Search results for: hospital site suitability

Authors: Nihayatul Munaa, Nyoman A. Damayanti

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This study seeks to understand what factors might influence a patient’s perception of health care under national health insurance in early implementation. In Indonesia, National Health Insurance was first implemented in 2014 and planned to achieve universal health coverage by 2019. However, the little understanding of this new policy lead to increase of complaint in hospital as a health care provider. This is a observational descriptive study with cross sectional design method. Data was collected through in-depth interview with 96 patient from Jemursari Islamic Hospital of Surabaya (Rumah Sakit Islam Jemursari Surabaya) who participate in National Health Insurance. Subject was selected by simple random sampling. The findings demonstrated that from five categories, 82,3% patient was satisfied in reliability aspect and 85,4% in assurance aspect, while in tangible, responsiveness and empathy aspect > 90% patient was satisfied. Meanwhile, in Indonesia, the minimum service standard of healthcare of patient satisfaction is 90%.

Keywords: patient’s satisfaction, national health insurance, hospital, complaint

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Authors: Haitham Al Rawahi

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Oman Electricity Transmission Company (OETC) has implemented Computerized Maintenance Management System (CMMS), which is based on Oracle enterprise asset management model e-AM. This was implemented with cooperation of Nama Shared Services (NSS). CMMS is mainly used to create maintenance work orders with a preconfigured workflow of defined maintenance schedules/plans, required resources, and materials, obtaining shutdown approvals, completing maintenance activities, and closing the work orders. Furthermore, CMMS is also configured with asset failure classifications, asset hierarchy, asset maintenance activities, integration with spare inventories, etc. Since the year 2017, site engineer is working on CMMS by filling-in manually all related maintenance and inspection records on paper forms and then scanning and attaching it in CMMS for further analysis. Site engineer will finalize all paper works at site and then goes back to office to scan and attach it to work order in CMMS. This creates sub tasks for site engineer and makes it very difficult and lengthy process. Also, there is a significant risk for missing or deleted important fields on the paper due to usage of pen to fill the paper. In addition to that, site engineer may take time and days working outside of the office. therefore, OETC has decided to digitize these inspection and maintenance forms in one platform in CMMS, and it can be opened with both functionalities online and offline. The ArcGIS product formats or web-enabled solutions which has ability to access from mobile and desktop devices via arc map modules will be used too. The purpose of interlinking is to setup for maintenance and inspection forms to work orders in e-AM, which the site engineer has daily interactions with. This ArcGIS environment or tool is designed to link with e-AM, so when site engineer opens this application from the site and a window will take him through same ArcGIS. This window opens the maintenance forms and shows the required fields to fill-in and save the work through his mobile application. After saving his work with the availability of network (Off/In) line, notification will trigger to his line manager to review and take further actions (approve/reject/request more information). In this function, the user can see the assigned work orders to his departments as well as chart of all work orders with status. The approver has ability to see the statistics of all work.

Keywords: e-AM, GIS, CMMS, integration

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Authors: Rebiahi Sid Ahmed, Boutarfi Zakaria, Rahmoun Malika, Antonio Galvez

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The objective of this study was to explore the possible correlation between resistance to antibiotics and tolerance to biocides in Gram-negative bacilli isolated from the University Hospital Center of Tlemcen. This study focused on 175 clinical isolates of Gram-negative bacilli, it is a question of exploring: their level and profile of resistance to antibiotics, their tolerance to biocides, as well as the identification of the genetic supports of this resistance. Enterobacter spp. was the most predominant bacterial genus, all isolates harbored at least one of the studied genes with significant resistance capacity. Our results show, in some cases, a possible positive correlation between the presence of biocide tolerance genes and those of antibiotic resistance; in fact, tolerance to biocides could be one of the co-selection factors for antibiotic resistance. The results of this study should encourage the good practice of hygiene measures as well as the rational use of antimicrobials in order to hinder the development and emergence of resistance in our hospital departments.Mots clés : Antibiotiques, Biocides, Enterobacter, Hôpital, Résistance,

Keywords: antibiotic, biocides, enterobacter, hospital, resistance

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Authors: Rifaldy, Misbahudin, Khalid Rizky, Ricky Aryanto, M. Alfiyan Bagus, Fahri Septianto, Firman Najib Wibisana, Excobar Arman

