Search results for: public sector hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10169

Search results for: public sector hospital

9689 The Effects of Semi-Public Spaces with Distinctive Functions on the Urban Space Quality

Authors: Melike Orhan

Abstract:

Along with impetuous physical change, configuration and increase in the density of cities, urban public spaces have started to become a transition area rather than spaces to inhabit. The insufficiency of public spaces, one of the most significant components of a city, where communal life is maintained and the decrease in the quality of urban spaces have led to an increase in the use of semi-public spaces as urban space. Semi-public spaces are those that ensure transition between private and public spaces and can be seen, observed, reached and used by urban-dwellers. Humans are in a constant relation to their surroundings and care for integration as part of their surroundings. Semi-public spaces providing balance for the individual between private spaces (structures) and urban-public spaces make this integration easier. Spaces with a semi-public characteristic serve for a particular neighboring unit and the user (i.e. common use areas in residential spaces and dwellings, common outdoor areas situated between office buildings, and etc.) These spaces, whose density of usage is increased with distinctive functions and activities, gain different attributions according to the characteristics of the urban space they are located in (commercial, residential, touristic, and etc.) and to the functions of the structures with which they are in relation. At the same time, they begin to serve other neighboring units along with an increase in public usage. As a result, the interaction between environment-space-structure-humans changes, which directly affects the urban space quality. The aim of this study is to determine how and depending on what characteristics the public usage density of semi-public spaces change and to put forth the effects of this change on the urban environment it is located in and to designate its role in terms of 'urban space quality'. In conclusion, within the scope of this study, semi-public spaces located in urban spaces with distinctive functions will be explored through examples, and the effects of these spaces with altered public usage and density on urban space and quality of life will be put forward. Accordingly, applicable criteria will be determined by means of semi-public spaces oriented at increasing and sustaining the quality of urban space.

Keywords: semi-public spaces, urban public spaces, urban space quality, public usage

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9688 Admission C-Reactive Protein Serum Levels and In-Hospital Mortality in the Elderly Admitted to the Acute Geriatrics Department

Authors: Anjelika Kremer, Irina Nachimov, Dan Justo

Abstract:

Background: C-reactive protein (CRP) serum levels are commonly measured in hospitalized patients. Elevated admission CRP serum levels and in-hospital mortality has been seldom studied in the general population of elderly patients admitted to the acute Geriatrics department. Methods: A retrospective cross-sectional study was conducted at a tertiary medical center. Included were all elderly patients (age 65 years or more) admitted to a single acute Geriatrics department from the emergency room between April 2014 and January 2015. CRP serum levels were measured routinely in all patients upon the first 24 hours of admission. A logistic regression analysis was used to study if admission CRP serum levels were associated with in-hospital mortality independent of age, gender, functional status, and co-morbidities. Results: Overall, 498 elderly patients were included in the analysis: 306 (61.4%) female patients and 192 (38.6%) male patients. The mean age was 84.8±7.0 years (median: 85 years; IQR: 80-90 years). The mean admission CRP serum levels was 43.2±67.1 mg/l (median: 13.1 mg/l; IQR: 2.8-51.7 mg/l). Overall, 33 (6.6%) elderly patients died during the hospitalization. A logistic regression analysis showed that in-hospital mortality was independently associated with history of stroke (p < 0.0001), heart failure (p < 0.0001), and admission CRP serum levels (p < 0.0001) – and to a lesser extent with age (p = 0.042), collagen vascular disease (p=0.011), and recent venous thromboembolism (p=0.037). Receiver operating characteristic (ROC) curve showed that admission CRP serum levels predict in-hospital mortality fairly with an area under the curve (AUC) of 0.694 (p < 0.0001). Cut-off value with maximal sensitivity and specificity was 19.7 mg/L. Conclusions: Admission CRP serum levels may be used to predict in-hospital mortality in the general population of elderly patients admitted to the acute Geriatrics department.

