Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Functional Confirmation Using a Medical X-Ray System of a Semiconductor Survey Meter

In recent years, semiconductor survey meters have been developed and are in increasing demand worldwide. This study determined if it is possible to use the X-ray system installed in each medical facility to calculate the time constant of a semiconductor survey meter and confirm the meter’s function. An additional filter was attached to the medical X-ray system to satisfy the standards of N-60 to N-120, more copper plates were added as needed, and the first and second half-value layers were calculated to enable comparisons of the facility’s X-ray system quality with the N-60 to N-120 quality values. Next, we used a medical X-ray system to measure the leakage dose and calculate the time constant of the survey meter. The functionality of the meter was then checked and compared with the energy characteristics of the meter. The experimental results showed that it was possible to use a medical X-ray system to reproduce the N-60 to N-120 radiation quality values and to calculate the time constant from the measured results, assuming actual leakage dosimetry for that radiation quality. We also found that the calibration factor was equivalent to that of the energy characteristics of the survey meter.

The Practice and Exploration of Applying EBM to Bilingual Teaching of Medical Genetics at OSBCM

In the process of teaching medical genetics of undergraduate clinical medicine, the practice and exploration of applying EBM to the bilingual teaching of OSBCM medical genetics are carried out. Using CBL and PBL as the carrier can make up for the shortcomings of a single teaching mode, synthesize the advantages of multiple teaching modes. It starts from integrating the basic theoretical knowledge of medicine and clinical practice knowledge, improving students’ bilingual level of medical genetics, cultivating students’ literature retrieval ability, and promoting early clinical, multi-clinical and repeated clinical consciousness for medical students. Therefore, it is more conducive to cultivate students’ ability to learn independently, accurately analyze and solve problems, improve medical students’ clinical thinking ability and scientific research awareness, improve medical students’ ability of international communication, and lay a solid foundation for improving medical students’ future post competence, innovative spirit and lifelong learning ability.

A Study on Service-Oriented Smart Medical Systems Combined with Key Algorithms in the IoT Environment

A smart medical service system architecture is proposed in this paper to increase medical resource utilization and improve the efficiency of the medical diagnosis process for complex business scenarios in the Medical Internet of Things(MIoT)environment.The resource representation model theory,multi-terminal aggregation algorithm,and the resource discovery algorithm based on latent factor model are also studied.A smart medical service system within the IoT environment is then developed,based on the open source project.Experimental results using real-world datasets illustrate that the proposed smart medical service system architecture can promote the intelligent and efficient management of medical resources to an extent,and assists in the develop towards digitization,intelligence,and precision in the field of medicine.

Ultra-Wideband Systems with Energy Harvesting Units for Sensors, 5G, IoT and Medical Systems

The high tech industrial revolution in the last fifty years depleted and ruined the planet natural resources. Energy harvesting is the main challenge in the research in green technologies. Compact wideband efficient antennas are crucial for energy harvesting portable sensors and systems. Small antennas have low efficiency. The efficiency of 5G, IoT communication and energy harvesting systems may be improved by using wideband efficient passive and active antennas. The system dynamic range may be improved by connecting amplifiers to the small antenna feed line. Ultra-wideband portable harvesting systems are presented in this paper. This paper presents new Ultra-Wideband energy harvesting system and antennas in frequencies ranging from 0.15 GHz to 18 GHz. Three wideband antennas cover the frequency range from 0.15 GHz to 18 GHz. A wideband metamaterial antenna with metallic strips covers the frequency range from 0.15 GHz to 0.42 GHz. The antenna bandwidth is around 75% for VSWR better than 2.3:1. A wideband slot antenna covers the frequency range from 0.4 GHz to 6.4 GHz. A wideband fractal notch antenna covers the frequency range from 6 GHz to 18 GHz. Printed passive and active notch and slot antennas are compact, low cost and have low volume. The active antennas may be employed in energy harvesting portable systems. The antennas and the harvesting system components may be assembled on the same, printed board. The printed notch and slot antennas bandwidth are from 75% to 100% for VSWR better than 3:1. The slot and notch antenna gain is around 3 dBi with efficiency higher than 90%. The antennas electrical parameters were computed in free space and near the human body. There is a good agreement between computed and measured results.

Maturity Assessment of Hospital Information Systems Based on Electronic Medical Record Adoption Model (EMRAM)— Private Hospital Cases in Iran

Introduction: Today, information technology is considered as an important national development principle in each country which is applied in different fields. Health care as a whole and the hospitals could be regarded as a field and organizations with most remarkable IT applications respectively. Although different benchmarks and frameworks have been developed to assess different aspects of Hospital Information Systems (HISs) by various researchers, there is not any suitable reference model yet to benchmark HIS in the world. Electronic Medical Record Adoption Model (EMRAM) has been currently presented and is globally well-known to benchmark the rate of HIS utilization in the hospitals. Notwithstanding, this model has not been introduced in Iran so far. Methods: This research was carried out based on an applied descriptive method in three private hospitals of Isfahan—one of the most important provinces of Iran—in the year 2015. The purpose of this study was to investigate IT utilization stage in three selected private hospitals. Conclusion: The findings revealed that HIS is not at the center of concern in studied hospitals and is in the first maturity stage in accordance with EMRAM. However, hospital managers are enforced and under the pressure of different beneficiaries including insurance companies to improve their HIS. Therefore, it could be concluded that these types of hospitals are still far away from desirable conditions and need to enhance their IT utilization stage significantly.

