Search results for: patient related elbow evaluation scale

Authors: G. Quiroga-Cubides, A. Díaz, M. Gómez

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The genus Azotobacter has been widely used as bio-fertilizer due to its significant effects on the stimulation and promotion of plant growth in various agricultural species of commercial interest. In order to obtain significantly viable cellular concentration, a scale-up strategy for a liquid fermentation process (SmF) with two strains of A. chroococcum (named Ac1 and Ac10) was validated and adjusted at laboratory and pilot scale. A batch fermentation process under previously defined conditions was carried out on a biorreactor Infors®, model Minifors of 3.5 L, which served as a baseline for this research. For the purpose of increasing process efficiency, the effect of the reduction of stirring speed was evaluated in combination with a fed-batch-type fermentation laboratory scale. To reproduce the efficiency parameters obtained, a scale-up strategy with geometric and fluid dynamic behavior similarities was evaluated. According to the analysis of variance, this scale-up strategy did not have significant effect on cellular concentration and in laboratory and pilot fermentations (Tukey, p > 0.05). Regarding air consumption, fermentation process at pilot scale showed a reduction of 23% versus the baseline. The percentage of reduction related to energy consumption reduction under laboratory and pilot scale conditions was 96.9% compared with baseline.

Keywords: Azotobacter chroococcum, scale-up, liquid fermentation, fed-batch process.

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Authors: Chung-Hung Tsai

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Global environmental changes lead to increased frequency and scale of natural disaster, Taiwan is under the influence of global warming and extreme weather. Therefore, the vulnerability was increased and variability and complexity of disasters is relatively enhanced. The purpose of this study is to consider the source and magnitude of hazard characteristics on the tourism industry. Using modern risk management concepts, integration of related domestic and international basic research, this goes beyond the Taiwan typhoon disaster risk assessment model and evaluation of loss. This loss evaluation index system considers the impact of extreme weather, in particular heavy rain on the tourism industry in Taiwan. Consider the extreme climate of the compound impact of disaster for the tourism industry; we try to make multi-hazard risk assessment model, strategies and suggestions. Related risk analysis results are expected to provide government department, the tourism industry asset owners, insurance companies and banking include tourist disaster risk necessary information to help its tourism industry for effective natural disaster risk management.

Keywords: Tourism industry, extreme weather, multi-hazard, vulnerability analysis, loss exceeding probability, risk management.

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Authors: Yi-Yun Ko, Der-Ming Liou

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

Keywords: consent, EHR, HL7, IHE

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Authors: 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: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: Patient education, post-operative pain, patient satisfaction, post-operative outcome.

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Authors: Arne Koschel, Irina Astrova, Elena Deutschkämer, Jacob Ester, Johannes Feldmann

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In this paper various techniques in relation to large-scale systems are presented. At first, explanation of large-scale systems and differences from traditional systems are given. Next, possible specifications and requirements on hardware and software are listed. Finally, examples of large-scale systems are presented.

Keywords: Distributed file systems, cashing, large scale systems, MapReduce algorithm, NoSQL databases.

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Authors: Chao Qi, Fuyang Peng, Bo Deng, Xiaoyan Su

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In the upgrade process of enterprise information systems, how to deal with and utilize those legacy systems affects the efficiency of construction and development of the new system. We propose an evaluation system, which comprehensively describes the capacity of legacy information systems in five aspects. Then we propose a practical legacy systems evaluation method. Base on the evaluation result, we can determine the current state of legacy system which was evaluated.

Keywords: Legacy Information Systems, Evaluation IndexSystem, Evaluation Method, Evaluation Level

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Authors: Philippe A. Martin

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This article first summarizes reasons why current approaches supporting Open Learning and Distance Education need to be complemented by tools permitting lecturers, researchers and students to cooperatively organize the semantic content of Learning related materials (courses, discussions, etc.) into a fine-grained shared semantic network. This first part of the article also quickly describes the approach adopted to permit such a collaborative work. Then, examples of such semantic networks are presented. Finally, an evaluation of the approach by students is provided and analyzed.

Keywords: knowledge sharing, knowledge evaluation, e-learning

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Authors: J. Erina, I. Erins

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The goals of the present research are to estimate Six Sigma implementation in Latvian commercial banks and to identify the perceived benefits of its implementation. To achieve the goals, the authors used sequential explanatory method. To obtain empirical data, the authors have developed the questionnaire and adapted it for the employees of Latvian commercial banks. The questions are related to Six Sigma implementation and its perceived benefits. The questionnaire mainly consists of closed questions, the evaluation of which is based on 5 point Likert scale. The obtained empirical data has shown that of the two hypotheses put forward in the present research – Hypothesis 1 – has to be rejected, while Hypothesis 2 has been partially confirmed. The authors have also faced some research limitations related to the fact that the participants in the questionnaire belong to different rank of the organization hierarchy.

