Search results for: the hospital residents problem
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9774

Search results for: the hospital residents problem

9414 Constant Factor Approximation Algorithm for p-Median Network Design Problem with Multiple Cable Types

Authors: Chaghoub Soraya, Zhang Xiaoyan

Abstract:

This research presents the first constant approximation algorithm to the p-median network design problem with multiple cable types. This problem was addressed with a single cable type and there is a bifactor approximation algorithm for the problem. To the best of our knowledge, the algorithm proposed in this paper is the first constant approximation algorithm for the p-median network design with multiple cable types. The addressed problem is a combination of two well studied problems which are p-median problem and network design problem. The introduced algorithm is a random sampling approximation algorithm of constant factor which is conceived by using some random sampling techniques form the literature. It is based on a redistribution Lemma from the literature and a steiner tree problem as a subproblem. This algorithm is simple, and it relies on the notions of random sampling and probability. The proposed approach gives an approximation solution with one constant ratio without violating any of the constraints, in contrast to the one proposed in the literature. This paper provides a (21 + 2)-approximation algorithm for the p-median network design problem with multiple cable types using random sampling techniques.

Keywords: approximation algorithms, buy-at-bulk, combinatorial optimization, network design, p-median

Procedia PDF Downloads 186
9413 Timing of Ileostomy Closure Following Rectal Cancer Surgery at an Australian Regional Hospital

Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

Abstract:

Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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9412 Satisfaction Evaluation on the Fundamental Public Services for a Large-Scale Indemnificatory Residential Community: A Case Study of Nanjing

Authors: Dezhi Li, Peng Cui, Bo Zhang, Tengyuan Chang

Abstract:

In order to solve the housing problem for the low-income families, the construction of affordable housing is booming in China. However, due to various reasons, the service facilities and systems in the indemnificatory residential community meet many problems. This article established a Satisfaction Evaluation System of the Fundamental Public Services for Large-scale Indemnificatory Residential Community based on the national standards and local criteria and developed evaluation methods and processes. At last, in the case of Huagang project in Nanjing, the satisfaction of basic public service is calculated according to a survey of local residents.

Keywords: indemnificatory residential community, public services, satisfaction evaluation, structural equation modeling

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9411 Magnitude and Outcome of Resuscitation Activities at Rwanda Military Hospital for the Period of April 2013-September 2013

Authors: Auni Idi Muhire

Abstract:

Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

Procedia PDF Downloads 262
9410 A Comparative Study on the Positive and Negative of Electronic Word-of-Mouth on the SERVQUAL Scale-Take A Certain Armed Forces General Hospital in Taiwan As An Example

Authors: Po-Chun Lee, Li-Lin Liang, Ching-Yuan Huang

Abstract:

Purpose: Research on electronic word-of-mouth (eWOM)& online review has been widely used in service industry management research in recent years. The SERVQUAL scale is the most commonly used method to measure service quality. Therefore, the purpose of this research is to combine electronic word of mouth & online review with the SERVQUAL scale. To explore the comparative study of positive and negative electronic word-of-mouth reviews of a certain armed force general hospital in Taiwan. Data sources: This research obtained online word-of-mouth comment data on google maps from a military hospital in Taiwan in the past ten years through Internet data mining technology. Research methods: This study uses the semantic content analysis method to classify word-of-mouth reviews according to the revised PZB SERVQUAL scale. Then carry out statistical analysis. Results of data synthesis: The results of this study disclosed that the negative reviews of this military hospital in Taiwan have been increasing year by year. Under the COVID-19 epidemic, positive word-of-mouth has a downward trend. Among the five determiners of SERVQUAL of PZB, positive word-of-mouth reviews performed best in “Assurance,” with a positive review rate of 58.89%, Followed by 43.33% of “Responsiveness.” In negative word-of-mouth reviews, “Assurance” performed the worst, with a positive rate of 70.99%, followed by responsive 29.01%. Conclusions: The important conclusions of this study disclosed that the total number of electronic word-of-mouth reviews of the military hospital has revealed positive growth in recent years, and the positive word-of-mouth growth has revealed negative growth after the epidemic of COVID-19, while the negative word-of-mouth has grown substantially. Regardless of the positive and negative comments, what patients care most about is “Assurance” of the professional attitude and skills of the medical staff, which needs to be strengthened most urgently. In addition, good “Reliability” will help build positive word-of-mouth. However, poor “Responsiveness” can easily lead to the spread of negative word-of-mouth. This study suggests that the hospital should focus on these few service-oriented quality management and audits.

