Search results for: inpatient medication order entry system

Authors: Emre Alan, Yusuf Yamanturk, Gokay Bas

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Non-grain oriented electrical steels are high silicon containing steels in which the direction of magnetism is intended the same in any direction of the material. Major applications of non-grain-oriented electrical steels are electrical motors, generators, etc. where low magnetic losses are required. Selection of proper hot rolling process parameters is an important factor in order to produce a material that has desired magnetic properties. In this study, the effect of finishing and coiling temperatures on magnetic properties of Fe-3%Si non-grain oriented electrical steels will be investigated. Additionally, the effect of slab reheating temperature at same entry finishing temperature will be investigated by means of reduction in roughing mill pass number from 1-5 to 1-3.

Keywords: electrical steels, hot rolling, magnetic properties, roughing mill

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Authors: Sung-Chul Hwang, Di Ren, Sang-Moon Yoon, Jong-Chun Park, Abbas Khayyer, Hitoshi Gotoh

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The slamming impact problem has a very important engineering background. For seaplane landing, recycling for the satellite re-entry capsule, and the impact load of the bow in the adverse sea conditions, the slamming problem always plays the important role. Due to its strong nonlinear effect, however, it seems to be not easy to obtain the accurate simulation results. Combined with the strong interaction between the fluid field and the elastic structure, the difficulty for the simulation leads to a new level for challenging. This paper presents a fully Lagrangian coupled solver for simulations of fluid-structure interactions, which is based on the Moving Particle Semi-implicit (MPS) method to solve the governing equations corresponding to incompressible flows as well as elastic structures. The developed solver is verified by reproducing the high velocity impact loads of deformable thin wedges with two different materials such as aluminum and steel on water entry. The present simulation results are compared with analytical solution derived using the hydrodynamic Wagner model and linear theory by Wan.

Keywords: fluid-structure interaction, moving particle semi-implicit (MPS) method, elastic structure, incompressible flow, wedge slamming impact

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Authors: Fagner Luiz P. Salles, Janaina C. Oliveira, Ivair P. Cesar

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Statement of the Problem: Auriculotherapy (AT) is a TCM technique, which uses seeds instead of needles, based physiologically on the mechanical stimulation of the cranial nerves. In the context of understanding the new concept of health of the WHO, the AT is an integrative approach for achieving Global Health Care so as to achieve the global health care concerns. This study aimed to evaluate the effect of auriculotherapy on pain and sleep quality in patients with chronic pain. Methodology and Theoretical Orientation: This study was performed between February and March 2017 at the Faculdade Estácio de Sá de Vitória, Brazil. The pain evaluation was through VAS in 4 periods: maximum, minimum, average and at the time of evaluation; the evaluation of sleep quality was used the Pittsburgh Sleep Quality Index. Socio-demographic data included: gender, age, use of medication and BMI. All data are presented as mean (standard deviation), Teste Mann-Whitney and T-student with P-values < 0.05 were regarded as significant. Findings: Participated in this study thirty-two individuals with age (M = 43.18, SD = 17.86), the time with pain in years (M = 3.67, SD = 3.68), 81.7% were female, 75% of the individuals used medication and BMI (M = 26.67; SD = 6.20). The pain presented improvement in the maximum level and the average of the pain and sleep quality before did not have statistically significant results. Conclusion and Significance: This study showed that TA is efficacy for reduction levels of pain. However, AT was not effective in improving sleep quality.

Keywords: auriculotherapy, chronic pain, sleep quality, integrative approach

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Authors: Perumalsamy Muthiah, Murugesan Thanapalan

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The remains of cheese production contain nutritional value added proteins viz., α-Lactalbumin, β-Lactoglobulin representing 80- 90% of the total volume of milk entering the process. Although several possibilities for cheese-whey exploitation have been assayed, approximately half of world cheese-whey production is not treated but is discarded as effluent. It is necessary to develop an effective and environmentally benign extraction process for the recovery of value added cheese whey proteins. Recently aqueous two phase system (ATPS) have emerged as potential separation process, particularly in the field of biotechnology due to the mild conditions of the process, short processing time, and ease of scale-up. In order to design an ATPS process for the recovery of cheese whey proteins, development of phase diagram and the effect of system parameters such as pH, types and the concentrations of the phase forming components, temperature, etc., on the partitioning of proteins were addressed in order to maximize the recovery of proteins. Some of the practical problems encountered in the application of aqueous two-phase systems for the recovery of Cheese whey proteins were also discussed.

