Search results for: quality enhancement

Authors: Clara T. Fatoye, April Betts, Abayomi Odeyemi, Francis A. Fatoye, Isaac O. Odeyemi

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Background: The post-launch stage is the last stage in the development of a pharmaceutical product. It is important to involve patients in the development of pharmaceutical products at the post-launch stage, as patients are the end-users of pharmaceutical products. It is expected that involving them might ensure an effective working relationship among the various stakeholders. However, involving patients in the development of pharmaceutical products comes with its problems. Hence, this study examined how to resolve problems experienced by involving patients in the developments of pharmaceutical products’ at post-launch consisting of Positioning of pharmaceutical products (POPP), detailing of pharmaceutical products (DOPP) and reimbursement and Formulary Submission (R&FS). Methods: A questionnaire was used for the present study. It was administered at the ISPOR Glasgow 2017 to 104 participants, all of which were professionals from Market access (MA) and health economics and outcomes research (HEOR) backgrounds. They were asked how the issues experienced by patients can be resolved. Participants responded under six domains as follows: communication, cost, effectiveness, external factors, Quality of life (QoL) and safety. Thematic analysis was carried out to identify strategies to resolve issues experienced by patients at the post-launch stage. Results: Three (3) factors cut across at POPP, DOPP, and R&FS that is (external factors, communication and QoL). The first resolution method was an external factor that is, the relationship with stakeholders and policymakers. Communication was also identified as a resolution method that can help to resolve problems experienced by patients at the post-launch stage. The third method was QoL as perceived by the patients based on professionals’ opinions. Other strategies that could be used to resolve problems experienced were the effectiveness of pharmaceutical products at the DOPP level and cost at R&FS. Conclusion: The study showed that focusing on external factors, communication, and patients’ QoL are methods for resolving issues experienced by involving patients at the post-launch stage of pharmaceutical product development. Hence, effective working relationships between patients, policymakers and stakeholders may help to resolve problems experienced at the post-launch stage. Healthcare policymakers are to be aware of these findings as they may help them to put appropriate strategies in place to enhance the involvement of patients in pharmaceutical product development at the post-launch stage, thereby improving the health outcomes of the patients.

Keywords: patients, pharmaceutical products, post-launch stage, quality of life, QoL

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Authors: Franca De Sarno, Alfonso Maria Ponsiglione, Enza Torino

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Recent advances in diagnostic imaging technology have significantly contributed to a better understanding of specific changes associated with diseases progression. Among different imaging modalities, Magnetic Resonance Imaging (MRI) represents a noninvasive medical diagnostic technique, which shows low sensitivity and long acquisition time and it can discriminate between healthy and diseased tissues by providing 3D data. In order to improve the enhancement of MRI signals, some imaging exams require intravenous administration of contrast agents (CAs). Recently, emerging research reports a progressive deposition of these drugs, in particular, gadolinium-based contrast agents (GBCAs), in the body many years after multiple MRI scans. These discoveries confirm the need to have a biocompatible system able to boost a clinical relevant Gd-chelate. To this aim, several approaches based on engineered nanostructures have been proposed to overcome the common limitations of conventional CAs, such as the insufficient signal-to-noise ratios due to relaxivity and poor safety profile. In particular, nanocarriers, labeling or loading with CAs, capable of carrying high payloads of CAs have been developed. Currently, there’s no a comprehensive understanding of the thermodynamic contributions enable of boosting the efficacy of conventional CAs by using biopolymers matrix. Thus, considering the importance of MRI in diagnosing diseases, here it is reported a successful example of the next generation of these drugs where the commercial gadolinium chelate is incorporate into a biopolymer nanostructure, formed by cross-linked hyaluronic acid (HA), with improved relaxation properties. In addition, they are highlighted the basic principles ruling biopolymer-CA interactions in the perspective of their influence on the relaxometric properties of the CA by adopting a multidisciplinary experimental approach. On the basis of these discoveries, it is clear that the main point consists in increasing the rigidification of readily-available Gd-CAs within the biopolymer matrix by controlling the water dynamics, the physicochemical interactions, and the polymer conformations. In the end, the acquired knowledge about polymer-CA systems has been applied to develop of Gd-based HA nanoparticles with enhanced relaxometric properties.

Keywords: biopolymers, MRI, nanoparticles, contrast agent

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Authors: Nora Arbaoui, Rachid Tadili

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The substantial increase of areas cultivated under glasshouses compels the use of other natural heating and cooling procedures to make a profit as well as avoid both exorbitant fuel consumption and CO₂ emissions. This experimental study is designed to examine the functioning of a solar heating system that will increase positive consequences in terms of both quantity and quality while successfully enhancing greenhouse microclimate during wintertime. Those configurations have been tested in a miniaturized greenhouse simply after having optimized the operating parameters. These were noteworthy results when compared to an unheated witness greenhouse.

Keywords: solar system, agricultural greenhouse, heating, cooling, storage, drying

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Authors: Ana C. R. P. Ferreira, Adriano H. P. Pereira

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Given the frequent variation of mineral properties throughout the Araxá pyrochlore deposit, even if a good homogenization work has been carried out before feeding the processing plants, an operation with quality and performance’s high variety standard is expected. These results could be improved and standardized if the blend composition parameters that most influence the processing route are determined, and then the types of raw materials are grouped by them, finally presenting a great reference with operational settings for each group. Associating the physical and chemical parameters of a unit operation through benchmarking or even an optimal reference of metallurgical recovery and product quality reflects in the reduction of the production costs, optimization of the mineral resource, and guarantee of greater stability in the subsequent processes of the production chain that uses the mineral of interest. Conducting a comprehensive exploratory data analysis to identify which characteristics of the ore are most relevant to the process route, associated with the use of Machine Learning algorithms for grouping the raw material (ore) and associating these with reference variables in the process’ benchmark is a reasonable alternative for the standardization and improvement of mineral processing units. Clustering methods through Decision Tree and K-Means were employed, associated with algorithms based on the theory of benchmarking, with criteria defined by the process team in order to reference the best adjustments for processing the ore piles of each cluster. A clean user interface was created to obtain the outputs of the created algorithm. The results were measured through the average time of adjustment and stabilization of the process after a new pile of homogenized ore enters the plant, as well as the average time needed to achieve the best processing result. Direct gains from the metallurgical recovery of the process were also measured. The results were promising, with a reduction in the adjustment time and stabilization when starting the processing of a new ore pile, as well as reaching the benchmark. Also noteworthy are the gains in metallurgical recovery, which reflect a significant saving in ore consumption and a consequent reduction in production costs, hence a more rational use of the tailings dams and life optimization of the mineral deposit.

