Search results for: capacity for care

Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: C. Park, H. Lee, Y-J. Lee

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Aim: This study aims to present the Sustainability Innovation Capacity Building Framework (SICBF) to enable the wider public to achieve UN Sustainable Development Goals (UN SDGs) for a sustainable future. The intrinsically interwoven nature of sustainability requires systematic approaches to attain. However, there is a lack of an effective framework for capacity building that enables a systematic implementation approach for UN SDGs. The SICBF illustrates the six core components and their dynamics: 1. Momentum creation; 2. Exposure to diverse worldviews; 3. Serendipity/Eureka moment; 4. Creative problem solving; 5. Individual empowerment; 6. Systems thinking. Method: First, a structured literature review was used to synthesise existing sustainability competencies studies and generic innovation competencies. Secondly, the conceptual framework based on literature findings was tested with the participants' survey and interview data collected from four sets of MAKEathon events. The interview analysis and event observation data were used to further refine and validate the conceptual framework. Contributions: The scientific contribution of this study is to pave the way for SDGs specific capacity building framework that caters to the need for systematic approaches to allow the wider public aspiring to tackle the seemingly intractable sustainable development goals. The framework will aid sustainable development academics, educators, and practitioners in understanding the dynamics of how capacity building can be facilitated.

Keywords: capacity building, sustainability innovation, sustainable development, systems thinking, UN SDGs

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: Kulveer Sandhu

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Background: In 1999, the Government of Canada legalized the use of cannabis for the therapeutic purpose (CTP); however, its users remain highly vulnerable to stigma and are judged by care providers and nonusers of cannabis. Findings from a literature review suggest health care providers (HCPs), including nurses in palliative care settings, lack knowledge about medical cannabis. For this reason, it is important to enhance HCPs’awarenessand knowledge of medical cannabis. Significance of the Project: Nurses are the first point of contact and spend more time with patients than other care providers; it is, therefore, important for them to be informed about CTPto provide quality and equitable care for medical cannabis users. Although nurses and other HCPs want information on CTP, the topic is rarely included in their educational curriculum. The purpose of this project is to create an evidence informed Package designed to increase knowledge among palliative care nurses about CTP. The information package will empower palliative nurses to help palliative patients make informed decisions about their treatment plan. Method: The information package will include a basic overview of the endocannabinoid system, common cannabis plants and products, and methods of consumption, as well as information to help nurses better understand consumption and harm reduction. The package will also include a set of cannabis fact sheets for nurses. Each fact sheet will comprise a high-level overview with graphics followed by a description of medical cannabis with links and references. At the end of the learning package, there are five self-reflection questions that allow nurses to examine their personal values, attitudes, and practices regarding medical cannabis. These questions will help each nurse understand their personal approach towards CTP and its users.

Keywords: medical cannabis, improve knowledge, cannabis for therapeutic purpose (CTP), patient experience, palliative care

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Authors: Mamata Mohanty, J. T. Shahu

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The in-situ deep mixing is an effective ground improvement technique which involves columnar inclusion into soft ground to increase its bearing capacity and reduce settlement. The first part of the study presents the results of unconfined compression on cement-admixed clay prepared at different cement content and subjected to varying curing periods. It is found that cement content is a prime factor controlling the strength of the cement-admixed clay. Besides cement content, curing period is important parameter that adds to the strength of cement-admixed clay. Increase in cement content leads to significant increase in Unconfined Compressive Strength (UCS) values especially at cement contents greater than 8%. The second part of the study investigated the bearing capacity of the clay ground improved by a group of end-bearing column using model tests under plain-strain condition. This study mainly focus to examine the effect of cement contents on the ultimate bearing capacity and failure stress of the improved clay ground. The study shows that the bearing capacity of the improved ground increases significantly with increase in cement contents of the soil-cement columns. A considerable increase in the stiffness of the model ground and failure stress was observed with increase in cement contents.

