Search results for: patient safety in home hemodialysis.

Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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

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

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

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Authors: Jinn-Yi Yeh, Tai-Hsi Wu

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Hemodialysis patients might suffer from unhealthy care behaviors or long-term dialysis treatments. Ultimately they need to be hospitalized. If the hospitalization rate of a hemodialysis center is high, its quality of service would be low. Therefore, how to decrease hospitalization rate is a crucial problem for health care. In this study we combined temporal abstraction with data mining techniques for analyzing the dialysis patients' biochemical data to develop a decision support system. The mined temporal patterns are helpful for clinicians to predict hospitalization of hemodialysis patients and to suggest them some treatments immediately to avoid hospitalization.

Keywords: Hemodialysis, Temporal abstract, Data mining, Healthcare quality.

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Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

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Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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Authors: Geon-Woo Kim, Do-Woo Kim, Jun-Ho Lee, Jin-Beon Hwang, Jong-Wook Han

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As various mobile sensing technologies, remote control and ubiquitous infrastructure are developing and expectations on quality of life are increasing, a lot of researches and developments on home network technologies and services are actively on going, Until now, we have focused on how to provide users with high-level home network services, while not many researches on home network security for guaranteeing safety are progressing. So, in this paper, we propose an access control model specific to home network that provides various kinds of users with home network services up one-s characteristics and features, and protects home network systems from illegal/unnecessary accesses or intrusions.

Keywords: Home network security, RBAC, access control, authentication.

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Authors: B. Sabayan, A. Alidadi, S. Ebrahimi, N. M. Bakhshani

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Neuropsychological problems are more common in hemodialysis (HD) patients than in healthy individuals. The aim of this study was to investigate the effect of long term HD on memory types of HD patients. To assess the different type of memory, we used memory parts of the Persian Papers and Pencil Cognitive assessment package (PCAP) and Addenbrooke's Cognitive Examination (ACE-R). Our study included 80 HD patients of whom 39 had less than six months of HD and 41 patients and another group which had a history of HD more than six months. The population had a mean age of 51.60 years old and 27.5% of them were female. The scores of patients who have been hemodialyzed for a long time (median time of HD was up to 4 years) had lower score in anterograde, explicit, visual, recall and recognition memory (5.44±1.07, 9.49±3.472, 22.805±6.6913, 5.59±10.435, 11.02±3.190 score) than the HD patients who underwent HD for a shorter term, where the median time was 3 to 5 months (P<0.01). The regression result shows that, by increasing the HD duration, all memory types are reduced (R2=0.600, P<0.01). The present study demonstrated that HD patients who were under HD for a long time had significantly lower scores in the different types of memory. However, additional researches are needed in this area.

Keywords: Hemodialysis patients, duration of hemodialysis, memory types, Zahedan.

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Authors: Nálevka Petr

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

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

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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: A. Karaali

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This paper will seek to clarify important key terms such as home schooling and home education as well as the legalities attached to such terms. It will reflect on the recent proposed changes to terminology in NSW, Australia. The various pedagogical approaches to home education will be explored including their prominence in the Australian context. There is a strong focus on literature from Australia. The historical background of home education in Australia will be explained as well as the difference between distance education and home education. The future of home education in Australia will be discussed.

Keywords: Alternative education, e-learning, home education, home schooling, online resources, technology.

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Authors: Mawahib Gafare Abdalrahman Ahmed, Abdallah Belal Adam, John Ojur Dennis

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Air bubbles have been detected in human circulation of end-stage renal disease patients who are treated by hemodialysis. The consequence of air embolism, air bubbles, is under recognized and usually overlooked in daily practice. This paper shows results of a capacitor based detection method that capable of detecting the presence of air bubbles in the blood stream in different frequencies. The method is based on a parallel plates capacitor made of platinum with an area of 1.5 cm2 and a distance between the two plates is 1cm. The dielectric material used in this capacitor is Dextran70 solution which mimics blood rheology. Simulations were carried out using RC circuit at two frequencies 30Hz and 3 kHz and results compared with experiments and theory. It is observed that by injecting air bubbles of different diameters into the device, there were significant changes in the capacitance of the capacitor. Furthermore, it is observed that the output voltage from the circuit increased with increasing air bubble diameter. These results demonstrate the feasibility of this approach in improving air bubble detection in Hemodialysis.

Keywords: Air bubbles, Hemodialysis, Capacitor, Dextran70, Air bubbles diameters.

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Authors: Do-Woo Kim, Geon Woo Kim, Jun-Ho Lee, Jong-Wook Han

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The home in these days has not one computer connected to the Internet but rather a network of many devices within the home, and that network might be connected to the Internet. In such an environment, the potential for attacks is greatly increased. The general security technology can not apply because of the use of various wired and wireless network, middleware and protocol in digital home environment and a restricted system resource of home information appliances. To offer secure home services home network environments have need of access control for various home devices and information when users want to access. Therefore home network access control for user authorization is a very important issue. In this paper we propose access control model using RBAC in home network environments to provide home users with secure home services.