Keywords: mineral clustering, machine learning, process optimization, pyrochlore processing

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Authors: Alok Agrawal, Alok Satapathy

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In this paper, an attempt to determine the effective thermal conductivity (keff) of particulate filled polymer composites using finite element method (FEM) a powerful computational technique is made. A commercially available finite element package ANSYS is used for this numerical analysis. Three-dimensional spheres-in-cube lattice array models are constructed to simulate the microstructures of micro-sized particulate filled polymer composites with filler content ranging from 2.35 to 26.8 vol %. Based on the temperature profiles across the composite body, the keff of each composition is estimated theoretically by FEM. Composites with similar filler contents are than fabricated using compression molding technique by reinforcing micro-sized aluminium oxide (Al2O3) in polypropylene (PP) resin. Thermal conductivities of these composite samples are measured according to the ASTM standard E-1530 by using the Unitherm™ Model 2022 tester, which operates on the double guarded heat flow principle. The experimentally measured conductivity values are compared with the numerical values and also with those obtained from existing empirical models. This comparison reveals that the FEM simulated values are found to be in reasonable good agreement with the experimental data. Values obtained from the theoretical model proposed by the authors are also found to be in even closer approximation with the measured values within percolation limit. Further, this study shows that there is gradual enhancement in the conductivity of PP resin with increase in filler percentage and thereby its heat conduction capability is improved. It is noticed that with addition of 26.8 vol % of filler, the keff of composite increases to around 6.3 times that of neat PP. This study validates the proposed model for PP-Al2O3 composite system and proves that finite element analysis can be an excellent methodology for such investigations. With such improved heat conduction ability, these composites can find potential applications in micro-electronics, printed circuit boards, encapsulations etc.

Keywords: analytical modelling, effective thermal conductivity, finite element method, polymer matrix composite

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Authors: Sisaynew Tesfaw Admassu

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The strengthening of timber beams can be necessary for several reasons including the increase of live loads (possible in a historical building for a change of destination of use or upgrading to meet new requirements), the reduction of the resistant cross-sections following deterioration (attacks of biological agents such as fungi, and insects) or traumatic events (fires) and the excess of deflection in the members. The main purpose of strengthening an element is not merely to repair it, but also to prevent and minimize the appearance of future problems. This study did an experimental investigation on the behavior of reference and strengthened solid timber beams. The strengthening materials used in this study were CSM-450 glass fiber and steel materials for both flexural and shear strengthening techniques. Twenty-two solid timber beams of Juniperus procera (TID) species with the dimensions of 60 x 90 x 780 mm were used in the present study. The binding material to bond the strengthening materials with timber was general-purpose resin with Luperox® K10 MEKP catalyst. Three beams were used as control beams (unstrengthen beams) while the remaining nineteen beams were strengthened using the strengthening materials for flexure and shear. All the beams were tested for three points loading to failure by using a Universal Testing Machine, UTM-600kN machine. The experimental results showed that the strengthened beams performed better than the unstrengthen beams. The experimental result of flexural strengthened beams showed that the load-bearing capacity of strengthened beams increased between 16.34 – 42.55%. Four layers of Glass Fiber Reinforced polymer on the tension side of the beams was shown to be the most effective way to enhance load-bearing capacity. The strengthened beams also have an enhancement in their flexural stiffness. The stiffness of flexural strengthened beams was increased between 1.18 – 65.53% as compared to the control beams. The highest increment in stiffness has occurred on beams strengthened using 2x60 mm steel plates. The shear-strengthened beams showed a relatively small amount of performance as compared to flexural-strengthened beams; the reason is that the beams are sufficient for shear. The polyester resin used in the experimental work showed good performance in bonding agents between materials. The resin showed more effectiveness in GFRP materials than steel materials.

Keywords: heritage structures, strengthening, stiffness, adhesive, polyester resin, steel plates

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Authors: Chuang-Hung Lin, Cheng-Yuan Hsu, Jia-Yan Lin

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It is an indispensible strategy to adopt greenery approach on architectural bases so as to improve ecological habitats, decrease heat-island effect, purify air quality, and relieve surface runoff as well as noise pollution, all of which are done in an attempt to achieve sustainable environment. How we can do with plant design to attain the best visual quality and ideal carbon dioxide fixation depends on whether or not we can appropriately make use of greenery according to the nature of architectural bases. To achieve the goal, it is a need that architects and landscape architects should be provided with sufficient local references. Current greenery studies focus mainly on the heat-island effect of urban with large scale. Most of the architects still rely on people with years of expertise regarding the adoption and disposition of plantation in connection with microclimate scale. Therefore, environmental design, which integrates science and aesthetics, requires fundamental research on landscape environment technology divided from building environment technology. By doing so, we can create mutual benefits between green building and the environment. This issue is extremely important for the greening design of the bases of green buildings in cities and various open spaces. The purpose of this study is to establish plant selection and allocation strategies under different building sunshade levels. Initially, with the shading of sunshine on the greening bases as the starting point, the effects of the shades produced by different building types on the greening strategies were analyzed. Then, by measuring the PAR( photosynthetic active radiation), the relative DLI( daily light integral) was calculated, while the DLI Map was established in order to evaluate the effects of the building shading on the established environmental greening, thereby serving as a reference for plant selection and allocation. The discussion results were to be applied in the evaluation of environment greening of greening buildings and establish the “right plant, right place” design strategy of multi-level ecological greening for application in urban design and landscape design development, as well as the greening criteria to feedback to the eco-city greening buildings.

