Search results for: humanized care service

Authors: Sadaf Shaikh, Aishwariya Kapoor, Mustabshira Tahir, Zille Huma

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In accordance with national criteria, the purpose of this audit is to assess how quickly Doppler ultrasound can diagnose suspected deep vein thrombosis (DVT). In particular, it emphasizes the 4- and 24-hour ultrasound imaging targets that are advised by medical guidelines. In order to avoid consequences like pulmonary embolism or post-thrombotic syndrome, which might result from postponed treatment, it is imperative that DVT be diagnosed promptly. Data on patients who presented with suspected DVT during a certain time period were extracted from electronic health records as part of the retrospective analysis. The study's main goal is to evaluate the hospital's compliance with the deadlines for Doppler ultrasounds performed after a clinical suspicion of DVT.

Keywords: DVT, NICE compliance, Doppler ultrasound, d-dimer testing, vascular ultrasound, service delivery standards

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Authors: Mohammed Almograbi

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Libya is one of the largest producers of dates from date palm, generating about 60000 tonnes of date palm seeds (DPS) annually. This large amount of seeds led to studies into the possible use as aggregates in lightweight concrete for some special structures. The utilization of DPS as aggregate in concrete provides a good solution as alternative aggregate to the stone aggregate. It has been recognized that, DPS can be used as coarse aggregate in structural lightweight concrete industry. For any structure member, the durability is one of the most important considerations during its service life. This paper presents the durability properties of DPS concrete. These include the water permeability, water absorption, sorptivity and chloride penetration. The test results obtained were comparable to the conventional lightweight concrete.

Keywords: date palm seeds, lightweight concrete, durability, sustainability, permeability of concrete, water absorption of concrete, sorptivity of concrete

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Authors: Tareq N. Issa

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The main pressuring challenges of global competition and high returns have forced businesses to shift their strategic competitive advantage from physical distribution management to integrated logistics management, finally moving into supply chain management. Conventionally, corporate profitability is a function of cost, capital employed, revenue and customer service. This article gives an insight into the effect of supply chain management on each of the above variables. It investigates the impact of the changing levels/ effects of these variables on corporate profitability and the means of measuring supply chain financial effectiveness. Information technology tools form the basis for supply chain optimal performance through alignment of supply chain systems in this ever increasing complexity in business decisions.

Keywords: corporate profitability, sypply chain systems, business decisions, competitive advanage

Procedia PDF Downloads 337

Authors: Taras Agryzkov, Almudena Nolasco-Cirugeda, Jose L. Oliver, Leticia Serrano-Estrada, Leandro Tortosa, Jose F. Vicent

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This paper aims to represent the commercial activity of a city taking as source data the social network Foursquare. The city of Murcia is selected as case study, and the location-based social network Foursquare is the main source of information. After carrying out a reorganisation of the user-generated data extracted from Foursquare, it is possible to graphically display on a map the various city spaces and venues –especially those related to commercial, food and entertainment sector businesses. The obtained visualisation provides information about activity patterns in the city of Murcia according to the people`s interests and preferences and, moreover, interesting facts about certain characteristics of the town itself.

Keywords: social networks, spatial analysis, data visualization, geocomputation, Foursquare

Procedia PDF Downloads 426

Authors: Anna Ghosh, Dominic Shields, Ceri McIntosh, Stephen Crank

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A 29-year-old male was a referral to the maxillofacial unit following a referral from his general dental practitioner via a routine pathway regarding a large periapical lesion on the LR4 with root resorption. The patient was asymptomatic, the LR4 vital and unrestored, and this was an incidental finding at a routine check-up. The patient's past medical history was unremarkable. Examination revealed no extra or intra-oral pathology and non-mobile teeth. No focal neurology was detected. An orthopantogram demonstrated a well-defined unilocular corticated radiolucency associated with the LR4. The root appeared shortened with the radiolucency between the root and a radio-opacity, possibly representing the displacement of the apical tip of the tooth. It was recommended that the referring general practitioner should proceed with orthograde root canal therapy, after which time exploration, enucleation, and retrograde root filling of the LR4 would be carried out by a maxillofacial unit. The patient was reviewed six months later where, due to the COVID-19 pandemic, the patient had been unable to access general dental services for the root canal treatment. He was still entirely asymptomatic. A one-year review was planned in the hope this would allow time for the orthograde root canal therapy to be completed. At this review, the orthograde root canal therapy had still not been completed. Interestingly, a repeat orthopantogram revealed a significant reduction in size with good bony infill and a significant reduction in the size of the lesion. Due to the ongoing delays with primary care dental therapy, the patient was subsequently internally referred to the restorative dentistry department for care. The patient was seen again by oral and maxillo-facial surgery in mid-2022 where he still reports this tooth as asymptomatic with no focal neurology. The patient's history was fully reviewed, and noted that 15 years previously, the patient underwent open reduction and internal fixation of a left angle of mandible fracture. Temporary IMF involving IMF screws and fixation wires were employed to maintain occlusion during plating and subsequently removed post-operatively. It is proposed that the radiolucency was, as a result of the IMF screw placement, penetrating the LR4 root resulting in resorption of the tooth root and development of a radiolucency. This case highlights the importance of careful screw size and physical site location, and placement of IMF screws, as there can be permeant damage to a patient’s dentition.

