Search results for: patient satisfaction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 754

Search results for: patient satisfaction

544 The Attitudes of Pre-Service Teachers towards Analytical Thinking Skill Development Based On Miller’s Model

Authors: Thassanant Unnanantn, Suttipong Boonphadung

Abstract:

This research study aimed to survey and analyze the attitudes of pre-service teachers’ the analytical thinking development based on Miller’s Model. The informants of this study were 22 third year teacher students majoring in Thai. The course where the instruction was conducted was English for Academic Purposes in Thai Language 2. The instrument of this research was an open-ended questionnaire with two dimensions of questions: academic and satisfaction dimensions. The investigation revealed the positive attitudes. In the academic dimension, the majority of 12 (54.54%), the highest percentage, reflected that the method of teaching analytical thinking and language simultaneously was their new knowledge and the similar percentage also belonged to text cohesion in writing. For the satisfaction, the highest frequency count was from 17 of them (77.27%) and this majority favored the openness or friendliness of the teacher.

Keywords: Analytical thinking development, Attitudes, Miller’s Model, Pre-service teachers.

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543 Training Isolated Respiratory in Rehabilitation

Authors: Marketa Kotova, Jana Kolarova, Ludek Zalud, Petr Dobsak

Abstract:

A game for training of breath (TRABR) for continuous monitoring of pulmonary ventilation during the patients’ therapy focuses especially on monitoring of their ventilation processes. It is necessary to detect, monitor and differentiate abdominal and thoracic breathing during the therapy. It is a fun form of rehabilitation where the patient plays and also practicing isolated breathing. Finally the game to practice breath was designed to evaluate whether the patient uses two types of breathing or not.

Keywords: Pulmonary ventilation, thoracic breathing, abdominal breathing, breath monitoring using pressure sensors, game TRABR (TRAining of BReath).

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542 Understanding Cruise Passengers’ On-board Experience throughout the Customer Decision Journey

Authors: Sabina Akter, Osiris Valdez Banda, Pentti Kujala, Jani Romanoff

Abstract:

This paper examines the relationship between on-board environmental factors and customer overall satisfaction in the context of the cruise on-board experience. The on-board environmental factors considered are ambient, layout/design, social, product/service and on-board enjoyment factors. The study presents a data-driven framework and model for the on-board cruise experience. The data are collected from 893 respondents in an application of a self-administered online questionnaire of their cruise experience. This study reveals the cruise passengers’ on-board experience through the customer decision journey based on the publicly available data. Pearson correlation and regression analysis have been applied, and the results show a positive and a significant relationship between the environmental factors and on-board experience. These data help understand the cruise passengers’ on-board experience, which will be used for the ultimate decision-making process in cruise ship design.

Keywords: Cruise behavior, on-board environmental factors, on-board experience, user or customer satisfaction.

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541 Improving Decision Support for Organ Transplant

Authors: I. McCulloh, A. Placona, D. Stewart, D. Gause, K. Kiernan, M. Stuart, C. Zinner, L. Cartwright

Abstract:

We find in our data that an alarming number of viable deceased donor kidneys are discarded every year in the US, while waitlisted candidates are dying every day. We observe as many as 85% of transplanted organs are refused at least once for a patient that scored higher on the match list. There are hundreds of clinical variables involved in making a clinical transplant decision and there is rarely an ideal match. Decision makers exhibit an optimism bias where they may refuse an organ offer assuming a better match is imminent. We propose a semi-parametric Cox proportional hazard model, augmented by an accelerated failure time model based on patient-specific suitable organ supply and demand to estimate a time-to-next-offer. Performance is assessed with Cox-Snell residuals and decision curve analysis, demonstrating improved decision support for up to a 5-year outlook. Providing clinical decision-makers with quantitative evidence of likely patient outcomes (e.g., time to next offer and the mortality associated with waiting) may improve decisions and reduce optimism bias, thus reducing discarded organs and matching more patients on the waitlist.

Keywords: Decision science, KDPI, optimism bias, organ transplant.