Keywords: daily light integral, plant design, urban open space

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Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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Authors: Ji Young Lee, Jong Woon Kim

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It is essential to secure high availability of railway vehicles to realize high quality and efficiency of railway service. Once the availability decreased, planned railway service could not be provided or more cars need to be reserved. additional cars need to be purchased or the frequency of railway service could be decreased. Such situation would be a big loss in terms of quality and cost related to railway service. Therefore, we make various efforts to get high availability of railway vehicles. Because it is a big loss to operators, we make various efforts to get high availability of railway vehicles. To secure high availability, the idle time of the vehicle needs to be reduced and the following methods are applied to railway vehicles. First, through modularization design, exchange time for line replaceable units is reduced which makes railway vehicles could be put into the service quickly. Second, to reduce periodic preventive maintenance time, preventive maintenance with short period would be proceeded test oriented to minimize the maintenance time, and reliability is secured through overhauls for each main component. With such design changes for railway vehicles, modularized components are exchanged first at the time of vehicle failure or overhaul so that vehicles could be put into the service quickly and exchanged components are repaired or overhauled. Therefore, spare components are required for any future failures or overhauls. And, as components are modularized and costs for components are high, it is considerably important to get reasonable quantities of spare components. Especially, when a number of railway vehicles were put into the service simultaneously, the time of overhauls come almost at the same time. Thus, for some vehicles, components need to be exchanged and overhauled before appointed overhaul period so that these components could be secured as spare parts for the next vehicle’s component overhaul. For this reason, components overhaul time and spare parts quantities should be decided at the same time. This study deals with the time of overhauls for repairable components of railway vehicles and the calculation of spare parts quantities in consideration of future failure/overhauls. However, as railway vehicles are used according to the service schedule, maintenance work cannot be proceeded after the service was closed thus it is quite difficult to resolve this situation mathematically. In this study, Simulation software system is used in this study for analyzing the time of overhauls for repairable components of railway vehicles and the spare parts for the railway systems.

Keywords: overhaul time, rolling stocks, simulation, spare parts

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Authors: Khaled Moh. Alhamad

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This paper describes a tabu search heuristic for a ship routing and scheduling problem (SRSP). The method was developed to address the problem of loading cargos for many customers using heterogeneous vessels. Constraints relate to delivery time windows imposed by customers, the time horizon by which all deliveries must be made and vessel capacities. The results of a computational investigation are presented. Solution quality and execution time are explored with respect to problem size and parameters controlling the tabu search such as tenure and neighbourhood size.

Keywords: heuristic, scheduling, tabu search, transportation

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Authors: Mohammadreza DaqiqShirazi, Rouhollah Torabi, Alireza Riasi, Ahmad Nourbakhsh

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In this paper, the flow in a sidewall gap of an impeller which belongs to a centrifugal pump is studied using numerical method. The flow in sidewall gap forms internal leakage and is the source of “disk friction loss” which is the most important cause of reduced efficiency in low specific speed centrifugal pumps. Simulation is done using CFX software and a high quality mesh, therefore the modeling error has been reduced. Navier-Stokes equations have been solved for this domain. In order to predict the turbulence effects the SST model has been employed.

Keywords: numerical study, centrifugal pumps, disk friction loss, sidewall gap

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Authors: Ergin Toros, Manar Aslan

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This study was planned as a descriptive study in order to learn the opinions of the students who are studying in nursing undergraduate program about their theoretical/practical lessons and departments. The education in the undergraduate nursing programs has great importance because it contains the knowledge and skills to prepare student nurses to the clinic in the future. In order to provide quality-nursing services in the future, the quality of nursing education should be measured, and opinions of student nurses about education should be taken. The research population was composed of students educated in a university with 1-4 years of theoretical and clinical education (N=550), and the sample was composed of 460 students that accepted to take part in the study. It was reached to 83.6% of target population. Data collected through a survey developed by the researchers. Survey consists of 48 questions about sociodemographic characteristics (9 questions), theoretical courses (9 questions), laboratory applications (7 questions), clinical education (14 questions) and services provided by the faculty (9 questions). It was determined that 83.3% of the nursing students found the nursing profession to be suitable for them, 53% of them selected nursing because of easy job opportunity, and 48.9% of them stayed in state dormitory. Regarding the theoretical courses, 84.6% of the students were determined to agree that the question ‘Course schedule is prepared before the course and published on the university web page.’ 28.7% of them were determined to do not agree that the question ‘Feedback is given to students about the assignments they prepare.’. It has been determined that 41,5% of the students agreed that ‘The time allocated to laboratory applications is sufficient.’ Students said that physical conditions in laboratory (41,5%), and the materials used are insufficient (44.6%), and ‘The number of students in the group is not appropriate for laboratory applications.’ (45.2%). 71.3% of the students think that the nurses view in the clinics the students as a tool to remove the workload, 40.7% of them reported that nurses in the clinic area did not help through the purposes of the course, 39.6% of them said that nurses' communication with students is not good. 37.8% of students stated that nurses did not provide orientation to students, 37.2% of them think that nurses are not role models for students. 53.7% of the students stated that the incentive and support for the student exchange program were insufficient., %48 of the students think that career planning services, %47.2 security services,%45.4 the advisor spent time with students are not enough. It has been determined that nursing students are most disturbed by the approach of the nurses in the clinical area within the undergraduate education program. The clinical area education which is considered as an integral part of nursing education is important and affect to student satisfaction.

