Search results for: diversity and tirunesh beijing hospital
Commenced in January 2007
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Edition: International
Paper Count: 4102

Search results for: diversity and tirunesh beijing hospital

3802 A Literature Review on the Use of Information and Communication Technology within and between Emergency Medical Teams during a Disaster

Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

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3801 Perceived Competence toward Helping an Accident Victim in Pre-Hospital Setting among Medical Graduates: A Cross Sectional Study from Jodhpur, Rajasthan

Authors: Neeti Rustagi, Naveen Dutt, Arvind Sinha, Mahaveer S. Rhodha, Pankaja R. Raghav

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Background: Pre-hospital trauma care services are in developing stage in fast-urbanizing cities of India including Jodhpur. Training of health professionals in providing necessary pre-hospital trauma care is an essential step in decreasing accident related morbidity and mortality. The current study explores the response of a medical graduate toward helping an accident victim in a pre-hospital setting before patient can be transferred to definitive trauma facility. Methodology: This study examines the perceived competence in predicting response to an accident victim by medical graduates in Jodhpur, Rajasthan. Participants completed measures of attitude, normative influence and perceived behavior control toward providing pre-hospital care to an accident victim. Likert scale was used to measure the participant responses. Preliminary and descriptive analysis were used using SPSS 21.0. Internal consistency of the responses received was measured using Cronbach’s alpha. Results: Almost all medical graduates agreed that road accidents are common in their area (male: 92%; female: 78%). More male medical graduates (28%) reported helping an accident victim as compared to female physicians (9%) in the previous three months. Majority of study participants (96%) reported that providing immediate care to an accident victim is essential to save the life of an individual. Experience of helping an accident victim was considered unpleasant by the majority of female participants (70%) as compared to male participants (36%). A large number of participants believed that their friends (80%) and colleagues (96%) would appreciate them helping an accident victim in a pre-hospital setting. A large number of participants also believed that they possess the necessary skills and competencies (80%) towards helping a roadside accident victim in the pre-hospital care environment. Perceived competence of helping a roadside accident victim until they are transferred to a health facility was reported by less than half of the participants (male: 56%; female: 43%). Conclusion: Medical graduates have necessary attitude, competencies, and intention of helping a roadside accident victim. The societal response towards helping a road side accident victim is also supportive. In spite of positive determinants, a large proportion of medical graduates have perceived lack of competence in helping a roadside accident victim. This is essential to explore further as providing pre-hospital care to a roadside accident victim is an essential step in establishing the continuum of care to an accident victim especially in countries where pre-hospital services are in developing phase.

Keywords: prehospital care, perceived behavior, perceived competence, medical graduates

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3800 Dietary Diversity of Pregnant Mothers in a Semi-Urban Setting: Sri Lanka

Authors: R. B. B. Samantha Ramachandra, L. D. J. Upul Senarath, S. H. Padmal De Silva

Abstract:

Dietary pattern largely differs over countries and even within a country, it shows cultural differences. The dietary pattern changes the energy consumption and micronutrient intake, directly affects the pregnancy outcome. The dietary diversity was used as an indirect measure to assess micronutrient adequacy for pregnant mothers in this study. The study was conducted as a baseline survey with the objective of designing an intervention to improve the dietary diversity of pregnant mothers in Sri Lanka. The survey was conducted in Kalutara district of Sri Lanka in 2015 among 769 pregnant mothers at different gestational ages. Dietary diversity questionnaire developed by Food and Agricultural Organization’s (FAO) Food and Nutrition technical Assistance (FANTA) II project, recommended for cross-country use with adaptations was used for data collection. Trained data collectors met pregnant mothers at field ante-natal clinic and questioned on last 24hr dietary recall with portion size and coded food items to identify the diversity. Pregnant mothers were identified from randomly selected 21 clusters of public health midwife areas. 81.5% mothers (n=627) in the sample had been registered at Public Health Midwife (PHM) before 8 weeks of gestation. 24.4% of mothers were with low starting BMI and 22.7% mothers were with high starting BMI. 47.6% (n=388) mothers had abstained from at least one food item during the pregnancy. The food group with the highest consumption was rice (98.4%) followed by sugar (89.9%). 76.1% mothers had consumed milk, 73% consumed fish and sea foods. Consumption of green leaves was 52% and Vit A rich foods consumed only by 49% mothers. Animal organs, flesh meat and egg all showed low prevalence as 4.7%, 21.6% and 20% respectively. Consumption of locally grown roots, nut, legumes all showed very low prevalence. Consumption of 6 or more food groups was considered as good dietary diversity (DD), 4 to 5 food groups as moderate diversity and 3 or less food groups as poor diversity by FAO FANTA II project. 42.1% mothers demonstrated good DD while another 42.1% recorded moderate diversity. Working mothers showed better DD (51.6%, n=82/159) compared to housewives in the sample (chi = 10.656a,. df=2, p=0.005). The good DD showed gradual improvement from 43.1% to 55.5% along the poorest to richest wealth index (Chi=48.045, df=8 and p=0.000). DD showed significant association with the ethnicity and Moors showed the lowest DD. DD showed no association with the home gardening even though where better diversity expected among those who have home gardening (p=0.548). Sri Lanka is a country where many food items can be grown in the garden and semi-urban setting have adequate space for gardening. Many Sri Lankan mothers do not add homegrown items in their meal. At the same time, their consumption of animal food shows low prevalence. The DD of most of the mothers being either moderate or low (58%) may result from inadequate micro nutrient intake during pregnancy. It is recommended that adding green leaves, locally grown vegetables, roots, nuts and legumes can help increasing the DD of Sri Lankan mothers at low cost.

