Search results for: healthcare management

Authors: Ying-Lun Tseng Chiu-Ying Chen

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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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Authors: Hossein Bakhtiari, Mathias Cehlin, Jan Akander

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Envelopes with low thermal performance is a common characteristic in many European historic buildings which leads to higher energy demand for heating and cooling as well as insufficient thermal comfort for the occupants. This paper presents the results of a study on the thermal comfort in the City Hall (Rådhuset) in Gävle, Sweden. This historic building is currently used as an office building. It is equipped with two relatively modern mechanical heat recovery ventilation systems with displacement ventilation supply devices in the offices. The district heating network heats the building via pre-heat supply air and radiators. Summer cooling comes from an electric heat pump that rejects heat into the exhaust ventilation air. A building management system controls HVAC equipment (heating, ventilation and air conditioning). The methodology is based on on-site measurements, data logging on the management system and evaluating the occupants’ perception of a summer and a winter period indoor environment using a standardized questionnaire. The main aim of the study is to investigate whether or not it is enough to have modernized HVAC systems to get adequate thermal comfort in a historic building with poor envelope performance used as an office building in Nordic climate conditions.

Keywords: historic buildings, on-site measurements, standardized questionnaire, thermal comfort

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Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

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The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

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Authors: Romuald Temomo Wamba, Robert Wanda

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The issue of creative accounting in the psychological and sociological framework has been a mixed subject for over 60 years. The objective of this article is to ensure the existence of creative accounting in Cameroonian entities on the one hand and to understand the strategies used by audit agents to detect errors, omissions, irregularities, or inadequacies in the financial state; optimization techniques used by account preparers to strategically bypass texts on the other hand. To achieve this, we conducted an exploratory study using a cognitive approach, and the data analysis was performed by the software 'decision explorer'. The results obtained challenge the authors' cognition (manifest latent and deceptive behavior). The tax inspectors stress that the entities in Cameroon do not derogate from the rules of piloting in the financial statements. Likewise, they claim a change in current income and net income through depreciation, provisions, inventories, and the spreading of charges over long periods. This suggests the suspicion or intention of manipulating the financial statements. As for the techniques, the account preparers manage the accruals at the end of the year as the basis of the practice of creative accounting. Likewise, management accounts are more favorable to results management.

Keywords: creative accounting, sociocognitive approach, psychological and sociological approach, cognitive dissonance theory, cognitive mapping

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Authors: S. Blanchard, D. Beladjine, K. Beddiar

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Since 2015, the arrival of BIM in the building sector in France has turned the corporation world upside down. Not only constructive practices have been impacted, but also the uses and the men who have undergone important changes. Thus, the new collaborative mode generated by the BIM and the digital model has challenged the supremacy of some construction actors because the process involves working together taking into account the needs of other contributors. New BIM tools have emerged and actors in the act of building must take ownership of them. It is in this context that under the impetus of a European directive and the French government's encouragement of new missions and job profiles have. Moreover, concurrent engineering requires that each actor can advance at the same time as the others, at the whim of the information that reaches him, and the information he has to transmit. However, in the French legal system around public procurement, things are not planned in this direction. Also, a consequent evolution must take place to adapt to the methodology. The new missions generated by the BIM in France require a good mastery of the tools and the process. Also, to meet the objectives of the BIM approach, it is possible to define a typical job profile around the BIM, adapted to the various sectors concerned. The multitude of job offers using the same terms with very different objectives and the complexity of the proposed missions motivated by our approach. In order to reinforce exchanges with professionals or specialists, we carried out a statistical study to answer this problem. Five topics are discussed around the business area: the BIM in the company, the function (business), software used and BIM missions practiced (39 items). About 1400 professionals were interviewed. These people work in companies (micro businesses, SMEs, and Groups) of construction, engineering offices or, architectural agencies. 77% of respondents have the status of employees. All participants are graduated in their trade, the majority having level 1. Most people have less than a year of experience in BIM, but some have 10 years. The results of our survey help to understand why it is not possible to define a single type of BIM Manager. Indeed, the specificities of the companies are so numerous and complex and the missions so varied, that there is not a single model for a function. On the other hand, it was possible to define 3 main professions around the BIM (Manager, Coordinator and Modeler) and 3 main missions for the BIM Manager (deployment of the method, assistance to project management and management of a project).

Keywords: BIM manager, BIM modeler, BIM coordinator, project management

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Authors: Ahmad Masduki Bin Selamat, Kang Chia Yang

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The International Standard Organization (ISO) is an international consensus on good management practice. It is derived from the Greek word “isos” meaning equal. ISO is aimed to give organization guidelines on what bring quality management system that leads to continuous improvement. The need of quality product is essential these days, especially in the manufacturing and service sectors. The requirement to produce good product is demanded, hence the certification of ISO enables the company to gain the trust from the public. Due to this, organizations whether government or private sectors in Malaysia are going for the ISO certification. However recently there has been an introduction of Islamic standard known as Islamic Standard Institute 2020 (ISI 2020). The ISI standards emphasize more on values that should be in the employees’ mind. By possessing good values, employees will work only for the betterment of the company. Currently only the feelings of being paid for the job exist in the employees’ mind. The non-Malays like Chinese and others, which comprise 40% of the sample size, are not aware about the existence of any Islamic quality system. As for the Malay managers, they support the Islamic quality systems. For them such values are encouraged by religion. By imitating religion, Allah promises a better life in this world and hereafter. Even though ISI 2020 is still new but the majority of Malays would support the need of Islamic quality system. Our findings suggest that integration of these two-quality systems running parallel would bring a better result.