Keywords: nursing education, student, clinical area, opinion

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Authors: Ni'mal Baroya, Andrei Ramani, Irma Prasetyowati

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The access to reproduction health services, including with safe and effective contraception were human rights regardless of social stratum and residence. In addition to individual factors, family and contextual factors were also believed to be the cause in the use of contraceptive methods. This study aimed to assess the determinants of long-term contraceptive methods (LTCM) by considering all the factors at either the individual level or contextual level. Thereby, this study could provide basic information for program development of prevalence enhancement of MKJP in East Java. The research, which used cross-sectional design, utilized Riskesdas 2013 data, particularly in East Java Province for further analysis about multilevel modeling of MKJP application. The sample of this study consisted of 20.601 married women who were not in pregnant that were drawn by using probability sampling following the sampling technique of Riskesdas 2013. Variables in this study were including the independent variables at the individual level that consisted of education, age, occupation, access to family planning services (KB), economic status and residence. As independent variables in district level were the Human Development Index (HDI, henceforth as IPM) in each districts of East Java Province, the ratio of field officers, the ratio of midwives, the ratio of community health centers and the ratio of doctors. As for the dependent variable was the use of Long-Term Contraceptive Method (LTCM or MKJP). The data were analyzed by using chi-square test and Pearson product moment correlation. The multivariable analysis was using multilevel logistic regression with 95% of Confidence Interval (CI) at the significance level of p < 0.05 and 80% of strength test. The results showed a low CPR LTCM was concentrated in districts in Madura Island and the north coast. The women which were 25 to 35 or more than 35 years old, at least high school education, working, and middle-class social status were more likely to use LTCM or MKJP. The IPM and low PLKB ratio had implications for poor CPR LTCM / MKJP.

Keywords: multilevel, long-term contraceptive methods, east java, contextual factor

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Authors: Rodriguez Diego, Del Valle Martin, Hargreaves Matias, Riveros Jose Luis

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Nutrient deficiencies due to a diet low in quantitative and qualitative terms, are prevalent throughout the developing world, especially in sub-Saharan Africa. Children and women of childbearing age are especially vulnerable. Limited availability, access and intake of animal foods at home and lack of knowledge about their value in the diet and the role they play in health, contribute to poor diet quality. Poor bioavailability of micronutrients in diets based on foods high in fiber and phytates, the low content of some micronutrients in these foods are further factors to consider. Goats are deeply embedded in almost every Sub-Saharan African rural culture, generally kept for their milk, meat, hair or leather. Goats have played an important role in African social life, especially in food security. Goat meat has good properties for human wellbeing, with a special role in lower income households. It has a high-quality protein (20 protein g/100 meat g) including all essential amino acids, good unsaturated/satured fatty acids relationship, and it is an important B-vitamin source with high micronutrients bioavailability. Mozambique has major food security problems, with poor food access and utilization, undiversified diets, chronic poverty and child malnutrition. Our objective was to design a nutritional intervention based on a dietary diversification, nutritional education, cultural beliefs and local resources, aimed to strengthen food security of children at Barrio Broma village (15°43'58.78"S; 32°46'7.27"E) in Chitima, Mozambique. Two surveys were conducted first of socio-productive local databases and then to 100 rural households about livelihoods, food diversity and anthropometric measurements in children under 5 years. Our results indicate that the main economic activity is goat production, based on a native breed with two deliveries per year in the absence of any management. Adult goats weighted 27.2±10.5 kg and raised a height of 63.5±3.8 cm. Data showed high levels of poverty, with a food diversity score of 2.3 (0-12 points), where only 30% of households consume protein and 13% iron, zinc, and B12 vitamin. The main constraints to food security were poor access to water and low income to buy food. Our dietary intervention was based on improving diet quality by increasing the access to dried goat meat, fresh vegetables, and legumes, and its utilization by a nutritional education program. This proposal was based on local culture and living conditions characterized by the absence of electricity power and drinkable water. The drying process proposed would secure the food maintenance under local conditions guaranteeing food safety for a longer period. Additionally, an ancient local drying technique was rescued and used. Moreover, this kind of dietary intervention would be the most efficient way to improve the infant nutrition by delivering macro and micronutrients on time to these vulnerable populations.

Keywords: child malnutrition, dietary diversification, food security, goat meat

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Authors: Jaco Oosthuizen, Nerina C. Van Der Merwe

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The National Health Laboratory Services in Bloemfontien has been the diagnostic testing facility for 1830 patients for familial breast cancer since 1997. From the cohort, 540 were comprehensively screened using High-Resolution Melting Analysis or Next Generation Sequencing for the presence of point mutations and/or indels. Approximately 90% of these patients stil remain undiagnosed as they are BRCA1/2 negative. Multiplex ligation-dependent probe amplification was initially added to screen for copy number variation detection, but with the introduction of next generation sequencing in 2017, was substituted and is currently used as a confirmation assay. The aim was to investigate the viability of utilizing internationally designed copy number variation detection assays based on mostly European/Caucasian genomic data for use within a South African context. The multiplex ligation-dependent probe amplification technique is based on the hybridization and subsequent ligation of multiple probes to a targeted exon. The ligated probes are amplified using conventional polymerase chain reaction, followed by fragment analysis by means of capillary electrophoresis. The experimental design of the assay was performed according to the guidelines of MRC-Holland. For BRCA1 (P002-D1) and BRCA2 (P045-B3), both multiplex assays were validated, and results were confirmed using a secondary probe set for each gene. The next generation sequencing technique is based on target amplification via multiplex polymerase chain reaction, where after the amplicons are sequenced parallel on a semiconductor chip. Amplified read counts are visualized as relative copy numbers to determine the median of the absolute values of all pairwise differences. Various experimental parameters such as DNA quality, quantity, and signal intensity or read depth were verified using positive and negative patients previously tested internationally. DNA quality and quantity proved to be the critical factors during the verification of both assays. The quantity influenced the relative copy number frequency directly whereas the quality of the DNA and its salt concentration influenced denaturation consistency in both assays. Multiplex ligation-dependent probe amplification produced false positives due to ligation failure when ligation was inhibited due to a variant present within the ligation site. Next generation sequencing produced false positives due to read dropout when primer sequences did not meet optimal multiplex binding kinetics due to population variants in the primer binding site. The analytical sensitivity and specificity for the South African population have been proven. Verification resulted in repeatable reactions with regards to the detection of relative copy number differences. Both multiplex ligation-dependent probe amplification and next generation sequencing multiplex panels need to be optimized to accommodate South African polymorphisms present within the genetically diverse ethnic groups to reduce the false copy number variation positive rate and increase performance efficiency.

