Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5484

Search results for: patients’ related risks in the current home hemodialysis practices

5484 The Current Home Hemodialysis Practices and Patients’ Safety Related Factors: A Case Study from Germany

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

Abstract:

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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5483 Assessing the Physiological, Psychological Stressors and Coping Strategies among Hemodialysis Patients in the Kingdom of Saudi Arabia

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

Abstract:

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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5482 A Decision Support System for Predicting Hospitalization of Hemodialysis Patients

Authors: Jinn-Yi Yeh, Tai-Hsi Wu

Abstract:

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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5481 Memory Types in Hemodialysis Patients: A Study Based on Hemodialysis Duration, Zahedan, South East of Iran

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

Abstract:

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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5480 Resilience in Patients with Chronic Kidney Disease in Hemodialysis

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

Abstract:

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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5479 Capacitive Air Bubble Detector Operated at Different Frequencies for Application in Hemodialysis

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

Abstract:

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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5478 Mobile Learning Implementation: Students- Perceptions in UTP

Authors: Ahmad Sobri bin Hashim, Wan Fatimah Bt. Wan Ahmad, Rohiza Bt. Ahmad

Abstract:

Mobile Learning (M-Learning) is a new technology which is to enhance current learning practices and activities for all people especially students and academic practitioners UTP is currently, implemented two types of learning styles which are conventional and electronic learning. In order to improve current learning approaches, it is necessary for UTP to implement m-learning in UTP. This paper presents a study on the students- perceptions on mobile utilization in the learning practices in UTP. Besides, this paper also presents a survey that was conducted among 82 students from System Analysis and Design (SAD) course in UTP. The survey includes basic information of mobile devices that have been used by the students, opinions on current learning practices and also the opinions regarding the m-learning implementation in the current learning practices especially in SAD course. Based on the results of the survey, majority of the students are using the mobile devices that can support m-learning environment. Other than that, students also agreed that current learning practices are ineffective and they believe that m-learning utilization can improve the effectiveness of current learning practices.

Keywords: m-learning, conventional learning, electronic learning, mobile devices.

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5477 A Study of Applying the Use of Breathing Training to Palliative Care Patients, Based on the Bio-Psycho-Social Model

Authors: Wenhsuan Lee, Yachi Chang, Yingyih Shih

Abstract:

In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

Keywords: Palliative care, breathing training, bio-psycho-social Model, heart rate variability.

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5476 Home Education in the Australian Context

Authors: A. Karaali

Abstract:

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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5475 Risk Management in Islamic Banks: A Case Study of the Faisal Islamic Bank of Egypt

Authors: Mohamed Saad Ahmed Hussien

Abstract:

This paper discusses the risk management in Islamic banks and aims to determine the difference in the practices and methods of risk management in those banks compared to the conventional banks, and to make a case study of the biggest Islamic bank in Egypt (Faisal Islamic Bank of Egypt) to identify the most important financial risks faced and how to manage those risks. It was found that Islamic banks face two types of risks. The first type is similar to the risks in conventional banks; the second type is the additional risks which facing the Islamic banks only as a result of some Islamic modes of financing. With regard to the risk management, Islamic banks such as conventional banks applied the regulatory rules issued by the Central Banks and the Basel Committee; Islamic banks also applied the instructions and procedures issued by the Islamic Financial Services Board (IFSB). Also, Islamic banks are similar to the conventional banks in the practices and methods which they use to manage the risks. And there are some factors that may affect the risk management in Islamic banks, such as the size of the bank and the efficiency of the administration and the staff of the bank.

Keywords: Conventional banks, Faisal Islamic Bank of Egypt, Islamic banks, risk management.

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5474 A Semi-Automatic Mechanism Used in the Peritoneal Dialysis Connection

Authors: I-En Lin, Feng-Jung Yang

Abstract:

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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5473 Role-based Access Control Model in Home Network Environments

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

Abstract:

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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5472 Managing Legal, Consumers and Commerce Risks in Phishing

Authors: Dinna N. M. N., Leau Y. B., Habeeb S. A. H., Yanti A. S.

Abstract:

Phishing scheme is a new emerged security issue of E-Commerce Crime in globalization. In this paper, the legal scaffold of Malaysia, United States and United Kingdom are analyzed and followed by discussion on critical issues that rose due to phishing activities. The result revealed that inadequacy of current legal framework is the main challenge to govern this epidemic. However, lack of awareness among consumers, crisis on merchant-s responsibility and lack of intrusion reports and incentive arrangement contributes to phishing proliferating. Prevention is always better than curb. By the end of this paper, some best practices for consumers and corporations are suggested.

Keywords: Phishing, Online Fraud, Business risks, Consumers privacy, Legal Issue, Cyber law.