Keywords: dietary diversity, pregnant mothers, micro-nutrient, food groups

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3799 Investigating Unplanned Applications and Admissions to Hospitals of Children with Cancer

Authors: Hacer Kobya Bulut, Ilknur Kahriman, Birsel C. Demirbag

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Introduction and Purpose: The lives of children with cancer are affected by long term hospitalizations in a negative way due to complications arising from diagnosis or treatment. However, the children's parents are known to have difficulties in meeting their children’s needs and providing home care after cancer treatment or during remission process. Supporting these children and their parents by giving a planned discharge training starting from the hospital and home care leads to reducing hospital applications, hospitalizations, hospital costs, shortening the length of hospital stay and increasing the satisfaction of the children with cancer and their families. This study was conducted to investigate the status of children and their parents' unplanned application to hospital and re-hospitalization. Methods: The study was carried out with 65 children with hematological malignancy in 0-17 age group and their families in a hematology clinic and polyclinic of a university hospital in Trabzon. Data were collected with survey methodology between August-November, 2015 through face to face interview using numbers, percentage and chi-square test in the evaluation. Findings: Most of the children were leukemia (90.8%) and 49.2% had been ill over 13 months. Few of the parents (32.3%) stated that they had received discharge and home care training (24.6%) but most of them (69.2%) found themselves enough in providing home care. Very few parents (6.2%) received home care training after their children being discharged and the majority of parents (61.5%) faced difficulties in home care and had no one to call around them. The parents expressed that in providing care to their children with hematological malignance, they faced difficulty in feeding them (74.6%), explaining their disease (50.0%), giving their oral medication (47.5%), providing hygiene (43.5%) and providing oral care (39.3%). The question ‘What are the emergency situations in which you have to bring your children to a doctor immediately?' was replied as fever (89.2%), severe nausea and vomiting (87.7%), hemorrhage (86.2%) and pain (81.5%). The study showed that 50.8% of the children had unplanned applications to hospitals and 33.8% of them identified as unplanned hospitalization and the first causes of this were fever and pain. The study showed that the frequency of applications (%78.8) and hospitalizations (%81.8) was higher for boys and a statistically significant difference was found between gender and unplanned applications (X=4.779; p=0.02). Applications (48.5%) and hospitalizations (40.9%) were found lower for the parents who had received hospital discharge training, and a significant difference was determined between receiving training and unplanned hospitalizations (X=8.021; p=0.00). Similarly, applications (30.3%) and hospitalizations (40.9%) was found lower for the ones who had received home care training, and a significant difference was determined between receiving home care training and unplanned hospitalizations (X=4.758; p=0.02). Conclusion: It was found out that caregivers of children with cancer did not receive training related to home care and complications about treatment after discharging from hospital, so they faced difficulties in providing home care and this led to an increase in unplanned hospital applications and hospitalizations.

Keywords: cancer, children, unplanned application, unplanned hospitalization

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3798 Cultivating Individuality and Equality in Education: A Literature Review on Respecting Dimensions of Diversity within the Classroom

Authors: Melissa C. Ingram

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This literature review sought to explore the dimensions of diversity that can affect classroom learning. This review is significant as it can aid educators in reaching more of their diverse student population and creating supportive classrooms for teachers and students. For this study, peer-reviewed articles were found and compiled using Google Scholar. Key terms used in the search include student individuality, classroom equality, student development, teacher development, and teacher individuality. Relevant educational standards such as Common Core and Partnership for the 21st Century were also included as part of this review. Student and teacher individuality and equality is discussed as well as methods to grow both within educational settings. Embracing student and teacher individuality was found to be key as it may affect how each person interacts with given information. One method to grow individuality and equality in educational settings included drafting and employing revised teaching standards which include various Common Core and U.S. State standards. Another was to use educational theories such as constructivism, cognitive learning, and Experiential Learning Theory. However, barriers to growing individuality, such as not acknowledging differences in a population’s dimensions of diversity, still exist. Studies found preserving the dimensions of diversity owned by both teachers and students yielded more positive and beneficial classroom experiences.

Keywords: classroom equality, student development, student individuality, teacher development, teacher individuality

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3797 A Hill Town in Nature to Urban Sprawl: Shimla (HP) India

Authors: Minakshi Jain, I. P. Singh

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The mountain system makes the one fifth of the world’s landscape and is the home to the 600 million people. Though hills and mountains contain about 10 percent of the total population of the country, yet almost half of the country’s population living in or adjacent to the mountain areas depend directly or indirectly on the resources of the hills. Mountain environments are essential to the survival of the global ecosystems, as they sustain the economy of India through its perennial river system and precious forest wealth. Hill areas, with distinct climate, diverse vegetation and valuable flora & fauna are distinguished primarily by unique eco-system, rich both in bio-diversity and visual resources. These areas have special significance in terms of environment and economy. Still the irony is that these mountain ecosystems are fragile and highly susceptible to disturbance, with a low ability to rebound and heal after damage. Hills are home to endangered species, biological diversity and an essential part of the ecosystem. They are extremely sensitive to any human related development. Natural systems are the most ignored in the hills. The way the cities and towns have encroached them today has the serious repercussions on the climate. Amidst immense resources and constraints of nature, the town had a fantastic diversity of cultural and ethnic characteristics nurtured through ages along river basin and valley strung across the length and breadth of this Himalayan setting.

