Search results for: hospital industry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7438

Search results for: hospital industry

3628 Correlation between Fetal Umbilical Cord pH and the Day, the Time and the Team Hand over Times: An Analysis of 6929 Deliveries of the Ulm University Hospital

Authors: Sabine Pau, Sophia Volz, Emanuel Bauer, Amelie De Gregorio, Frank Reister, Wolfgang Janni, Florian Ebner

Abstract:

Purpose: The umbilical cord pH is a well evaluated contributor for prediction of neonatal outcome. This study correlates nenonatal umbilical cord pH with the weekday of delivery, the time of birth as well as the staff hand over times (midwifes and doctors). Material and Methods: This retrospective study included all deliveries of a 20 year period (1994-2014) at our primary obstetric center. All deliveries with a newborn cord pH under 7,20 were included in this analysis (6929 of 48974 deliveries (14,4%)). Further subgroups were formed according to the pH (< 7,05; 7,05 – 7,09; 7,10 – 7,14; 7,15 – 7,19). The data were then separated in day- and night time (8am-8pm/8pm-8am) for a first analysis. Finally, handover times were defined at 6 am – 6.30 am, 2 pm -2.30 pm, 10 pm- 10.30 pm (midwives) and for the doctors 8-8.30 am, 4 – 4.30 pm (Monday- Thursday); 2 pm -2.30 pm (Friday) and 9 am – 9.30 am (weekend). Routinely a shift consists of at least three doctors as well as three midwives. Results: During the last 20 years, 6929 neonates were born with an umbilical cord ph < 7,20 ( < 7,05 : 7,1%; 7,05 – 7,09 : 10,9%; 7,10 – 7,14 : 30,2%; 7,15 – 7,19:51,8%). There was no significant difference between either night/day delivery (p = 0.408), delivery on different weekdays (p = 0.253), delivery between Monday to Thursday, Friday and the weekend (p = 0.496 ) or delivery during the handover times of the doctors as well as the midwives (p = 0.221). Even the standard deviation showed no differences between the groups. Conclusion: Despite an increased workload over the last 20 years, the standard of care remains high even during the handover times and night shifts. This applies for midwives and doctors. As the neonatal outcome depends on various factors, further studies are necessary to take more factors influencing the fetal outcome into consideration. In order to maintain this high standard of care, an adaption of work-load and changing conditions is necessary.

Keywords: delivery, fetal umbilical cord pH, day time, hand over times

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3627 Learning the Most Common Causes of Major Industrial Accidents and Apply Best Practices to Prevent Such Accidents

Authors: Rajender Dahiya

Abstract:

Investigation outcomes of major process incidents have been consistent for decades and validate that the causes and consequences are often identical. The debate remains as we continue to experience similar process incidents even with enormous development of new tools, technologies, industry standards, codes, regulations, and learning processes? The objective of this paper is to investigate the most common causes of major industrial incidents and reveal industry challenges and best practices to prevent such incidents. The author, in his current role, performs audits and inspections of a variety of high-hazard industries in North America, including petroleum refineries, chemicals, petrochemicals, manufacturing, etc. In this paper, he shares real life scenarios, examples, and case studies from high hazards operating facilities including key challenges and best practices. This case study will provide a clear understanding of the importance of near miss incident investigation. The incident was a Safe operating limit excursion. The case describes the deficiencies in management programs, the competency of employees, and the culture of the corporation that includes hazard identification and risk assessment, maintaining the integrity of safety-critical equipment, operating discipline, learning from process safety near misses, process safety competency, process safety culture, audits, and performance measurement. Failure to identify the hazards and manage the risks of highly hazardous materials and processes is one of the primary root-causes of an incident, and failure to learn from past incidents is the leading cause of the recurrence of incidents. Several investigations of major incidents discovered that each showed several warning signs before occurring, and most importantly, all were preventable. The author will discuss why preventable incidents were not prevented and review the mutual causes of learning failures from past major incidents. The leading causes of past incidents are summarized below. Management failure to identify the hazard and/or mitigate the risk of hazardous processes or materials. This process starts early in the project stage and continues throughout the life cycle of the facility. For example, a poorly done hazard study such as HAZID, PHA, or LOPA is one of the leading causes of the failure. If this step is performed correctly, then the next potential cause is. Management failure to maintain the integrity of safety critical systems and equipment. In most of the incidents, mechanical integrity of the critical equipment was not maintained, safety barriers were either bypassed, disabled, or not maintained. The third major cause is Management failure to learn and/or apply learning from the past incidents. There were several precursors before those incidents. These precursors were either ignored altogether or not taken seriously. This paper will conclude by sharing how a well-implemented operating management system, good process safety culture, and competent leaders and staff contributed to managing the risks to prevent major incidents.

