Search results for: emergency department visits

Authors: Souhir Chelly, Asma Ben Cheikh, Hela Ghali, Salwa Khefacha, Lamine Dhidah, Mohamed Ben Rejeb, Houyem Said Latiri

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The hospital risk management department is firstly involved in the methodological analysis of grade zero sterilization incidents. The system is based on a subsequent analysis process in compliance with the ongoing requirements of the Haute Autorité de santé (HAS) for a reactive approach to risk, allowing to identify failures and start the appropriate preventive and corrective measures. The use of the association of litigation and risk management (ALARM) method makes easier the grade zero analysis and brings to light the team or institutional, organizational, temporal, individual factors representative of undesirable effects. Two main factors come out again from this analysis, pre-disinfection step of the emergency block unsupervised instrumentalist intern was poorly done since she did not remove the battery from micro air motor. At the sterilization unit, the worker who was not supervised by the nurse did the conditioning of the motor without having checked it if it still contained the battery. The main cause is that the management of human resources was inadequate at both levels, the instrumental trainee in the block who was not supervised by his supervisor and the worker of the sterilization unit who was not supervised by the responsible nurse. There is a lack of research help, advice, and collaboration. The difficulties encountered during this type of analysis are multiple. The first is based on its necessary acceptance by the various actors of care involved, which should not perceive it as a tool leading to individual punishment, but rather as a means to improve their practices.

Keywords: ALARM (Association of Litigation and Risk Management Method), incident, risk management, sterilization

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Authors: Lakhoua Najeh

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Introduction: In most situations, an industrial system already existing, conditioned by its history, its culture and its context are in difficulty facing the necessity to restructure itself in an organizational and technological environment in perpetual evolution. This is why all operations of restructuring first of all require a diagnosis based on a functional analysis. After a presentation of the functionality of a supervisory system for complex processes, we present the concepts of industrial automation and supervisory control and data acquisition (SCADA). Methods: This global analysis exploits the various available documents on the one hand and takes on the other hand in consideration the various testimonies through investigations, the interviews or the collective workshops; otherwise, it also takes observations through visits as a basis and even of the specific operations. The exploitation of this diagnosis enables us to elaborate the project of restructuring thereafter. Leaving from the system analysis for the restructuring of industrial systems, and after a technical diagnosis based on visits, an analysis of the various technical documents and management as well as on targeted interviews, a focusing retailing the various levels of analysis has been done according a general methodology. Results: The methodology adopted in order to contribute to the restructuring of industrial systems by its participative and systemic character and leaning on a large consultation a lot of human resources that of the documentary resources, various innovating actions has been proposed. These actions appear in the setting of the TQM gait requiring applicable parameter quantification and a treatment valorising some information. The new management environment will enable us to institute an information and communication system possibility of migration toward an ERP system. Conclusion: Technological advancements in process monitoring, control and industrial automation over the past decades have contributed greatly to improve the productivity of virtually all industrial systems throughout the world. This paper tries to identify the principles characteristics of a process monitoring, control and industrial automation in order to provide tools to help in the decision-making process.

Keywords: automation, supervision, SCADA, TQM

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Authors: Panasbodee Thachaopas, Duangdorm Gamnerdsap, Waraporn Inthip, Arissara Pungpa

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LDD’s IM Farm or Land Development Department’s Integrated Management Farm is the agricultural simulation application developed by Land Development Department relies on actual data in simulation game to grow 12 cash crops which are rice, corn, cassava, sugarcane, soybean, rubber tree, oil palm, pineapple, longan, rambutan, durian, and mangosteen. Launching in simulation game, players could select preferable areas for cropping from base map or Orthophoto map scale 1:4,000. Farm management is simulated from field preparation to harvesting. The system uses soil group, and present land use database to facilitate player to know whether what kind of crop is suitable to grow in each soil groups and integrate LDD’s data with other agencies which are soil types, soil properties, soil problems, climate, cultivation cost, fertilizer use, fertilizer price, socio-economic data, plant diseases, weed, pest, interest rate for taking on loan from Bank for Agriculture and Agricultural Cooperatives (BAAC), labor cost, market prices. These mentioned data affect the cost and yield differently to each crop. After completing, the player will know the yield, income and expense, profit/loss. The player could change to other crops that are more suitable to soil groups for optimal yields and profits.

