Abstract: The extermination and proper disposal of
pharmaceutical wastes from expired and unused medications remains
a disputable issue due to their specific nature and characteristics.
Even though the hazards from these wastes are already well known in
terms of environment and human health, people still treat them as
usual wastes. At a national level, in many countries the management
of pharmaceutical and medical wastes has been one of the main
objectives in order to protect people’s health and the environment.
Even though many legal regulations exist in this respect, there has not
been a single law that would clearly explain the procedures of
returning medicines, ways of selection, treatment and extermination
of pharmaceutical wastes. This paper aims at analyzing the practices
of pharmaceutical waste management and treatment in some
European countries as well as a review of the legislation and official
guidelines in managing these kinds of wastes and protecting the
environment and human health. A suitable treatment and
management of expired medications and other similar wastes would
be in the interest of public health in the first place, as well as in the
interest of healthcare institutions and other bodies engaged in
environment protection.
Abstract: In this paper, we propose an intelligent system that is
used for monitoring the health conditions of patients. Monitoring the
health condition of patients is a complex problem that involves
different medical units and requires continuous monitoring especially
in rural areas because of inadequate number of available specialized
physicians. The proposed system will improve patient care and drive
costs down comparing to the existing system in Jordan. The proposed
system will be the start point to faster and improve the
communication between different units in the health system in
Jordan. Connecting patients and their physicians beyond hospital
doors regarding their geographical area is an important issue in
developing the health system in Jordan. The ability of making
medical decisions, the quality of medical is expected to be improved.
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.
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.
Abstract: During the post-Civil War era, the city of Nashville,
Tennessee, had the highest mortality rate in the United States. The
elevated death and disease rates among former slaves were
attributable to lack of quality healthcare. To address the paucity of
healthcare services, Meharry Medical College, an institution with the
mission of educating minority professionals and serving the
underserved population, was established in 1876.
Purpose: The social ecological framework and partial least squares
(PLS) path modeling were used to quantify the impact of
socioeconomic status and adverse health outcome on primary care
professionals serving the disadvantaged community. Thus, the study
results could demonstrate the accomplishment of the College’s
mission of training primary care professionals to serve in underserved
areas.
Methods: Various statistical methods were used to analyze alumni
data from 1975 – 2013. K-means cluster analysis was utilized to
identify individual medical and dental graduates in the cluster groups
of the practice communities (Disadvantaged or Non-disadvantaged
Communities). Discriminant analysis was implemented to verify the
classification accuracy of cluster analysis. The independent t-test was
performed to detect the significant mean differences of respective
clustering and criterion variables. Chi-square test was used to test if
the proportions of primary care and non-primary care specialists are
consistent with those of medical and dental graduates practicing in
the designated community clusters. Finally, the PLS path model was
constructed to explore the construct validity of analytic model by
providing the magnitude effects of socioeconomic status and adverse
health outcome on primary care professionals serving the
disadvantaged community.
Results: Approximately 83% (3,192/3,864) of Meharry Medical
College’s medical and dental graduates from 1975 to 2013 were
practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the
PLS path modeling demonstrated that alumni served as primary care
professionals in communities with significantly lower socioeconomic
status and higher adverse health outcome (p < .001). The PLS path
modeling exhibited the meaningful interrelation between primary
care professionals practicing communities and surrounding
environments (socioeconomic statues and adverse health outcome),
which yielded model reliability, validity, and applicability.
Conclusion: This study applied social ecological theory and
analytic modeling approaches to assess the attainment of Meharry
Medical College’s mission of training primary care professionals to
serve in underserved areas, particularly in communities with low
socioeconomic status and high rates of adverse health outcomes. In
summary, the majority of medical and dental graduates from Meharry
Medical College provided primary care services to disadvantaged
communities with low socioeconomic status and high adverse health
outcome, which demonstrated that Meharry Medical College has
fulfilled its mission. The high reliability, validity, and applicability of
this model imply that it could be replicated for comparable
universities and colleges elsewhere.
Abstract: This study, for its research subjects, uses patients who
had undergone total knee replacement surgery from the database of the
National Health Insurance Administration. Through the review of
literatures and the interviews with physicians, important factors are
selected after careful screening. Then using Cross Entropy Method,
Genetic Algorithm Logistic Regression, and Particle Swarm
Optimization, the weight of each factor is calculated and obtained. In
the meantime, Excel VBA and Case Based Reasoning are combined
and adopted to evaluate the system. Results show no significant
difference found through Genetic Algorithm Logistic Regression and
Particle Swarm Optimization with over 97% accuracy in both
methods. Both ROC areas are above 0.87. This study can provide
critical reference to medical personnel as clinical assessment to
effectively enhance medical care quality and efficiency, prevent
unnecessary waste, and provide practical advantages to resource
allocation to medical institutes.
