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

Search results for: patient satisfaction

514 Causal Modeling of the Glucose-Insulin System in Type-I Diabetic Patients

Authors: J. Fernandez, N. Aguilar, R. Fernandez de Canete, J. C. Ramos-Diaz

Abstract:

In this paper, a simulation model of the glucose-insulin system for a patient undergoing diabetes Type 1 is developed by using a causal modeling approach under system dynamics. The OpenModelica simulation environment has been employed to build the so called causal model, while the glucose-insulin model parameters were adjusted to fit recorded mean data of a diabetic patient database. Model results under different conditions of a three-meal glucose and exogenous insulin ingestion patterns have been obtained. This simulation model can be useful to evaluate glucose-insulin performance in several circumstances, including insulin infusion algorithms in open-loop and decision support systems in closed-loop.

Keywords: Causal modeling, diabetes, glucose-insulin system, diabetes, causal modeling, OpenModelica software.

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513 Investigating the Road Maintenance Performance in Developing Countries

Authors: Jamaa Salih, Francis Edum-Fotwe, Andrew Price

Abstract:

One of the most critical aspects of the management of road infrastructure is the type and scale of maintenance systems adopted and the consequences of their inadequacy. The performance of road maintenance systems can be assessed by a number of important indicators such as: cost, safety, environmental impact, and level of complaints by users. A review of practice reveals that insufficient level of expenditure or poor management of the road network often has serious consequences for the economic and social life of a country in terms of vehicle operating costs (VOC), travel time costs, accident costs and environmental impact. Despite an increase in the attention paid by global road agencies to the environmental and the road users’ satisfaction, the overwhelming evidence from the available literature agree on the lack of similar levels of attention for the two factors in many developing countries. While many sources agree that the road maintenance backlog is caused by either the shortage of expenditures or lack of proper management or both, it appears that managing the available assets particularly in the developing countries is the main issue. To address this subject, this paper will concentrate on exposing the various issues related to this field.  

Keywords: Environmental impact, performance indicators, road maintenance, users’ satisfaction.

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512 Robot-assisted Relaxation Training for Children with Autism Spectrum Disorders

Authors: V. Holeva, V. Aliki Nikopoulou, P. Kechayas, M. Dialechti Kerasidou, M. Papadopoulou, G. A. Papakostas, V. G. Kaburlasos, A. Evangeliou

Abstract:

Cognitive Behavioral Therapy (CBT) has been proven an effective tool to address anger and anxiety issues in children and adolescents with Autism Spectrum Disorders (ASD). Robot-enhanced therapy has been used in psychosocial and educational interventions for children with ASD with promising results. Whenever CBT-based techniques were incorporated in robot-based interventions, they were mainly performed in group sessions. Objectives: The study’s main objective was the implementation and evaluation of the effectiveness of a relaxation training intervention for children with ASD, delivered by the social robot NAO. Methods: 20 children (aged 7–12 years) were randomly assigned to 16 sessions of relaxation training implemented twice a week. Two groups were formed: the NAO group (children participated in individual sessions with the support of NAO) and the control group (children participated in individual sessions with the support of the therapist only). Participants received three different relaxation scenarios of increasing difficulty (a breathing scenario, a progressive muscle relaxation scenario and a body scan medication scenario), as well as related homework sheets for practicing. Pre- and post-intervention assessments were conducted using the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire for parents (SDQ-P). Participants were also asked to complete an open-ended questionnaire to evaluate the effectiveness of the training. Parents’ satisfaction was evaluated via a questionnaire and children satisfaction was assessed by a thermometer scale. Results: The study supports the use of relaxation training with the NAO robot as instructor for children with ASD. Parents of enrolled children reported high levels of satisfaction and provided positive ratings of the training acceptability. Children in the NAO group presented greater motivation to complete homework and adopt the learned techniques at home. Conclusions: Relaxation training could be effectively integrated in robot-assisted protocols to help children with ASD regulate emotions and develop self-control.

Keywords: Autism spectrum disorders, CBT, children relaxation training, robot-assisted therapy.