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Indonesia is a country that has a high level of disaster because it is on the ring of fire, and there are several regions with three major plates meeting in the world. So that disaster analysis must always be done to see the potential disasters that might always occur, especially in this research are landslides and liquefaction. This research was conducted to analyze areas that are vulnerable to landslides and liquefaction hazards and their relationship with the assessment of the issue of moving the new capital of the Republic of Indonesia to the island of Kalimantan with a total area of 612,267.22 km². The method in this analysis uses the Analytical Hierarchy Process and consistency ratio testing as a complex and unstructured problem-solving process into several parameters by providing values. The parameters used in this analysis are the slope, land cover, lithology distribution, wetness index, earthquake data, peak ground acceleration. Weighted overlay was carried out from all these parameters using the percentage value obtained from the Analytical Hierarchy Process and confirmed its accuracy with a consistency ratio so that a percentage of the area obtained with different vulnerability classification values was obtained. Based on the analysis results obtained vulnerability classification from very high to low vulnerability. There are (0.15%) 918.40083 km² of highly vulnerable, medium (20.75%) 127,045,44815 km², low (56.54%) 346,175.886188 km², very low (22.56%) 138,127.484832 km². This research is expected to be able to map landslides and liquefaction disasters on the island of Kalimantan and provide consideration of the suitability of regional development of the new capital of the Republic of Indonesia. Also, this research is expected to provide input or can be applied to all regions that are analyzing the vulnerability of landslides and liquefaction or the suitability of the development of certain regions.

Keywords: analytic hierarchy process, Borneo Island, landslide and liquefaction, vulnerability analysis

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Authors: Nouha Mhimdi, Wahiba Ben Abdessalem Karaa, Henda Ben Ghezala

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The methods identified in data collection are diverse: electronic media, focus group interviews and short-answer questionnaires [1]. The collection of poor-quality data resulting, for example, from poorly designed questionnaires, the absence of good translators or interpreters, and the incorrect recording of data allow conclusions to be drawn that are not supported by the data or to focus only on the average effect of the program or policy. There are several solutions to avoid or minimize the most frequent errors, including obtaining expert advice on the design or adaptation of data collection instruments; or use technologies allowing better "anonymity" in the responses [2]. In this context, we opted to collect good quality data by doing a sizeable questionnaire-based survey on hospital emergencies to improve emergency services and alleviate the problems encountered. At the level of this paper, we will present our study, and we will detail the steps followed to achieve the collection of relevant, consistent and practical data.

Keywords: data collection, survey, questionnaire, database, data analysis, hospital emergencies

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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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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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Authors: Hoo Cheol Lee, Dae Seung Kim, Sang Myung Jung, Gwang Heum Yoon, Hwa Sung Shin

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Loss of bone tissue can occur due to a bone tissue disease and aging or fracture. Renewable formation of bone is mainly made by its differentiation and metabolism. For this reason, osteoblasts have been studied for regeneration of bone tissue. So, tissue engineering has attracted attention as a recovery means. In tissue engineering, a particularly important factor is a scaffold that supports cell growth. For osteoblast scaffold, we used the cellulose nanowhisker (CNW) extracted from marine organism. CNW is one of an abundant material obtained from a number of plants and animals. CNW is polymer consisting of monomer cellulose and this composition offers biodegradability and biocompatibility to CNW. Mechanical strength of CNW is superior to the existing natural polymers. In addition, substances of marine origin have a low risk of secondary infection by bacteria and pathogen in contrast with those of land-derived. For evaluating its suitability as an osteoblast scaffold, we fabricate CNW film for osteoblast culture and performed the MTT assay and ALP assay to confirm its cytotoxicity and effect on differentiation. Taking together these results, we assessed CNW is a potential candidate of a material for bone tissue regeneration.

Keywords: bone regeneration, cellulose nanowhisker, marine derived material, osteoblast

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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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Authors: V. Balamuralidhara

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The aim of the present work was to develop Paclitaxel loaded polyacrylamide grafted guar gum nanoparticles as pH responsive nanoparticle systems for targeting colon. The pH sensitive nanoparticles were prepared by modified ionotropic gelation technique. The prepared nanoparticles showed mean diameters in the range of 264±0.676 nm to 726±0.671nm, and a negative net charge 10.8 mV to 35.4mV. Fourier Transformed Infrared Spectroscopy (FT-IR) and Differential Scanning Calorimetry (DSC) studies suggested that there was no chemical interaction between drug and polymers. The encapsulation efficiency of the drug was found to be 40.92% to 48.14%. The suitability of the polyacrylamide grafted guar gum ERN’s for the release of Paclitaxel was studied by in vitro release at pH 1.2 and 7.4. It was observed that, there was no significant amount of drug release at gastric pH and 97.63% of drug release at pH 7.4 was obtained for optimized formulation F3 at the end of 12 hrs. In vivo drug targeting performance for the prepared optimized formulation (F3) and pure drug Paclitaxel was evaluated by HPLC. It was observed that the polyacrylamide grafted guar gum can be used to prepare nanoparticles for targeting the drug to the colon. The release performance was greatly affected by the materials used in ERN’s preparation, which allows maximum release at colon’s pH. It may be concluded that polyacrylamide grafted guar gum nanoparticles loaded with paclitaxel have desirable release responsive to specific pH. Hence it is a unique approach for colonic delivery of drug having appropriate site specificity and feasibility and controlled release of drug.