Keywords: Six Sigma, Quality, Commercial banking sector, Latvia.

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Authors: Fatemeh Nikpay, Rodina Binti Ahmad, Babak Darvish Rouhani

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Enterprise Architecture (EA) is employed by enterprises for providing integrated Information Systems (ISs) in order to support alignment of their business and Information Technology (IT). Evaluation of EA implementation can support enterprise to reach intended goals. There are some problems in current evaluation methods of EA implementation that lead to ineffectiveness implementation of EA. This paper represents current issues on evaluation of EA implementation. In this regard, we set the framework in order to represent evaluation’s issues based on their functionality and structure. The results of this research not only increase the knowledge of evaluation, but also could be useful for both academics and practitioners in order to realize the current situation of evaluations.

Keywords: Current issues on EA, implementation evaluation, Evaluation, Enterprise Architecture, Evaluation of Enterprise Architecture Implementation.

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Authors: Ilze Gramatina, Jelena Zagorska, Evita Straumite, Svetlana Sarvi

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In the meat processing industry the substitution of meat with non-meat ingredients is considered an important strategy for reducing overall production costs. The main purpose of the current research was to evaluate differences in physical-chemical composition of cooked sausage with different legumes additions. Peas (Pisum sativum), beans (Phaseolus vulgaris) and lentil (Lens culinaris) were used in preparation of sausages. The legumes at proportion of 20% of the total weight of meat were added in sausages. The whole ingredients were mixed, filled into casing, compressed, cooked and cooled. After storage the samples were sensory evaluated. The sensory evaluation was carried out using the nine point hedonic scale and line scale. Sausages without legumes flour was used as control sample. The main conclusion of the current research the legumes flour can be successfully used for cooked sausages production.

Keywords: Legumes, cooked sausages.

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Authors: A. Seham A. Elgamal, Reham H. Saleh

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Chronic kidney disease became a global health problem worldwide. Therefore, in order to maintain a patient’s life and improve the survival rate, hemodialysis is essential to replace the function of their kidneys. However, those patients may complain about multiple physical and psychological stressors due to the nature of the disease and the need for frequent hemodialysis sessions. So, those patients use various strategies to cope with the stressors related to their disease and the treatment procedures. Cross-sectional, descriptive study was carried out to achieve the aim of the study. A convenient sample including all adult patients was recruited for this study. Hemodialysis Stressors Scale (HSS) and Jalowiec Coping Scale (JCS) were used to investigate the stressors and coping strategies of 89 hemodialysis patients, at a governmental hospital (King Khalid Hospital-Jeddah). Results of the study revealed that 50.7% experienced physiological stressors and 38% experienced psychosocial stressors. Also, optimistic, fatalistic, and supportive coping strategies were the most common coping strategies used by the patients with mean scores (2.88 + 0.75, 2.87 + 0.75, and 1.82 + 0.71), respectively. In conclusion, being familiar with the types of stressors and the effective coping strategies of hemodialysis patients and their families are important in order to enhance their adaptation with chronic kidney diseases.

Keywords: Coping strategies, hemodialysis, physiological stressors, psychological stressors.

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Authors: Ong Sing Goh, C. Ardil, Wilson Wong, Chun Che Fung

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The evaluation of conversational agents or chatterbots question answering systems is a major research area that needs much attention. Before the rise of domain-oriented conversational agents based on natural language understanding and reasoning, evaluation is never a problem as information retrieval-based metrics are readily available for use. However, when chatterbots began to become more domain specific, evaluation becomes a real issue. This is especially true when understanding and reasoning is required to cater for a wider variety of questions and at the same time to achieve high quality responses. This paper discusses the inappropriateness of the existing measures for response quality evaluation and the call for new standard measures and related considerations are brought forward. As a short-term solution for evaluating response quality of conversational agents, and to demonstrate the challenges in evaluating systems of different nature, this research proposes a blackbox approach using observation, classification scheme and a scoring mechanism to assess and rank three example systems, AnswerBus, START and AINI.