Keywords: incident investigation, risk management, loss prevention, process safety, accident prevention

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3626 Techno-Economic Assessments of Promising Chemicals from a Sugar Mill Based Biorefinery

Authors: Kathleen Frances Haigh, Mieke Nieder-Heitmann, Somayeh Farzad, Mohsen Ali Mandegari, Johann Ferdinand Gorgens

Abstract:

Lignocellulose can be converted to a range of biochemicals and biofuels. Where this is derived from agricultural waste, issues of competition with food are virtually eliminated. One such source of lignocellulose is the South African sugar industry. Lignocellulose could be accessed by changes to the current farming practices and investments in more efficient boilers. The South African sugar industry is struggling due to falling sugar prices and increasing costs and it is proposed that annexing a biorefinery to a sugar mill will broaden the product range and improve viability. Process simulations of the selected chemicals were generated using Aspen Plus®. It was envisaged that a biorefinery would be annexed to a typical South African sugar mill. Bagasse would be diverted from the existing boilers to the biorefinery and mixed with harvest residues. This biomass would provide the feedstock for the biorefinery and the process energy for the biorefinery and sugar mill. Thus, in all scenarios a portion of the biomass was diverted to a new efficient combined heat and power plant (CHP). The Aspen Plus® simulations provided the mass and energy balance data to carry out an economic assessment of each scenarios. The net present value (NPV), internal rate of return (IRR) and minimum selling price (MSP) was calculated for each scenario. As a starting point scenarios were generated to investigate the production of ethanol, ethanol and lactic acid, ethanol and furfural, butanol, methanol, and Fischer-Tropsch syncrude. The bypass to the CHP plant is a useful indicator of the energy demands of the chemical processes. An iterative approach was used to identify a suitable bypass because increasing this value had the combined effect of increasing the amount of energy available and reducing the capacity of the chemical plant. Bypass values ranged from 30% for syncrude production to 50% for combined ethanol and furfural production. A hurdle rate of 15.7% was selected for the IRR. The butanol, combined ethanol and furfural, or the Fischer-Tropsch syncrude scenarios are unsuitable for investment with IRRs of 4.8%, 7.5% and 11.5% respectively. This provides valuable insights into research opportunities. For example furfural from sugarcane bagasse is an established process although the integration of furfural production with ethanol is less well understood. The IRR for the ethanol scenario was 14.7%, which is below the investment criteria, but given the technological maturity it may still be considered for investment. The scenarios which met the investment criteria were the combined ethanol and lactic acid, and the methanol scenarios with IRRs of 20.5% and 16.7%, respectively. These assessments show that the production of biochemicals from lignocellulose can be commercially viable. In addition, this assessment have provided valuable insights for research to improve the commercial viability of additional chemicals and scenarios. This has led to further assessments of the production of itaconic acid, succinic acid, citric acid, xylitol, polyhydroxybutyrate, polyethylene, glucaric acid and glutamic acid.

Keywords: biorefineries, sugar mill, methanol, ethanol

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3625 On the Exergy Analysis of the Aluminum Smelter

Authors: Ayoola T. Brimmo, Mohamed I. Hassan

Abstract:

The push to mitigate the aluminum smelting industry’s enormous energy consumption and high emission releases is now even more persistent with the recent climate change happenings. Common approaches to achieve this have been focused on improving energy efficiency in the pot line and cast house sections of the smelter. However, the conventional energy efficiency analyses are based on the first law of thermodynamics, which do not shed proper light on the smelter’s degradation of energy. This just gives a general idea of the furnace’s performance with no reference to locations where improvement is a possibility based on the second law of thermodynamics. In this study, we apply exergy analyses on the pot line and cast house sections of the smelter to identify the locality and causes of energy degradation. The exergy analyses, which are based on a real life smelter conditions, highlight the possible locations for technology improvement in a typical smelter. With this established, methods of minimizing the smelter’s exergy losses are assessed.