Keywords: International Standard Organization (ISO), Islamic standard, quality, ISI 2020

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Authors: Emmanuel U. Unuafe, Oyegoke T. Bukoye, Sandhya Sastry, Yanqing Duan

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Globally, there is increasing interest in project management due to a shortage in infrastructure services supply capability. Hence, it is of utmost importance that organisations understand that choosing a particular project over another is an opportunity cost – tying up the organisations resources. In order to devise constructive ways to bring direction, structure, and oversight to the process of project selection has led to the development of tools and techniques by researchers and practitioners. However, despite the development of various frameworks to assist in the appraisal and selection of government projects, failures are still being recorded with government projects. In developing countries, where frameworks are rarely used, the problems are compounded. To improve the situation, this study will investigate the current practice of construction project selection processes within the Nigeria public sector in order to inform theories of decision making from the perspective of developing nations and project management practice. Unlike other research around construction projects in Nigeria this research concentrate on factors influencing the selection process within the Nigeria public sector, which has received limited study. The authors report the findings of semi-structured interviews of top management in the Nigerian public sector and draw conclusions in terms of decision making extant theory and current practice. Preliminary results from the data analysis show that groups make project selection decisions and this forces sub-optimal decisions due to pressure on time, clashes of interest, lack of standardised framework for selecting projects, lack of accountability and poor leadership. Consequently, because decision maker is usually drawn from different fields, religious beliefs, ethnic group and with different languages. The choice of a project by an individual will be greatly influence by experience, political precedence than by realistic investigation as well as his understanding of the desired outcome of the project, in other words, the individual’s ideology and their level of fairness.

Keywords: factors influencing project selection, public sector construction project selection, projects portfolio selection, strategic decision-making

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Authors: Nithra Kitreerawutiwong, Sunsanee Mekrungrongwong, Artitaya Wongwonsin, Chakkraphan Phetphoom, Buaploy Phromjang

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Background: Thailand has implemented a district health system based on the concept of primary health care. Since 2014, Family Care Team (FCT) was launched to improve the quality of care through a multidisciplinary team include not only the health sector but also social sector work together. FCT classified into 3 levels: district, sub-district, and community. This system now consists of 66,353 teams, including 3,890 teams at district level, 12,237 teams at the sub-district level, and 50,326 teams at the community level. There is a report regarding assessment the situation and perception on FCT, however, relatively few examined the operationality of this policy. This study aimed to explore the perception of district manager on the process of the implementation of FCT policy and the factors associating to implement FCT in the district health system. Methods/Results: Forty in-depth interviews were performed: 5 of primary care manager at the provincial medical health office, 5 of community hospital director, 5 of district administrative health office, 10 of sub-district health promoting hospital, and 10 of local organization. Semi-structure interview guidelines were used in the discussions. The data was analyzed by thematic analysis. This policy was formulated based on the demographic change and epidemiology transition to serve a long term care for elderly. Facilitator factors are social capital in district health systems such as family health leader and multidisciplinary team. Barrier factors are communication to the frontline provider and local organization. The output of this policy in relation to the structure of FCT is well-defined. Unanticipated effects include training of FCT in community level. Conclusion: Early feedback from healthcare manager is valuable information for the improvement of FCT to function optimally. Moreover, in the long term, health outcome need to be evaluated.

Keywords: family care team, district health system, primary care, qualitative study

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Authors: Wabinyai Fidel Raja, Gideon Lubisa

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Air pollution is becoming a growing concern in Africa due to rapid industrialization and urbanization, leading to implications for public health and the environment. Establishing a comprehensive air quality monitoring network is crucial to combat this issue. However, conventional methods of monitoring are insufficient in African cities due to the high cost of setup and maintenance. To address this, low-cost sensors (LCS) can be deployed in various urban areas through the use of participatory air quality network siting (PAQNS). PAQNS involves stakeholders from the community, local government, and private sector working together to determine the most appropriate locations for air quality monitoring stations. This approach improves the accuracy and representativeness of air quality monitoring data, engages and empowers community members, and reflects the actual exposure of the population. Implementing PAQNS in African cities can build trust, promote accountability, and increase transparency in the air quality management process. However, challenges to implementing this approach must be addressed. Nonetheless, improving air quality is essential for protecting public health and promoting a sustainable environment. Implementing participatory and data-informed air quality monitoring can take a significant step toward achieving these important goals in African cities and beyond.

Keywords: low-cost sensors, participatory air quality network siting, air pollution, air quality management

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Authors: Vivek Saxena, Shreshtha Saxena

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Background: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance first recognized during pregnancy. Uncontrolled or untreated GDM is associated with various adverse outcomes to the maternal and fetal health. Overt diabetes mellitus may also develop in such patients. It is universally accepted fact that first and foremost management to treat GDM is dietary control and lifestyle modification even before starting any oral hypoglycemic agent (OHA) or insulin. So, proper dietary management and little changes in the patient’s lifestyle are very effective for reducing her plasma glucose level. Objectives: Proper counselling of the patients and flexibility in their lifestyle and diet can effectively control the plasma glucose level in GDM patients. Methods: Total 60 GDM patients of age > 18 years were taken. We had three counselling sessions with the patient and other members of the family like husband, parents, and in-laws at different intervals, discussed their lifestyle and diet pattern, helped them to eliminate the factors those had an adverse effect on plasma glucose level and promoted them to acquire a healthy lifestyle. We have counselled the patient and her family member separately and then together also. They have explained how increased plasma glucose level can be effectively controlled with the little modification in their diet and routine activities. They were also taught to remain stress-free during their rest of antenatal period. We have excluded the patients from our study who were diabetic before pregnancy and patients with other comorbid illnesses like hypothyroidism and valvular heart disease. Results and conclusions: Results were very rewarding as patients could acquire a lifestyle of their choice. They were happy because extra pill burden was not there. All the 60 patients were normoglycemic in remaining antenatal period, 48 patients were delivered normally and 12 patients underwent cesarean section due to various reasons.Regular counselling of the patients regarding their disease and little alterations in diet and lifestyle controlled the plasma glucose level much effectively. The things were more easier and effective when we included other family members during our counselling session because they play a major role in patient’s day to day activity and influence her life.