Abstract: This paper describes a novel sensor device, a pressure
pulse wave meter, which uses a bidirectional condenser microphone.
The microphone work as a microphone as well as a sensor with high
gain over a wide frequency range; they are also highly reliable and
economic. Currently aging is becoming a serious social issue in Japan causing
increased medical expenses in the country. Hence, it is important for
elderly citizens to check health condition at home, and to care the
health conditions through daily monitoring. Given this circumstances,
we developed a novel pressure pulse wave meter based on a
bidirectional condenser microphone: this device is used as a measuring
instrument of health conditions.
Abstract: Human beings have the ability to make logical
decisions. Although human decision - making is often optimal, it is
insufficient when huge amount of data is to be classified. Medical
dataset is a vital ingredient used in predicting patient’s health
condition. In other to have the best prediction, there calls for most
suitable machine learning algorithms. This work compared the
performance of Artificial Neural Network (ANN) and Decision Tree
Algorithms (DTA) as regards to some performance metrics using
diabetes data. WEKA software was used for the implementation of
the algorithms. Multilayer Perceptron (MLP) and Radial Basis
Function (RBF) were the two algorithms used for ANN, while
RegTree and LADTree algorithms were the DTA models used. From
the results obtained, DTA performed better than ANN. The Root
Mean Squared Error (RMSE) of MLP is 0.3913 that of RBF is
0.3625, that of RepTree is 0.3174 and that of LADTree is 0.3206
respectively.
Abstract: The availability to deploy mobile applications for
health care is increasing daily thru different mobile app stores. But
within these capabilities the number of hacking attacks has also
increased, in particular into medical mobile applications. The security
vulnerabilities in medical mobile apps can be triggered by errors in
code, incorrect logic, poor design, among other parameters. This is
usually used by malicious attackers to steal or modify the users’
information. The aim of this research is to analyze the vulnerabilities
detected in mobile medical apps according to risk factor standards
defined by OWASP in 2014.
Abstract: A teeming set of doctors that graduated from various
universities within and outside Nigeria with the hope of practicing in
the country, has their hope shattered because of poor financing, lack
of medical equipments and a very weak healthcare systems. Such
hydra headed challenges, allows room for quackery which
increasingly contributes to the cause of mortality in Nigeria. With a
view of reversing the challenges of healthcare delivery and financing
in Nigeria, African Health Market for Equity (AHME), a project
funded by the Bill and Melinda Gates foundation [With contribution
from Department For International Development (DFID)] and
currently implemented in three African Countries (Nigeria, Kenya
and Ghana) over a Five (5) year period supports the healthcare sector
via Medical credit fund (MCF). The study examines the impact of
credit policy and medical credit funding on Nigerian health market.
Ordinary least square analysis, correlation and granger causality tests
were employed to measure the extent to which the Nigerian
healthcare market has been influenced. Medical credit fund
significantly and positively influenced average monthly turnover of
private healthcare providers and Commercial bank’s lending rate had
a weak relationship with access to credit/approved loans (13.46%).
The programme has so far made 13.91% progress, which is very
poor, considering the minimum targeted private health care providers
(437.6) and expected number of loan approvals (180.4) for the two
years. Medical credit policy in Nigeria should be revised to include
private healthcare providers in rural area for more positive impact
and increased returns. Good brand advert and sensitization of the
programme to stakeholders and health pressure group, and an
extension of the programme beyond five years is necessary to better
address the issues raised in the study.
Abstract: This paper reports on the response of a fiber-optic
sensing probe to small concentrations of hydrogen peroxide (H2O2)
vapor at room temperature. H2O2 has extensive applications in industrial and medical
environments. Conversely, H2O2 can be a health hazard by itself. For
example, H2O2 induces cellular damage in human cells and its
presence can be used to diagnose illnesses such as asthma and human
breast cancer. Hence, development of reliable H2O2 sensor is of vital
importance to detect and measure this species. Ferric ferrocyanide, referred to as Prussian Blue (PB), was
deposited on the tip of a multimode optical fiber through the single
source precursor technique and served as an indicator of H2O2 in a
spectroscopic manner. Sensing tests were performed in H2O2-H2O
vapor mixtures with different concentrations of H2O2. The results of sensing tests show the sensor is able to detect H2O2
concentrations in the range of 50.6 ppm to 229.5 ppm. Furthermore,
the sensor response to H2O2 concentrations is linear in a log-log scale
with the adjacent R-square of 0.93. This sensing behavior allows us
to detect and quantify the concentration of H2O2 in the vapor phase.
Abstract: Introduction: To update ourselves and understand the
concept of latest electronic formats available for Health care
providers and how it could be used and developed as per standards.