Keywords: exergy analysis, electrolytic cell, furnace, heat transfer

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3624 Leadership Values in Succession Processes

Authors: Peter Heimerl, Alexander Plaikner, Mike Peters

Abstract:

Background and Significance of the Study: Family-run businesses are a decisive economic factor in the Alpine tourism and leisure industry. Within the next years, it is expected that a large number of family-run small and medium-sized businesses will transfer ownership due to demographic developments. Four stages of succession processes can be identified by several empirical studies: (1) the preparation phase, (2) the succession planning phase, (3) the development of the succession concept, (4) and the implementation of the business transfer. Family business research underlines the importance of individual's and family’s values: Especially leadership values address mainly the first phase, which strongly determines the following stages. Aim of the Study: The study aims at answering the following research question: Which leadership values are dominating during succession processes in family-run businesses in Austrian Alpine tourism industry? Methodology: Twenty-two problem-centred individual interviews with 11 transferors and their 11 transferees were conducted. Data analysis was carried out using the software program MAXQDA following an inductive approach to data coding. Major Findings: Data analysis shows that nine values particularly influence succession processes, especially during the vulnerable preparation phase. Participation is the most-dominant value (162 references). It covers a style of cooperation, communication, and controlling. Discipline (142) is especially prevailing from the transferor's perspective. It addresses entrepreneurial honesty and customer orientation. Development (138) is seen as an important value, but it can be distinguished between transferors and transferees. These are mainly focused on strategic positioning and new technologies. Trust (105) is interpreted as a basic prerequisite to run the family firm smoothly. Interviewees underline the importance to be able to take a break from family-business management; however, this is only possible when openness and honesty constitute trust within the family firm. Loyalty (102): Almost all interviewees perceive that they can influence the loyalty of the employees through their own role models. A good work-life balance (90) is very important to most of the transferors, especially for their employees. Despite the communicated importance of a good work-life-balance, but however, mostly the commitment to the company is prioritised. Considerations of regionality (82) and regional responsibility are also frequently raised. Appreciation (75) is of great importance to both the handover and the takeover generation -as appreciation towards the employees in the company and especially in connection with the family. Familiarity (66) and the blurring of the boundaries between private and professional life are very common, especially in family businesses. Familial contact and open communication with employees which is mentioned in almost all handing over. Conclusions: In the preparation phase of succession, successors and incumbents have to consider and discuss their leadership and family values of family-business management. Quite often, assistance is needed to commonly and openly discuss these values in the early stages of succession processes. A large majority of handovers fail because of these values. Implications can be drawn to support family businesses, e.g., consulting initiatives at chambers of commerce and business consultancies must address this problem.

Keywords: leadership values, family business, succession processes, succession phases

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3623 Recent Nano technological Advancements in Antimicrobial Edible Films for Food Packaging: A Review

Authors: Raana Babadi Fathipour

Abstract:

Researchers are now focusing on sustainable advancements in active packaging systems to meet the growing consumer demand for high-quality food with Eco-friendly packaging. One significant advancement in this area is the inclusion of antimicrobial agents in bio-polymer-based edible films, which effectively inhibit or kill pathogenic/spoilage microbes that can contaminate food. This technology also helps reduce undesirable flavors caused by active compounds directly incorporated into the food. To further enhance the efficiency of antimicrobial bio-based packaging systems, Nano technological concepts such as bio-nano composites and Nano encapsulation systems have been applied. This review examines the current state and applications of antimicrobial biodegradable films in the food packaging industry, while also highlighting ongoing research on the use of nanotechnology to develop innovative bio-based packaging systems.

