Search results for: planning patient care information system.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11815

Search results for: planning patient care information system.

11695 Nutrition Program Planning Based on Local Resources in Urban Fringe Areas of a Developing Country

Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

Abstract:

Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: Developing country, local resources, nutrition program, urban fringe.

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11694 The Care Management Network as an Effective Intervention in Mitigating the Risks of Hypertension

Authors: Feng-Chuan Pan, Fang-Yue Liu

Abstract:

Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Keywords: hypertension, joint care management network, cardiovascular diseases, metabolic syndrome.

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11693 A Novel Approach to Handle Uncertainty in Health System Variables for Hospital Admissions

Authors: Manisha Rathi, Thierry Chaussalet

Abstract:

Hospital staff and managers are under pressure and concerned for effective use and management of scarce resources. The hospital admissions require many decisions that have complex and uncertain consequences for hospital resource utilization and patient flow. It is challenging to predict risk of admissions and length of stay of a patient due to their vague nature. There is no method to capture the vague definition of admission of a patient. Also, current methods and tools used to predict patients at risk of admission fail to deal with uncertainty in unplanned admission, LOS, patients- characteristics. The main objective of this paper is to deal with uncertainty in health system variables, and handles uncertain relationship among variables. An introduction of machine learning techniques along with statistical methods like Regression methods can be a proposed solution approach to handle uncertainty in health system variables. A model that adapts fuzzy methods to handle uncertain data and uncertain relationships can be an efficient solution to capture the vague definition of admission of a patient.

Keywords: Admission, Fuzzy, Regression, Uncertainty

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11692 Impact of Flexibility on Patient Satisfaction and Behavioral Intention: A Critical Reassessment and Model Development

Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

Abstract:

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

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

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11691 Framework for the Modeling of the Supply Chain Collaborative Planning Process

Authors: D. Pérez, M. M. E. Alemany

Abstract:

In this work, a framework to model the Supply Chain (SC) Collaborative Planning (CP) process is proposed. The main contributions of this framework concern 1) the presentation of the decision view, the most important one due to the characteristics of the process, jointly within the physical, organisation and information views, and 2) the simultaneous consideration of the spatial and temporal integration among the different supply chain decision centres. This framework provides the basis for a realistic and integrated perspective of the supply chain collaborative planning process and also the analytical modeling of each of its decisional activities.

Keywords: Collaborative Planning, Decision View, Distributed Decision-Making, Framework.

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11690 An Efficient Fall Detection Method for Elderly Care System

Authors: S. Sowmyayani, P. Arockia Jansi Rani

Abstract:

Fall detection is one of the challenging problems in elderly care system. The objective of this paper is to identify falls in elderly care system. In this paper, an efficient fall detection method is proposed to identify falls using correlation factor and Motion History Image (MHI). The proposed method is tested on URF (University of Rzeszow Fall detection) dataset and evaluated with some efficient measures like sensitivity, specificity, precision and classification accuracy. It is compared with other recent methods. The experimental results substantially proved that the proposed method achieves 1.5% higher sensitivity when compared to other methods.

Keywords: Pearson correlation coefficient, motion history image, human shape identification.

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11689 Parking Space Detection and Trajectory Tracking Control for Vehicle Auto-Parking

Authors: Shiuh-Jer Huang, Yu-Sheng Hsu

Abstract:

On-board available parking space detecting system, parking trajectory planning and tracking control mechanism are the key components of vehicle backward auto-parking system. Firstly, pair of ultrasonic sensors is installed on each side of vehicle body surface to detect the relative distance between ego-car and surrounding obstacle. The dimension of a found empty space can be calculated based on vehicle speed and the time history of ultrasonic sensor detecting information. This result can be used for constructing the 2D vehicle environmental map and available parking type judgment. Finally, the auto-parking controller executes the on-line optimal parking trajectory planning based on this 2D environmental map, and monitors the real-time vehicle parking trajectory tracking control. This low cost auto-parking system was tested on a model car.

Keywords: Vehicle auto-parking, parking space detection, parking path tracking, intelligent fuzzy controller.

