Swimming pools and beaches

99 the bottom because deposited particles are ‘more friendly’ with the movement of water molecules. Better coupling will cause a certain portion to be reflected back into the water and others will be absorbed. This is good for communication because ab- sorption will have a negative impact on multipath, the bottom efficiently acts as cushions to shield some reflected signals and thereby declining N. The actual efficiency will rely on the com- position of the deposit. We have seen signal propagation in respect to time. Let us now see the signal propagation in respect to distance. Consider a sig- nal S d, whereby d is the distance travelled by the signal. The signal S will definitely weaken if d increases. Below is a basic mathematics equation that explained their relationship. Attenuation is usually indicated in dB, the signal loss is L is expressed as:- Note : L is not to be confused with the notation in Equation 2.2 that represents the number of levels available: It also can be simplified as: 3.3 3.4 3.5 100 The whole discussion provides an understanding into the complex situation of using telemedicine underwater in healthcare. Details of underwater wireless communication can be obtained from Etter 2003a, Etter 2003b. In this chapter, a number of cases whereby telemedicine can helpto save lives have been discussed. Besides that, telemedicine application can be used for monitering general health so it is benificial to healthy people. Wireless communication technology can be used to handle difficult challenges in rough surroundings. Baricades like plants and water can influence the reliability of the system, thus it is not totally problem free although technological developmments have enhance their capabilities. 101 CHAPTER 4 INFORMATION TECHNOLOGIES IN PROCESSING MEDICAL There are numerous of examples telemedicine technologies that can save lives whereby these were not possible back in few dec- ades ago. Today, these technologies are readily. Its wide- ranging series of technologies is able to facilitate almost every- thing ranging from search and rescue operation to general health checkups. These services include converting raw medical in- formation into digital form. According to Haykin 2006 there are many benefits of using digital data compared to raw infor- mation in analog form for instance the ease of transmission, processing and storing of digital data. Let us discuss the differ- ence between medical data represented by a series of 1s and 0s, and other digital things such as CDs and cameras. A com- mon thread in all these applications is that data is sent and pro- cessed in binary form and we are only required to deal with 1s and 0s. Nevertheless, there are some differences between cap- turing medical data and capturing general data. First of all, the medical information is strictly private and confidential to an in- dividual. Compared to losing normal documents or an MP3 file, the consequence of losing analysis results of a medical test is far more severe. For instance, it would cause a negative impact on the medical institution’s reputation, patient unable to receive 102 prompt medication and others. Also, misinterpretation of data also can be a serious issue. In comparison, if the MP3 file is misinterpreted and the music playback is disrupted, the worst consequence would just be the degradation of sound quality. However, in terms of medical information, the misinterpretation of data may lead to possible-life threatening consequences. Figure 4.1 shows the way of using medical data is just like in any information systems whereby it acquires data from various sources for diagnosing and continuous monitoring. In related to telemedicine, most of the data come from patients who include a wide range of data from bio signals and surveys related to dai- ly routines which are manually entered. Immediately as soon as the data has been captured, it must be transferred to a suitable location for further processing so as to know how the data re- lates about the patient. The processing of data requires different technologies such as multimedia, signal processing and data mining. The basis of processing the data is based on the nature of the data and the relevant applications. Once the data is ana- lyzed and corresponding actions is taken pertaining to the situa- tion, the data should be kept in the archive. This form of storage can be utilized for various purposes. For instance, information about a patient’s allergy can be made known before receiving subsequent treatments. 103 Figure 4.1 information systems of medical FONG et al 2011 In the case of disease control, the anonymous data can be uti- lized to perform statistical analysis of virus mutation and the pattern of spreading. The government agency can use the data for regulatory planning. Therefore, a method to store large amount of data and quickly retrieve the data is important. In this chapter, we shall take a look at the complete procedure of pro- cessing medical processing data and conclude the chapter by analyzing an Electronic Drug Store which uses medical data that is collected to ensure safe and efficient dispensing of drugs. It serves as an exemplar to showcase the role of advance tech- nology in healthcare sector for aiding patients who require extra care, hence ensuring that dispensing medicine can be risk-free and easily accessible.

