Search results for: senior patient.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 422

Search results for: senior patient.

272 The Current Awareness of Just-In-Time Techniques within the Libyan Textile Private Industry: A Case Study

Authors: Rajab Abdullah Hokoma

Abstract:

Almost all Libyan industries (both private and public) have struggled with many difficulties during the past three decades due to many problems. These problems have created a strongly negative impact on the productivity and utilization of many companies within Libya. This paper studies the current awareness and implementation levels of Just-In-Time (JIT) within the Libyan Textile private industry. A survey has been applied in this study using an intensive detailed questionnaire. Based on the analysis of the survey responses, the results show that the management body within the surveyed companies has a modest strategy towards most of the areas that are considered as being very crucial in any successful implementation of JIT. The results also show a variation within the implementation levels of the JIT elements as these varies between Low and Acceptable levels. The paper has also identified limitations within the investigated areas within this industry, and has pointed to areas where senior managers within the Libyan textile industry should take immediate actions in order to achieve effective implementation of JIT within their companies.

Keywords: Industry, questionnaire, JIT, textile.

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271 Transmission Model for Plasmodium Vivax Malaria: Conditions for Bifurcation

Authors: P. Pongsumpun, I.M. Tang

Abstract:

Plasmodium vivax malaria differs from P. falciparum malaria in that a person suffering from P. vivax infection can suffer relapses of the disease. This is due the parasite being able to remain dormant in the liver of the patients where it is able to re-infect the patient after a passage of time. During this stage, the patient is classified as being in the dormant class. The model to describe the transmission of P. vivax malaria consists of a human population divided into four classes, the susceptible, the infected, the dormant and the recovered. The effect of a time delay on the transmission of this disease is studied. The time delay is the period in which the P. vivax parasite develops inside the mosquito (vector) before the vector becomes infectious (i.e., pass on the infection). We analyze our model by using standard dynamic modeling method. Two stable equilibrium states, a disease free state E0 and an endemic state E1, are found to be possible. It is found that the E0 state is stable when a newly defined basic reproduction number G is less than one. If G is greater than one the endemic state E1 is stable. The conditions for the endemic equilibrium state E1 to be a stable spiral node are established. For realistic values of the parameters in the model, it is found that solutions in phase space are trajectories spiraling into the endemic state. It is shown that the limit cycle and chaotic behaviors can only be achieved with unrealistic parameter values.

Keywords: Equilibrium states, Hopf bifurcation, limit cyclebehavior, local stability, Plasmodium Vivax, time delay.

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270 Pre-Operative Tool for Facial-Post-Surgical Estimation and Detection

Authors: Ayat E. Ali, Christeen R. Aziz, Merna A. Helmy, Mohammed M. Malek, Sherif H. El-Gohary

Abstract:

Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.

Keywords: K-nearest neighbor, face detection, vitiligo, bone deformity.

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269 A Study of the Problems and Demands of Community Leaders- Training in the Upper Northeastern Region

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

Abstract:

This research is aimed at studying the nature of problems and demands of the training for community leaders in the upper northeastern region of Thailand. Population and group samplings are based on 360 community leaders in the region who have experienced prior training from the Udonthani Rajabhat University. Stratified random samplings have been drawn upon 186 participants. The research tools is questionnaires. The frequency, percentage and standard deviation are employed in data analysis. The findings indicate that most of community leaders are males and senior adults. The problems in training are associated with the inconveniences of long-distance travelling to training locations, inadequacy of learning centers and training sites and high training costs. The demand of training is basically motivated by a desire for self-development in modern knowledge in keeping up-to-date with the changing world and the need for technological application and facilitation in shortening the distance to training locations and in limiting expensive training costs.

Keywords: Community leaders, Distance Training, Management, Technology.

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268 Development of a Miniature and Low-Cost IoT-Based Remote Health Monitoring Device

Authors: Sreejith Jayachandran, Mojtaba Ghodsi, Morteza Mohammadzaheri

Abstract:

The modern busy world is running behind new embedded technologies based on computers and software meanwhile some people are unable to monitor their health condition and regular medical check-ups. Some of them postpone medical check-ups due to a lack of time and convenience while others skip these regular evaluations and medical examinations due to huge medical bills and hospital expenses. In this research, we present a device in the telemonitoring system capable of monitoring, checking, and evaluating the health status of the human body remotely through the internet for the needs of all kinds of people. The remote health monitoring device is a microcontroller-based embedded unit. The various types of sensors in this device are connected to the human body, and with the help of an Arduino UNO board, the required analogue data are collected from the sensors. The microcontroller on the Arduino board processes the analogue data collected in this way into digital data and transfers that information to the cloud and stores it there; the processed digital data are then instantly displayed through the LCD attached to the machine. By accessing the cloud storage with a username and password, the concerned person’s health care teams/doctors, and other health staff can collect these data for the assessment and follow-up of that patient. Besides that, the family members/guardians can use and evaluate these data for awareness of the patient's current health status. Moreover, the system is connected to a GPS module. In emergencies, the concerned team can be positioning the patient or the person with this device. The setup continuously evaluates and transfers the data to the cloud and also the user can prefix a normal value range for the evaluation. For example, the blood pressure normal value is universally prefixed between 80/120 mmHg. Similarly, the Remote Health Monitoring System (RHMS) is also allowed to fix the range of values referred to as normal coefficients. This IoT-based miniature system 11×10×10 cm3 with a low weight of 500 gr only consumes 10 mW. This smart monitoring system is manufactured for 100 GBP (British Pound Sterling), and can facilitate the communication between patients and health systems, but also it can be employed for numerous other uses including communication sectors in the aerospace and transportation systems.

Keywords: Embedded Technology, Telemonitoring system, Microcontroller, Arduino UNO, Cloud storage, GPS, RHMS, Remote Health Monitoring System, Alert system.

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267 Effect of Non Uniformity Factors and Assignment Factors on Errors in Charge Simulation Method with Point Charge Model

Authors: Gururaj S Punekar, N K Kishore Senior, H S Y Shastry

Abstract:

Charge Simulation Method (CSM) is one of the very widely used numerical field computation technique in High Voltage (HV) engineering. The high voltage fields of varying non uniformities are encountered in practice. CSM programs being case specific, the simulation accuracies heavily depend on the user (programmers) experience. Here is an effort to understand CSM errors and evolve some guidelines to setup accurate CSM models, relating non uniformities with assignment factors. The results are for the six-point-charge model of sphere-plane gap geometry. Using genetic algorithm (GA) as tool, optimum assignment factors at different non uniformity factors for this model have been evaluated and analyzed. It is shown that the symmetrically placed six-point-charge models can be good enough to set up CSM programs with potential errors less than 0.1% when the field non uniformity factor is greater than 2.64 (field utilization factor less than 52.76%).

Keywords: Assignment factor, Charge Simulation Method, High Voltage, Numerical field computation, Non uniformity factor, Simulation errors.

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266 Virtual Reality in COVID-19 Stroke Rehabilitation: Preliminary Outcomes

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of COVID-19 infection. Understanding novel treatment approaches is important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with VR included. This game-based VR technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with COVID-19 related CVA. The safety of developed instruments for such cases provides approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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265 Bayes Net Classifiers for Prediction of Renal Graft Status and Survival Period

Authors: Jiakai Li, Gursel Serpen, Steven Selman, Matt Franchetti, Mike Riesen, Cynthia Schneider

Abstract:

This paper presents the development of a Bayesian belief network classifier for prediction of graft status and survival period in renal transplantation using the patient profile information prior to the transplantation. The objective was to explore feasibility of developing a decision making tool for identifying the most suitable recipient among the candidate pool members. The dataset was compiled from the University of Toledo Medical Center Hospital patients as reported to the United Network Organ Sharing, and had 1228 patient records for the period covering 1987 through 2009. The Bayes net classifiers were developed using the Weka machine learning software workbench. Two separate classifiers were induced from the data set, one to predict the status of the graft as either failed or living, and a second classifier to predict the graft survival period. The classifier for graft status prediction performed very well with a prediction accuracy of 97.8% and true positive values of 0.967 and 0.988 for the living and failed classes, respectively. The second classifier to predict the graft survival period yielded a prediction accuracy of 68.2% and a true positive rate of 0.85 for the class representing those instances with kidneys failing during the first year following transplantation. Simulation results indicated that it is feasible to develop a successful Bayesian belief network classifier for prediction of graft status, but not the graft survival period, using the information in UNOS database.