Keywords: c-reactive protein, elderly, mortality, prediction

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9687 Social Impact Bonds in the US Context

Authors: Paula M. Lantz

Abstract:

In the United States, significant socioeconomic and racial inequalities exist in many population-based indicators of health and social welfare. Although a number of effective prevention programs and interventions are available, local and state governments often do not pursue prevention in the face of budgetary constraints and more acute problems. There is growing interest in and excitement about Pay for Success” (PFS) strategies, also referred to as social impact bonds, as an approach to financing and implementing promising prevention programs and services that help the public sector either save money or achieve greater value for an investment. The PFS finance model implements evidence-based interventions using capital from investors who only receive a return on their investment from the government if agreed-upon, measurable outcomes are achieved. This paper discusses the current landscape regarding social impact bonds in the U.S., and their potential and challenges in addressing serious health and social problems. The paper presents an analysis of a number of social science issues that are fundamental to the potential for social impact bonds to successfully address social inequalities in health and social welfare. This includes: a) the economics of the intervention and a potential public payout; b) organizational and management issues in intervention implementation; c) evaluation research design and methods; d) legal/regulatory issues in public payouts to investors; e) ethical issues in the design of social impact bond deals and their evaluation; and f) political issues. Despite significant challenges in the U.S. context, there is great potential for social impact bonds as a type of social impact investing to encourage private investments in evidence-based interventions that address important public health and social problems in underserved populations and provide a return on investment.

Keywords: pay for success, public/private partnerships, social impact bonds, social impact investing

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9686 Optimizing the Public Policy Information System under the Environment of E-Government

Authors: Qian Zaijian

Abstract:

E-government is one of the hot issues in the current academic research of public policy and management. As the organic integration of information and communication technology (ICT) and public administration, e-government is one of the most important areas in contemporary information society. Policy information system is a basic subsystem of public policy system, its operation affects the overall effect of the policy process or even exerts a direct impact on the operation of a public policy and its success or failure. The basic principle of its operation is information collection, processing, analysis and release for a specific purpose. The function of E-government for public policy information system lies in the promotion of public access to the policy information resources, information transmission through e-participation, e-consultation in the process of policy analysis and processing of information and electronic services in policy information stored, to promote the optimization of policy information systems. However, due to many factors, the function of e-government to promote policy information system optimization has its practical limits. In the building of E-government in our country, we should take such path as adhering to the principle of freedom of information, eliminating the information divide (gap), expanding e-consultation, breaking down information silos and other major path, so as to promote the optimization of public policy information systems.

Keywords: China, e-consultation, e-democracy, e-government, e-participation, ICTs, public policy information systems

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9685 Analysis of the CO2 Emissions of Public Passenger Transport in Tianjin City of China

Authors: Tao Zhao, Xianshuo Xu

Abstract:

Low-carbon public passenger transport is an important part of low carbon city. The CO2 emissions of public passenger transport in Tianjin from 1995 to 2010 are estimated with IPCC CO2 counting method, which shows that the total CO2 emissions of Tianjin public passenger transport have gradually become stable at 1,425.1 thousand tons. And then the CO2 emissions of the buses, taxies, and rail transits are calculated respectively. A CO2 emission of 829.9 thousand tons makes taxies become the largest CO2 emissions source among the public passenger transport in Tianjin. Combining with passenger volume, this paper analyzes the CO2 emissions proportion of the buses, taxies, and rail transits compare the passenger transport rate with the proportion of CO2 emissions, as well as the CO2 emissions change of per 10,000 people. The passenger volume proportion of bus among the three public means of transport is 72.62% which is much higher than its CO2 emissions proportion of 36.01%, with the minimum number of CO2 emissions per 10,000 people of 4.90 tons. The countermeasures to reduce CO2 emissions of public passenger transport in Tianjin are to develop rail transit, update vehicles and use alternative fuel vehicles.

Keywords: public passenger transport, carbon emissions, countermeasures, China

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9684 Modelling Public Knowledge and Attitude towards Genetically Modified Maize in Kenya

Authors: Ezrah Kipkirui Tonui, George Otieno Orwa

Abstract:

A survey of 138 farmers was conducted in Rift valley, Kenya, in November and December 2013 in three counties (Uasin-gishu, Elgeyo-marakwet, and Tranzoia) to determine public knowledge and attitude towards genetically modified (GM) maize. Above two third (70%) of the respondents had knowledge of GM maize, mostly those educated and male. Female was found to be having low knowledge on GM maize. Public acknowledged the technology’s potential positive impacts, with more than 90% willing to adopt and more than 98% willing to buy GM seedlings at any given price. A small percentage less than 3% were of a negative opinion about willing to buy and adopt GM seeds. We conclude that GM technology has a role to play in food security in Kenya. However, the public needs more information about the technology, which can be provided through established sources of information and training. Finally, public knowledge and attitude on GM maize should be studied on a regular basis, and the survey population broadened to 47 counties.

Keywords: public, knowledge, attitudes, GM maize, Kenya

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9683 The Breast Surgery Movement: A 50 Year Development of the Surgical Specialty

Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman

Abstract:

The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.