Keywords: colon targeting, polyacrylamide grafted guar gum nanoparticles, paclitaxel, nanoparticles

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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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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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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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Authors: Bing-Shun Huang, Hung-Ju Chiu, Wen-Kai Hsieh, Hsiu-Chuan Lin, Ming-Lung Hung

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Taiwan's solar photovoltaic target in 2025 is 20 GW, of which the fish-electricity symbiosis target is 4 GW. In the future, many solar photovoltaic installations may cause local environmental or social impacts. Therefore, the Taiwan government inspects the fish-electricity symbiosis to reduce the impact of solar photovoltaics on the local environment or society. This stuy takes the symbiosis of fishery and electricity in Kaohsiung City as an example to explore Taiwan's environmental and social inspection practices. It mainly analyzes the two aspects of environmental ecology and social economy. The results show that the environmental inspection is mainly through site surveys, ecological information mapping, on-site interviews, and public consultation meetings. Social inspection mainly includes document analysis, on-site interviews, site surveys, expert discussions, and public consultations to identify possible local problems. Although the government had recognized the local issues, the future status may also change. It is recommended that future photoelectric companies should reconfirm the current situation of development sites when applying for the installation and propose countermeasures to solve the problem.

Keywords: taiwan, fish-electricity symbiosis, environment, society, inspection

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Authors: Buket Metin

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Buildings cause a variety of loads on the environment due to activities performed at each stage of the building life cycle. Construction is the first stage that affects both the natural and built environments at different steps of the process, which can be defined as transportation of materials within the construction site, formation and preparation of materials on-site and the application of materials to realize the building subsystems. All of these steps require the use of technology, which varies based on the facilities that contractors and subcontractors have. Hence, environmental consequences of the construction process should be tackled by focusing on construction technology options used in every step of the process. This paper presents an environmental decision-making model for assessing on-site performances of subcontractors based on the construction technology options which they can supply. First, construction technologies, which constitute information, tools and methods, are classified. Then, environmental performance criteria are set forth related to resource consumption, ecosystem quality, and human health issues. Finally, the model is developed based on the relationships between the construction technology components and the environmental performance criteria. The Fuzzy Analytical Hierarchy Process (FAHP) method is used for weighting the environmental performance criteria according to environmental priorities of decision-maker(s), while the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method is used for ranking on-site environmental performances of subcontractors using quantitative data related to the construction technology components. Thus, the model aims to provide an insight to decision-maker(s) about the environmental consequences of the construction process and to provide an opportunity to improve the overall environmental performance of construction sites.

Keywords: construction process, construction technology, decision making, environmental performance, subcontractor

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Authors: Tsegaw Abebe, Temesgen Abebe

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Land degradation is one of a serious environmental challenge in Ethiopia and is one of the major underlying causes for declining agricultural productivity. The Ethiopia government realized the significance of environmental restoration specifically on deforested and degraded land after the 1973 and 1984/85 major famines that struck the country. Among the various conservation strategies, the establishment of area exclosures have been regarded as an effective response to halt and reverse the problems of land degradation. There are limited studies in Ethiopia dealing how the conversion of free grazing lands and degraded lands by closures increase biomass accumulation. However, these studies are not sufficient to conclude about the strength of area closures to restore degraded vegetations at the diverse agro-ecological condition. The overall objective of this study was, therefore, to assess and evaluate the usefulness of area closure technique in enhancing rehabilitation of degraded ecosystem and thereby increase the natural capital in the study site (southern Ethiopia). Woody plant species were collected from area exclosure for eight year and adjacent degraded land with similar landscape positions using systematic sampling plot design technique. Woody species diversity was determined by Shannon diversity. Comparative assessment result of woody plant species analysis showed that the density of woody species in the exclosure and degraded site were 778 and 222 individuals per hectare, respectively. A total of 16 woody species, representing 12 families were recorded in the study site. Out of the 12 families, all were recorded in the exclosure while 5 were recorded in the degraded site. Out of the 16 species, 15 were recorded in the exclosure while six were in the degraded site. A total of 10 species were recorded in the exclosure, which were absent in the degraded site. Similarly, one species was recorded in the degraded site which was not present in the exclosure. The results showed that protecting of degraded site from human and animal disturbances promotes woody plant species regenerations and productivity Apart from increasing woody plant species, the local communities have benefited from the exclosure in the form of both products (grass harvesting) and services (ecological). Due to this reason the local communities have positive attitudes and contribute a lot for the success of enclosures in the study site. The present study clearly showed that area closure interventions should be oriented towards managing and improving the productivity of the degraded land, in such a way that both the need for conservation of biodiversity and environmental sustainability, and the demands of the local people for biomass resources can be achieved.