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511 Using Discrete Event Simulation Approach to Reduce Waiting Times in Computed Tomography Radiology Department

Authors: Mwafak Shakoor

Abstract:

The purpose of this study was to reduce patient waiting times, improve system throughput and improve resources utilization in radiology department. A discrete event simulation model was developed using Arena simulation software to investigate different alternatives to improve the overall system delivery based on adding resource scenarios due to the linkage between patient waiting times and resource availability. The study revealed that there is no addition investment need to procure additional scanner but hospital management deploy managerial tactics to enhance machine utilization and reduce the long waiting time in the department.

Keywords: Arena, Computed Tomography (CT), Discrete event simulation, Healthcare modeling, Radiology department, Waiting time.

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510 Theoretical Appraisal of Satisfactory Decisions: Uncertainty, Evolutionary Ideas and Beliefs, and Satisfactory Time Use

Authors: Okay Gunes

Abstract:

Unsatisfactory experiences due to an information shortage regarding the future pay-offs of actual choices, yield satisficing decision-making. This research will examine, for the first time in the literature, the motivation behind suboptimal decisions due to uncertainty by subjecting Adam Smith’s and Jeremy Bentham’s assumptions about the nature of the actions that lead to satisficing behavior, in order to clarify the theoretical background of a “consumption-based satisfactory time” concept. The contribution of this paper with respect to the existing literature is threefold: firstly, it is showed in this paper that Adam Smith’s uncertainty is related to the problem of the constancy of ideas and not related directly to beliefs. Secondly, possessions, as in Jeremy Bentham’s oeuvre, are assumed to be just as pleasing, as protecting and improving the actual or expected quality of life, so long as they reduce any displeasure due to the undesired outcomes of uncertainty. Finally, each consumption decision incurs its own satisfactory time period, owed to not feeling hungry, being healthy, not having transportation…etc. This reveals that the level of satisfaction is indeed a behavioral phenomenon where its value would depend on the simultaneous satisfaction derived from all activities.

Keywords: Decision-making, idea and belief, satisficing, uncertainty.

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509 A Budget and Deadline Constrained Fault Tolerant Load Balanced Scheduling Algorithm for Computational Grids

Authors: P. Keerthika, P. Suresh

Abstract:

Grid is an environment with millions of resources which are dynamic and heterogeneous in nature. A computational grid is one in which the resources are computing nodes and is meant for applications that involves larger computations. A scheduling algorithm is said to be efficient if and only if it performs better resource allocation even in case of resource failure. Resource allocation is a tedious issue since it has to consider several requirements such as system load, processing cost and time, user’s deadline and resource failure. This work attempts in designing a resource allocation algorithm which is cost-effective and also targets at load balancing, fault tolerance and user satisfaction by considering the above requirements. The proposed Budget Constrained Load Balancing Fault Tolerant algorithm with user satisfaction (BLBFT) reduces the schedule makespan, schedule cost and task failure rate and improves resource utilization. Evaluation of the proposed BLBFT algorithm is done using Gridsim toolkit and the results are compared with the algorithms which separately concentrates on all these factors. The comparison results ensure that the proposed algorithm works better than its counterparts.

Keywords: Grid Scheduling, Load Balancing, fault tolerance, makespan, cost, resource utilization.

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508 Patient’s Knowledge and Use of Sublingual Glyceryl Trinitrate Therapy in Taiping Hospital, Malaysia

Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md Saad

Abstract:

Background: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self-administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: Glyceryl trinitrate, knowledge, adherence.

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507 Comparison between Different Classifications of Periodontal Diseases and Their Advantages

Authors: Ilma Robo, Saimir Heta, Merilda Tarja, Sonila Kapaj, Eduart Kapaj, Geriona Lasku

Abstract:

The classification of periodontal diseases has changed significantly in favor of simplifying the protocol of diagnosis and periodontal treatment. This review study aims to highlight the latest publications in the new periodontal disease classification, talking about the most significant differences versus the old classification with the tendency to express the advantages or disadvantages of clinical application. The aim of the study also includes the growing tendency to link the way of classification of periodontal diseases with predetermined protocols of periodontal treatment of the diagnoses included in the classification. The new classification of periodontal diseases is rather comprehensive in its subdivisions, as the disease is viewed in its entirety, with the biological dimensions of the disease, the degree of aggravation and progression of the disease, in relation to risk factors, predisposition to patient susceptibility and impact of periodontal disease to the general health status of the patient.