Keywords: breast cancer, breast fellowship, breast surgery, surgical history

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9682 Territories' Challenges and Opportunities to Promote Circular Economy in the Building Sector

Authors: R. Tirado, G. Habert, A. Mailhac, S. Laurenceau

Abstract:

The rapid development of cities implies significant material inflows and outflows. The construction sector is one of the main consumers of raw materials and producers of waste. The waste from the building sector, for its quantity and potential for recovery, constitutes significant deposits requiring major efforts, by combining different actors, to achieve the circular economy's objectives. It is necessary to understand and know the current construction actors' knowledge of stocks, urban metabolism, deposits, and recovery practices in this context. This article aims to explore the role of local governments in planning strategies by facilitating a circular economy. In particular, the principal opportunities and challenges of communities for applying the principles of the circular economy in the building sector will be identified. The approach used for the study was to conduct semi-structured interviews with those responsible for circular economy projects within local administrations of some communities in France. The results show territories' involvement in the inclusion and application of the principles of the circular economy in the building sector. The main challenges encountered are numerous, hence the importance of having identified and described them so that the different actors can work to meet them.

Keywords: building stock, circular economy, interview, local authorities

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9681 Research on the Development and Space Optimization of Rental-Type Public Housing in Hangzhou

Authors: Xuran Zhang, Huiru Chen

Abstract:

In recent years, China has made great efforts to cultivate and develop the housing rental market, especially the rental-type public housing, which has been paid attention to by all sectors of the society. This paper takes Hangzhou rental-type public housing as the research object, and divides it into three development stages according to the different supply modes of rental-type public housing. Through data collection and field research, the paper summarizes the spatial characteristics of rental-type public housing from the five perspectives of spatial planning, spatial layout, spatial integration, spatial organization and spatial configuration. On this basis, the paper proposes the optimization of the spatial layout. The study concludes that the spatial layout of rental-type public housing should be coordinated with the development of urban planning. When planning and constructing, it is necessary to select more mixed construction modes, to be properly centralized, and to improve the surrounding transportation service facilities.  It is hoped that the recommendations in this paper will provide a reference for the further development of rental-type public housing in Hangzhou.

Keywords: Hangzhou, rental-type public housing, spatial distribution, spatial optimization

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9680 Food Security in Germany: Inclusion of the Private Sector through Law Reform Faces Challenges

Authors: Agnetha Schuchardt, Jennifer Hartmann, Laura Schulte, Roman Peperhove, Lars Gerhold

Abstract:

If critical infrastructures fail, even for a short period of time, it can have significant negative consequences for the affected population. This is especially true for the food sector that is strongly interlinked with other sectors like the power supply. A blackout could lead to several cities being without food supply for numerous days, simply because cash register systems do no longer work properly. Following the public opinion, securing the food supply in emergencies is considered a task of the state, however, in the German context, the key players are private enterprises and private households. Both are not aware of their responsibility and both cannot be forced to take any preventive measures prior to an emergency. This problem became evident to officials and politicians so that the law covering food security was revised in order to include private stakeholders into mitigation processes. The paper will present a scientific review of governmental and regulatory literature. The focus is the inclusion of the food industry through a law reform and the challenges that still exist. Together with legal experts, an analysis of regulations will be presented that explains the development of the law reform concerning food security and emergency storage in Germany. The main findings are that the existing public food emergency storage is out-dated, insufficient and too expensive. The state is required to protect food as a critical infrastructure but does not have the capacities to live up to this role. Through a law reform in 2017, new structures should to established. The innovation was to include the private sector into the civil defense concept since it has the required knowledge and experience. But the food industry is still reluctant. Preventive measures do not serve economic purposes – on the contrary, they cost money. The paper will discuss respective examples like equipping supermarkets with emergency power supply or self-sufficient cash register systems and why the state is not willing to cover the costs of these measures, but neither is the economy. The biggest problem with the new law is that private enterprises can only be forced to support food security if the state of emergency has occurred already and not one minute earlier. The paper will cover two main results: the literature review and an expert workshop that will be conducted in summer 2018 with stakeholders from different parts of the food supply chain as well as officials of the public food emergency concept. The results from this participative process will be presented and recommendations will be offered that show how the private economy could be better included into a modern food emergency concept (e. g. tax reductions for stockpiling).