Keywords: agricultural simulation, smart farmer, web application, factors of agricultural production

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Authors: Radmila Hajkova, Jiri Palecek, Hana Malachova, Alena Oulehlova

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Ensuring of continuity of business is the basic strategy of every company. Continuity of organization activities includes comprehensive procedures that help in solving unexpected situations of natural and anthropogenic character (for example flood, blaze, economic situations). Planning of continuity operations is a process that helps identify critical processes and implement plans for the security and recovery of key processes. The aim of this article demonstrates application of system approach to managing business continuity called business continuity management systems in military issues. This article describes the life cycle of business continuity management which is based on the established cycle PDCA (plan-do-check-act). After this is carried out by activities which are making by the University of Defence during activation of forces and means of the Integrated rescue system in case of emergencies - accidents at a nuclear power plant in Czech republic. Activities of various stages of deployment earmarked forces and resources are managed and evaluated by using MCMS application (military continuity management system).

Keywords: business continuity management system, emergency management, military, nuclear safety

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Authors: Kgabo H. Badimo, Sheryl Buckley

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Knowledge is increasingly recognised in this, the knowledge era, as a strategic resource, by public sector organisations, in view of the public sector reform initiatives. People and knowledge play a vital role in attaining improved organisational performance and high service quality. Many government departments in the public sector have started to realise the importance of knowledge management in streamlining their operations and processes. This study focused on knowledge management in the public healthcare service organisations, where the concept of service provider competitiveness pales to insignificance, considering the huge challenges emanating from the healthcare and public sector reforms. Many government departments are faced with challenges of improving organisational performance and service delivery, improving accountability, making informed decisions, capturing the knowledge of the aging workforce, and enhancing partnerships with stakeholders. The purpose of this paper is to examine the knowledge management practices of the Gauteng Department of Health in South Africa, in order to understand how knowledge management practices influence improvement in organisational performance and healthcare service delivery. This issue is explored through a review of literature on dominant views on knowledge management and healthcare service delivery, as well as results of interviews with, and questionnaire responses from, the general staff of the Gauteng Department of Health. Web-based questionnaires, face-to-face interviews and organisational documents were used to collect data. The data were analysed using both the quantitative and qualitative methods. The central question investigated was: To what extent can the conditions required for successful knowledge management be observed, in order to improve organisational performance and healthcare service delivery in the Gauteng Department of Health. The findings showed that the elements of knowledge management capabilities investigated in this study, namely knowledge creation, knowledge sharing and knowledge application, have a positive, significant relationship with all measures of organisational performance and healthcare service delivery. These findings thus indicate that by employing knowledge management principles, the Gauteng Department of Health could improve its ability to achieve its operational goals and objectives, and solve organisational and healthcare challenges, thereby improving organisational.

Keywords: knowledge management, Healthcare Service Delivery, public healthcare, public sector

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Authors: Navneet Kaur, Amarpreet Singh

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In Vehicular Adhoc Networks, Data Dissemination is a challenging task. There are number of techniques, types and protocols available for disseminating the data but in order to preserve limited bandwidth and to disseminate maximum data over networks makes it more challenging. There are broadcasting, multicasting and geocasting based protocols. Multicasting based protocols are found to be best for conserving the bandwidth. One such protocol named BEAM exists that improves the performance of Vehicular Adhoc Networks by reducing the number of in-network message transactions and thereby efficiently utilizing the bandwidth during an emergency situation. But this protocol may result in multicar chain collision as there was no V2V communication. So, this paper proposes a new protocol named Enhanced Bandwidth Efficient Cluster Based Multicasting Protocol (EBECM) that will overcome the limitations of existing BEAM protocol. And Simulation results will show the improved performance of EBECM in terms of Routing overhead, throughput and PDR when compared with BEAM protocol.