Keywords: aqueous two-phase system, phase diagram, extraction, cheese whey

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Authors: Siddharth Vashisth, Varun Mathur

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This review provides an overview of the impact that implementation of various Knowledge Management (KM) strategies has had on the growth of a department in a Public Sector Company in India. In a regulated utility controlled by the government, the growth of an organization such as Hindustan Petroleum Corporation Limited (HPCL) had depended largely on the efficiencies of the systems and its people. However, subsequent to the de-regularization & to the entry of the private competition, the need for a ‘systematic templating’ of knowledge was recognized. This necessitated the introduction of Knowledge Management Centre (KMC). Projects & Pipelines Department (P&P) of HPCL introduced KMC that contributed significantly towards KM by adopting various strategies such as standardization, leveraging information system, competency enhancement, and improvements & innovations. These strategies gave both tangible as well as intangible benefits towards KM. Knowledge, technology & people are the three pillars that need to be catered for effective knowledge management in any organization. In HPCL, the initiative of KMC has served as an intermediary between these three major pillars as each activity of the strategy was centered on them and contributed significantly to their growth and up-gradation, ensuring overall growth of KM in the department.

Keywords: knowledge, knowledge management, public sector organization, standardization, technology, people, skill, information system, innovation, competency, impact

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Authors: Aydin M. Torkabadi, Ehsan Pourjavad

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A decade after the introduction of Lean in Saskatchewan’s public healthcare system, its effectiveness remains a controversial subject among health researchers, workers, managers, and politicians. Therefore, developing a framework to quantitatively assess the Lean achievements is significant. This study investigates the success of initiatives across Saskatchewan health regions by recognizing the Lean healthcare criteria, measuring the success levels, comparing the regions, and identifying the areas for improvements. This study proposes an integrated intelligent computing approach by applying Fuzzy Inference System (FIS) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). FIS is used as an efficient approach to assess the Lean healthcare criteria, and TOPSIS is applied for ranking the values in regards to the level of leanness. Due to the innate uncertainty in decision maker judgments on criteria, principals of the fuzzy theory are applied. Finally, FIS-TOPSIS was established as an efficient technique in determining the lean merit in healthcare systems.

Keywords: lean healthcare, intelligent computing, fuzzy inference system, healthcare evaluation, technique for order of preference by similarity to ideal solution, multi-criteria decision making, MCDM

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Authors: Zhang Zijian

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Nowadays, spherical robots have played an important role in many fields, but the insufficient ability of obstacle surmounting limits their wider application fields. To solve this problem, a jumping system of a spherical robot is designed based on Archimedes helix. The jumping system of the robot utilizes the characteristics of Archimedes helix and isovelocity helix to achieve constant speed and stable contraction, which ensures the stability of the system. Also, the jumping action of the robot is realized by instantaneous release of elastic potential energy. In order to verify the effectiveness of the jumping system, we designed a spherical robot and its jumping system. The experimental results show that the jumping system has the advantages of light weight, small size, high energy conversion efficiency, and can realize the spherical jumping function.

Keywords: hopping mechanism, Archimedes' Helix, hopping robot, spherical robot

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Authors: Renata Masarova, Bohuslava Juhasova, Martin Juhas, Zuzana Sutova

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In dynamic system theory a mathematical model is often used to describe their properties. In order to find a transfer matrix of a dynamic system we need to calculate an inverse matrix. The paper contains the fusion of the classical theory and the procedures used in the theory of automated control for calculating the inverse matrix. The final part of the paper models the given problem by the Matlab.

Keywords: dynamic system, transfer matrix, inverse matrix, modeling

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Authors: A. A. James, A. O. Adesanya, M. R. Odekunle, D. G. Yakubu

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This paper examines the development of one step, five hybrid point method for the solution of first order initial value problems. We adopted the method of collocation and interpolation of power series approximate solution to generate a continuous linear multistep method. The continuous linear multistep method was evaluated at selected grid points to give the discrete linear multistep method. The method was implemented using a constant order predictor of order seven over an overlapping interval. The basic properties of the derived corrector was investigated and found to be zero stable, consistent and convergent. The region of absolute stability was also investigated. The method was tested on some numerical experiments and found to compete favorably with the existing methods.

