the medical services can enhance the patient care services. Specifically, patients suffering from chronic diseases such as cardiac patients need a special care and monitoring. In reality, some efforts were previously taken to automate and improve the patient monitoring systems. However, the previous efforts have some limitations and lack the real-time feature needed for chronic kind of diseases. In this paper, an improved process model for patient monitoring system specialized for cardiac patients is presented. A survey was distributed and interviews were conducted to gather the needed requirements to improve the cardiac patient monitoring system. Business Process Model and Notation (BPMN) language was used to model the proposed process. In fact, the proposed system uses the IOT Technology to assist doctors to remotely monitor and follow-up with their heart patients in real-time. In order to validate the effectiveness of the proposed solution, simulation analysis was performed using Bizagi Modeler tool. Analysis results show performance improvements in the heart monitoring process. For the future, authors suggest enhancing the proposed system to cover all the chronic diseases.

Keywords: Business process model and notation, cardiac patient, cardiac monitoring, heart monitoring, healthcare, internet of things, remote patient monitoring system, process model, telemedicine, wearable sensors.

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

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

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

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Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. Our work applies modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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Authors: Sharifah Sumayyah Engku Alwi, Masrah Azrifah Azmi Murad

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The development of the information technology and Internet has been transforming the healthcare industry. The internet is continuously accessed to seek for health information and there are variety of sources, including search engines, health websites, and social networking sites. Providing more and better information on health may empower individuals, however, ensuring a high quality and trusted health information could pose a challenge. Moreover, there is an ever-increasing amount of information available, but they are not necessarily accurate and up to date. Thus, this paper aims to provide an insight of the models and frameworks related to online health information seeking of consumers. It begins by exploring the definition of information behavior and information seeking to provide a better understanding of the concept of information seeking. In this study, critical factors such as performance expectancy, effort expectancy, and social influence will be studied in relation to the value of seeking health information. It also aims to analyze the effect of age, gender, and health status as the moderator on the factors that influence online health information seeking, i.e. trust and information quality. A preliminary survey will be carried out among the health professionals to clarify the research problems which exist in the real world, at the same time producing a conceptual framework. A final survey will be distributed to five states of Malaysia, to solicit the feedback on the framework. Data will be analyzed using SPSS and SmartPLS 3.0 analysis tools. It is hoped that at the end of this study, a novel framework that can improve online health information seeking is developed. Finally, this paper concludes with some suggestions on the models and frameworks that could improve online health information seeking.

Keywords: Information behavior, information seeking, online health information, technology acceptance model, the theory of planned behavior, UTAUT.

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: Central venous access, critically ill patients, hospital-acquired complications, prevention.

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Authors: Susana Oguntoye, Naana Otoo-Oyortey, Joanne Hemmings, Kate Norman, Eiman Hussein

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There is inadequate information on the practice of female genital mutilation (FGM) in the UK, and there are often myths and perceptions within communities that influence the effectiveness of prevention programmes. This means it is difficult to address the trends and changes in the practice in the UK. To this end, FORWARD undertook novel and innovative research using the Participatory Ethnographic and Evaluative Research (PEER) method to explore the views of women from Eritrea, Sudan, Somalia and Ethiopia that live in London and Bristol (two UK cities). Women-s views, taken from PEER interviews, reflected reasons for continued practice of FGM: marriageability, the harnessing and control of female sexuality, and upholding traditions from their countries of origin. It was also clear that the main supporters of the practice were believed to be older women within families and communities. Women described the impact FGM was having on their lives as isolating. And although it was clearly considered a private and personal matter, they developed a real sense of connection with their peers within the research process. The women were overwhelmingly positive about combating the practice, although they believed it would probably take a while before it ends completely. They also made concrete recommendations on how to improve support services for women affected by FGM: Training for professionals (particularly in healthcare), increased engagement with, and outreach to, communities, culturally appropriate materials and information made available and accessible to communities, and more consequent implementation of legislation. Finally, the women asked for more empathy and understanding, particularly from health professionals. Rather than presenting FGM as a completely alien and inconceivable practice, it may help for those looking into these women-s lives and working with them to understand the social and economic context in which the practice takes place.

