Search results for: public hospital unions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7565

Search results for: public hospital unions

7295 On the Path of the Ottoman Modernization Period Mesire: As a Women Place in 19th Century

Authors: Merve Kurt

Abstract:

How women should behave in public spaces and how they should be dressed was a loaded issues in the Ottoman Empire. They pointed to what kind of state the Ottoman State was. One of such public space was Mesires, promenades. Women's visibility and invisibility, their morals were reflected and linked to the society as a whole. How the public space and private space is defined, what were the lines that separates them, how much blurred these lines were discussed in this paper. Moreover, all these points were strengthened by the primary sources from archives dating to the end of the 19th century.

Keywords: Mesire, Ottoman Empire, Ottoman women, public spaces

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7294 Development of a Nursing Care Program Based on Anthroposophic External Therapy for the Pediatric Hospital in Brazil and Germany

Authors: Karina Peron, Ricardo Ghelman, Monica Taminato, Katia R. Oliveira, Debora C. A. Rodrigues, Juliana R. C. Mumme, Olga K. M. Sunakozaua, Georg Seifert, Vicente O. Filho

Abstract:

The nurse is the most available health professional for the interventions of support in the integrative approach in hospital environment, therefore a professional group key to changes in the model of care. The central components in the performance of anthroposophic nursing procedures are direct physical contact, promotion of proper rhythm, thermal regulation and the construction of a calm and empathic atmosphere, safe for patients and their caregivers. The procedures of anthroposophic external therapies (AET), basically composed of the application of compresses and the use of natural products, provide an opportunity to intensify the therapeutic results through an innovative, complementary and integrative model in the university hospital. The objective of this work is to report the implementation of a program of nursing techniques (AET) through a partnership between the Pediatric Oncology Sector of the Department of Pediatrics of the Faculty of Medicine of the University of Sao Paulo and Charite University of Berlin, with lecturers from Berlin's Integrative Hospital Havelhöhe and Witten-Herdecke Integrative Hospital, both in Germany. Intensive training activities of the Hospital's nursing staff and a survey on AET needs were developed based on the most prevalent complaints in pediatric oncology patients in the three environments of the Hospital of Pediatric Oncology: Bone Marrow Transplantation Unit, Intensive Care Unit and Division of Internal Patients. We obtained the approval of the clinical protocol of external anthroposophic therapies for nursing care by the Ethics Committee and the Academic Council of the Hospital. With this project, we highlight the key AET needs that will be part of the standard program of pediatric oncology care with appropriate scientific support. The results of the prevalent symptoms were: vomiting, nausea, pain, difficulty in starting sleep, constipation, cold extremities, mood disorder and psychomotor agitation. This project was the pioneer within the Integrative Pediatrics Program, as an innovative concept of Medicine and Integrative Health presented at scientific meetings.

Keywords: integrative health care, integrative nursing, pediatric nursing, pediatric oncology

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7293 The Potential of Shifting Urban Village to Public Housing through Sharing Economy: Case Study of Shenzhen

Authors: Xinrui Gao

Abstract:

This research aims to explore the potential of shifting urban villages to public housing in China. In common practice, the central and local governments established two divided systems of urban redevelopment and public housing, including aims, design ideas, policy, headquarters, and branch offices. In most cases, the urban regeneration and public housing projects satisfy only the selected part of the society who can afford it (urban regeneration) or meet the requirements (public housing), which fail to cover the housing demand. However, there are many similarities between these two types of housing under the background of a shared economy, especially in target groups, affordable prices, and efficient use of spaces. Shenzhen always takes the lead in China’s urban regeneration and housing reformation. There are some top-down approaches to transforming housing in the urban village into public housing at present. These new approaches will provide a good chance to evaluate existing practices and explore the future development path of urban villages; while at the same time it could positively influence the housing problem in China.