Keywords: critical infrastructure, disaster control, emergency food storage, food security, private economy, resilience

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9679 Utilizing Public Spaces as a Precursor for Community Social Cohesion

Authors: Oloruntoba Kayode, Mohd Hisyam Rasidi, Ismail Said

Abstract:

This study investigates the influence of public space in developing social cohesion among residents in science cities. The study takes into consideration the need for social cohesion in knowledge-based development and focuses on Cyberjaya Malaysia being a science city that is characterized by public spaces. As such, we adopted validated measuring tools for this study we developed a theoretical framework that links public space utilization with people's social cohesion. A total of 211 survey questions were administered by the residents in the study area on public space utilization and their social cohesion potentials. The research framework was validated to confirm its fit using structural equation modeling (SEM). The findings indicated that the observed public space utilization variables significantly influenced people's social cohesion, while group social ties have a positive influence on their collective minds.

Keywords: public space, social cohesion, knowledge-based development, theoretical framework

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9678 Analysis of the Factors Affecting the Public Bicycle Projects in Chinese Cities

Authors: Xiujuan Wang, Weiguo Wang, Lei Yu, Xue Liu

Abstract:

There are many purported benefits of public bike systems, therefore, it has seen a sharp increase since 2008 in Hangzhou, China. However, there are few studies on the public bicycle system in Chinese cities. In order to make recommendations for the development of public bicycle systems, this paper analyzes the influencing factors by using the system dynamics method according to the main characteristics of Chinese cities. The main characteristics of Chinese cities lie in the city size and process of urbanization, traffic mode division, demographic characteristics, bicycle infrastructure and right of way, regime structure. Finally, under the context of Chinese bike sharing systems, these analyses results can help to design some feasible strategies for the planner to the development of the public bicycles.

Keywords: engineering of communication and transportation system, bicycle, public bike, characteristics of Chinese cities, system dynamics

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9677 Dutch Disease and Industrial Development: An Investigation of the Determinants of Manufacturing Sector Performance in Nigeria

Authors: Kayode Ilesanmi Ebenezer Bowale, Dominic Azuh, Busayo Aderounmu, Alfred Ilesanmi

Abstract:

There has been a debate among scholars and policymakers about the effects of oil exploration and production on industrial development. In Nigeria, there were many reforms resulting in an increase in crude oil production in the recent past. There is a controversy on the importance of oil production in the development of the manufacturing sector in Nigeria. Some scholars claim that oil has been a blessing to the development of the manufacturing sector, while others regard it as a curse. The objective of the study is to determine if empirical analysis supports the presence of Dutch Disease and de-industrialisation in the Nigerian manufacturing sector between 2019- 2022. The study employed data that were sourced from World Development Indicators, Nigeria Bureau of Statistics, and the Central Bank of Nigeria Statistical Bulletin on manufactured exports, manufacturing employment, agricultural employment, and service employment in line with the theory of Dutch Disease using the unit root test to establish their level of stationarity, Engel and Granger cointegration test to check their long-run relationship. Autoregressive. Distributed Lagged bound test was also used. The Vector Error Correction Model will be carried out to determine the speed of adjustment of the manufacturing export and resource movement effect. The results showed that the Nigerian manufacturing industry suffered from both direct and indirect de-industrialisation over the period. The findings also revealed that there was resource movement as labour moved away from the manufacturing sector to both the oil sector and the services sector. The study concluded that there was the presence of Dutch Disease in the manufacturing industry, and the problem of de-industrialisation led to the crowding out of manufacturing output. The study recommends that efforts should be made to diversify the Nigerian economy. Furthermore, a conducive business environment should be provided to encourage more involvement of the private sector in the agriculture and manufacturing sectors of the economy.

Keywords: Dutch disease, resource movement, manufacturing sector performance, Nigeria

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9676 Smart Card Technology Adaption in a Hospital Setting

Authors: H. K. V. Narayan

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This study was conducted at Tata Memorial Hospital (TMH), Mumbai, India. The study was to evaluate the impact of adapting Smart Card (SC) for clinical and business transactions in order to reduce Lead times and to enforce business rules of the hospital. The objective for implementing the Smart Card was to improve the patient perception of quality in terms of structures process and outcomes and also to improve the productivity of the Institution. The Smart Card was implemented in phases from 2011 and integrated with the Hospital Information System (HIS/EMR). The implementation was a learning curve for all the stake holders as software obviated the need to use hardcopies of transactions. The acceptability to the stake holders was challenge in change management. The study assessed the impact 3 years into the implementation and the observed trends have suggested that it has decreased the lead times for services and increased the no of transactions and thereby the productivity. Patients who used to complain of multiple queues and cumbersome transactions now compliment the administration for effective use of Information and Communication Technology.