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11688 Meeting Criminogenic Needs to Reduce Recidivism: The Diversion of Vulnerable Offenders from the Criminal Justice System into Care

Authors: Paulo Rocha

Abstract:

Once in touch with the Criminal Justice System, offenders with mental disorder tend to return to custody more often than nondisordered individuals, which suggests they have not been receiving appropriate treatment in prison. In this scenario, diverting individuals into care as early as possible in their trajectory seems to be the appropriate approach to rehabilitate mentally unwell offenders and alleviate overcrowded prisons. This paper builds on an ethnographic research investigating the challenges encountered by practitioners working to divert offenders into care while attempting to establish cross-boundary interactions with professionals in the Criminal Justice System and Mental Health Services in the UK. Drawing upon the findings of the study, this paper suggests the development of adequate tools to enable liaison between agencies which ultimately results in successful interventions.

Keywords: Criminogenic needs, interagency collaboration, liaison and diversion, recidivism.

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11687 Virtual Reality for Mutual Understanding in Landscape Planning

Authors: Ball J., Capanni N., Watt S.

Abstract:

This paper argues that fostering mutual understanding in landscape planning is as much about the planners educating stakeholder groups as the stakeholders educating the planners. In other words it is an epistemological agreement as to the meaning and nature of place, especially where an effort is made to go beyond the quantitative aspects, which can be achieved by the phenomenological experience of the Virtual Reality (VR) environment. This education needs to be a bi-directional process in which distance can be both temporal as well as spatial separation of participants, that there needs to be a common framework of understanding in which neither 'side' is disadvantaged during the process of information exchange and it follows that a medium such as VR offers an effective way of overcoming some of the shortcomings of traditional media by taking advantage of continuing technological advances in Information, Technology and Communications (ITC). In this paper we make particular reference to this as an extension to Geographical Information Systems (GIS). VR as a two-way communication tool offers considerable potential particularly in the area of Public Participation GIS (PPGIS). Information rich virtual environments that can operate over broadband networks are now possible and thus allow for the representation of large amounts of qualitative and quantitative information 'side-by-side'. Therefore, with broadband access becoming standard for households and enterprises alike, distributed virtual reality environments have great potential to contribute to enabling stakeholder participation and mutual learning within the planning context.

Keywords: 3D, communication, geographical information systems, planning, public participation, virtual reality, visualisation.

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11686 An Integrated Operational Research and System Dynamics Approach for Planning Decisions in Container Terminals

Authors: A. K. Abdel-Fattah, A. B. El-Tawil, N. A. Harraz

Abstract:

This paper focuses on the operational and strategic planning decisions related to the quayside of container terminals. We introduce an integrated operational research (OR) and system dynamics (SD) approach to solve the Berth Allocation Problem (BAP) and the Quay Crane Assignment Problem (QCAP). A BAP-QCAP optimization modeling approach which considers practical aspects not studied before in the integration of BAP and QCAP is discussed. A conceptual SD model is developed to determine the long-term effect of optimization on the system behavior factors like resource utilization, attractiveness to port, number of incoming vessels to port and port profits. The framework can be used for improving the operational efficiency of container terminals and providing a strategic view after applying optimization.

Keywords: Operational research, system dynamics, container terminal, quayside operational problems, strategic planning decisions.

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11685 Application of Simulation and Response Surface to Optimize Hospital Resources

Authors: Shamsuddin Ahmed, Francis Amagoh

Abstract:

This paper presents a case study that uses processoriented simulation to identify bottlenecks in the service delivery system in an emergency department of a hospital in the United Arab Emirates. Using results of the simulation, response surface models were developed to explain patient waiting time and the total time patients spend in the hospital system. Results of the study could be used as a service improvement tool to help hospital management in improving patient throughput and service quality in the hospital system.

Keywords: Simulation, Hospital Service, Resource Utilization, United Arab Emirates.