Keywords: urban village, public housing, sharing economy, urban redevelopment

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7292 Covid-19: Preparedness, Response, and Use of Video Technology in Managing Infection Rate at Lagos University Teaching Hospital, Lagos-Nigeria

Authors: Afolakemi Helen Olaleye, Ogunjobi A. O

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Since coronavirus disease 2019 (COVID-19) was first reported in Nigeria, the virus has spread to virtually all sub-Saharan Africa (SSA) countries. In Nigeria, government agencies came together to create a goal-driven taskforce in improving our response against the virus. As COVID-19 international spread has been curtailed, community spread became rampant locally, leading to many health authorities raising concerns over the scarcity of medical consumables and supplies. Here at Lagos university teaching Hospital (LUTH), we present data analysis of COVID-19 infections offered at our Hospital (LUTH) and the surrounding communities. In addition, the adopted innovative solution to control the spread of infection, methods used in filling shortages of consumables, personal protective equipment (PPE), and use of mobile video technology in patient’s consultation. The management style and strategy adopted has led to a decline in infection rates in our community and among our front line staff. The current COVID -19 crisis has created an opportunity to test and demonstrate our pandemic response and control of infectious disease along with the revealed unknown potential in our community.

Keywords: COVID-19, preparedness, response, Lagos university teaching hospital

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7291 Stress and Personality as Predictors of Aggressive Behaviour among Nurses of Private Hospitals in Imo State, Nigeria

Authors: Ngozi N. Sydney-Agbor, Chioma N. Ihegboro

Abstract:

Stress and personality as factors influencing nurses’ aggressive behaviour were investigated. The participants comprised of one hundred and fifty nurses selected through convenience sampling technique from four (4) private hospitals in Imo State, Nigeria; namely: Eastern Summit Specialist Clinics and Maternity, St. David Hospital, New Cross Hospital, and Christian Teaching Hospital. The nurses were all females with ages between 20–35 and a mean age of 25.10 years and a standard deviation of 4.15. The participants were administered with Job Related Tension Scale, Type A Behaviour Scale and Buss- Perry Aggressive Behaviour Scale. Two hypotheses were postulated and tested. Cross- sectional survey and Regression Analysis were adopted as design and statistics respectively. Results showed that as stress increased, nurses aggression also increased. Personality also predicted nurses aggressive behaviour with Type As’ exhibiting higher aggression than Type Bs’.The study recommended that hospital management board should improve the welfare of the nurses and their morale should be boosted by involving them in policy-making concerning their welfare and care of their patients, this will help minimise situations capable of increasing aggressive behaviour. There should also be sensitization on the negative impact of aggressive behaviour to patients especially amongst the personality Type A’s who are more susceptible to aggression.

Keywords: aggressive behaviour, nurses, personality, stress

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7290 A Comparative Analysis of the Role, Representations and Architectural Identity of Public Space in Medieval and Contemporary Cairo

Authors: Muhammad Feteha

Abstract:

The socio-political Middle East scene has radically changed over the last decade, and one major contributor to this change was the Egyptian revolution of 2011. The massive impact of this revolution that originally started as a small protest in the Tahrir square has attracted more scholars to study the public space in Egypt, where it has become a necessity in order to understand and improve the socio-political conditions. The status of public space in Egypt has been deteriorating due to many reasons, including privatization and neglect. This paper studies one of the major problems of the contemporary public space in Cairo, which is the lack of identity. This takes place through a comparative analysis between selected case studies from both medieval and contemporary Cairo. The theoretical framework upon which the analysis is based views public space as a ‘container of social action’ and a ‘product of spatial practice’. Through the ‘deciphering of space’, differences in the socio-political role, symbolism, and identity of public spaces between both eras are shown. The paper aims to extract some lessons from public space in medieval Cairo, which was truly the ‘centerpiece of the public realm’ and a ‘fundamental expressions’ of the unique trans-dynastic architectural identity of Cairo. In addition, it suggests some strategies to revive the Cairene identity of public space instead of constructing new ones to be only ‘utilitarian spaces used for circulation’ and lack any identity.

Keywords: architectural identity, Cairene public space, Islamic architectural history, production of space

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7289 The Implementation of Information Security Audits in Public Sector: Perspective from Indonesia

Authors: Nur Imroatun Sholihat, Gresika Bunga Sylvana

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Currently, cyber attack became an incredibly serious problem due to its increasing trend all over the world. Therefore, information security becomes prominent for every organization including public sector organization. In Indonesia, unfortunately, Ministry of Finance (MoF) is the only public sector organization that has already formally established procedure to assess its information security adequacy by performing information security audits (November 2017). We assess the implementation of information security audits in the MoF using qualitative data obtained by interviewing IT auditors and by analysis of related documents. For this reason, information security audit practice in the MoF could become the acceptable benchmark for all other public sector organizations in Indonesia. This study is important because, to the best of the author’s knowledge, our research into information security audits practice in Indonesia’s public sector have not been found yet. Results showed that information security audits performed mostly by doing pentest (penetration testing) to MoF’s critical applications.