Keywords: Bayesian network classifier, renal transplantation, graft survival period, United Network for Organ Sharing

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264 Research on the Strategy of Whole-Life-Cycle Campus Design from the Perspective of Sustainable Concept: A Case Study on Hangzhou Senior High School in Zhejiang

Authors: Fan Yang

Abstract:

With the development of social economy and the popularization of quality education, the Chinese government invests more and more funding in education. Campus constructions are experiencing a great development phase. Under the trend of sustainable development, modern green campus design needs to meet new requirements of contemporary, informational and diversified education means and adapt to future education development. Educators, designers and other participants of campus design are facing new challenges. By studying and analyzing the universal unsatisfied current situations and sustainable development requirements of Chinese campuses, this paper summarizes the strategies and intentions of the whole-life-cycle campus design. In addition, a Chinese high school in Zhejiang province is added to illustrate the design cycle in an actual case. It is aimed to make all participants of campus design, especially the designers, to realize the importance of whole-life-cycle campus design and cooperate better. Sustainable campus design is expected to come true in deed instead of becoming a slogan in this way.

Keywords: Campus design, green school, sustainable development, whole-life-cycle design.

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263 Student Feedback and Its Impact on Fostering the Quality of Teaching at the Academia

Authors: S. Vanker, A. Aaver, A. Roio, L. Nuut

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To be sure about the effective and less effective/ineffective approaches to course instruction, we hold the opinion that the faculty members need regular feedback from their students in order to be aware of how well or unwell their teaching styles have worked when instructing the courses. It can be confirmed without a slightest hesitation that undergraduate students’ motivated-ness can be sustained when continually improving the quality of teaching and properly sequencing the academic courses both, in the curricula and timetables. At Estonian Aviation Academy, four different forms of feedback are used: Lecture monitoring, questionnaires for all students, study information system subject monitoring and direct feedback received by the lecturer. Questionnaires for all students are arranged once during a study year and separately for the first year and senior students. The results are discussed in academic departments together with student representatives, analyzed with the teaching staff and, if needed, improvements are suggested. In addition, a monitoring system is planned where a lecturer acts in both roles – as an observer and as the lecturer. This will foster better exchange of experience and through this help to make the whole study process more interesting.

Keywords: Student support, learner motivation, feedback, undergraduate education.

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262 Socio-Economic Determinants of Physical Activity of Non-Manual Workers, Including the Early Senior Group, from the City of Wroclaw in Poland

Authors: Daniel Puciato, Piotr Oleśniewicz, Julita Markiewicz-Patkowska, Krzysztof Widawski, Michał Rozpara, Władysław Mynarski, Agnieszka Gawlik, Małgorzata Dębska, Soňa Jandová

Abstract:

Physical activity as a part of people’s everyday life reduces the risk of many diseases, including those induced by lifestyle, e.g. obesity, type 2 diabetes, osteoporosis, coronary heart disease, degenerative arthritis, and certain types of cancer. That refers particularly to professionally active people, including the early senior group working on non-manual positions. The aim of the study is to evaluate the relationship between physical activity and the socio-economic status of non-manual workers from Wroclaw—one of the biggest cities in Poland, a model setting for such investigations in this part of Europe. The crucial problem in the research is to find out the percentage of respondents who meet the health-related recommendations of the World Health Organization (WHO) concerning the volume, frequency, and intensity of physical activity, as well as to establish if the most important socio-economic factors, such as gender, age, education, marital status, per capita income, savings and debt, determine the compliance with the WHO physical activity recommendations. During the research, conducted in 2013, 1,170 people (611 women and 559 men) aged 21–60 years were examined. A diagnostic poll method was applied to collect the data. Physical activity was measured with the use of the short form of the International Physical Activity Questionnaire with extended socio-demographic questions, i.e. concerning gender, age, education, marital status, income, savings or debts. To evaluate the relationship between physical activity and selected socio-economic factors, logistic regression was used (odds ratio statistics). Statistical inference was conducted on the adopted ex ante probability level of p<0.05. The majority of respondents met the volume of physical effort recommended for health benefits. It was particularly noticeable in the case of the examined men. The probability of compliance with the WHO physical activity recommendations was highest for workers aged 21–30 years with secondary or higher education who were single, received highest incomes and had savings. The results indicate the relations between physical activity and socio-economic status in the examined women and men. People with lower socio-economic status (e.g. manual workers) are physically active primarily at work, whereas those better educated and wealthier implement physical effort primarily in their leisure time. Among the investigated subjects, the youngest group of non-manual workers have the best chances to meet the WHO standards of physical activity. The study also confirms that secondary education has a positive effect on the public awareness on the role of physical activity in human life. In general, the analysis of the research indicates that there is a relationship between physical activity and some socio-economic factors of the respondents, such as gender, age, education, marital status, income per capita, and the possession of savings. Although the obtained results cannot be applied for the general population, they show some important trends that will be verified in subsequent studies conducted by the authors of the paper.