Keywords: Evaluation, conversational agents, Response Quality, chatterbots

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Authors: Kyoung-Jong Park, Woong-Gi Jeon, Hee-Cheol Kim, Dong-Eog Kim, Heung-Kook Choi

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The brain MR imaging-based clinical research and analysis system were specifically built and the development for a large-scale data was targeted. We used the general clinical data available for building large-scale data. Registration period for the selection of the lesion ROI and the region growing algorithm was used and the Mesh-warp algorithm for matching was implemented. The accuracy of the matching errors was modified individually. Also, the large ROI research data can accumulate by our developed compression method. In this way, the correctly decision criteria to the research result was suggested. The experimental groups were age, sex, MR type, patient ID and smoking which can easily be queries. The result data was visualized of the overlapped images by a color table. Its data was calculated by the statistical package. The evaluation for the utilization of this system in the chronic ischemic damage in the area has done from patients with the acute cerebral infarction. This is the cause of neurologic disability index location in the center portion of the lateral ventricle facing. The corona radiate was found in the position. Finally, the system reliability was measured both inter-user and intra-user registering correlation.

Keywords: Software tool design, Cerebral infarction, Brain MR image, Registration

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Authors: Goh Ong Sing, C. Ardil, Wilson Wong, Shahrin Sahib

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The evaluation of the question answering system is a major research area that needs much attention. Before the rise of domain-oriented question answering systems based on natural language understanding and reasoning, evaluation is never a problem as information retrieval-based metrics are readily available for use. However, when question answering systems began to be more domains specific, evaluation becomes a real issue. This is especially true when understanding and reasoning is required to cater for a wider variety of questions and at the same time achieve higher quality responses The research in this paper discusses the inappropriateness of the existing measure for response quality evaluation and in a later part, the call for new standard measures and the related considerations are brought forward. As a short-term solution for evaluating response quality of heterogeneous systems, and to demonstrate the challenges in evaluating systems of different nature, this research presents a black-box approach using observation, classification scheme and a scoring mechanism to assess and rank three example systems (i.e. AnswerBus, START and NaLURI).

Keywords: Evaluation, question answering, response quality.

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Authors: Münevver Başman, Ezel Tavşancıl

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Making the right decisions about students depends on teachers’ use of the assessment and evaluation techniques effectively. In order to do that, teachers should have positive attitudes and adequate self-efficacy perception towards assessment and evaluation. The purpose of this study is to investigate relationship between self-efficacy perception and the attitudes of prospective teachers towards assessment and evaluation and what kind of differences these issues have in terms of a variety of demographic variables. The study group consisted of 277 prospective teachers who have been studying in different departments of Marmara University, Faculty of Education. In this study, ‘Personal Information Form’, ‘A Perceptual Scale for Measurement and Evaluation of Prospective Teachers Self-Efficacy in Education’ and ‘Attitudes toward Educational Measurement Inventory’ are applied. As a result, positive correlation was found between self-efficacy perceptions and the attitudes of prospective teachers towards assessment and evaluation. Considering different departments, there is a significant difference between the mean score of attitudes of prospective teachers and between the mean score of self-efficacy perceptions of them. However, considering variables of attending statistics class and the class types at the graduated high school, there is no significant difference between the mean score of attitudes of prospective teachers and between the mean score of self-efficacy perceptions of them.

Keywords: Attitude, perception, prospective teacher, self-efficacy.

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Authors: Gulten Yilmaz, A. Beril Tugrul, Mustafa Demir, Dogan Yasar, Bayram Demir, Bulent Buyuk

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A Positron Emission Tomography (PET) is a radioisotope imaging technique that illustrates the organs and the metabolisms of the human body. This technique is based on the simultaneous detection of 511 keV annihilation photons, annihilated as a result of electrons annihilating positrons that radiate from positron-emitting radioisotopes that enter biological active molecules in the body. This study was conducted on ten patients in an effort to conduct patient-related experimental studies. Dosage monitoring for the bladder, which was the organ that received the highest dose during PET applications, was conducted for 24 hours. Assessment based on measuring urination activities after injecting patients was also a part of this study. The MIRD method was used to conduct dosage calculations for results obtained from experimental studies. Results obtained experimentally and theoretically were assessed comparatively.

Keywords: PET/CT, TLD, MIRD, Dose measurement, Patient doses.