Recent progress of respiratory inhalation drug delivery systems

With the influence of many factors such as the aging of the population,the younger smokers,and the serious air pollution,the incidence of chronic respiratory diseases is increasing year by year.In the treatment of respiratory diseases,clinical intervention is still mainly based on drug control of pulmonary symptoms.However,systemic drugs have disadvantages such as many adverse reactions and severe systemic side effects.In recent years,the research and development of local drug delivery systems for the respiratory tract has brought new changes to the treatment of respiratory diseases.Locally delivered drugs can directly act on the airways and have the characteristics of fast onset,good curative effect and small side effects.It is a simple,efficient and safe treatment method,which has a very significant effect,and has become a hot topic of current research and promotion.This paper briefly reviews the development track and latest research progress of respiratory local drug delivery systems at home and abroad,in order to provide reference for clinical workers in drug selection and application.

Failure to prevent medication errors: We need smarter nearly error proof systems

Purpose: To determine if nurses are able to identify medication errors that have the potential to bypass computer physician order entry (CPOE) and smart ordering systems. Background: Medical care systems employ computer “smart” systems to reduce medication errors by using artificial intelligence (preprogrammed methods of decision support and error reduction). However, these systems are not perfect and they can be bypassed. Nurses who carry out the order represent the last check point in error prevention prior to the administration of medication orders. Methods: A paper exercise was created with 513 physician orders. Nurses were asked to indicate whether they would carry out the order, refuse to carry out the order, consult a pharmacist for clarification, or carry out the order with special precautions. Nurses were given the option of using any nursing or medical reference. Results: The rate of correctly identifying 23 of the contraindicated orders was low. Both experienced and inexperienced nurses had high rates of not identifying the errors despite similar use of references and requests for assistance from pharmacists. Conclusions: This study demonstrates that if an error escapes a smart system, nurses were able to identify most of these errors, but not all of these. The current system features high stress, self-esteem issues, time pressure, high volume, and high risk. The system must change radically to meet the public’s expectations of being nearly error free which can only be achieved with smarter systems that are more resistant to human errors.

Revelation of Rural System of Medical Services in BRICS to China

In recent years, the great achievements of basic medical and healthcare services of BRICS have gained great attention and acknowledgement from the whole world. In their medical system reform, India, Brazil, Russia and South Africa have established their medical systems with their own characteristics. This provides valuable references for China in its critical stage of medical system reform. This paper explored the experience of BRICS＇ reform of medical system in order to offer some references and guidance for the establishment of basic medical and health services with Chinese characteristics and conforming to Chinese practice.

A Study on the Public Awareness of Hierarchical Medical System in Taiwan

The purpose of hierarchical medical system is to lead in terms of improving efficiency, differentiating healthcare services and promoting labor division by changing the healthcare seeking behavior. The purpose of this research aims to discuss the public awareness of hierarchical medical system in Taiwan for the reference of health policy makers. We obtained our research data using a questionnaire survey;the total number of qualified patients was 1340. This research finds that more subjects agreed to the hierarchical medical system and medical referral system, but many people still disagreed with changes to their healthcare seeking choices due to policy promotion. Subtle changes, therefore, are observed that imply a crisis in terms of the trust in healthcare. The healthcare seeking behavior will not change if there is a difference between the medical awareness of patients and policy implementation, and the government needs to be concerned with this result when making policies.

Issues concerning Migrant Workers' Participation in the New Rural Cooperative Medical System and Countermeasures——Based on the Survey in Wenjiang District and Jintang County, Chengdu City

We conduct questionnaire survey of migrant workers in Wenjiang District and Jintang County of Chengdu City,respectively,using the method of key-point investigation and the sampling survey. We describe the status quo of the sample migrant workers' participation in the New Rural Cooperative Medical System,analyze the issues concerning migrant workers' participation in the New Rural Cooperative Medical System,and put forward the countermeasures and recommendations as follows: using many types of medical insurance; establishing universal reimbursement points in strange land and premium-paying system for migrant workers; making the proportion of reimbursement open and transparent; establishing and improving medicare security system for migrant workers.

TOWARDS AN ONTOLOGY-BASED MULTI-AGENT MEDICAL INFORMATION SYSTEM BASED ON THE WEB

This paper described an ontology based multi agent knowledge process made (MAKM) which is one of multi agents systems (MAS) and uses semantic network to describe agents to help to locate relative agents distributed in the workgroup. In MAKM, an agent is the entity to implement the distributed task processing and to access the information or knowledge. Knowledge query manipulation language (KQML) is adapted to realize the communication among agents. So using the MAKM mode, different knowledge and information on the medical domain could be organized and utilized efficiently when a collaborative task is implemented on the web.