Keywords: bearing capacity, cement content, curing time, unconfined compressive strength, undrained shear strength

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Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

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Authors: Beatrice Adeoye

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Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

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Authors: A. Bouhaloufa, T. Kadri, S. Zouaoui, A. Belhacene

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To put more durable bridges, it is important to maintain existing structures, rather than investing in new structures. Instead of demolishing the old bridge and replace them with new, we must preserve and upgrade using better methods of diagnosis, auscultation and repair, the interest of this work is to increase the bearing capacity bridges damaged by additional prestressing, this type of reinforcement is growing continuously. In addition to excellent static strength, prestressing also has a very high resistance to fatigue, so it is suitable to solve the problem of failure of the bearing capacity of the bridges. This failure often comes to the development of overloads in quantity and quality, that is our daily traffic has increased and become very complicated, on the other hand its constituents are advanced in weight and speed and therefore almost all old bridges became unable to support the movement of the latter and remain disabled to all these problems. The main purpose of this work includes the following three aspects: - Determination of the main diseases and factors affecting the deterioration of bridges in Algeria, - Evaluation of the bearing capacity of bridges, - Proposal technical reinforcement to improve the bearing capacity of a degraded structure.

Keywords: bridges, repair, auscultation, diagnosis, pathology, additional prestressing

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Authors: Corbel Camille, Le Cerf Flora, Capriz Françoise, Vaillant-Ciszewicz Anne-Julie, Breaud Jean, Guerin Olivier, Corveleyn Xavier

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Background: The medical environment can generate stressful and anxiety-provoking situations for patients, particularly during painful care procedures for the older population. These stressful environments have deleterious effects on the quality of care and can even put the patient at risk and set the care team up for failure. The search for a solution is, therefore, imperative. The development of new technologies, such as virtual reality (VR), seems to be an answer to this problem. Objectives: The objective of this study is to compare the effects of virtual reality on pain and anxiety when caring for older hospitalized people with the effects of usual care. More precisely, different individual factors (age, cognitive level, individual preferences, etc.) and different virtual reality universes (personalized or non-personalized) are studied to understand the role of these factors in reducing pain and anxiety during care procedures. The aim of this study is to improve the quality of life of patients and caregivers in their work environment. Method: This mono-centered, randomized, controlled study was conducted from September 2023 to September 2024 on 120 participants recruited from the geriatric departments of the Cimiez Hospital, Nice, France. Participants are randomized into three groups: a control group, a personalized VR group and a non-personalized VR group. Each participant is followed during a painful care session. Data are collected before, during and after the care, using measures of pain (Algoplus and numerical scale) and anxiety (Hospital anxiety scale and numerical scale). Physiological assessments with an oximeter are also performed to collect both heart and respiratory rate measurements. The implementation of the care will be assessed among healthcare providers to evaluate its effects on the difficulty and fatigue associated with the care. Additionally, a questionnaire (System Usability Scale) will be administered at the conclusion of the study to determine the willingness of healthcare providers to integrate VR into their daily care practices. Result: The preliminary results indicate significant effects on anxiety (p=.001) and pain (p=<.001) following the VR intervention during care, as compared to the control group. Conclusion: The preliminary results suggest that VRI appears to be a suitable and effective method for reducing anxiety and pain among older hospitalized individuals compared with standard care. Finally, the experiences of healthcare professionals involved will also be considered to assess the impact of these interventions on working conditions and patient support.

Keywords: anxiety, care, pain, older adults, virtual reality

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Authors: Avinashkumar Karre

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Sulfur recovery unit, most commonly called as Claus process, is very significant gas desulfurization process unit in refinery and gas industries. Explorations of new natural gas fields, refining of high-sulfur crude oils, and recent crude expansion projects are needing capacity expansion of Claus unit for many companies around the world. In refineries, the sulphur recovery units take acid gas from amine regeneration units and sour water strippers, converting hydrogen sulfide to elemental sulfur using the Claus process. The Claus process is hydraulically limited by mass flow rate. Reducing the pressure drop across control valves, flow meters, lines, knock-out drums, and packing improves the capacity. Oxygen enrichment helps improve the capacity by removing nitrogen, this is more commonly done on all capacity expansion projects. Typical upgrades required due to oxygen enrichment are new burners, new refractory in thermal reactor, resizing of 1st condenser, instrumentation changes, and steam/condensate heat integration. Some other capacity expansion options typically considered are tail gas compressor, replacing air blower with higher head, hydrocarbon minimization in the feed, water removal, and ammonia removal. Increased capacity related upgrades in sulfur recovery unit also need changes in the tail gas treatment unit, typical changes include improvement to quench tower duty, packing area upgrades in quench and absorber towers and increased amine circulation flow rates.

