Security Model of a Unified Communications and Integrated Collaborations System in the Health Sector Environment of Developing Countries: A Case of Uganda

Access to information holds the key to the empowerment of everybody despite where they are living. This research has been carried out in respect of the people living in developing countries, considering their plight and complex geographical, demographic, social-economic conditions surrounding the areas they live, which hinder access to information and of professionals providing services such as medical workers, which has led to high death rates and development stagnation. Research on Unified Communications and Integrated Collaborations (UCIC) system in the health sector of developing countries aims at creating a possible solution of bridging the digital canyon among the communities. The system is meant to deliver services in a seamless manner to assist health workers situated anywhere to be accessed easily and access information which will enhance service delivery. The proposed UCIC provides the most immersive telepresence experience for one-to-one or many-to-many meetings. Extending to locations anywhere in the world, the transformative platform delivers Ultra-low operating costs through the use of general purpose networks and using special lenses and track systems. The essence of this study is to create a security model for the deployment of the UCIC system in the health sector of developing countries. The model approach used for building the UCIC system security carefully considers the specific requirements for the health sector environment organization such as data centre, national, regional and district hospitals, and health centers IV, III, II and I and then builds the single best possible secure network to meet their needs. The security model demonstrates on how the components of the UCIC system will be protected physically and logically in the health sector environment. The UCIC system once adopted and implemented correctly will bring enhancement to the speed and quality of services offered by health workers. The capacities of UCIC will help health workers shorten decision cycles, accelerate service delivery and save lives by speeding access to information and by making it possible for all health workers and patients to collaborate ubiquitously.

Assessing Psycho-Social Stressors for Chronically Infected Hepatitis C Virus Patients in Egypt

People with hepatitis C are likely to experience psychological distress related to adjustment issues following diagnosis. Objective: The study was conducted to determine the psycho-social stressors accompanying Hepatitis C virus (HCV) chronic infection. The study focused on immediate and later on reactions to being diagnosed as infected HCV patients. Effect of HCV on disruption of patients’ relationships in term of family relationship and friendship, employment and financial status was assessed. The magnitude and causes of the social stigma and its relation to awareness about illness, level of education were also assessed. Methods: During this study the subjective experiences of people having HCV was explored through a designed questionnaire targeted 540 cases; 359 males and 181 females from ten out of 21 National Treatment Reference Centers of National Hepatology and Tropical Medicine Research Institutes of Ministry of Health (MOH) hospitals. The study was conducted along a period of six months from September 2011 to March 2012. Results: The study revealed that the financial problems are the commonest problems faced by 75.5% of the cases. More than 70% of the cases suffered from immediate sadness versus 67.4% suffered from worry. Social stigma was reported by 13 % of HCV +patients, the majority of which were females. Conclusions: Exploring the psychosocial consequences of HCV infection can act as pressing motivators for behavior change needed for limiting HCV endemicity in Egypt.

Impact of Hepatitis C Virus Chronic Infection on Quality of Life in Egypt

The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL), its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know how to cope with having a family member with hepatitis C and more importantly to know what should you say and what shouldn’t you say as a positive hopeful attitude is essential for combating HCV chronic infection.

Consumption Pattern and Dietary Practices of Pregnant Women in Odeda Local Government Area of Ogun State

The importance of maternal nutritional practices during pregnancy cannot be overemphasized. This paper assessed the consumption pattern and dietary practices of 50 pregnant women selected using purposive sampling technique from three health care centres (Primary Health Care Centre, Obantoko; Primary Health Care Centre Alabata; and the General Hospital, Odeda) in Odeda Local Government Area of Ogun State, Nigeria. Structured questionnaire was used to elicit information on socioeconomic status, consumption pattern and dietary practices. Data were analyzed using the Statistical Package for Social Sciences (SPSS, 17). The results indicated that about 58% of the pregnant women were below the age of 30 while 42% were ages 28-40 years. Only 16% had tertiary education while (38%) had secondary education, 52% earn income through petty trading. On food intake, 52% got their energy source from rice on a daily basis, followed by pap (38%) and eko (34%). For protein intake, 36% consumed bean cake on a daily basis while 66% consumed moinmoin 2-3 times a week. Orange (48%) and Green Leafy vegetable (40%) accounted for the mostly consumed fruit and vegetable on daily basis. In terms of animal origin, fish (76%), meat (58%) and eggs (30%) were consumed daily, while chicken and snail were consumed occasionally by 54% and 42%, respectively. Forty-six percent (46%) of the pregnant women eat more than three times daily; while 60% of the women eat outside their homes with 42% respondents eat out lunch and only two percent least eaten out dinner. It is important to increase in awareness campaign to sensitize the pregnant women on the importance of good nutrition especially fruits, vegetables and dairy products. 