Keywords: active packaging, antimicrobial edible films, bioactive agents, biopolymers, bio-nanocomposites

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3622 Prevalence and Risk Factors of Eimeria Spp. and Giardia Spp. in Rabbits of Local Algerian Population

Authors: Mina Henneb, Rafik Belabbas, Safia Zenia

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The objective of this study was to determine the prevalence and to identify the risk factors of Eimeria spp. and Giardia spp. infection in rabbits from the local population of four localities in northern Algeria. Dung samples were collected from 16 farms, totalling 111 rabbits, and were analysed by the flotation method. Additional, data regarding the farms and management practices were obtained by means of a questionnaire used in the surveys and interviews. The results revealed that the prevalence of Eimerias pp. contamination was 68.75% (11/16) for farms and 58.56% (65/111) for rabbits, respectively. The prevalence of Giardia spp. was respectively 56.25% (9/16) for farms and 11.7% (13/111) for rabbits. The analyses showed that the prevalence of Eimeria spp. was significantly higher in the farms that did not comply with hygiene and non-conventional feeding and watering. However, the prevalence of Giardia spp. was significant in rabbits kept in poor conditions of rearing. In conclusion, this study showed that the prevalence of these two parasites in rabbits from the local population is relevant and may have important implications for the rabbit industry and public health, especially in rural areas.

Keywords: Algeria, digestive parasites, prevalence, rabbits, risk factors

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3621 The Influence of Fiber Fillers on the Bonding Safety of Structural Adhesives: A Fracture Analytical Evaluation

Authors: Brandtner-Hafner Martin

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Adhesives have established themselves as an innovative joining technology in the industry. Their strengths lie in joining different materials, avoiding structural weakening as in welding or screwing, and enabling lightweight construction methods. Now there are a variety of ways to improve the efficiency and effectiveness of bonded joints. One way is to add fiber fillers. This leads to an improvement in adhesion and cohesion (structural integrity). In this study, the effectiveness of fiber-modified adhesives for bonding different construction materials is reviewed. A series of experimental tests were performed using the fracture analytical GF principle to study the adhesive bonding safety and performance of the joint. Three different structural adhesive systems based on epoxy, CA/A hybrid, and PUR were modified with different fiber materials on different substrates. The results show that significant performance improvements can be achieved and that bonding reliability can be sustainably increased.

Keywords: fiber-modified adhesives, bonding safety, GF-principle, fracture analysis

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3620 Structural Safety of Biocomposites under Cracking: A Fracture Analytical Approach using the Gғ-Concept

Authors: Brandtner-Hafner Martin

Abstract:

Biocomposites have established themselves as a sustainable material class in the industry. Their advantages include lower density, lower price, and easier recycling compared to conventional materials. Now there are a variety of ways to measure their technical performance. One possibility is mechanical tests, which are widely used and standardized. However, these provide only very limited insights into damage capacity, which is particularly problematic under cracking conditions. To overcome such shortcomings, experimental tests were performed applying the fracture energetically GF-concept to study the structural safety of the interface under crack opening (mode-I loading). Two different types of biocomposites based on extruded henequen-fibers (NFRP) and wood-particles (WPC) in an HDPE matrix were evaluated. The results show that the fracture energy values obtained are higher than those given in the literature. This suggests that alternatives to previous linear elastic testing methods are needed to perform authentic safety evaluations of green plastics.

Keywords: biocomposites, structural safety, Gғ-concept, fracture analysis

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3619 Public Preferences for Lung Cancer Screening in China: A Discrete Choice Experiment

Authors: Zixuan Zhao, Lingbin Du, Le Wang, Youqing Wang, Yi Yang, Jingjun Chen, Hengjin Dong

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Objectives: Few results from public attitudes for lung cancer screening are available both in China and abroad. This study aimed to identify preferred lung cancer screening modalities in a Chinese population and predict uptake rates of different modalities. Materials and Methods: A discrete choice experiment questionnaire was administered to 392 Chinese individuals aged 50–74 years who were at high risk for lung cancer. Each choice set had two lung screening options and an option to opt-out, and respondents were asked to choose the most preferred one. Both mixed logit analysis and stepwise logistic analysis were conducted to explore whether preferences were related to respondent characteristics and identify which kinds of respondents were more likely to opt out of any screening. Results: On mixed logit analysis, attributes that were predictive of choice at 1% level of statistical significance included the screening interval, screening venue, and out-of-pocket costs. The preferred screening modality seemed to be screening by low-dose computed tomography (LDCT) + blood test once a year in a general hospital at a cost of RMB 50; this could increase the uptake rate by 0.40 compared to the baseline setting. On stepwise logistic regression, those with no endowment insurance were more likely to opt out; those who were older and housewives/househusbands, and those with a health check habit and with commercial endowment insurance were less likely to opt out from a screening programme. Conclusions: There was considerable variance between real risk and self-perceived risk of lung cancer among respondents, and further research is required in this area. Lung cancer screening uptake can be increased by offering various screening modalities, so as to help policymakers further design the screening modality.