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11684 A Framework for Personalized Multi-Device Information Communicating System

Authors: Rohiza Ahmad, Rozana Kasbon, Eliza Mazmee Mazlan, Aliza Sarlan

Abstract:

Due to the mobility of users, many information systems are now developed with the capability of supporting retrieval of information from both static and mobile users. Hence, the amount, content and format of the information retrieved will need to be tailored according to the device and the user who requested for it. Thus, this paper presents a framework for the design and implementation of such a system, which is to be developed for communicating final examination related information to the academic community at one university in Malaysia. The concept of personalization will be implemented in the system so that only highly relevant information will be delivered to the users. The personalization concept used will be based on user profiling as well as context. The system in its final state will be accessible through cell phones as well as intranet connected personal computers.

Keywords: System framework, personalization, informationcommunicating system, multi-device.

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11683 Building an Inferential Model between Caregivers and Patients by using RFID

Authors: Yung-Ting Chang, Chung-You Tsai, Yu-Chuan Li

Abstract:

Nosocomial (i.e., hospital-acquired) infections (NI) is a major cause of morbidity and mortality in hospitals. NI rate is higher in intensive care units (ICU) than in the general ward due to patients with severe symptoms, poor immunity, and accepted many invasive therapies. Contact behaviors between health caregivers and patients is one of the infect factors. It is difficult to obtain complete contact records by traditional method of retrospective analysis of medical records. This paper establishes a contact history inferential model (CHIM) intended to extend the use of Proximity Sensing of rapid frequency identification (RFID) technology to transferring all proximity events between health caregivers and patients into clinical events (close-in events, contact events and invasive events).The results of the study indicated that the CHIM can infer proximity care activities into close-in events and contact events. The infection control team could redesign and build optimal workflow in the ICU according to the patient-specific contact history which provided by our automatic tracing system.

Keywords: Active Radio Frequency Identification, Intensive Care Unit, Nosocomial Infections

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11682 Study on Scheduling of the Planning Method Using the Web-based Visualization System in a Shipbuilding Block Assembly Shop

Authors: A. Eui Koog Ahn, B. Gi-Nam Wang, C. Sang C. Park

Abstract:

Higher productivity and less cost in the ship manufacturing process are required to maintain the international competitiveness of morden manufacturing industries. In shipbuilding, however, the Engineering To Order (ETO) production method and production process is very difficult. Thus, designs change frequently. In accordance with production, planning should be set up according to scene changes. Therefore, fixed production planning is very difficult. Thus, a scheduler must first make sketchy plans, then change the plans based on the work progress and modifications. Thus, data sharing in a shipbuilding block assembly shop is very important. In this paper, we proposed to scheduling method applicable to the shipbuilding industry and decision making support system through web based visualization system.

Keywords: Shipbuilding, Monitoring, Block assembly shop, Visualization

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11681 Variable Rough Set Model and Its Knowledge Reduction for Incomplete and Fuzzy Decision Information Systems

Authors: Da-kuan Wei, Xian-zhong Zhou, Dong-jun Xin, Zhi-wei Chen

Abstract:

The information systems with incomplete attribute values and fuzzy decisions commonly exist in practical problems. On the base of the notion of variable precision rough set model for incomplete information system and the rough set model for incomplete and fuzzy decision information system, the variable rough set model for incomplete and fuzzy decision information system is constructed, which is the generalization of the variable precision rough set model for incomplete information system and that of rough set model for incomplete and fuzzy decision information system. The knowledge reduction and heuristic algorithm, built on the method and theory of precision reduction, are proposed.

Keywords: Rough set, Incomplete and fuzzy decision information system, Limited valued tolerance relation, Knowledge reduction, Variable rough set model

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11680 Modeling the Impact of Controls on Information System Risks

Authors: M. Ndaw, G. Mendy, S. Ouya

Abstract:

Information system risk management helps to reduce or eliminate risk by implementing appropriate controls. In this paper, we propose a quantification model of controls impact on information system risks by automatizing the residual criticality estimation step of FMECA which is based on a inductive reasoning. For this, we defined three equations based on type and maturity of controls. For testing, the values obtained with the model were compared to estimated values given by interlocutors during different working sessions and the result is satisfactory. This model allows an optimal assessment of controls maturity and facilitates risk analysis of information system.