Keywords: facial trauma, inter-maxillary fixation, mandibular radiolucency, oral and maxillo-facial surgery

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Authors: Djehich Mohamed Yousri

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In recent years, the world has witnessed a phenomenon of displacement that is unprecedented in history. The number of refugees has reached record levels, due to wars, persecution, many conflicts and repression in a number of countries. The interest of United Nations bodies and international and regional organizations in the issue of refugees has increased, as they have defined a refugee and thus Determining who is entitled to this legal protection, and the 1951 Convention for the Protection of Refugees defines rights for refugee protection and sets obligations that they must perform. The institutional mechanisms for refugee protection are represented in the various agencies that take care of refugee affairs. At the forefront of these agencies is the United Nations High Commissioner for Refugees, as well as the various efforts provided by the International Committee of the Red Cross and the United Nations Relief and Works Agency for Palestine Refugees in the Middle East (UNRWA).

Keywords: protection, refugees, international, persecution, legal

Procedia PDF Downloads 78

Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

Procedia PDF Downloads 276

Authors: M. Illias Kanchan

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The death of a woman during pregnancy and childbirth is not only a health issue, but also a matter of social injustice. This study makes an attempt to explore the association between maternal death and associated factors in West Bengal using the approaches of facility-based and community-based maternal death review. Bivariate and binary logistic regression analysis have been performed to understand the causes and circumstances of maternal deaths in West Bengal. Delay in seeking care was the major contributor in maternal deaths, near about one-third women died due to this factor. The most common cause of maternal death is found to be hypertensive disorders of pregnancy or eclampsia. We believe that these deaths can be averted by reducing hypertensive disorders of pregnancy or eclampsia.

Keywords: maternal death, facility-based, community-based, review, west Bengal, eclampsia

Procedia PDF Downloads 433

Authors: Hyung Jun Ahn

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With the growing importance of social media, it is imperative to analyze it to understand the users. Users share useful information and their experience through social media, where much of what is shared is in the form of texts. This study focused on blogs and aimed to test whether the psycho-linguistic characteristics of blog texts vary with the subject or the type of experience of the texts. For this goal, blog texts about four different types of experience, Go, skiing, reading, and musical were collected through the search API of the Tistory blog service. The analysis of the texts showed that various psycholinguistic characteristics of the texts are different across the four categories of the texts. Moreover, the machine learning experiment using the characteristics for automatic text classification showed significant performance. Specifically, the ensemble method, based on functional tree and bagging appeared to be most effective in classification.

Keywords: blog, social media, text analysis, psycholinguistics

Procedia PDF Downloads 279

Authors: Muhammad Mustafizur Rahaman

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Social business is a new concept in the field of Business Economics and Capitalist Economy. It has increased the importance in economic and social development in emerging economies. Professor Muhammad Yunus is the founding father of the notion. While conventional business underscores profit maximization as a core business principle, social business calls for addressing social problems at the expense of profit. This underlying principle gives social business advantageous position over conventional businesses to serve those who live at the bottom of the pyramid. It also poses grave challenges to the social business because social business sacrifices profit at one hand and seeks financial sustainability on the other. For the sake of its financial sustainability, the social business might increase the price of its product or service which might lower its social impact, thus, makes the business self-defeating. Therefore, social business should be more innovative in every business process including production, marketing, and management. Otherwise, the business is unlikely to be driven out from the society.