Keywords: lung cancer, screening, China., discrete choice experiment

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3618 Endometriosis-Associated Ovarian Cancer: Clinical and Pathological Pattern

Authors: I. Ramalho, S. Campos, M. Dias

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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.

Keywords: endometriosis, histology, observational study, ovarian cancer

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3617 Efficient Utilization of Commodity Computers in Academic Institutes: A Cloud Computing Approach

Authors: Jasraj Meena, Malay Kumar, Manu Vardhan

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Cloud computing is a new technology in industry and academia. The technology has grown and matured in last half decade and proven their significant role in changing environment of IT infrastructure where cloud services and resources are offered over the network. Cloud technology enables users to use services and resources without being concerned about the technical implications of technology. There are substantial research work has been performed for the usage of cloud computing in educational institutes and majority of them provides cloud services over high-end blade servers or other high-end CPUs. However, this paper proposes a new stack called “CiCKAStack” which provide cloud services over unutilized computing resources, named as commodity computers. “CiCKAStack” provides IaaS and PaaS using underlying commodity computers. This will not only increasing the utilization of existing computing resources but also provide organize file system, on demand computing resource and design and development environment.

Keywords: commodity computers, cloud-computing, KVM, CloudStack, AppScale

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3616 Differential Diagnosis of an Asymptomatic Lesion in Contact with the Bladder

Authors: Angelis P. Barlampas

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PURPOSE: Presentation of an interesting finding in an asymptomatic patient. MATERIAL: A patient came at hospital because of dysuric complaints and after a urologist’s prescription of a US exam of the urogenital system. The simple ultrasound examination of the lower abdomen revealed a moderate hypertrophy of the prostate and a solitary large bladder stone. The kidneys were normal. Then, the patient underwent a CT scan, which depicted the bladder stone and, as an incidental finding, a cystic lesion in contact with the upper anterior right surface of the bladder, with mural calcifications. METHOD: Abdominal ultrasound and abdominal computed tomography before and after intravenous contrast administration. RESULTS: The repeated US exam showed a cylindrical cystic lesion with a double wall and two mural hyperechoic foci, with partial posterior shadowing. Blood flow was not recognized on color doppler. The CT exam confirmed the cystic-like anechoic lesion, in the right iliac fossa, with the presence of two foci of mural calcifications. The differential diagnosis includes cases of enteric cyst, intestinal duplication cyst, chronic abscess, urachal cyst, Meckel's diverticulum, bladder diverticulum, old hematoma, thrombosed vascular aneurysm, diverticular abscess, etc. The patient refused surgical removal and is being monitored by ultrasound. CONCLUSIONS: The careful examination of the wider peri-abdominal area, especially during the routine ultrasound examination, can contribute to the identification of important asymptomatic findings. The radiologist must not be solely focused in a certain area of examination, even if the clinical doctor asks so, but should give attention to the neighboring areas, too.

Keywords: enteric cyst, US, CT, urogenital tract, miscellaneous findings

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3615 A Study on the Microbilogical Profile and Antibiotic Sensitivity Pattern of Bacterial Isolates Causing Urinary Tract Infection in Intensive Care Unit Patients in a Tertiary Care Hospital in Eastern India

Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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3614 Theoretical Investigation of Gas Adsorption on Metal- Graphene Surface

Authors: Fatemeh Safdari, Amirnaser Shamkhali, Gholamabbas Parsafar

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Carbon nanostructures are of great importance in academic research and industry, which can be mentioned to chemical sensors, catalytic processes, pharmaceutical and environmental issues. Common point in all of these applications is the occurrence of adsorption of molecules on these structures. Important carbon nanostructures in this case are mainly nanotubes and graphene. To modify pure graphene, recently, many experimental and theoretical studies have carried out to investigate of metal adsorption on graphene. In this work, the adsorption of CO molecules on pure graphene and on metal adatom on graphene surface has been simulated based on density functional theory (DFT). All calculations were performed by PBE functional and Troullier-Martins pseudopotentials. Density of states (DOS) for graphene-CO, graphen and CO around the Fermi energy has been moved and very small mixing occured which implies the physisorption of CO on the bare graphen surface. While, the results have showed that CO adsorption on transition-metal adatom on graphene surface is chemisorption.