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5471 Perceptions of Health Risks amongst Tertiary Education Students in Mauritius

Authors: Smita S. D. Goorah, Dilish Jokhoo

Abstract:

A personal estimate of a health risk may not correspond to a scientific assessment of the health risk. Hence, there is a need to investigate perceived health risks in the public. In this study, a young, educated and healthy group of people from a tertiary institute were questioned about their health concerns. Ethics clearance was obtained and data was collected by means of a questionnaire. 362 students participated in the study. Tobacco use, heavy alcohol drinking, illicit drugs, unsafe sex and potential carcinogens were perceived to be the five greatest threats to health in this cohort. On the other hand natural health products, unemployment, unmet contraceptive needs, family violence and homelessness were felt to be the least perceived health risks. Nutrition-related health risks as well as health risks due to physical inactivity and obesity were not perceived as major health threats. Such a study of health perceptions may guide health promotion campaigns.

Keywords: Health promotion, perceptions of health risks, university students.

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5470 A Location-Allocation-Routing Model for a Home Health Care Supply Chain Problem

Authors: Amir Mohammad Fathollahi Fard, Mostafa Hajiaghaei-Keshteli, Mohammad Mahdi Paydar

Abstract:

With increasing life expectancy in developed countries, the role of home care services is highlighted by both academia and industrial contributors in Home Health Care Supply Chain (HHCSC) companies. The main decisions in such supply chain systems are the location of pharmacies, the allocation of patients to these pharmacies and also the routing and scheduling decisions of nurses to visit their patients. In this study, for the first time, an integrated model is proposed to consist of all preliminary and necessary decisions in these companies, namely, location-allocation-routing model. This model is a type of NP-hard one. Therefore, an Imperialist Competitive Algorithm (ICA) is utilized to solve the model, especially in large sizes. Results confirm the efficiency of the developed model for HHCSC companies as well as the performance of employed ICA.

Keywords: Home health care supply chain, location-allocation-routing problem, imperialist competitive algorithm, optimization.

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5469 Analysing Environmental Risks and Perceptions of Risks to Assess Health and Well-being in Poor Areas of Abidjan

Authors: Kouassi Dongo, Christian Zurbrügg, Gueladio Cissé1, Brigit Obrist, Marcel Tanner, Jean Biémi

Abstract:

This study analyzed environmental health risks and people-s perceptions of risks related to waste management in poor settlements of Abidjan, to develop integrated solutions for health and well-being improvement. The trans-disciplinary approach used relied on remote sensing, a geographic information system (GIS), qualitative and quantitative methods such as interviews and a household survey (n=1800). Mitigating strategies were then developed using an integrated participatory stakeholder workshop. Waste management deficiencies resulting in lack of drainage and uncontrolled solid and liquid waste disposal in the poor settlements lead to severe environmental health risks. Health problems were caused by direct handling of waste, as well as through broader exposure of the population. People in poor settlements had little awareness of health risks related to waste management in their community and a general lack of knowledge pertaining to sanitation systems. This unfortunate combination was the key determinant affecting the health and vulnerability. For example, an increased prevalence of malaria (47.1%) and diarrhoea (19.2%) was observed in the rainy season when compared to the dry season (32.3% and 14.3%). Concerted and adapted solutions that suited all the stakeholders concerned were developed in a participatory workshop to allow for improvement of health and well-being.

Keywords: Abidjan, environmental health risks, informalsettlements, vulnerability, waste management.

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5468 Poor Medical Waste Management (MWM) Practices and Its Risks to Human Health and the Environment: A Literature Review

Authors: Babanyara Y. Y., Ibrahim D. B., Garba T., Bogoro A. G., Abubakar, M. Y.

Abstract:

Medical care is vital for our life, health and well-being. But the waste generated from medical activities can be hazardous, toxic and even lethal because of their high potential for diseases transmission. The hazardous and toxic parts of waste from healthcare establishments comprising infectious, medical and radioactive material as well as sharps constitute a grave risks to mankind and the environment, if these are not properly treated / disposed or are allowed to be mixed with other municipal waste. In Nigeria, practical information on this aspect is inadequate and research on the public health implications of poor management of medical wastes is few and limited in scope. Findings drawn from Literature particularly in the third world countries highlights financial problems, lack of awareness of risks involved in MWM, lack of appropriate legislation and lack of specialized MWM staff. The paper recommends how MWM practices can be improved in medical facilities.

Keywords: Environmental pollution, infectious, management, medical waste, public health.