Keywords: International physical activity questionnaire, non-manual workers, physical activity, socio-economic factors, WHO.

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261 Artifacts in Spiral X-ray CT Scanners: Problems and Solutions

Authors: Mehran Yazdi, Luc Beaulieu

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Artifact is one of the most important factors in degrading the CT image quality and plays an important role in diagnostic accuracy. In this paper, some artifacts typically appear in Spiral CT are introduced. The different factors such as patient, equipment and interpolation algorithm which cause the artifacts are discussed and new developments and image processing algorithms to prevent or reduce them are presented.

Keywords: CT artifacts, Spiral CT, Artifact removal.

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260 Lack of BIM Training: Investigating Practical Solutions for the State of Kuwait

Authors: Noor M. Abdulfattah, Ahmed M. Khalafallah, Nabil A. Kartam

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Despite the evident benefits of building information modeling (BIM) to the construction industry, it faces significant implementation challenges in the State of Kuwait. This study investigates the awareness of construction stakeholders of BIM implementation challenges, and identifies various solutions to overcome these challenges. Specifically, the main objectives of this study are to: (1) characterize the barriers that deter utilization of BIM, (2) examine the awareness of engineers, architects, and construction stakeholders of these barriers, and (3) identify practical solutions to facilitate BIM utilization. A questionnaire survey was designed to collect data on the aforementioned objectives from local companies and senior BIM experts. It was found that engineers are highly aware of BIM implementation barriers. In addition, it was concluded from the questionnaire that the biggest barrier is the lack of BIM training. Based on expert feedback, the study concluded with a number of recommendations on how to overcome the barriers of BIM utilization. This should prove useful to the construction industry stakeholders and can lead to significant changes to design and construction practices.

Keywords: Building information modeling, construction, challenges, information technology.

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259 Comparing Data Analysis, Communication and Information Technologies Expertise Levels in Undergraduate Psychology Students

Authors: Ana Cázares

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Aims for this study: first, to compare the expertise level in data analysis, communication and information technologies in undergraduate psychology students. Second, to verify the factor structure of E-ETICA (Escala de Experticia en Tecnologias de la Informacion, la Comunicacion y el Análisis or Data Analysis, Communication and Information'Expertise Scale) which had shown an excellent internal consistency (α= 0.92) as well as a simple factor structure. Three factors, Complex, Basic Information and Communications Technologies and E-Searching and Download Abilities, explains 63% of variance. In the present study, 260 students (119 juniors and 141 seniors) were asked to respond to ETICA (16 items Likert scale of five points 1: null domain to 5: total domain). The results show that both junior and senior students report having very similar expertise level; however, E-ETICA presents a different factor structure for juniors and four factors explained also 63% of variance: Information E-Searching, Download and Process; Data analysis; Organization; and Communication technologies.

Keywords: Data analysis, Information, Communications Technologies, Expertise'Levels.

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258 Traumatic Ankle Pain: Adequacy of Clinical Information in X-Ray Request with Reference to the Ottawa Ankle Rule

Authors: Rania Mustafa

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This audit was conducted at Manchester University NHS Foundation Trust, Wythenshawe Hospital Radiology and Accident and Emergency [A&E] Department to assess the appropriateness of clinical information in X-ray requests, specifically in cases of acute ankle injuries. As per the Ottawa Ankle Rules and the recommendations of National Institute for Health and Care Excellence [NICE] and the Royal College of Radiology, we aimed to evaluate the appropriateness of referrals and the thoroughness of clinical information provided by Emergency Department [ED] clinicians for ankle radiography. Our goal was to achieve 100% compliance with these guidelines. The audit involved a comprehensive analysis spanning the period from August 2022 to January 2023, encompassing patient records, radiographic orders, and clinical assessments. Data collection included patient demographics, presenting complaints, clinical assessments, adherence to Ottawa Ankle Rules criteria, and subsequent radiography orders. Here we conducted two audit cycles, involving 38 patients in the first cycle and 86 patients in the second cycle. The data were furtherly filtered to include all patients who were referred from the ED for an ankle Xray with a history of acute trauma and age of more than 18 years. The key finding was that in August 2022, 60% of cases met the Ottawa Ankle Rules criteria accurately, indicating a need for improvement in adherence. However, by January 2023, there was a notable improvement, with 95% of cases accurately meeting the criteria. This significant change reflects an increased alignment with best practices for ankle radiography referrals.

