Erythema Multiforme Exudativum Major Caused by Isoniazid Hypersensitivity in a Child
Erythema Multiforme Exudativum Major (EMEM) is one of the drug allergy diseases. Drug allergies caused by isoniazid rarely causes EMEM. Cutaneous reactions caused by isoniazid were obtained in 0.98% of patients, but the precise occurrence of Steven Johnson’s Syndrome (SJS) and Toxic Epidermolisis Necrolisis (TEN) due to isoniazid is not known for certain. We present this case to show hypersensitivity of isoniazid in a child. Based on the history of drug intake, physical diagnostic tests, drug elimination and provocation; we established the diagnosis of isoniazid hypersensitivity. The child showed improvement on skin manifestation after stopped isoniazid therapy.
A 3-Year Evaluation Study on Fine Needle Aspiration Cytology and Corresponding Histology
Background and Objectives: Incidence of thyroid carcinoma has been increasing world-wide. In the present study, we evaluated diagnostic accuracy of Fine needle aspiration (FNA) and its efficiency in early detecting neoplastic lesions of thyroid gland over a 3-year period. Methods: Data have been retrieved from pathology files in King Khalid Hospital. For each patient, age, gender, FNA, site & size of nodule and final histopathologic diagnosis were recorded. Results: Study included 490 cases where 419 of them were female and 71 male. Male to female ratio was 1:6. Mean age was 43 years for males and 38 for females. Cases with confirmed histopathology were 131. In 101/131 (77.1%), concordance was found between FNA and histology. In 30/131 (22.9%), there was discrepancy in diagnosis. Total malignant cases were 43, out of which 14 (32.5%) were true positive and 29 (67.44%) were false negative. No false positive cases could be found in our series. Conclusion: FNA could diagnose benign nodules in all cases, however, in malignant cases, ultrasound findings have to be taken into consideration to avoid missing of a microcarcinoma in the contralateral lobe.
Application of Gamma Frailty Model in Survival of Liver Cirrhosis Patients
Goals and Objectives: A typical analysis of survival data involves the modeling of time-to-event data, such as the time till death. A frailty model is a random effect model for time-to-event data, where the random effect has a multiplicative influence on the baseline hazard function. This article aims to investigate the use of gamma frailty model with concomitant variable in order to individualize the prognostic factors that influence the liver cirrhosis patients’ survival times. Methods: During the one-year study period (May 2008-May 2009), data have been used from the recorded information of patients with liver cirrhosis who were scheduled for liver transplantation and were followed up for at least seven years in Imam Khomeini Hospital in Iran. In order to determine the effective factors for cirrhotic patients’ survival in the presence of latent variables, the gamma frailty distribution has been applied. In this article, it was considering the parametric model, such as Exponential and Weibull distributions for survival time. Data analysis is performed using R software, and the error level of 0.05 was considered for all tests. Results: 305 patients with liver cirrhosis including 180 (59%) men and 125 (41%) women were studied. The age average of patients was 39.8 years. At the end of the study, 82 (26%) patients died, among them 48 (58%) were men and 34 (42%) women. The main cause of liver cirrhosis was found hepatitis 'B' with 23%, followed by cryptogenic with 22.6% were identified as the second factor. Generally, 7-year’s survival was 28.44 months, for dead patients and for censoring was 19.33 and 31.79 months, respectively. Using multi-parametric survival models of progressive and regressive, Exponential and Weibull models with regard to the gamma frailty distribution were fitted to the cirrhosis data. In both models, factors including, age, bilirubin serum, albumin serum, and encephalopathy had a significant effect on survival time of cirrhotic patients. Conclusion: To investigate the effective factors for the time of patients’ death with liver cirrhosis in the presence of latent variables, gamma frailty model with parametric distributions seems desirable.
An Evaluation of the Effectiveness of Health and Safety Induction Practices in the Zambian Construction Industry
The study discusses the effectiveness of health and safety induction practices on construction sites against the background of the Zambian construction industry experience. The research design included the literature review of relevant literature. Questionnaires and interviews were administered to regulatory bodies, health, and safety personnel. Observation was also employed on construction sites to assess the health and safety practices being used. Health and safety in the construction industry are not something to be ignored or overlooked. The construction industry needs to take heed of the serious consequences of inadequate health and safety induction practices. The implications of inadequate health and safety induction procedures included among others threats to profitability, corporate social responsibility and increased turnover of the workforce leading to poor productivity. Adequate health and safety practices can improve the health and wellbeing of employees, reduce financial implications on firms and encourage productivity on construction sites. Despite this, accidents are still prevalent on construction sites in Zambia. The overall result of this research denotes that the implementation of health and safety induction practices is inadequate, as indicated by the negligent and non-adherent attitude to health and safety induction aspects on the sites by most stakeholders on construction sites. Therefore, health and safety induction practices are ineffective as preventive measures for reduction of accidents on construction sites in Zambia.