Keywords: information security audit, information technology, Ministry of Finance of Indonesia, public sector organization

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7288 Covid-19 Pandemic: Another Lesson Learned by a Military Hospital

Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

Abstract:

SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

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7287 Heat Waves and Hospital Admissions for Mental Disorders in Hanoi Vietnam

Authors: Phan Minh Trang, Joacim Rocklöv, Kim Bao Giang, Gunnar Kullgren, Maria Nilsson

Abstract:

There are recent studies from high income countries reporting an association between heat waves and hospital admissions for mental health disorders. It is not previously studied if such relations exist in sub-tropical and tropical low- and middle-income countries. In this study from Vietnam, the assumption was that hospital admissions for mental disorders may be triggered, or exacerbated, by heat exposure and heat waves. A database from Hanoi Mental Hospital with mental disorders diagnosed by the International Classification of Diseases 10, spanning over five years, was used to estimate the heatwave-related impacts on admissions for mental disorders. The relationship was analysed by a Negative Binomial regression model accounting for year, month, and days of week. The focus of the study was heat-wave events with periods of three or seven consecutive days above the threshold of 35oC daily maximum temperature. The preliminary study results indicated that heat-waves increased the risks for hospital admission for mental disorders (F00-79) from heat-waves of three and seven days with relative risks (RRs) of 1.16 (1.01–1.33) and 1.42 (1.02–1.99) respectively, when compared with non-heat-wave periods. Heatwave-related admissions for mental disorders increased statistically significantly among men, among residents in rural communities and in elderly. Moreover, cases for organic mental disorders including symptomatic illnesses (F0-9) and mental retardation (F70-79) raised in high risks during heat waves. The findings are novel studying a sub-tropical middle-income city, facing rapid urbanisation and epidemiological and demographic transitions.

Keywords: mental disorders, admissions for F0-9 or F70-79, maximum temperature, heat waves

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7286 Analysis of Differences between Public and Experts’ Views Regarding Sustainable Development of Developing Cities: A Case Study in the Iraqi Capital Baghdad

Authors: Marwah Mohsin, Thomas Beach, Alan Kwan, Mahdi Ismail

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This paper describes the differences in views on sustainable development between the general public and experts in a developing country, Iraq. This paper will answer the question: How do the views of the public differ from the generally accepted view of experts in the context of sustainable urban development in Iraq? In order to answer this question, the views of both the public and the experts will be analysed. These results are taken from a public survey and a Delphi questionnaire. These will be analysed using statistical methods in order to identify the significant differences. This will enable investigation of the different perceptions between the public perceptions and the experts’ views towards urban sustainable development factors. This is important due to the fact that different viewpoints between policy-makers and the public will impact on the acceptance by the public of any future sustainable development work that is undertaken. The brief findings of the statistical analysis show that the views of both the public and the experts are considered different in most of the variables except six variables show no differences. Those variables are ‘The importance of establishing sustainable cities in Iraq’, ‘Mitigate traffic congestion’, ‘Waste recycling and separating’, ‘Use wastewater recycling’, ‘Parks and green spaces’, and ‘Promote investment’.

Keywords: urban sustainability, experts views, public views, principle component analysis, PCA

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7285 The Use of Emergency Coronary Angiography in Patients Following Out-Of-Hospital Cardiac Arrest and Subsequent Cardio-Pulmonary Resuscitation

Authors: Scott Ashby, Emily Granger, Mark Connellan

Abstract:

Objectives: 1) To identify if emergency coronary angiography improves outcomes in studies examining OHCA from assumed cardiac aetiology? 2) If so, is it indicated in all patients resuscitated following OHCA, and if not, who is it indicated for? 3) How effective are investigations for screening for the appropriate patients? Background: Out-of-hospital cardiac arrest is one of the leading mechanisms of death, and the most common causative pathology is coronary artery disease. In-hospital treatment following resuscitation greatly affects outcomes, yet there is debate over the most effective protocol. Methods: A literature search was conducted over multiple databases to identify all relevant articles published from 2005. An inclusion criterion was applied to all publications retrieved, which were then sorted by type. Results: A total of 3 existing reviews and 29 clinical studies were analysed in this review. There were conflicting conclusions, however increased use of angiography has shown to improve outcomes in the majority of studies, which cover a variety of settings and cohorts. Recommendations: Currently, emergency coronary angiography appears to improve outcomes in all/most cases of OHCA of assumed cardiac aetiology, regardless of ECG findings. Until a better tool for screening is available to reduce unnecessary procedures, the benefits appear to outweigh the costs/risks.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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7284 Strategies Considered Effective for Funding Public Tertiary Institutions in Nigeria