Keywords: Claus process, oxygen enrichment, sulfur recovery unit, tail gas treatment unit

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Authors: Catelyn Coyle, Helena Kwakwa

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Objective: As novel and better tolerated therapies become available, effective HCV testing and care models become increasingly necessary to not only identify individuals with active infection but also link them to HCV providers for medical evaluation and treatment. Our aim is to describe an effective HCV testing and linkage to care model piloted in a network of five community health centers located in Philadelphia, PA. Methods: In October 2012, National Nursing Centers Consortium piloted a routine opt-out HCV testing model in a network of community health centers, one of which treats HCV, HIV, and co-infected patients. Key aspects of the model were medical assistant initiated testing, the use of laboratory-based reflex test technology, and electronic medical record modifications to prompt, track, report and facilitate payment of test costs. Universal testing on all adult patients was implemented at health centers serving patients at high-risk for HCV. The other sites integrated high-risk based testing, where patients meeting one or more of the CDC testing recommendation risk factors or had a history of homelessness were eligible for HCV testing. Mid-course adjustments included the integration of dual HIV testing, development of a linkage to care coordinator position to facilitate the transition of HIV and/or HCV-positive patients from primary to specialist care, and the transition to universal HCV testing across all testing sites. Results: From October 2012 to June 2015, the health centers performed 7,730 HCV tests and identified 886 (11.5%) patients with a positive HCV-antibody test. Of those with positive HCV-antibody tests, 838 (94.6%) had an HCV-RNA confirmatory test and 590 (70.4%) progressed to current HCV infection (overall prevalence=7.6%); 524 (88.8%) received their RNA-positive test result; 429 (72.7%) were referred to an HCV care specialist and 271 (45.9%) were seen by the HCV care specialist. The best linkage to care results were seen at the test and treat the site, where of the 333 patients were current HCV infection, 175 (52.6%) were seen by an HCV care specialist. Of the patients with active HCV infection, 349 (59.2%) were unaware of their HCV-positive status at the time of diagnosis. Since the integration of dual HCV/HIV testing in September 2013, 9,506 HIV tests were performed, 85 (0.9%) patients had positive HIV tests, 81 (95.3%) received their confirmed HIV test result and 77 (90.6%) were linked to HIV care. Dual HCV/HIV testing increased the number of HCV tests performed by 362 between the 9 months preceding dual testing and first 9 months after dual testing integration, representing a 23.7% increment. Conclusion: Our HCV testing model shows that integrated routine testing and linkage to care is feasible and improved detection and linkage to care in a primary care setting. We found that prevalence of current HCV infection was higher than that seen in locally in Philadelphia and nationwide. Intensive linkage services can increase the number of patients who successfully navigate the HCV treatment cascade. The linkage to care coordinator position is an important position that acts as a trusted intermediary for patients being linked to care.

Keywords: HCV, routine testing, linkage to care, community health centers

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Authors: Meimei Zheng

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Product personalization could not only bring new profits to companies but also provide the direction of long-term development for companies. However, the characteristics of personalized product cause some new problems. This paper investigates how companies make decisions on the supply of personalized products when facing different customer attitudes to personalized product and service, constraints due to limited capacity and updates of personalized demand information. This study will provide optimal decisions for companies to develop personalized markets, resulting in promoting business transformation and improving business competitiveness.