Keywords: eco-system, bio-diversity, urban sprawl, vernacular landscape

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3796 Diversity and Inclusion in Focus: Cultivating a Sense of Belonging in Higher Education

Authors: Naziema Jappie

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South Africa is a diverse nation but with many challenges. The fundamental changes in the political, economic and educational domains in South Africa in the late 1990s affected the South African community profoundly. In higher education, experiences of discrimination and bias are detrimental to the sense of belonging of staff and students. It is therefore important to cultivate an appreciation of diversity and inclusion. To bridge common understandings with the reality of racial inequality, we must understand the ways in which senior and executive leadership at universities think about social justice issues relating to diversity and inclusion and contextualize these within the current post-democracy landscape. The position and status of social justice issues and initiatives in South African higher education is a slow process. The focus is to highlight how and to what extent initiatives or practices around campus diversity and inclusion have been considered and made part of the mainstream intellectual and academic conversations in South Africa. This involves an examination of the social and epistemological conditions of possibility for meaningful research and curriculum practices, staff and student recruitment, and student access and success in addressing the challenges posed by social diversity on campuses. Methodology: In this study, university senior and executive leadership were interviewed about their perceptions and advancement of social justice and examine the buffering effects of diverse and inclusive peer interactions and institutional commitment on the relationship between discrimination–bias and sense of belonging for staff and students at the institutions. The paper further explores diversity and inclusion initiatives at the three institutions using a Critical Race Theory approach in conjunction with a literature review on social justice with a special focus on diversity and inclusion. Findings: This paper draws on research findings that demonstrate the need to address social justice issues of diversity and inclusion in the SA higher education context. The reason for this is so that university leaders can live out their experiences and values as they work to transform students into being accountable and responsible. Documents were selected for review with the intent of illustrating how diversity and inclusion work being done across an institution can shape the experiences of previously disadvantaged persons at these institutions. The research has highlighted the need for institutional leaders to embody their own mission and vision as they frame social justice issues for the campus community. Finally, the paper provides recommendations to institutions for strengthening high-level diversity and inclusion programs/initiatives among staff, students and administrators. The conclusion stresses the importance of addressing the historical and current policies and practices that either facilitate or negate the goals of social justice, encouraging these privileged institutions to create internal committees or task forces that focus on racial and ethnic disparities in the institution.

Keywords: diversity, higher education, inclusion, social justice

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3795 Reallocation of Bed Capacity in a Hospital Combining Discrete Event Simulation and Integer Linear Programming

Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

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The number of inpatient admissions in the UK has been significantly increasing over the past decade. These increases cause bed occupancy rates to exceed the target level (85%) set by the Department of Health in England. Therefore, hospital service managers are struggling to better manage key resource such as beds. On the other hand, this severe demand pressure might lead to confusion in wards. For example, patients can be admitted to the ward of another inpatient specialty due to lack of resources (i.e., bed). This study aims to develop a simulation-optimization model to reallocate the available number of beds in a mid-sized hospital in the UK. A hospital simulation model was developed to capture the stochastic behaviours of the hospital by taking into account the accident and emergency department, all outpatient and inpatient services, and the interactions between each other. A couple of outputs of the simulation model (e.g., average length of stay and revenue) were generated as inputs to be used in the optimization model. An integer linear programming was developed under a number of constraints (financial, demand, target level of bed occupancy rate and staffing level) with the aims of maximizing number of admitted patients. In addition, a sensitivity analysis was carried out by taking into account unexpected increases on inpatient demand over the next 12 months. As a result, the major findings of the approach proposed in this study optimally reallocate the available number of beds for each inpatient speciality and reveal that 74 beds are idle. In addition, the findings of the study indicate that the hospital wards will be able to cope with 14% demand increase at most in the projected year. In conclusion, this paper sheds a new light on how best to reallocate beds in order to cope with current and future demand for healthcare services.

Keywords: bed occupancy rate, bed reallocation, discrete event simulation, inpatient admissions, integer linear programming, projected usage

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3794 Plant Species Composition and Frequency Distribution Along a Disturbance Gradient in Kano Metropolis Nigeria

Authors: Hamisu Jibril

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The study explores changes in plant species composition along disturbance gradient in urban areas in Nigeria at Bayero University Kano campuses. The aim is to assess changes in plant species composition and distribution within a degraded dryland environment in Kano Metropolis, Nigeria. Vegetation sampling was conducted using plots quadrat and transect methods, and different plant species were identified in the three study sites. Data were analyzed using ANOVA, t-tests and conventional indices to compare species richness, evenness and diversity. The study found no significant differences in species frequency among sites or sampling methods but observed higher species richness, evenness and diversity values in grasses species compared to trees. The study addressed changes in plant species composition along a disturbance gradient in an urban environment, focusing on species richness, evenness, and diversity. The study contributes to understanding the vegetation dynamics in degraded urban environments and highlights the need for conservation efforts. The research also adds to the existing literature by confirming previous findings and suggesting re-planting efforts. The study suggests similarities in plant species composition between old and new campus areas and emphasizes the importance of further investigating factors leading to vegetation loss for conservation purposes.

Keywords: species diversity, urban kano, dryland environment, vegetation sampling

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3793 Mite Soil as Biological Indicators the Quality of the Soil in the Forested Area of the Coast of Algeria

Authors: Soumeya Fekkoun, Djelloul Ghezali, Doumandji Salaheddine

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The majority of the mite soil contributes to decompose the organic matter in the soil, the richness or poverty is a way of knowing the quality of the soil, in this regard we studied the ecological side of the soil mite in a forest park «coast of Algeria». 6 by taking soil samples every month for the year 2010/2011 .The samples are collected and extracted using the technique of Berlese Tullgren. It was obtained 604 individuals. These riches can indicate the fertility of soil and knead the high proportion of organic material in it. The largest number observed in the spring, followed by the separation of the 252 individuals fall 222 individuals and then the summer with 106 individuals and winter 80 individuals. Among the 18 families obtained. Scheloribatidae is the most dominant with 30.6% followed by Ceratozetidae with 16%, then Euphthiracaridae 14%. The families remain involved with low percentages. the diversity index Schanonweaver varied between 2.3 bits in the summer and 3.83 bits in the spring. As the results of the analysis statistic confirm the existence of a clear difference between the four seasons and the richness of soil mite and diversity.