Keywords: BEAM, data dissemination, emergency situation, vehicular adhoc network

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Authors: Odaleia de O. Farias, Suzelene C. Marinho, Ecleidson B. Fragoso, Daniel S. Lima, Francisco R. S. Lira, Lara S. Araújo, Gabriel dos S. D. Soares

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In populous cities, prehospital care services that use vehicles alternative to ambulances are needed in order to reduce costs and improve response time to occurrences in areas with large concentration of people, such as leisure and tourism spaces. In this context, it was implanted a program called BIKE VIDA, that is innovative quick access and assistance program. The aim of this study is to describe the implantation and initial profile of occurrences performed by an urgency/emergency pre-hospital care service through paramedics on bicycles. It is a cross-sectional, descriptive study carried out in the city of Fortaleza, Ceara, Brazil. The data included service records from July to August 2017. Ethical aspects were respected. The service covers a perimeter of 4.5 km, divided into three areas with perimeter of 1.5 km for each paramedic, attending from 5 am to 9 pm. Materials transported by bicycles include External Automated Defibrillator - DEA, portable oxygen, oximeter, cervical collar, stethoscope, sphygmomanometer, dressing and immobilization materials and personal protective equipment. Occurrences are requested directly by calling the emergency number 192 or through direct approach to the professional. In the first month of the program, there were 93 emergencies/urgencies, mainly in the daytime period (71,0%), in males (59,7%), in the age range of 26 to 45 years (46,2%). The main nature was traumatic incidents (53.3%). Most of the cases (88,2%) did not require ambulance transport to the hospital, and there were two deaths. Pre-hospital service through bicycles is an innovative strategy in Brazil and has shown to be promising in terms of reducing costs and improving the quality of the services offered.

Keywords: emergency, response time, prehospital care, urgency

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Authors: Joy Aworookoroh

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Writing is one of the active skills in language learning. Students of English as a foreign language are expected to write efficiently and proficiently in the language; however, there are usually challenges to optimal performance and competence in writing. Errors, on the other hand, in a foreign language learning situation are more positive than negative as they provide the basis for solving the limitations of the students. This paper investigates the situation in the Department of English, Taraba State University Jalingo. Students are administered a descriptive writing test across different levels of study. The target students are multilingual with an L1 of either Kuteb, Hausa or Junkun languages. The essays are accessed to identify the different kinds of errors in them alongside the classification of the order. Errors of correctness, clarity, engagement, and delivery were identified. However, the study identified that the degree of errors reduces alongside the experience and exposure of the students to an EFL classroom.

Keywords: errors, writings, descriptive essay, multilingual

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Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

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Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

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Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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Authors: Mark Edward S. Paulo

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This study was conducted to determine the extent of constructivist learning in science classes of the college department of Southville International School and Colleges. This explores the students’ assessment of their learning when professors would give lecture and various activities in the classroom and at the same time their perception on how their professors maintain a constructivist learning environment. In this study, a total of 185 students participated. These students were enrolled in Science courses offered in the first semester of AY 2014 to 2015. Descriptive correlational method was used in this study while simple random sampling technique was utilized in getting the number of target population. The results revealed that student often observed that their professors apply constructivist approach when teaching sciences. A positive correlation was found between students’ level of learning and extent of constructivism.

Keywords: college teaching, constructivism, pedagogy, student-centered approach

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Authors: Adam Abdullahi Mohammed

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Performance appraisal is an assessment made to ensure the level of a worker’s productivity in a given period of time. The appraisal system is divided into two categories that are traditional methods and modern methods, with emphasis based on the evaluation of work results. In the traditional approach of staff appraisal, which puts more emphasis on individual traits, supervisors are required to measure employees through interactions based on what they achieved with reference to job descriptions, as well as rating them based on questionnaires without staff interaction. These methods are not effective because staff may give biased information. The study will attempt to assess the effect of performance appraisal on employee productivity at Yobe State University, Damaturu. It is aimed at assessing the process, methods, and objectives of performance appraisal and its feedback to know how they affect the success of the appraisal, its results, and employee productivity. In this study, a quantitative research method is adopted in collecting and analyzing data, and a questionnaire will be used as data collecting instrument. As it is a case study, the target population is the staff of the department of Islamic Studies. The research will employ a census sampling technique where all the subjects in the target populations are given a chance to participate in the study. This sampling method was considered because the entire target population is considered researchable. The expected findings are that staff performance appraisal in the department of Islamic Studies has effects on employee productivity; this is to say if it is given due consideration and the needful being done will improve employee productivity.