Keywords: demand forecast updating, limited capacity, personalized products, optimization

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Authors: Goran Baloevic, Jure Radnic, Nikola Grgic

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The application of frames with masonry or panel infill is common in the engineering practice. In these cases, a frame is often considered to be a primary structure, while an infill is considered to be a secondary structure. In past calculations, the infill was rarely included in the design of frame structures in terms of their bearing capacity and safety. Recent calculations of such structures necessarily include the effect of infill since it contributes to stiffness and bearing capacity of overall system, especially under horizontal loads. In certain cases, if the infill is not included in the seismic design of frame structures, the result can be lower design safety. However, since the different configuration of the infill through the building’s height can be made, it is possible that contribution of such infill to the overall bearing capacity can be lower and seismic forces on the building can be increased due to greater stiffness of the structure. So far, many experimental and numerical researches on the behavior of infilled frames under horizontal static forces and earthquake have been performed. In this paper, several masonry-infilled concrete and steel frames under horizontal static forces and earthquake are analysed. The experimental results by shake-table and numerical results are compared in terms of the bearing capacity of bare and infilled frames. Herein, the stiffness of frames and infill were varied, with different position of the infill and different types of openings. Cases with positive and negative effects of the infill to the bearing capacity of the frames were considered. Finally, main conclusions and recommendations for practical application and design of masonry-infilled concrete and steel frames are given.

Keywords: bearing capacity, infilled frame, numerical model, shake table

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Authors: Muhammad Idrees, Masroor Abro, Sikandar Almani

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Presently, the increasing CO₂ concentration in the atmosphere has been taken as one of the major challenges faced by the modern world. The average CO₂ in the atmosphere reached the highest value of 414.72 ppm in 2021, as reported in a conference of the parties (COP26). This study focuses on (i) the comparative study of MEA, NaOH, Acetic acid, and Na₂CO₃ in terms of their CO₂ capture performance, (ii) the significance of adding various frothing agents achieving improved absorption capacity of Na₂CO₃ and (iii) the overall economic evaluation of process with the help of Aspen Plus. The results obtained suggest that the addition of frothing agents significantly increased the absorption rate of dilute sodium carbonate such that from 45% to 99.9%. The effect of temperature, pressure and flow rate of liquid and flue gas streams on CO₂ absorption capacity was also investigated. It was found that the absorption capacity of Na₂CO₃ decreased with increasing temperature of the liquid stream and decreasing flow rate of the liquid stream and pressure of the gas stream.

Keywords: CO₂, absorbents, frothing agents, process simulation

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Authors: Ourn Vimoil, Kallaya Suntornvongsagul

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Cambodia is considered as one of the most disaster prone countries in South East Asia, and most of natural disasters are related to floods. Cambodia, a developing country, faces significant impacts from floods, such as environmental, social, and economic losses. Using data accessed from focus group discussions and field surveys with villagers in Ba Baong commune, prey Veng province, Cambodia, the research would like to examine roles of social networks in raising community’s coping capacity with floods. The findings indicate that social capital play crucial roles in three stages of floods, namely preparedness, response, and recovery to overcome the crisis. People shared their information and resources, and extent their assistances to one another in order to adapt to floods. The study contribute to policy makers, national and international agencies working on this issue to pay attention on social networks as one factors to accelerate flood coping capacity at community level.

Keywords: social network, community, coping capacity, flood, Cambodia

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Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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Authors: Saradiya Mukherjee

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Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

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Authors: Ruqaya H. Aljabery

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Reinforced Concrete (RC) deep beams are one of the main critical structural elements in terms of safety since significant loads are carried in a short span. The shear capacity of these sections cannot be predicted accurately by the current design codes like ACI and EC2; thus, they must be investigated. In this research, non-linear behavior of RC deep beams strengthened in shear with Fiber Reinforced Polymer (FRP) strips, and the efficiency of FRP in terms of enhancing the shear capacity in RC deep beams are examined using Finite Element Analysis (FEA), which is conducted using the software ABAQUS. The effect of several parameters on the shear capacity of the RC deep beam are studied in this paper as well including the effect of the cross-sectional area of the FRP strip and the shear reinforcement area to the spacing ratio (As/S), and it was found that FRP enhances the shear capacity significantly and can be a substitution of steel stirrups resulting in a more economical design.