Keywords: quality of medical service, electronic word-of-mouth, armed forces general hospital

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9409 Effect of Serum Electrolytes on a QTc Interval and Mortality in Patients admitted to Coronary Care Unit

Authors: Thoetchai Peeraphatdit, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham, Niyada Naksuk

Abstract:

Background: Serum electrolyte abnormalities are a common cause of an acquired prolonged QT syndrome, especially, in the coronary care unit (CCU) setting. Optimal electrolyte ranges among the CCU patients have not been sufficiently investigated. Methods: We identified 8,498 consecutive CCU patients who were admitted to the CCU at Mayo Clinic, Rochester, the USA, from 2004 through 2013. Association between first serum electrolytes and baseline corrected QT intervals (QTc), as well as in-hospital mortality, was tested using multivariate linear regression and logistic regression, respectively. Serum potassium 4.0- < 4.5 mEq/L, ionized calcium (iCa) 4.6-4.8 mg/dL, and magnesium 2.0- < 2.2 mg/dL were used as the reference levels. Results: There was a modest level-dependent relationship between hypokalemia ( < 4.0 mEq/L), hypocalcemia ( < 4.4 mg/dL), and a prolonged QTc interval; serum magnesium did not affect the QTc interval. Association between the serum electrolytes and in-hospital mortality included a U-shaped relationship for serum potassium (adjusted odds ratio (OR) 1.53 and OR 1.91for serum potassium 4.5- < 5.0 and ≥ 5.0 mEq/L, respectively) and an inverted J-shaped relationship for iCa (adjusted OR 2.79 and OR 2.03 for calcium < 4.4 and 4.4- < 4.6 mg/dL, respectively). For serum magnesium, the mortality was greater only among patients with levels ≥ 2.4 mg/dL (adjusted OR 1.40), compared to the reference level. Findings were similar in sensitivity analyses examining the association between mean serum electrolytes and mean QTc intervals, as well as in-hospital mortality. Conclusions: Serum potassium 4.0- < 4.5 mEq/L, iCa ≥ 4.6 mg/dL, and magnesium < 2.4 mg/dL had a neutral effect on QTc intervals and were associated with the lowest in-hospital mortality among the CCU patients.

Keywords: calcium, electrocardiography, long-QT syndrome, magnesium, mortality, potassium

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9408 Nurse's Professional Space: Psychiatric Outpatient Clinic of Ottawa's Montfort Hospital 1976-2002

Authors: Silvia Maria Moya

Abstract:

After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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9407 Expert and Novice Problem-Solvers Differences: A Discourse for Effective Teaching Delivery in Physics Classrooms

Authors: Abubakar Sa’adatu Mohammed

Abstract:

This paper reports on a study of problem solving differences between expert and novice Problem solvers for effective physics teaching. Significant differences were found both at the conceptual level and at the level of critical thinking, creative thinking and reasoning. It is suggested for a successful solution of a problem, conceptual knowledge alone may not be sufficient. There is the need of the knowledge of how the conceptual knowledge should be applied (problem solving skills). It is hoped that this research might contribute to efforts of exploring ways for students to acquire a powerful conceptual toolkit based on experts like problem solvers approach for effective teaching delivery.

Keywords: conceptual knowledge, procedural knowledge, critical thinking, creative thinking, reasoning ability

Procedia PDF Downloads 283
9406 Developing the Morphological Field of Problem Context to Assist Multi-Methodology in Operations Research

Authors: Mahnaz Hosseinzadeh, Mohammad Reza Mehregan

Abstract:

In this paper, we have developed a morphological field to assist multi- methodology (combining methodologies together in whole or part) in Operations Research (OR) for the problem contexts in Iranian organizations. So, we have attempted to identify some dimensions for problem context according to Iranian organizational problems. Then, a general morphological program is designed which helps the OR practitioner to determine the suitable OR methodology as output for any configuration of conditions in a problem context as input and to reveal the fields necessary to be improved in OR. Applying such a program would have interesting results for OR practitioners.

