Adaptive mobility-aware and reliable routing protocols for healthcare vehicular network.

Healthcare vehicles such as ambulances are the key drivers for digital and pervasive remote care for elderly patients. Thus, Healthcare Vehicular Ad Hoc Network (H-VANET) plays a vital role to empower the digital and Intelligent Transportation System (ITS) for the smart medical world. Quality of Service (QoS) performance of vehicular communication can be improved through the development of a robust routing protocol having enhanced reliability and scalability. One of the most important issues in vehicular technology is allowing drivers to make trustworthy decisions, therefore building an efficient routing protocol that maintains an appropriate level of Quality of Service is a difficult task. Restricted mobility, high vehicle speeds, and continually changing topologies characterize the vehicular network environment. This paper contributes in four ways. First, it introduces adaptive, mobility-aware, and reliable routing protocols. The optimization of two routing protocols which are based on changing nature topologies of the network used for vehicular networks has been performed, amongst them, Optimized Link State Routing (Proactive) and Ad-hoc on Demand Distance Vector (Reactive) are considered for Packet Delivery Ratio (PDR) and throughput. Furthermore, Packet Loss Ratio (PLR), and end-to-end (E2E) delay parameters have also been calculated. Second, a healthcare vehicle system architecture for elderly patients is proposed. Third, a Platoon-based System model for routing protocols in VANET is proposed. Fourth, a dynamic channel model has been proposed for the vehicle to vehicle communication using IEEE8011.p. To optimize the QoS, the experimental setup is conducted in a discrete Network Simulator (NS-3) environment. The results reveal that the AODV routing protocol gives better performance for PDR as well as for PLR and the communication link established is also reliable for throughput. Where OLSR produces a large average delay. The adoptive mobility-aware routing protocols are potential candidates for providing Intelligent Transportation Systems with acceptable mobility, high reliability, high PDR, low PLR, and low E2E delay.

Knowledge of asthma management by general practitioners in Karachi, Pakistan: comparison with international guidelines.

BACKGROUND: Suboptimal management of asthma by general practitioners (GPs) can lead to poor health outcomes AIMS: To assess the management of common asthma presentations by GPs using the Global Initiative for Asthma (GINA) guidelines as a comparative tool. METHODS: A cross-sectional survey was conducted in Karachi, Pakistan. Of 250 GPs approached, 192 completed a self-administered questionnaire regarding pathology, key history points, risk factors, diagnosis, and management of asthma. RESULTS: Overall, 28.6% of GPs had adequate knowledge of the core concepts of asthma, while only 10.4% had adequate practice in asthma management. About 78% of GPs had inadequate knowledge of pathology, about 90% had inadequate knowledge of medications to be used, and 63% had inadequate knowledge regarding diet restrictions. Knowledge regarding symptoms not usually associated with asthma was adequate, as was knowledge regarding non-pharmacological management (79% each). Practices regarding asthma diagnosis were good (99.0%). However, practices regarding acute exacerbations and patients who wish to exercise were inadequate in 85.9% and 82.8% of GPs, respectively. CONCLUSIONS: The majority of GPs had poor knowledge and practice of asthma. We recommend initiation of programmes to improve their knowledge and practices.