Keywords: Female Genital Mutilation, FemaleCircumcision/Cutting, Participatory Research, PEER method.

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Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

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Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: Family carers, coercive treatment, independent living, mental health crisis, persons with mental illness.

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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Authors: Ah-young Jeon, In-cheol Kim, Jae-hee Jung, Soo-young Ye, Jae-hyung Kim, Ki-gon Nam, Seoung-wan Baik, Jung-hoon Ro, Gye-rok Jeon

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The aged are faced with increasing risk for falls. The aged have the easily fragile bones than others. When falls have occurred, it is important to detect this emergency state because such events often lead to more serious illness or even death. A implementation of PDA system, for detection of emergency situation, was developed using 3-axis accelerometer in this paper as follows. The signals were acquired from the 3-axis accelerometer, and then transmitted to the PDA through Bluetooth module. This system can classify the human activity, and also detect the emergency state like falls. When the fall occurs, the system generates the alarm on the PDA. If a subject does not respond to the alarm, the system determines whether the current situation is an emergency state or not, and then sends some information to the emergency center in the case of urgent situation. Three different studies were conducted on 12 experimental subjects, with results indicating a good accuracy. The first study was performed to detect the posture change of human daily activity. The second study was performed to detect the correct direction of fall. The third study was conducted to check the classification of the daily physical activity. Each test was lasted at least 1 min. in third study. The output of acceleration signal was compared and evaluated by changing a various posture after attaching a 3-axis accelerometer module on the chest. The newly developed system has some important features such as portability, convenience and low cost. One of the main advantages of this system is that it is available at home healthcare environment. Another important feature lies in low cost to manufacture device. The implemented system can detect the fall accurately, so will be widely used in emergency situation.

Keywords: Alarm System, Ambulatory monitoring, Emergency detection, Classification of activity, and 3-axis accelerometer.

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Authors: Katerina Antoniou

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When examining conflicts around the world, it is evident that the majority of intractable conflicts are steeped in identity. Identity seems to be not only a causal variable for conflict, but also a catalytic parameter for the process of reconciliation that follows ceasefire. This paper focuses on the process of identity securitization that occurs between rival groups of heterogeneous collective identities – ethnic, national or religious – as well as on the relationship between identity securitization and the ability of the groups involved to reconcile. Are securitized identities obstacles to the process of reconciliation, able to hinder any prospects of peace? If the level to which an identity is securitized is catalytic to a conflict’s discourse and settlement, then which factors act as indicators of identity de-securitization? The level of an in-group’s identity securitization can be estimated through a number of indicators, one of which is narrative. The stories, views and stances each in-group adopts in relation to its history of conflict and relation with their rival out-group can clarify whether that specific in-group feels victimized and threatened or safe and ready to reconcile. Accordingly, this study discusses identity securitization through narrative in relation to intractable conflicts. Are there conflicts around the world that, despite having been identified as intractable, stagnated or insoluble, show signs of identity de-securitization through narrative? This inquiry uses the case of the Cyprus conflict and its partitioned societies to present official narratives from the two communities and assess whether these narratives have transformed, indicating a less securitized in-group identity for the Greek and Turkish Cypriots. Specifically, the study compares the official historical overviews presented by each community’s Ministry of Foreign Affairs website and discusses the extent to which the two official narratives present a securitized collective identity. In addition, the study will observe whether official stances by the two communities – as adopted by community leaders – have transformed to depict less securitization over time. Additionally, the leaders’ reflection of popular opinion is evaluated through recent opinion polls from each community. Cyprus is currently experiencing renewed optimism for reunification, with the leaders of its two communities engaging in rigorous negotiations, and with rumors calling for a potential referendum for reunification to be taking place even as early as within 2016. Although leaders’ have shown a shift in their rhetoric and have moved away from narratives of victimization, this is not the case for the official narratives used by their respective ministries of foreign affairs. The study’s findings explore whether this narrative inconsistency proves that Cyprus is transitioning towards reunification, or whether the leaders are risking sending a securitized population to the polls to reject a potential reunification. More broadly, this study suggests that in the event that intractable conflicts might be moving towards viable peace, in-group narratives--official narratives in particular--can act as indicators of the extent to which rival entities have managed to reconcile.