Keywords: innovativeness, self-defeat, social business, social problem

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Authors: Tao Feng, Fei Xing, Ye Lu, Jun Li Fang

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NDN is a kind of future Internet architecture. Due to the NDN design introduces four privacy challenges,Many research institutions began to care about the privacy issues of naming data network(NDN).In this paper, we are in view of the major NDN’s privacy issues to investigate privacy protection,then put forwards more effectively anonymous transfer policy for NDN.Firstly,based on mutual anonymity communication for MP2P networks,we propose NDN mutual anonymity protocol.Secondly,we add interest package authentication mechanism in the protocol and encrypt the coding coefficient, security of this protocol is improved by this way.Finally, we proof the proposed anonymous transfer protocol security and anonymity.

Keywords: NDN, mutual anonymity, anonymous routing, network coding, authentication mechanism

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Authors: Neal Rupani

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Background: A surgical trainee has limited learning opportunities in the operating room in order to gain an ever-increasing standard of surgical skill, competency, and proficiency. These opportunities continue to decline due to numerous factors such as the European Working Time Directive and increasing requirement for service provision. It is therefore imperative to obtain the highest educational value from each educational opportunity. A measure that has yet to be validated in England on surgical trainees called the Operating Room Educational Environment Measure (OREEM) has been developed to identify and evaluate each component of the educational environment with a view to steer future change in optimising educational events in theatre. Aims: The aims of the study are to assess the reliability of the OREEM within England and to evaluate the surgical trainee’s objective perspective of the current operating room educational environment within one region within England. Methods: Using a quantitative study approach, data was collected over one month from surgical trainees within Health Education Thames Valley (Oxford) using an online questionnaire consisting of demographic data, the OREEM, a global satisfaction score. Results: 140 surgical trainees were invited to the study, with an online response of 54 participants (response rate = 38.6%). The OREEM was shown to have good internal consistency (α = 0.906, variables = 40) and unidimensionality, along with all four of its subgroups. The mean OREEM score was 79.16%. The areas highlighted for improvement predominantly focused on improving learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). The trainee perception is most satisfactory for the level of supervision and workload (average subscale score = 82.87%). There was no differences found between gender (U = 191.5, p = 0.535) or type of hospital (U = 258.0, p = 0.099), but the learning environment was favoured towards senior trainees (U = 223.5, p = 0.017). There was strong correlation between OREEM and the global satisfaction score (r = 0.755, p<0.001). Conclusions: The OREEM was shown to be reliable in measuring the educational environment in the operating room. This can be used to identify potentially modifiable components for improvement and as an audit tool to ensure high standards are being met. The current perception of the education environment in Health Education Thames Valley is satisfactory, and modifiable internal and external factors such as reducing service provision requirements, empowering trainees to plan lists, creating a team-working ethic between all personnel, and using tools that maximise learning from each operation have been identified to improve learning in the future. There is a favourable attitude to use of such improvement tools, especially for those currently dissatisfied.

Keywords: education environment, surgery, post-graduate education, OREEM

Procedia PDF Downloads 184

Authors: E. V. Fakhrutdinova, K. R. Maksimova, P. B. Chursin

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At the present stage of the society progress the health care is an integral part of both the economic system and social, while in the second case the medicine is a major component of a number of basic and necessary social programs. Since the foundation of the health system are highly qualified health professionals, it is logical proposition that increase of doctor`s professionalism improves the effectiveness of the system as a whole. Professionalism of the doctor is a collection of many components, essential role played by such personal-psychological factors as honesty, willingness and desire to help people, and motivation. A number of researchers consider motivation as an expression of basic human needs that have passed through the “filter” which is a worldview and values learned in the process of socialization by the individual, to commit certain actions designed to achieve the expected result. From this point of view a number of researchers propose the following classification of highly skilled employee’s needs: 1. the need for confirmation the competence (setting goals that meet the professionalism and receipt of positive emotions in their decision), 2. The need for independence (the ability to make their own choices in contentious situations arising in the process carry out specialist functions), 3. The need for ownership (in the case of health care workers, to the profession and accordingly, high in the eyes of the public status of the doctor). Nevertheless, it is important to understand that in a market economy a significant motivator for physicians (both legal and natural persons) is to maximize its own profits. In the case of health professionals duality motivational structure creates an additional contrast, as in the public mind the image of the ideal physician; usually a altruistically minded person thinking is not primarily about their own benefit, and to assist others. In this context, the question of the real motivation of health workers deserves special attention. The survey conducted by the American researcher Harrison Terni for the magazine "Med Tech" in 2010 revealed the opinion of more than 200 medical students starting courses, and the primary motivation in a profession choice is "desire to help people", only 15% said that they want become a doctor, "to earn a lot". From the point of view of most of the classical theories of motivation this trend can be called positive, as intangible incentives are more effective. However, it is likely that over time the opinion of the respondents may change in the direction of mercantile motives. Thus, it is logical to assume that well-designed system of motivation of doctor`s labor should be based on motivational foundations laid during training in higher education.