Keywords: Ankle, injuries, Ottawa Ankle Rule, X-rays.

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257 Physicians’ Knowledge and Perception of Gene Profiling in Malaysia

Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires were returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge; however, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: Gene Profiling, Knowledge, Malaysia, Physician.

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256 Dental Ethics versus Malpractice, as Phenomenon with a Growing Trend

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

Abstract:

Dealing with emerging cases of dental malpractice with justifications that stem from the clear rules of dental ethics is a phenomenon with an increasing trend in today's dental practice. Dentists should clearly understand how far the limit of malpractice goes, with or without minimal or major consequences, for the affected patient, which can be justified as a complication of dental treatment, in support of the rules of dental ethics in the dental office. Indeed, malpractice can occur in cases of lack of professionalism, but it can also come as a consequence of anatomical and physiological limitations in the implementation of the dental protocols, predetermined and indicated by the patient in the paragraph of the treatment plan in his personal card. Let this article serve as a short communication between readers and interested parties about the problems that dental malpractice can bring to the community. Malpractice should not be seen only as a professional wrong approach, but also as a phenomenon that can occur during dental practice. The aim of this article is presentation of the latest data published in the literature about malpractice. The combination of keywords is done in such a way with the aim to give the necessary space for collecting the right information in the networks of publications about this field, always first from the point of view of the dentist and not from that of the lawyer or jurist. From the findings included in this article, it was noticed that the diversity of approaches towards the phenomenon depends on the different countries based on the legal basis that these countries have. There is a lack of or a small number of articles that touch on this topic, and these articles are presented with a limited amount of data on the same topic. Dental malpractice should not be hidden under the guise of various dental complications that we justify with the strict rules of ethics for patients treated in the dental chair. The individual experience of dental malpractice must be published with the aim of serving as a source of experience for future generations of dentists.

Keywords: Dental ethics, malpractice, professional protocol, random deviation, dental tourism.

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255 IT Workforce Enablement – How Cloud Computing Changes the Competence Mix of the IT Workforce

Authors: Dominik Krimpmann

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Cloud computing has provided the impetus for change in the demand, sourcing, and consumption of IT-enabled services. The technology developed from an emerging trend towards a ‘musthave’. Many organizations harnessed on the quick-wins of cloud computing within the last five years but nowadays reach a plateau when it comes to sustainable savings and performance. This study aims to investigate what is needed from an organizational perspective to make cloud computing a sustainable success. The study was carried out in Germany among senior IT professionals, both in management and delivery positions. Our research shows that IT executives must be prepared to realign their IT workforce to sustain the advantage of cloud computing for today and the near future. While new roles will undoubtedly emerge, roles alone cannot ensure the success of cloud deployments. What is needed is a change in the IT workforce’s business behaviour, or put more simply, the ways in which the IT personnel works. It gives clear guidance on which dimensions of an employees’ working behaviour need to be adapted. The practical implications are drawn from a series of semi-structured interviews, resulting in a high-level workforce enablement plan. Lastly, it elaborates on tools and gives clear guidance on which pitfalls might arise along the proposed workforce enablement process.

Keywords: Cloud Computing, Organization Design, Organizational Change, Workforce Enablement.

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254 Knowledge Impact on Measurement: A Conceptual Metric for Evaluating Performance Improvement (PI) at the Kuwait Institute for Scientific Research (KISR)

Authors: AlMatrouk H. S., Juszczak M. D.

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Research and development R&D work involves enormous amount of work that has to do with data measurement and collection. This process evolves as new information is fed, new technologies are utilized, and eventually new knowledge is created by the stakeholders i.e., researchers, clients, and end-users. When new knowledge is created, procedures of R&D work should evolve and produce better results within improved research skills and improved methods of data measurements and collection. This measurement improvement should then be benchmarked against a metric that should be developed at the organization. In this paper, we are suggesting a conceptual metric for R&D work performance improvement (PI) at the Kuwait Institute for Scientific Research (KISR). This PI is to be measured against a set of variables in the suggested metric, which are more closely correlated to organizational output, as opposed to organizational norms. The paper also mentions and discusses knowledge creation and management as an addedvalue to R&D work and measurement improvement. The research methodology followed in this work is qualitative in nature, based on a survey that was distributed to researchers and interviews held with senior researchers at KISR. Research and analyses in this paper also include looking at and analyzing KISR-s literature.