Keywords: dietary management, gestational diabetes mellitus, impaired glucose tolerance, oral hypoglycemic agent, pregnancy

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Authors: John Zanetich

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Designing an educational activity that encourages inquiry and collaboration is key to engaging students in meaningful learning. Educational Information and Communications Technology (EICT) plays an important role in facilitating cooperative and collaborative learning in the classroom. The EICT also facilitates students’ learning and development of the critical thinking skills needed to solve real world problems. Projects and activities based on constructivism encourage students to embrace complexity as well as find relevance and joy in their learning. It also enhances the students’ capacity for creative and responsible real-world problem solving. Classroom activities based on constructivism offer students an opportunity to develop the higher–order-thinking skills of defining problems and identifying solutions. Participating in a classroom project is an activity for both acquiring experiential knowledge and applying new knowledge to practical situations. It also provides an opportunity for students to integrate new knowledge into a skill set using reflection. Classroom projects can be developed around a variety of learning objects including social media, knowledge management and learning communities. The construction of meaning through project-based learning is an approach that encourages interaction and problem-solving activities. Projects require active participation, collaboration and interaction to reach the agreed upon outcomes. Projects also serve to externalize the invisible cognitive and social processes taking place in the activity itself and in the student experience. This paper describes a classroom project designed to elicit interactions by helping students to unfreeze existing knowledge, to create new learning experiences, and then refreeze the new knowledge. Since constructivists believe that students construct their own meaning through active engagement and participation as well as interactions with others. knowledge management can be used to guide the exchange of both tacit and explicit knowledge in interpersonal interactions between students and guide the construction of meaning. This paper uses an action research approach to the development of a classroom project and describes the use of technology, social media and the active use of tacit knowledge in the college classroom. In this project, a closed group Facebook page becomes the virtual classroom where interaction is captured and measured using engagement analytics. In the virtual learning community, the principles of knowledge management are used to identify the process and components of the infrastructure of the learning process. The project identifies class member interests and measures student engagement in a learning community by analyzing regular posting on the Facebook page. These posts are used to foster and encourage interactions, reflect a student’s interest and serve as reaction points from which viewers of the post convert the explicit information in the post to implicit knowledge. The data was collected over an academic year and was provided, in part, by the Google analytic reports on Facebook and self-reports of posts by members. The results support the use of active tacit knowledge activities, knowledge management and social media to enhance the student learning experience and help create the knowledge that will be used by students to construct meaning.

Keywords: constructivism, knowledge management, tacit knowledge, social media

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Authors: Phichak Phutrakhul

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The purposes of this research were to study concepts and strategies of human resource development in the automotive manufacturers and to articulate the proposals against the government about the human resource development for automotive industry. In the present study, qualitative study was an in-depth interview in which the qualitative data were collected from the executive or the executive of human resource division from five automotive companies - Toyota Motor (Thailand) Co., Ltd., Nissan Motor (Thailand) Co., Ltd., Mitsubishi Motors (Thailand) Co., Ltd., Honda Automobile (Thailand) Co., Ltd., and Suzuki Motor (Thailand) Co., Ltd. Qualitative data analysis was performed by using inter-coder agreement technique. The research findings were as follows: The external factors included the current conditions of the automotive industry, government’s policy related to the automotive industry, technology, labor market and human resource development systems of the country. The internal factors included management, productive management, organizational strategies, leadership, organizational culture and philosophy of human resource development. These factors were affected to the different concept of human resources development -the traditional human resource development and the strategies of human resource development. The organization focuses on human resources as intellectual capital and uses the strategies of human resource development in all development processes. The strategies of human resource development will enhance the ability of human resources in the organization and the country.

Keywords: human resource development strategy, automotive industry, eco-cars, ASEAN

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Authors: Geeta, Richa, M. L. Sharma

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Himachal Pradesh, a hilly State of India located in the Western Himalayas, with varied altitudinal gradients and climatic conditions, is a repository of plant diversity and the traditional knowledge associated with plants. The State is inhabited by various tribal communities who usually depend upon local plants for curing various ailments. Utilization of plant resources in their day-to-day life has been an age old practice of the people inhabiting this State. The present study pertains to the tribal district Kinnaur of Himachal Pradesh, located between 77°45’ and 79°00’35” east longitudes and between 31°05’50” and 32°05’15” north altitudes. Being a remote area with only very basic medical facilities, local people mostly use traditional herbal medicines for primary healthcare needs. Traditional healers called “Amji” are usually very secretive in revealing their medicinal knowledge to novice and pass on their knowledge to next generation orally. As a result, no written records of healing herbs are available. The aim of present study was to collect and consolidate the ethno-medicinal knowledge of local people of the district about the use of plants for treating gastrointestinal ailments. The ethnobotanical information was collected from the local practitioners, herbal healers and elderly people having rich knowledge about the medicinal herbs through semi-structured questionnaire and key informant discussions. A total 46 plant species belonging to 40 genera and 24 families have been identified which are used as cure for gastrointestinal ailments. Among the parts used for gastointestinal ailments, aerial parts (14%) were followed by the whole plant (13%), root (8%), leaves (6%), flower (5%), fruit and seed (3%) and tuber (1%). These plant species could be prioritized for conservation and subject to further studies related to phytochemical screening for their authenticity. Most of the medicinal plants of the region are collected from the wild and are often harvested for trade. Sustainable harvesting and domestication of the highly traded species from the study area is needed.