Keywords: Periodontal diseases, clinical application, periodontal treatment, oral diagnosis.

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506 User-Driven Product Line Engineering for Assembling Large Families of Software

Authors: Zhaopeng Xuan, Yuan Bian, C. Cailleaux, Jing Qin, S. Traore

Abstract:

Traditional software engineering allows engineers to propose to their clients multiple specialized software distributions assembled from a shared set of software assets. The management of these assets however requires a trade-off between client satisfaction and software engineering process. Clients have more and more difficult to find a distribution or components based on their needs from all of distributed repositories.

This paper proposes a software engineering for a user-driven software product line in which engineers define a Feature Model but users drive the actual software distribution on demand. This approach makes the user become final actor as a release manager in software engineering process, increasing user product satisfaction and simplifying user operations to find required components. In addition, it provides a way for engineers to manage and assembly large software families.

As a proof of concept, a user-driven software product line is implemented for Eclipse, an integrated development environment. An Eclipse feature model is defined, which is exposed to users on a cloud-based built platform from which clients can download individualized Eclipse distributions.

Keywords: Software Product Line, Model-driven Development, Reverse Engineering and Refactoring, Agile Method

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505 User Pattern Learning Algorithm based MDSS(Medical Decision Support System) Framework under Ubiquitous

Authors: Insung Jung, Gi-Nam Wang

Abstract:

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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504 Malpractice, Even in Conditions of Compliance with the Rules of Dental Ethics

Authors: Saimir Heta, Kers Kapa, Rialda Xhizdari, Ilma Robo

Abstract:

Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: Dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments.

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503 Exoskeleton for Hemiplegic Patients: Mechatronic Approach to Move One Disabled Lower Limb

Authors: Alaoui Hamza, Moutacalli Mohamed Tarik, Chebak Ahmed

Abstract:

The number of people suffering from hemiplegia is growing each year. This lower limb disability affects all the aspects of their lives by taking away their autonomy. This implicates their close relatives, as well as the health system to provide the necessary care they need. The integration of exoskeletons in the medical field became a promising solution to resolve this issue. This paper presents an exoskeleton designed to help hemiplegic people get back the sensation and ability of normal walking. For this purpose, three step models have been created. The first step allows a simple forward movement of the leg. The second method is designed to overcome some obstacles in the patient path, and finally the third step model gives the patient total control over the device. Each of the control methods was designed to offer a solution to the challenges that the patients may face during the walking process.

Keywords: Ability of normal walking, exoskeleton, hemiplegic patients, lower limb motion, mechatronics.

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502 Simulating Human Behavior in (Un)Built Environments: Using an Actor Profiling Method

Authors: Hadas Sopher, Davide Schaumann, Yehuda E. Kalay

Abstract:

This paper addresses the shortcomings of architectural computation tools in representing human behavior in built environments, prior to construction and occupancy of those environments. Evaluating whether a design fits the needs of its future users is currently done solely post construction, or is based on the knowledge and intuition of the designer. This issue is of high importance when designing complex buildings such as hospitals, where the quality of treatment as well as patient and staff satisfaction are of major concern. Existing computational pre-occupancy human behavior evaluation methods are geared mainly to test ergonomic issues, such as wheelchair accessibility, emergency egress, etc. As such, they rely on Agent Based Modeling (ABM) techniques, which emphasize the individual user. Yet we know that most human activities are social, and involve a number of actors working together, which ABM methods cannot handle. Therefore, we present an event-based model that manages the interaction between multiple Actors, Spaces, and Activities, to describe dynamically how people use spaces. This approach requires expanding the computational representation of Actors beyond their physical description, to include psychological, social, cultural, and other parameters. The model presented in this paper includes cognitive abilities and rules that describe the response of actors to their physical and social surroundings, based on the actors’ internal status. The model has been applied in a simulation of hospital wards, and showed adaptability to a wide variety of situated behaviors and interactions.

Keywords: Agent based modeling, architectural design evaluation, event modeling, human behavior simulation, spatial cognition.