Keywords: familial breast cancer, multiplex ligation-dependent probe amplification, next generation sequencing, South Africa

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Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Razia Sultana, Md Faroque Miah

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Mental health remains a significant global public health challenge, profoundly affecting millions worldwide. In Bangladesh, the situation is dire, with the National Mental Health Survey 2018-19 indicating that 19% of adults suffer from any kind of mental disorders, including severe mental disorder of around 2%. Despite these high prevalence rates, there is a substantial treatment gap in low- and middle-income countries, including Bangladesh, where up to 92% of individuals with mental illnesses do not receive adequate care. This gap is exacerbated by social barriers such as stigma, discrimination, social exclusion, poverty, homelessness, and human rights violations. To address these challenges, the SAJIDA Foundation launched the Proshanti in November 2022. Proshanti is a community based supportive housing intervention designed to provide cost-effective, sustainable, long-term care for individuals with chronic mental illnesses. It aims to rehabilitate participants by improving their mental health, quality of life, and equipping them with skills necessary for independent living and social mobility. Currently, Proshanti operates seven houses in Manikganj and Habiganj districts of Bangladesh, accommodating up to 40 individuals. Over a two-year period, individuals have received personalized support from trained personal assistants and care coordinators, regular health checkups, and opportunities for vocational training and community engagement. In this presentation, we will present the outcome of such intervention on individual’s functionality, quality of life and psychological health generated from 24 months of journey. Additionally, a qualitative approach will be employed to understand the facilitators and barriers of program implementation. The Proshanti program represents a promising model for addressing the significant mental health treatment gap in Bangladesh at the community level. Our findings will provide crucial insights into the program's feasibility, effectiveness, and the factors influencing its implementation, potentially guiding future mental health interventions in similar contexts.

Keywords: mental health, community based supportive housing, treatment gap, bangladesh

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Authors: John Acord, Ankita Batla, Kiran Khepar, Maude Schmidt, Charlotte Allen, Russ Bradford

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Objectives: Despite the availability oftreatment options, Parkinson’s disease (PD) continues to impact heavily on a patient’s quality of life (QoL), as many symptoms that bother the patient remain unexplored and untreated in clinical settings. The aims of this research were to understand the burden of PDsymptoms from a patient perspective, particularly those which are the most persistent and debilitating, and to determine if current treatments and treatment algorithms adequately focus on their resolution. Methods: A13-question, online, patient-reported survey was created based on the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)and symptoms listed on Parkinson’s Disease Patient Advocacy Groups websites, and then validated by 10 Parkinson’s patients. In the survey, patients were asked to choose both their most common and their most bothersome symptoms, whether they had received treatment for those and, if so, had it been effective in resolving those symptoms. Results: The most bothersome symptoms reported by the 111 participants who completed the survey were sleep problems (61%), feeling tired (56%), slowness of movements (54%), and pain in some parts of the body (49%). However, while 86% of patients reported receiving dopamine or dopamine like drugs to treat their PD, far fewer reported receiving targeted therapies for additional symptoms. For example, of the patients who reported having sleep problems, only 33% received some form of treatment for this symptom. This was also true for feeling tired (30% received treatment for this symptom), slowness of movements (62% received treatment for this symptom), and pain in some parts of the body (61% received treatment for this symptom). Additionally, 65% of patients reported that the symptoms they experienced were not adequately controlled by the treatments they received, and 9% reported that their current treatments had no effect on their symptoms whatsoever. Conclusion: The survey outcomes highlight that the majority of patients involved in the study received treatment focused on their disease, however, symptom-based treatments were less well represented. Consequently, patient-reported symptoms such as sleep problems and feeling tired tended to receive more fragmented intervention than ‘classical’ PD symptoms, such as slowness of movement, even though they were reported as being amongst the most bothersome symptoms for patients. This research highlights the need to explore symptom burden from the patient’s perspective and offer Customised treatment/support for both motor and non-motor symptoms maximize patients’ quality of life.

Keywords: survey, patient reported symptom burden, unmet needs, parkinson's disease

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Authors: Inna Vinokurova, N. Savvina

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The goal of research: to study the organization of multi-field hospital’s work environment in the Republic of Sakha (Yakutia), Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine. Results: Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine is a multidisciplinary, specialized hospital complex that provides specialized and high-tech medical care to children and adults in the Republic of Sakha (Yakutia) of the Russian Federation. There are 5 diagnostic and treatment centers (advisory and diagnostic, clinical, pediatric, perinatal, Republican cardiologic dispensary) with 45 clinical specialized departments with 727 cots, 5 resuscitation departments, 20 operating rooms and out-patient department with 905 visits in alternation in the National Center of Medicine. Annually more than 20,000 patients receive treatment in the hospital of the Republican Hospital of the Republic of Sakha (Yakutia), more than 70,000 patients visit out-patient sections, more than 2 million researches are done, more than 12,000 surgeries are performed, more than 2 thousand babies are delivered. National Center of Medicine has a great influence with such population’s health indicators as total mortality, birth rate, maternal, infant and perinatal mortality, circulatory system incidence. The work environment of the Republican Hospital of the Republic of Sakha (Yakutia) is represented by the following structural departments: pharmacy, blood transfusion department, sterilization department, laundry, dietetic department, infant-feeding centre, material and technical supply. More than 200 employees work in this service. The main function of these services is to provide on-time and fail-safe supply with all necessary: wear parts, medical supplies, donated blood and its components, foodstuffs, hospital linen , sterile instruments, etc. Thus, the activity of medical organization depends on the work environment, including quality health care, so it is a main part of multi-field hospital activity.