Smart Dynamic Resource Allocation Model for Patient-Driven Mobile Medical Information System Using C4.5 Algorithm

A mobile medical information system (MMIS) is an integrated application (app) of traditional hospital information systems (HIS) which comprise a picture archiving and communications system (PACS), laboratory information system (LIS), pharmaceutical management information system (PMIS), radiology information system (RIS), and nursing information system (NIS). A dynamic resource allocation table is critical for optimizing the performance to the mobile system, including the doctors, nurses, or other relevant health workers. We have designed a smart dynamic resource allocation model by using the C4.5 algorithm and cumulative distribution for optimizing the weight of resource allocated for the five major attributes in a cooperation communications system. Weka is used in this study. The class of concept is the performance of the app, optimal or suboptimal. Three generations of optimization of the weight in accordance with the optimizing rate are shown.

Government Responsibility in New Rural Cooperative Medical Care System from the Perspective of Equity and Efficiency

Equity and efficiency,as two essential parts of social security,always influence construction of China's new rural cooperative medical care system.The new rural cooperative medical care system is a rural social security system particularly intended to make it more affordable for the rural poor.It is a multi-channel fundraising system with fund of comprehensive arrangement for serious disease composed by the government,collectives and individuals.Since its implementation,it has made considerable achievements,but there are still many apparent and hidden problems.Through analyzing existing problems in the implementation of new rural cooperative medical care system,from the perspective of equity and efficiency,it reached the conclusion that government should take corresponding responsibilities.At the same time of constantly increasing efficiency,it is recommended to attach importance to the equity,so as to realize the objective of improving the security level of new rural cooperative medical care system.

The Brazilian public healthcare system and its participation in medical training

Introduction: In Brazil, in a joint initiative of the Ministries of Health and of Education and Culture, the Program for the Promotion of Changes in Medical School Curricula (PROMED) was created, in order to give financial support to medical schools for the development and implementation of curricular changes to the medicine courses. Objective: To ascertain the influence of PROMED on the interaction between the Brazilian public healthcare system (SUS) and the universities. Method: Using the qualitative method by way of content analysis of the Bardin, interviews with 19 coordinators of the medicine courses which received financial support from PROMED were carried out and analyzed. Results: Subcategories which express the current relation between SUS and the universities were found: the need to train SUS professionals and the teaching staff involved, the lines of research directed toward SUS and partnership relations as part of the student learning process, the strengthening of SUS and the internal problems. Conclusions: Observing the needs of the relationship between SUS and the curricular changes it was noted that the public health services are of extreme importance as part of the training process of the medical student. Besides favoring practice, it establishes student activities within the health services, the evaluation of the policies, planning and management of the health services in activities of training and social communication in healthcare, linked to community organizations or diverse social entities. Thus, problems associated with the healthcare service can be identified, as well as the health conditions and life style of the population.

Study on Dynamic Model of Initial Emission Rights for Medical Sewage System

The chemical oxygen demand (COD) is selected as the index in this paper. The system dynamics method is used to analyze the emission right price of medical sewage, the boundary of the emission right price system is determined, and the system dynamics model of the initial emission right of medical sewage is constructed, in which the system is divided into water resources subsystem, population subsystem, economic subsystem and social subsystem. It is expected to expand the theory of the system modeling of the initial discharge right of medical sewage, and to provide the basis for the relevant decision of the environmental management authorities.

Wavelet Packet-based Feedback System for Medical Image Fusion

In order to meet the requirements of medical research,diagnosis and treatment,a new algorithm for image fusion based on the wavelet packet transform in conjunction with both subjective and objective assessments is put forward in the paper.Compared to the wavelet transform,the wavelet packet transform is more intricate and effective for the medical image fusion.As indicated by the experimental results,parameters of the feedback system of the new algorithm are significantly superior to those of the wavelet transform,with practicability and accuracy.

Study on Clinical Thinking of Traditional Chinese Medicine Based on Wang Yongyan＇s MedicalRecord Information System

运用医案信息系统工程技术将王永炎教授医案设定为总系统,并将其中的病、证、治、验分次建模,根据医家经验按照“问题一解”的程序将其组合,以此来研究王教授的治疗经验及其临床思维.

Restraining Factors and Improving Paths for the Operation Mechanism of New Rural Cooperative Medical System in China

The new rural cooperative medical system has achieved periodical achievements since its establishment.Nevertheless,there are many factors hampering the development of the new system,such as the high cost,the difficulties in fund procurement,the lack of management,the narrow coverage of benefit,the ineffective constraint to the designated medical institutions,the high fund balance rate,and the poor medical facilities and services in rural areas.Countermeasures are put forward to solve these problems,including improving the system design,expanding the coverage of the system,expanding the fund sources,reducing the financing costs,strengthening the fund supervision,enhancing the supervision of designated medical institutions,and improving the capacity of health services in rural areas.