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501 TheAnalyzer: Clustering-Based System for Improving Business Productivity by Analyzing User Profiles to Enhance Human-Computer Interaction

Authors: D. S. A. Nanayakkara, K. J. P. G. Perera

Abstract:

E-commerce platforms have revolutionized the shopping experience, offering convenient ways for consumers to make purchases. To improve interactions with customers and optimize marketing strategies, it is essential for businesses to understand user behavior, preferences, and needs on these platforms. This paper focuses on recommending businesses to customize interactions with users based on their behavioral patterns, leveraging data-driven analysis and machine learning techniques. Businesses can improve engagement and boost the adoption of e-commerce platforms by aligning behavioral patterns with user goals of usability and satisfaction. We propose TheAnalyzer, a clustering-based system designed to enhance business productivity by analyzing user-profiles and improving human-computer interaction. TheAnalyzer seamlessly integrates with business applications, collecting relevant data points based on users' natural interactions without additional burdens such as questionnaires or surveys. It defines five key user analytics as features for its dataset, which are easily captured through users' interactions with e-commerce platforms. This research presents a study demonstrating the successful distinction of users into specific groups based on the five key analytics considered by TheAnalyzer. With the assistance of domain experts, customized business rules can be attached to each group, enabling TheAnalyzer to influence business applications and provide an enhanced personalized user experience. The outcomes are evaluated quantitatively and qualitatively, demonstrating that utilizing TheAnalyzer’s capabilities can optimize business outcomes, enhance customer satisfaction, and drive sustainable growth. The findings of this research contribute to the advancement of personalized interactions in e-commerce platforms. By leveraging user behavioral patterns and analyzing both new and existing users, businesses can effectively tailor their interactions to improve customer satisfaction, loyalty and ultimately drive sales.

Keywords: Data clustering, data standardization, dimensionality reduction, human-computer interaction, user profiling.

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500 Plasmodium Vivax Malaria Transmission in a Network of Villages

Authors: P. Pongsumpun, I. M. Tang

Abstract:

Malaria is a serious, acute and chronic relapsing infection to humans. It is characterized by periodic attacks of chills, fever, nausea, vomiting, back pain, increased sweating anemia, splenomegaly (enlargement of the spleen) and often-fatal complications.The malaria disease is caused by the multiplication of protozoa parasite of the genus Plasmodium. Malaria in humans is due to 4 types of malaria parasites such that Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale. P.vivax malaria differs from P. falciparum malaria in that a person suffering from P. vivax malaria can experience relapses of the disease. Between the relapses, the malaria parasite will remain dormant in the liver of the patient, leading to the patient being classified as being in the dormant class. A mathematical model for the transmission of P. vivax is developed in which the human population is divided into four classes, the susceptible, the infected, the dormant and the recovered. In this paper, we formulate the dynamical model of P. vivax malaria to see the distribution of this disease at the district level.

Keywords: Dynamical model, household, local level, Plasmodium Vivax Malaria.

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499 Quality Service Standard of Food and Beverage Service Staff in Hotel

Authors: Thanasit Suksutdhi

Abstract:

This survey research aims to study the standard of service quality of food and beverage service staffs in hotel business by studying the service standard of three sample hotels, Siam Kempinski Hotel Bangkok, Four Seasons Resort Chiang Mai, and Banyan Tree Phuket. In order to find the international service standard of food and beverage service, triangular research, i.e. quantitative, qualitative, and survey were employed. In this research, questionnaires and in-depth interview were used for getting the information on the sequences and method of services. There were three parts of modified questionnaires to measure service quality and guest’s satisfaction including service facilities, attentiveness, responsibility, reliability, and circumspection. This study used sample random sampling to derive subjects with the return rate of the questionnaires was 70% or 280. Data were analyzed by SPSS to find arithmetic mean, SD, percentage, and comparison by t-test and One-way ANOVA. The results revealed that the service quality of the three hotels were in the international level which could create high satisfaction to the international customers. Recommendations for research implementations were to maintain the area of good service quality, and to improve some dimensions of service quality such as reliability. Training in service standard, product knowledge, and new technology for employees should be provided. Furthermore, in order to develop the service quality of the industry, training collaboration between hotel organization and educational institutions in food and beverage service should be considered.

Keywords: Service standard, food and beverage department, sequence of service, service method.