Keywords: adsorption, density functional theory, graphene, metal adatom

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3613 Institutional Capacity of Health Care Institutes for Diagnosis and Management of Common Genetic Diseases-a Study from a North Coastal District of Andhra Pradesh, India

Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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3612 Significance of Occupational Safety for Healthcare Professionals

Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

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3611 Information Exchange Process Analysis between Authoring Design Tools and Lighting Simulation Tools

Authors: Rudan Xue, Annika Moscati, Rehel Zeleke Kebede, Peter Johansson

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Successful buildings’ simulation and analysis inevitably require information exchange between multiple building information modeling (BIM) software. The BIM infor-mation exchange based on IFC is widely used. However, Industry Foundation Classifi-cation (IFC) files are not always reliable and information can get lost when using dif-ferent software for modeling and simulations. In this research, interviews with lighting simulation experts and a case study provided by a company producing lighting devices have been the research methods used to identify the necessary steps and data for suc-cessful information exchange between lighting simulation tools and authoring design tools. Model creation, information exchange, and model simulation have been identi-fied as key aspects for the success of information exchange. The paper concludes with recommendations for improved information exchange and more reliable simulations that take all the needed parameters into consideration.

Keywords: BIM, data exchange, interoperability issues, lighting simulations

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3610 The Impact of Shariah Non-Compliance Risk on Islamic Financial Institutions

Authors: Ibtissam Mharzi Alaoui, Camélia Sehaqui

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The success of a bank depends upon its effective risk management. With the growing complexity and diversity of financial products and services, as well as the accelerating pace of globalization over the past decade, risk management is becoming increasingly difficult. thus, all measurement and monitoring functions must be much more vigorous, relevant and adequate. The Shariah non-compliance risk is specific aspect of Islamic finance which ipso facto, deserves particular attention. It affects the validity of all Islamic financial contracts and it turns out to be likely to result in considerable losses on the overall Islamic financial institutions (IFIs). The purpose of this paper is to review the theoretical literature on Shariah non-compliance risk in order to give a clearer understanding of its sources, causes and consequences. Our intention through this work is to bring added value to the Islamic finance industry all over the world. The findings provide a useful reference work for the Islamic banks in structuring (or restructuring) of their own system of shariah risk management and internal control.

Keywords: Shariah non-compliance, risk management, financial products, Islamic finance.

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3609 Does Clinical Guidelines Affect Healthcare Quality and Populational Health: Quebec Colorectal Cancer Screening Program

Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix

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In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.

Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference

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3608 Utilization of Jackfruit Seed Flour (Artocarpus heterophyllus L.) as a Food Additive

Authors: C. S. D. S. Maduwage, P. W. Jeewanthi, W. A. J. P. Wijesinghe

Abstract:

This study investigated the use of Jackfruit Seed Flour (JSF) as a thickening agent in tomato sauce production. Lye peeled mature jackfruit seeds were used to obtain JSF. Flour was packed in laminated bags and stored for further studies. Three batches of tomato sauce samples were prepared according to the Sri Lankan Standards for tomato sauce by adding JSF, corn flour and without any thickening agent. Samples were stored at room temperature for 8 weeks in glass bottles. The physicochemical properties such as pH, total soluble solids, titratable acidity, and water activity were measured during the storage period. Microbial analysis and sensory evaluation were done to determine the quality of tomato sauce. JSF showed the role of a thickening agent in tomato sauce with lowest serum separation and highest viscosity during the storage period. This study concludes that JSF can be successfully used as a thickening agent in food industry.