Keywords: hard, soft and emancipatory operations research, General Morphological Analysis (GMA), multi-methodology, problem context

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9405 Innovation Trends in Latin America Countries

Authors: José Carlos Rodríguez, Mario Gómez

Abstract:

This paper analyses innovation trends in Latin America countries by means of the number of patent applications filed by residents and non-residents during the period 1965 to 2012. Making use of patent data released by the World Intellectual Property Organization (WIPO), we search for the presence of multiple structural changes in patent application series in Argentina, Brazil Chile, and Mexico. These changes may suggest that firms’ innovative activity has been modified as a result of implementing a particular science, technology and innovation (STI) policy. Accordingly, the new regulations implemented in these countries during 1980s and 1990s have influenced their intellectual property regimes. The question conducting this research is thus how STI policies in these countries have affected their innovation activity? The results achieved in this research confirm the existence of multiple structural changes in the series of patent applications resulting from STI policies implemented in these countries.

Keywords: econometric methods, innovation activity, Latin America countries, patents, science, technology and innovation policy

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9404 Solving Stochastic Eigenvalue Problem of Wick Type

Authors: Hassan Manouzi, Taous-Meriem Laleg-Kirati

Abstract:

In this paper we study mathematically the eigenvalue problem for stochastic elliptic partial differential equation of Wick type. Using the Wick-product and the Wiener-Ito chaos expansion, the stochastic eigenvalue problem is reformulated as a system of an eigenvalue problem for a deterministic partial differential equation and elliptic partial differential equations by using the Fredholm alternative. To reduce the computational complexity of this system, we shall use a decomposition-coordination method. Once this approximation is performed, the statistics of the numerical solution can be easily evaluated.

Keywords: eigenvalue problem, Wick product, SPDEs, finite element, Wiener-Ito chaos expansion

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9403 Strength of Gratitude Determining Subjective Well-Being: Evidence for Mediating Role of Problem-Solving Styles

Authors: Sarwat Sultan, Shahzad Gul

Abstract:

This study was carried out to see the mediating role of problem solving styles (sensing, intuitive, feeling, and thinking) in the predictive relationship of gratitude with subjective well-being. A sample of 454 college students aged 20-26 years old participated in this study and provided data on the measures of gratitude, problem solving styles, and subjective well-being. Results indicated the significant relationships of gratitude with subjective well-being and problem solving styles of intuitive and thinking. Results further indicated the positive link of intuitive and thinking styles with subjective well-being. Findings also provided the evidence for the significant mediating role of problem solving styles in the relationship of gratitude with subjective well-being. The implication for this study is likely to enhance the medium to long term effects of gratitude on subjective well-being among students and as well as assessing its value in promoting psychological health and problem solving strategies among students.

Keywords: gratitude, subjective well-being, problem solving styles, college students

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9402 A Preliminary Study of the Reconstruction of Urban Residential Public Space in the Context of the “Top-down” Construction Model in China: Based on Research of TianZiFang District in Shanghai and Residential Space in Hangzhou

Authors: Wang Qiaowei, Gao Yujiang

Abstract:

With the economic growth and rapid urbanization after the reform and openness, some of China's fast-growing cities have demolished former dwellings and built modern residential quarters. The blind, incomplete reference to western modern cities and the one-off construction lacking feedback mechanism have intensified such phenomenon, causing the citizen gradually expanded their living scale with the popularization of car traffic, and the peer-to-peer lifestyle gradually settled. The construction of large-scale commercial centers has caused obstacles to small business around the residential areas, leading to space for residents' interaction has been compressed. At the same time, the advocated Central Business District (CBD) model even leads to the unsatisfactory reconstruction of many historical blocks such as the Hangzhou Southern Song Dynasty Imperial Street. However, the popularity of historical spaces such as Wuzhen and Hongcun also indicates the collective memory and needs of the street space for Chinese residents. The evolution of Shanghai TianZiFang also proves the importance of the motivation of space participants in space construction in the context of the “top-down” construction model in China. In fact, there are frequent occurrences of “reconstruction”, which may redefine the space, in various residential areas. If these activities can be selectively controlled and encouraged, it will be beneficial to activate the public space as well as the residents’ intercourse, so that the traditional Chinese street space can be reconstructed in the context of modern cities.