Keywords: performance appraisal, employee productivity, Yobe state University, appraisal feedback

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Authors: Collen Maseloane, Chris Cloete

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The study investigated the status of building condition assessments of state-owned immovable assets in South Africa. A stratified random sample of 200 (out of 372) personnel was drawn from the eight rele-vant business units of the Department of Public Works (DPW). A questionnaire comprising open-ended questions was distributed to the sampled participants and a total of 139 completed questionnaires were received. A significant number of state asset properties were found to be in poor condition owing to the asset managers’ inability to access automated information on the conditions of assets. It is recommended that the immovable asset register of the Department requires constant enhancement to update information on the condition of each state-owned immovable asset under its custodianship. Implementation of the proposals should contribute to the maintenance of the value of state assets in South Africa.

Keywords: building condition assessment, immovable asset register, life cycle asset management, public works, South Africa

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Authors: Emily Magoma-Nthite, Nonhlanhla Maseko, Mabatho Sedibe

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In this study, the focus is on the exploration and description of the teachers’ perceptions regarding retirement in Gauteng school in Tshwane North districts. From the individual and group interviews, the findings are leading to suggestions that a more comprehensive program for preparing teachers for retirement is highly necessary. All the participants were aware of their retirement age of 60 years as stipulated in the department of education internal memorandum No: 05 of 2021, which states that the compulsory retirement age in the public service is 60 years. It further states that the age restriction is in accordance with Chapter 4 of the Public Service Act, 1994 and Chapter 4 of the Employment of Educators Act, 1998, as amended. It was found out that there are some anxieties and fears as the majority seemed not ready and maybe not prepared enough for the retirement. Recommendations for a pre-retirement programme aimed at timeous preparation, which may include psychological, financial, and ability to keep functioning post retirement, will be proposed to the department of education in Gauteng and for the Tshwane North district as the pilot site on approval.

Keywords: teachers, pre-retirement, preparedness, gauteng schools

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Authors: R. Govender, T. C. Katsande, E. Madoroba, N. M. Thiebaut, D. Naidoo

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South African control over meat safety is managed by the Department of Agriculture, Forestry and Fisheries (DAFF). Veterinary services department in each of the nine provinces in the country is tasked with overseeing the farm and abattoir segments of the meat supply chain. Abattoirs are privately owned. The number of abattoirs over the years has increased. This increase has placed constraints on government resources required to monitor these abattoirs. This paper presents empirical research results on the hygienic processing of meat in high and low throughout abattoirs. This paper presents a case for the adoption of risk-based regulation as a method of government control over hygiene and safe meat processing at abattoirs in South Africa. Recommendations are made to the DAFF regarding policy considerations on risk-based regulation as a model of control in South Africa.

Keywords: risk-based regulation, abattoir, food control, meat safety

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Authors: Nimrod Bantigue

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The Department of Education is continuously providing safe teaching-learning facilities and hazard-free environments to the learners. To achieve this goal, teachers’ awareness of DepEd’s DRRM programs and activities is extremely important; thus, this descriptive correlational quantitative study was conceptualized. This research answered four questions on the profile and level of awareness of the 153 teacher respondents of Oriental Mindoro National High School for the academic year 2018-2019. Stratified proportional sampling was employed, and both descriptive and inferential statistics were utilized to treat data. The findings revealed that the majority of the teachers at OMNHS are female and are in the age bracket of 20-40. Most are married and pursue graduate studies. They have moderate awareness of the Department of Education’s DRRM programs and activities in terms of assessment of risks activities, planning activities, implementation activities during disaster and evaluation and monitoring activities with 3.32, 3.12, 3.40 and 3.31 as computed means, respectively. Further, the result showed a significant relationship between the profile of the respondents such as age, civil status and educational attainment and the level of awareness. On the contrary, sex does not have a significant relationship with the level of awareness. The Support School DRRM program with Utilization Guide on School DRRM Manual was proposed to increase, improve and strengthen the weakest areas of awareness rated in each DRRM activity, such as assessment of risks, planning, and implementation during disasters and monitoring and evaluation.