Keywords: Abaqus, concrete, deep beam, finite element analysis, FRP, shear strengthening, strut-and-tie

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Authors: K. Malak, A. Nourah, S.Liyakathunisa

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Nowadays, healthcare services are facing many challenges since they are becoming more complex and more needed. Every detail of a patient’s interactions with health care providers is maintained in Electronic Health Records (ECR) and Healthcare information systems (HIS). However, most of the existing systems are often focused on documenting what happens in manual health care process, rather than providing the highest quality patient care. Healthcare business processes and stakeholders can no longer rely on manual processes, to provide better patient care and efficient utilization of resources, Healthcare processes must be automated wherever it is possible. In this research, a detail survey and analysis is performed on the existing health care systems in Saudi Arabia, and an automated smart medical healthcare business process model is proposed. The business process management methods and rules are followed in discovering, collecting information, analysis, redesign, implementation and performance improvement analysis in terms of time and cost. From the simulation results, it is evident that our proposed smart medical records system can improve the quality of the service by reducing the time and cost and increasing efficiency

Keywords: business process management, electronic health records, efficiency, cost, time

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Authors: Antonio Pratelli, Lorenzo Brocchini, Reginald Roy Souleyrette

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A rotary is a traffic circle intersection where vehicles entering from branches give priority to circulating flow. Vehicles entering the intersection from converging roads move around the central island and weave out of the circle into their desired exiting branch. This creates merging and diverging conflicts among any entry and its successive exit, i.e., a section. Therefore, rotary capacity models are usually based on the weaving of the different movements in any section of the circle, and the maximum rate of flow value is then related to each weaving section of the rotary. Nevertheless, the single-section capacity value does not lead to the typical performance characteristics of the intersection, such as the entry average delay which is directly linked to its level of service. From another point of view, modern roundabout capacity models are based on the limitation of the flow entering from the single entrance due to the amount of flow circulating in front of the entrance itself. Modern roundabouts capacity models generally lead also to a performance evaluation. This paper aims to incorporate a modern roundabout capacity model into an old rotary capacity method to obtain from the latter the single input capacity and ultimately achieve the related performance indicators. Put simply; the main objective is to calculate the average delay of each single roundabout entrance to apply the most common Highway Capacity Manual, or HCM, criteria. The paper is organized as follows: firstly, the rotary and roundabout capacity models are sketched, and it has made a brief introduction to the model combination technique with some practical instances. The successive section is deserved to summarize the TRRL old rotary capacity model and the most recent HCM-7th modern roundabout capacity model. Then, the two models are combined through an iteration-based algorithm, especially set-up and linked to the concept of roundabout total capacity, i.e., the value reached due to a traffic flow pattern leading to the simultaneous congestion of all roundabout entrances. The solution is the average delay for each entrance of the rotary, by which is estimated its respective level of service. In view of further experimental applications, at this research stage, a collection of existing rotary intersections operating with the priority-to-circle rule has already started, both in the US and in Italy. The rotaries have been selected by direct inspection of aerial photos through a map viewer, namely Google Earth. Each instance has been recorded by location, general urban or rural, and its main geometrical patterns. Finally, conclusion remarks are drawn, and a discussion on some further research developments has opened.

Keywords: mixed methods, old rotary and modern roundabout capacity models, total capacity algorithm, level of service estimation

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Authors: A. Dali-Ali, F. Agag, H. Beldjilali, A. Oukebdane, K. Meddeber, R. Dali-Yahia, N. Midoun

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The ability of Acinetobacter baumannii to develop multiple resistances towards to the majority of antibiotics explains the therapeutic difficulties encountered in severe infections. Furthermore, its persistence in the humid or dry environment promotes cross-contamination in intensive care units. The aim of our study was to describe the epidemiological and bacterial resistance profiles of hospital-acquired infections caused by Acinetobacter baumannii in the intensive care unit of our teaching hospital. During the study period (June 3, 2012 to December 31, 2013), 305 patients having duration of hospitalization equal or more than 48 hours were included in the study. Among these, 36 had developed, at least, one health-care associated infection caused by Acinetobacter baumannii. The rate of infected patients was equal to 11.8% (36/305). The rate of cumulative incidence of hospital-acquired pneumonia was the highest (9.2%) followed by central venous catheter infection (1.3%). Analysis of the various antibiotic resistance profile shows that 93.8% of the strains were resistant to imipenem. The nosocomial infection control committee set up a special program not only to reduce the high rates of incidence of these infections but also to descrease the rate of imipenem resistance.