Keywords: rapid urbanization, traditional street space, space re-construction, bottom-up design

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9401 The Adoption of Leagility in Healthcare Services

Authors: Ana L. Martins, Luis Orfão

Abstract:

Healthcare systems have been subject to various research efforts aiming at process improvement under a lean approach. Another perspective, agility, has also been used, though in a lower scale, in order to analyse the ability of different hospital services to adapt to demand uncertainties. Both perspectives have a common denominator, the improvement of effectiveness and efficiency of the services in a healthcare setting context. Mixing the two approached allows, on one hand, to streamline the processes, and on the other hand the required flexibility to deal with demand uncertainty in terms of both volume and variety. The present research aims to analyse the impacts of the combination of both perspectives in the effectiveness and efficiency of an hospital service. The adopted methodology is based on a case study approach applied to the process of the ambulatory surgery service of Hospital de Lamego. Data was collected from direct observations, formal interviews and informal conversations. The analyzed process was selected according to three criteria: relevance of the process to the hospital, presence of human resources, and presence of waste. The customer of the process was identified as well as his perception of value. The process was mapped using flow chart, on a process modeling perspective, as well as through the use of Value Stream Mapping (VSM) and Process Activity Mapping. The Spaghetti Diagram was also used to assess flow intensity. The use of the lean tools enabled the identification of three main types of waste: movement, resource inefficiencies and process inefficiencies. From the use of the lean tools improvement suggestions were produced. The results point out that leagility cannot be applied to the process, but the application of lean and agility in specific areas of the process would bring benefits in both efficiency and effectiveness, and contribute to value creation if improvements are introduced in hospital’s human resources and facilities management.

Keywords: case study, healthcare systems, leagility, lean management

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9400 An Approximation Algorithm for the Non Orthogonal Cutting Problem

Authors: R. Ouafi, F. Ouafi

Abstract:

We study the problem of cutting a rectangular material entity into smaller sub-entities of trapezoidal forms with minimum waste of the material. This problem will be denoted TCP (Trapezoidal Cutting Problem). The TCP has many applications in manufacturing processes of various industries: pipe line design (petro chemistry), the design of airfoil (aeronautical) or cuts of the components of textile products. We introduce an orthogonal build to provide the optimal horizontal and vertical homogeneous strips. In this paper we develop a general heuristic search based upon orthogonal build. By solving two one-dimensional knapsack problems, we combine the horizontal and vertical homogeneous strips to give a non orthogonal cutting pattern.

Keywords: combinatorial optimization, cutting problem, heuristic

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9399 Analysis of Ecological Footprint of Residents for Urban Spatial Restructuring

Authors: Taehyun Kim, Hyunjoo Park, Taehyun Kim

Abstract:

Since the rapid economic development, Korea has recently entered a period of low growth due to population decline and aging. Due to the urbanization around the metropolitan area and the hollowing of local cities, the ecological capacity of a city is decreasing while ecological footprints are increasing, requiring a compact space plan for maintaining urban functions. The purpose of this study is to analyze the relationship between urban spatial structure and residents' ecological footprints for sustainable spatial planning. To do this, we try to analyze the relationship between intra-urban spatial structure, such as net/gross density and service accessibility, and resident ecological footprints of food, housing, transportation, goods and services through survey and structural equation modeling. The results of the study will be useful in establishing an implementation plan for sustainable development goals (SDGs), especially for sustainable cities and communities (SDG 11) and responsible consumption and production (SDG 12) in the future.

Keywords: ecological footprint, structural equation modeling, survey, sustainability, urban spatial structure

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9398 Decision Support System for Solving Multi-Objective Routing Problem

Authors: Ismail El Gayar, Ossama Ismail, Yousri El Gamal

Abstract:

This paper presented a technique to solve one of the transportation problems that faces us in real life which is the Bus Scheduling Problem. Most of the countries using buses in schools, companies and traveling offices as an example to transfer multiple passengers from many places to specific place and vice versa. This transferring process can cost time and money, so we build a decision support system that can solve this problem. In this paper, a genetic algorithm with the shortest path technique is used to generate a competitive solution to other well-known techniques. It also presents a comparison between our solution and other solutions for this problem.