Keywords: Amji, gastrointestinal, Kinnaur, medicinal plants, traditional knowledge

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Authors: Yi Fung Lin, Pei Chen Tsai

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Purpose: Many breast cancer survivors actively seek information about diet, exercise, and nutritional supplements to expedite recovery, reduce the risk of recurrence, and enhance their quality of life. While weight loss is not a primary concern for overweight or obese patients during the active treatment phase, they continue to face the additional burden and risks associated with excess weight post-treatment. This group has complex views on weight loss: they are concerned that exercise or dietary control might exacerbate symptoms, yet they also believe that obesity could negatively impact health. These perceptions can have both positive and negative effects on weight management. Therefore, this qualitative study aimed to explore the factors that influence overweight or obese breast cancer survivors' ability to manage their weight. Method: Eight women participated in in-depth interviews in 2022. Data was extracted based on the verbatim transcripts of the audio files, and the analysis was conducted through careful reading of the text. This qualitative research collected data until data saturation was reached. Results: A total of 22 codes were identified and subsequently integrated into three main themes: (1) Facilitators, including support systems, others' successful weight loss experiences, education, responsibility to others, and motivation; (2) Barriers, encompassing physical limitations, the stigma associated with weight loss, the cost of weight loss, antiestrogen medication, and cancer symptoms; (3) Variable Factors, which comprise perspectives on cancer, perspectives on obesity, and past experiences with weight loss. Conclusions: These findings are similar to previous research on barriers and motivators, highlighting variable factors that exist and can lead to either positive or negative effects on weight loss. The results can inform the development of weight management programs tailored to the needs of overweight or obese breast cancer survivors. Additionally, the identified factors represent vital variables for future studies, serving as valuable references for further research in this area.

Keywords: weight management, breast cancer, overweight, obese, cancer survivors

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Authors: Pingrong Liao

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Currently, as China is in the stage of rapid urbanization, a large number of rural population have flown into the city and it is urgent to solve the housing problem. Xiamen is the typical city of China characterized by high housing price and low-income. Due to the government failed to provide adequate public cheap housing, a large number of immigrants dwell in the informal rental housing represented by the "city village". Comfortable housing is the prerequisite for the harmony and stability of the city. Therefore, with "city village" and the affordable housing as the main object of study, this paper makes an analysis on the housing status, personnel distribution and mobility of the "city village" of Xiamen, and also carries out a primary research on basic facilities such as the residential form and commercial, property management services, with the combination of the existing status of the affordable housing in Xiamen, and finally summary and comparison are made by the author in an attempt to provide some references and experience for the construction and improvement of the government-subsidized housing to improve the residential quality of the urban-poverty stricken people. In this paper, the data and results are collated and quantified objectively based on the relevant literature, the latest market data and practical investigation as well as research methods of comparative study and case analysis. Informal rental housing, informal economy and informal management of "city village" as social-housing units in many ways fit in the housing needs of the floating population, providing a convenient and efficient condition for the flowing of people. However, the existing urban housing in Xiamen have some drawbacks, for example, the housing are unevenly distributed, the spatial form is single, the allocation standard of public service facilities is not targeted to the subsidized object, the property management system is imperfect and the cost is too high, therefore, this paper draws lessons from the informal model of city village”, and finally puts forward some improvement strategies.

Keywords: urban problem, urban village, affordable housing, living mode, Xiamen constructing

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Authors: Abilio Pires Zacarias

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Analyzing company boards of directors is a relevant and timely topic. As the representative of shareholders, the board is the most senior management body of this type of company. Therefore, ascertaining the best kind of candidates to nominate, namely the most appropriate characteristics for leading the board to achieve better levels of performance, is certainly of great interest. The companies selected for this study were the 1,000 largest non-financial companies and the 100 largest financial companies in Portugal according to the Instituto Nacional de Estatística for 2010. The information stemmed from a questionnaire addressed to the person in charge of daily company management and then processed through STATA 17 with the multivariate analysis of variables - MANOVA. The study may correspondingly report that the vast majority of boards in the sample operate a dual leadership structure. By in terms of its prevalence, unitary leadership represents only a minority. Agency theory and stewardship theory postulate different characteristics for the ideal chairman but neither receive confirmation from our results. On the other hand, our findings do validate the behavioral theory of firms (BToF), concluding that experience is associated with organizational performance. This study is also relevant due to its analysis of companies not listed on the financial markets not only because of their weighting in the economy but also because they remain only very poorly studied in this field and thus also correspondingly contributing to deepening the literature.