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Authors: Omid A. Zargar

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The simulated mass and spring method evaluation for subway or railways construction and installation systems have a wide application in rail industries. This kind of design should be optimizing all related parameters to reduce the amount of vibration in cities, homelands, historical zones and other critical locations. Finite element method could help us a lot to analysis such applications with an excellent accuracy but always developing some simple, fast and user friendly evaluation method required in subway industrial applications. In addition, process parameter optimization extremely required in railway industries to achieve some optimal design of railways with maximum safety, reliability and performance. Furthermore, it is important to reduce vibrations and further related maintenance costs as well as possible. In this paper a simple but useful simulated mass and spring evaluation system developed for Esfahan subway construction. Besides, some of related recent patent and innovations in rail world industries like Suspension mass tuned vibration reducer, short sleeper vibration attenuation fastener and Airtight track vibration-noise reducing fastener discussed in details.

Keywords: Subway construction engineering, natural frequency, operation frequency, vibration analysis, polyurethane layer.

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Authors: Sh. Yasini, M. B. Naghibi-Sistani, A. Karimpour

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This paper employs a new approach to regulate the blood glucose level of type I diabetic patient under an intensive insulin treatment. The closed-loop control scheme incorporates expert knowledge about treatment by using reinforcement learning theory to maintain the normoglycemic average of 80 mg/dl and the normal condition for free plasma insulin concentration in severe initial state. The insulin delivery rate is obtained off-line by using Qlearning algorithm, without requiring an explicit model of the environment dynamics. The implementation of the insulin delivery rate, therefore, requires simple function evaluation and minimal online computations. Controller performance is assessed in terms of its ability to reject the effect of meal disturbance and to overcome the variability in the glucose-insulin dynamics from patient to patient. Computer simulations are used to evaluate the effectiveness of the proposed technique and to show its superiority in controlling hyperglycemia over other existing algorithms

Keywords: Insulin Delivery rate, Q-learning algorithm, Reinforcement learning, Type I diabetes.

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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Authors: Seongmin Yim

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The Korean government has applied preliminary feasibility study for a new R&D program over about $50 Million since 2008 as a part of official process in budget planning. The investigations of technology, policy, and economics are carried out separately to arrive at a definite result: whether a program is feasible or unfeasible. This paper describes the concept and check-points related to technological analysis from a preliminary evaluation’s stand-point. First of all, the fundamental concept of technological analysis in evaluation systems such as Program Assessment Rating Tool (PART) by Office of Management and Budget (OMB) and Evaluation Methods by Department of Energy (DOE) in the United States, the Green Book in the United Kingdom are reviewed. After the review, customized questionnaire for technological analysis are developed. Conclusively, limitations and further research directions are provided.

Keywords: Preliminary Feasibility Study, R&D Program, Evaluation System, Technological analysis, R&D Logic Analysis.

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: Data integration, disease-related malnutrition, expert systems, mobile health.

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Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

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In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Keywords: Healthcare, flexibility, patient satisfaction, behavioral intention.

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Authors: Eduardo da Silva, Tânia Caetano, Jessica B. Lopes

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Emotion dysregulation has been linked to psychopathology in general and, in particular, to substance abuse and other addiction-related disorders, such as eating disorders, impulsive disorder, and gambling. It has been proposed that a lessening of the difficulties in emotion regulation can have a significant positive impact on the treatment of these disorders. The present study explores the association between the progress in the Change & Grow^® therapeutic model (5 stages of treatment), and the decrease in the difficulties related to emotion regulation. The Change & Grow^® model has five stages of treatment according to the model’s five principles (Truth, Acceptance, Gratitude, Love and Responsibility) and incorporates different therapeutic approaches such as positive psychology, cognitive and behavioral therapy and third generation therapies. The main objective is to understand the impact of the presented therapeutic model on difficulties in emotion regulation in patients with addiction-related disorders. The exploratory study has a cross-sectional design. Participants were 44 (15 women and 29 men) Portuguese patients in the residential Villa Ramadas International Treatment Centre. The instrument used was the Portuguese version of the Difficulties in Emotion Regulation Scale (DERS), which measures six dimensions of emotion regulation (Strategies, Non-acceptance, Awareness, Impulse, Goals, and Clarity). The mean rank scores for both the DERS total score and the Impulse subscale showed statistically significant differences according to Stage of Treatment/Principles. Furthermore, Stage of Treatment/Principles held a negative correlation with the scores of the Non-acceptance and Impulse subscales, as well as the DERS total score. The results indicate that the Change & Grow^® model seems to have an impact in lessening the patient’s difficulties in emotion regulation. The Impulse dimension suffered the greater impact, which supports the well-known relevance of impulse control, or related difficulties, in addiction-related disorders.

Keywords: Addiction, Change & Grow®, emotion regulation, psychopathology.