The idea is to correlate between the patients Manual Medical Records
keeping and maintaining patients Electronic Information in a Health
care setup in this world. Furthermore, this stands with adapting to the
right technology depending upon the organization and improve our
quality and quantity of Healthcare providing skills. Objective: The
concept and theory is to explain the terms of Electronic Medical
Record (EMR), Electronic Health Record (EHR) and Personal Health
Record (PHR) and selecting the best technical among the available
Electronic sources and software before implementing. It is to guide
and make sure the technology used by the end users without any
doubts and difficulties. The idea is to evaluate is to admire the uses
and barriers of EMR-EHR-PHR. Aim and Scope: The target is to
achieve the health care providers like Physicians, Nurses, Therapists,
Medical Bill reimbursements, Insurances and Government to assess
the patient’s information on easy and systematic manner without
diluting the confidentiality of patient’s information. Method: Health
Information Technology can be implemented with the help of
Organisations providing with legal guidelines and help to stand by
the health care provider. The main objective is to select the correct
embedded and affordable database management software and
generating large-scale data. The parallel need is to know how the
latest software available in the market. Conclusion: The question lies
here is implementing the Electronic information system with
healthcare providers and organization. The clinicians are the main
users of the technology and manage us to “go paperless”. The fact is
that day today changing technologically is very sound and up to date.
Basically, the idea is to tell how to store the data electronically safe
and secure. All three exemplifies the fact that an electronic format
has its own benefit as well as barriers.
Abstract: Growth and remodeling of biological structures have
gained lots of attention over the past decades. Determining the
response of living tissues to mechanical loads is necessary for a wide
range of developing fields such as prosthetics design or computerassisted
surgical interventions. It is a well-known fact that biological
structures are never stress-free, even when externally unloaded. The
exact origin of these residual stresses is not clear, but theoretically,
growth is one of the main sources. Extracting body organ’s shapes
from medical imaging does not produce any information regarding
the existing residual stresses in that organ. The simplest cause of such
stresses is gravity since an organ grows under its influence from
birth. Ignoring such residual stresses might cause erroneous results in
numerical simulations. Accounting for residual stresses due to tissue
growth can improve the accuracy of mechanical analysis results. This
paper presents an original computational framework based on gradual
growth to determine the residual stresses due to growth. To illustrate
the method, we apply it to a finite element model of a healthy human
face reconstructed from medical images. The distribution of residual
stress in facial tissues is computed, which can overcome the effect of
gravity and maintain tissues firmness. Our assumption is that tissue
wrinkles caused by aging could be a consequence of decreasing
residual stress and thus not counteracting gravity. Taking into
account these stresses seems therefore extremely important in
maxillofacial surgery. It would indeed help surgeons to estimate
tissues changes after surgery.
Abstract: Wireless Body Area Network (WBAN) is a short-range
wireless communication around human body for various applications
such as wearable devices, entertainment, military, and especially
medical devices. WBAN attracts the attention of continuous health
monitoring system including diagnostic procedure, early detection of
abnormal conditions, and prevention of emergency situations.
Compared to cellular network, WBAN system is more difficult to
control inter- and inner-cell interference due to the limited power,
limited calculation capability, mobility of patient, and
non-cooperation among WBANs.
In this paper, we compare the performance of resource allocation
scheme based on several Pseudo Orthogonal Codewords (POCs) to
mitigate inter-WBAN interference. Previously, the POCs are widely
exploited for a protocol sequence and optical orthogonal code. Each
POCs have different properties of auto- and cross-correlation and
spectral efficiency according to its construction of POCs. To identify
different WBANs, several different pseudo orthogonal patterns based
on POCs exploits for resource allocation of WBANs. By simulating
these pseudo orthogonal resource allocations of WBANs on
MATLAB, we obtain the performance of WBANs according to
different POCs and can analyze and evaluate the suitability of POCs
for the resource allocation in the WBANs system.
Abstract: To increase the temperature contrast in thermal
images, the characteristics of the electrical conductivity and thermal
imaging modalities can be combined. In this experimental study, it is
objected to observe whether the temperature contrast created by the
tumor tissue can be improved just due to the current application
within medical safety limits. Various thermal breast phantoms are
developed to simulate the female breast tissue. In vitro experiments
are implemented using a thermal infrared camera in a controlled
manner. Since experiments are implemented in vitro, there is no
metabolic heat generation and blood perfusion. Only the effects and
results of the electrical stimulation are investigated. Experimental
study is implemented with two-dimensional models. Temperature
contrasts due to the tumor tissues are obtained. Cancerous tissue is
determined using the difference and ratio of healthy and tumor
images. 1 cm diameter single tumor tissue causes almost 40 °mC
temperature contrast on the thermal-breast phantom. Electrode
artifacts are reduced by taking the difference and ratio of background
(healthy) and tumor images. Ratio of healthy and tumor images show
that temperature contrast is increased by the current application.
Abstract: The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.
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.
Abstract: In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.
Abstract: The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.
Abstract: In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.