Keywords: awareness, management, monitoring, risk reduction

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Authors: Masashi Kanazawa, Takaaki Nakano, Masaaki Takemoto, Tomonori Imamura, Mamiko Sugimura, Toshitaka Ito

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Introduction: We experienced a massive disaster due to inhalation of water-soluble paint. Sixteen patients were brought to our emergency room, and pulmonary edema was revealed on the CT images of 12 cases. Purpose: Transition of chest CT-scan findings in cases with pulmonary edema was examined. Method: CT-scans were performed on the 1st, 2nd, 5th, and 19th days after the inhalation event. Patients whose pulmonary edema showed amelioration or exacerbation were classified into the improvement or the exacerbation group, respectively. Those with lung edema findings appearing at different sites after the second day were classified into the changing group. Results: Eight, one and three patients were in the improvement, exacerbation and changing groups, respectively. In all cases, the pulmonary edema had disappeared from CT images on the 19th day after the inhalation event. Conclusion: Inhalation of water-soluble paints is considered to be relatively safe. However, our observations in these emergency cases suggest that, even if pulmonary edema is not severe immediately after the exposure, new lesions may appear later and existing lesions may worsen. Follow-up imaging is thus necessary for about two weeks.

Keywords: CT scan, intoxication, pulmonary edema, water-soluble paint

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Authors: Ndukwe, Chinedu O.

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Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

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Authors: Fares Mahdi

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Background: Infection control is an important concern for all health care professionals, especially nurses. Nurses have a higher risk for both self-acquiring and transmitting infections to other patients. Aim of this study: to assess nurses' knowledge regarding infection control for wound care. Methodology: a descriptive research design was used in the study. The total number studied sample was 200 nurses, were conducting in Amran Public Hospitals in Amran City- Yemen. The study covered sample nurses in the hospital according to the study population; a standard closed-ended questionnaire was used to collect the data. Results: The results showed less than half (37.5 %) of nurses were from 22 May Hospital, also followed by (62.5%) of them were from Maternal and Child Hospital. Also according to the department name. Most (22.5%) of nurses worked in an intensive care unit, followed by (20%) of them were working in the pediatric world, also about (19%) of them were working in the surgical department. While in finally, only about (8.5%) of them worked from another department. According to course training, The results showed about (21%) of nurses had course training in wound care management. At the same time, others (79%) of them have not had course training in wound care management. According to the total nurse's knowledge of infection control for wound care, that find more than two-thirds (68%) of nurses had fair knowledge according to total all of nurse's knowledge of infection control wound care. Conclusion:The results showed that more than two-thirds (68%) of nurses had fair knowledge according to total all of the nurse's knowledge of infection control for wound care. Recommendations: There should be providing training program about infection control masseurs and it's important for new employees of nurses. Providing continuing refreshment training courses about infection control programs and about evidence-based practice in infection control for all health care teams.

Keywords: assessment, knowledge, infection control, wound care, nurses, amran hospitals

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Authors: Giya Erina

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Linguists have analyzed the rhetorical structure of various forensic genres, but only a few have investigated the complete structure of death row statements. Unlike other forensic text types, such as suicide or ransom notes, the focus of death row statement analysis is not the authenticity or falsity of the text, but its intended meaning and its communicative purpose. As it constitutes their last statement before their execution, there are probably many things that inmates would like to express. This study mainly examines the rhetorical moves of 200 death row statements from the Texas Department of Criminal Justice website using rhetorical move analysis. The rhetorical moves identified in the statements will be classified based on their communicative purpose, and they will be grouped into moves and steps. A move structure will finally be suggested from the most common or characteristic moves and steps, as well as some sub-moves. However, because of some statements’ atypicality, some moves may appear in different parts of the texts or not at all.