Keywords: Acinetobacer baumannii, epidemiological profile, hospital acquired infections, intensive care unit

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Authors: M. Aljumaan, F. Alkhadra, A. Aldajani, M. Alarfaj, A. Alawami, Y. Aljamaan

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Introduction: The internet has been widely available with 18 million users in Saudi Arabia alone. It was shown that 58% of Saudis are using the internet as a source of health-related information which may contribute to overcrowding of the Emergency Room (ER). Not many studies have been conducted to show the effect of online searching for health related information (HRI) and its role in influencing internet users to visit various health care facilities. So the main objective is to determine a correlation between HRI website use and health care facility visits in Saudi Arabia. Methodology: By conducting a cross sectional study and distributing a questionnaire, a total number of 1095 people were included in the study. Demographic data was collected as well as questions including the use of HRI websites, type of websites used, the reason behind the internet search, which health care facility it lead them to visit and whether seeking health information on the internet influenced their attitude towards visiting health care facilities. The survey was distributed using an internet survey applications. The data was then put on an excel sheet and analyzed with the help of a biostatician for making a correlation. Results: We found 91.4% of our population have used the internet for medical information using mainly General medical websites (77.8%), Forums (34.2%), Social Media (21.6%), and government websites (21.6%). We also found that 66.9% have used the internet for medical information to diagnose and treat their medical conditions on their own while 34.7% did so due to the inability to have a close referral and 29.5% due to their lack of time. Searching for health related information online caused 62.5% of people to visit health care facilities. Outpatient clinics were most visited at 77.9% followed by the ER (27.9%). The remaining 37.5% do not visit because using HRI websites reassure them of their condition. Conclusion: In conclusion, there may be a correlation between health information website use and health care facility visits. However, to avoid potentially inaccurate medical information, we believe doctors have an important role in educating their patients and the public on where to obtain the correct information & advertise the sites that are regulated by health care officials.

Keywords: ER visits, health related information, internet, medical websites

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Authors: Chaliya Wamaloon, Malee Chaisaena, Nusara Prasertsri

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Informal caregivers providing home-based palliative and end-of-life (EOL) care to people with advanced cancer is needed, however, there has not been develop caregiver skills for the EOL in cancer patients. The aim of this research was to study the model development of caregiver skills for the EOL in cancer patients. Mixed methods research was conducted in 3 phases. All subjects were in Ubon Rathchathani Cancer Hospital including 30 EOL cancer patient caregivers, 30 EOL cancer patients, and 111 health care professionals who provided care for the EOL cancer patients and 30 EOL target participants who had been trained to be cancer patient caregivers. The research tools were questionnaires, semi structured interviews, and caregiver skills questionnaires. Data were analyzed by using percentage, mean, standard deviation, pair t-test, and content analysis. The result from this study showed the model development of caregiver skills for cancer patients consisted of 9 domains skills: 1. monitoring, 2. interpreting, 3. making decisions, 4. taking action, 5. making adjustments, 6. providing hands-on care, 7. accessing resources, 8. working together with the ill patients, and 9. navigating the healthcare system. The model composed of skills development curriculum for cancer patient caregivers, Manual of palliative care for caregivers, diary of health care records for cancer patients, and the evaluation model of development of caregiver skills for EOL cancer patients. The results of the evaluation in the development model of caregiver skills for EOL cancer patients showed that the caregivers were satisfied with the model of development for caregiver skills at a high level. The comparison of the caregiver skills before and after obtaining the development of caregivers skills revealed that it improved at a statistically significant level (p < 0.05).

Keywords: caregiver, caregiver skills, cancer patients, end of life

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Authors: Rayleigh Dada Abu, Halilu Ahmad Shaba