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Authors: Ibrahim A. Alkali

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

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

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Authors: 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: Alfrina Marwan, Erna Sulistyawati

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Class III malocclusion shows both skeletal and dentoalveolar component. Sketal Class III malocclusion can have variants in different region, maxilla or mandibular. Skeletal Class III malocclusion during growth period is considered to treat to prevent its severity in adulthood. Orthopedics treatment of skeletal Class III malocclusion in growing patient can be treated by using reverse twin block with expansion screw to modify the growth pattern. The objective of this case report was to describe the functional correction of skeletal Class III maloclussion using reverse twin block with expansion screw in growing patient. A patient with concave profile came with a chief complaint of aesthetic problems. The cephalometric analysis showed that patient had skeletal Class III malocclusion (ANB -5⁰, SNA 75º, Wits appraisal -3 mm) with anterior cross bite and deep bite (overjet -3 mm, overbite 6 mm). In this case report, the patient was treated with reverse twin block appliance with expansion screw. After three months of treatment, the skeletal problems have been corrected (ANB -1°), overjet, overbite and aesthetic were improved. Reverse twin block appliance with expansion screw can be used as orthopedics treatment for skeletal Class III malocclusion in growing patient and can improve the aesthetic with great satisfaction which was the main complaint in this patient.

Keywords: Growing patient, maxilla retrognatism, reverse twin blocks, skeletal Class III malocclusion.

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Authors: Eldah Ephraim Buba

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This paper evaluated the quality of tourism education in Nigeria higher education. The problem of poor quality of tourism education in Nigeria’s higher institutions prompted the study. Archival research was used with evaluation reports as secondary data, twenty evaluation reports for different polytechnics from the National board for technical education (NBTE) from 1995-2012 were assessed. The evidence from the documents shows that the quality of teaching and evaluation is fair. The programmes resources are fairly good, and most of the teachers do not have a postgraduate qualification in tourism related courses. It is therefore recommended that the institutions running tourism programmes in Nigeria need to introduce self -assessment of programmes and not rely on the NBTE accreditation which comes up in three years. Also there is need for a staff development policy that will encourage Tourism educators to further their education; The Tertiary Educational Trust Fund (TETFUND) should focus on developing staff of tourism education because it is an area of study in Nigeria that lacks qualified personnel. With the way higher institution in Nigeria are finding interest in tourism programmes, having good quality programmes will not only produce better professionals but it will help in offering better services in the industry and maximizing the impacts of the business.

Keywords: Education, evaluation tourism, quality.

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Authors: L. Bennaceur Farah, I. R. Farah, R. Bennaceur, Z. Belhadj, M. R. Boussema

Abstract:

The overall objective of this paper is to retrieve soil surfaces parameters namely, roughness and soil moisture related to the dielectric constant by inverting the radar backscattered signal from natural soil surfaces. Because the classical description of roughness using statistical parameters like the correlation length doesn't lead to satisfactory results to predict radar backscattering, we used a multi-scale roughness description using the wavelet transform and the Mallat algorithm. In this description, the surface is considered as a superposition of a finite number of one-dimensional Gaussian processes each having a spatial scale. A second step in this study consisted in adapting a direct model simulating radar backscattering namely the small perturbation model to this multi-scale surface description. We investigated the impact of this description on radar backscattering through a sensitivity analysis of backscattering coefficient to the multi-scale roughness parameters. To perform the inversion of the small perturbation multi-scale scattering model (MLS SPM) we used a multi-layer neural network architecture trained by backpropagation learning rule. The inversion leads to satisfactory results with a relative uncertainty of 8%.

Keywords: Remote sensing, rough surfaces, inverse problems, SAR, radar scattering, Neural networks and Fractals.

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Authors: Nálevka Petr

Abstract:

Many contemporary telemedical applications rely on regular consultations over the phone or video conferencing which consumes valuable resources such as the time of the doctors. Some applications or treatments allow automated diagnostics on the patient side which only notifies the doctors in case a significant worsening of patient’s condition is measured. Such programs can save valuable resources but an important implementation issue is how to ensure effective and cheap diagnostics on the patient side. First, specific diagnostic devices on patient side are expensive and second, they need to be user-˜friendly to encourage patient’s cooperation and reduce errors in usage which may cause noise in diagnostic data. This article proposes the use of modern smartphones and various build-in or attachable sensors as universal diagnostic devices applicable in a wider range of telemedical programs and demonstrates their application on a case-study – a program for schizophrenic relapse prevention.

Keywords: Smartphones, Actigraphy, Telemedicine, In-home Diagnostics

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