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498 Determinants of Knowledge-Based Improving Workflow and Communication within Surgical Team

Authors: J. Bartnicka

Abstract:

Surgical team consists of variety types of medical specialists possessing different kind of knowledge, motivations, personalities or abilities. This together with poor knowledge transfer, lack of information and communication technologies (ICT) implementations in hospitals can cause protraction of patient care processes and even jeopardize patient safety. There is presented in the article the outcomes of studies on communication and workflow in surgical team in the background of different collaboration levels in healthcare system. As a result the five determinants of improving workflow and communication within surgical team were indicated as well as knowledge-based tools and supporting information technology were proposed.

Keywords: Knowledge transfer, absorption abilities, knowledge representation, information and communication technologies, cooperation.

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497 A Distributed Cognition Framework to Compare E-Commerce Websites Using Data Envelopment Analysis

Authors: C. lo Storto

Abstract:

This paper presents an approach based on the adoption of a distributed cognition framework and a non parametric multicriteria evaluation methodology (DEA) designed specifically to compare e-commerce websites from the consumer/user viewpoint. In particular, the framework considers a website relative efficiency as a measure of its quality and usability. A website is modelled as a black box capable to provide the consumer/user with a set of functionalities. When the consumer/user interacts with the website to perform a task, he/she is involved in a cognitive activity, sustaining a cognitive cost to search, interpret and process information, and experiencing a sense of satisfaction. The degree of ambiguity and uncertainty he/she perceives and the needed search time determine the effort size – and, henceforth, the cognitive cost amount – he/she has to sustain to perform his/her task. On the contrary, task performing and result achievement induce a sense of gratification, satisfaction and usefulness. In total, 9 variables are measured, classified in a set of 3 website macro-dimensions (user experience, site navigability and structure). The framework is implemented to compare 40 websites of businesses performing electronic commerce in the information technology market. A questionnaire to collect subjective judgements for the websites in the sample was purposely designed and administered to 85 university students enrolled in computer science and information systems engineering undergraduate courses.

Keywords: Website, e-commerce, DEA, distributed cognition, evaluation, comparison.

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496 The Resource Description Framework (RDF) as a Modern Structure for Medical Data

Authors: Gabriela Lindemann, Danilo Schmidt, Thomas Schrader, Dietmar Keune

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The amount and heterogeneity of data in biomedical research, notably in interdisciplinary fields, requires new methods for the collection, presentation and analysis of information. Important data from laboratory experiments as well as patient trials are available but come out of distributed resources. The Charité - University Hospital Berlin has established together with the German Research Foundation (DFG) a new information service centre for kidney diseases and transplantation (Open European Nephrology Science Centre - OpEN.SC). Beside a collaborative aspect to create new research groups every single partner or institution of this science information centre making his own data available is allowed to search the whole data pool of the various involved centres. A core task is the implementation of a non-restricting open data structure for the various different data sources. We decided to use a modern RDF model and in a first phase transformed original data coming from the web-based Electronic Patient Record database TBase©.

Keywords: Medical databases, Resource Description Framework (RDF), metadata repository.

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495 Revisiting Hospital Ward Design Basics for Sustainable Family Integration

Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

Abstract:

The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: Caregiving, design basics, family integration, hospital ward, sustainability.

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494 A New Rigid Fistulectomy Set for Minimally Invasive “Core-Out“ Excision of High Anal Fistulas

Authors: Siamak Najarian, Meysam Esmaeili, Mohsen Towliat Kashani

Abstract:

In this article, we propose a new surgical device for circumferentially excision of high anal fistulas in a minimally invasive manner. The new apparatus works on the basis of axially rotating and moving a tubular blade along a fistulous tract straightened using a rigid straight guidewire. As the blade moves along the tract, its sharp circular cutting edge circumferentially separates approximately 2.25 mm thickness of tract encircling the rigid guidewire. We used the new set to excise two anal fistulas in a 62-year-old male patient, an extrasphincteric type and a long tract with no internal opening. With regard to the results of this test, the new device can be considered as a sphincter preserving mechanism for treatment of high anal fistulas. Consequently, a major reduction in the risk of fecal incontinence, recurrence rate, convalescence period and patient morbidity may be achieved using the new device for treatment of fistula-in-ano.