Keywords: bus scheduling problem, decision support system, genetic algorithm, shortest path

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9397 From Ondoy to Habagat: Comparison of the Community Coping Strategies between Barangay Tumana and Provident Village, Marikina City

Authors: Dinnah Feye H. Andal, Ann Laurice V. Salonga

Abstract:

The paper investigates the flooding event that was experienced by Marikina City residents during the onslaught of Tropical Storm Ondoy on September 26, 2009 and during the heavy downpour caused by the southwest monsoon (Habagat) on August 1-8, 2012. Typhoon Ketsana, locally known as Tropical Storm Ondoy, devastated the whole of Marikina City, displacing a lot of people from their homes and damages properties as well, as flood rose at a very short period of time. Meanwhile, the massive amount of rain water brought by the southwest monsoon lasted for a week that also caused flooding to different parts of Metro Manila including Marikina City. This paper examines how the respondents’ experiences of the flooding caused by Tropical Storm Ondoy informed the coping strategies that the households in Barangay Tumana and Provident Village employed during the flooding brought by the southwest monsoon rains. Specifically, the research compares the coping strategies to flood hazards between residents of Barangay Tumana and Provident Village before, during and after the flooding caused by the southwest monsoon rains. Both study sites have relatively low elevation and are located along rivers and creeks which make them highly susceptible to flood. Interviews with affected residents were undertaken to understand how a household's coping strategies contribute to the development of community coping strategies at the respective neighborhood level. Based from the findings, income levels, local politics, religion and social relations between and among neighbors affect the way household and community coping strategies differ in the two case study sites.

Keywords: community coping strategies, Habagat, Marikina, Ondoy

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9396 Cytotoxic Drugs: Handling Practices and Clinical Manifestations among Hospital Staff

Authors: Boularas El-Alia, Arbi Raja, Bachir Bouiadjra Sara, Rezk-Kallah Haciba, Rezkkallah Baghdad

Abstract:

Objectives : To determine the handling practices of cytotoxic drugs and to describe clinical manifestations expressed by hospital personnel of Sidi Bel Abbes during the year 2014. Methods: Sectional descriptive study conducted in 3 center university hospital units (Hematology, Oncology and Urology) and Gynecology of EHS Sidi Bel Abbes. A questionnaire was administered to hospital workers regulary exposed to cytotoxic drugs. A work-place visit was performed to have an overview about working conditions. The Cytotoxic Contact Index (CCI) was calculated for each nurse on a period of 15 working days. Treatment of the results was done using SPSS software. Results: The survey reveals that 22 men and 58 women are exposed to cytotoxic drugs for an average of 7 years. Many symptoms such as ocular irritation (38,75%), throat irritation (56,25%), headache (68,75%), dizziness (43,75%), nausea (37,5%), metallic taste (30%), were reported with high frequency. Are noted in the offspring, 3 congenital anomalies,2 diaphragmatic hernia and a cleft palate. The Cytotoxic Contact Index (CCI) was higher than 3 among Oncology nurses and higher than 1 for most of the nurses of Hematology and Gynecology service. The wearing of personal protective clothing was not respected by all workers: (22/23) wear gloves and (20/23) wear a mask,(5/23) wear a cap, (2/23) wear glasses. Only 3 nurses have benefited from continuous training on handling cytotoxic drugs. Conclusion: This study shows a high occupational exposure risk to cytotoxic drugs among persons handling these drugs and the necessity to apply rigorously all measures related to personal protection awareness and training of personnel to minimize these exposure.

Keywords: cytotoxic drugs, handling, clinical manifestations, hospital staff

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9395 Analyzing the Readiness of Resuscitation Team during Cardiac Arrest

Authors: J. Byimana, I. A. Muhire, J. E. Nzabahimana, A. Nyombayire

Abstract:

Introduction: A successful cardiopulmonary resuscitation during a sudden cardiac arrest can be delayed by different components including new hospital setting, lack of adequate training, lack of pre-established resuscitation team and ineffective communication and lead to an unexpected outcome which is death. The main objective of the study was to assess the readiness of resuscitation teams during cardiac arrest and the organizational approaches that would best support their functioning in a new hospital facility, and to detect any factor that may have contributed to responses. This study analyses the readiness of Resuscitation Team (RT) during cardiac arrest. —Material and methods: A prospective Analytic design was carried out at a newly established United Nations level 2 hospital facility, on four RTM (resuscitation team member). A semi structured questionnaire was used to collect data. —Results: This study highlights indicate that the response time during cardiac arrest simulation meet both American heart association (AHA) and European resuscitation council guidelines. The study offers useful evidence about the impact of a new facility on RTM performance and provides an exposure of staff to emergency events within the Work setting.