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5467 Home Network-Specific RBAC Model

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

Abstract:

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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5466 Critical Analysis of the Hong Kong International Convention on Ship Recycling

Authors: K. P. Jain, J. F. J. Pruyn, J. J. Hopman

Abstract:

In May 2009, the International Maritime Organization (IMO) adopted the Hong Kong International Convention for the Safe and Environmentally Sound Recycling of Ships to address the growing concerns about the environmental, occupational health and safety risks related to ship recycling. The aim of the Hong Kong Convention is to provide a legally binding instrument which ensures that the process of ship recycling does not pose risks to human health, safety and to the environment. In this paper, critical analysis of the Hong Kong Convention has been carried out in order to study the effectiveness of the Convention to meet its objectives. The Convention has been studied in detail including its background, main features, major stakeholders, strengths and weaknesses. The Convention, though having several deficiencies, is a major breakthrough in not only recognizing but also dealing with the ill-practices associated with ship recycling.

Keywords: Hong Kong Convention, IMO, Ship breaking, Ship recycling.

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5465 Context Aware Anomaly Behavior Analysis for Smart Home Systems

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

Abstract:

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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5464 Daily Site Risks Associated with Construction Projects and On-spot Corrective Measurements: Case Study of Revamping Projects in Kuwait Oil Company Fields Area

Authors: Yousef S. Al-Othman

Abstract:

The growth and expansion of the industrial facilities comes proportional to the market increasing demand of products and services. Furthermore, raw material producers such as oil companies usually undergo massive revamping projects to maintain a synchronized supply. These revamping projects are usually delivered through challenging construction projects held and associated with daily site risks related to the construction process. Henceforth, a case study related to these risks and corresponding on-spot corrective measurements has been made on a certain number of construction project contractors at Kuwait Oil Company (KOC) to derive the benefits and overall effectiveness of the on-spot corrective measurements during the construction phase of a project, and how would the same help in avoiding major incidents, ensuring a smooth, cost effective and on time delivery of the project. Findings of this case study shall have an added value to the overall risk management process by minimizing the daily site risks that may affect the project lead time, resulting in an undisturbed on-site construction process.

Keywords: Oil and gas, risk management, construction projects, project lead time.

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5463 Underwriting Risks as Determinants of Insurance Cycles: Case of Croatia

Authors: D. Jakovčević, M. Mihelja Žaja

Abstract:

The purpose of this paper is to analyze the influence and relative share of underwriting risks in explaining the variation in insurance cycles in subsequent periods. Through the insurance contracts they underwrite, insurance companies assume risks. Underwriting risks include pricing risk, reserve risk, reinsurance risk and occurrence risk. These risks pose major risks for property and liability insurers, and therefore their impact on the insurance cycle is important. The main goal of this paper is to determine the relative proportion of underwriting risks in explaining the variation of insurance cycle. In order to fulfill the main goal of the paper vector autoregressive model, VAR, will be applied.

Keywords: Insurance cycle, insurance risks, combined ratio, Republic of Croatia.

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5462 Accessible Facilities in Home Environment for Elderly Family Members in Sri Lanka

Authors: M. A. N. Rasanjalee Perera

Abstract:

The world is facing several problems due to increasing elderly population. In Sri Lanka, along with the complexity of the modern society and structural and functional changes of the family, “caring for elders” seems as an emerging social problem. This situation may intensify as the county is moving into a middle income society. Seeking higher education and related career opportunities, and urban living in modern housing are new trends, through which several problems are generated. Among many issues related with elders, “lack of accessible and appropriate facilities in their houses as well as public buildings” can be identified as a major problem. This study argues that welfare facilities provided for the elderly people, particularly in the home environment, in the country are not adequate. Modern housing features such as bathrooms, pantries, lobbies, and leisure areas etc. are questionable as to whether they match with elders’ physical and mental needs. Consequently, elders have to face domestic accidents and many other difficulties within their living environments. Records of hospitals in the country also proved this fact. Therefore, this study tries to identify how far modern houses are suited with elders’ needs. The study further questioned whether “aging” is a considerable matter when people are buying, planning and renovating houses. A randomly selected sample of 50 houses were observed and 50 persons were interviewed around the Maharagama urban area in Colombo district to obtain primary data, while relevant secondary data and information were used to have a depth analysis. The study clearly found that none of the houses included to the sample are considering elders’ needs in planning, renovating, or arranging the home. Instead, most of the families were giving priority to the rich and elegant appearance and modern facilities of the houses. Particularly, to the bathrooms, pantry, large setting areas, balcony, parking slots for two vehicles, ad parapet walls with roller-gates are the main concerns. A significant factor found here is that even though, many children of the aged are in middle age and reaching their older years at present, they do not plan their future living within a safe and comfortable home, despite that they are hoping to spent the latter part of their lives in the their current homes. This fact highlights that not only the other responsible parts of the society, but also those who are reaching their older ages are ignoring the problems of the aged. At the same time, it was found that more than 80% of old parents do not like to stay at their children’s homes as the living environments in such modern homes are not familiar or convenient for them. Due to this context, the aged in Sri Lanka may have to be alone in their own homes due to current trend of society of migrating to urban living in modern houses. At the same time, current urban families who live in modern houses may have to face adding accessible facilities in their home environment, as current modern housing facilities may not be appropriate them for a better life in their latter part of life.