Keywords: soil mite, forest, coast of Algeria, diversity

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3792 Improving Cyber Resilience in Mobile Field Hospitals: Towards an Assessment Model

Authors: Nasir Baba Ahmed, Nicolas Daclin, Marc Olivaux, Gilles Dusserre

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The Mobile field hospital is critical in terms of managing emergencies in crisis. It is a sub-section of the main hospitals and the health sector, tasked with delivering responsive, immediate, and efficient medical services during a crisis. With the aim to prevent further crisis, the assessment of the cyber assets follows different methods, to distinguish its strengths and weaknesses, and in turn achieve cyber resiliency. The work focuses on assessments of cyber resilience in field hospitals with trends growing in both the field hospital and the health sector in general. This creates opportunities for the adverse attackers and the response improvement objectives for attaining cyber resilience, as the assessments allow users and stakeholders to know the level of risks with regards to its cyber assets. Thus, the purpose is to show the possible threat vectors which open up opportunities, with contrast to current trends in the assessment of the mobile field hospitals’ cyber assets.

Keywords: assessment framework, cyber resilience, cyber security, mobile field hospital

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3791 Reliability of Self-Reported Language Proficiency Measures in l1 Attrition Research: A Closer Look at the Can-Do-Scales.

Authors: Anastasia Sorokina

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Self-reported language proficiency measures have been widely used by researchers and have been proven to be an accurate tool to assess actual language proficiency. L1 attrition researchers also rely on self-reported measures. More specifically, can-do-scales has gained popularity in the discipline of L1 attrition research. The can-do-scales usually contain statements about language (e.g., “I can write e-mails”); participants are asked to rate each statement on a scale from 1 (I cannot do it at all) to 5 (I can do it without any difficulties). Despite its popularity, no studies have examined can-do-scales’ reliability at measuring the actual level of L1 attrition. Do can-do-scales positively correlate with lexical diversity, syntactic complexity, and fluency? The present study analyzed speech samples of 35 Russian-English attriters to examine whether their self-reported proficiency correlates with their actual L1 proficiency. The results of Pearson correlation demonstrated that can-do-scales correlated with lexical diversity, syntactic complexity, and fluency. These findings provide a valuable contribution to the L1 attrition research by demonstrating that can-do-scales can be used as a reliable tool to measure L1 attrition.

Keywords: L1 attrition, can-do-scales, lexical diversity, syntactic complexity

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3790 Monitoring Prolong Use of Intravenous Antibiotics: Antimicrobial Stewardship

Authors: Komal Fizza

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Irrational and non-judicious use of antibiotics pave the way for an upsurge in antibiotic resistance, diminished effectiveness of different therapeutic regimens and as well as impounding effect on disease management leading to further morbidities. In the backdrop of this the current research is aimed to assess whether antimicrobial prescribing is in accordance with the Infectious Disease Society of America Guidelines in hospitalized patients at Shifa International Hospital, Islamabad, Pakistan. Shifa International Hospital, Islamabad is a 500 bed hospital. With the help of MIS team a form wad developed that gave the information about medical records number, name of the patient, day of start of antibiotic, the day antibiotic is supposed to be stopped and as well as the diagnosis of the patient. A ward pharmacist was employed to generate this report on a daily basis. The therapeutic regiment was reviewed by the pharmacist by monitoring the clinical progress, laboratory report and diagnosis. On the basis of this information, pharmacist made suggestions and forwarded to the hospital doctors responsible for prescribing antibiotics. If desired, changes were made regularly. In the current research our main focus was to implement this action and therefore, started monitoring patients who were on antibiotic regimens for more than 10-15 days. We took this initiative since November, 2013. At the start of the program a maximum 19 patients/day were reported to be on antibiotic regimen for more than 10-15 days. After the implementation of the initiative, the number of patients was decreased to fifteen patients per day in December, further decreased to 7 in the month of January and 9 and 6 in February and March respectively. The average patient census was 350. The current pilot study highlighted the role of pharmacist in initiating antibiotic stewardship programs in hospital settings.

Keywords: stewardship, antibiotics, resistance, clinical process

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3789 Management of the Asthma Crisis in the Unit of Intensive Care of the General Hospital of Reference of Kinshasa

Authors: Eddy K. Mukadi

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The aim of this study was to provide contributing elements to improve the management of the asthma crisis in the intensive care unit of the General Reference Hospital of Kinshasa. This was a descriptive study of all patients in the intensive care unit presenting with the asthma attack during the period from February 5, 2013 to February 5, 2014. The main data were obtained from consultation registry and medical records. A total of 35 patients, 21 of whom were male (majority) compared to 14 female. Average age of patients was 46.48 plus or minus 16.98 with extremes ranging from 21-75 years. The clinic was dominated by dyspnea in 100% of cases, followed by rales with 91.4% of cases. In spite of the control of the crisis obtained after the treatment with B2 mimetic by inhalation was introduced A 91.5%; 88% corticosteroids; 80% oxygen, the therapeutic principle recommended for the management of asthma attacks was not respected in the majority of cases. This is why we suggest that improving the quality of care to be administered to patients will yield more adequate results.