Keywords: degraded land, exclosure, land restoration, woody vegetation

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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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Authors: Ana Violante, Jodie Maccarrone, Maria Fimiani

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In the United States, over 30 million people are hospitalized annually for conditions that require acute, 24-hour, supervised care. The experience of hospitalization can be traumatic, exposing the patient to loss of control, autonomy, and productivity. Furthermore, 40% of patients admitted to hospitals for general medical illness have a comorbid psychiatric diagnosis. Research suggests individuals admitted with psychiatric comorbidities experience poorer health outcomes, higher utilization rates and increased overall cost of care. Empirical work suggests hospital settings that include a consultation liaison (CL) service report reduced length of stay, lower costs per patient, improved medical staff and patient satisfaction and reduced readmission after 180 days. Despite the overall positive impact CL services can have on patient care, it is estimated that only 1% - 2.8% of hospital admits receive these services, and most research has been conducted by the field of psychiatry. Health psychologists could play an important role in increasing access to this valuable service, though the extent to which health psychologists participate in CL settings is not well known. Objective: Outline the preliminary findings from an empirical study to understand how many APPIC internship training programs offer adult consultation liaison rotations within inpatient hospital settings nationally, as well as describe the specific nature of these training experiences. Research Method/Design: Data was exported into Excel from the 2022-2023 APPIC Directory categorized as “health psychology” sites. It initially returned a total of 537 health training programs out 1518 total programs (35% of all APPIC programs). A full review included a quantitative and qualitative comprehensive review of the APPIC program summary, the site website, and program brochures. The quantitative review extracted the number of training positions; amount of stipend; location or state of program, patient, population, and rotation. The qualitative review examined the nature of the training experience. Results: 29 (5%) of all APPIC health psychology internship training programs (2%) respectively of all APPIC training internship programs offering internship CL training were identified. Of the 29 internship training programs, 16 were exclusively within a pediatric setting (55%), 11 were exclusively within an adult setting (38%), and two were a mix of pediatric and adult settings (7%). CL training sites were located to 19 states, offering a total of 153 positions nationally, with Florida containing the largest number of programs (4). Only six programs offered 12-month training opportunities while the rest offered CL as a major (6 month) to minor (3-4 month) rotation. The program’s stipend for CL training positions ranged from $25,000 to $62,400, with an average of $32,056. Conclusions: These preliminary findings suggest CL training and services are currently limited. Training opportunities that do exist are mostly limited to minor, short rotations and governed by psychiatry. Health psychologists are well-positioned to better define the role of psychology in consultation liaison services and enhance and formalize existing training protocols. Future research should explore in more detail empirical outcomes of CL services that employ psychology and delineate the contributions of psychology from psychiatry and other disciplines within an inpatient hospital setting.

Keywords: consultation liaison, health psychology, hospital setting, training

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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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Authors: M. Al Azri, M. Elzain, K. Bouziane, S. M. Chérif

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n-Type 6H-SiC(0001) substrates were implanted with three fluencies of Mn+ 5x1015 Mn/cm2 (Mn content: 0.7%), 1x1016 (~2 %), and 5x1016 cm–2 (7%) with implantation energy of 80 keV and substrate temperature of 365ºC. The samples were characterized using Rutherford Backscattering and Channeling Spectroscopy (RBS/C), High-Resolution X-Ray Diffraction technique (HRXRD), micro-Raman Spectroscopy (μRS), and Superconducting Quantum Interference Device (SQUID) techniques. The aim of our work is to investigate implantation induced defects with dose and to study any correlation between disorder-composition and magnetic properties. In addition, ab-initio calculations were used to investigate the structural and magnetic properties of Mn-doped 6H-SiC. Various configurations of Mn sites and vacancy types were considered. The calculations showed that a substitutional Mn atom at Si site possesses larger magnetic moment than Mn atom at C site. A model is introduced to explain the dependence of the magnetic structure on site occupation. The magnetic properties of ferromagnetically (FM) and antiferromagnetically (AFM) coupled pairs of Mn atoms with and without neighboring vacancies have also been explored.