Authors: Jacinta Ifeoma Obidile

Abstract:

The study sought to ascertain from the opinions of the business educators, effective strategies for funding public tertiary institutions in Anambra State Nigeria, for effective functioning and delivery. Funding of tertiary institutions has become so important following the dilapidated state of most of the public tertiary institutions in Nigeria. Tertiary institutions are known for the production of competitive and competent workforce in the nation. Considering the state of public tertiary institutions currently, one wonders if their objectives are achieved. Many scholars have identified funding as one of the major barriers to effective functioning of tertiary institutions. Although federal and state governments have been supporting the tertiary institutions, but their support seems not to be adequate. This study therefore ascertained from the perspective of business educators, other strategies for funding public tertiary institutions in Anambra State Nigeria, for effective functioning and delivery. Survey research design was adopted for the study. A total of 104 business educators from the public tertiary institutions in the State constituted the population. There was no sampling, hence the whole population was used. Structured questionnaire validated by three experts with a reliability coefficient of 0.82 was the instrument for data collection. Data collected were analyzed using mean and standard deviation. Findings from the study revealed that public-private partnership and external aids were among the strategies considered effective for funding public tertiary institutions. It was therefore recommended among others that associations like alumni should be strongly instituted in each of the public tertiary institutions so as to assist in the funding of tertiary institutions for effective functioning and delivery.

Keywords: strategies, funding, tertiary institutions, business educators

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7283 Leveraging Li-Fi to Enhance Security and Performance of Medical Devices

Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

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The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: hospital, light fidelity, Li-Fi, medical devices, security

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7282 The Neglected Elements of Implementing Strategic Succession Management in Public Organizations

Authors: François Chiocchio, Mahshid Gharibpour

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Regardless of the extent to which succession management is implemented in the private sector, it is still overlooked in the public sector. Traditional succession management is evolving providing a better alignment between business strategies and HR strategies. Succession management brings sustainable effectiveness for succession programs through career path development, knowledge and skill transfer, job retention, as well as high-potential candidates’ empowerment for upcoming vacancies. By way of a systematic literature review, we bring into focus strategic succession management in public organizations and discuss best ways of implementation. 

Keywords: succession management, strategic succession management, public organization, succession management model

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7281 Patient Safety Culture in Brazilian Hospitals from Nurse's Team Perspective

Authors: Carmen Silvia Gabriel, Dsniele Bernardi da Costa, Andrea Bernardes, Sabrina Elias Mikael, Daniele da Silva Ramos

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The goal of this quantitative study is to investigate patient safety culture from the perspective of professional from the hospital nursing team.It was conducted in two Brazilian hospitals,.The sample included 282 nurses Data collection occurred in 2013, through the questionnaire Hospital Survey on Patient Safety Culture.Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor overlooks patient safety problems.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.On hospital management support for patient safety, 52.8% refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.On frequency of event reporting, 64.7% said often and always notify events with no damages to patients..About teamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8 % disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6 % classified it as very good. it is concluded that there are positive points in the safety culture, and some weaknesses as a punitive culture and impaired patient safety due to work overload .

Keywords: quality of health care, health services evaluation, safety culture, patient safety, nursing team

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7280 Revisiting Hospital Ward Design Basics for Sustainable Family Integration

Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

Abstract:

The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: caregiving, design basics, family integration, hospital ward, sustainability

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7279 On the Efficiency of the Algerian FRR Sovereign Fund

Authors: Abdelkader Guendouz, Fatima Zohra Adel

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Since about two decades, the Algerian government created a new instrument in the field of its fiscal policy, which is the FRR (Fonds de Régulation des Recettes). The FRR is a sovereign fund, which the initial role was saving the surplus generated by the fixation of a referential oil price to establish the state budget in the aim equilibrium between budgetary incomes and public expenditures. After a while, the government turns to use this instrument in boosting the public investment more than keeping for funding a deficit budget in periods of crisis. This lead to ask some justified questions about the efficiency of this sovereign fund and its real role.