Keywords: asthma crisis, intensive care, general hospital, Kinshasa

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3788 Enhancing Wayfinding and User Experience in Hospital Environments: A Study of University Medical Centre Ljubljana

Authors: Nastja Utrosa, Matevz Juvancic

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Hospital buildings are complex public environments characterized by intricate functional arrangements and architectural layouts. Effective wayfinding is essential for patients, visitors, students, and staff. However, spatial orientation planning is often overlooked until after construction. While these environments meet functional needs, they frequently neglect the psychological aspects of user experience. This study investigates wayfinding within complex urban healthcare environments, focusing on the influences of spatial design, spatial cognition, and user experience. The inherent complexity of these environments, with extensive spatial dimensions and dispersed buildings, exacerbates the problem. Gradual expansions and additions contribute to disorientation and navigational difficulties for users. Effective route guidance in urban healthcare settings has become increasingly crucial. However, research on the environmental elements that influence wayfinding in such environments remains limited. To address this gap, we conducted a study at the University Medical Centre Ljubljana (UMCL), Slovenia's largest university hospital. Using a questionnaire, we assessed how individuals' perceptions and use of outdoor hospital spaces with a diverse sample (n=179). We evaluated the area’s usability by analyzing visit frequency, stops, modes of arrival, and parking patterns and examined the visitors' age distribution. Additionally, we investigated spatial aids and the use of color as an orientation element at three specific locations within the medical center. Our study explored the impact of color on entrance selection and the effectiveness of warm versus cool colors for wayfinding. Our findings highlight the significance of graphic adjustments in shaping perceptions of hospital outdoor spaces. Most participants preferred visually organized entrances, underscoring the importance of effective visual communication. Implementing these adaptations can substantially enhance the user experience, reducing stress and increasing satisfaction in hospital environments.

Keywords: hospital layout design, healthcare facilities, wayfinding, navigational aids, spatial orientation, color, signage

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3787 A Study on Personnel Commitment Factors in Hafes Hospital

Authors: Farzaneh Bayat

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Successful and effective presence in regional and global markets along with optimal use of available utilities and proper utilization of new sources for offering desirable services based on customer satisfaction is inevitable. Commitment has a significant role in offering optimal services. Offering high quality job and desirable services to the customers are personnel’s commitment. Thus, Shiraz Chamran Hospital which is affiliated with Shiraz Medical School and is one of the orthopedic poles in southern Iran was studied. This hospital has 750 personnel and physicians which a sample of 200 of them were chosen as the statistic society for a 5 month period from June to November 2009. Main variables in this decision are: responsibility and responsiveness, job security, team work, task autonomy, gradation opportunity, information sharing, payments and commitment. The study approach is descriptive-correlative. With applied and segmental nature of the tests and statistic analysis, the 7 hypotheses were approved with 95% of certainty.

Keywords: commitment, information sharing, responsibility and responsiveness, job security, task autonomy

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3786 Effects of Front Porch and Loft on Indoor Ventilation in the Renewal of Beijing Courtyard

Authors: Zhongzhong Zeng, Zichen Liang

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In recent years, Beijing courtyards have been facing the problem of renewal and renovation, and the residents are faced with the problems of small house areas, large household sizes, old and dangerous houses, etc. Among the many renovation methods, the authors note two more common practices of using the front porch to expand the floor area and adding a loft. Residents and architects, however, did not give the ventilation performance of the significant interior consideration before beginning the remodeling. The aim of this article is to explore the good or negative impacts of both front porch and loft structures on the manner of interior ventilation in the courtyard. Ventilation, in turn, is crucial to the indoor environmental quality of a home. The major method utilized in this study is the comparative analysis method, in which the authors create four alternative house models with or without a front porch and an attic as two variables and examine internal ventilation using the CFD(Computational Fluid Dynamics) technique. The authors compare the indoor ventilation of four different architectural models with or without front porches and lofts as two variables. The results obtained from the analysis of the sectional airflow and the plane 1.5m height cloud are the existence of the loft, to a certain extent, disrupts the airflow organization of the building and makes the rear wall high windows of the building less effective. Occupying the front porch to become the area of the house has no significant effect on ventilation, but try not to occupy the front porch and add the loft at the same time in the building renovation. The findings of this study led to the following recommendations: strive to preserve the courtyard building's original architectural design and make adjustments to only the inappropriate elements or constructions. The ventilation in the loft portion is inadequate, and the inhabitants typically use the loft as a living area. This may lead to the building relying more on air conditioning in the summer, which would raise energy demand. The front porch serves as a transition place as well as a source of shade, weather protection, and inside ventilation. In conclusion, the examination of interior environments in upcoming studies should concentrate on cross-disciplinary, multi-angle, and multi-level research topics.

Keywords: Beijing courtyard renewal, CFD, indoor environment, ventilation analysis

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3785 Entomofauna Biodiversity of a Citrus Orchard in Baraki, Algeria

Authors: Ahlem Guerzou, Salheddine Doumandji

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Orchards and minimally processed with surrounding hedges form a significant source of biodiversity. These orchards are an entire ecosystem, home to a rich insect fauna associated with the presence of a large diversity of plant species. The values of the richness and diversity rise when the intensity of the chemical protection is reduced emphasizing the importance of such orchard in the conservation of biodiversity. To show the interest hedges fauna perspective, we conducted a study in an orange grove located Baraki surrounded by hedges and windbreaks consist of several plant species. With the sweep net there were the invertebrate fauna of the herbaceous and after a year of inventory was collected consists of a 2177 individuals distributed among 156 species grouped into five classes and 15 orders fauna. Hymenoptera and Diptera are in first place with 34 species (AR% = 19.3%), followed by Coleoptera with 27 species (AR% = 15.3%), Homoptera dominate in the workforce with 735 individuals (AR% = 34.1%). The Shannon-Weaver index calculated reflects a great diversity of population sampled equal to 5.2 bits. The equitability is 0.7, showing a strong trend of balance between the numbers of species present.