Keywords: Aging population, elderly care, home environment, housing facilities.

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5461 Heavy Metal Pollution of the Soils around the Mining Area near Shamlugh Town (Armenia) and Related Risks to the Environment

Authors: G. A. Gevorgyan, K. A. Ghazaryan, T. H. Derdzyan

Abstract:

The heavy metal pollution of the soils around the mining area near Shamlugh town and related risks to human health were assessed. The investigations showed that the soils were polluted with heavy metals that can be ranked by anthropogenic pollution degree as follows: Cu>Pb>As>Co>Ni>Zn. The main sources of the anthropogenic metal pollution of the soils were the copper mining area near Shamlugh town, the Chochkan tailings storage facility and the trucks transferring ore from the mining area. Copper pollution degree in some observation sites was unallowable for agricultural production. The total non-carcinogenic chronic hazard index (THI) values in some places, including observation sites in Shamlugh town, were above the safe level (THI<1) for children living in this territory. Although the highest heavy metal enrichment degree in the soils was registered in case of copper, however, the highest health risks to humans especially children were posed by cobalt which is explained by the fact that heavy metals have different toxicity levels and penetration characteristics.

Keywords: Armenia, copper mine, heavy metal pollution of soil, health risks.

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5460 A Qualitative Study of Health-Related Beliefs and Practices among Vegetarians

Authors: Lorena Antonovici, Maria Nicoleta Turliuc

Abstract:

The process of becoming a vegetarian involves changes in several life aspects, including health. Despite its relevance, however, little research has been carried out to analyze vegetarians' self-perceived health, and even less empirical attention has received in the Romanian population. This study aimed to assess health-related beliefs and practices among vegetarian adults in a Romanian sample. We have undertaken 20 semi-structured interviews (10 males, 10 females) based on a snowball sample with a mean age of 31 years. The interview guide was divided into three sections: causes of adopting the diet, general aspects (beliefs, practices, tensions, and conflicts) and consequences of adopting the diet (significant changes, positive aspects, and difficulties, physical and mental health). Additional anamnestic data were reported by means of a questionnaire. Data analyses were performed using Tropes text analysis software (v. 8.2) and SPSS software (v. 24.0.) Findings showed that most of the participants considered a vegetarian diet as a natural and healthy choice as opposed to meat-eating, which is not healthy, and its consumption should be moderated among omnivores. A higher proportion of participants (65%) had an average body mass index (BMI), and several women even assumed having certain affections that no longer occur after following a vegetarian diet. Moreover, participants admitted having better moods and mental health status, given their self-contentment with the dietary choice. Relatives were perceived as more skeptical about their practices than others, and especially women had this view. This study provides a valuable insight into health-related beliefs and practices and how a vegetarian diet might interact.

Keywords: Health-related beliefs, health, practices, vegetarians.

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5459 Grade and Maximum Tumor Dimension as Determinants of Lymphadenectomy in Patients with Endometrioid Endometrial Cancer (EEC)

Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

Abstract:

Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: Endometrial cancer, FIGO grade, lymphadenectomy, tumor size.

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5458 Security Architecture for At-Home Medical Care Using Sensor Network

Authors: S.S.Mohanavalli, Sheila Anand

Abstract:

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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5457 Cooperative Movements in Malaysia: The Issue of Governance

Authors: Intan Waheedah Othman, Maslinawati Mohamad, Azizah Abdullah

Abstract:

Cooperative organizations in Malaysia are going through a phase of rapid growth. They are seen by the government as another crucial vehicle to drive and boost up the country-s economical development and growth. Hence, the issue of cooperative governance is of great importance. Unlike literatures on corporate governance for public listed companies-, literatures on governance for social enterprises, in particular the cooperative organizations are still at the early stage in Malaysia and very scant in number. This paper will look into current practices as well as issues and challenges related to cooperative governance. The need for a better solution towards forming best practices of cooperative governance framework appears imperative in deterring cases of mismanagement and fraud.

Keywords: Cooperative, Governance, Issues, Malaysia.

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5456 Adoption of Lean Thinking and Service Improvement for Care Home Service

Authors: Chuang-Chun Chiou

Abstract:

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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5455 Web-Based Control and Notification for Home Automation Alarm Systems

Authors: Helder Adão, Rui Antunes, Frederico Grilo

Abstract:

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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