Keywords: Conflict, Identity, Narrative, Reconciliation.

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Authors: Giulia I. Pintea

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The Roma people are a nomadic ethnic group native to India, and they are one of the most prevalent minorities in Europe. In the past, Roma were enslaved and they were imprisoned in concentration camps during the Holocaust; today, Roma are subject to hate crimes and are denied access to healthcare, education, and proper housing. The aim of this project is to analyze how the public perception of the Roma people may be influenced by antiziganist and pro-Roma institutions in Europe. In order to carry out this project, we used social network analysis to build two large social networks: The antiziganist network, which is composed of institutions that oppress and racialize Roma, and the pro-Roma network, which is composed of institutions that advocate for and protect Roma rights. Measures of centrality, density, and modularity were obtained to determine which of the two social networks is exerting the greatest influence on the public’s perception of Roma in European societies. Furthermore, data on hate crimes on Roma were gathered from the Organization for Security and Cooperation in Europe (OSCE). We analyzed the trends in hate crimes on Roma for several European countries for 2009-2015 in order to see whether or not there have been changes in the public’s perception of Roma, thus helping us evaluate which of the two social networks has been more influential. Overall, the results suggest that there is a greater and faster exchange of information in the pro-Roma network. However, when taking the hate crimes into account, the impact of the pro-Roma institutions is ambiguous, due to differing patterns among European countries, suggesting that the impact of the pro-Roma network is inconsistent. Despite antiziganist institutions having a slower flow of information, the hate crime patterns also suggest that the antiziganist network has a higher impact on certain countries, which may be due to institutions outside the political sphere boosting the spread of antiziganist ideas and information to the European public.

Keywords: Applied mathematics, oppression, Roma people, social network analysis.

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Authors: Ana Cristina García-Luna Romero

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This document seeks to reflect on the urban project from its conceptual identity root. In the first instance, a proposal is made on how the city project is sustained from the conceptual root, from the logos: it opens a way to assimilate the imagination; what we imagine becomes a reality. In this way, firstly, the need to use language as a vehicle for transmitting the stories that sustain us as humanity can be deemed as an important social factor that enables us to social behavior. Secondly, the need to attend to the written language as a mechanism of power, as a means to consolidate a dominant ideology or a political position, is raised; as it served to carry out the modernization project, it is therefore addressed differences between the real and the literate city. Thus, the consolidated urban-architectural project is based on logos, the project, and planning. Considering the importance of materiality and its relation to subjective well-being contextualized from a socio-urban approach, we question ourselves into how we can look at something that is doubtful. From a philosophy perspective, the truth is considered to be nothing more than a matter of correspondence between the observer and the observed. To understand beyond the relative of the gaze, it is necessary to expose different perspectives since it depends on the understanding of what is observed and how it is critically analyzed. Therefore, the analysis of materiality, as a political field, takes a proposal based on this research in the principles in transgenesis: principle of communication, representativeness, security, health, malleability, availability of potentiality or development, conservation, sustainability, economy, harmony, stability, accessibility, justice, legibility, significance, consistency, joint responsibility, connectivity, beauty, among others. The (urban) human being acts because he wants to live in a certain way: in a community, in a fair way, with opportunity for development, with the possibility of managing the environment according to their needs, etc. In order to comply with this principle, it is necessary to design strategies from the principles in transgenesis, which must be named, defined, understood, and socialized by the urban being, the companies, and from themselves. In this way, the technical status of the city in the neoliberal present determines extraordinary conditions for reflecting on an almost emergency scenario created by the impact of cities that, far from being limited to resilient proposals, must aim at the reflection of the urban process that the present social model has generated. Therefore, can we rethink the paradigm of the perception of life quality in the current neoliberal model in the production of the character of public space related to the practices of being urban. What we are trying to do within this document is to build a framework to study under what logic the practices of the social system that make sense of the public space are developed, what the implications of the phenomena of the inscription of action and materialization (and its results over political action between the social and the technical system) are and finally, how we can improve the quality of life of individuals from the urban space.