Keywords: Knowledge Creation, Performance Improvement (PI), Conceptual Metric, Knowledge Management (KM) addedvalue.

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253 Parental and Related Factors Affecting Students’ Academic Achievement in Oyo State, Nigeria

Authors: Oladele K. Ogunsola, Kazeem A. Osuolale, Akintayo O. Ojo

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Many factors influence the educational outcome of students. Some of these have been studied by researchers with many emphasizing the role of students, schools, governments, peer groups and so on. More often than not, some of these factors influencing the academic achievement of the students have been traced back to parents and family; being the primary platform on which learning not only begins but is nurtured, encouraged and developed which later transforms to the performance of the students. This study not only explores parental and related factors that predict academic achievement through the review of relevant literatures but also, investigates the influence of parental background on the academic achievement of senior secondary school students in Ibadan North Local Government Area of Oyo State, Nigeria. As one of the criteria of the quality of education, students’ academic achievement was investigated because it is most often cited as an indicator of school effectiveness by school authorities and educationists. The data collection was done through interviews and use of well-structured questionnaires administered to one hundred students (100) within the target local government. This was statistically analysed and the result showed that parents’ attitudes towards their children’s education had significant effect(s) on students’ self-reporting of academic achievement. However, such factors as parental education and socioeconomic background had no significant relationship with the students’ self-reporting of academic achievement.

Keywords: Academic attainment, Parental factors, students, Oyo State, Nigeria.

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252 A Retrospective Cross-Sectional Study on the Prevalence and Factors Associated with Virological Non-Suppression among HIV-Positive Adult Patients on Antiretroviral Therapy in Woliso Town, Oromia, Ethiopia

Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

Abstract:

Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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251 CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire

Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

Abstract:

The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: Alcohol screening, AUDIT-C, CAGE, Hazardous drinking.

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250 Software Architecture and Support for Patient Tracking Systems in Critical Scenarios

Authors: Gianluca Cornetta, Abdellah Touhafi, David J. Santos, Jose Manuel Vazquez

Abstract:

In this work a new platform for mobile-health systems is presented. System target application is providing decision support to rescue corps or military medical personnel in combat areas. Software architecture relies on a distributed client-server system that manages a wireless ad-hoc networks hierarchy in which several different types of client operate. Each client is characterized for different hardware and software requirements. Lower hierarchy levels rely in a network of completely custom devices that store clinical information and patient status and are designed to form an ad-hoc network operating in the 2.4 GHz ISM band and complying with the IEEE 802.15.4 standard (ZigBee). Medical personnel may interact with such devices, that are called MICs (Medical Information Carriers), by means of a PDA (Personal Digital Assistant) or a MDA (Medical Digital Assistant), and transmit the information stored in their local databases as well as issue a service request to the upper hierarchy levels by using IEEE 802.11 a/b/g standard (WiFi). The server acts as a repository that stores both medical evacuation forms and associated events (e.g., a teleconsulting request). All the actors participating in the diagnostic or evacuation process may access asynchronously to such repository and update its content or generate new events. The designed system pretends to optimise and improve information spreading and flow among all the system components with the aim of improving both diagnostic quality and evacuation process.

Keywords: IEEE 802.15.4 (ZigBee), IEEE 802.11 a/b/g (WiFi), distributed client-server systems, embedded databases, issue trackers, ad-hoc networks.

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249 The Governance of Islamic Banks in Morocco: Meaning, Strategic Vision and Purposes Attributed to the Governance System

Authors: Lalla Nezha Lakmiti, Abdelkahar Zahid

Abstract:

Due to the setbacks on the international scene and the wave of cacophonic financial scandals affecting large international groups, the new Islamic finance industry is not immune despite its initial resistance. The purpose of this paper is to understand and analyze the meaning of the Corporate Governance (CG) concept in Moroccan Islamic banking systems with specific reference to their institutions. The research objective is to identify also the path taken and adopted by these banks recently set up in Morocco. The foundation is rooted in shari'a, in particular, no stakeholder (the shareholding approach) must be harmed, and the ethical value is reflected into these parties’ behavior. We chose a qualitative method, semi-structured interviews where six managers provided answers about their banking systems. Since these respondents held a senior position (directors) within their organizations, it is felt that they are well placed and have the necessary knowledge to provide us with information to answer the questions asked. The results identified the orientation of participating banks and assessing how governance works, while determining which party is fovoured: shareholders, stakeholders or both. This study discusses the favorable condition to the harmonization of the regulations and therefore a better integration between Islamic finance and conventional ones in the economic context of Morocco.