Keywords: Fecal Incontinence, Fistulectomy, High Anal Fistula, Minimally Invasive.

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493 Counterfeit Drugs Prevention in Pharmaceutical Industry with RFID: A Framework Based On Literature Review

Authors: Zeeshan Hamid, Asher Ramish

Abstract:

The purpose of this paper is to focus on security and safety issues facing by pharmaceutical industry globally when counterfeit drugs are in question. Hence, there is an intense need to secure and authenticate pharmaceutical products in the emerging counterfeit product market. This paper will elaborate the application of radio frequency identification (RFID) in pharmaceutical industry and to identify its key benefits for patient’s care. The benefits are: help to co-ordinate the stream of supplies, accuracy in chains of supplies, maintaining trustworthy information, to manage the operations in appropriate and timely manners and finally deliver the genuine drug to patient. It is discussed that how RFID supported supply chain information sharing (SCIS) helps to combat against counterfeit drugs. And a solution how to tag pharmaceutical products; since, some products prevent RFID implementation in this industry. In this paper, a proposed model for pharma industry distribution suggested to combat against the counterfeit drugs when they are in supply chain.

Keywords: Supply chain, RFID, pharmaceutical industry, counterfeit drugs, patients care.

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492 Optimizing and Evaluating Performance Quality Control of the Production Process of Disposable Essentials Using Approach Vague Goal Programming

Authors: Hadi Gholizadeh, Ali Tajdin

Abstract:

To have effective production planning, it is necessary to control the quality of processes. This paper aims at improving the performance of the disposable essentials process using statistical quality control and goal programming in a vague environment. That is expressed uncertainty because there is always a measurement error in the real world. Therefore, in this study, the conditions are examined in a vague environment that is a distance-based environment. The disposable essentials process in Kach Company was studied. Statistical control tools were used to characterize the existing process for four factor responses including the average of disposable glasses’ weights, heights, crater diameters, and volumes. Goal programming was then utilized to find the combination of optimal factors setting in a vague environment which is measured to apply uncertainty of the initial information when some of the parameters of the models are vague; also, the fuzzy regression model is used to predict the responses of the four described factors. Optimization results show that the process capability index values for disposable glasses’ average of weights, heights, crater diameters and volumes were improved. Such increasing the quality of the products and reducing the waste, which will reduce the cost of the finished product, and ultimately will bring customer satisfaction, and this satisfaction, will mean increased sales.

Keywords: Goal programming, quality control, vague environment, disposable glasses’ optimization, fuzzy regression.

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491 A Comprehensive Key Performance Indicators Dashboard for Emergency Medical Services

Authors: G. Feletti, D. Tedesco, P. Trucco

Abstract:

The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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490 Performances and Activities of Urban Communities Leader Based On Sufficiency Economy Philosophy in Dusit District, Bangkok Metropolitan

Authors: Phusit Phukamchanoad

Abstract:

The research studies the behaviors based on sufficiency economy philosophy at individual and community levelsas well as the satisfaction of the urban community leaders by collecting data with purposive sampling technique. For in-depth interviews with 26 urban community leaders, the result shows that the urban community leaders have good knowledge and understanding about sufficiency economy philosophy. Especially in terms of money spending, they must consider the need for living and be economical. The activities in the community or society should not take advantage of the others as well as colleagues. At present, most of the urban community leaders live in sufficient way. They often spend time with public service, but many families are dealing with debt. Many communities have some political conflict and high family allowances because of living in the urban communities with rapid social and economic changes. However, there are many communities that leaders have applied their wisdom in development for their people by gathering and grouping the professionals to form activities such as making chilli sauce, textile organization, making artificial flowers to worship the sanctity. The most prominent group is the foot massage business in Wat Pracha Rabue Tham. This professional group is supported continuously by the government. One of the factors in terms of satisfaction used for evaluating community leaders is the customary administration in brotherly, interdependent way rather than using the absolute power or controlling power, but using the roles of leader to perform the activities with their people intently, determinedly and having public mind for people.

Keywords: Performance and Activities, Sufficiency Economy, Urban Communities Leader.