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Siltation is a serious problem that affects public water supply infrastructures such as dams and reservoirs. It is a major problem which threatens the performance and sustainability of dams and reservoirs. It reduces the dam capacity for flood control, potable water supply, changes water stage, reduces water quality and recreational benefits. The focus of this study is the Lower Usuma reservoir. At completion the reservoir had a gross storage capacity of 100 × 106 m3 (100 million cubic metres), a maximum operational level of 587.440 m a.s.l., with a maximum depth of 49 m and a catchment area of 241 km2 at dam site with a daily designed production capacity of 10,000 cubic metres per hour. The reservoir is 1,300 m long and feeds the treatment plant mainly by gravity. The reservoir became operational in 1986 and no survey has been conducted to determine its current storage capacity and rate of siltation. Hydrographic survey of the reservoir by integrated acoustic echo-sounding technique was conducted in November 2012 to determine the level and rate of siltation. The result obtained shows that the reservoir has lost 12.0 meters depth to siltation in 26 years of its operation; indicating 24.5% loss in installed storage capacity. The present bathymetric survey provides baseline information for future work on siltation depth and annual rates of storage capacity loss for the Lower Usuma reservoir.

Keywords: sedimentation, lower Usuma reservoir, acoustic echo sounder, bathymetric survey

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Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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Authors: A. De Serres-Lafontaine, S. Porlier, K. Poitras

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Introduction: Placement is, without doubt, a challenging experience for both foster children and biological parents who witness their child being removed from their care. Yet, few studies have examined parenting in such a context through critical parental skills such as parental sensitivity and commitment. Sensitivity is described as the capacity of parents to respond accurately to their child’s needs in a warm, predictable and consistent way, whereas commitment is the ability of the parent to get involved physically and emotionally in an enduring relationship with his child. The research confirms the important role of parental sensitivity and parental commitment on child development following placement in foster care. Nevertheless, these studies were mainly conducted with foster parents, and few studies have examined these components of parenthood with biological parents. Method: This study evolves in two times. At first, 17 parents participated throughout a 90-minutes interview. It allowed to collect information regarding the sociodemographic situation, contacts, placement trajectory. Parental sensitivity is observed during a supervised parent-child contact. The second time occurred one to two years later and implied an at-home 90-minutes interview where we updated the information from the first interview and were able to assess the level of parental commitment. In this ongoing part of the study, five parents have already participated in implying the rest of them remain to be interviewed in the coming months - from October through December 2018. Results: Descriptive analysis from the first part of the study suggests the examination of two groups: 11 children have been reunified whereas six are still in foster care. Qualitative analysis allows to compare themes of sensitivity and commitment regarding if the reunification project occurs or not. Preliminary analysis about thematic content shows key components of parental commitment through parent’s reveal of the way they nurture a relationship with their child. Furthermore, preliminary analysis suggests that parental sensitivity is not associated with family reunification (r = 0,11, p = 0,74). Further analysis will be assessed with the date from the second part of the study to examine the potential association between commitment and reunification. Discussion: Parental sensitivity and commitment are fundamental to the well-being of the child in a placement trajectory. They need to be understood better as two different complex concepts and as two parenting skills that might have a way of echoing to one another when engaged in a specific context. Above all, a more accurate comprehension of parenting in a placement trajectory allows to sustain adequate intervention practices for birth parents and could change the way parental adequacy is assessed when reaching for reunification.

Keywords: child welfare, foster care, intervention practices, parenthood

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Authors: Aran Dezhban, Hooshang Dolatshahi Pirooz

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The phenomenon of corrosion, especially in the Persian Gulf region, is the main cause of the deterioration of offshore platforms, due to the high corrosion of its water. This phenomenon occurs mostly in the area of water spraying, threatening the members of the first floor of the jacket, legs, and piles in this area. In the current study, the effect of bracing arrangement on the Capacity Curve and Reserve Strength Ratio of Fixed-Type Offshore Platforms is investigated. In order to continue the operation of the platform, two modes of robust and damaged structures are considered, while checking the adequacy of the platform capacity based on the allowable values of API RP-2SIM regulations. The platform in question is located in the Persian Gulf, which is modeled on the OpenSEES software. In this research, the Nonlinear Pushover Analysis has been used. After validation, the Capacity Curve of the studied platforms is obtained and then their Reserve Strength Ratio is calculated. Results are compared with the criteria in the API-2SIM regulations.