4.1 Data Collection from Patients

Data can be collected from a patient from every part of the body. In this section, we will focus on biomedical data that re- lated to human anatomy and set aside the discussion on survey collection in order to deliberate on the technical issues. There- fore, we will discuss the types and methods in which infor- 104 mation can be collected from a patient and the necessary pre- cautions during data collection. However, the human body is too complex and as such it is not feasible to touch upon all measurable parameters in this volume. The main aim in this sec- tion is to cover the commonly used features and understand what happens when the medical data is being processed. The most important area is the vital signs of a human body as it re- flects on the health status of an individual; a person without a vital sign is impossible to stay alive. Lets take a look of some of the attributes of vital sign and how it can be collected. For example, some of the vital signs can present circadian rhythms in 24 hour behavioral cycle which fluctuate due to temporary regulation of the environment.

4.1.1 Temperature Body Normal Range: 36.0-37.4 ◦C

The body temperature changes from time to time, it depends on the surrounding environment as well as which part of the body is taken to measure. More than that, gender can also differenti- ate the measurement of body temperature. Generally, body tem- perature able to indicate whether an individual has hyperthermia or hypothermia; in short, fever when exposed to extreme condi- tions. Body temperature that is above 40 Celsius can cause se- vere dehydration due to excessive sweating whereas body temperature that is below 35 Celsius can be considered as a cold. Both these situations can be fatal if proper medication is not administered. Abnormal body temperature can indicate fe- ver which may cause permanent damage to the organs and death. Therefore, a monitoring of body temperature pattern and precise measurement is important issue to be concerned. There are various ways to measure body temperature ranging from the level of precision and time required to measure. We can take the measurement from different parts of the body, including armpit, tongue, ear, mouth, underneath the tongue and rectum. The age of the person can also affect the temperature measurement to be 105 less predictable. For example, as a normal response; a child will generate more heat inside the body while playing hard whereas an elderly will not generate as much heat as a child under such normal circumstances as they do not have enough energy. To get a clearer picture about the temperature differences between people with different ages, we take an example of 3 perfectly healthy people- 5, 35, and 70 years old respectively as shown in Figure 4.2. Although the daily activities of each person are dif- ferent, the circadian rhythm cities of all the subjects involved remain fairly consistent. The body temperature that we consider as a normal measurement can be quite unpredictable. Body temperature of a person can be gathered by different method and it will be affected by various environmental variables. A common example, the conventional way of measuring body temperature by inserting thermometer into mouth varies based on prior drinking of hot or cold drink. Besides, the measurement of temperature taken under the arm can be influence by sweat. Therefore, through advances in technology, more efficient methods are developed. One of the good examples is the infra- red ear thermometer that can measure the amount of infrared energy radiated from the eardrum of the patient to measure tympanic temperature. This is much more reliable as the ear- drum is located nearby the hypothalamus, the main temperature regulator of human body. The infrared ear thermometer is port- able, affordable and gives a quick reading. This reading can be transmitted via suitable wireless technology to another terminal to update patient records. 106 Figure 4.2 Normal variation in body temperature measured in a day FONG et al 2011 The best method for measuring a patient’s body temperature is to use an ear thermometer as it requires inserting a probe into the ear. In order to prevent the spread of diseases, this type of measuring technique can be deployed at checkpoint where peo- ple must walk pass. It includes the use heat sensor camera that can show the core body temperature as color images immediate- ly flashes as a person walks pass the camera. Infrared thermal imaging is widely used for this mechanism whereby a change in the color of an image of a person’s body temperature indicates the abnormalities. Although this method is not as accurate as other methods, it is able to provide fast and efficient measure- ment and can be designed to trigger an alarm if abnormalities of body temperature among the people who are walking through the camera are detected. Next, forehead and spot infrared ther- mometer is also available in the market but it is not widely used for some reasons. The reason why forehead thermometer is not widely used is because the temperature at forehead can be af- fected by ambient temperature and some fever-relieve medica- tion such as acetaminophen and ibuprofen. The spot infrared is