Keywords: biodiversity, citrus orchard, reaps net, hedges, Baraki

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3784 Analysis of Genetic Variations in Camel Breeds (Camelus dromedarius)

Authors: Yasser M. Saad, Amr A. El Hanafy, Saleh A. Alkarim, Hussein A. Almehdar, Elrashdy M. Redwan

Abstract:

Camels are substantial providers of transport, milk, sport, meat, shelter, security and capital in many countries, particularly in Saudi Arabia. Inter simple sequence repeat technique was used to detect the genetic variations among some camel breeds (Majaheim, Safra, Wadah, and Hamara). Actual number of alleles, effective number of alleles, gene diversity, Shannon’s information index and polymorphic bands were calculated for each evaluated camel breed. Neighbor-joining tree that re-constructed for evaluated these camel breeds showed that, Hamara breed is distantly related from the other evaluated camels. In addition, the polymorphic sites, haplotypes and nucleotide diversity were identified for some camelidae cox1 gene sequences (obtained from NCBI). The distance value between C. bactrianus and C. dromedarius (0.072) was relatively low. Analysis of genetic diversity is an important way for conserving Camelus dromedarius genetic resources.

Keywords: camel, genetics, ISSR, neighbor-joining

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3783 Improving Diagnostic Accuracy in Rural Medicine

Authors: Kelechi Emmanuel, Kyaw Thein Aung, William Burch

Abstract:

Introduction: Although rewarding in more ways than one, rural medicine can be challenging. The factors that lead to the challenges experienced in rural medicine include but are not limited to scarcity of resources, poor patient education inadequately trained professionals. This is the first single center study done on the challenges of and ways to improve diagnosis in rural medicine. Materials and Methods: Questionnaires were given to providers in a single hospital in rural Tennessee USA. In which providers were asked the question ‘In the past six months, what measures have you taken to improve your diagnostic accuracy given limited resources. Results: The questionnaire was passed to ten physicians working in a two hundred and twentyfive hospital bed. Physicians who participated included physicians in hospital medicine, emergency medicine, surgery, cardiology and gastroenterology. The study found that improved physical examination skills, access to specialist especially via telemedicine and affiliation to centers with more experienced professionals improved diagnosis and overall patient outcome in rural medicine. Conclusion: From this single center study, there is evidence to show that in addition to honing physical examination skills and having access to immediate results of testing done; hospital collaborations and access to highly trained specialist via telemedicine does improve diagnosis in rural medicine.

Keywords: rural medicine, diagnostic accuracy, diagnosis, telemedicine

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3782 A Profile of Out-of-Hospital Cardiac Arrest in ‘Amang’ Rodriguez Memorial Medical Center: A Prospective Cohort Study

Authors: Donna Erika E. De Jesus

Abstract:

Introduction: Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7-10%. It is crucial that CPR be initiated within 4-6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes. Methods: This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Results: 43 were male patients, comprising the majority at 73.02%. Hypertension was identified as the top co-morbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival, which comprised only hands-only CPR. Twenty-three of which were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remains dismal, as a return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

Keywords: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, emergency medical services

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3781 Healthcare Professional’s Well-Being: Case Study of Two Care Units in a Big Hospital in Canada

Authors: Zakia Hammouni

Abstract:

Healthcare professionals’ well-being is becoming a priority during this Covid-19 pandemic due to stress, fatigue, and workload. Well before this pandemic, contemporary hospitals are endowed with environmental attributes that contribute to achieving well-being within their environment with the emphasis on the patient. The patient-centered care approach has been followed by the patient-centered design approach. Studies that have focused on the physical environment in hospitals have dealt with the patient's recovery process and his well-being. Prior scientific literature has placed less emphasis on the healthcare professionals’ interactions within the physical environment and to guide hospital designers to make evidence-based design choices to meet the needs and expectations of hospital users by considering, in addition to patients, healthcare professionals. This paper examines these issues related to the daily stress of professionals who provide care in a hospital environment. In this exploratory study, the interest was to grasp the issues related to this environment and explores the current realities of newly built hospitals based on design approaches and what attributes of the physical setting support healthcare professional’s well-being. Within a constructivist approach, this study was conducted in two care units in a new hospital in a big city in Canada before the Covid-19 pandemic (august 2nd to November 2nd 2018). A spatial evaluation of these care units allowed us to understand the interaction of health professionals in their work environment, to understand the spatial behavior of these professionals, and the narratives from 44 interviews of various healthcare professionals. The mental images validated the salient components of the hospital environment as perceived by these healthcare professionals. Thematic analysis and triangulation of the data set were conducted. Among the key attributes promoting the healthcare professionals’ well-being as revealed by the healthcare professionals are the overall light-color atmosphere in the hospital and care unit, particularly in the corridors and public areas of the hospital, the maintenance and cleanliness. The presence of the art elements also brings well-being to the health professionals as well as panoramic views from the staff lounge and corridors of the care units or elevator lobbies. Despite the overall positive assessment of this environment, some attributes need to be improved to ensure the well-being of healthcare professionals and to provide them with a restructuring environment. These are the supply of natural light, softer colors, sufficient furniture, comfortable seating in the restroom, and views, which are important in allowing these healthcare professionals to recover from their work stress. Noise is another attribute that needs to be further improved in the hospital work environment, especially in the nursing workstations and consultant's room. In conclusion, this study highlights the importance of providing healthcare professionals with work and rest areas that allow them to resist the stress they face, particularly during periods of extreme stress and fatigue such as a Covid-19 pandemic.