Keywords: smart card, high availability of health care information, reduction in potential medical errors due to elimination of transcription errors, reduction in no of queues, increased transactions, augmentation of revenue

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9675 Patient Outcomes Following Out-of-Hospital Cardiac Arrest

Authors: Scott Ashby, Emily Granger, Mark Connellan

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Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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9674 The Effect of Technology in Improving Tourism Cluster Competitveness

Authors: Nancy Ayman Kamal Mohamed Mehrz

Abstract:

Like the economies of other countries in the Mediterranean region, the tourism sector in our country has excellent economic prospects. Tourism companies are building tourism, a sector that faces various challenges in its activities. These problems have made business activities and competition between companies difficult. In this study, which was conducted to identify the problems of the tourism sector in the Central Anatolia region, most of the problems faced by the tourism sector and consumer information on consumer rights were used. The aim is to contribute to the awareness of workers and managers working in the tourism sector and to attract the attention of companies and legislators working in the tourism sector. E-tourism is one of the newest issues in the field of tourism. Infrastructure and Information Technology (or ICT) and partner government and tourism organizations are required to achieve this type of tourism. This study measures the views of managers and tourism managers in Leman City regarding e-tourism; In addition, the effect of the literacy level of the tourism management system on tourist attractions was also examined. This research has been carried out. One of the suburbs of Isfahan province. This research is a documentary research and source material that includes literature and surveys. The results obtained show that if managers use ICT, it can help the development of e-tourism in the region, and increasing managers' views about e-tourism and improving their literacy levels can affect the development of tourism.

Keywords: financial problems, the problems of tourism businesses, tourism businesses, internet, marketing, tourism, tourism management economic competitiveness, enhancing competitiveness

Procedia PDF Downloads 56
9673 Government Big Data Ecosystem: A Systematic Literature Review

Authors: Syed Iftikhar Hussain Shah, Vasilis Peristeras, Ioannis Magnisalis

Abstract:

Data that is high in volume, velocity, veracity and comes from a variety of sources is usually generated in all sectors including the government sector. Globally public administrations are pursuing (big) data as new technology and trying to adopt a data-centric architecture for hosting and sharing data. Properly executed, big data and data analytics in the government (big) data ecosystem can be led to data-driven government and have a direct impact on the way policymakers work and citizens interact with governments. In this research paper, we conduct a systematic literature review. The main aims of this paper are to highlight essential aspects of the government (big) data ecosystem and to explore the most critical socio-technical factors that contribute to the successful implementation of government (big) data ecosystem. The essential aspects of government (big) data ecosystem include definition, data types, data lifecycle models, and actors and their roles. We also discuss the potential impact of (big) data in public administration and gaps in the government data ecosystems literature. As this is a new topic, we did not find specific articles on government (big) data ecosystem and therefore focused our research on various relevant areas like humanitarian data, open government data, scientific research data, industry data, etc.

Keywords: applications of big data, big data, big data types. big data ecosystem, critical success factors, data-driven government, egovernment, gaps in data ecosystems, government (big) data, literature review, public administration, systematic review

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9672 Solar Energy Technology Adoption; A Vignette Study for the Up-Scale Residential Sector in Egypt

Authors: Mazen Zaki, Sherwat E. Ibrahim

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Renewable energy has become a very important and critical topic all around the world due to the limited resources that led to shifting to the trend of renewable energy and its integration with the conventional ones. This paper investigates the adoption of the solar energy technology for up-scale residential sector in Cairo, Egypt. The technology acceptance model uses several stakeholder points’ of views to develop vignettes to be used in examining the intention and attitude of the householders to adopt the solar energy technology.

Keywords: solar energy, technology acceptance model, TAM, stakeholder analysis, vignette, residential sector

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9671 Infection Profile of Patients Undergoing Autologous Bone Marrow Transplantation in Tabriz, Iran

Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour

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Background and Objective: Hematopoietic stem cell transplantation (HSCT) has been widely used for treating oncological and hematological diseases. Although HSCT has helped to improve patient survival, the risk of developing an infection during hospitalization is an important cause of morbidity and mortality. This study aimed to analyze the infection profile during hospitalization and the associated risk factors among patients undergoing autologous HSCT at the University Hospital, Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects and Methods: This was a cross-sectional study on patients undergoing autologous HSCT at a public university hospital. Methods: Patients with febrile neutropenia between 2015 and 2018 were retrospectively evaluated regarding their infection profile and associated risk factors. This survey included: bacterial culture and blood culture on specific media. Results: Infection occurred in 57.2% of 56 patients with febrile neutropenia. The main source of infection was the central venous catheter (25.9%). Infection was chiefly due to Gram-positive bacteria, although Gram-negative-related infections were more severe and caused a higher death rate. Sex, age, skin color, nutritional status, and underlying disease were not associated with the development of infection. Patients with severe mucositis (Grades III and IV) had a higher infection rate (P < 0.001). Patients who developed pulmonary complications during hospitalization had higher infection rates (P = 0.002). Infection was the main cause of death (57.1%) in the study sample. Conclusion: Strategies aimed at reducing infection-related mortality rates among patients undergoing autologous HSCT are necessary.