Analysis of Stress and Strain in Head Based Control of Cooperative Robots through Tetraplegics
Industrial robots as part of highly automated manufacturing are recently developed to cooperative (light-weight) robots. This offers the opportunity of using them as assistance robots and to improve the participation in professional life of disabled or handicapped people such as tetraplegics. Robots under development are located within a cooperation area together with the working person at the same workplace. This cooperation area is an area where the robot and the working person can perform tasks at the same time. Thus, working people and robots are operating in the immediate proximity. Considering the physical restrictions and the limited mobility of tetraplegics, a hands-free robot control could be an appropriate approach for a cooperative assistance robot. To meet these requirements, the research project MeRoSy (human-robot synergy) develops methods for cooperative assistance robots based on the measurement of head movements of the working person. One research objective is to improve the participation in professional life of people with disabilities and, in particular, mobility impaired persons (e.g. wheelchair users or tetraplegics), whose participation in a self-determined working life is denied. This raises the research question, how a human-robot cooperation workplace can be designed for hands-free robot control. Here, the example of a library scenario is demonstrated. In this paper, an empirical study that focuses on the impact of head movement related stress is presented. 12 test subjects with tetraplegia participated in the study. Tetraplegia also known as quadriplegia is the worst type of spinal cord injury. In the experiment, three various basic head movements were examined. Data of the head posture were collected by a motion capture system; muscle activity was measured via surface electromyography and the subjective mental stress was assessed via a mental effort questionnaire. The muscle activity was measured for the sternocleidomastoid (SCM), the upper trapezius (UT) or trapezius pars descendens, and the splenius capitis (SPL) muscle. For this purpose, six non-invasive surface electromyography sensors were mounted on the head and neck area. An analysis of variance shows differentiated muscular strains depending on the type of head movement. Systematically investigating the influence of different basic head movements on the resulting strain is an important issue to relate the research results to other scenarios. At the end of this paper, a conclusion will be drawn and an outlook of future work will be presented.
Classroom Incivility Behaviours among Medical Students: A Comparative Study in Pakistan
Trained medical practitioners are produced from medical colleges serving in public and private sectors. Prime responsibility of teaching faculty is to inculcate required work ethic among the students by serving as role models for them. It is an observed fact that classroom incivility behaviours are providing a friction in achieving these targets. Present study aimed at identification of classroom incivility behaviours observed by teachers and students of public and private medical colleges as per Glasser’s Choice Theory, making a comparison and investigating the strategies being adopted by teachers of both sectors to control undesired class room behaviours. Findings revealed that a significant difference occurs between teacher and student incivility behaviours. Public sector teacher focussed on survival as a strong factor behind in civil behaviours whereas private sector teachers considered power as the precedent for incivility. Teachers of both sectors are required to use verbal as well as non-verbal immediacy to reach a healthy leaning environment.
Relationship-Centred Care in Cross-Linguistic Medical Encounters
This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.
The Applications of Four Fingers Theory: The Proof of 66 Acupoints under the Human Elbow and Knee
Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.
A Descriptive Study on Psychiatric Morbidity among Nurses Working in Selected Hospitals of Udupi and Mangalore Districts Karnataka, India
Nursing is recognized as a stressful occupation and has indicated a probable high prevalence of distress. It is a helping profession requiring a high degree of commitment and involvement. If stress is intense, continuous and repeated, it becomes a negative phenomenon or "distress," which can lead to physical illness and psychological disorders. The frequency of common psychosomatic symptoms including sleeping problems, tension headache, chronic fatigue, palpitation etc. may be an indicator of nurses’ work-related stress level. Objectives of the study were to determine psychiatric morbidity among nurses and to find its association with selected variables. The study population consisted of 1040 registered nurses working in selected medical college hospitals and government hospitals of Udupi and Mangalore districts. Descriptive survey design was used to conduct the study. Subjects were selected by using purposive sampling. Data were gathered by administering background proforma and General Health questionnaire. Severe distress was experienced by 0.9% of nurses and 5.6% had some evidence of distress. Subjects who did not have any distress were 93.5%. No significant association between psychiatric morbidity in nurses and demographic variables was observed. With regard to work variables significant association is observed between psychiatric morbidity and total years of experience (z=10.67, p=0.03) and experience in current area of work (z=9.43, p=0.02).
Criminal Justice System, Health and Imprisonment in India
Imprisonment is an expansive concept, as it is regulated by laws under criminal justice system of the state. The state sets principles of punishment to control offenders and also puts limits to excess punitive control. One significant way through which it exercises control is through rules governing healthcare of imprisoned population. Prisons signify specialized settings which accommodate both medical and legal concerns. The provision of care operates within the institutional paradigm of punishment. This requires the state to negotiate adequately between goals of punishment and fulfilment of basic human rights of offenders. The present study is based on a critical analysis of prison healthcare standards in India, which include government policies and guidelines. It also demonstrates how healthcare is delivered by drawing insights from a primary study conducted in a correctional home in the state of West Bengal, India, which houses both male and female inmates. Forty women were interviewed through semi-structured interviews, followed by focus group discussions. Doctors and administrative personnel were also interviewed. Findings show how institutional practices control women through subversion of the role of doctors to prison administration. Also, poor healthcare infrastructure, unavailability of specialized services, hierarchies between personnel and inmates make prisons unlikely sites for therapeutic intervention. The paper further discusses how institutional practices foster gender-based discriminatory practices.