Keywords: healthcare facilities, healthcare professionals, physical environment, well-being

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3780 Allelic Diversity of Productive, Reproductive and Fertility Traits Genes of Buffalo and Cattle

Authors: M. Moaeen-ud-Din, G. Bilal, M. Yaqoob

Abstract:

Identification of genes of importance regarding production traits in buffalo is impaired by a paucity of genomic resources. Choice to fill this gap is to exploit data available for cow. The cross-species application of comparative genomics tools is potential gear to investigate the buffalo genome. However, this is dependent on nucleotide sequences similarity. In this study gene diversity between buffalo and cattle was determined by using 86 gene orthologues. There was about 3% difference in all genes in term of nucleotide diversity; and 0.267±0.134 in amino acids indicating the possibility for successfully using cross-species strategies for genomic studies. There were significantly higher non synonymous substitutions both in cattle and buffalo however, there was similar difference in term of dN – dS (4.414 vs 4.745) in buffalo and cattle respectively. Higher rate of non-synonymous substitutions at similar level in buffalo and cattle indicated a similar positive selection pressure. Results for relative rate test were assessed with the chi-squared test. There was no significance difference on unique mutations between cattle and buffalo lineages at synonymous sites. However, there was a significance difference on unique mutations for non synonymous sites indicating ongoing mutagenic process that generates substitutional mutation at approximately the same rate at silent sites. Moreover, despite of common ancestry, our results indicate a different divergent time among genes of cattle and buffalo. This is the first demonstration that variable rates of molecular evolution may be present within the family Bovidae.

Keywords: buffalo, cattle, gene diversity, molecular evolution

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3779 An Improved Transmission Scheme in Cooperative Communication System

Authors: Seung-Jun Yu, Young-Min Ko, Hyoung-Kyu Song

Abstract:

Recently developed cooperative diversity scheme enables a terminal to get transmit diversity through the support of other terminals. However, most of the introduced cooperative schemes have a common fault of decreased transmission rate because the destination should receive the decodable compositions of symbols from the source and the relay. In order to achieve high data rate, we propose a cooperative scheme that employs hierarchical modulation. This scheme is free from the rate loss and allows seamless cooperative communication.

Keywords: cooperative communication, hierarchical modulation, high data rate, transmission scheme

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3778 A Model for Operating Rooms Scheduling

Authors: Jose Francisco Ferreira Ribeiro, Alexandre Bevilacqua Leoneti, Andre Lucirton Costa

Abstract:

This paper presents a mathematical model in binary variables 0/1 to make the assignment of surgical procedures to the operating rooms in a hospital. The proposed mathematical model is based on the generalized assignment problem, which maximizes the sum of preferences for the use of the operating rooms by doctors, respecting the time available in each room. The corresponding program was written in Visual Basic of Microsoft Excel, and tested to schedule surgeries at St. Lydia Hospital in Ribeirao Preto, Brazil.

Keywords: generalized assignment problem, logistics, optimization, scheduling

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3777 Organizational Culture of a Public and a Private Hospital in Brazil

Authors: Fernanda Ludmilla Rossi Rocha, Thamiris Cavazzani Vegro, Silvia Helena Henriques Camelo, Carmen Silvia Gabriel, Andrea Bernardes

Abstract:

Introduction: Organizations are cultural, symbolic and imaginary systems composed by values and norms. These values and norms represent the organizational culture, which determines the behavior of the workers, guides the work practices and impacts the quality of care and the safety culture of health services worldwide. Objective: To analyze the organizational culture of a public and a private hospital in Brazil. Method: Descriptive study with quantitative approach developed in a public and in a private hospital of Brazil. Sample was composed by 281 nursing workers, of which 73 nurses and 208 nursing auxiliaries and technicians. The data collection instrument comprised the Brazilian Instrument for Assessing Organizational Culture. Data were collected from March to December 2013. Results: At the public hospital, the results showed an average score of 2.85 for the values concerning cooperative professionalism (CP); 3.02 for values related to hierarchical rigidity and the centralization of power (HR); 2.23 for individualistic professionalism and competition at work (IP); 2.22 for values related to satisfaction, well-being and motivation of workers (SW); 3.47 for external integration (EI); 2.03 for rewarding and training practices (RT); 2.75 for practices related to the promotion of interpersonal relationships (IR) About the private hospital, the results showed an average score of 3.24 for the CP; 2.83 for HR; 2.69 for IP; 2.71 for SW; 3.73 for EI; 2.56 for RT; 2.83 for IR at the hospital. Discussion: The analysis of organizational values of the studied hospitals shows that workers find the existence of hierarchical rigidity and the centralization of power in the institutions; believed there was cooperation at workplace, though they perceived individualism and competition; believed that values associated with the workers’ well-being, satisfaction and motivation were seldom acknowledged by the hospital; believed in the adoption of strategic planning actions within the institution, but considered interpersonal relationship promotion, continuous education and the rewarding of workers to be little valued by the institution. Conclusion: This work context can lead to professional dissatisfaction, compromising the quality of care and contributing to the occurrence of occupational diseases.

Keywords: nursing management, organizational culture, quality of care, interpersonal relationships

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3776 Total Parenteral Nutrition Wastage: A Retrospective Cohort Study in a Small District General Hospital

Authors: Muhammad Faizan Butt, Maria Ambreen Tahir, Joshua James Pilkington, A. A. Warsi

Abstract:

Background: Total parenteral nutrition (TPN) use within the NHS is crucial in the prevention of malnourishment. TPN prescriptions are tailored to an individual patient’s needs. TPN bags come in fixed sizes, and minimizing wastage has financial and sustainability implications for the health service. The aim of the study is to assess current prescribing practices, look at the volume of TPN wastage and identify reasons for it. Methodology: A retrospective cohort study on TPN prescriptions over a period of 1 year (Jan-Dec 2022) was performed. All patients prescribed TPN that had been admitted under a general surgery consultant in a small district hospital were included. Data were extracted from hospital electronic records and dietician charts. Data were described, and reasons for TPN wastage were explored. Results: 49 patients were identified. The average length of TPN prescription was 8 days (median). This totaled 608 prescriptions. Of the bags prescribed, 258, 169, and 181 were 10g (2500ml), 14g (2000ml), and 18g (2000ml), respectively. The mean volume wasted from each type of bag was 634ml, 634ml, and 648ml, respectively. Reasons for TPN wastage identified were: no loss (25%), smaller bags not available (53.6%), step-down regime (8.1%), and other (12.2%). Conclusion: This study has identified that the current stocking and prescribing of TPN within a district general hospital leads to a significant wastage of 638.2ml (average). The commonest reason for wastage is the non-availability of a more appropriate sized bag.