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540 Transmitting a Distance Training Model to the Community in the Upper Northeastern Region

Authors: Teerawach Khamkorn, Laongtip Mathurasa, Savittree Rochanasmita Arnold, Witthaya Mekhum

Abstract:

The objective of this research seeks to transmit a distance training model to the community in the upper northeastern region. The group sampling consists of 60 community leaders in the municipality of sub-district Kumphawapi, Kumphawapi Disrict, Udonthani Province. The research tools rely on the following instruments, they are : 1) the achievement test of community leaders- training and 2) the satisfaction questionnaires of community leaders. The statistics used in data analysis takes the statistical mean, percentage, standard deviation, and statistical T-test. The resulted findings reveal : 1) the efficiency of the distance training developed by the researcher for the community leaders joining in the training received the average score between in-training and post-training period higher than the setup criterion, 2) the two groups of participants in the training achieved higher knowledge than their pre-training state, 3) the comparison of the achievements between the two group presented no different results, 4) the community leaders obtained the high-to-highest satisfaction.

Keywords: Distance Training, Management, Technology, Transmitting.

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539 An Intelligent System for Knee and Ankle Rehabilitation

Authors: Dimitar Karastoyanov, Vladimir Monov

Abstract:

The paper is concerned with the state examination as well as the problems during the post surgical (orthopedic) rehabilitation of the knee and ankle joint. An observation of the current appliances for a passive rehabilitation devices is presented. The major necessary and basic features of the intelligent rehabilitation devices are considered. An approach for a new intelligent appliance is suggested. The main advantages of the device are: both active as well as passive rehabilitation of the patient based on the human - patient reactions and a real time feedback. The basic components: controller; electrical motor; encoder, force – torque sensor are discussed in details. The main modes of operation of the device are considered.

Keywords: Ankle, knee, rehabilitation, computer control.

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538 Reducing Stock-out Incidents at a Hospital Using Six Sigma

Authors: Lina Al-Qatawneh, Abdallah Abdallah, Salam Zalloum

Abstract:

In managing healthcare logistics, cost is not the only factor to be considered. The level of items- criticality used in patient care services plays an important role as well. A stock-out incident of a high critical item could threaten a patient's life. In this paper, the DMAIC (Define-Measure-Analyze-Improve-Control) methodology is used to drive improvement projects based on customer driven critical to quality characteristics at a Jordanian hospital. This paper shows how the application of Six Sigma improves the performance of the case hospital logistics system by reducing the number of stock-out incidents.

Keywords: Criticality level, Healthcare, Logistics, and Six Sigma.

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537 Use of Heliox during Spontaneous Ventilation: Model Study

Authors: Martin Rozanek, Karel Roubik

Abstract:

The study deals with the modelling of the gas flow during heliox therapy. A special model has been developed to study the effect of the helium upon the gas flow in the airways during the spontaneous breathing. Lower density of helium compared with air decreases the Reynolds number and it allows improving the flow during the spontaneous breathing. In the cases, where the flow becomes turbulent while the patient inspires air the flow is still laminar when the patient inspires heliox. The use of heliox decreases the work of breathing and improves ventilation. It allows in some cases to prevent the intubation of the patients.

Keywords: Gas flow, heliox, Reynolds number, turbulent flow.

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536 Use of Cultural Symbols for Transferring House to the Home in the Case of Famagusta

Authors: M. Sokhanvar, S. M. Shahidipour

Abstract:

One of the essential requirements for the human beings is the house for living. This is necessary to make the place of satisfaction for contemporary houses residents by attention to their culture. In this article represented the relevant theoretical literature on cultural symbols by use the architecture semiotic to construct the houses as a better place for living. In fact, make a place for everyday life with changing the house to the home is one of the most challengeable subject for architects all around the world. The target of this article is to find Cypriot houses cultural symbols that assist architect to design and build contemporary houses, to make more satisfaction for its residents according to Cypriot life style and their culture. This paper is based on researching the effect of cultural symbols on housing, would require various types of methods. However, this study focuses on two methods, which are quantitative and qualitative. The purpose of the case-specific study is to finding the symbols that used in contemporary houses by attention to the Cypriot cultural symbols in Famagusta houses.

Keywords: Houses, home, architectural symbols, cultural symbols.

