A novel initiative in providing advanced civic amenities is the idea of smart city driven by the lnternet of Things. Owing to a lack of consensus regarding what constitutes a smart city, diverse smart city architectur...A novel initiative in providing advanced civic amenities is the idea of smart city driven by the lnternet of Things. Owing to a lack of consensus regarding what constitutes a smart city, diverse smart city architectures have been proposed. However, it is observed that adequate consideration is not given to the most important element of a smart city i.e. its people. In our opinion, energy efficient technologically driven city does not necessarily lead to a smart city. Ethics, tradition and law form essential ingredients of complex social palette that cannot be ignored. In this work we propose Ethics-Aware Object-Oriented Smart City Architecture （EOSCA） that has two distinguishing features. Firstly, we propose an object oriented layered architecture where an object represents an abstraction of a real world thing along with requisite security and ethics parameters. Secondly, we propose to integrate socio-cultural and ethical aspects within the smart city architecture by dedicating a separate ethics layer. Such enhancement not only addresses the challenge of privacy and security of a smart city, but also makes it people friendly by incorporating ethics. Such measures would facilitate social acceptance of smart city paradigm and augment its economic value.展开更多
Background Heart failure （HF） is a physically and socially debilitating disease that carries the burden of hospital re-admission and mortality. As an aging society, Hong Kong urgently needs to find ways to reduce th...Background Heart failure （HF） is a physically and socially debilitating disease that carries the burden of hospital re-admission and mortality. As an aging society, Hong Kong urgently needs to find ways to reduce the hospital readmission of HF patients. This study evaluates the effects of a nurse-led HF clinic on the hospital readmission and mortality rates among older HF patients in Hong Kong. Methods This study is a retrospective data analysis that compares HF patient in a nurse-led HF clinic in Hong Kong compared with HF patients who did not attend the clinic. The nurses of this clinic provide education on lifestyle modification and symptom monitoring, as well as titrate the medications and measure biochemical markers by following established protocols. This analysis used the socio-demographic and clinical data of HF patients who were aged 〉 65 years old and stayed in the clinic over a six-month period. Results The data of a total of 78 HF patients were included in this data analysis. The mean age of the patients was 77.38 ± 6.80 years. Approximately half of the HF patients were male （51.3%）, almost half were smokers （46.2%）, and the majority received 〈 six years of formal education. Most of the HF patients （87.2%） belonged to classes II and III of the New York Heart Association Functional Classification, with a mean ejection fraction of 47.15± 20.31 mL. The HF patients who attended the clinic （n = 38, 75.13 ± 5.89 years） were significantly younger than those who did not attend the clinic （n = 40, 79.53 ± 6.96 years） （P = 0.04）, and had lower recorded blood pressure. No other statistically significant difference existed between the socio-demographic and clinical characteristics of the two groups. The HF patients who did not attend the nurse-led HF clinic demonstrated a significantly higher risk of hospital readmission [odd ratio （OR）： 7.40; P 〈 0.01] than those who attended after adjusting for the effect of age and blood pressure. In addition, HF patients who attended the clinic had lower mortality （n = 4） than those who did not attend （n = 14）. However, such a difference did not reach statistical significance when the effects of age and blood pressure were adjusted. A signifi- cant reduction in systolic blood pressure IF （2, 94） = 3.39, P = 0.04] and diastolic blood pressure [F （2, 94） = 8.48, P 〈 0.01] was observed among the HF patients who attended the clinic during the six-month period. Conclusions The finding of this study suggests the important role of nurse-led HF clinics in reducing healthcare burden and improving patient outcomes among HF patients in Hong Kong.展开更多
文摘A novel initiative in providing advanced civic amenities is the idea of smart city driven by the lnternet of Things. Owing to a lack of consensus regarding what constitutes a smart city, diverse smart city architectures have been proposed. However, it is observed that adequate consideration is not given to the most important element of a smart city i.e. its people. In our opinion, energy efficient technologically driven city does not necessarily lead to a smart city. Ethics, tradition and law form essential ingredients of complex social palette that cannot be ignored. In this work we propose Ethics-Aware Object-Oriented Smart City Architecture （EOSCA） that has two distinguishing features. Firstly, we propose an object oriented layered architecture where an object represents an abstraction of a real world thing along with requisite security and ethics parameters. Secondly, we propose to integrate socio-cultural and ethical aspects within the smart city architecture by dedicating a separate ethics layer. Such enhancement not only addresses the challenge of privacy and security of a smart city, but also makes it people friendly by incorporating ethics. Such measures would facilitate social acceptance of smart city paradigm and augment its economic value.
文摘Background Heart failure （HF） is a physically and socially debilitating disease that carries the burden of hospital re-admission and mortality. As an aging society, Hong Kong urgently needs to find ways to reduce the hospital readmission of HF patients. This study evaluates the effects of a nurse-led HF clinic on the hospital readmission and mortality rates among older HF patients in Hong Kong. Methods This study is a retrospective data analysis that compares HF patient in a nurse-led HF clinic in Hong Kong compared with HF patients who did not attend the clinic. The nurses of this clinic provide education on lifestyle modification and symptom monitoring, as well as titrate the medications and measure biochemical markers by following established protocols. This analysis used the socio-demographic and clinical data of HF patients who were aged 〉 65 years old and stayed in the clinic over a six-month period. Results The data of a total of 78 HF patients were included in this data analysis. The mean age of the patients was 77.38 ± 6.80 years. Approximately half of the HF patients were male （51.3%）, almost half were smokers （46.2%）, and the majority received 〈 six years of formal education. Most of the HF patients （87.2%） belonged to classes II and III of the New York Heart Association Functional Classification, with a mean ejection fraction of 47.15± 20.31 mL. The HF patients who attended the clinic （n = 38, 75.13 ± 5.89 years） were significantly younger than those who did not attend the clinic （n = 40, 79.53 ± 6.96 years） （P = 0.04）, and had lower recorded blood pressure. No other statistically significant difference existed between the socio-demographic and clinical characteristics of the two groups. The HF patients who did not attend the nurse-led HF clinic demonstrated a significantly higher risk of hospital readmission [odd ratio （OR）： 7.40; P 〈 0.01] than those who attended after adjusting for the effect of age and blood pressure. In addition, HF patients who attended the clinic had lower mortality （n = 4） than those who did not attend （n = 14）. However, such a difference did not reach statistical significance when the effects of age and blood pressure were adjusted. A signifi- cant reduction in systolic blood pressure IF （2, 94） = 3.39, P = 0.04] and diastolic blood pressure [F （2, 94） = 8.48, P 〈 0.01] was observed among the HF patients who attended the clinic during the six-month period. Conclusions The finding of this study suggests the important role of nurse-led HF clinics in reducing healthcare burden and improving patient outcomes among HF patients in Hong Kong.