Keywords: interpolation, approximate solution, collocation, differential system, half step, converges, block method, efficiency

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Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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Authors: Hossein Kabir, Mojtaba Sadeghi

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Finding the linear and nonlinear responses of a typical single-degree-of-freedom system (SDOF) is always being regarded as a time-consuming process. This study attempts to provide modifications in the renowned Newmark method in order to make it more time efficient than it used to be and make it more accurate by modifying the system in its own non-linear state. The efficacy of the presented method is demonstrated by assigning three base excitations such as Tabas 1978, El Centro 1940, and MEXICO CITY/SCT 1985 earthquakes to a SDOF system, that is, SDOF, to compute the strength reduction factor, yield pseudo acceleration, and ductility factor.

Keywords: single-degree-of-freedom system (SDOF), linear acceleration method, nonlinear excited system, equivalent displacement method, equivalent energy method

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Authors: Tahseen Saad, Halim Ceylan, Jonathan Weaver, Osman Nuri Çelik, Onur Gungor Sahin

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A new concept of uniform delay offset dependent mathematical optimization problem is derived as the main objective for this study using a differential evolution algorithm. To control the coordination problem, which depends on offset selection and to estimate uniform delay based on the offset choice in a traffic signal network. The assumption is the periodic sinusoidal function for arrival and departure patterns. The cycle time is optimized at the entry links and the optimized value is used in the non-entry links as a common cycle time. The offset optimization algorithm is used to calculate the uniform delay at each link. The results are illustrated by using a case study and are compared with the canonical uniform delay model derived by Webster and the highway capacity manual’s model. The findings show new model minimizes the total uniform delay to almost half compared to conventional models. The mathematical objective function is robust. The algorithm convergence time is fast.

Keywords: area traffic control, traffic flow, differential evolution, sinusoidal periodic function, uniform delay, offset variable

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Authors: Nadiah Yola Putri, Nesia Putri Sharfina, Traviata Prakarti

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This paper is a literature review presented descriptively to review the concept of green building to face the challenge of sustainable development and food in urban areas. In this paper, researchers initiated the concept of green building with sky farming method. Sky farming use vertical landscape system in order to realizing food self-sufficient green city. Sky farming relying on plantings and irrigation system efficiency in the building which is adopted the principles of green building. Planting system is done by applying hydroponic plants with Nutrient Film Technique (NFT) using energy source of solar cell and grey water from the processing of waste treatment plant. The application of sky farming in urban areas can be a recommendation for the design of environmental-friendly construction. In order to keep the land and distance efficiency, this system is a futuristic idea that would be the connector of human civilization in the future.

Keywords: green building, urban area, sky farming, vertical landscape

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Authors: Evgeni Baratashvili, Nino Pailodze, Ana Bolkvadze, Giorgi Sulashvili

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At the present stage in our country intensifies cooperation with different business cultures, actively developing the process of implementation of Georgia in the global business system that requires us to develop a specific concept, including in the field of management. With the entry of Georgia into the international community, exchange of experience will only intensify. It is clear that the achievement of goals such as the doubling of the National Product increase the competitiveness of Georgian enterprises can’t be recorded without foreign management experience. On the other hand, knowledge of the areas of comparative management can be used in the process of choosing the path of socio-economic development of Georgia.

Keywords: business cultures, comparative management, corporate culture, Georgian business, Anglo-Saxon model, Georgian civilization, anti-capitalist mentality, culture management

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Authors: N. Hadjigeorgiou, A. C. Tsalikidou, E. Hristoforou, P. P. Sotiriadis

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During the last few decades, the continuously increasing demand for accurate and reliable magnetic measurements has paved the way for the development of different types of magnetic sensing systems as well as different measurement techniques. Sensor sensitivity and linearity, signal-to-noise ratio, measurement range, cross-talk between sensors in multi-sensor applications are only some of the aspects that have been examined in the past. In this paper, a fully analog closed loop system in order to optimize the performance of AMR sensors has been developed. The operation of the proposed system has been tested using a Helmholtz coil calibration setup in order to control both the amplitude and direction of magnetic field in the vicinity of the AMR sensor. Experimental testing indicated that improved linearity of sensor response, as well as low noise levels can be achieved, when the system is employed.