Keywords: Jackfruit seed flour, food additive, thickening agent, tomato sauce

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3607 Achieving Sustainable Rapid Construction Using Lean Principles

Authors: Muhamad Azani Yahya, Vikneswaran Munikanan, Mohammed Alias Yusof

Abstract:

There is the need to take the holistic approach in achieving sustainable construction for a contemporary practice. Sustainable construction is the practice that involved method of human preservation of the environment, whether economically or socially through responsibility, management of resources and maintenance utilizing support. This paper shows the correlation of achieving rapid construction with sustainable concepts using lean principles. Lean principles being used widely in the manufacturing industry, but this research will demonstrate the principles into building construction. Lean principle offers the benefits of stabilizing work flow and elimination of unnecessary work. Therefore, this principle contributes to time and waste reduction. The correlation shows that pulling factor provides the improvement of progress curve and stabilizing the time-quality relation. The finding shows the lean principles offer the elements of rapid construction synchronized with the elements of sustainability.

Keywords: sustainable construction, rapid construction, time reduction, lean construction

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3606 Integrating Nursing Informatics to Improve Patient-Centered Care: A Project to Reduce Patient Waiting Time at the Blood Pressure Counter

Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

Abstract:

Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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3605 Effectiveness of Shock Wave Therapy Versus Intermittent Mechanical Traction on Mechanical Low Back Pain and Disabilities

Authors: Ahmed Assem Abd El Rahim

Abstract:

Background: Mechanical low back pain is serious physical and social health problem. Purpose: To examine impact of shock wave therapy versus intermittent mechanical traction on mechanical LBP, and disabilities. Subjects: 60 mechanical LBP male studied cases years old 20-35 years were assigned randomly into 3 groups, Picked up from Sohag university orthopedic hospital outpatient clinic. Methods: (Study Group) A: 20 studied cases underwent shock wave therapy plus conventional physical therapy. (Study Group) B: twenty studied cases underwent intermittent mechanical traction plus conventional physical therapy. (Control Group) C: 20 patients underwent conventional physical therapy alone. Three sessions were applied weekly for four weeks. Pain was quantified using McGill Pain Questionnaire, Roland Morris Disability Questionnaire was used for measuring disability, and the ROM was evaluated by (BROM) device pre- & post-therapy. Results: Groups (A, B & C) found a reduction in pain & disability & rise in their in flexion and extension ROM after end of 4 weeks of program. Mean values of pain scale after therapy were 15.3, 9.47, and 23.07 in groups A, B, & C. mean values of Disability scale after therapy were 8.44, 4.87, 11.8in groups A, B & C. mean values of ROM of flexion were 25.53, 29.06, & 23.9 in groups A, B & C. mean values of ROM of extension were 11.73, 15.53 & 9.85 in groups A, B & C. studied cases who received intermittent mechanical traction & conventional physical therapy (group B), found reduction in pain & disability & improvement in ROM of flexion & extension value (P<0.001) after therapy program. Conclusion: Shock wave therapy and intermittent mechanical traction, as well as conventional physical treatment, can be beneficial in studied cases with mechanical LBP.

Keywords: mechanical low back pain, shock wave, mechanical, low back pain

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3604 Detection of Voltage Sag and Voltage Swell in Power Quality Using Wavelet Transforms

Authors: Nor Asrina Binti Ramlee

Abstract:

Voltage sag, voltage swell, high-frequency noise and voltage transients are kinds of disturbances in power quality. They are also known as power quality events. Equipment used in the industry nowadays has become more sensitive to these events with the increasing complexity of equipment. This leads to the importance of distributing clean power quality to the consumer. To provide better service, the best analysis on power quality is very vital. Thus, this paper presents the events detection focusing on voltage sag and swell. The method is developed by applying time domain signal analysis using wavelet transform approach in MATLAB. Four types of mother wavelet namely Haar, Dmey, Daubechies, and Symlet are used to detect the events. This project analyzed real interrupted signal obtained from 22 kV transmission line in Skudai, Johor Bahru, Malaysia. The signals will be decomposed through the wavelet mothers. The best mother is the one that is capable to detect the time location of the event accurately.