Keywords: Cities, nature, society, urban quality of life.

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Authors: Haythem A. Nakkas, Philip J. Scott, Jim S. Briggs

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This paper reports a structured literature review of the application of Health Information Technology in developing countries, defined as the World Bank categories Low-income countries, Lower-middle-income, and Upper-middle-income countries. The aim was to identify and classify the various applications of health information technology to assess its current state in developing countries and explore potential areas of research. We offer specific analysis and application of HIT in Libya as one of the developing countries. A structured literature review was conducted using the following online databases: IEEE, Science Direct, PubMed, and Google Scholar. Publication dates were set for 2000-2013. For the PubMed search, publications in English, French, and Arabic were specified. Using a content analysis approach, 159 papers were analyzed and a total number of 26 factors were identified that affect the adoption of health information technology. Of the 2681 retrieved articles, 159 met the inclusion criteria which were carefully analyzed and classified. The implementation of health information technology across developing countries is varied. Whilst it was initially expected financial constraints would have severely limited health information technology implementation, some developing countries like India have nevertheless dominated the literature and taken the lead in conducting scientific research. Comparing the number of studies to the number of countries in each category, we found that Low-income countries and Lower-middle-income had more studies carried out than Upper-middle-income countries. However, whilst IT has been used in various sectors of the economy, the healthcare sector in developing countries is still failing to benefit fully from the potential advantages that IT can offer.

Keywords: Developing Countries, Developed Countries, Factors, Failure, Implementation, Libya, Success.

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Authors: A.H.Javadi, Sh.Mirdamadi, M.A.Faghisani, S.Shakhesi

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Nanostructured materials have attracted many researchers due to their outstanding mechanical and physical properties. For example, carbon nanotubes (CNTs) or carbon nanofibres (CNFs) are considered to be attractive reinforcement materials for light weight and high strength metal matrix composites. These composites are being projected for use in structural applications for their high specific strength as well as functional materials for their exciting thermal and electrical characteristics. The critical issues of CNT-reinforced MMCs include processing techniques, nanotube dispersion, interface, strengthening mechanisms and mechanical properties. One of the major obstacles to the effective use of carbon nanotubes as reinforcements in metal matrix composites is their agglomeration and poor distribution/dispersion within the metallic matrix. In order to tap into the advantages of the properties of CNTs (or CNFs) in composites, the high dispersion of CNTs (or CNFs) and strong interfacial bonding are the key issues which are still challenging. Processing techniques used for synthesis of the composites have been studied with an objective to achieve homogeneous distribution of carbon nanotubes in the matrix. Modified mechanical alloying (ball milling) techniques have emerged as promising routes for the fabrication of carbon nanotube (CNT) reinforced metal matrix composites. In order to obtain a homogeneous product, good control of the milling process, in particular control of the ball movement, is essential. The control of the ball motion during the milling leads to a reduction in grinding energy and a more homogeneous product. Also, the critical inner diameter of the milling container at a particular rotational speed can be calculated. In the present work, we use conventional and modified mechanical alloying to generate a homogenous distribution of 2 wt. % CNT within Al powders. 99% purity Aluminium powder (Acros, 200mesh) was used along with two different types of multiwall carbon nanotube (MWCNTs) having different aspect ratios to produce Al-CNT composites. The composite powders were processed into bulk material by compaction, and sintering using a cylindrical compaction and tube furnace. Field Emission Scanning electron microscopy (FESEM), X-Ray diffraction (XRD), Raman spectroscopy and Vickers macro hardness tester were used to evaluate CNT dispersion, powder morphology, CNT damage, phase analysis, mechanical properties and crystal size determination. Despite the success of ball milling in dispersing CNTs in Al powder, it is often accompanied with considerable strain hardening of the Al powder, which may have implications on the final properties of the composite. The results show that particle size and morphology vary with milling time. Also, by using the mixing process and sonication before mechanical alloying and modified ball mill, dispersion of the CNTs in Al matrix improves.