Keywords: AMR sensor, closed loop, memory effects, chopper, linearity improvement, sensitivity improvement, magnetic noise, electronic noise

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Authors: Etta Conteh, Tracy Macintosh

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Introduction: Restraints are often used in the Emergency Department when it is necessary for a patient to be restrained in order to decrease their agitation and better treat them. Chemical and physical restraints may be used on these patients at the discretion of the medical provider. Racism and injustice are rampant within our country, and medicine and healthcare are not spared. While racism and racial bias in medicine and healthcare have been studied, information on the differences in the use of restraints by race are scarce. Objective: The objective of this study is to determine if African Americans and Hispanic-American patients are restrained at higher rates compared to their White counterparts. Methods: This study will be carried out through a retrospective analysis utilizing the Hospital Corporation of America (HCA) national Emergency Department (ED) and inpatient database with patient visits from 2016-2019. All patient visits, with patients aged 18 years or older, will be reviewed, looking specifically for the race and the use and type of restraints. Other factors, such a pre-existing psychiatric condition, will be used for sub-analysis. Rationale: The outcome of this project will demonstrate the absence or presence of a racial disparity in the use of restraints in the Emergency Department. These results can be used as a foundation for improving racial equity in healthcare treatment.

Keywords: emergency medicine, public health, racism, restraint use

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Authors: Matthew C. Best

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Linear Multi-Input Multi-Output (MIMO) dynamic models can be identified, with no a priori knowledge of model structure or order, using a new Generalised Identifying Filter (GIF). Based on an Extended Kalman Filter, the new filter identifies the model iteratively, in a continuous modal canonical form, using only input and output time histories. The filter’s self-propagating state error covariance matrix allows easy determination of convergence and conditioning, and by progressively increasing model order, the best fitting reduced-order model can be identified. The method is shown to be resistant to noise and can easily be extended to identification of smoothly nonlinear systems.

Keywords: system identification, Kalman filter, linear model, MIMO, model order reduction

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Authors: Bolin Hua

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In city governance, various data are involved, including city component data, demographic data, housing data and all kinds of business data. These data reflects different aspects of people, events and activities. Data generated from various systems are different in form and data source are different because they may come from different sectors. In order to reflect one or several facets of an event or rule, data from multiple sources need fusion together. Data from different sources using different ways of collection raised several issues which need to be resolved. Problem of data fusion include data update and synchronization, data exchange and sharing, file parsing and entry, duplicate data and its comparison, resource catalogue construction. Governments adopt statistical analysis, time series analysis, extrapolation, monitoring analysis, value mining, scenario prediction in order to achieve pattern discovery, law verification, root cause analysis and public opinion monitoring. The result of Multi-source data fusion is to form a uniform central database, which includes people data, location data, object data, and institution data, business data and space data. We need to use meta data to be referred to and read when application needs to access, manipulate and display the data. A uniform meta data management ensures effectiveness and consistency of data in the process of data exchange, data modeling, data cleansing, data loading, data storing, data analysis, data search and data delivery.

Keywords: multi-source data fusion, urban comprehensive management, information fusion, government data

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Authors: Angela Bargenda, Erhard Lick, Dhoha Trabelsi

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Research in retailing has identified the importance of atmospherics as an essential element in enhancing store image, store patronage intentions, and the overall shopping experience in a retail environment. However, in the area of atmospherics, store window design, which represents an essential component of external store atmospherics, remains a vastly underrepresented phenomenon in extant scholarship. This paper seeks to fill this gap by exploring the relevance of store window design as an atmospheric tool. In particular, empirical evidence of theme-based theatrical store front windows, which put emphasis on the use of verbo-visual design elements, was found in Paris and New York. The purpose of this study was to identify to what extent such multimodal window designs of high-end department stores in metropolitan cities have an impact on store entry decisions and attitudes towards the retailer’s image. As theoretical construct, the linguistic concept of multimodality and Mehrabian’s and Russell’s model in environmental psychology were applied. To answer the research question, two studies were conducted. For Study 1 a case study approach was selected to define three different types of store window designs based on different types of visual-verbal relations. Each of these types of store window design represented a different level of cognitive elaboration required for the decoding process. Study 2 consisted of an on-line survey carried out among more than 300 respondents to examine the influence of these three types of store window design on the consumer behavioral variables mentioned above. The results of this study show that the higher the cognitive elaboration needed to decode the message of the store window, the lower the store entry propensity. In contrast, the higher the cognitive elaboration, the higher the perceived image of the retailer’s image. One important conclusion is that in order to increase consumers’ propensity to enter stores with theme-based theatrical store front windows, retailers need to limit the cognitive elaboration required to decode their verbo-visual window design.