Keywords: organization of multi-field hospital’s, work environment, quality health care, pharmacy, blood transfusion department, sterilization department

Procedia PDF Downloads 237

Authors: Payman Davoodi-Nasab, Ahmad Rahbar-Kelishami, Jaber Safdari, Hossein Abolghasemi

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The high purity rare earth elements (REEs) have been vastly used in the field of chemical engineering, metallurgy, nuclear energy, optical, magnetic, luminescence and laser materials, superconductors, ceramics, alloys, catalysts, and etc. Neodymium is one of the most abundant rare earths. By development of a neodymium–iron–boron (Nd–Fe–B) permanent magnet, the importance of neodymium has dramatically increased. Solvent extraction processes have many operational limitations such as large inventory of extractants, loss of solvent due to the organic solubility in aqueous solutions, volatilization of diluents, etc. One of the promising methods of liquid membrane processes is emulsion liquid membrane (ELM) which offers an alternative method to the solvent extraction processes. In this work, a study on Nd extraction through multi-walled carbon nanotubes (MWCNTs) assisted ELM using response surface methodology (RSM) has been performed. The ELM composed of diisooctylphosphinic acid (CYANEX 272) as carrier, MWCNTs as nanoparticles, Span-85 (sorbitan triooleate) as surfactant, kerosene as organic diluent and nitric acid as internal phase. The effects of important operating variables namely, surfactant concentration, MWCNTs concentration, and treatment ratio were investigated. Results were optimized using a central composite design (CCD) and a regression model for extraction percentage was developed. The 3D response surfaces of Nd(III) extraction efficiency were achieved and significance of three important variables and their interactions on the Nd extraction efficiency were found out. Results indicated that introducing the MWCNTs to the ELM process led to increasing the Nd extraction due to higher stability of membrane and mass transfer enhancement. MWCNTs concentration of 407 ppm, Span-85 concentration of 2.1 (%v/v) and treatment ratio of 10 were achieved as the optimum conditions. At the optimum condition, the extraction of Nd(III) reached the maximum of 99.03%.

Keywords: emulsion liquid membrane, extraction of neodymium, multi-walled carbon nanotubes, response surface method

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Authors: D. S. Nagesh, G. L. Datta

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In the field of welding, various studies had been made by some of the previous investigators to predict as well as optimize weld bead geometric descriptors. Modeling of weld bead shape is important for predicting the quality of welds. In most of the cases, design of experiments technique to postulate multiple linear regression equations have been used. Nowadays, Genetic Algorithm (GA) an intelligent information treatment system with the characteristics of treating complex relationships as seen in welding processes used as a tool for inverse mapping/optimization of the process is attempted.

Keywords: smaw, genetic algorithm, bead geometry, optimization/inverse mapping

Procedia PDF Downloads 447

Authors: D. S. Nagesh, G. L. Datta

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In the field of welding, various studies had been made by some of the previous investigators to predict as well as optimize weld bead geometric descriptors. Modeling of weld bead shape is important for predicting the quality of welds. In most of the cases design of experiments technique to postulate multiple linear regression equations have been used. Nowadays Genetic Algorithm (GA) an intelligent information treatment system with the characteristics of treating complex relationships as seen in welding processes used as a tool for inverse mapping/optimization of the process is attempted.

Keywords: SMAW, genetic algorithm, bead geometry, optimization/inverse mapping

Procedia PDF Downloads 417

Authors: Semira Zeru Haileslassie

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Lack of awareness and practices of PEP treatment were observed among respondents, but they had a better attitude towards PEP. To this end, a formal training for all respondents regarding PEP for HIV prior to their clinical attachments is of utmost importance. The training ought to incorporate a brief clarification with respect to the unpleasant impact of non-adherence that essentially incorporate destitute treatment result and most prominent hazard of resistance and few given as a major cause for non-compliance to PEP, common transient side-effects of PEP and its administrations ought to be cloister educated healthcare specialists to diminish its effect on adherence. Besides, the propensity of detailing needle adhere harm was destitute that needs endeavors to progress. Progressing the culture of detailing and making the detailing handle simple is very necessary. In reality, announcing such wounds as early as conceivable will educate others not to commit same issue once more and, for the most part, will empower stakeholders to intercede the issue sometime prior to it re-occur. At long last, as distant as get up and go utilize has cleared out with so numerous bothers, risk decrease is the foremost choice. With this, taking the increased significance of protective barriers so as to decrease the hazard of exposure to HIV, distinctive stakeholders (the healing center hardware supply chain director, the HIV/ Helps clinic, the clinic chief, hardware and supply quality confirmation group, and other authoritative bodies) ought to work together in co-ordination to secure the supply and guarantee the quality of those crucial protective barriers and to advance demand health laborers to continuously wear protective barriers when exposed to HIV hazard components as well as to dispose appropriately once done. At long last, we prescribe future examiners to conduct planned multicenter studies with extra goals (counting indicator investigation) for way better generalization and result. In spite of satisfactory information and favorable state of mind towards PEP for HIV in most of the respondents, this study uncovered that there were delays in starting, low utilization, and fragmented use of the prescribed PEP. So, health care staff need to progress their practice on PEP of HIV through diverse training program related to PEP of HIV.