Keywords: Corporate governance, participating banks, stakeholders, shareholders, and interests.

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248 Improving the Elder-s Quality of Life with Smart Television Based Services

Authors: Van-Quang Trinh, Gi-Soo Chung, Hee-Cheol Kim

Abstract:

The increasing number of senior population gradually causes to demand the use of information and communication technology for their satisfactory lives. This paper presents the development of an integrated TV based system which offers an opportunity to provide value added services to a large number of elderly citizens, and thus helps improve their quality of life. The design philosophy underlying this paper is to fulfill both technological and human aspects. The balance between these two dimensions has been currently stressed as a crucial element for the design of usable systems in real use, particularly to the elderly who have physical and mental decline. As the first step to achieve it, we have identified human and social factors that affect the elder-s quality of life by a literature review, and based on them, build four fundamental services: information, healthcare, learning and social network services. Secondly, the system architecture, employed technologies and the elderly-friendly system design considerations are presented. This reflects technological and human perspectives in terms of the system design. Finally, we describe some scenarios that illustrate the potentiality of the proposed system to improve elderly people-s quality of life.

Keywords: Elderly people, human computer interaction, quality of life, smart television, user-centered system design

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247 Comparison of Statins Dose Intensity on HbA1c Control in Outpatients with Type 2 Diabetes: A Prospective Cohort Study

Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Ahmed A. Khamis, Abeer Kharshid, Nor Azizah Aziz

Abstract:

The effect of statins dose intensity (SDI) on glycemic control in patients with existing diabetes is unclear. Also, there are many contradictory findings were reported in the literature; thus, it is limiting the possibility to draw conclusions. This project was designed to compare the effect of SDI on glycated hemoglobin (HbA1c%) control in outpatients with Type 2 diabetes in the endocrine clinic at Hospital Pulau Pinang, Malaysia, between July 2015 and August 2016. A prospective cohort study was conducted, where records of 345 patients with Type 2 diabetes (Moderate-SDI group 289 patients and high-SDI cohort 56 patients) were reviewed to identify demographics and laboratory tests. The target of glycemic control (HbA1c < 7% for patient < 65 years, and < 8% for patient ≥ 65 years) was estimated, and the results were presented as descriptive statistics. From 289 moderate-SDI cohorts with a mean age of 57.3 ± 12.4 years, only 86 (29.8%) cases were shown to have controlled glycemia, while there were 203 (70.2%) cases with uncontrolled glycemia with confidence interval (CI) of 95% (6.2–10.8). On the other hand, the high-SDI group of 56 patients with Type 2 diabetes with a mean age 57.7±12.4 years is distributed among 11 (19.6%) patients with controlled diabetes, and 45 (80.4%) of them had uncontrolled glycemia, CI: 95% (7.1–11.9). The study has demonstrated that the relative risk (RR) of uncontrolled glycemia in patients with Type 2 diabetes that used high-SDI is 1.15, and the excessive relative risk (ERR) is 15%. The absolute risk (AR) is 10.2%, and the number needed to harm (NNH) is 10. Outpatients with Type 2 diabetes who use high-SDI of statin have a higher risk of uncontrolled glycemia than outpatients who had been treated with a moderate-SDI.

Keywords: Cohort study, diabetes control, dose intensity, HbA1c, Malaysia, statin, Type 2 diabetes mellitus, uncontrolled glycemia.

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246 Using Data Clustering in Oral Medicine

Authors: Fahad Shahbaz Khan, Rao Muhammad Anwer, Olof Torgersson

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The vast amount of information hidden in huge databases has created tremendous interests in the field of data mining. This paper examines the possibility of using data clustering techniques in oral medicine to identify functional relationships between different attributes and classification of similar patient examinations. Commonly used data clustering algorithms have been reviewed and as a result several interesting results have been gathered.

Keywords: Oral Medicine, Cluto, Data Clustering, Data Mining.