Keywords: hematopoietic stem cell, autologous bone marrow transplantation, infection profile, tabriz, Iran

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9670 Modelling a Hospital as a Queueing Network: Analysis for Improving Performance

Authors: Emad Alenany, M. Adel El-Baz

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In this paper, the flow of different classes of patients into a hospital is modelled and analyzed by using the queueing network analyzer (QNA) algorithm and discrete event simulation. Input data for QNA are the rate and variability parameters of the arrival and service times in addition to the number of servers in each facility. Patient flows mostly match real flow for a hospital in Egypt. Based on the analysis of the waiting times, two approaches are suggested for improving performance: Separating patients into service groups, and adopting different service policies for sequencing patients through hospital units. The separation of a specific group of patients, with higher performance target, to be served separately from the rest of patients requiring lower performance target, requires the same capacity while improves performance for the selected group of patients with higher target. Besides, it is shown that adopting the shortest processing time and shortest remaining processing time service policies among other tested policies would results in, respectively, 11.47% and 13.75% reduction in average waiting time relative to first come first served policy.

Keywords: queueing network, discrete-event simulation, health applications, SPT

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9669 Effect of Fortification of Expressed Human Breast Milk with Olive Oil and Skimmed Milk in Improving Weight Gain in Very Low Birth Weight Neonates and Shortening Their Length of Hospital Stay

Authors: Sumrina Kousar

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Objective: The aim of this study was to observe the effect of fortification of expressed human breast milk with olive oil and skimmed milk in improving weight gain in very low birth weight neonates and shortening their length of hospital stay. Study Design and place: A randomized controlled trial was carried out at the Combined Military Hospital Lahore from March 2018 to March 2019. Methods: Neonates admitted with very low birth weight and gestational age of < 34 weeks were included in the study. Sixty babies were enrolled using non-probability consecutive sampling; a random number table was used to allocate them into a fortification group and a control group. The control group received expressed milk alone, while olive oil 1 ml twice daily and skimmed milk 1 gram in every third feed were added to expressed milk in the fortification group. Data was analyzed on SPSS 20. Proportions were compared by applying the chi-square test. An independent sample t-test was applied for comparing means. A p-value of ≤ 0.05 was considered significant. Results: The study comprised of 60 neonates, with 30 in each of the groups. Weight gain was 24.83±5.63 in the fortification group and 11.72±3.95 in the control group (p =< 0.001). Mean hospital stay was 20.5716.511 in the fortification group and 27.678.89 in the control group (p =< 0.043). Conclusion: Olive oil and skimmed milk fortification of breast milk was effective for weight gain and reducing the length of hospital stay in very low birth weight neonates.

Keywords: fortification, olive oil, skimmed milk, weight gain

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9668 Healthcare Professionals' Utilization of Physical Exercise as a Strategy to Prevent Non-Communicable Diseases in Ethiopian Public Sector Hospitals

Authors: Jeanne Grace, Melkamu D. Kassa

Abstract:

Background: Despite the recognized benefits of physical exercise, including a reduction of health risk factor indicators, illness and deaths related to Non-Communicable Diseases (NCDs) like cardiovascular disease, diabetes, hypertension, and cancer, the extent of its recognition and use as a prevention strategy by healthcare professionals working in Ethiopian referral hospitals is unknown. Objective: This study explored healthcare professionals’ use of physical exercise as a non-communicable disease prevention strategy in the Ethiopian public sector healthcare system. Methods: In this cross-sectional study, a self-administered questionnaire was conducted after being piloted to ensure validity and reliability. For the study, 312 participants were selected from 13 purposively selected Ethiopian referral hospitals, these being 99 physicians who were purposively selected and 213 nurses who were proportionately and randomly selected. Results: The results indicated that three-quarters (78%) of healthcare professionals working in Ethiopian hospitals are not using physical exercise as a strategy to prevent NCDs. Increased specialization (AOR = 20.203, p < 0.001), longer service years (AOR = 0.041, p = 0.014), young age (AOR = 19.871, p < 0.001), and being male (AOR = 0.269, p < 0.001), were predictors of using physical exercise as a strategy for the prevention of NCDs. Conclusion: Healthcare professionals’ utilization of physical exercise as a strategy for NCDs prevention was inadequate in Ethiopia. Given the increasing burden of NCD disease in Ethiopia, training nurses, physicians and medical managers have to acknowledge the use of physical exercise as an NCD prevention strategy. The results of this study highlight the importance of formulating physical exercise intervention strategies for NCDs patients, and the need to incorporate training for healthcare professionals on the type, intensity, duration, and frequency of physical exercise to prevent NCDs in the Ethiopian healthcare system.