Keywords: consumer behavior, multimodality, store atmospherics, store window design

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Authors: Pachawo Bisani, Goodall Nyirenda

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The Malawi National Antiretroviral Therapy (NART) Electronic Medical Record (EMR) system was designed and developed with guidance from the Ministry of Health through the Department of HIV and AIDS (DHA) with the aim of supporting the management of HIV patient data and reporting in high prevalence ART clinics. As of 2021, the system has been scaled up to over 206 facilities across the country. The system is integrated with the clinical decision support system (CDSS) to assist healthcare providers in making a decision about an individual patient at a particular point in time. Despite NART EMR undergoing several evaluations and assessments, little has been done to evaluate the clinical decision support system in the NART EMR system. Hence, the study aimed to evaluate the use of CDSS in the NART EMR system in Malawi. The study adopted a mixed-method approach, and data was collected through interviews, observations, and questionnaires. The study has revealed that the CDSS tools were integrated into the ART clinic workflow, making it easy for the user to use it. The study has also revealed challenges in system reliability and information accuracy. Despite the challenges, the study further revealed that the system is effective and efficient, and overall, users are satisfied with the system. The study recommends that the implementers focus more on the logic behind the clinical decision-support intervention in order to address some of the concerns and enhance the accuracy of the information supplied. The study further suggests consulting the system's actual users throughout implementation.

Keywords: clinical decision support system, electronic medical record system, usability, antiretroviral therapy

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Authors: Dana A. Al Qudah, Alexandra I. Critea, Rizik M. H. Al Sayyed, Amer Obeidah

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Online advertisement is one of the major incomes for many companies; it has a role in the overall business flow and affects the consumer behavior directly. Unfortunately most users tend to block their ads or ignore them. MyAds is a social adaptive hypermedia system for online advertising and its main goal is to explore how to make online ads more acceptable. In order to achieve such a goal, various technologies and techniques are used. This paper presents a theoretical framework as well as the system architecture for MyAds that was designed based on a set of hypotheses and an exploratory study. The system then was implemented and a pilot experiment was conducted to validate it. The main outcomes suggest that the system has provided personalized ads for users. The main implications suggest that the system can be used for further testing and validating.

Keywords: adaptive hypermedia, e-advertisement, social, hypotheses, exploratory study, framework

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Authors: Yu Qin

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In order to tackle the ever-growing problem of the lack of parking space, this paper presents the design and implementation of a smart unmanned parking system that is based on RFID (radio frequency identification) technology and Wireless communication technology. This system uses RFID technology to achieve the identification function (transmitted by 2.4 G wireless module) and is equipped with an STM32L053 micro controller as the main control chip of the smart vehicle. This chip can accomplish automatic parking (in/out), charging and other functions. On this basis, it can also help users easily query the information that is stored in the database through the Internet. Experimental tests have shown that the system has the features of low power consumption and stable operation, among others. It can effectively improve the level of automation control of the parking lot management system and has enormous application prospects.

Keywords: RFID, embedded system, unmanned, parking management

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Authors: I. Gahlouz, A. Chellil

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The paper concerns the estimation of system components faults by using an unknown inputs observer. To reach this goal, we used the Bond Graph approach to physical modelling. We showed that this graphical tool is allowing the representation of system components faults as unknown inputs within the state representation of the considered physical system. The study of the causal and structural features of the system (controllability, observability, finite structure, and infinite structure) based on the Bond Graph approach was hence fulfilled in order to design an unknown inputs observer which is used for the system component fault estimation.

Keywords: estimation, bond graph, controllability, observability

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Authors: Abdon Choque-Rivero

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The Jacobi system with the Dirichlet boundary condition is considered on a half-line lattice when the coefficients are real valued. The inverse problem of recovery of the coefficients from various data sets containing the so-called transmission eigenvalues is analyzed. The Marchenko method is utilized to solve the corresponding inverse problem.

Keywords: inverse scattering, discrete system, transmission eigenvalues, Marchenko method

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Authors: Lloyd A. Taylor

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An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.