Keywords: multiwall carbon nanotube, Aluminum matrixcomposite, dispersion, mechanical alloying, sintering

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Authors: Li-Ping Hsiao, Feng-Chuan Pan

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Leave of absence is important in maintaining a good status of human resource quality. Allowing the employees temporarily free from the routine assignments can vitalize the workers- morality and productivity. This is particularly critical to secure a satisfactory service quality for healthcare professionals of which were typically featured with labor intensive and complicated works to perform. As one of the veteran hospitals that were found and operated by the Veteran Department of Taiwan, the nursing staff of the case hospital was squeezed to an extreme minimum level under the pressure of a tight budgeting. Leave of absence on schedule became extremely difficult, especially for the intensive care units (ICU), in which required close monitoring over the cared patients, and that had more easily driven the ICU nurses nervous. Even worse, the deferred leaves were more than 10 days at any time in the ICU because of a fluctuating occupancy. As a result, these had brought a bad setback to this particular nursing team, and consequently defeated the job performance and service quality. To solve this problem and accordingly to strengthen their morality, a project team was organized across different departments specific for this. Sufficient information regarding jobs and positions requirements, labor resources, and actual working hours in detail were collected and analyzed in the team meetings. Several alternatives were finalized. These included job rotating, job combination, leave on impromptu and cross-departmental redeployment. Consequently, the deferred leave days sharply reduced 70% to a level of 3 or less days. This improvement had not only provided good shelter for the ICU nurses that improved their job performance and patient safety but also encouraged the nurses active participating of a project and learned the skills of solving problems with colleagues.

Keywords: Information, job rotating, human resource, intensive care unit.

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Authors: Sugandhi, Parteek Kumar, Sanmeet Kaur

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Sign Language (SL) is used by deaf and other people who cannot speak but can hear or have a problem with spoken languages due to some disability. It is a visual gesture language that makes use of either one hand or both hands, arms, face, body to convey meanings and thoughts. SL automation system is an effective way which provides an interface to communicate with normal people using a computer. In this paper, an avatar based dictionary has been proposed for text to Indian Sign Language (ISL) generation system. This research work will also depict a literature review on SL corpus available for various SL s over the years. For ISL generation system, a written form of SL is required and there are certain techniques available for writing the SL. The system uses Hamburg sign language Notation System (HamNoSys) and Signing Gesture Mark-up Language (SiGML) for ISL generation. It is developed in PHP using Web Graphics Library (WebGL) technology for 3D avatar animation. A multilingual ISL dictionary is developed using HamNoSys for both English and Hindi Language. This dictionary will be used as a database to associate signs with words or phrases of a spoken language. It provides an interface for admin panel to manage the dictionary, i.e., modification, addition, or deletion of a word. Through this interface, HamNoSys can be developed and stored in a database and these notations can be converted into its corresponding SiGML file manually. The system takes natural language input sentence in English and Hindi language and generate 3D sign animation using an avatar. SL generation systems have potential applications in many domains such as healthcare sector, media, educational institutes, commercial sectors, transportation services etc. This research work will help the researchers to understand various techniques used for writing SL and generation of Sign Language systems.

Keywords: Avatar, dictionary, HamNoSys, hearing-impaired, Indian Sign Language, sign language.