Hospital-Pharmacy Management System: A UAE Case Study

Large patients’ queues at pharmacies and hospitals are a problem that faces the supposedly smooth and healthy environment in United Arab Emirates. As this sometimes leads to dissatisfaction from visiting patients, we tried to solve this problem with additional beneficial functions by developing the Hospital-Pharmacy Management System. The primary purpose of this research is to develop a system that joins the databases of a hospital and a pharmacy together for a better integrated system that provides a better coherent working environment. Three methods are used to design the system. These methods are detailed literature review, an extensive feasibility study and surveys for doctors, hospital IT managers and End-users. Interviews and surveys with related stakeholders were done to depict system’s requirements; design and prototype. The prototype illustrates system’s features and its client and server architecture. The system has a mobile application for visiting patients to, mainly, keep track of their prescriptions and access to their personal information. The server side allows doctors to submit the prescriptions online to pharmacists who will process them. This system is expected to reduce the long waiting queues of patients and increase their satisfaction while also reducing doctors and pharmacists’ stress and facilitating their work. It will be deployed to users of Android devices only. This limitation will be resolved, as one of main future enhancements, once the system finds acceptance from hospitals and pharmacies in United Arab Emirates.

Determinants of Knowledge-Based Improving Workflow and Communication within Surgical Team

Surgical team consists of variety types of medical specialists possessing different kind of knowledge, motivations, personalities or abilities. This together with poor knowledge transfer, lack of information and communication technologies (ICT) implementations in hospitals can cause protraction of patient care processes and even jeopardize patient safety. There is presented in the article the outcomes of studies on communication and workflow in surgical team in the background of different collaboration levels in healthcare system. As a result the five determinants of improving workflow and communication within surgical team were indicated as well as knowledge-based tools and supporting information technology were proposed.

Survey of Cerebral Palsy Cases in Tripoli Children Hospital in the Period between (2009-2010)

The aim of this study is to survey the incidence, prevalence, types and associated impairments of CP in children at the Tripoli children hospital (T.C.H). The study covered all the cases the hospital had diagnosed in the period between (1.1.2009) and (31.12.2010), during which 38 cases of ages between 2 months to 3 years were diagnosed in the mentioned period. The incidence of CP was (17.42 per one thousand) out of (2143) of different neurological cases and came with a result of 23 cases of spastic CP which represented about (60.53%) out of the total number of cases, and the most associated impairment is convulsion. Medical information was collected from the patients’ files at the registration department from the neurology department. The data has been collected by a questionnaire, which had been set to finely organize the patient’s files.

A Study of Current Maintenance Strategies and the Reliability of Critical Medical Equipment in Hospitals in Relation to Patient Outcomes

This study investigates the relationship between the reliability of critical medical equipment (CME) and the effectiveness of CME maintenance management strategies in relation to patient outcomes in 84 public hospitals of a top 20 OECD country. The work has examined the effectiveness of CME maintenance management strategies used by the public hospital system of a large state run health organization. The conceptual framework was designed to examine the significance of the relationship between six variables: (1) types of maintenance management strategies, (2) maintenance services, (3) maintenance practice, (4) medical equipment reliability, (5) maintenance costs and (6) patient outcomes. The results provide interesting insights into the effectiveness of the maintenance strategies used. For example, there appears to be about a 1 in 10 000 probability of failure of anesthesia equipment, but these seem to be confined to specific maintenance situations. There are also some findings in relation to outsourcing of maintenance. For each of the variables listed, results are reported in relation to the various types of maintenance strategies and services. Decision-makers may use these results to evaluate more effective maintenance strategies for their CME and generate more effective patient outcomes.