Keywords: ADHD, diagnostic criteria, risk management model, pediatricians

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Authors: Woosik Jang, Seung Heon Han, Seung Won Baek

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Natural gas (NG) is an energy resource in a few countries, and most NG producers do business in politically unstable countries. In addition, as 90% of the LNG market is controlled by a small number of international oil companies (IOCs) and national oil companies (NOCs), entry of latecomers into the market is extremely limited. To meet these challenges, project viability needs to be assessed based on limited information from a project screening perspective. However, the early stages of the project have the following difficulties: (1) What are the factors to consider? (2) How many professionals do you need to decide? (3) How to make the best decision with limited information? To address this problem, this study proposes a model for evaluating LNG project viability based on the Dempster-Shafer theory (DST). A total of 11 indicators for analyzing the gas field, reflecting the characteristics of the LNG industry, and 23 indicators for analyzing the market environment, were identified. The proposed model also evaluates the LNG project based on the survey and provides uncertainty of the results based on DST as well as quantified results. Thus, the proposed model is expected to be able to support the decision-making process of the gas field project using quantitative results as a systematic framework, and it was developed as a stand-alone system to improve its usefulness in practice. Consequently, the amount of information and the mathematical approach are expected to improve the quality and opportunity of decision making for LNG projects for enterprises.

Keywords: project screen, energy enterprise, decision support system, Dempster-Shafer theory

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Authors: Rebeca V. Tholen, Elaine Bundy

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Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

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Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan

Abstract:

The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.

Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing

Procedia PDF Downloads 235

Authors: Pradeep Kulshrestha, Maulana Ayoub Ali

Abstract:

The concept of financial inclusion has been tabled in the whole world where practitioners, academicians, policy makers and economists are working hard to look for the best possible opportunities in order to enable the whole society to be in the banking cycle. The Islamic banking system is considered to be one of the said opportunities. Countries like the United Kingdom, United States of America, Malaysia, Saudi Arabia, the whole of the United Arab Emirates and many African countries have accommodated the aspect of Islamic banking in the conventional banking system as one of the financial inclusion strategies. This paper tries to analyse the current state of affairs of the Islamic Banking system in Tanzania in order to understand the improvement of the provision of Islamic banking products and services in the said country. The paper discusses the historical background of the banking system in Tanzania, the level of penetration of banking products and services and the coming of the Islamic banking system in the country. Furthermore, the paper discusses banking regulatory bodies, legal instruments governing banking operations as well as number of legal challenges facing Islamic banking operations in the country. Following a critical literature review, the paper discovered that there is no legal instrument which talks about the introduction and provision of Islamic banking system in Tanzania. Furthermore, the Islamic banking system was considered as a banking product which is absolutely incorrect because Islamic banking is considered to be as a banking system of its own. In addition to that, it has been discovered that lack of a proper regulatory system and legal instruments to harmonize the conventional and Islamic banking systems has resulted in the closure of one Islamic window in the country, which in the end affects the credibility of the newly introduced banking system. In its conclusive remarks, the paper suggests that Tanzania should work on all legal challenges affecting the smooth operations of the Islamic banking system. This can be in a way of adopting various Islamic banking legal models which are used in countries like Malaysia and others, or a borrowing legal harmonization process which has been adopted by the UK, Uganda, Nigeria and Kenya.

Keywords: Islamic banking, Islamic windows, regulations, banks

Procedia PDF Downloads 164

Authors: Abdelbaset M. Elghriani, Abdelsalam M. Maatuk, Isam Denna, Amira Abdulla Werfalli

Abstract:

Electronic prescription software (e-prescribing) benefits patients and physicians by preventing handwriting errors and giving accurate prescriptions. E-prescribing allows prescriptions to be written and sent to pharmacies electronically instead of using handwritten notes. Significant factors that may affect the adoption of e-prescription systems include lacking technical support, financial resources to operate the systems, and change resistance from some clinicians, which have been identified as barriers to the implementation of e-prescription systems. This study aims to explore the trends and opinions of physicians and pharmacists about e-prescriptions and to identify the obstacles and benefits of the application of e-prescriptions in the health care system. A cross-sectional descriptive study was conducted at three Libyan public hospitals. Data were collected through a self-constructed questionnaire to assess the opinions regarding potential constraining factors and benefits of implementing an e-prescribing system in hospitals. Data presented as mean, frequency distribution table, cross-tabulation, and bar charts. Data analysis was performed, and the results show that technical, financial, and organizational obstacles are the most important obstacles that prevent the application of e-prescribing systems in Libyan hospitals. In addition, there was awareness of the benefits of e-prescribing, especially reducing medication dispensing errors, and a desire of physicians and pharmacists to use electronic prescriptions.

Keywords: physicians, e-prescribing, health care system, pharmacists

Procedia PDF Downloads 103