Keywords: motivation, quality of working life, health system, personal-psychological factors, motivational structure

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Authors: Hakan Erol, Altan Elibol, Ömer Eryılmaz, Mehmet Şimşek

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Organizations aim to manage information in a most possible effective way for sustainment and development. In doing so, they apply various procedures and methods. The very same situation is valid for each service of Armed Forces. During long-lasting endeavors such as shaping and maintaining security environment, supporting and securing peace, knowledge management is a crucial asset. Optimum Balance Model aims to promote the system from a decisive point to a higher decisive point. In this context, this paper analyses the application of optimum balance model to knowledge management in Armed Forces and tries to find answer to the question how Optimum Balance Model is integrated in knowledge management.

Keywords: optimum balance model, knowledge management, security environment, supporting peace

Procedia PDF Downloads 398

Authors: Amit Sarkar, Jayanta K. Mahato, Tushar Bhattacharya, Amrita Kundu, P. C. Chakraborti

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With increasing the demand for safety and fuel efficiency of automobiles, automotive manufacturers are looking for light weight, high strength steel with excellent formability and corrosion resistance. Dual-phase steel is finding applications in automotive sectors, because of its high strength, good formability, and high corrosion resistance. During service automotive components suffer from environmental attack and thereby gradual degradation of the components occurs reducing the service life of the components. The objective of the present investigation is to assess the effect of deformation on corrosion behaviour of DP590 grade dual phase steel which is used in automotive industries. The material was received from TATA Steel Jamshedpur, India in the form of 1 mm thick sheet. Tensile properties of the steel at strain rate of 10-3 sec-1: 0.2 % Yield Stress is 382 MPa, Ultimate Tensile Strength is 629 MPa, Uniform Strain is 16.30% and Ductility is 29%. Rectangular strips of 100x10x1 mm were machined keeping the long axis of the strips parallel to rolling direction of the sheet. These strips were longitudinally deformed at a strain rate at 10-3 sec-1 to a different percentage of strain, e.g. 2.5, 5, 7.5,10 and 12.5%, and then slowly unloaded. Small specimens were extracted from the mid region of the unclamped portion of these deformed strips. These small specimens were metallographic polished, and corrosion behaviour has been studied by potentiodynamic polarization, electrochemical impedance spectra, and cyclic polarization and potentiostatic tests. Present results show that among three different environments, the 3.5 pct NaCl solution is most aggressive in case of DP 590 dual-phase steel. It is observed that with the increase in the amount of deformation, corrosion rate increases. With deformation, the stored energy increases and leads to enhanced corrosion rate. Cyclic polarization results revealed highly deformed specimen are more prone to pitting corrosion as compared to the condition when amount of deformation is less. It is also observed that stability of the passive layer decreases with the amount of deformation. With the increase of deformation, current density increases in a passive zone and passive zone is also decreased. From Electrochemical impedance spectroscopy study it is found that with increasing amount of deformation polarization resistance (Rp) decreases. EBSD results showed that average geometrically necessary dislocation density increases with increasing strain which in term increased galvanic corrosion as dislocation areas act as the less noble metal.

Keywords: dual phase 590 steel, prestrain, potentiodynamic polarization, cyclic polarization, electrochemical impedance spectra

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Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

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Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

Procedia PDF Downloads 290

Authors: Siti Marlia Abd Rahim, Mad Khir Johari Abdullah Sani

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The ever-increasing use of social media applications by library users has raised concerns about the purpose and effectiveness of these platforms in academic libraries. While social media has the potential to revolutionize library services, its usage for non-educational purposes and security concerns have hindered its full potential. This paper aims to address the user behavioral factors affecting social media engagement in academic libraries and examine the impact of social media engagement on user participation. Additionally, it seeks to measure the effect of user participation in social media on the development of powerful learning communities.