Keywords: Death row statements, forensic linguistics, genre analysis, move analysis

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Authors: A. Al Hajeri, M. E. Minton, B. Haskins, F. H. Cummins

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The pre-hospital endotracheal intubation is fraught with difficulties; one solution offered has been video laryngoscopy (VL) which permits better visualization of the glottis than the standard method of direct laryngoscopy (DL). This method has resulted in a higher first attempt success rate and fewer failed intubations. However, VL has mainly been evaluated by experienced providers (experienced anesthetists), and as such the utility of this device for those whom infrequently intubate has not been thoroughly assessed. We sought to evaluate this equipment to determine whether in the hands of novice providers this equipment could prove an effective airway management adjunct. DL and two VL methods (C-Mac with distal screen/C-Mac with attached screen) were evaluated by simulating practice on a Laerdal airway management trainer manikin. Twenty Emergency Medical Technicians (basics) were recruited as novice practitioners. This group was used to eliminate bias, as these clinicians had no pre-hospital experience of intubation (although they did have basic airway skills). The following areas were assessed: Time taken to intubate, number of attempts required to successfully intubate, ease of use of equipment VL (attached screen) took on average longer for novice clinicians to successfully intubate and had a lower success rate and reported higher rating of difficulty compared to DL. However, VL (with distal screen) and DL were comparable on intubation times, success rate, gastric inflation rate and rating of difficulty by the user. This study highlights the routine use of VL by inexperienced clinicians would be of no added benefit over DL. Further studies are required to determine whether Emergency Medical Technicians (Paramedics) would benefit from this airway adjunct, and ascertain whether after initial mastery of VL (with a distal screen), lower intubation times and difficulty rating may be achievable.

Keywords: direct laryngoscopy, endotracheal intubation, pre-hospital, video laryngoscopy

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Authors: E. M. Mhlongo, E. Lutge

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In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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Authors: Naila Awan, Shahrukh Inam

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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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Authors: Geetanjali Sharma

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Guillain Barre’ syndrome (GBS) is an auto-immune mediated demyelination poly-radiculo-neuropathy. Clinical features include progressive symmetrical ascending muscle weakness of more than two limbs, areflexia with or without sensory, autonomic and brainstem abnormalities, the purpose of this study was to determine subclinical neurological changes of CNS with GBS and to establish the presence of central demyelination in GBS. The study was prospective and conducted in the Department of Physiology, Pt. B. D. Sharma Post-graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, Haryana, India to find out early central demyelination in clinically diagnosed patients of GBS. These patients were referred from the department of Medicine of our Institute to our department for electro-diagnostic evaluation. The study group comprised of 40 subjects (20 clinically diagnosed GBS patients and 20 healthy individuals as controls) aged between 6-65 years. Brain Stem evoked Potential (BAEP) were done in both groups using RMS EMG EP mark II machine. BAEP parameters included the latencies of waves I to IV, inter peak latencies I-III, III-IV & I-V. Statistically significant increase in absolute peak and inter peak latencies in the GBS group as compared with control group was noted. Results of evoked potential reflect impairment of auditory pathways probably due to focal demyelination in Schwann cell derived myelin sheaths that cover the extramedullary portion of auditory nerves. Early detection of the sub-clinical abnormalities is important as timely intervention reduces morbidity.

Keywords: brainstem, demyelination, evoked potential, Guillain Barre’

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Authors: Faisal Ali, Mansoor Shuakat, Cui Lirong, Rabia Riasat

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HR is a department that enhances the power of employee performance in regard with their services, and to make the organization strategic objectives. The main concern of HR department is to organize people, focus on policies and their system. The empirical study shows the relationship between HRM (Human Resource Management practices) and their Job Satisfaction. The Hypothesis is testing on a sample of overall 320 employees of 5 different Pharmaceutical departments of different organizations in Pakistan. The important thing as Relationship of Job satisfaction with HR Practices, Impact on Job Satisfaction with HR Practices, Participation of Staff of Different Departments, HR Practices effects the Job satisfaction, Recruitment or Hiring and Selection effects the Job satisfaction, Training and Development, Performance and Appraisals, Compensation affects the Job satisfaction , and Industrial Relationships affects the Job satisfaction. After finishing all data analysis, the conclusion is that lots of Job related activities raise the confidence of Job satisfaction of employees with their salary and other benefits. Implications of HR practices discussed, Limitations, and future research study also offered write the main conclusion for your paper.