Mediation in Turkish Health Law for Healthcare Disputes
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.
A SiGe Low Power RF Front-End Receiver for 5.8GHz Wireless Biomedical Application
It is necessary to realize new biomedical wireless communication systems which send the signals collected from various bio sensors located at human body in order to monitor our health. Also, it should seamlessly connect to the existing wireless communication systems. A 5.8 GHz ISM band low power RF front-end receiver for a biomedical wireless communication system is implemented using a 0.5 µm SiGe BiCMOS process. To achieve low power RF front-end, the current optimization technique for selecting device size is utilized. The implemented low noise amplifier (LNA) shows a power gain of 9.8 dB, a noise figure (NF) of below 1.75 dB, and an IIP3 of higher than 7.5 dBm while current consumption is only 6 mA at supply voltage of 2.5 V. Also, the performance of a down-conversion mixer is measured as a conversion gain of 11 dB and SSB NF of 10 dB.
Ethnographic Exploration of Elderly Residents' Perceptions and Utilization of Health Care to Improve Their Quality of Life
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.
Community‐Based Participatory Research in Elderly Health Care of Paisanee Ramintra 65 Community, Bangkok, Thailand
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.
Health Assessment and Disorders of External Respiration Function among Physicians
Aims and Objectives: Assessment of health status and detection disorders of external respiration functions (ERF) during preventative medical examination among physicians of Armenia. Subjects and Methods: Overall, fifty-nine physicians (17 men and 42 women) were examined and spirometry was carried out. The average age of the physicians was 50 years old. The studies were conducted on the Micromedical MicroLab 3500 Spirometer. Results: 25.4% among 59 examined physicians are overweight; 22.0% of them suffer from obesity. Two physicians are currently smokers. About half of the examined physicians (50.8%) at the time of examination were diagnosed with some diseases and had different health-related problems (excluding the problems related to vision and hearing). FVC was 2.94±0.1, FEV1 – 2.64±0.1, PEF – 329.7±19.9, and FEV1%/FVC – 89.7±1.3. Pathological changes of ERF are identified in 23 (39.0%) cases. 28.8% of physicians had first degree of restrictive disorders, 3.4% – first degree of combined obstructive/ restrictive disorders, 6.8% – second degree of combined obstructive/ restrictive disorders. Only three physicians with disorders of the ERF were diagnosed with chronic bronchitis and bronchial asthma. There were no statistically significant changes in ERF depending on the severity of obesity (P> 0.05). Conclusion: The study showed the prevalence of ERF among physicians, observing mainly mild and moderate changes in ERF parameters.
CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire
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.
A Framework for Early Differential Diagnosis of Tropical Confusable Diseases Using the Fuzzy Cognitive Map Engine
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.
Evaluation of Residual Stresses in Human Face as a Function of Growth
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.
Transforming Health Information from Manual to Digital (Electronic) World–Reference and Guide
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.
Fiber Optic Sensors for Hydrogen Peroxide Vapor Measurement
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.
Impact Assessment of Credit Policy and Medical Credit Facility (MCF) on Nigerian Private Sector Health Market: Evidence from Eight Nigerian States
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.
Analysis of Security Vulnerabilities for Mobile Health Applications
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.
Performance Analysis of Artificial Neural Network with Decision Tree in Prediction of Diabetes Mellitus
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
Evaluation Using a Bidirectional Microphone as a Pressure Pulse Wave Meter
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.
A Study on the Assessment of Prosthetic Infection after Total Knee Replacement Surgery
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.
A Study on the Relation among Primary Care Professionals Serving the Disadvantaged Community, Socioeconomic Status, and Adverse Health Outcome
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
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
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.
On the Combination of Patient-Generated Data with Data from a Secure Clinical Network Environment – A Practical Example
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.
GSM Based Smart Patient Monitoring System
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.
Legal Regulation and Critical Analysis for an Effectively Treatment of Pharmaceutical Waste
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
Medical Imaging Techniques in Clinical Medicine
Medical imaging technology has experienced a
dramatic change in the last few years. Medical imaging refers to the
techniques and processes used to create images of the human body
(or parts thereof) for various clinical purposes such as medical
procedures and diagnosis or medical science including the study of
normal anatomy and function. With the growth of computers and
image technology, medical imaging has greatly influenced the
medical field. The diagnosis of a health problem is now highly
dependent on the quality and the credibility of the image analysis.
This paper deals with the various aspects and types of medical