Keywords: social media adoption, social media engagement, academic library, social media in academic library, learning community

Procedia PDF Downloads 117

Authors: Alexander Sharashenidze

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This article discusses the role of tourism in the economics of Georgia, justifies the necessity of several governmental supporting tools for diversification of tourism product and increasing competitiveness. Tourism directions are characterized through discovering Georgian tourism potential, considering cultural and geographical features; tools of formating supplemental products and development opportunities of Tbilisi and, also regions are asserted in the case of conducting appropriate government policy. There are presented tools of suggesting innovative tourism products, improvement of service, decreasing taxes, also providing availability to them. The role of tourism cluster in improvement of national competitiveness is substantiated. Based on the analysis of competitive factors influencing the development of tourism cluster, conclusions are made, and recommendations are suggested.

Keywords: economic competitivness, enhancing competitiveness, Georgian economic, tourism cluster, tourism product

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Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto

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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.

Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice

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Authors: Mohanaad Talal Shakir, Saad AJAJ Khalaf, Nawar Ahmed Aljumaily, Mustafa Talal Shakere

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Cloud computing is a model for enabling convenient, on demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. Objectives of this paper are to investigate the role of the Enterprise System and Cloud Computing Services to assist and guide him to ensure the initiative become successful. The cloud computing technology offers great potential for Enterprise such as the speed of dealing with data and product introductions, innovations and speed of response. The use of cloud computing technology leads to the rapid development and competitiveness of enterprises in various fields.

Keywords: cloud computing, information management, marketing, enterprise systems

Procedia PDF Downloads 689

Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Wei-Zhao, Yannian-Bao, Xing-Fan, Lei-Cao

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An isostatic pressing working cylinder automatic exhaust valve is designed. The finite element models of valve core and valve body under ultra-high pressure work environment are built to study the influence of interact of valve core and valve body to sealing performance. The contact stresses of metal sealing surface with different sizes are calculated and the automatic exhaust valve is optimized. The result of simulation and experiment shows that the sealing of optimized exhaust valve is more reliable and the service life is greatly improved. The optimized exhaust valve has been used in the warm isostatic pressing equipment.

Keywords: exhaust valve, sealing, ultra-high pressure, isostatic pressing

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Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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Authors: Sevket Ceyhun Cetin, Mehmet Oren

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According to existing educational research studies, students learn better with high teacher quality. Therefore, professional development has become a crucial way of increasing the quality of novices and veteran in-service teachers by providing support regarding content and pedagogy. To answer what makes PD effective, researchers have studied different PD models and revealed some critical elements that need to be considered, such as duration of a PD and the manner of delivery (e.g., lecture vs. engaging). Also, it has been pointed out that if PDs are prepared as one-size-fits-all, they most likely be ineffective in addressing teachers’ needs toward improving instructional quality. Instead, teachers’ voices need to be heard, and the foci of PDs should be determined based on their specific needs. Thus, this study was conducted to identify professional development needs of middle school mathematics teachers based on their self-evaluation of their performances in light of teaching standards. This study also aimed to explore whether the PD needs with respect to years of teaching experience (novice vs. veteran). These teachers had participated in a federally-funded research grant, which aimed to improve the competencies of 6-9 grade-level mathematics teachers in pedagogy and content areas. In the research project, the participants had consistently videoed their lessons throughout a school year and reflected on their performances, using Teacher Advanced Program (TAPTM) rubric, which was based on the best practices of teaching. Particularly, they scored their performances in the following areas and provided evidence as the justifications of their scores: Standards and Objectives, Presenting Instructional Content, Lesson Structure and Pacing, Activities and Materials, Academic Feedback, Grouping Students, and Questioning. The rating scale of the rubric is 1 through 5 (i.e., 1=Unsatisfactory [performance], 3=Proficient, and 5=Exemplary). For each area mentioned above, the numerical scores of 77 written reports (for 77 videoed lessons) of 24 teachers (nnovices=12 and nveteran=12) were averaged. Overall, the average score of each area was below 3 (ranging between 2.43 and 2.86); in other words, teachers judged their performances incompetent across the seven areas. In the second step of the data analysis, the lowest three areas in which novice and veteran teachers performed poorly were selected for further qualitative analysis. According to the preliminary results, the lowest three areas for the novice teachers were: Questioning, Grouping Students, and Academic Feedback. Grouping Students was also one of the lowest areas of the veteran teachers, but the other two areas for this group were: Lesson Structure & Pacing, and Standards & Objectives. Identifying in-service teachers’ needs based on their reflective practitioner experiences provides educators very crucial information that can be used to create more effective PD that improves teacher quality.