Keywords: HRM, HR practices, job satisfaction, TQM

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Authors: Soyhan Egitim

Abstract:

This case study aims to investigate leadership practices in diversity management in the liberal arts department of a Japanese university. In 2013, the Japanese Ministry of Education, Sports, Science, and Technology (MEXT) revealed their English education reform plan in response to rapid globalization. Based on the new reform plan, Japanese universities would expand their international faculty in order to promote globalization through an increased number of intercultural communication and content-based language classes in English. The study employed a two-phased qualitative approach to gain a deeper understanding of the management strategies employed in diversity management, and the leadership practices influenced those management strategies. In the first phase, a closed-ended qualitative survey was conducted with ten adjunct faculty members from the liberal arts department. The results indicate that syllabus design, grading scheme, textbook choices, and class management policies are strictly regulated by the tenured Japanese faculty. In the second phase, semi-structured interviews were held with international faculty members to understand their personal experiences. Their responses revealed that top-down management approaches are counter-effective in the department’s efforts to promote diversity and thus, a new organizational culture needs to be nurtured to emphasize inclusion alongside diversity. In this regard, the study proposes collaborative leadership as an inclusive leadership practice to minimize power differences in the hierarchy and increase opportunities for inclusion in the rapidly diversifying workforce.

Keywords: collaborative leadership, diversity, inclusion, international faculty, top-down

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Authors: Shosh Kazaz, Shmuel Banai, Vered Zilberberg

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Optimizing high business performance and employee's well-being simultaneously often challenges organizations. 'TIP' intervention enables achieving them both as the given project demonstrates. Increasing outcomes and improving performance were the initial motivators for this explorative project, followed by a request of the head of the Cardiology department: 'I know we are the best at our clinical practice, but we need to take it further and break our own glass ceiling.' Two guided interventions were conducted in two different units within the department, designed to implement advanced managerial and business-oriented tools, along with 'soft tools' based on coaching psychology and particularly wellness coaching. The organ department multi-disciplinary teams were assembled, aiming to manage and lead the process: mapping the patients' flow, creating solutions, implementing, assessing, improving and assimilating them. Approximately four months later, without additional external resources, meaningful results emerged by the teams in terms of business and performance: shortening the hospitalization length at a given procedure (from 7 to 2.1 days); increasing the availability of Catheterization laboratory by 16% daily – resulting profitability raise; improving patients' journey and experience. A year later, those results are maintained. Furthermore, interviews with the participants revealed positive perceptions regarding the department; a higher sense of joyfulness, connectedness, belonging and a better department climate were reported. Additionally, participants reported a higher sense of fulfillment as opposed to their earliest skepticism and cynicism about their ability to enhance outcomes without more resources (budget and/or manpower), experiencing a mindset change toward the possibility of leading personal and professional growth processes. These reports were supported by analyzing a set of questionnaires that the participants completed, parallel to a control group of non-participating colleagues. Although the assessment was taken a year after the completion of the project and during 'covid-19th-3rd national quarantine, the results indicated a significant impact on several personal parameters associated with wellness, compared to the control group. The participants were higher in self-efficacy and organizational commitment; men were higher in resilience and optimism and women were higher in well-being. In conclusion, the 'TIP' relatively short intervention integrates advanced managerial and wellness coaching tools, empowers organizational resources: Team, Individual and Process and by that generates multi-impact measurable results in terms of employee's wellness parameters along with business performance and patient care.

Keywords: coaching, health and wellness, health management, leadership and well-being

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Authors: Usha Lokala, Srinivas Nowduri, Prabhakar K. Sharma

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Useful information has been extracted from the road accident data in United Kingdom (UK), using data analytics method, for avoiding possible accidents in rural and urban areas. This analysis make use of several methodologies such as data integration, support vector machines (SVM), correlation machines and multinomial goodness. The entire datasets have been imported from the traffic department of UK with due permission. The information extracted from these huge datasets forms a basis for several predictions, which in turn avoid unnecessary memory lapses. Since data is expected to grow continuously over a period of time, this work primarily proposes a new framework model which can be trained and adapt itself to new data and make accurate predictions. This work also throws some light on use of SVM’s methodology for text classifiers from the obtained traffic data. Finally, it emphasizes the uniqueness and adaptability of SVMs methodology appropriate for this kind of research work.