Keywords: Information System, Risk, Control, FMECA.

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11679 Design and Trajectory Planning of Bipedal Walking Robot with Minimum Sufficient Actuation System

Authors: H. Siswoyo Jo, N. Mir-Nasiri, E. Jayamani

Abstract:

This paper presents a new type of mechanism and trajectory planning strategy for bipedal walking robot. The newly designed mechanism is able to improve the performance of bipedal walking robot in terms of energy efficiency and weight reduction by utilizing minimum number of actuators. The usage of parallelogram mechanism eliminates the needs of having an extra actuator at the knee joint. This mechanism works together with the joint space trajectory planning in order to realize straight legged walking which cannot be achieved by conventional inverse kinematics trajectory planning due to the singularity. The effectiveness of the proposed strategy is confirmed by computer simulation results.

Keywords: Bipedal robot, Energy efficiency, Straight legged walking, Trajectory planning.

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11678 Strategic Management via System Dynamics Simulation Models

Authors: G. Papageorgiou, A. Hadjis

Abstract:

This paper examines the problem of strategic management in highly turbulent dynamic business environmental conditions. As shown the high complexity of the problem can be managed with the use of System Dynamics Models and Computer Simulation in obtaining insights, and thorough understanding of the interdependencies between the organizational structure and the business environmental elements, so that effective product –market strategies can be designed. Simulation reveals the underlying forces that hold together the structure of an organizational system in relation to its environment. Such knowledge will contribute to the avoidance of fundamental planning errors and enable appropriate proactive well focused action.

Keywords: Strategic Management, System Dynamics, Modelingand Simulation, Strategic Planning, Organizational Dynamics

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11677 A Vehicle Monitoring System Based on the LoRa Technique

Authors: Chao-Linag Hsieh, Zheng-Wei Ye, Chen-Kang Huang, Yeun-Chung Lee, Chih-Hong Sun, Tzai-Hung Wen, Jehn-Yih Juang, Joe-Air Jiang

Abstract:

Air pollution and climate warming become more and more intensified in many areas, especially in urban areas. Environmental parameters are critical information to air pollution and weather monitoring. Thus, it is necessary to develop a suitable air pollution and weather monitoring system for urban areas. In this study, a vehicle monitoring system (VMS) based on the IoT technique is developed. Cars are selected as the research tool because it can reach a greater number of streets to collect data. The VMS can monitor different environmental parameters, including ambient temperature and humidity, and air quality parameters, including PM2.5, NO2, CO, and O3. The VMS can provide other information, including GPS signals and the vibration information through driving a car on the street. Different sensor modules are used to measure the parameters and collect the measured data and transmit them to a cloud server through the LoRa protocol. A user interface is used to show the sensing data storing at the cloud server. To examine the performance of the system, a researcher drove a Nissan x-trail 1998 to the area close to the Da’an District office in Taipei to collect monitoring data. The collected data are instantly shown on the user interface. The four kinds of information are provided by the interface: GPS positions, weather parameters, vehicle information, and air quality information. With the VMS, users can obtain the information regarding air quality and weather conditions when they drive their car to an urban area. Also, government agencies can make decisions on traffic planning based on the information provided by the proposed VMS.

Keywords: Vehicle, monitoring system, LoRa, smart city.

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11676 Client Satisfaction: Does Private or Public Health Sector Make a Difference? Results from Secondary Data Analysis in Sindh, Pakistan

Authors: Wajiha Javed, Arsalan Jabbar, Nelofer Mehboob, Muhammad Tafseer, Zahid Memon

Abstract:

Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset on 3133 women. Ten different multivariate models were made. to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92, 95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29). Discussion: Public sector has successfully attained substantial satisfaction levels with respect to provision of contraceptives, but it contrasts previous literature from a multi country studies. Our study though in is concordance with a study from Tanzania where public sector was more likely to offer family planning services to clients as compared to private facilities. Conclusion: In majority of the developing countries, public sector is more involved in FP service provision; however, in Pakistan clients’ satisfaction in private sector is more, which opens doors for public-private partnerships and collaboration in the near future. 