Keywords: Home network, access control, RBAC, security.

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Authors: Gomes C. C. Izabel, Lanzotti B. Rafaela, Orlandi S. Fabiana

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Chronic Kidney Disease is considered a serious public health problem. The exploitation of resilience has been guided by studies conducted in various contexts, especially in hemodialysis, since the impact of diagnosis and restrictions produced during the treatment process because, despite advances in treatment, remains the stigma of the disease and the feeling of pain, hopelessness, low self-esteem and disability. The objective was to evaluate the level of resilience of patients in chronic renal dialysis. This is a descriptive, correlational, cross and quantitative research. The sample consisted of 100 patients from a Renal Replacement Therapy Unit in the countryside of São Paulo. For data collection were used the characterization instrument of Participants and the Resilience Scale. There was a predominance of males (70.0%) were Caucasian (45.0%) and had completed elementary education (34.0%). The average score obtained through the Resilience Scale was 131.3 (± 20.06) points. The resiliency level submitted may be considered satisfactory. It is expected that this study will assist in the preparation of programs and actions in order to avoid possible situations of crises faced by chronic renal patients.

Keywords: Hemodialysis units, hospital, renal dialysis, renal insufficiency chronic, resilience psychological.

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Authors: Mannan Mridha, Mohammad S. Islam

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

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

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

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

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

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: Lean, Service improvement, SERVQUAL, Care home service.

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Authors: Taisuke Sakaki, Toshihiko Shimokawa, Nobuhiro Ushimi, Koji Murakami, Yong-Kwun Lee, Kazuhiro Tsuruta, Kanta Aoki, Kaoru Fujiie, Ryuji Katamoto, Atsushi Sugyo

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Recently attention has been focused on incomplete spinal cord injuries (SCI) to the central spine caused by pressure on parts of the white matter conduction pathway, such as the pyramidal tract. In this paper, we focus on a training robot designed to assist with primary walking-pattern training. The target patient for this training robot is relearning the basic functions of the usual walking pattern; it is meant especially for those with incomplete-type SCI to the central spine, who are capable of standing by themselves but not of performing walking motions. From the perspective of human engineering, we monitored the operator’s actions to the robot and investigated the movement of joints of the lower extremities, the circumference of the lower extremities, and exercise intensity with the machine. The concept of the device was to provide mild training without any sudden changes in heart rate or blood pressure, which will be particularly useful for the elderly and disabled. The mechanism of the robot is modified to be simple and lightweight with the expectation that it will be used at home.

Keywords: Training, rehabilitation, SCI patient, welfare, robot.

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Authors: Helder Adão, Rui Antunes, Frederico Grilo

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This paper describes the project and development of a very low-cost and small electronic prototype, especially designed for monitoring and controlling existing home automation alarm systems (intruder, smoke, gas, flood, etc.), via TCP/IP, with a typical web browser. Its use will allow home owners to be immediately alerted and aware when an alarm event occurs, and being also able to interact with their home automation alarm system, disarming, arming and watching event alerts, with a personal wireless Wi-Fi PDA or smartphone logged on to a dedicated predefined web page, and using also a PC or Laptop.

Keywords: Alarm Systems, Home Automation, Web-Server, TCP/IP.

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Authors: Mohammad Rajabalinejad

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Safety is often seen as a requirement or a performance indicator through the design process, and this does not always result in optimally safe products or systems. This paper suggests integrating the best safety practices with the design process to enrich the exploration experience for designers and add extra values for customers. For this purpose, the commonly practiced safety standards and design methods have been reviewed and their common blocks have been merged forming Safety Cube. Safety Cube combines common blocks for design, hazard identification, risk assessment and risk reduction through an integral approach. An example application presents the use of Safety Cube for design of machinery.

Keywords: Safety, safety cube, design, product, system, machinery.

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Authors: I-En Lin, Feng-Jung Yang

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In addition to kidney transplant, renal replacement therapy involves hemodialysis and peritoneal dialysis (PD). PD possesses advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home dialysis treatment. However, potential danger still exists despite the numerous advantages of PD, particularly when patients require dialysis exchange four to five times a day, during which improper operation can easily lead to peritonitis. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. Connecting the transfer set requires sterile technique. Transfer set may require a new cap each time that it disconnects from the bag after an exchange. There are many chances to get infection due to unsafe behavior (ex: hand tremor, poor eyesight and weakness, cap fall-down). The proposed semi-automatic connection mechanism used in the PD can greatly reduce infection chances. This light-weight connection device is portable. The device also does not require using throughout the entire process. It is capable of significantly improving quality of life. Therefore, it is very promising to adopt in home care application.