Keywords: FRR sovereign fund, public expenditures, public investment, efficiency

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7278 Assessing the Accessibility to Primary Percutaneous Coronary Intervention

Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

Abstract:

Background: Ensuring patients with ST-elevation myocardial infarction (STEMI) access to hospitals that could perform percutaneous coronary intervention (PCI) in time is an important concern of healthcare managers. One commonly used the method to assess the coverage of population access to PCI hospital is the use GIS-estimated linear distance (crow's fly distance) between the district centroid and the nearest PCI hospital. If the distance is within a given distance (such as 20 km), the entire population of that district is considered to have appropriate access to PCI. The premise of using district centroid to estimate the coverage of population resident in that district is that the people live in the district are evenly distributed. In reality, the population density is not evenly distributed within the administrative district, especially in rural districts. Fortunately, the Taiwan government released basic statistical area (on average 450 population within the area) recently, which provide us an opportunity to estimate the coverage of population access to PCI services more accurate. Objectives: We aimed in this study to compare the population covered by a give PCI hospital according to traditional administrative district versus basic statistical area. We further examined if the differences between two geographic units used would be larger in a rural area than in urban area. Method: We selected two hospitals in Tainan City for this analysis. Hospital A is in urban area, hospital B is in rural area. The population in each traditional administrative district and basic statistical area are obtained from Taiwan National Geographic Information System, Ministry of Internal Affairs. Results: Estimated population live within 20 km of hospital A and B was 1,515,846 and 323,472 according to traditional administrative district and was 1,506,325 and 428,556 according to basic statistical area. Conclusion: In urban area, the estimated access population to PCI services was similar between two geographic units. However, in rural areas, the access population would be overestimated.

Keywords: accessibility, basic statistical area, modifiable areal unit problem (MAUP), percutaneous coronary intervention (PCI)

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7277 Patients' Out-Of-Pocket Expenses-Effectiveness Analysis of Presurgical Teledermatology

Authors: Felipa De Mello-Sampayo

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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.

Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time

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7276 Risk Factors Associated to Low Back Pain among Active Adults: Cross-Sectional Study among Workers in Tunisian Public Hospital

Authors: Lamia Bouzgarrou, Irtyah Merchaoui, Amira Omrane, Salma Kammoun, Amine Daafa, Neila Chaari

Abstract:

Backgrounds: Currently, low back pain (LBP) is one of the most prevalent public health problems, which caused severe morbidity among a large portion of the adult population. It is also associated with heavy direct and indirect costs, in particular, related to absenteeism and early retirement. Health care workers are one of most occupational groups concerned by LBP, especially because of biomechanical and psycho-organizational risk factors. Our current study aims to investigate risk factors associated with chronic low back pain among Tunisian caregivers in university-hospitals. Methods: Cross-sectional study conducted over a period of 14 months, with a representative sample of caregivers, matched according to age, sex and work department, in two university-hospitals in Tunisia. Data collection included items related to socio-professional characteristics, the evaluation of the working capacity index (WAI), the occupational stress (Karazek job strain questionnaire); the quality of life (SF12), the musculoskeletal disorders Nordic questionnaire, and the examination of the spine flexibility (distance finger-ground, sit-stand maneuver and equilibrium test). Results: Totally, 293 caregivers were included with a mean age equal to 42.64 ± 11.65 years. A body mass index (BMI) exceeding 30, was noted in 20.82% of cases. Moreover, no regular physical activity was practiced in 51.9% of cases. In contrast, domestic activity equal or exceeding 20 hours per week, was reported by 38.22%. Job strain was noted in 19.79 % of cases and the work capacity was 'low' to 'average' among 27.64% of subjects. During the 12 months previous to the investigation, 65% of caregivers complained of LBP, with pain rated as 'severe' or 'extremely severe' in 54.4% of cases and with a frequency of discomfort exceeding one episode per week in 58.52% of cases. During physical examination, the mean distance finger-ground was 7.10 ± 7.5cm. Caregivers assigned to 'high workload' services had the highest prevalence of LBP (77.4%) compared to other categories of hospital services, with no statistically significant relationship (P = 0.125). LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p < 10⁻³). Moreover, the increase of the distance finger-ground was statistically associated with LBP (p = 0.05), advanced age (p < 10⁻³), professional seniority (p < 10⁻³) and the BMI ≥ 25 (p = 0.001). Furthermore, others physical tests of spine flexibility were underperformed among LBP suffering workers with a statistically significant difference (sit-stand maneuver (p = 0.03); equilibrium test (p = 0.01)). According to the multivariate analysis, only the domestic activity exceeding 20H/week, the degraded quality of physical life, and the presence of neck pain were significantly corelated to LBP. The final model explains 36.7% of the variability of this complaint. Conclusion: Our results highlighted the elevate prevalence of LBP among caregivers in Tunisian public hospital and identified both professional and individual predisposing factors. The preliminary analysis supports the necessity of a multidimensional approach to prevent this critical occupational and public health problem. The preventive strategy should be based both on the improvement of working conditions, and also on lifestyle modifications, and reinforcement of healthy behaviors in these active populations.