Keywords: fixed-type jacket structure, structural integrity management, nonlinear pushover analysis, robust and damaged structure, reserve strength ration, capacity curve

Procedia PDF Downloads 98

Authors: Suppawan Lertpongpakpoom, Anongnat Boonrat, Kunya BoontummoSuppawan

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This descriptive cost analysis aimed to analyze the unit cost of patients in medical intensive care unit. Purposive sampling was used to select 20 nurses, 6 practical nurses, 5 nurses aid and select samples 30 patients. Data were collected from both primary source (activity and average time of nursing care) and secondary source Z bill of payment and patient record). Instruments were cost recording form, activity observation form, and service recording form. Content validity of all instruments were evaluated by three experts (CVI = 0.87). Descriptive statistics was employed for data analysis. The results of the Activity-Based Costing Analysis showed that total activity cost of 4 service types for the patients was 14,776.92 Bath. The highest cost was nursing record was 5,674.78 Bath, followed direct nursing activity was 5,176.18 Bath, medical treatment was 1,976.6 Bath. The lowest cost was management activity was 1,003.64 Bath per visit. The result suggested that Activity-Base Costing Analysis could be applied to give better understanding of cost structure, enabling better consideration wasted expense and non-value-added activity, and improvement of effective utilization.

Keywords: activity-based costing, medical intensive care, nursing care, cost analysis

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Authors: Moses Balina, Archbald Bahizi

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Introduction: Early onset neonatal sepsis is a systemic infection in a newborn baby during the first week after birth and contributes to 50% of neonatal deaths each year. Risk factors for early onset neonatal sepsis, which can be maternal, health care provider, or health care facility associated, can be prevented with access to quality antenatal care. Objective: The objective of the study was to assess early onset neonatal sepsis and antenatal factors associated with Fort Portal Regional Referral Hospital. Methodology: A cross sectional study design was used. The study involved 60 respondents who were mothers of breastfeeding neonates being treated for early onset neonatal sepsis at Fort Portal Regional Referral Hospital neonatal intensive care unit. Simple random sampling was used to select study participants. Data were collected using questionnaires, entered in Stata 16, and analysed using logistic regression. Results: The prevalence of early onset neonatal sepsis at Fort Portal Regional Referral Hospital was 25%. Multivariate analysis revealed that institutional factors were the only antenatal factors found to be significantly associated with early onset neonatal sepsis at Fort Portal Regional Referral Hospital (p < 0.01). Bivariate analysis revealed that attending antenatal care at a health centre III or IV instead of a hospital (p = 0.011) and attending antenatal care in health care facilities with no laboratory investigations (p = 0.048) were risk factors for early onset neonatal sepsis in the newborn at Fort Portal Regional Referral Hospital. Conclusion: Antenatal factors were associated with early onset neonatal sepsis, and health care facility factors like lower level health centre and unavailability of quality laboratory investigations to pregnant women contributed to early onset neonatal sepsis in the newborn. Mentorships, equipping/stocking laboratories, and improving staffing levels were necessary to reduce early onset neonatal sepsis.

Keywords: antenatal factors, early onset neonatal sepsis, neonates 0-7 days, fort portal regional referral hospital

Procedia PDF Downloads 87

Authors: Michael T. Ajayi, Oluwakemi E. Fapojuwo

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Farmers are in need of regular and relevant information relating to new technologies. Production of extension materials has been found to be useful in facilitating the process. Extension materials help to provide information to reach large numbers of farmers quickly and economically. However, as good as extension materials are, previous materials produced are not used by farmers. The reasons for this include lack of involvement of farmers in the production of the extension materials, most of the extension materials are not relevant to the farmers’ environments, the agricultural extension agents lack capacity to prepare the materials, and many extension agents lack commitment. These problems led to this innovative capacity building of extension agents. This innovative approach involves five stages. The first stage is the diagnostic survey of farmers’ environment to collect useful information. The second stage is the development and production of draft extension materials. The third stage is the field testing and evaluation of draft materials by the same farmers that were involved at the diagnostic stage. The fourth stage is the revision of the draft extension materials by incorporating suggestions from farmers. The fifth stage is the action plans. This process improves the capacity of agricultural extension agents in the preparation of extension materials and also promotes engagement of farmers and beneficiaries in the process. The process also makes farmers assume some level of ownership of the exercise and the extension materials.

Keywords: capacity building, extension agents, dissemination, information/technologies

Procedia PDF Downloads 346