Keywords: Automatic connection, catheter, glomerulonephritis, peritoneal dialysis.

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Authors: Dong-Young Yoo, Jong-Whoi Shin, Jin-Young Choi

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Social interest and demand on Home-Network has been increasing greatly. Although various services are being introduced to respond to such demands, they can cause serious security problems when linked to the open network such as Internet. This paper reviews the security requirements to protect the service users with assumption that the Home-Network environment is connected to Internet and then proposes the security model based on the requirement. The proposed security model can satisfy most of the requirements and further can be dynamically applied to the future ubiquitous Home-Networks.

Keywords: Home-Network, Security, Vulnerability, Response, Countermeasure.

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Authors: Ahmed ElShafee, Karim Alaa Hamed

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This paper presents a design and prototype implementation of new home automation system that uses WiFi technology as a network infrastructure connecting its parts. The proposed system consists of two main components; the first part is the server (web server), which presents system core that manages, controls, and monitors users- home. Users and system administrator can locally (LAN) or remotely (internet) manage and control system code. Second part is hardware interface module, which provides appropriate interface to sensors and actuator of home automation system. Unlike most of available home automation system in the market the proposed system is scalable that one server can manage many hardware interface modules as long as it exists on WiFi network coverage. System supports a wide range of home automation devices like power management components, and security components. The proposed system is better from the scalability and flexibility point of view than the commercially available home automation systems.

Keywords: Home automation, Wireless LAN, WiFi, MicroControllers

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Authors: S.S.Mohanavalli, Sheila Anand

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This paper proposes a novel architecture for At- Home medical care which enables senior citizens, patients with chronic ailments and patients requiring post- operative care to be remotely monitored in the comfort of their homes. This architecture is implemented using sensors and wireless networking for transmitting patient data to the hospitals, health- care centers for monitoring by medical professionals. Patients are equipped with sensors to measure their physiological parameters, like blood pressure, pulse rate etc. and a Wearable Data Acquisition Unit is used to transmit the patient sensor data. Medical professionals can be alerted to any abnormal variations in these values for diagnosis and suitable treatment. Security threats and challenges inherent to wireless communication and sensor network have been discussed and a security mechanism to ensure data confidentiality and source authentication has been proposed. Symmetric key algorithm AES has been used for encrypting the data and a patent-free, two-pass block cipher mode CCFB has been used for implementing semantic security.

Keywords: data confidentiality, integrity, remotemonitoring, source authentication

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Authors: Ahlam Elkilani, Bayan Elsheikh Ali, Rasha Abu Romman, Amjed Al-mousa, Belal Sababha

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The amount of energy the world uses doubles every 20 years. Green homes play an important role in reducing the residential energy demand. This paper presents a platform that is intended to learn the behavior of home residents and build a profile about their habits and actions. The proposed resident aware home controller intervenes in the operation of home appliances in order to save energy without compromising the convenience of the residents. The presented platform can be used to simulate the actions and movements happening inside a home. The paper includes several optimization techniques that are meant to save energy in the home. In addition, several test scenarios are presented that show how the controller works. Moreover, this paper shows the computed actual savings when each of the presented techniques is implemented in a typical home. The test scenarios have validated that the techniques developed are capable of effectively saving energy at homes.

Keywords: Green Home, Resident Aware, Resident Profile, Activity Learning, Machine Learning.

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Authors: Oluwatosin A. Ijabadeniyi

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The fact that traditional food safety system in the absence of food safety culture is inadequate has recently become a cause of concern for food safety professionals and other stakeholders. Focusing on implementation of traditional food safety system i.e HACCP prerequisite program and HACCP without the presence of food safety culture in the food industry has led to the processing, marketing and distribution of contaminated foods. The results of this are regular out breaks of food borne illnesses and recalls of foods from retail outlets with serious consequences to the consumers and manufacturers alike. This article will consider the importance of food safety culture, the cases of outbreaks and recalls that occurred when companies did not make food safety culture a priority. Most importantly, the food safety cultures of some food industries in South Africa were assessed from responses to questionnaires from food safety/food industry professionals in Durban South Africa. The article was concluded by recommending that both food industry employees and employers alike take food safety culture seriously.

Keywords: Good Manufacturing Practices (GMPs), food borne illnesses, food safety culture, food safety system, HACCP.

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Authors: Pierre Parrend, Stephane Frenot

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Providing Services at Home has become over the last few years a very dynamic and promising technological domain. It is likely to enable wide dissemination of secure and automated living environments. We propose a methodology for identifying threats to Services at Home Delivery systems, as well as a threat analysis of a multi-provider Home Gateway architecture. This methodology is based on a dichotomous positive/preventive study of the target system: it aims at identifying both what the system must do, and what it must not do. This approach completes existing methods with a synthetic view of potential security flaws, thus enabling suitable measures to be taken into account. Security implications of the evolution of a given system become easier to deal with. A prototype is built based on the conclusions of this analysis.