Keywords: power quality, voltage sag, voltage swell, wavelet transform

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3603 A Method of Drilling a Ground Using a Robotic Arm

Authors: Lotfi Beji, Laredj Benchikh

Abstract:

Underground tunnel face bolting and pipe umbrella reinforcement are one of the most challenging tasks in construction whether industrial or not, and infrastructures such as roads or pipelines. It is one of the first sectors of economic activity in the world. Through a variety of soil and rock, a cyclic Conventional Tunneling Method (CTM) remains the best one for projects with highly variable ground conditions or shapes. CTM is the only alternative for the renovation of existing tunnels and creating emergency exit. During the drilling process, a wide variety of non-desired vibrations may arise, and a method using a robot arm is proposed. The main kinds of drilling through vibration here is the bit-bouncing phenomenon (resonant axial vibration). Hence, assisting the task by a robot arm may play an important role on drilling performances and security. We propose to control the axial-vibration phenomenon along the drillstring at a practical resonant frequency, and embed a Resonant Sonic Drilling Head (RSDH) as a robot end effector for drilling. Many questionable industry drilling criteria and stability are discussed in this paper.

Keywords: drilling, resonant vibration, robot arm, control

Procedia PDF Downloads 284
3602 Arabic Light Stemmer for Better Search Accuracy

Authors: Sahar Khedr, Dina Sayed, Ayman Hanafy

Abstract:

Arabic is one of the most ancient and critical languages in the world. It has over than 250 million Arabic native speakers and more than twenty countries having Arabic as one of its official languages. In the past decade, we have witnessed a rapid evolution in smart devices, social network and technology sector which led to the need to provide tools and libraries that properly tackle the Arabic language in different domains. Stemming is one of the most crucial linguistic fundamentals. It is used in many applications especially in information extraction and text mining fields. The motivation behind this work is to enhance the Arabic light stemmer to serve the data mining industry and leverage it in an open source community. The presented implementation works on enhancing the Arabic light stemmer by utilizing and enhancing an algorithm that provides an extension for a new set of rules and patterns accompanied by adjusted procedure. This study has proven a significant enhancement for better search accuracy with an average 10% improvement in comparison with previous works.

Keywords: Arabic data mining, Arabic Information extraction, Arabic Light stemmer, Arabic stemmer

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3601 Patient Advocates to Improve Access to Justice in Involuntary Hospitalisation

Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

Abstract:

This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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3600 Antioxidant Activity of the Methanolic Extract and Antimicrobial Activity of the Essential Oil of Rosmarinus officinalis L. Grown in Algeria

Authors: Nassim Belkacem, Amina Azzam, Dalila Haouchine, Kahina Bennacer, Samira Soufit

Abstract:

Objective: To evaluate the antioxidant activity of the methanolic extract along with the antimicrobial activity of the essential oil of the aerial parts of Rosmarinus officinalis L. collected in the region of Bejaia (northern center of Algeria). Materials and methods: The polyphenols and flavonoids contents of the methanolic extract were measured. The antioxidant activity was evaluated using two methods: the ABTS method and DPPH assay. The antimicrobial activity was studied by the agar diffusion method against five bacterial strains (Three Gram positive strains and two Gram negative strains) and one fungus. Results: The total polyphenol and flavonoid content was about 43.8 mg gallic acid equivalent per gram (GA Eq/g) and 7.04 mg quercetin equivalent per gram (Q Eq/g), respectively. In the ABTS assay, the rosemary extract has shown an inhibition of 98.02% at the concentration of 500ug/ml with a half maximal inhibitory concentration value (IC50) of 194.92ug/ml. The results of DPPH assay have shown that the rosemary extract has an inhibition of 94.67 % with an IC50 value of 17.87ug/ml, which is lower than that of Butylhydroxyanisol (BHA) about 6.03ug/ml and ascorbic acid about 1.24μg/ml. The yield in essential oil of rosemary obtained by hydrodistillation was 1.42%. Based on the determination of the diameter of inhibition, different antimicrobial activity of the essential oil was revealed against the six tested microbes. Escherichia coli from the University Hospital (UH), Streptococcus aureus (UH) and Pseudomonas aeruginosa ATCC have a minimum inhibitory concentration value (MIC) of 62.5µl/ml. However, Bacillus sp (UH) and Staphylococcus aureus ATCC have an MIC value of 125μl/ml. The inhibition zone against Candida sp was about 24 mm. The aromatograms showed that the essential oil of rosemary exercises an antifungal activity more important than the antibacterial one.

Keywords: Rosmarinus officinalis L., maceration, essential oil, antioxidant, antimicrobial activity

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3599 Opioid Administration on Patients Hospitalized in the Emergency Department

Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

Abstract:

Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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