Keywords: agency theory, behavioral theory of the firm, board of directors, corporate governance, stewardship theory

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Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

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Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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Authors: Eman Hegazy, Stefan Anderberg, Joakim Krook

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Urban water infrastructure is crucial for efficient and reliable water supply in growing cities. With the growth of cities, the need for maintenance and renewal of these systems increases but often goes unfulfilled due to a variety of reasons, such as limited funding, political priorities, or lack of public awareness. Neglecting the renewal needs of these systems can lead to frequent malfunctions and reduced quality and reliability of water supply, as well as increased costs and health and environmental hazards. It is important for cities to prioritize investment in water infrastructure and develop long-term plans to address renewal needs. Drawing general conclusions about the rate of renewal of urban water infrastructure systems at an international or national level can be challenging due to the influence of local management decisions. In many countries, the responsibility for water infrastructure management lies with the municipal authorities, who are responsible for making decisions about the allocation of resources for repair, maintenance, and renewal. These decisions can vary widely based on factors such as local finances, political priorities, and public perception of the importance of water infrastructure. As a result, it is difficult to make generalizations about the rate of renewal across different countries or regions. In Sweden, the situation is not different, and the information from Svenskt Vatten indicates that the rate of renewal varies across municipalities and can be insufficient, leading to a buildup of maintenance and renewal needs. This study aims to examine the adequacy of the rate of renewal of urban water infrastructure in Linköping case city in Sweden. Using a case study framework, the study will assess the current status of the urban water system and the need for renewal. The study will also consider the role of factors such as proper identification processes, limited funding, competing for political priorities, and local management decisions in contributing to insufficient renewal. The study investigates the following questions: (1) What is the current status of water and sewerage networks in terms of length, age distribution, and material composition, estimated total water leakage in the network per year, damages, leaks, and outages occur per year, both overall and by district? (2) What are the main causes of these damages, leaks, and interruptions, and how are they related to lack of maintenance and renewal? (3) What is the current status of renewal work for the water and sewerage networks, including the renewal rate and changes over time, recent renewal material composition, and the budget allocation for renewal and emergency repairs? (4) What factors influence the need for renewal and what conditions should be considered in the assessment? The findings of the study provide insights into the challenges facing urban water infrastructure and identify strategies for improving the rate of renewal to ensure a reliable and sustainable water supply.

Keywords: case study, infrastructure, management, renewal need, Sweden

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Introduction: Despite the development of technologies and improvements in the interior of dialysis stations, dialysis remains an unpleasant procedure, difficult to accept by the patients (who undergo it 2 to 3 times a week, a single treatment lasting several hours). Haemodialysis is one of the renal replacement therapies, in Poland most commonly used in patients with chronic or acute kidney failure. Purpose: An attempt was made to evaluate the quality of life in haemodialysed patients using the WHOQOL-BREF questionnaire. Material and methods: The study covered 422 patients (200 women and 222 men, aged 60.5 ± 12.9 years) undergoing dialysis at three selected stations in Poland. The patients were divided into 2 groups, depending on the duration of their dialysis treatment. The evaluation was conducted with the WHOQOL-BREF questionnaire containing 26 questions analysing 4 areas of life, as well as the perception of the quality of life and health self-assessment. A 5-point scale is used to answer them. The maximum score in each area is 20 points. The results in individual areas have a positive direction. Results: In patients undergoing dialysis for more than 3 years, a reduction in the quality of life was found in the physical area and in their environment versus a group of patients undergoing dialysis for less than 3 years, where a reduced quality of life was found in the areas of social relations and mental well-being (p < 0.05). A significant correlation (p < 0.01) between the two groups was found in self-perceived general health, while no significant differences were observed in the general perception of the quality of life (p > 0.05). Conclusions: The study confirmed that in patients undergoing dialysis for more than three years, the quality of life is especially reduced in their environment (access to and quality of healthcare, financial resources, and mental and physical safety). The assessment of the quality of life should form a part of the therapeutic process, in which the role of the patient in chronic renal care should be emphasised, reflected in the quality of services provided by dialysis stations.

Keywords: haemodialysis, perception of quality of life, quality of services provided, dialysis station

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Authors: Rajkumar Ghosh

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Water scarcity is a pressing issue in urban areas, even in smart cities where efficient resource management is a priority. This scarcity is mainly caused by factors such as lifestyle changes, excessive groundwater extraction, over-usage of water, rapid urbanization, and uncontrolled population growth. In the specific case of Gomti Nagar, Lucknow, Uttar Pradesh, India, the depletion of groundwater resources is particularly severe, leading to a water imbalance and posing a significant challenge for the region's sustainable development. The aim of this study is to address the water shortage in the Gomti Nagar region by focusing on the implementation of artificial groundwater recharge methods. Specifically, the research aims to investigate the effectiveness of rainwater collection through rooftop rainwater harvesting systems (RTRWHs) as a sustainable approach to reduce aquifer depletion and bridge the gap between groundwater recharge and extraction. The research methodology for this study involves the utilization of RTRWHs as the main method for collecting rainwater. This approach is considered effective in managing and conserving water resources in a sustainable manner. The focus is on implementing RTRWHs in residential and commercial buildings to maximize the collection of rainwater and its subsequent utilization for various purposes in the Gomti Nagar region. The study reveals that the installation of RTRWHs in the Gomti Nagar region has a positive impact on addressing the water scarcity issue. Currently, RTRWHs cover only a small percentage (0.04%) of the total rainfall collected in the region. However, when RTRWHs are installed in all buildings, their influence on increasing water availability and reducing aquifer depletion will be significantly greater. The study also highlights the significant water imbalance of 24519 ML/yr in the region, emphasizing the urgent need for sustainable water management practices. This research contributes to the theoretical understanding of sustainable water management systems in smart cities. By highlighting the effectiveness of RTRWHs in reducing aquifer depletion, it emphasizes the importance of implementing such systems in urban areas. The findings of this study can serve as a basis for policymakers, urban planners, and developers to prioritize and incentivize the installation of RTRWHs as a potential solution to the water shortage crisis. The data for this study were collected through various sources such as government reports, surveys, and existing groundwater abstraction patterns. The collected data were then analysed to assess the current water situation, groundwater depletion rate, and the potential impact of implementing RTRWHs. Statistical analysis and modelling techniques were employed to quantify the water imbalance and evaluate the effectiveness of RTRWHs. The findings of this study demonstrate that the implementation of RTRWHs can effectively mitigate the water scarcity crisis in Gomti Nagar. By reducing aquifer depletion and bridging the gap between groundwater recharge and extraction, RTRWHs offer a sustainable solution to the region's water scarcity challenges. The study highlights the need for widespread adoption of RTRWHs in all buildings and emphasizes the importance of integrating such systems into the urban planning and development process. By doing so, smart cities like Gomti Nagar can achieve efficient water management, ensuring a better future with improved water availability for its residents.

