Healthcare for elderly people has become a vital issue. The Wearable Health Monitoring System (WHMS) is used to manage and monitor chronic disease in elderly people, postoperative rehabilitation patients and persons with special needs. Location-aware healthcare is achievable as positioning systems and telecommunications have been developed and have fulfilled the technology needed for this kind of healthcare system. In this paper, the researchers propose a Location-Based Mobile Cardiac Emergency System (LMCES) to track the patient's current location when Emergency Medical Services (EMS) has been activated as well as to locate the nearest healthcare unit for the ambulance service. The location coordinates of the patients can be retrieved by GPS and sent to the healthcare centre using GPRS. The location of the patient, cell ID information will also be transmitted to the LMCES server in order to retrieve the nearest health care unit. For the LMCES, we use Dijkstra's algorithm for selecting the shortest path between the nearest healthcare unit and the patient location in order to facilitate the ambulance's path under critical conditions.
With the increase of consumers’ privacy concerns and the government-enforced regulations on data protection, it is necessary for organizations to implement Privacy Enhancing Technologies (PETs) to protect consumers’ personal data. PETs refer to any protection in the form of technology. Since employees are the main stakeholders who are directly involved in the PETs implementation and execution process, it is important to understand employees’ perceptions especially those daily tasks involving the process of collecting and processing consumers’ data. Prior literature showed limited research on the effects of PETs implementation through employees’ work process and their perception on the implementation in protection personal data. Hence, the purpose of this research is to explore how PETs adoption affects employees’ work process and their perception. A qualitative single case study was adopted in a telecommunications company in Malaysia. Data were collected through in-depth interviews from nine respondents who were involved in data collecting, data processing and data controlling in their daily tasks. The results showed that employees experience difference levels of change depending on their work nature. The affected areas of change in implementing PETs are workload, communication level and data access. Employees also raised their concerns on vendors’ accountability. This research provides an insight into employees’ perception towards personal data protection based on their experience in implementing PETs. Continuous awareness, updates, monitoring and evaluating of system are perceived as the key to successful PETs implementation in protecting personal data.
There is growing interest globally in using real-world data (RWD) and real-world evidence (RWE) for health technology assessment (HTA). Optimal collection, analysis, and use of RWD/RWE to inform HTA requires a conceptual framework to standardize processes and ensure consistency. However, such framework is currently lacking in Asia, a region that is likely to benefit from RWD/RWE for at least two reasons. First, there is often limited Asian representation in clinical trials unless specifically conducted in Asian populations, and RWD may help to fill the evidence gap. Second, in a few Asian health systems, reimbursement decisions are not made at market entry; thus, allowing RWD/RWE to be collected to give more certainty about the effectiveness of technologies in the local setting and inform their appropriate use. Furthermore, an alignment of RWD/RWE policies across Asia would equip decision makers with context-relevant evidence, and improve timely patient access to new technologies. Using data collected from eleven health systems in Asia, this paper provides a review of the current landscape of RWD/RWE in Asia to inform HTA and explores a way forward to align policies within the region. This paper concludes with a proposal to establish an international collaboration among academics and HTA agencies in the region: the REAL World Data In ASia for HEalth Technology Assessment in Reimbursement (REALISE) working group, which seeks to develop a non-binding guidance document on the use of RWD/RWE to inform HTA for decision making in Asia.
Computer-mediated conferencing commonly is used to promote collaborative learning, including student learning across distance. This article presents the outcomes and experiences of Master of Nursing students in three countries using flexible learning approaches facilitated by the use of computer-mediated conferencing. It examines issues relating to support for global nursing education, presents an evaluation of one particular unit, and presents themes in the feedback from students about their experience. The authors report the findings in three categories: broadened perspectives, tackling the technology, and adaptive learning. Furthermore, the article offers suggestions for enhancing student-learning experiences when computer-mediated conferencing facilities are used.