Poisoning Admission in Children Hospital in Benghazi-Libya, Three Years Review of Medical Record

Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Sensitivity Comparison between Rapid Immuno-Chromatographic Device Test and ELISA in Detection and Sero-Prevalence of HBsAg and Anti-HCV antibodies in Apparently Healthy Blood Donors of Lahore, Pakistan

Hepatitis B and hepatitis C are among the most significant hepatic infections all around the world that may lead to hepatocellular carcinoma. This study is first time performed at the blood transfussion centre of Omar hospital, Lahore. It aims to determine the sero-prevalence of these diseases by screening the apparently healthy blood donors who might be the carriers of HBV or HCV and pose a high risk in the transmission. It also aims the comparison between the sensitivity of two diagnostic tests; chromatographic immunoassay – one step test device and Enzyme Linked Immuno Sorbant Assay (ELISA). Blood serum of 855 apparently healthy blood donors was screened for Hepatitis B surface antigen (HBsAg) and for anti HCV antibodies. SPSS version 12.0 and X2 (Chi-square) test were used for statistical analysis. The seroprevalence of HCV was 8.07% by the device method and by ELISA 9.12% and that of HBV was 5.6% by the device and 6.43% by ELISA. The unavailability of vaccination against HCV makes it more prevalent. Comparing the two diagnostic methods, ELISA proved to be more sensitive.

Application of Simulation and Response Surface to Optimize Hospital Resources

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.

Knowledge Management: The Need for a Total Knowledge Transfer Model to Diffuse Innovation of the Public Health Workforce

The purpose of this article is to propose a model designed to achieve Total Knowledge Transfer in the public health sector. The Total Knowledge Transfer Model integrated four essential organizational factors which have been under examined in totality in the literature. The research design was inductive in nature and used a case study for accomplishing the research objectives. The researcher investigated the factors that created a base to design a framework for total knowledge transfer in the public health sector. The results of this study are drawn from a fairly large sample in only two hospitals. A further research can be conducted to cover more responses from a wider health sector. The Total Knowledge Transfer Model is essential to improve the transfer and application of total common health knowledge.

High Speed Video Transmission for Telemedicine using ATM Technology

In this paper, we study statistical multiplexing of VBR video in ATM networks. ATM promises to provide high speed realtime multi-point to central video transmission for telemedicine applications in rural hospitals and in emergency medical services. Video coders are known to produce variable bit rate (VBR) signals and the effects of aggregating these VBR signals need to be determined in order to design a telemedicine network infrastructure capable of carrying these signals. We first model the VBR video signal and simulate it using a generic continuous-data autoregressive (AR) scheme. We carry out the queueing analysis by the Fluid Approximation Model (FAM) and the Markov Modulated Poisson Process (MMPP). The study has shown a trade off: multiplexing VBR signals reduces burstiness and improves resource utilization, however, the buffer size needs to be increased with an associated economic cost. We also show that the MMPP model and the Fluid Approximation model fit best, respectively, the cell region and the burst region. Therefore, a hybrid MMPP and FAM completely characterizes the overall performance of the ATM statistical multiplexer. The ramifications of this technology are clear: speed, reliability (lower loss rate and jitter), and increased capacity in video transmission for telemedicine. With migration to full IP-based networks still a long way to achieving both high speed and high quality of service, the proposed ATM architecture will remain of significant use for telemedicine.

Using Copulas to Measure Association between Air Pollution and Respiratory Diseases

Air pollution is still considered as one of the major environmental and health issues. There is enough research evidence to show a strong relationship between exposure to air contaminants and respiratory illnesses among children and adults. In this paper we used the Copula approach to study a potential relationship between selected air pollutants (PM10 and NO2) and hospital admissions for respiratory diseases. Kendall-s tau and Spearman-s rho rank correlation coefficients are calculated and used in Copula method. This paper demonstrates that copulas can be used to provide additional information as a measure of an association when compared to the standard correlation coefficients. The results find a significant correlation between the selected air pollutants and hospital admissions for most of the selected respiratory illnesses.

Hospitals Disaster Preparedness during Arab Spring in Yemen

Objective: The objective of this paper is to assess the hospitals preparedness for emergency using WHO standards. Method: This is a cross-sectional study, consisted of site visit, questionnaire survey, 16 health facilities were included. The WHO standard for emergency preparedness of health facilities was used to evaluate and assess the hospitals preparedness of health facilities. Result: 13 hospitals were responded. They scored below average in all measure >75%), while above average score was in 7 out 9 nine measure with a range of 8%-25%. Un acceptable below average was noted in two measures only. Discussion: The biggest challenge facing the hospitals in their emergency intervention is the lack of pre-emergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. Conclusion: The studied hospitals presently are far from international disasters preparedness protocols. That necessitates improvements in emergency preparedness, as well as in physician skills for injury management.