Keywords: rooftop rainwater harvesting, rainwater, water management, aquifer

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Authors: Shobha Ramalingam

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The majority of the infrastructure projects are affected by time overrun, resulting in project delays and subsequently cost overruns. Time overrun may vary from a few months to as high as five or more years, placing the project viability at risk. One of the probable reasons noted in the literature for this outcome in projects is due to poor productivity. Researchers contend that productivity in construction has only marginally increased over the years. While studies in the literature have extensively focused on time and cost parameters in projects, there are limited studies that integrate time and cost with productivity to assess project performance. To this end, a study was conducted to understand the project delay factors concerning cost, time and productivity. A case-study approach was adopted to collect rich data from a nuclear power plant project site for two months through observation, interviews and document review. The data were analyzed using three different approaches for a comprehensive understanding. Foremost, a root-cause analysis was performed on the data using Ishikawa’s fish-bone diagram technique to identify the various factors impacting the delay concerning time. Based on it, a questionnaire was designed and circulated to concerned executives, including project engineers and contractors to determine the frequency of occurrence of the delay, which was then compiled and presented to the management for a possible solution to mitigate. Second, a productivity analysis was performed on select activities, including rebar bending and concreting through a time-motion study to analyze product performance. Third, data on cost of construction for three years allowed analyzing the cost performance using earned value management technique. All three techniques allowed to systematically and comprehensively identify the key factors that deter project performance and productivity loss in the construction of the nuclear power plant project. The findings showed that improper planning and coordination between multiple trades, concurrent operations, improper workforce and material management, fatigue due to overtime were some of the key factors that led to delays and poor productivity. The findings are expected to act as a stepping stone for further research and have implications for practitioners.

Keywords: earned value analysis, time performance, project costs, project delays, construction productivity

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Authors: Huicong Jia, Donghua Pan

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As a key component of disaster reduction management, disaster emergency relief and reconstruction is an important process. Based on disaster system theory, this study analyzed the Jiangsu tornado from the formation mechanism of disasters, through to the economic losses, loss of life, and social infrastructure losses along the tornado disaster chain. The study then assessed the emergency relief and reconstruction efforts, based on an analytic hierarchy process method. The results were as follows: (1) An unstable weather system was the root cause of the tornado. The potentially hazardous local environment, acting in concert with the terrain and the river network, was able to gather energy from the unstable atmosphere. The wind belt passed through a densely populated district, with vulnerable infrastructure and other hazard-prone elements, which led to an accumulative disaster situation and the triggering of a catastrophe. (2) The tornado was accompanied by a hailstorm, which is an important triggering factor for a tornado catastrophe chain reaction. (3) The evaluation index (EI) of the emergency relief and reconstruction effect for the ‘‘6.23’’ tornado disaster in Yancheng was 91.5. Compared to other relief work in areas affected by disasters of the same magnitude, there was a more successful response than has previously been experienced. The results provide new insights for studies of disaster systems and the recovery measures in response to tornado catastrophe in China.

Keywords: China, disaster system, emergency relief, tornado catastrophe

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Authors: Philippa Anne French

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This paper presents a case study of 3000acres, a for-purpose organisation established in 2013 to improve the health of Melbournians by enabling them to grow more of their own food. Over the past four years, the organisation has encountered a number of barriers, both obvious and less obvious, which discourage communities from beginning their own food-growing projects. These include soil contamination, planning policies, public perception and access to land. 3000acres has been working to remove these barriers if possible, or otherwise to find ways around them. Strategies have included the use of removable planter boxes on temporarily vacant land, separating the site soil from above-ground garden beds, writing planning exemptions, developing relationships with land management authorities and recording both the quantitative and qualitative products of food gardens in Melbourne. While creating change in policy and legal requirements will be a gradual process, discernable progress has been made in the attitudes of land management authorities and the establishment of new food gardens is becoming easier. Over the past four years, 3000acres has supported the establishment of 14 food gardens in and around Melbourne, including public community gardens, fenced community gardens and urban farms supplying food to a food relief organisation.

Keywords: case study, community gardens, land access, land contamination, urban agriculture

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Authors: Masoumeh Tadayoni, Saeed Kamyabi, Alireza Entezari

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Background and goal of the research: In planning and management system, the tourism carrying capacity is used as a holistic approach and supportive instrument. Evaluating the carrying capacity is used in quantitative the resource exploitation in line with sustainable development and as a foundation for identifying the changes in natural ecosystem and for the final evaluation and monitoring the tensions and decays in regressed ecosystem. Therefore, the present research tries to determine the carrying capacity of effective, physical and real range of Siahsard tourism region. Method: In the present research, the quantitative analysis of tourism carrying capacity is studied by used of effective or permissible carrying capacity (EPCC), real carrying capacity (PCC) and physical carrying capacity (RCC) in Siahsard fountain. It is analyzed based on the field survey and various resources were used for collecting information. Findings: The results of the analysis shows that, 3700 people use the Siahsard tourism region every day and 1350500 people use it annually. However, the evaluation of carrying capacity can be annually 1390650 people in this place. It can be an important tourism place along with other places in the region. Results: Siahsard’s tourism region has a little way to reach to its carrying capacity that needs to be analyzed. However, based on the results, some suggestions were offered for sustainable development of this region and as the most logical alternations for tourism management.