Keywords: Client satisfaction, Family Planning, Public private partnership, Quality of care

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11675 Electricity Power Planning: the Role of Wind Energy

Authors: Paula Ferreira, Madalena Araújo, M.E.J. O’Kelly

Abstract:

Combining energy efficiency with renewable energy sources constitutes a key strategy for a sustainable future. The wind power sector stands out as a fundamental element for the achievement of the European renewable objectives and Portugal is no exception to the increase of the wind energy for the electricity generation. This work proposes an optimization model for the long range electricity power planning in a system similar to the Portuguese one, where the expected impacts of the increasing installed wind power on the operating performance of thermal power plants are taken into account. The main results indicate that the increasing penetration of wind power in the electricity system will have significant effects on the combined cycle gas power plants operation and on the theoretically expected cost reduction and environmental gains. This research demonstrated the need to address the impact that energy sources with variable output may have, not only on the short-term operational planning, but especially on the medium to long range planning activities, in order to meet the strategic objectives for the energy sector.

Keywords: Wind power, electricity planning model, cost, emissions.

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11674 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

Abstract:

Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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11673 A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations

Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

Abstract:

A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: Critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team.

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11672 Antibiotic Prescribing in the Acute Care in Iraq

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

Abstract:

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

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

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11671 On the Combination of Patient-Generated Data with Data from a Secure Clinical Network Environment – A Practical Example

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

Abstract:

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

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

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11670 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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11669 Automatic Real-Patient Medical Data De-Identification for Research Purposes

Authors: Petr Vcelak, Jana Kleckova

Abstract:

Our Medicine-oriented research is based on a medical data set of real patients. It is a security problem to share patient private data with peoples other than clinician or hospital staff. We have to remove person identification information from medical data. The medical data without private data are available after a de-identification process for any research purposes. In this paper, we introduce an universal automatic rule-based de-identification application to do all this stuff on an heterogeneous medical data. A patient private identification is replaced by an unique identification number, even in burnedin annotation in pixel data. The identical identification is used for all patient medical data, so it keeps relationships in a data. Hospital can take an advantage of a research feedback based on results.

Keywords: DASTA, De-identification, DICOM, Health Level Seven, Medical data, OCR, Personal data

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11668 Implementation of CMMS Software for a Maintenance Plan in a Manufacturing Industry

Authors: Abimbola O. Aniki, Esther T. Akinlabi

Abstract:

This paper proposes an effective maintenance method by considering the implementation of the Computerized Maintenance Management System (CMMS) software to plan a maintenance activity in a manufacturing industry. Globally, maintenance is a very important activity in the manufacturing sector to prolong the life span of equipment and machinery; it is also applicable to all household items. It is obvious and well known that apart from giving long life to equipment, it reduces the substantial financial losses for repairs and save the production downtime. In some cases, appropriate maintenance of plant equipment and machinery reduces the tendencies of injuries to personnel in the job floor. But before the maintenance process can be carried out, proper and effective work order planning and scheduling must be in place in other to achieve the set goals and objectives of a maintenance shop. Brief reviews of common planning tools which include the Computerized Maintenance Management System (CMMS) are presented. An interesting outline of analyses on planning and scheduling for effective job planning in a typical manufacturing industry using the CMMS is also presented and discussed. Finally, the steps to adhere to in making job planning effective in a manufacturing industry are also highlighted.

Keywords: Advanced Downtime Analysis Programme (ADAP), Computerized Maintenance Management System (CMMS), Corrective Maintenance (CM), Executing Department (ED), Maintenance Department (MD), Preventive Maintenance (PM).

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11667 Robotic Assistance in Nursing Care: Survey on Challenges and Scenarios

Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

Abstract:

Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: Robotics and automation, engineering management, engineering in medicine and biology, medical services, public healthcare.

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11666 Video-Based System for Support of Robot-Enhanced Gait Rehabilitation of Stroke Patients

Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

Abstract:

We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: Video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance.

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