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535 A Proposal of a Method to Measure the Satisfaction Indicator of the Local Community Concerning Tourism: A Case Study of Jalapão State Park, Tocantins

Authors: Veruska C. Dutra, Mary L. G. S. Senna, Afonso R. Aquino

Abstract:

Tourists bring many benefits to a local community, encouraging it to be involved in that activity; however, it may also have detrimental effects like garbage, noise, violence, external culture and the damaging of the natural environment among others, which may promote community dissatisfaction. The contact between the tourist and the local community is a concern, especially when the community is located near protected areas. In this case, the community must know the tourist destination well, so it can collaborate in the tourism development without harming the environment. In this context, the present article aims to demonstrate the results of a research study conducted as part of a doctorate program in Sciences from the University of Sao Paulo, Brazil. It had as an objective to elaborate a methodology proposal to measure the local community satisfaction indicator, with applicability on a case study in the Mateiros community located in the surrounding area of the Parque Estadual do Jalapão –PEJ conservation unit in the state of Tocantins, Brazil. This is a study of an interdisciplinary nature that had the deductive method as its guide. The indicator result is going to be presented in this study. It pointed out as negative factors: there is no involvement between the local community and the tourism sector, and there is also dissatisfaction with regard to the town’s basic services. The study showed as positive the local community knowledge about the various attractions in the surrounding area and that the group recognizes the importance of the tourism for the town and life. Concerning the methodology that was used, the results showed that it can collaborate in seeking actions of improvement and involvement of the community in the planning and development of the local tourism. It comes out as an efficient analysis tool, thus enabling the perceiving of the local community point of view.

Keywords: Satisfaction indicator, tourism, community, Jalapão.

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534 Relationship between Trauma and Acute Scrotum: Test Torsion and Epididymal Appendix Torsion

Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

Abstract:

Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: Acute scrotum, testicular torsion, newborns, infants, clinical presentation.

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533 Cephalometric Changes of Patient with Class II Division 1 [Malocclusion] Post Orthodontic Treatment with Growth Stimulation: A Case Report

Authors: Pricillia Priska Sianita

Abstract:

An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.

Keywords: Cephalometric evaluation, Class II Division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems.

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532 Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control

Authors: Gorazd Karer

Abstract:

When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents is one of the main tasks of the anesthesiologist. That being said, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. This paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a User-Datagram-Protocol-based (UDP-based) communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of medical-device manufacturer and is implemented in MATLAB-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: Closed-loop control, Depth of Anesthesia, DoA, optical signal acquisition, Patient State index, PSi, UDP communication protocol.

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531 Clique and Clan Analysis of Patient-Sharing Physician Collaborations

Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

Abstract:

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

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

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530 Study and Design of Patient Flow at the Medicine Department of a University Hospital

Authors: P. Prudtikul, S. Pathomsiri

Abstract:

Most, if not all, public hospitals in Thailand have encountered a common problem regarding the increasing demand for medical services. The increasing number of patients causes so much strain on the hospital-s services, over-crowded, overloaded working hours, staff fatigue, medical error and long waiting time. This research studied the characteristics of operational processes of the medical care services at the medicine department in a large public university hospital. The research focuses on details regarding methods, procedures, processes, resources, and time management in overall processes. The simulation model is used as a tool to analyze the impact of various improvement strategies.

Keywords: Patient flow, medicine department, simulation, outpatient department.

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529 The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

Abstract:

Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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528 Designing Software Quality Measurement System for Telecommunication Industry Using Object-Oriented Technique

Authors: Nor Fazlina Iryani Abdul Hamid, Mohamad Khatim Hasan

Abstract:

Numbers of software quality measurement system have been implemented over the past few years, but none of them focuses on telecommunication industry. Software quality measurement system for telecommunication industry was a system that could calculate the quality value of the measured software that totally focused in telecommunication industry. Before designing a system, quality factors, quality attributes and quality metrics were identified based on literature review and survey. Then, using the identified quality factors, quality attributes and quality metrics, quality model for telecommunication industry was constructed. Each identified quality metrics had its own formula. Quality value for the system was measured based on the quality metrics and aggregated by referring to the quality model. It would classify the quality level of the software based on Net Satisfaction Index (NSI). The system was designed using object-oriented approach in web-based environment. Thus, existing of software quality measurement system was important to both developers and users in order to produce high quality software product for telecommunication industry.

Keywords: Software Quality, Quality Measurement, Object-oriented Approach, Net satisfaction Index.