Keywords: support vector mechanism (SVM), machine learning (ML), support vector machines (SVM), department of transportation (DFT)

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Authors: Ivana R. Moser, Joao C. Souza

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Building fires are random phenomena that can be extremely violent, and safe evacuation of people is the most guaranteed tactic in saving lives. The correct evacuation of buildings, and other spaces occupied by people, means leaving the place in a short time and by the appropriate way. It depends on the perception of spaces by the individual, the architectural layout and the presence of appropriate routing systems. As historical buildings were constructed in other times, when, as in general, the current security requirements were not available yet, it is necessary to adapt these spaces to make them safe. Computer models of evacuation simulation are widely used tools for assessing the safety of people in a building or agglomeration sites and these are associated with the analysis of human behaviour, makes the results of emergency evacuation more correct and conclusive. The objective of this research is the performance evaluation of historical interest buildings, regarding the safe evacuation of people, through computer simulation, using PTV Viswalk software. The buildings objects of study are the Colégio Catarinense, centennial building, located in the city of Florianópolis, Santa Catarina / Brazil. The software used uses the variables of human behaviour, such as: avoid collision with other pedestrians and avoid obstacles. Scenarios were run on the three-dimensional models and the contribution to safety in risk situations was verified as an alternative measure, especially in the impossibility of applying those measures foreseen by the current fire safety codes in Brazil. The simulations verified the evacuation time in situations of normality and emergency situations, as well as indicate the bottlenecks and critical points of the studied buildings, to seek solutions to prevent and correct these undesirable events. It is understood that adopting an advanced computational performance-based approach promotes greater knowledge of the building and how people behave in these specific environments, in emergency situations.

Keywords: computer simulation, escape routes, fire safety, historic buildings, human behavior

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Authors: Yu-Chuan Huang

Abstract:

Introduction: There is a higher mortality rate for unplanned transfer to intensive care units. It also needs a longer length of stay and makes the intensive care unit beds cannot be effectively used. It affects the immediate medical treatment of critically ill patients, resulting in a drop in the quality of medical care. Purpose: The purpose of this study was using SOFA and APACHEII score to analyze the mortality rate of the cases transferred from ED to ICU. According to the score that should be provide an appropriate care as early as possible. Methods: This study was a descriptive experimental design. The sample size was estimated at 220 to reach a power of 0.8 for detecting a medium effect size of 0.30, with a 0.05 significance level, using G-power. Considering an estimated follow-up loss, the required sample size was estimated as 242 participants. Data were calculated by medical system of SOFA and APACHEII score that cases transferred from ED to ICU in 2016. Results: There were 233 participants meet the study. The medical records showed 33 participants’ mortality. Age and sex with QSOFA , SOFA and sex with APACHEII showed p>0.05. Age with APCHHII in ED and ICU showed r=0.150, 0,268 (p < 0.001**). The score with mortality risk showed: ED QSOFA is r=0.235 (p < 0.001**), exp(B)=1.685(p = 0.007); ICU SOFA 0.78 (p < 0.001**), exp(B)=1.205(p < 0.001). APACHII in ED and ICU showed r= 0.253, 0.286 (p < 0.001**), exp(B) = 1.041,1.073(p = 0.017,0.001). For SOFA, a cutoff score of above 15 points was identified as a predictor of the 95% mortality risk. Conclusions: The SOFA and APACHE II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hours of ICU admission. In conclusion, the SOFA and APACHII score is significantly associated with mortality and strongly predicting mortality. Early predictors of morbidity and mortality, which we can according the predicting score, and provide patients with a detail assessment and proper care, thereby reducing mortality and length of stay.

Keywords: SOFA, APACHEII, mortality, ICU

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