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245 A Case Study on Barriers in Total Productive Maintenance Implementation in the Abu Dhabi Power Industry

Authors: A. Alseiari, P. Farrell

Abstract:

Maintenance has evolved into an imperative function, and contributes significantly to efficient and effective equipment performance. Total Productive Maintenance (TPM) is an ideal approach to support the development and implementation of operation performance improvement. It systematically aims to understand the function of equipment, the service quality relationship with equipment and the probable critical equipment failure conditions. Implementation of TPM programmes need strategic planning and there has been little research applied in this area within Middle-East power plants. In the power sector of Abu Dhabi, technologically and strategically, the power industry is extremely important, and it thus needs effective and efficient equipment management support. The aim of this paper is to investigate barriers to successful TPM implementation in the Abu Dhabi power industry. The study has been conducted in the context of a leading power company in the UAE. Semi-structured interviews were conducted with 16 employees, including maintenance and operation staff, and senior managers. The findings of this research identified seven key barriers, thus: managerial; organisational; cultural; financial; educational; communications; and auditing. With respect to the understanding of these barriers and obstacles in TPM implementation, the findings can contribute towards improved equipment operations and maintenance in power organisations.

Keywords: Abu Dhabi power industry, TPM implementation, key barriers, organisational culture, critical success factors.

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244 Asset Management for Educational Buildings in Egypt

Authors: M. Abdelhamid, I. Beshara, M. Ghoneim

Abstract:

In Egypt, the concept of Asset Management (AM) is new; however, the need for applying it has become crucial because deteriorating or losing an asset is unaffordable in a developing country like Egypt. Therefore the current study focuses on educational buildings as one of the most important assets regarding planning, building, operating and maintenance expenditures. The main objective of this study is to develop a SAMF for educational buildings in Egypt. The General Authority for Educational Buildings (GAEB) was chosen as a case study of the current research as it represents the biggest governmental organization responsible for planning, operating and maintaining schools in Egypt. To achieve the research objective, structured interviews were conducted with senior managers of GAEB using a pre designed questionnaire to explore the current practice of AM. Gab analysis technique was applied against best practices compounded from a vast literature review to identify gaps between current practices and the desired one. The previous steps mainly revealed; limited knowledge about strategic asset management, no clear goals, no training, no real risk plan and lack of data, technical and financial resources. Based on the findings, a SAMF for GAEB was introduced and Framework implementation steps and assessment techniques were explained in detail.

Keywords: Strategic Asset Management, Educational Building, Framework, Gab Analysis, Developing Country.

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243 Vancomycin and Rifaximin Combination Therapy for Diarrhoea Predominant Irritable Bowel Syndrome: An Observational Study

Authors: P. Murphy, D. Vasic, A. W. Gunaratne, T. Tugonon, M. Ison, C. Pagonis, E. T. Sitchon, A. Le Busque, T. J. Borody

Abstract:

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by an alteration in bowel movements. There are three different types of IBS: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). Antimicrobials are increasingly being used as treatment for all types of IBS. Due to this increased use and subsequent success, the gut microbiome as a factor in the etiology of IBS is becoming more apparent. Accepted standard treatment has focused on IBS-C and involves either vancomycin or rifaximin. Here, we report on a cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients were aged between 24-74 years (mean 44 years) and nine were female. At baseline all patients had diarrhea, four with mucus and one with blood. Other reported symptoms include abdominal pain (n = 11) bloating (n = 9), flatulence (n = 7), fatigue (n = 4) and nausea (n = 3). Patient’s treatments were personalized according to their symptom severity and tolerability and were treated with a combination of rifaximin (500-3000 mg/d) and vancomycin (500 mg-1500 mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks. Of all patients, 89% reported improvement of at least 1 symptom, one reported no change and one patient’s symptoms got worse. The success of this combination treatment could be due to the different mechanisms of action undertaken by each medication. Vancomycin works by inhibiting the cell wall of the bacteria and rifaximin by inhibiting protein synthesis. This success in treatment validates the idea that IBS-D may be driven by a bacterial infection of the gastrointestinal microbiome. As IBS-D presents similarly to Clostridium difficile and symptom improvement can occur with the same treatment as Clostridium difficile of rifaximin and vancomycin, there is reason to suggest that the infectious agent could be an unidentified strain of Clostridium. Although these results offer some validity to the theory, more research is required.

Keywords: Clostridium difficile infection, diarrhea predominant irritable bowel syndrome, microbiome, vancomycin/rifaximin combination.

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