Keywords: Security requirements, Connected Home, OSGi, Sofware Components.

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Authors: Minwoo Son, Seung-Hun Lee, Dongkyoo Shin, Dongil Shin

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The next stage of the home networking environment is supposed to be ubiquitous, where each piece of material is equipped with an RFID (Radio Frequency Identification) tag. To fully support the ubiquitous environment, home networking middleware should be able to recommend home services based on a user-s interests and efficiently manage information on service usage profiles for the users. Therefore, USN (Ubiquitous Sensor Network) technology, which recognizes and manages a appliance-s state-information (location, capabilities, and so on) by connecting RFID tags is considered. The Intelligent Multi-Agent Middleware (IMAM) architecture was proposed to intelligently manage the mobile RFID-based home networking and to automatically supply information about home services that match a user-s interests. Evaluation results for personalization services for IMAM using Bayesian-Net and Decision Trees are presented.

Keywords: Intelligent Agents, Home Network, Mobile RFID, Intelligent Middleware.

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Authors: M. Tsirintani

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The article is proposing a base plan for the future Patient Care Information Systems in a changing health care environment where it is necessary to assure quality patient care services and reducing cost and where new technology trends give the opportunities to develop clinical applications and services patient focused according to new business objectives.

Keywords: Health care management, planning patient care information system.

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Authors: Zhiwen Pan, Jesus Pacheco, Salim Hariri, Yiqiang Chen, Bozhi Liu

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The Internet of Things (IoT) will lead to the development of advanced Smart Home services that are pervasive, cost-effective, and can be accessed by home occupants from anywhere and at any time. However, advanced smart home applications will introduce grand security challenges due to the increase in the attack surface. Current approaches do not handle cybersecurity from a holistic point of view; hence, a systematic cybersecurity mechanism needs to be adopted when designing smart home applications. In this paper, we present a generic intrusion detection methodology to detect and mitigate the anomaly behaviors happened in Smart Home Systems (SHS). By utilizing our Smart Home Context Data Structure, the heterogeneous information and services acquired from SHS are mapped in context attributes which can describe the context of smart home operation precisely and accurately. Runtime models for describing usage patterns of home assets are developed based on characterization functions. A threat-aware action management methodology, used to efficiently mitigate anomaly behaviors, is proposed at the end. Our preliminary experimental results show that our methodology can be used to detect and mitigate known and unknown threats, as well as to protect SHS premises and services.

Keywords: Internet of Things, network security, context awareness, intrusion detection

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Authors: Roxana Poushang Baghery, Matthew D. Reyes

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This paper presents a comprehensive investigation into jobsite safety orientation programs within the US construction industry. Through interviews with industry professionals, this paper explores the domains of safety roles, daily safety practices, safety culture, and experts’ insights. This study underscores the pivotal significance of safety orientation programs, addressing their content, coordination, technology integration, and emergency procedures. Key findings emphasize the influential roles of leadership, language, and technology in the enhancement of these programs. Advocating for a paradigm shift, this paper calls for a multifaceted approach rooted in engagement, leadership commitment, clear communication, technological integration, simplicity, and a persistent pursuit of improvement in safety orientations. This study significantly contributes to the ongoing evolution and enhancement of safety practices, ensuring the safety and success of construction projects and, above all, the safeguarding of its workforce.

Keywords: Jobsite safety orientation, construction industry, safety culture, workplace incidents.

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Authors: Benson Chizubem

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Because of the severe hazards that substantially impact workers' lives and assets lost, the oil and gas industry has established a goal of establishing zero occurrences or accidents in operations. Using leading indicators to measure and assess an organization's safety performance is a proactive approach to safety management. Also, it will provide early warning signals to solve inherent safety issues before they lead to an accident in the study industry. The analysis of these indicators' performance was based on a questionnaire-based methodology. A total number of 1000 questionnaires were disseminated to the workers, of which 327 were returned to the researcher team. The data collected were analysed to evaluate their safety perceptions on indicators performance. Data analysis identified safety training, safety system, safety supervision, safety rules and procedures, safety auditing, strategies and policies, management commitment, safety meeting and safety behaviour, as potential leading indicators that are capable of measuring organizational safety performance and as capable of providing early warning signals of weak safety area in an operational environment. The findings of this study have provided safety researchers and industrial safety practitioners with helpful information on the improvement of the existing safety monitoring process in the oil and gas industry, both locally and globally, as proactive actions.

Keywords: Early warning, safety, accident risks, oil and gas industry.

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