Keywords: HIV infection, prophylaxis, knowledge, attitude

Procedia PDF Downloads 189

Authors: Jesús M. Martín, Francisco Corona, Dolores Hidalgo

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Landfills present long-term threats to soil, air, groundwater and surface water due to the formation of greenhouse gases (methane gas and carbon dioxide) and leachate from decomposing garbage. The composition of leachate differs from site to site and also within the landfill. The leachates alter with time (from weeks to years) since the landfilled waste is biologically highly active and their composition varies. Mainly, the composition of the leachate depends on factors such as characteristics of the waste, the moisture content, climatic conditions, degree of compaction and the age of the landfill. Therefore, the leachate composition cannot be generalized and the traditional treatment models should be adapted in each case. Although leachate composition is highly variable, what different leachates have in common is hazardous constituents and their potential eco-toxicological effects on human health and on terrestrial ecosystems. Since leachate has distinct compositions, each landfill or dumping site would represent a different type of risk on its environment. Nevertheless, leachates consist always of high organic concentration, conductivity, heavy metals and ammonia nitrogen. Leachate could affect the current and future quality of water bodies due to uncontrolled infiltrations. Therefore, control and treatment of leachate is one of the biggest issues in urban solid waste treatment plants and landfills design and management. This work presents a treatment model that will be carried out "in-situ" using a cost-effective novel technology that combines solar evaporation/condensation plus forward osmosis. The plant is powered by renewable energies (solar energy, biomass and residual heat), which will minimize the carbon footprint of the process. The final effluent quality is very high, allowing reuse (preferred) or discharge into watercourses. In the particular case of this work, the final effluents will be reused for cleaning and gardening purposes. A minority semi-solid residual stream is also generated in the process. Due to its special composition (rich in metals and inorganic elements), this stream will be valorized in ceramic industries to improve the final products characteristics.

Keywords: forward osmosis, landfills, leachate valorization, solar evaporation

Procedia PDF Downloads 198

Authors: Desalegn Feyissa Desu

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Drug therapy problem is a significant challenge to provide high quality health care service for the patients. It is associated with morbidity, mortality, increased hospital stay, and reduced quality of life. Moreover, pediatric patients are quite susceptible to drug therapy problems. Thus this study aimed to assess drug therapy problem and its contributing factors among pediatric patients diagnosed with infectious disease admitted to pediatric ward of Jimma university medical center, from April 1 to June 30, 2018. Prospective observational study was conducted among pediatric patients with infectious disease admitted from April 01 to June 30, 2018. Drug therapy problems were identified by using Cipolle’s and strand’s drug related problem classification method. Patient’s written informed consent was obtained after explaining the purpose of the study. Patient’s specific data were collected using structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to statistical software package version 21.0 for analysis. To identify predictors of drug therapy problems occurrence, multiple stepwise backward logistic regression analysis was done. The 95% CI was used to show the accuracy of data analysis and statistical significance was considered at p-value < 0.05. A total of 304 pediatric patients were included in the study. Of these, 226(74.3%) patients had at least one drug therapy problem during their hospital stay. A total of 356 drug therapy problems were identified among two hundred twenty six patients. Non-compliance (28.65%) and dose too low (27.53%) were the most common type of drug related problems while disease comorbidity [AOR=3.39, 95% CI= (1.89-6.08)], Polypharmacy [AOR=3.16, 95% CI= (1.61-6.20)] and more than six days stay in hospital [AOR=3.37, 95% CI= (1.71-6.64) were independent predictors of drug therapy problem occurrence. Drug therapy problems were common in pediatric patients with infectious disease in the study area. Presence of comorbidity, polypharmacy and prolonged hospital stay were the predictors of drug therapy problem in study area. Therefore, to overcome the significant gaps in pediatric pharmaceutical care, clinical pharmacists, Pediatricians, and other health care professionals have to work in collaboration.

Keywords: drug therapy problem, pediatric, infectious disease, Ethiopia

Procedia PDF Downloads 149

Authors: Athanasios A. Gavrilidis, Mihai R. Nita, Larissa N. Stoia, Diana A. Onose

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Contemporary global environmental challenges must be primarily addressed at local levels. Cities are under continuous pressure as they must ensure high quality of life levels for their citizens and at the same time to adapt and address specific environmental issues. Innovative solutions using natural features or mimicking natural systems are endorsed by the scientific community as efficient approaches for both mitigating climate change effects and the decrease of environmental quality and for maintaining high standards of living for urban dwellers. The aim of this study was to assess whether Romanian cities’ authorities are considering nature-based innovation as solutions for their planning, management, and environmental issues. Data were gathered by applying 140 questionnaires to urban authorities throughout the country. The questionnaire was designed for assessinglocal policy makers’ perspective over the efficiency of nature-based innovations as a tool to address specific challenges. It also focused on extracting data about financing sources and challenges they must overcome for adopting nature-based approaches. The gather results from the municipalities participating in our study were statistically processed, and they revealed that Romanian city managers acknowledge the benefits of nature-based innovations, but investments in this sector are not on top of their priorities. More than 90% of the selected cities have agreed that in the last 10 years, their major concern was to expand the grey infrastructure (roads and public amenities) using traditional approaches. When asked how they would react if faced with different socio-economic and environmental challenges, local urban managers indicated investments nature-based solutions as a priority only in case of biodiversity loss and extreme weather, while for other 14 proposed scenarios, they would embrace the business-as-usual approach. Our study indicates that while new concepts of sustainable urban planning emerge within the scientific community, local authorities need more time to understand and implement them. Without the proper knowledge, personnel, policies, or dedicated budgets, local administrators will not embrace nature-based innovations as solutions for their challenges.

Keywords: nature based innovations, perception analysis, policy making, urban planning