Keywords: ab-initio calculations, diluted magnetic semiconductors, magnetic properties, silicon carbide

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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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Authors: Malay K. Pramanik

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In recent years, climate change has become a major threat and has been widely documented in the geographic distribution of many plant species. However, the impacts of climate change on the distribution of ecologically vulnerable medicinal species remain largely unknown. The identification of a suitable habitat for a species under climate change scenario is a significant step towards the mitigation of biodiversity decline. The study, therefore, aims to predict the impact of current, and future climatic scenarios on the distribution of the threatened Garcinia indica across the northern Western Ghats using Maximum Entropy (MaxEnt) modelling. The future projections were made for the year 2050 and 2070 with all Representative Concentration Pathways (RCPs) scenario (2.6, 4.5, 6.0, and 8.5) using 56 species occurrence data, and 19 bioclimatic predictors from the BCC-CSM1.1 model of the Intergovernmental Panel for Climate Change’s (IPCC) 5th assessment. The bioclimatic variables were minimised to a smaller number of variables after a multicollinearity test, and their contributions were assessed using jackknife test. The AUC value of 0.956 ± 0.023 indicates that the model performs with excellent accuracy. The study identified that temperature seasonality (39.5 ± 3.1%), isothermality (19.2 ± 1.6%), and annual precipitation (12.7 ± 1.7%) would be the major influencing variables in the current and future distribution. The model predicted 10.5% (19318.7 sq. km) of the study area as moderately to very highly suitable, while 82.60% (151904 sq. km) of the study area was identified as ‘unsuitable’ or ‘very low suitable’. Our predictions of climate change impact on habitat suitability suggest that there will be a drastic reduction in the suitability by 5.29% and 5.69% under RCP 8.5 for 2050 and 2070, respectively. Finally, the results signify that the model might be an effective tool for biodiversity protection, ecosystem management, and species re-habitation planning under future climate change scenarios.

Keywords: Garcinia Indica, maximum entropy modelling, climate change, MaxEnt, Western Ghats, medicinal plants

Procedia PDF Downloads 157

Authors: Yehya Rasool, Mohit Agrawal

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The site characterization and site response analysis are the crucial steps for reliable seismic microzonation of an area. So, the basic parameters involved in these fundamental steps are required to be chosen properly in order to efficiently characterize the vulnerable sites of the study region. In this study, efforts are made to delineate the variations in the physical parameter of the soil for the summer and monsoon seasons of the year (2021) by using Horizontal-to-Vertical Spectral Ratios (HVSRs) recorded at five sites of the Indian Institute of Technology (Indian School of Mines), Dhanbad, Jharkhand, India. The data recording at each site was done in such a way that less amount of anthropogenic noise was recorded at each site. The analysis has been done for five seismic parameters like predominant frequency, H/V ratio, the phase velocity of Rayleigh waves, shear wave velocity (Vs), compressional wave velocity (Vp), and Poisson’s ratio for both the seasons of the year. From the results, it is observed that these parameters majorly vary drastically for the upper layers of soil, which in turn may affect the amplification ratios and probability of exceedance obtained from seismic hazard studies. The HVSR peak comes out to be higher in monsoon, with a shift in predominant frequency as compared to the summer season of the year 2021. Also, the drastic reduction in shear wave velocity (up to ~10 m) of approximately 7%-15% is also perceived during the monsoon period with a slight decrease in compressional wave velocity. Generally, the increase in the Poisson ratios is found to have higher values during monsoon in comparison to the summer period. Our study may be very beneficial to various agricultural and geotechnical engineering projects.

Keywords: HVSR, shear wave velocity profile, Poisson ratio, microtremor data

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Authors: Kelechi Emmanuel, Kyaw Thein Aung, William Burch

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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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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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Authors: Donna Erika E. De Jesus

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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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Authors: Zakia Hammouni

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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

Procedia PDF Downloads 127

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

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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

Procedia PDF Downloads 292

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

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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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Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

Procedia PDF Downloads 242