Keywords: general surgery, TPN, sustainability, wastage

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3775 Fish Diversity of Two Lacustrine Wetlands of the Upper Benue Basin, Nigeria

Authors: D. L. David, J. A. Wahedi, Q. T. Zaku

Abstract:

A study was conducted at River Mayo Ranewo and River Lau, Taraba State Nigeria. The two rivers empty into the Upper Benue Basin. A survey of visual encounter was conducted within the two wetlands from June to August, 2014. The fish record was based entirely on landings of fishermen, number of canoes that land fish was counted, types of nets and baits used on each sampling day. Fishes were sorted into taxonomic groups, identified to family/ species level, counted and weighed in groups by species. Other aquatic organisms captured by the fishermen were scallops, turtles and frogs. The relative species abundance was determined by dividing the number of species from a site by the total number of species from all tributaries/sites. The fish were preserved in 2% formaldehyde solution and taken to the laboratory, were identified through keys of identification to African fishes and field guides. Shannon-Wieiner index of species diversity indicated that the diversity was highest at River Mayo Ranewo than River Lau. Results showed that at River Mayo Ranewo, the family Mochokidae recorded the highest (23.15%), followed by Mormyridae (22.64%) and the least was the family Lepidosirenidae (0.04%). While at River Lau, the family Mochokidae recorded the highest occurrence of (24.1%), followed by Bagridae (20.20%), and then Mormyridae, which also was the second highest in River Lau, with 18.46% occurrence. There was no occurrence of Malapteruridae and Osteoglossidae (0%) in River Lau, but the least occurrence was the family Gymnarchidae (0.04%). According to the result from the t-test, the fish composition was not significantly different (p≤0.05).

Keywords: Diversity Index, Lau, Mayo Ranewo, Wetlands

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3774 Attitudes toward Cultural Diversity: A Study of Russian Teachers

Authors: Rezeda Khairutdinova, Chulpan Gromova, Dina Birman

Abstract:

The paper presents results of an exploratory study of teachers’ social attitudes toward ethnic and religious diversity, and variables influencing such attitudes. The study was conducted in Russia and is focused on school teachers, given their special role in culturally diverse modern societies. Using the social distance scale (adapted from Bogardus, 1926), we sampled 355 school teachers from two Russian regions known for their high cultural diversity: Moscow and Moscow region, Kazan and Republic of Tatarstan, and measured teacher attitudes toward large religious and ethnic groups (including migrants). The findings showed that teachers hold mostly tolerant attitudes with respect to members belonging to culturally and religiously diverse groups. The social distance between respondents and native residents of their region was minimal. Social distance was larger with respect to such ethnic groups as migrants from the Caucasian and Central Asian countries. The analysis of perception of different religious groups also showed positive attitudes toward these groups and readiness to interact with them. Teacher attitudes were not related to their age or ethnicity. The findings indicated that there was a significant correlation between social distance and the region of residence on the one hand, and between social distance and the degree of social interaction on the other. The results of this study will be used to develop a large-scale study to contribute to a better understanding of teacher attitudes toward immigrant students in public schools.

Keywords: attitudes of teachers, cultural diversity, migrants, social distance

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3773 Nucleotide Diversity and Bacterial Endosymbionts of the Black Cherry Aphid Myzus cerasi (Fabricus, 1775) (Hemiptera: Aphididae) from Turkey

Authors: Burcu Inal, Irfan Kandemir

Abstract:

Sequences of mitochondrial cytochrome oxidase I (COI) gene of twenty-five Turkish and one Greek Myzus cerasi (Fabricus) (Hemiptera: Aphididae) in populations were collected from Prunus avium and Prunus cerasus. The partial coding region of COI studied is 605 bp for all the populations, from which 565 nucleotides were conserved, 40 were variable, 37 were singleton, and 3 sites were parsimony-informative. Four haplotypes were identified based on nucleotide substitutions, and the mean of intraspecific divergence was calculated to be 0.3%. Phylogenetic trees were constructed using Maximum Likelihood, Minimum Evolution, Neighbor-joining, and Unweighed Pair Group Method of Arithmetic Averages (UPGMA) and Myzus persicae (Sulzer) and Myzus borealis Ossiannilson were included as outgroups. The population of M. cerasi from Isparta diverged from the rest of the groups and formed a clade (Haplotype B) with Myzus borealis. The rest of the haplotype diversity includes Haplotype A and Haplotype C with individuals characterized as Myzus cerasi pruniavium and Haplotype D with Myzus cerasi cerasi. M. cerasi diverge into two subspecies and it must be reevaluated whether this pest is monophagous or oligophagous in terms of plant type dependence. The obligated endosymbiont Buchnera aphidicola was also found during this research, but no facultative symbionts could be found. It is expected further studies will be required for a complete barcoding and diversity of bacterial endosymbionts present.

Keywords: bacterial endosymbionts, barcoding, black cherry aphid, nucleotide diversity

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