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489 Trends in Competitiveness of the Thai Printing Industry

Authors: Amon Lasomboon

Abstract:

Since the world printing industry has to confront globalization with a constant change, the Thai printing industry, as a small but increasingly significant part of the world printing industry, cannot inevitably escape but has to encounter with the similar change and also the need to revamp its production processes, designs and technology to make them more appealing to both international and domestic market. The essential question is what is the Thai competitive edge in the printing industry in changing environment? This research is aimed to study the Thai level of competitive edge in terms of marketing, technology, environment friendly, and the level of satisfaction of the process of using printing machines. To access the extent to which is the trends in competitiveness of Thai printing industry, both quantitative and qualitative study were conducted. The quantitative analysis was restricted to 100 respondents. The qualitative analysis was restricted to a focus group of 10 individuals from various backgrounds in the Thai printing industry. The findings from the quantitative analysis revealed that the overall mean scores are 4.53, 4.10, and 3.50 for the competitiveness of marketing, the competitiveness of technology, and the competitiveness of being environment friendly respectively. However, the level of satisfaction for the process of using machines has a mean score only 3.20. The findings from the qualitative analysis have revealed that target customers have increasingly reordered due to their contentment in both low prices and the acceptable quality of the products. Moreover, the Thai printing industry has a tendency to convert to ambient green technology which is friendly to the environment. The Thai printing industry is choosing to produce or substitute with products that are less damaging to the environment. It is also found that the Thai printing industry has been transformed into a very competitive industry which bargaining power rests on consumers who have a variety of choices.

Keywords: Competitiveness, Printing Industry

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488 Artificial Generation of Visual Evoked Potential to Enhance Visual Ability

Authors: A. Vani, M. N. Mamatha

Abstract:

Visual signal processing in human beings occurs in the occipital lobe of the brain. The signals that are generated in the brain are universal for all the human beings and they are called Visual Evoked Potential (VEP). Generally, the visually impaired people lose sight because of severe damage to only the eyes natural photo sensors, but the occipital lobe will still be functioning. In this paper, a technique of artificially generating VEP is proposed to enhance the visual ability of the subject. The system uses the electrical photoreceptors to capture image, process the image, to detect and recognize the subject or object. This voltage is further processed and can transmit wirelessly to a BIOMEMS implanted into occipital lobe of the patient’s brain. The proposed BIOMEMS consists of array of electrodes that generate the neuron potential which is similar to VEP of normal people. Thus, the neurons get the visual data from the BioMEMS which helps in generating partial vision or sight for the visually challenged patient. 

Keywords: Visual evoked potential, OpenViBe, BioMEMS, Neuro prosthesis.

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487 Ozone Therapy and Pulsed Electromagnetic Fields Interplay in Controlling Tumor Growth, Symptom and Pain Management: A Case Report

Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

Abstract:

Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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486 Perspectives and Outcomes of a Long and Shorter Community Mental Health Program

Authors: Danielle Klassen, Reiko Yeap, Margo Schmitt-Boshnick, Scott Oddie

Abstract:

The development of the 7-week Alberta Happiness Basics program was initiated in 2010 in response to the need for community mental health programming. This provincial wide program aims to increase overall happiness and reduce negative thoughts and feelings through a positive psychology intervention. While the 7-week program has proven effective, a shortened 4-week program has additionally been developed to address client needs. In this study, participants were interviewed to determine if the 4- and 7-week programs had similar success of producing lasting behavior change at 3, 6, and 9 months post-program. A health quality of life (HQOL) measure was also used to compare the two programs and examine patient outcomes. Quantitative and qualitative analysis showed significant improvements in HQOL and sustainable behavior change for both programs. Findings indicate that the shorter, patient-centered program was effective in increasing happiness and reducing negative thoughts and feelings.

Keywords: Primary care, mental health, depression, short duration.

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485 Pilot Trial of Evidence-Based Integrative Group Therapy to Improve Executive Functioning among Adults: Implications for Community Mental Health and Training Clinics

Authors: B. Parchem, M. Watanabe, D. Modrakovic, L. Mathew, A. Franklin, M. Cao, R. E. Broudy

Abstract:

Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

Keywords: Executive functioning, cognitive-behavioral therapy, dialectical behavior therapy, mindfulness, adult group therapy.

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