Keywords: health care workers, low back pain, prevention, risk factor

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7275 The Impact of Public Charging Infrastructure on the Adoption of Electric Vehicles

Authors: Shaherah Jordan, Paula Vandergert

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The discussion on public charging infrastructure is usually framed around the ‘chicken-egg’ challenge of consumers feeling reluctant to purchase without the necessary infrastructure and policymakers reluctant to invest in the infrastructure without the demand. However, public charging infrastructure may be more crucial to electric vehicle (EV) adoption than previously thought. Historically, access to residential charging was thought to be a major factor in potential for growth in the EV market as it offered a guaranteed place for a vehicle to be charged. The purpose of this study is to understand how the built environment may encourage uptake of EVs by seeking a correlation between EV ownership and public charging points in an urban and densely populated city such as London. Using a statistical approach with data from the Department for Transport and Zap-Map, a statistically significant correlation was found between the total (slow, fast and rapid) number of public charging points and a number of EV registrations per borough – with the strongest correlation found between EV registrations and rapid chargers. This research does not explicitly prove that there is a cause and effect relationship between public charging points EVs but challenges some of the previous literature which indicates that public charging infrastructure is not as important as home charging. Furthermore, the study provides strong evidence that public charging points play a functional and psychological role in the adoption of EVs and supports the notion that the built environment can influence human behaviour.

Keywords: behaviour change, electric vehicles, public charging infrastructure, transportation

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7274 Interest Charges and Sustainability Challenges: The Case of OECD Countries

Authors: Aime Philombe Zapji Ymele

Abstract:

Servicing public debt is a significant budgetary burden. In the sense that the payment of interest charges is a liability on the balance sheet of the public budget and affects fiscal policy. Interest charges can sometimes become a burden if they crowd out private activities. In order to analyse and understand the determinants of the debt burden and its impact on the sustainability of public finances, the present work focuses on OECD countries. It is noted from the literature that the factors that determine interest charges are macroeconomic (inflation, GDP growth, and interest rates) and public finances (primary balance and public debt). After analysing a panel of 33 OECD countries and using ordinary least squares (OLS), we find that public debt, inflation, and long-term interest rates are positively correlated with interest charges. An increase in any of these variables leads to an increase in debt charges. On the other hand, a growth in GDP is negatively associated with interest charges. Indeed, an increase in GDP generates enough revenue to meet the repayment of debt charges. According to the empirical analysis, we can say that, despite the large and growing debt-to-GDP ratio of major OECD countries, interest charges are not a threat to the sustainability of public finances. However, it is important for these countries to reduce the ratio of public debt to GDP because, in the face of the many challenges (health, aging population, etc.) that are looming on the horizon, an increase in interest rates could bring with it considerable burdens that would threaten the budgetary balance of these states.

Keywords: interest charges, sustainability, public debt, interest rates

Procedia PDF Downloads 103
7273 Poisoning Admission in Pediatrics Benghazi Hospital in Libya: Three Years Review of Medical Record

Authors: Mudafara Bengleil

Abstract:

Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Keywords: poisoning, children, hospital, medical

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7272 Scaffold on Trial: The Rhetorical Controversy of a Public Artifact in Minneapolis

Authors: Cynthia Pope

Abstract:

Though traditional art has been strong on showcasing aesthetics to imbue pleasantries, modern public art has been breaking trends to push citizens beyond the pleasure of seeing beauty. Contemporary public sculpture, in particular, has been the impetus of provoking questions about community standards, identity, and race relations. A phenomenon involving Scaffold, a sculpture by artist Sam Durant, became the focal point of contention within Minneapolis, Minnesota, recently. With intentions to better understand the power public sculpture has to disrupt community identity, in this book, It will use primarily rhetorical theory to explain how all parties involved—The Walker Art Museum, the Dakota Nation, Durant, and local citizens—participated in a controversy touching on racial politics, identity, culture, history and public art. This mixed-methods case study examines the public artifact contextually through historical and cultural frameworks. Findings in this project will reveal Scaffold to be represented as a tool of empowered Caucasians to the exclusion of marginalized people. This project also informs the fields of public rhetoric and political identity, marginalized voices, and community and social justice initiatives to include the difficult topic of race and identity.