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527 Virtual E-Medic: A Cloud Based Medical Aid

Authors: Madiajagan Muthaiyan, Neha Goel, Deepti Sunder Prakash

Abstract:

This paper discusses about an intelligent system to be installed in ambulances providing professional support to the paramedics on board. A video conferencing device over mobile 4G services enables specialists virtually attending the patient being transferred to the hospital. The data centre holds detailed databases on the patients past medical history and hospitals with the specialists. It also hosts various software modules that compute the shortest traffic –less path to the closest hospital with the required facilities, on inputting the symptoms of the patient, on a real time basis.

Keywords: 4G mobile services, cloud computing, data centre, intelligent system, optimization, real time traffic reporting, SaaS, video conferencing.

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526 Integration of Image and Patient Data, Software and International Coding Systems for Use in a Mammography Research Project

Authors: V. Balanica, W. I. D. Rae, M. Caramihai, S. Acho, C. P. Herbst

Abstract:

Mammographic images and data analysis to facilitate modelling or computer aided diagnostic (CAD) software development should best be done using a common database that can handle various mammographic image file formats and relate these to other patient information. This would optimize the use of the data as both primary reporting and enhanced information extraction of research data could be performed from the single dataset. One desired improvement is the integration of DICOM file header information into the database, as an efficient and reliable source of supplementary patient information intrinsically available in the images. The purpose of this paper was to design a suitable database to link and integrate different types of image files and gather common information that can be further used for research purposes. An interface was developed for accessing, adding, updating, modifying and extracting data from the common database, enhancing the future possible application of the data in CAD processing. Technically, future developments envisaged include the creation of an advanced search function to selects image files based on descriptor combinations. Results can be further used for specific CAD processing and other research. Design of a user friendly configuration utility for importing of the required fields from the DICOM files must be done.

Keywords: Database Integration, Mammogram Classification, Tumour Classification, Computer Aided Diagnosis.

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525 Online Learning Activities Kit on Plants in Thai Literature in Compliance with the School Botanical Garden of Plant Genetic Conservation Project under the Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn

Authors: Pornpapatsorn Princhankol, Kannika Udnunkarn

Abstract:

This research was aimed to develop and determine the quality of online learning activities kit as well as to examine the learning achievement of students and their satisfaction towards the kit through authentic assessment. The tools in this research contained online learning activities kit on plant in Thai literature in compliance with the School Botanical Garden of Plant Genetic Conservation Project under the Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn, the assessment form, the learning achievement test, the satisfaction form and the authentic assessment form. The population consisted of 40 students in the second range of primary years (Prathomsuksa 4 to 6) at Ban Khao Rak School, Suratthani Province, Thailand. The research results showed that the content quality of the developed online learning activities kit as assessed by the experts was 4.70 on average or at very high level. The pre-test and post-test comparison was made to examine the learning achievement and it revealed that the post-test score was higher than the pre-test score with statistical significance at the .01 level. The satisfaction of the sampling group towards the online learning activities kit was 4.74 or at the highest level. The authentic assessment showed an average of 1.69 or at good level. Therefore, the online learning activities kit on plant in Thai literature in compliance with the School Botanical Garden of Plant Genetic Conservation Project under the Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn could be used in real classroom situations.

Keywords: Online learning activities kit, Plants in Thai literature, School Botanical garden

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524 Factors Affecting General Practitioners’ Transfer of Specialized Self-Care Knowledge to Patients

Authors: Weidong Xia, Malgorzata Kolotylo, Xuan Tan

Abstract:

This study examines the key factors that influence general practitioners’ learning and transfer of specialized arthritis knowledge and self-care techniques to patients during normal patient visits. Drawing on the theory of planed behavior and using matched survey data collected from general practitioners before and after training sessions provided by specialized orthopedic physicians, the study suggests that the general practitioner’s intention to use and transfer learned knowledge was influenced mainly by intrinsic motivation, organizational learning culture and absorptive capacity, but was not influenced by extrinsic motivation. The results provide both theoretical and practical implications.

Keywords: Empirical study, healthcare knowledge management, patient self-care, physician knowledge transfer.