Keywords: carrying capacity, evaluation, Siahsard, tourism

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Authors: Alfredo Fortunato, Carmelofrancesco Origlia, Sara Laurita, Rossella Nicoletti

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In the post-pandemic recovery phase of tourism, the role of a Destination Management Organization (DMO) as a coordinated management system of all the elements that make up a destination (attractions, access, marketing, human resources, brand, pricing, etc.) is also becoming relevant for local territories. The objective of a DMO is to maximize the visitor's perception of value and quality while ensuring the competitiveness and sustainability of the destination, as well as the long-term preservation of its natural and cultural assets, and to catalyze benefits for the local economy and residents. In carrying out the multiple functions to which it is called, the DMO can leverage a collective intelligence that comes from the ability to pool information, explicit and tacit knowledge, and relationships of the various stakeholders: policymakers, public managers and officials, entrepreneurs in the tourism supply chain, researchers, data journalists, schools, associations and committees, citizens, etc. The DMO potentially has at its disposal large volumes of data and many of them at low cost, that need to be properly processed to produce value. Based on these assumptions, the paper presents a conceptual framework for building an information system to support the DMO in the intelligent management of a tourist destination tested in an area of southern Italy. The approach adopted is data-informed and consists of four phases: (1) formulation of the knowledge problem (analysis of policy documents and industry reports; focus groups and co-design with stakeholders; definition of information needs and key questions); (2) research and metadatation of relevant sources (reconnaissance of official sources, administrative archives and internal DMO sources); (3) gap analysis and identification of unconventional information sources (evaluation of traditional sources with respect to the level of consistency with information needs, the freshness of information and granularity of data; enrichment of the information base by identifying and studying web sources such as Wikipedia, Google Trends, Booking.com, Tripadvisor, websites of accommodation facilities and online newspapers); (4) definition of the set of indicators and construction of the information base (specific definition of indicators and procedures for data acquisition, transformation, and analysis). The framework derived consists of 6 thematic areas (accommodation supply, cultural heritage, flows, value, sustainability, and enabling factors), each of which is divided into three domains that gather a specific information need to be represented by a scheme of questions to be answered through the analysis of available indicators. The framework is characterized by a high degree of flexibility in the European context, given that it can be customized for each destination by adapting the part related to internal sources. Application to the case study led to the creation of a decision support system that allows: •integration of data from heterogeneous sources, including through the execution of automated web crawling procedures for data ingestion of social and web information; •reading and interpretation of data and metadata through guided navigation paths in the key of digital story-telling; •implementation of complex analysis capabilities through the use of data mining algorithms such as for the prediction of tourist flows.

Keywords: collective intelligence, data framework, destination management, smart tourism

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Authors: Maxutova I. O., Bulatbayeva A. A.

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In modern conditions, the competitiveness of the military, a special educational institution in the educational market, is determined by the quality of the provision of educational services and the economic efficiency of activities. Improving the quality of educational services of the military, the special educational institution is an urgent socially and economically significant problem. The article shows a possible system for the formation of the competitiveness of military, the special educational institution through an assessment of the quality of the educational process, the problem of the transition of the military, special educational institution to digital support of indicative monitoring of the quality of services provided is raised. Quality monitoring is presented in the form of a program or information system, the work of which is carried out in a military, the special educational institution through highlighted interrelated elements. A result-oriented model of management and assessment of the quality of work of the military, the special educational institution is proposed. The indicative indicators for assessing the quality of the teaching and methodological activity of the teacher are considered and described. The publication was prepared as part of an applied grant study for 2020-2022 commissioned by the Ministry of Education and Science of the Republic of Kazakhstan on the topic "Development of a comprehensive methodology for assessing the quality of education of graduates of military special educational institutions" IRN 00029/GF-20.

Keywords: quality assessment, indicative indicators, monitoring program, educational and methodological activities, professional activities, result

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Authors: Allaw Kamel, Al-Chami Leila

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It is important to reduce the human influence on natural resources by identifying an appropriate land use. Moreover, it is essential to carry out the scientific land evaluation. Such kind of analysis allows identifying the main factors of agricultural production and enables decision makers to develop crop management in order to increase the land capability. The key is to match the type and intensity of land use with its natural capability. Therefore; in order to benefit from these areas and invest them to obtain good agricultural production, they must be organized and managed in full. Lebanon suffers from the unorganized agricultural use. We take south Lebanon as a study area, it is the most fertile ground and has a variety of crops. The study aims to identify and locate the most suitable area to cultivate thirteen type of permanent trees which are: apples, avocados, stone fruits in coastal regions and stone fruits in mountain regions, bananas, citrus, loquats, figs, pistachios, mangoes, olives, pomegranates, and grapes. Several geographical factors are taken as criterion for selection of the best location to cultivate. Soil, rainfall, PH, temperature, and elevation are main inputs to create the final map. Input data of each factor is managed, visualized and analyzed using Geographic Information System (GIS). Management GIS tools are implemented to produce input maps capable of identifying suitable areas related to each index. The combination of the different indices map generates the final output map of the suitable place to get the best permanent tree productivity. The output map is reclassified into three suitability classes: low, moderate, and high suitability. Results show different locations suitable for different kinds of trees. Results also reflect the importance of GIS in helping decision makers finding a most suitable location for every tree to get more productivity and a variety in crops.