Keywords: public art controversy, technical communication, community narrative, ambient rhetoric

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7271 The Study of Public Consciousness of Undergraduate Students, Suan Sunandha Rajabhat University

Authors: Nantida Otakum

Abstract:

The purpose of the study is to study the level of public consciousness of Suan Sunandha Rajabhat University undergraduate students. This study also compares differences in the level of public consciousness among undergraduate students who are different in sex and year of study. The research methodology employed a questionnaire as a quantitative method. The respondents were undergraduate students at Suan Sunandha Rajabhat University. Totally, 400 usable questionnaires were received. Descriptive and inferential statistics were used in data analysis. The results showed that the level of public consciousness of undergraduate students was at a good level in all aspects. The aspect of social participation was at the highest level, while the aspect of shared vision was at the lowest level. The results also indicated that undergraduate students with differences in sex and year of study were not significantly different in public consciousness level.

Keywords: participation, public consciousness, Suan Sunandha Rajabhat University, undergraduate students

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7270 Interest Charges and Sustainability Challenges: The Case of OECD Countries

Authors: Zapji Ymele Aime Philombe

Abstract:

Servicing public debt is a significant budgetary burden in the sense that the payment of interest charges is a liability on the balance sheet of the public budget and affects fiscal policy. Interest charges can sometimes become a burden if they crowd out private activities. In order to analyse and understand the determinants of the debt burden and its impact on the sustainability of public finances, the present work focuses on OECD countries. It is noted from the literature that the factors that determine interest charges are macroeconomic (inflation, GDP growth and interest rates) and public finances (primary balance and public debt). After analysing a panel of 33 OECD countries and using ordinary least squares (OLS), we find that public debt, inflation and long-term interest rates are positively correlated with interest charges. An increase in any of these variables leads to an increase in debt charges. On the other hand, a growth in GDP is negatively associated with interest charges. Indeed, an increase in GDP generates enough revenue to meet the repayment of debt charges. According to the empirical analysis, we can say that, despite the large and growing debt-to-GDP ratio of major OECD countries, interest charges are not a threat to the sustainability of public finances. However, it is important for these countries to reduce the ratio of public debt to GDP because, in the face of the many challenges (health, aging population, etc.) that are looming on the horizon, an increase in interest rates could bring with it considerable burdens that would threaten the budgetary balance of these states.

Keywords: interests charges, public debt, sustainability, interest rates

Procedia PDF Downloads 103
7269 Research on Optimization Strategies for the Negative Space of Urban Rail Transit Based on Urban Public Art Planning

Authors: Kexin Chen

Abstract:

As an important method of transportation to solve the demand and supply contradiction generated in the rapid urbanization process, urban rail traffic system has been rapidly developed over the past ten years in China. During the rapid development, the space of urban rail Transit has encountered many problems, such as space simplification, sensory experience dullness, and poor regional identification, etc. This paper, focus on the study of the negative space of subway station and spatial softening, by comparing and learning from foreign cases. The article sorts out cases at home and abroad, make a comparative study of the cases, analysis more diversified setting of public art, and sets forth propositions on the domestic type of public art in the space of urban rail transit for reference, then shows the relationship of the spatial attribute in the space of urban rail transit and public art form. In this foundation, it aims to characterize more diverse setting ways for public art; then suggests the three public art forms corresponding properties, such as static presenting mode, dynamic image mode, and spatial softening mode; finds out the method of urban public art to optimize negative space.