Keywords: cardiac arrest, code blue, simulation, resuscitation team member

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9394 Self-reported Acute Pesticide Intoxication in Ethiopia

Authors: Amare Nigatu, Mågne Bratveit, Bente E. Moen

Abstract:

Background: Pesticide exposure is an important public health concern in Ethiopia, but there is limited information on pesticide intoxications. Residents may have an increased risk of pesticide exposure through proximity of their homes to farms using pesticides. Also the pesticide exposure might be related to employment at these farms. This study investigated the prevalence of acute pesticide intoxications (API) by residence proximity to a nearby flower farm and assessed if intoxications are related to working there or not. Methods: A cross-sectional survey involving 516 persons was conducted. Participants were grouped according to their residence proximity from a large flower farm; living within 5 kilometers and 5-12 kilometers away, respectively. In a structured interview, participants were asked if they had health symptoms within 48 hours of pesticide exposure in the past year. Those, who had experienced this and reported two or more typical pesticide intoxication symptoms, were considered as having had API. Chi-square and independent t-tests were used to compare categorical and continuous variables, respectively. Confounding variables were adjusted by using binomial regression model. Results: The prevalence of API in the past year among the residents in the study area was 26%, and it was higher in the population living close to the flower farm (42%) compared to those living far away (11%), prevalence ratio (PR) = 3.2, 95% CI: 2.2-4.8, adjusted for age, gender & education. A subgroup living close to the farm & working there had significantly more API (56%) than those living close & did not work there (16%), adjusted PR = 3.0, 95% CI: 1.8-4.9. Flower farm workers reported more API (56%) than those not working there (13%,), adjusted PR = 4.0, 95% CI: 2.9-5.6. Conclusion: The residents living closer than 5 kilometers to the flower farm reported significantly higher prevalence of API than those living 5-12 kilometers away. This increased risk of API was associated with work at the flower farm.

Keywords: acute pesticide intoxications, self-reported symptoms, flower farm workers, living proximity

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9393 Evaluation of Food Services by the Patients in Hospitals of Athens in Greece

Authors: I. Mentziou, C. Delezos, A. Nestoridou, G. Boskou

Abstract:

Introduction: The system of production and distribution of meals can have a significant impact on the food intake of hospital patients who are likely to develop malnutrition. In hospitals, the consequences of food borne infections can range from annoying to life-threatening for a patient, since they can lead up to death in vulnerable groups. Aim: The aim of the present study was to evaluate the satisfaction of the patients from the food services in Greek hospitals. Methods: Eleven hospitals of the Attica region were chosen. The sample derived from 637 adult patients who were hospitalized in those hospitals, during the period September 2009 - April 2010. Tailor made questionnaires were used to interview patients upon their satisfaction from the current food service system as well as from the total quality management system of the hospital. The number of completed questionnaires was proportional to the hospital capacity. Results: The majority of the patients seem to be pleased from the quality and the variety of the meals; they judged positively the behaviour of the food service personnel and the hygiene of serving conditions. Patients made suggestions for more frequent meals, larger variety of choices and better presented meals served under proper hygiene conditions by the personnel. Conclusions: The results indicate that the patients are satisfied in regards to the meal choices and the serving methods. However, factors like temperature and hygiene conditions are not always perceived to be in a way that fulfills the necessary prerequisite requirements. A total quality management system as a driver for better patient satisfaction is Indispensable.