Use of Multiple Linear Regressions to Evaluate the Influence of O3 and PM10 on Biological Pollutants

Exposure to ambient air pollution has been linked to a number of health outcomes, starting from modest transient changes in the respiratory tract and impaired pulmonary function, continuing to restrict activity/reduce performance and to the increase emergency rooms visits, hospital admissions or mortality. The increase of allergenic symptoms has been associated with air contaminants such as ozone, particulate matter, fungal spores and pollen. Considering the potential relevance of crossed effects of nonbiological pollutants and airborne pollens and fungal spores on allergy worsening, the aim of this work was to evaluate the influence of non-biological pollutants (O3 and PM10) and meteorological parameters on the concentrations of pollen and fungal spores using multiple linear regressions. The data considered in this study were collected in Oporto which is the second largest Portuguese city, located in the North. Daily mean of O3, PM10, pollen and fungal spore concentrations, temperature, relative humidity, precipitation, wind velocity, pollen and fungal spore concentrations, for 2003, 2004 and 2005 were considered. Results showed that the 90th percentile of the adjusted coefficient of determination, P90 (R2aj), of the multiple regressions varied from 0.613 to 0.916 for pollen and from 0.275 to 0.512 for fungal spores. O3 and PM10 showed to have some influence on the biological pollutants. Among the meteorological parameters analysed, temperature was the one that most influenced the pollen and fungal spores airborne concentrations. Relative humidity also showed to have some influence on the fungal spore dispersion. Nevertheless, the models for each pollen and fungal spore were different depending on the analysed period, which means that the correlations identified as statistically significant can not be, even so, consistent enough.

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

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.

Hospitality Program Postgraduate Theses: What Hinders Their Accomplishment?

Postgraduate education is generally aimed at providing in-depth knowledge and understanding that include general philosophy in the world sciences, management, technologies, applications and other elements closely related to specific areas. In most universities, besides core and non-core subjects, a thesis is one of the requirements for the postgraduate student to accomplish before graduating. This paper reports on the empirical investigation into attributes that are associated with the obstacles to thesis accomplishment among postgraduate students. Using the quantitative approach the experiences of postgraduate students were tapped. Findings clearly revealed that information seeking, writing skills and other factors which refer to supervisor and time management, in particular, are recognized as contributory factors which positively or negatively influence postgraduates’ thesis accomplishment. Among these, writing skills dimensions were found to be the most difficult process in thesis accomplishment compared to information seeking and other factors. This pessimistic indication has provided some implications not only for the students but supervisors and institutions as a whole.

E-health in Rural Areas: Case of Developing Countries

The Application of e-health solutions has brought superb advancements in the health care industry. E-health solutions have already been embraced in the industrialized countries. In an effort to catch up with the growth, the developing countries have strived to revolutionize the healthcare industry by use of Information technology in different ways. Based on a technology assessment carried out in Kenya – one of the developing countries – and using multiple case studies in Nyanza Province, this work focuses on an investigation on how five rural hospitals are adapting to the technology shift. The issues examined include the ICT infrastructure and e-health technologies in place, the knowledge of participants in terms of benefits gained through the use of ICT and the challenges posing barriers to the use of ICT technologies in these hospitals. The results reveal that the ICT infrastructure in place is inadequate for e-health implementations as a result to various challenges that exist. Consequently, suggestions on how to tackle the various challenges have been addressed in this paper.

Evaluating the Standards of Hospital Pharmacies in Therapeutic Centers Affiliated with Kermanshah University of Medical Sciences, Iran

Nowadays pharmaceutical care departments located in hospitals are amongst the important pillars of the healthcare system. The aim of this study was to evaluate quality of hospital drugstores affiliated with Kermanshah University of Medical Sciences. In this cross-sectional study a validated questionnaire was used. The questionnaire was filled in by the one of the researchers in all seventeen hospital drugstores located in the teaching and nonteaching hospitals affiliated with Kermanshah University of Medical Sciences. The results shows that in observed hospitals,24% of pharmacy environments, 25% of pharmacy store and storage conditions, 49% of storage procedure, 25% of ordering drugs and supplies, 73% of receiving supplies (proper procedure are fallowed for receiving supplies), 35% of receiving supplies (prompt action taken if deterioration of drugs received is suspected), 23.35% of drugs delivery to patients and finally 0% of stock cards are used for proper inventory control have full compliance with standards.