Keywords: diversification, negative space, optimization strategy, public art planning

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7268 The Initiation of Privatization, Market Structure, and Free Entry with Vertically Related Markets

Authors: Hung-Yi Chen, Shih-Jye Wu

Abstract:

The existing literature provides little discussion on why a public monopolist gives up its market dominant position and allows private firms entering the market. We argue that the privatization of a public monopolist under a vertically related market may induce the entry of private firms. We develop a model of a mixed oligopoly with vertically related markets to explain the change in the market from a public monopolist to a mixed oligopoly and examine issues on privatizing the downstream public enterprise both in the short run and long run in the vertically related markets. We first show that the welfare-maximizing public monopoly firm is suboptimal in the vertically related markets. This is due to the fact that the privatization will reduce the input price charged by the upstream foreign monopolist. Further, the privatization will induce the entry of private firms since input price will decrease after privatization. Third, we demonstrate that the complete privatizing the public firm becomes a possible solution if the entry cost of private firm is low. Finally, we indicate that the public firm should partially privatize if the free-entry of private firms is allowed. JEL classification: F12, F14, L32, L33

Keywords: free entry, mixed oligopoly, public monopoly, the initiation of privatization, vertically related markets, mixed oligopoly

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7267 Antifungal Susceptibility of Yeasts Isolated from Clinical Samples from a Tertiary Hospital from State of Puebla

Authors: Ricardo Munguia-Perez, Nayeli Remigio-Alvarado, M.Miriam Hernandez-Arroyo, Elsa Castañeda-Roldan

Abstract:

Fungi have emerged as important pathogens causing morbidity and mortality mainly in immunosuppressed, malnourished and elderly patients. It has detected an increase in resistance to azoles primarily to fluconazol. The fungal infections have become a problem of public health for the resistance to antifungal agents, they have developed new antifungals with broad-spectrum. The aim of this study was determine the antifungal susceptibility of yeasts isolated from clinical samples (respiratory secretions, exudates, wounds, blood cultures, urine cultures) obtained from inpatients and outpatients of a tertiary hospital from State of Puebla. The antifungal susceptibility of the yeast from several clinical samples were determined by the CLS M44-A disk diffusion methods. 149 samples of yeast were analyzed. All species were 100% susceptible to nystatin and amphotericin B. Candida albicans showed resistance of 95.5 % to fluconazole, 50.7 % to 5-flurocytosine and 55.2 % intermediate susceptibility to ketoconazole. Candida glabrata 81.3 % was susceptibility to ketoconazole and 75 % to fluconazole, for the case of 5-flurocytosine the 56.3 % was susceptible. Candida krusei 100 % was susceptible to ketoconazole, 50 % to fluconazole and 37.5 % to 5-flurocytosine. The internal medicine have greater diversity of yeast, the samples have susceptibility of 64.7% to ketoconazole, 47.1 % to fluconazole and 27.5 % to 5-flurocytosine. Hospitalized patients are more resistant to fluconazole and nystatin, but in the case of outpatients presents resistance to ketoconazole.

Keywords: antifungal, susceptibility, yeast, clinical samples

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7266 Environmental Health Risk Assessment of Hospital Wastewater in Enugu Urban, Nigeria

Authors: C. T. Eze, I. N. E. Onwurah

Abstract:

An important hydrogeologic problem in areas of high faults formations is high environmental health hazard occasioned by microbial and heavy metals contamination of ground waters. Consequently, we examined the microbial load and heavy metals concentration of hospital wastewater discharged into the environment at Park Lane General Hospital Enugu Urban, Nigeria. The microbial counts, characteristics and frequency of occurrences of the isolated microorganisms were determined by cultural, morphological and biochemical characteristics using established procedure while the varying concentrations of the identified heavy metals were determined using the spectrophotometric method. The microbiological analyses showed a mean total aerobic bacteria counts from 13.7 ± 0.65 × 107 to 22.8 ± 1.14 ×1010 CFU/ml, mean total anaerobic bacteria counts from 6.0 ± 1.6 × 103 to 1.7 ± 0.41 ×104 CFU/ml and mean total fungal counts from 0 ± 0 to 2.3 ± 0.16 × 105 CFU/ml. The isolated micro-organisms which included both pathogenic and non-pathogenic organisms were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi, Bacillus subtilis, Proteus vulgaris, Klesbsiella pneumonia and bacteriodes sp. The only fungal isolate was Candida albican. The heavy metals identified in the leachate were Arsenic, Cadmium, Lead, Mercury and Chromium and their concentrations ranged from 0.003 ± 0.00082 to 0.14 ± 0.0082 mg/l. These values were above WHO permissible limits while others fall within the limits. Therefore, hospital waste water can pose the environmental health risk when not properly treated before discharge, especially in geologic formations with high fault formations.

Keywords: bacterial isolates, fungal isolates, heavy metals, hospital wastewater, microbial counts

Procedia PDF Downloads 325