Keywords: exercise, medical managers, nurses, physicians

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9667 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit

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

Abstract:

Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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9666 Dysbiosis of the Intestinal Microbiome in Colorectal Cancer Patients at Hospital of Amizour, Bejaia, Algeria

Authors: Adjebli Ahmed, Messis Abdelaziz, Ayeche Riad, Tighilet Karim, Talbi Melissa, Smaili Yanis, Lehri Mokrane, Louardiane Mustapha

Abstract:

Colorectal cancer is one of the most common types of cancer worldwide, and its incidence has been increasing in recent years. Data and fecal samples from colorectal cancer patients were collected at the Amizour Public Hospital's oncology department (Bejaia, Algeria). Microbiological and cohort study were conducted at the Biological Engineering of Cancers laboratory at the Faculty of Medicine of the University of Bejaia. All the data showed that patients aged between 50 and 70 years were the most affected by colorectal cancer, while the age categories of [30-40] and [40-50] were the least affected. Males were more likely to be at risk of contracting colorectal cancer than females. The most common types of colorectal cancer among the studied population were sigmoid cancer, rectal cancer, transverse colon cancer, and ascending colon cancer. The hereditary factor was found to be more dominant than other risk factors. Bacterial identification revealed the presence of certain pathogenic and opportunistic bacterial genera, such as E. coli, K. pneumoniae, Shigella sp, and Streptococcus group D. These results led us to conclude that dysbiosis of the intestinal microbiome is strongly present in colorectal cancer patients at the EPH of Amizour.

Keywords: microbiome, colorectal cancer, risk factors, bacterial identification

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9665 Building a Performance Outline for Health Care Workers at Teaching Hospitals, Nigeria: The Role of Different Leadership Styles

Authors: Osuagwu Justine Ugochukwu

Abstract:

Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought brand-new knowledge to leadership literature.

Keywords: workers performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership

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9664 Evaluation of Radiological Health Danger Indices Arising from Diagnostic X-Ray Rooms

Authors: Jessica Chukwuyem Molua, Collins O Molua

Abstract:

The effective dose of selected health care workers who are constantly exposed to X-ray radiation was measured using thermoluminescence dosimeters (TLD) placed over the lead apron at the chest region in all categories of medical personnel investigated. To measure radiation in all the selected hospitals to ascertain the exposure of x-ray machines at exactly 1m from the primary source. The work was carried out within a year in each of the selected centers. The personnel examination records containing the type of examination each day, peak tube voltage, tube current, and exposure time, including the actual number of films used, were obtained. A total of 40personel were examined in government hospital Agbor, 21 in central hospital Owa Alero and 18 in Okonye hospital The method used here has also been used by other researchers. Findings showed that the results obtained from the three hospitals investigated in this work were found to conform with the recommendations of the National Commission on radiological and protection {NCRP} 70 and 116 protocols. The Radiologist in the three study areas has the highest dose level, but of particular note is the dosage of the radiologist in Okonye hospital. This, as observed, is because the protective shielding parameters were inadequate and this could result in severe health consequences over time.

Keywords: radiology, health, Agbor, Owa

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9663 Art, Nature, and City in the Construction of Contemporary Public Space

Authors: Rodrigo Coelho

Abstract:

We believe that in the majority of the “recent production of public space", the overvaluation of the "image", of the "ephemeral" and of the "objectual", has come to determine the configuration of banal and (more or less) arbitrary "public spaces", mostly linked to a problem of “outdoor decoration”, reflecting a clear sign of uncertainty and arbitrariness about the meaning, the role and shape of public space and public art.This "inconsistency" which is essentially linked to the loss of urban, but also social, cultural and political, vocation of the disciplines that “shape” the urban space (but is also linked to the lack of urban and technical culture of techinicians and policy makers) converted a significant set of the recently built "public space" and “urban art” into diffuse and multi-referenced pieces, which generally shares the inability of confering to the urban space, civic, aesthetic, social and symbolic meanings. In this sense we consider it is essential to undertake a theoretical reflection on the values, the meaning(s) and the shape(s) that open space, and urban art may (or must) take in the current urban and cultural context, in order to redeem for public space its status of significant physical reference, able to embody a spatial and urban identity, and simultaneously enable the collective accession and appropriation of public space. Taking as reference public space interventions built in the last decade on the European context, we will seek to explore and defend the need of considering public space as a true place of exception, an exceptional support where the emphasis is placed on the quality of the experience, especially by the relations public space/urban art can established with the city, with nature and geography in a broad sense, referring us back to a close and inseparable and timeless relationship between nature and culture.

Keywords: art, city, nature, public space

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9662 Towards A Framework for Using Open Data for Accountability: A Case Study of A Program to Reduce Corruption

Authors: Darusalam, Jorish Hulstijn, Marijn Janssen

Abstract:

Media has revealed a variety of corruption cases in the regional and local governments all over the world. Many governments pursued many anti-corruption reforms and have created a system of checks and balances. Three types of corruption are faced by citizens; administrative corruption, collusion and extortion. Accountability is one of the benchmarks for building transparent government. The public sector is required to report the results of the programs that have been implemented so that the citizen can judge whether the institution has been working such as economical, efficient and effective. Open Data is offering solutions for the implementation of good governance in organizations who want to be more transparent. In addition, Open Data can create transparency and accountability to the community. The objective of this paper is to build a framework of open data for accountability to combating corruption. This paper will investigate the relationship between open data, and accountability as part of anti-corruption initiatives. This research will investigate the impact of open data implementation on public organization.

Keywords: open data, accountability, anti-corruption, framework

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9661 Analysis of Public Space Usage Characteristics Based on Computer Vision Technology - Taking Shaping Park as an Example

Authors: Guantao Bai

Abstract:

Public space is an indispensable and important component of the urban built environment. How to more accurately evaluate the usage characteristics of public space can help improve its spatial quality. Compared to traditional survey methods, computer vision technology based on deep learning has advantages such as dynamic observation and low cost. This study takes the public space of Shaping Park as an example and, based on deep learning computer vision technology, processes and analyzes the image data of the public space to obtain the spatial usage characteristics and spatiotemporal characteristics of the public space. Research has found that the spontaneous activity time in public spaces is relatively random with a relatively short average activity time, while social activities have a relatively stable activity time with a longer average activity time. Computer vision technology based on deep learning can effectively describe the spatial usage characteristics of the research area, making up for the shortcomings of traditional research methods and providing relevant support for creating a good public space.

Keywords: computer vision, deep learning, public spaces, using features

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9660 Feedback of an Automated Hospital about the Performance of an Automated Drug Dispensing System’s Implementation

Authors: Bouami Hind, Millot Patrick

Abstract:

The implementation of automated devices in life-critical systems such as hospitals can bring a new set of challenges related to automation malfunctions. While automation has been identified as great leverage for the medication dispensing system’s security and efficiency, it also increases the complexity of the organization. In particular, the installation and operation stage of automated devices can be complex when malfunctions related to automated systems occur. This paper aims to document operators’ situation awareness about the malfunctions of automated drug delivery systems (ADCs) during their implementation through Saint Brieuc hospital’s feedback. Our evaluation approach has been deployed in Saint Brieuc hospital center’s pharmacy, which has been equipped with automated nominative drug dispensing systems since January of 2021. The analysis of Saint Brieuc hospital center pharmacy’s automation revealed numerous malfunctions related to the implementation of Automated Delivery Cabinets. It appears that the targeted performance is not reached in the first year of implementation in this case study. Also, errors have been collected in patients' automated treatments’ production such as lack of drugs in pill boxes or nominative carnets, excess of drugs, wrong location of the drug, drug blister damaged, non-compliant sachet, or ticket errors. Saint Brieuc hospital center’s pharmacy is doing a tremendous job of setting up and monitoring performance indicators from the beginning of automation and throughout ADC’s operation to control ADC’s malfunctions and meet the performance targeted by the hospital. Health professionals, including pharmacists, biomedical engineers and directors of work, technical services and safety, are heavily involved in an automation project. This study highlights the importance of the evaluation of ADCs’ performance throughout the implementation process and the hospital’s team involvement in automation supervision and management.

Keywords: life-critical systems, situation awareness, automated delivery cabinets, implementation, risks and malfunctions

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