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523 Antibiotic Prescribing in the Acute Care in Iraq

Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

Abstract:

Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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522 The Study of Tourists’ Behavior in Water Usage in Hotel Business: Case Study of Phuket Province, Thailand

Authors: A. Pensiri, K. Nantaporn, P. Parichut

Abstract:

Tourism is very important to the economy of many countries due to the large contribution in the areas of employment and income generation. However, the rapid growth of tourism can also be considered as one of the major uses of water user, and therefore also have a significant and detrimental impact on the environment. Guest behavior in water usage can be used to manage water in hotels for sustainable water resources management. This research presents a study of hotel guest water usage behavior at two hotels, namely Hotel A (located in Kathu district) and Hotel B (located in Muang district) in Phuket Province, Thailand, as case studies. Primary and secondary data were collected from the hotel manager through interview and questionnaires. The water flow rate was measured in-situ from each water supply device in the standard room type at each hotel, including hand washing faucets, bathroom faucets, shower and toilet flush. For the interview, the majority of respondents (n = 204 for Hotel A and n = 244 for Hotel B) were aged between 21 years and 30 years (53% for Hotel A and 65% for Hotel B) and the majority were foreign (78% in Hotel A, and 92% in Hotel B) from American, France and Austria for purposes of tourism (63% in Hotel A, and 55% in Hotel B). The data showed that water consumption ranged from 188 litres to 507 liters, and 383 litres to 415 litres per overnight guest in Hotel A and Hotel B (n = 244), respectively. These figures exceed the water efficiency benchmark set for Tropical regions by the International Tourism Partnership (ITP). It is recommended that guest water saving initiatives should be implemented at hotels. Moreover, the results showed that guests have high satisfaction for the hotels, the front office service reveal the top rates of average score of 4.35 in Hotel A and 4.20 in Hotel B, respectively, while the luxury decoration and room cleanliness exhibited the second satisfaction scored by the guests in Hotel A and B, respectively. On the basis of this information, the findings can be very useful to improve customer service satisfaction and pay attention to this particular aspect for better hotel management.

Keywords: Hotel, tourism, Phuket, water usage.

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521 Obstruction to Treatments Meeting International Standards for Lyme and Relapsing Fever Borreliosis Patients

Authors: J. Luché-Thayer, C. Perronne, C. Meseko

Abstract:

We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: Conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent.

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520 The Construction of Interactive Computer Multimedia Instruction on “Basic Japanese Vocabulary“

Authors: Kongrit Jittangthammagul, Sakesun Yampinij, Thapanee Endoo, Nattapong Kramwong

Abstract:

The study entitled “The Construction of Interactive Computer Multimedia Instruction on Basic Japanese Vocabulary" was aimed: 1) To construct the interactive computer multimedia instruction on Basic Japanese Vocabulary, 2) To find out multimedia-s quality, 3) To examine the student-s satisfaction and 4) To study the learning achievement in Basic Japanese vocabulary. The sampling group used in this study was composed of 40 1st year student in Educational Communications and Technology Department, Faculty of Industrial Education and Technology, King Mongkut-s University of Technology Thonburi, in the academic year 2553 B.E. (2010). According to research results, we found that 1). The quality assessment by 3 mass media experts was at 4.72 on average or at high level. 2) In terms of contents, the evaluation by 3 experts was at 4.81 on average or at high level. 3) In terms of achievement, there was a statistical significance between before and after the treatment at the .05 level. 4) The satisfaction of students towards the interactive computer multimedia Instruction on “Basic Japanese Vocabulary" was 4.35 on average, or at high level.

Keywords: Interactive Computer Multimedia on Basic Japanese Vocabulary, Learning Achievement, Quality

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519 Multidisciplinary Approach to Diagnosis of Primary Progressive Aphasia in a Younger Middle Aged Patient

Authors: Robert Krause

Abstract:

Primary progressive aphasia (PPA) is a neurodegenerative disease similar to frontotemporal and semantic dementia, while having a different clinical image and anatomic pathology topography. Nonetheless, they are often included under an umbrella term: frontotemporal lobar degeneration (FTLD). In the study, examples of diagnosing PPA are presented through the multidisciplinary lens of specialists from different fields (neurologists, psychiatrists, clinical speech therapists, clinical neuropsychologists and others) using a variety of diagnostic tools such as MR, PET/CT, genetic screening and neuropsychological and logopedic methods. Thanks to that, specialists can get a better and clearer understanding of PPA diagnosis. The study summarizes the concrete procedures and results of different specialists while diagnosing PPA in a patient of younger middle age and illustrates the importance of multidisciplinary approach to differential diagnosis of PPA.