Keywords: agricultural production, crop management, geographical factors, Geographic Information System, GIS, land capability, permanent trees, suitable location

Procedia PDF Downloads 133

Authors: R. Gwynn, P. Panwalkar, K. Veravalli , M. Tofighi, R. Clement, A. Mofidi

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The aim of this study was to access the impact of Covid-19 and lockdown on the incidence, injury pattern, and treatment of tibial plateau fractures in a combined rural and urban population in wales. Methods: Retrospective study was performed to identify tibial plateau fractures in 15-month period of Covid-19 lockdown 15-month period immediately before lockdown. Patient demographics, injury mechanism, injury severity (based on Schatzker classification), and associated injuries, treatment methods, and outcome of fractures in the Covid-19 period was studied. Results: The incidence oftibial plateau fracture was 9 per 100000 during Covid-19, and 8.5 per 100000, and both were similar to previous studies. The average age was 52, and female to male ratio was 1:1 in both control and study group. High energy injury was seen in only 20% of the patients and 35% in the control groups (2=12, p<0025). 14% of the covid-19 population sustained other injuries as opposed 16% in the control group(2=0.09, p>0.95). Lower severity isolated lateral condyle fracturesinjury (Schatzker 1-3) were seen in 40% of fractures this was 60% in the control populations. Higher bicondylar and shaft fractures (Schatzker 5-6) were seen in 60% of the Covid-19 group and 35% in the control groups(2=7.8, p<0.02). Treatment mode was not impacted by Covid-19. The complication rate was low in spite of higher number of complex fractures and the impact of covid-19 pandemic. Conclusion: The associated injuries were similar in spite of a significantly lower mechanism of injury. There were unexpectedly worst tibial plateau fracture based Schatzker classification in the Covid-19 period as compared to the control groups. This was especially relevant for medial condyle and shaft fractures. This was postulated to be caused by reduction in bone density caused by lack of vitamin D and reduction in activity. The treatment mode and outcome was not impacted by the impact of Covid-19 on care for tibial plateau fractures.

Keywords: Covid-19, knee, tibial plateau fracture, trauma

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Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Dóris F. Rabelo

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Some patients with COVID-19 disease and difficult airway characteristics undergo to endotracheal intubation (ETI) procedure. The tracheal introducer, known as the bougie guide, can aid ETI in patients with difficult airway pattern. Realistic simulation (RS) is a methodology utilized for healthcare professionals training. To improve skills in using the bougie guide of physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was carried out. Simulated scenario included the Nasco Lifeform realistic simulator for ETI and a bougie guide introducer. Training was a capacitation program organized by the Health Department of Bahia State. Objective: To report effects in participants´ self-confidence perception for using bougie guide after a RS based training. Methods: Descriptive study, secondary data extracted from questionnaires. Priority workplace and previous knowledge about bougie were reported on a preparticipation formulary. Participants also completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding to self-confidence in using bougie guide. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's exact test. Results: From May to June 2020 a total of 36 physicians participated of training, 25 (69%) from primary care setting, 32 (89%) with no previous knowledge about the bougie guide utilization. For those who had previous knowledge about bougie pre-training self-confidence median was 6,5, and 2 for participants who had not. In overall there was an increase in self-confidence median for bougie utilization. Median (variation) before and after training was 2.5 (1-7) vs. 8 (4-10) (p <0.0001). Among those who had no previous knowledge about bougie (n = 32) an increase in self-confidence greater than 3 points for bougie utilization was reported by 31 vs. 1 participants (p = 0.71). Conclusions: Most of participants had no previous knowledge about using the bougie guide. RS training contributed to self-confidence increase for using bougie for ETI procedure. RS methodology can contribute for training in using the bougie guide for ETI procedure during COVID-19 outbreak.

Keywords: bougie, confidence, COVID-19, endotracheal intubation, realistic simulation

Procedia PDF Downloads 125

Authors: Elaine Wong

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This research protocol aims to explore and justify the need for nutrition and physical activity intervention to improve health outcomes among SME (Small Medium Enterprise) employees. It was found that the worksite is an ideal and convenient setting for employees to take charge of their health thru active participation in health programmes since they spent a great deal of time at their workplace. This study will examine the impact of both general or/and targeted health interventions in both SME and non-SME companies utilizing the Workplace Health Promotion (WHP) grant over a 12 months period and assessed the improvement in chronic health disease outcomes in Singapore. Random sampling of both non-SME and SME companies will be conducted to undergo health intervention and statistical packages such as Statistical Package for Social Science (SPSS) 25 will be used to examine the impact of both general and targeted interventions on employees who participate and those who do not participate in the intervention and their effects on blood glucose (BG), blood lipid, blood pressure (BP), body mass index (BMI), and body fat percentage. Using focus groups and interviews, the data results will be transcribed to investigate enablers and barriers to workplace health intervention revealed by employees and WHP coordinators that could explain the variation in the health screening results across the organisations. Dietary habits and physical activity levels of the employees participating and not participating in the intervention will be collected before and after intervention to assess any changes in their lifestyle practices. It makes economic sense to study the impact of these interventions on health screening outcomes across various organizations that are existing grant recipients to justify the sustainability of these programmes by the local government. Healthcare policy makers and employers can then tailor appropriate and relevant programmes to manage these escalating chronic health disease conditions which is integral to the competitiveness and productivity of the nation’s workforce.

Keywords: chronic diseases, health screening, nutrition and fitness intervention , workplace health

Procedia PDF Downloads 136