Keywords: evaluation, food service, HACCP, hospital, patients

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9392 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

Abstract:

Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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9391 The Customer Expectations of Service Provided in a Banpaew Hospital Samutsakorn

Authors: Chanpen Meenakorn

Abstract:

This research aimed to examine the relationships between customer expectations and service quality management of Banpaew Hospital Samutsakorn in Thailand. The study sample consisted of 360 customers in patient unit. Data were collected using self-administered questionnaire. Descriptive statistics used were percentage, mean, and standard deviation. The analytical statistics comprised Pearson’s product moment correlation coefficient analysis. The result showed that service quality of nurses was very good with sustainable development trend. Physical evidence was at a high level, and the process and personal were rated at a high level. Additional, the study suggested that head nurse should be encouraged to improve service quality management, management training. Nurse administrators should create an appropriate nursing department climate, and provide necessary resources in the department. In addition, the nurse administrators should continuously follow up the results of customer expectations and focus on patients/customers, process management, information and knowledge management, and evaluation of service quality also.

Keywords: Banpaew Hospital, Customer Expectations, Service Provided, Samutsakorn

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9390 ATM Location Problem and Cash Management in ATM's

Authors: M. Erol Genevois, D. Celik, H. Z. Ulukan

Abstract:

Automated teller machines (ATMs) can be considered among one of the most important service facilities in the banking industry. The investment in ATMs and the impact on the banking industry is growing steadily in every part of the world. The banks take into consideration many factors like safety, convenience, visibility, cost in order to determine the optimum locations of ATMs. Today, ATMs are not only available in bank branches but also at retail locations. Another important factor is the cash management in ATMs. A cash demand model for every ATM is needed in order to have an efficient cash management system. This forecasting model is based on historical cash demand data which is highly related to the ATMs location. So, the location and the cash management problem should be considered together. Although the literature survey on facility location models is quite large, it is surprising that there are only few studies which handle together ATMs location and cash management problem. In order to fulfill the gap, this paper provides a general review on studies, efforts and development in ATMs location and cash management problem.

Keywords: ATM location problem, cash management problem, ATM cash replenishment problem, literature review in ATMs

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9389 Incidence, Pattern and Risk Factors of Congenial Heart Diseases in Neonates in a Tertiary Care Hospital, Egyptian Study

Authors: Gehan Hussein, Hams Ahmad, Baher Matta, Yasmeen Mansi, Mohamad Fawzi

Abstract:

Background: Congenital heart disease (CHD) is a common problem worldwide with variable incidence in different countries. The exact etiology is unknown, suggested to be multifactorial. We aimed to study the incidence of various CHD in a neonatal intensive care unit (NICU) in a tertiary care hospital in Egypt and the possible associations with variable risk factors. Methods: Prospective study was conducted over a period of one year (2013 /2014) at NICU KasrAlAini School of Medicine, Cairo University. Questionnaire about possible maternal and/or paternal risk factors for CHD, clinical examination, bedside echocardiography were done. Cases were classified into groups: group 1 without CHD and group 2 with CHD. Results: from 723 neonates admitted to NICU, 180 cases were proved to have CHD, 58 % of them were males. patent ductus arteriosus(PDA) was the most common CHD (70%), followed by an atrial septal defect (ASD8%), while Fallot tetralogy and single ventricle were the least common (0.45 %) for each. CHD was found in 30 % of consanguineous parents Maternal age ≥ 35 years at the time of conception was associated with increased incidence of PDA (p= 0.45 %). Maternal diabetes and insulin intake were significantly associated with cases of CHD (p=0.02 &0.001 respectively), maternal hypertension and hypothyroidism were both associated with VSD, but the difference did not reach statistical significance (P=0.36 &0.44respectively). Maternal passive smoking was significantly associated with PDA (p=0.03). Conclusion: The most frequent CHD in the studied population was PDA, followed by ASD. Maternal conditions as diabetes was associated with VSD occurrence.

Keywords: NICU, risk factors, congenital heart disease, echocardiography

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9388 Risk of Occupational Exposure to Cytotoxic Drugs: The Role of Handling Procedures of Hospital Workers

Authors: J. Silva, P. Arezes, R. Schierl, N. Costa

Abstract:

In order to study environmental contamination by cytostatic drugs in Portugal hospitals, sampling campaigns were conducted in three hospitals in 2015 (112 samples). Platinum containing drugs and fluorouracil were chosen because both were administered in high amounts. The detection limit was 0.01 pg/cm² for platinum and 0.1 pg/cm² for fluorouracil. The results show that spills occur mainly on the patient`s chair, while the most referenced occurrence is due to an inadequately closed wrapper. Day hospitals facilities were detected as having the largest number of contaminated samples and with higher levels of contamination.