The use of transobturator tape (TOT) for the treatment of stress urinary incontinence (SUI) has gained popularity since it was introduced in 2001. Only few studies have reported that TOT is superior in safety and efficacy when compared to tension free vaginal tape (TVT). This case-series study was conducted to investigate the safety and efficacy of the TOT procedure in patients at Ipoh Hospital. A cross sectional study on patients who underwent TOT procedures from Jan 2006 to Jun 2008 was conducted. Patients were followed-up 1 month, 3 month, 12 month and annually thereafter. Data were retrieved from patients‟ records based on the standard pre-operative assessment sheet and follow up record. Interviews were then made via telecommunication to assess the patients‟ progression and satisfaction using a validated questionnaire. Fifty-two subjects (n=52) were recruited. The mean age was 54.2 ± 10.6 years with the median follow up time of 19 months. Majority of cases (n=46; 88.5%) had concomitant pelvic organ prolapse (POP), while only 2 (3.8%) had an isolated stress urinary incontinence (SUI). Pre-operatively, only 16 patients (30.8%) were diagnosed with mixed urinary incontinence (MUI) and 24 patients (46.2%) had over active bladder symptoms (OAB) which include increased frequency and urgency. The objective cure rate for SUI was 42 (80.7%), 3 (5.8%) failed while 7 (13.5%) improved. Complications were limited to minor conditions and was only observed in four patients: one case (1.9%) of acute urinary retention, three (5.7%) had prolonged indwelling catheter more than 3 days and one (1.9%) each for mesh erosion, hematoma, urinary tract infection (UTI) and wound infection. Cure rate for MUI, frequency and urgency were 37.4%, 70.8% and 54.2% respectively. De novo urgency was noted in three (n=3: 5.7%) cases while (n=3: 5.7%) required revision of the tape. Forty-nine women (n=49: 94.2%) were satisfied with the procedure. TOT procedures significantly improve OAB symptoms with high patient‟s acceptance rate and no serious operative complication.
Studies reported that trans-obturator mid-urethral sling (TOT) is superior in safety and efficacy when compared with retro-pubic trans-vaginal tape (TVT) with regard to bladder, vascular and urethral injury. The purpose of this study is to determine if the TOT is equivalent to the TVT by using patient-reported outcomes for the treatment of urodynamic stress urinary incontinence (USI) at Ipoh Hospital. Methods: It is a cross-sectional study on all consecutive patients who underwent TVT procedure between Jan 2005 and Jan 2006 and TOT procedure from Jan 2006 to Jun 2008. Post operatively; all women were followed up at one month, three months, 12 months and annually, thereafter. Data was retrieved from the patients’ records based on the standard pre-operative assessment sheet and follow up record. Then, interviews were made via a telecommunication to assess the patients’ symptoms and satisfaction using a validated questionnaire. Data analysis were performed using IBM SPSS Statistics for Windows version 19 (SPSS Inc., Chicago, Illinois) considering a significant level of P < 0.05. Results: Total of 51 subjects in TVT group and 52 in TOT group were available for analysis. At 12 months, the stress urinary incontinence (SUI) cure rate is higher in the TVT (90.2%) compared to TOT (80.8%) group; however, it was not statistically significant (p=0.279). The lower urinary tract symptoms (LUT) were improved post-operatively in both groups with urgency and urgency incontinence being significantly better in the TVT group. Four (7.4%) subjects in the TVT group had a bladder perforation (p=0.992) and one case of vaginal erosion reported in the TOT group. Conclusion: TVT had a higher successful rate in the treatment of
SUI; however, it increases the risk of bladder perforation. Over active bladder symptom (OAB) were significantly mproved in the TVT compared to TOT group.
A study was carried out on 79 female telephone operators working in a Telecommunication Centre in Kuala Lumpur to determine the prevalence of Work Related Upper Limb Disorders (WRULD) and its risk factors. Data collection for this study was done between December 2000 and May 2001. The presence of WRULD was determined based on a guided questionnaire and physical examination. The response rate for this study was 94.9% (n= 75) and results showed that the prevalence of WRULD among the female telephone operators was 48.0%: Stage 1= 38.9%, Stage 2= 19.4%, Stage 3= 38.9%, Stage 4= 0% and Stage 5= 2.8%. In the telecommunication centre, it was found that those with WRULD had a mean of 11.59±9.09 years of employment duration whereas those without WRULD had a mean of 9.89 ± 8.48 years of employment duration. None of the factors studied such as Body Mass Index, age, ethnicity, menstrual cycle, hormone replacement therapy, overtime work, duration of employment in the present unit and in the telecommunication center differ in distribution between subjects with and without WRULD. This could be contributed by factors such as small number of subjects or the common healthy worker effect found in occupational health research. The findings studied of this study show that almost 40.0% of the workers experienced pain and neurological symptoms. Since none of the factors was found to be associated with WRULD, an elaborate study with a case-control design is needed in order to match cases and enable researchers to control the effect of confounding factors. This will ensure risk factors pertinent to WRULD in the Malaysian setting to be identified.