Keywords: Primary progressive aphasia, etiology, diagnosis, younger middle age.

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518 Trends, Problems and Needs of Urban Housing in Malaysia

Authors: Salfarina A.G., Nor Malina M., Azrina H.

Abstract:

The right to housing is a basic need while good quality and affordable housing is a reflection of a high quality of life. However, housing remains a major problem for most, especially for the bottom billions. Satisfaction on housing and neighbourhood conditions are one of the important indicators that reflect quality of life. These indicators are also important in the process of evaluating housing policy with the objective to increase the quality of housing and neighbourhood. The research method is purely based on a quantitative method, using a survey. The findings show that housing purchasing trend in urban Malaysia is determined by demographic profiles, mainly by education level, age, gender and income. The period of housing ownership also influenced the socio-cultural interactions and satisfaction of house owners with their neighbourhoods. The findings also show that the main concerns for house buyers in urban areas are price and location of the house. Respondents feel that houses in urban Malaysia is too expensive and beyond their affordability. Location of houses and distance from work place are also regarded as the main concern. However, respondents are fairly satisfied with religious and socio-cultural facilities in the housing areas and most importantly not many regard ethnicity as an issue in their decision-making, when buying a house.

Keywords: Housing, Urban Housing, Malaysia

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517 Instruction Resource Recommendation Services for Elementary Schools in Taiwan

Authors: Hong-Ren Chen, Fang-Yu Yeh

Abstract:

In the past, there were more researches of recommendation system in applied electronic commerce. However, because all circles promote information technology integrative instruction actively, the quantity of instruction resources website is more and more increasing on the Internet. But there are less website including recommendation service, especially for teachers. This study established an instruction resource recommendation website that analyzed teaching style of teachers, then provided appropriate instruction resources for teachers immediately. We used the questionnaire survey to realize teacher-s suggestions and satisfactions with the instruction resource contents and recommendation results. The study shows: (1)The website used “Transactional Ability Inventory" that realized teacher-s style and provided appropriate instruction resources for teachers in a short time, it reduced the step of data filter. (2)According to the content satisfaction of questionnaire survey, four styles teachers were almost satisfied with the contents of the instruction resources that the website recommended, thus, the conception of developing instruction resources with different teaching style is accepted. (3) According to the recommendation satisfaction of questionnaire survey, four styles teachers were almost satisfied with the recommendation service of the website, thus, the recommendation strategy that provide different results for teachers in different teaching styles is accepted.

Keywords: Instruction resource, recommendation service, teaching style.

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516 An Amalgam Approach for DICOM Image Classification and Recognition

Authors: J. Umamaheswari, G. Radhamani

Abstract:

This paper describes about the process of recognition and classification of brain images such as normal and abnormal based on PSO-SVM. Image Classification is becoming more important for medical diagnosis process. In medical area especially for diagnosis the abnormality of the patient is classified, which plays a great role for the doctors to diagnosis the patient according to the severeness of the diseases. In case of DICOM images it is very tough for optimal recognition and early detection of diseases. Our work focuses on recognition and classification of DICOM image based on collective approach of digital image processing. For optimal recognition and classification Particle Swarm Optimization (PSO), Genetic Algorithm (GA) and Support Vector Machine (SVM) are used. The collective approach by using PSO-SVM gives high approximation capability and much faster convergence.

Keywords: Recognition, classification, Relaxed Median Filter, Adaptive thresholding, clustering and Neural Networks

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515 Cognitive Behaviour Therapy to Treat Social Anxiety Disorder: A Psychology Case

Authors: Yasmin Binti Othman Mydin, Mohd. Fadzillah Abdul Razak

Abstract:

Rational Emotive Behaviour Therapy is the first cognitive behavior therapy which was introduced by Albert Ellis. This is a systematic and structured psychotherapy which is effective in treating various psychological problems. A patient, 25 years old male, experienced intense fear and situational panic attack to return to his faculty and to face his class-mates after a long absence (2 years). This social anxiety disorder was a major factor that impeded the progress of his study. He was treated with the use of behavioural technique such as relaxation breathing technique and cognitive techniques such as imagery, cognitive restructuring, rationalization technique and systematic desensitization. The patient reported positive improvement in the anxiety disorder, able to progress well in studies and lead a better quality of life as a student.

Keywords: Anxiety, behaviour, cognitive, therapy

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