Keywords: cytostatic, contamination, hospital, procedures, handling

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9387 Illegal Immigrants of Bangladesh in Malaysia and Present Situation

Authors: Md. Zahidul Islam

Abstract:

Illegal immigrants’ problem is a big problem all over the world including America. Malaysia is also facing this problem. Nowadays, it is turned into a major problem for Malaysia. Many illegal immigrants are staying in Malaysia from different countries such as Bangladesh, Myanmar, India, Pakistan, Indonesia, Vietnam, Thailand, Philippine, Nigeria. This article is only focusing on the present situation of illegal immigrants of Bangladesh. The aim of this article is to highlight how the Bangladeshi nationals are becoming an illegal immigrant in Malaysia. In the same time, this article also tries to identify the present situation of Bangladeshi illegal immigrants in Malaysia. The research will adopt qualitative methods of research. Both countries have to find a solution to solve this problem.

Keywords: illegal immigrants, present situation, Bangladesh, Malaysia

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9386 Heat: A Healthy Eating Programme

Authors: Osagbai Joshua Eriki, Ngozi Agunwamba, Alice Hill, Lorna Almond, Maniya Duffy, Devashini Naidoo, David Ho, Raman Deo

Abstract:

Aims: To evaluate the baseline eating pattern in a psychiatric hospital through quantifying purchases of food and drink items at the hospital shop and to implement a traffic light healthy eating labeling system. Method: A electronic till with reporting capabilities was purchased. A two-week period of baseline data collection was conducted. Thereafter, a system for labeling items based on the nutritional value of the food items at the hospital shop was implemented. Green labeling represented the items with the lowest calories and red the most. Further data was collated on the number and types of items purchased by patients according to the category, and the initial effectiveness of the system was evaluated. Result: Despite the implementation of the traffic light system, the red category had the highest number of items purchased by patients, highlighting the importance of promoting healthy eating choices. However, the study also showed that the system was effective in promoting healthy options, as the number of items purchased from the green category increased during the study period. Conclusion: The implementation of a traffic light labeling system for items sold at the hospital shop offers a promising approach to promoting healthy eating habits and choices. This is likely to contribute to a toolkit of measures when considering the multifactorial challenges that obesity and weight issues pose for long-stay psychiatric inpatients

Keywords: mental health, nutrition, food, healthy

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9385 Report of Candida Auris: An Emerging Fungal Pathogen in a Tertiary Healthcare Facility in Ekiti State, Nigeria

Authors: David Oluwole Moses, Odeyemi Adebowale Toba, Olawale Adetunji Kola

Abstract:

Candida auris, an emerging fungus, has been reported in more than 30 countries around the world since its first detection in 2009. Due to its several virulence factors, resistance to antifungals, and persistence in hospital settings, Candida auris has been reported to cause treatment-failure infections. This study was therefore carried out to determine the incidence of Candida auris in a tertiary hospital in Ekiti State, Nigeria. In this study, a total of 115 samples were screened for Candida species using cultural and molecular methods. The carriage of virulence factors and antifungal resistance among C. auris was detected using standard microbiological methods. Candida species isolated from the samples were 15 (30.0%) in clinical samples and 22 (33.85%) in hospital equipment screened. Non-albicans Candida accounted for 3 (20%) and 8 (36.36%) among the isolates from the clinical samples and equipment, respectively. Only five of the non-albicans Candida isolates were C. auris. All the isolates produced biofilm, gelatinase, and hemolysin, while none produced germ tubes. Two of the isolates were resistant to all the antifungals tested. Also, all the isolates were resistant to fluconazole and itraconazole. Nystatin appeared to be the most effective among the tested antifungals. The isolation of Candida auris is being reported for the second time in Nigeria, further confirming that the fungus has spread beyond Lagos and Ibadan, where it was first reported. The extent of the spread of the nosocomial fungus needed to be further investigated and curtailed in Nigeria before its outbreak in healthcare facilities.

Keywords: candida auris, virulence factors, antifungals, pathogen, hospital, infection

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