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Authors: Viviane Nascimento, Dania Mehmod

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

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

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

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

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

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Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

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Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector.

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Authors: M. Pushparani, A. Sagaya

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Embedded systems have emerged as important elements in various domains with extensive applications in automotive, commercial, consumer, healthcare and transportation markets, as there is emphasis on intelligent devices. On the other hand, Business Intelligence (BI) has also been extensively used in a range of applications, especially in the agriculture domain which is the area of this research. The aim of this research is to create a framework for Embedded Weight Comparison Algorithm with Business Intelligence (EWCA-BI). The weight comparison algorithm will be embedded within the plantation management system and the weighbridge system. This algorithm will be used to estimate the weight at the site and will be compared with the actual weight at the plantation. The algorithm will be used to build the necessary alerts when there is a discrepancy in the weight, thus enabling better decision making. In the current practice, data are collected from various locations in various forms. It is a challenge to consolidate data to obtain timely and accurate information for effective decision making. Adding to this, the unstable network connection leads to difficulty in getting timely accurate information. To overcome the challenges embedding is done on a portable device that will have the embedded weight comparison algorithm to also assist in data capture and synchronize data at various locations overcoming the network short comings at collection points. The EWCA-BI will provide real-time information at any given point of time, thus enabling non-latent BI reports that will provide crucial information to enable efficient operational decision making. This research has a high potential in bringing embedded system into the agriculture industry. EWCA-BI will provide BI reports with accurate information with uncompromised data using an embedded system and provide alerts, therefore, enabling effective operation management decision-making at the site.

Keywords: Embedded business intelligence, weight comparison algorithm, oil palm plantation, embedded systems.

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Authors: W. S. Barber, S. L. King

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This paper reports on a pilot project to develop a collaborative partnership between a community college in rural northern Ontario, Canada, and an urban university in the greater Toronto area in Oshawa, Canada. Partner institutions will collaborate to address learning needs of university applicants whose goals are to attain an undergraduate university BA in Educational Studies and Digital Technology degree, but who may not live in a geographical location that would facilitate this pathways process. The UOIT BA degree is attained through a 2+2 program, where students with a 2 year college diploma or equivalent can attain a four year undergraduate degree. The goals reported on the project are as: 1. Our aim is to expand the BA program to include an additional stream which includes serious educational games, simulations and virtual environments, 2. Develop fully (using both synchronous and asynchronous technologies) online learning modules for use by university applicants who otherwise are not geographically located close to a physical university site, 3. Assess the digital competencies of all students, including members of local, distance and Indigenous communities using a validated tool developed and tested by UOIT across numerous populations. This tool, the General Technical Competency Use and Scale (GTCU) will provide the collaborating institutions with data that will allow for analyzing how well students are prepared to succeed in fully online learning communities. Philosophically, the UOIT BA program is based on a fully online learning communities model (FOLC) that can be accessed from anywhere in the world through digital learning environments via audio video conferencing tools such as Adobe Connect. It also follows models of adult learning and mobile learning, and makes a university degree accessible to the increasing demographic of adult learners who may use mobile devices to learn anywhere anytime. The program is based on key principles of Problem Based Learning, allowing students to build their own understandings through the co-design of the learning environment in collaboration with the instructors and their peers. In this way, this degree allows students to personalize and individualize the learning based on their own culture, background and professional/personal experiences. Using modified flipped classroom strategies, students are able to interrogate video modules on their own time in preparation for one hour discussions occurring in video conferencing sessions. As a consequence of the program flexibility, students may continue to work full or part time. All of the partner institutions will co-develop four new modules, administer the GTCU and share data, while creating a new stream of the UOIT BA degree. This will increase accessibility for students to bridge from community colleges to university through a fully digital environment. We aim to work collaboratively with Indigenous elders, community members and distance education instructors to increase opportunities for more students to attain a university education.

Keywords: Aboriginal, college, competencies, digital, universities.

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