Keywords: mathematics teacher, professional development, self-reflection, video data

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Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

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Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

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Authors: Resul Öztürk

Abstract:

Experiential marketing is one of the marketing approaches that offers an exceptional framework to integrate elements of experience and entertainment in a product or service. Experiential marketing is defined as a memorable experience that goes deeply into the customer’s mind. Besides that, customer satisfaction is defined as an emotional response to the experiences provided by and associated with particular products or services purchased. Thus, experiential marketing activities can affect the level of customer satisfaction and loyalty. In this context, the research aims to explore the relationship among experiential marketing, customer satisfaction and customer loyalty among the cosmetic products customers in Konya. The partial least squares (PLS) method is used to analyse the survey data. The present study’s findings revealed have that experiential marketing has been a significant predictor of customer satisfaction and customer loyalty, and also experiential marketing has a significantly positive effect on customer satisfaction and customer loyalty.

Keywords: experiential marketing, customer satisfaction, customer loyalty, social sciences

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Authors: Jeon Chi-Ho, Lee Jae-Bin, Shim Chang-Su

Abstract:

National bridge inventory in Korea shows that the number of old prestressed concrete (PSC) bridgeover 30 years of service life is rapidly increasing. Recently tendon corrosion is one of the most critical issues in the maintenance of PSC bridges. In this paper, mechanical properties of corroded strands, which were removed from old bridges, were evaluated using tensile test. In the result, the equations to express the mechanical behavior of corroded strand were derived and compared to existing equation. For the decision of tendon replacement, it is necessary to evaluate the effect of corrosion level on strength and ductility of the structure. Considerations on analysis of PSC girders were introduced, and decision making on tendon replacement was also proposed.

Keywords: prestressed concrete bridge, tendon, corrosion, strength, ductility

Procedia PDF Downloads 258

Authors: Vandenbroucke Karel, Georges Annabel, Schuurman Dimitri

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In the past years, bundling of transport flows, whether or not implemented in an intermodal process, has popped up as a promising concept in the logistics sector. Bundling of transport flows is a process where two or more shippers decide to synergize their shipped goods over a common transport lane. Promoted by the European Commission, several programs have been set up and have shown their benefits. Bundling promises both shippers and logistics service providers economic, societal and ecological benefits. By bundling transport flows and thus reducing truck (or other carrier) capacity, the problems of driver shortage, increased fuel prices, mileage charges and restricted hours of service on the road are solved. In theory, the advantages of bundled transport exceed the drawbacks, however, in practice adoption among shippers remains low. In fact, bundling is mentioned as a disruptive process in the rather traditional logistics sector. In this context, a Belgian company asked iMinds Living Labs to set up a Living Lab research project with the goal to investigate how the uptake of bundling transport flows can be accelerated and to check whether an online data sharing platform can overcome the adoption barriers. The Living Lab research was conducted in 2016 and combined quantitative and qualitative end-user and market research. Concretely, extensive desk research was conducted and combined with insights from expert interviews with four consultants active in the Belgian logistics sector and in-depth interviews with logistics professionals working for shippers (N=10) and LSP’s (N=3). In the article, we present findings which show that there are several factors slowing down the uptake of bundling transport flows. Shippers are hesitant to change how they currently work and they are hesitant to work together with other shippers. Moreover, several practical challenges impede shippers to work together. We also present some opportunities that can accelerate the adoption of bundling of transport flows. First, it seems that there is not enough support coming from governmental and commercial organizations. Secondly, there is the chicken and the egg problem: too few interested parties will lead to no or very few matching lanes. Shippers are therefore reluctant to partake in these projects because the benefits have not yet been proven. Thirdly, the incentive is not big enough for shippers. Road transport organized by the shipper individually is still seen as the easiest and cheapest solution. A solution for the abovementioned challenges might be found in the online data sharing platform of the Belgian company. The added value of this platform is showing shippers possible matching lanes, without the shippers having to invest time in negotiating and networking with other shippers and running the risk of not finding a match. The interviewed shippers and experts indicated that the online data sharing platform is a very promising concept which could accelerate the uptake of bundling of transport flows.

Keywords: adoption barriers, bundling of transport, shippers, transport optimization

Procedia PDF Downloads 201