Procedia PDF Downloads 164

Authors: Kalayanee Senasu

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This research investigates Thai people’s happiness based on socioeconomic factors, i.e. region, municipality, gender, age, and occupation. The research data were collected from survey data using interviewed questionnaires. The primary data were from stratified multi-stage sampling in each region, province, district, and enumeration area; and simple random sampling in each enumeration area. These data were collected in 13 provinces: Bangkok and three provinces in each of all four regions. The data were collected over two consecutive years. There were 3,217 usable responses from the 2017 sampling, and 3,280 usable responses from the 2018 sampling. The Senasu’s Thai Happiness Index (THaI) was used to calculate the happiness level of Thai people in 2017 and 2018. This Thai Happiness Index comprises five dimensions: subjective well-being, quality of life, philosophy of living, governance, and standard of living. The result reveals that the 2017 happiness value is 0.506, while Thai people are happier in 2018 (THaI = 0.556). For 2017 happiness, people in the Central region have the highest happiness (THaI = 0.532), which is followed closely by people in the Bangkok Metropolitan Area (THaI = 0.530). People in the North have the lowest happiness (THaI = 0.476) which is close to the level for people in the Northeast (THaI = 0.479). Comparing age groups, it is found that people in the age range 25-29 years old are the happiest (THaI = 0.529), followed by people in the age range 55-59 and 35-39 years old (THaI = 0.526 and 0.523, respectively). Additionally, people who live in municipal areas are happier than those who live in non-municipal areas (THaI = 0.533 vs. 0.475). Males are happier than females (THaI = 0.530 vs. 0.482), and retired people, entrepreneurs, and government employees are all in the high happiness groups (THaI =0.614, 0.608, and 0.593, respectively). For 2018 happiness, people in the Northern region have the highest happiness (THaI = 0.590), which is followed closely by people in the South and Bangkok Metropolitan Area (THaI = 0.578 and 0.577, respectively). People in the Central have the lowest happiness (THaI = 0.530), which is close to the level for people in the Northeast (THaI = 0.533). Comparing age groups, it is found that people in the age range 35-39 years old are the happiest (THaI = 0.572), followed by people in the age range 40-44 and 60-64 years old (THaI = 0.569 and 0.568, respectively). Similar to 2017 happiness, people who live in municipal areas are happier than those who live in non-municipal areas (THaI = 0.567 vs. 0. 552). However, males and females are happy at about the same levels (THaI = 0.561 vs. 0.560), and government employees, retired people, and state enterprise employees are all in the high happiness groups (THaI =0.667, 0.639, and 0.661, respectively).

Keywords: happiness, quality of life, Thai happiness index, socio-economic factors

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Authors: Sadaf Rafiq, Muhammad Waqas, Shakeel Ahmad Khan, Nisar Ahmad

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Everyday life information seeking (ELIS) is considered as the mastery of life. It plays an important role in daily problem solving activities. Female students living in university hostels need variety of information to fulfil their everyday information needs. To find accurate and timely information is really challenging for females students who move from rural areas for educational purposes. These challenges involve culture differences, stress, financial issues, homesickness, diet needs and change in sleeping and eating habits. These complications create numerous problems for female students to adjust themselves in new and unfamiliar environment. Although the Internet has increased the ease of seeking everyday life information to survive successfully but there is still uncertainty to fully rely on the quality of information available on the web. Pakistan is an underdeveloped country where limited budget is allocated for educational institutions to enable them in developing well established hostels for their students. Female students who pursue for higher education has to stay at hostels for years to obtain education goals. It really becomes very difficult for them to spend life in hostels if they are not properly facilitated with relevant information sources to acquire everyday life information. The proposed study attempts to investigate the everyday life information seeking behavior of female students who are living in university and private hostels of Lahore. It investigates the various sources of information used by female students. It also identifies the problems faced by the female students in accessing everyday life information. The results of this study will be helpful for university management to understand their information need and provide required information sources which are essential for them to spend a comfortable, successful and peaceful life in hostels and achieve their educational goals. To achieve the objectives of the study, we will use quantitative research approach by using questionnaire as a data collection tool. The population of this study will be the university students living in public and private hostels of Lahore, Pakistan. This study will increase the understanding of everyday life information seeking behavior of female students living in hostels. Results of the study will be helpful for hostel administrations to better understand the students’ everyday life information needs and provide high quality of information services and living environment.

Keywords: everyday, information seeking, hostel, female

Procedia PDF Downloads 142

Authors: Yih-Chien Chen, Yu-Cheng You

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The microwave dielectric properties of La2MoO6 ceramics were investigated with a view to their application in mobile communication. La2MoO6 ceramics were prepared by the conventional solid-state method with various sintering conditions. The X-ray diffraction peaks of La2MoO6 ceramic did not vary significantly with sintering conditions. The average grain size of La2MoO6 ceramics increased as the temperature and time of sintering increased. A maximum density of 5.67 g/cm3, a dielectric constants (εr) of 14.1, a quality factor (Q×f) of 68,000 GHz, and a temperature coefficient of resonant frequency (τf) of -56 ppm/℃ were obtained when La2MoO6 ceramics that were sintered at 1300 ℃ for 4h.

Keywords: ceramics, sintering, microwave dielectric properties, La2MoO6

Procedia PDF Downloads 286

Authors: Azam Zare

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Separation flow control for performance enhancement over airfoils at high incidence angle has become an increasingly important topic. This work details the characteristics of an efficient feedback control of the turbulent subsonic flow over NACA23012 airfoil using forced reduced‐order model based on the proper orthogonal decomposition/Galerkin projection and perturbation method on the compressible Reynolds Averaged Navier‐Stokes equations. The forced reduced‐order model is used in the optimal control of the turbulent separated flow over a NACA23012 airfoil at Mach number of 0.2, Reynolds number of 5×106, and high incidence angle of 24° using blowing/suction controlling jets. The Spallart-Almaras turbulence model is implemented for high Reynolds number calculations. The main shortcoming of the POD/Galerkin projection on flow equations for controlling purposes is that the blowing/suction controlling jet velocity does not show up explicitly in the resulting reduced order model. Combining perturbation method and POD/Galerkin projection on flow equations introduce a forced reduced‐order model that can predict the time-varying influence of the blowing/suction controlling jet velocity. An optimal control theory based on forced reduced‐order system is used to design a control law for a nonlinear reduced‐order model, which attempts to minimize the vorticity content in the turbulent flow field over NACA23012 airfoil. Numerical simulations were performed to help understand the behavior of the controlled suction jet at 12% to 18% chord from leading edge and a pair of blowing/suction jets at 15% to 18% and 24% to 30% chord from leading edge, respectively. Analysis of streamline profiles indicates that the blowing/suction jets are efficient in removing separation bubbles and increasing the lift coefficient up to 22%, while the perturbation method can predict the flow field in an accurate Manner.

Keywords: flow control, POD, Galerkin projection, separation

Procedia PDF Downloads 146

Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper

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Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.

Keywords: patient safety, quality improvement, serious incidents, falls, clinical care

Procedia PDF Downloads 122