Search results for: hospital building

Authors: Mohamed Elassaly

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The damage status of RC buildings is greatly influenced by the characteristics of the imposed ground motion. Peak Ground Acceleration and frequency contents are considered the main two factors that affect ground motion characteristics; hence, affecting the seismic response of RC structures and consequently their damage state. A detailed investigation on the combined effects of these two factors on damage assessment of RC buildings, is carried out. Twenty one earthquake records are analyzed and arranged into three groups, according to their frequency contents. These records are used in an investigation to define the expected damage state that would be attained by RC buildings, if subjected to varying ground motion characteristics. The damage assessment is conducted through examining drift ratios and damage indices of the overall structure and the significant structural components of RC building. Base and story shear of RC building model, are also investigated, for cases when the model is subjected to the chosen twenty one earthquake records. Nonlinear dynamic analyses are performed on a 2-dimensional model of a 12-story R.C. building.

Keywords: damage, frequency content, ground motion, PGA, RC building, seismic

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Authors: Valerie Isaak

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Background: This study explores the effectiveness of refresher training sessions of an intervention program at reducing the employees’ risk of injury due to patient violence in a forensic psychiatric hospital. Methods: The original safety intervention program that consisted of a 3 days’ workshop was conducted in the maximum-security ward of a psychiatric hospital in Israel. Ever since the original intervention, annual refreshers were conducted, highlighting one of the safety elements covered in the original intervention. The study examines the effect of the intervention program along with the refreshers over a period of 10 years in four wards. Results: Analysis of the data demonstrates that beyond the initial reduction following the original intervention, refreshers seem to have an additional positive long-term effect, reducing both the number of violent incidents and the number of actual employee injuries in a forensic psychiatric hospital. Conclusions: We conclude that such an intervention program followed by refresher training would promote employees’ wellbeing. A healthy work environment is part of management’s commitment to improving employee wellbeing at the workplace.

Keywords: wellbeing, violence at work, intervention program refreshers, public sector mental healthcare

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Authors: Lucie Jirotková, Daniel Macek, Andrea Palazzo, Veronika Malinová

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Currently, the implementation of 3D models in the construction industry is gaining popularity. Countries around the world are developing their own modelling standards and implement the use of 3D models into their individual permitting processes. Another theme that needs to be addressed are public building spaces and their subsequent maintenance, where the usage of BIM methodology is directly offered. The significant benefit of the implementation of Building Information Management is the information transfer. The 3D model contains not only the spatial representation of the item shapes but also various parameters that are assigned to the individual elements, which are easily traceable, mainly because they are all stored in one place in the BIM model. However, it is important to keep the data in the models up to date to achieve useability of the model throughout the life cycle of the building. It is now becoming standard practice to use BIM models in the construction of buildings, however, the building environment is very often neglected. Especially in large-scale development projects, the public space of buildings is often forwarded to municipalities, which obtains the ownership and are in charge of its maintenance. A 3D model of the building surroundings would include both the above-ground visible elements of the development as well as the underground parts, such as the technological facilities of water features, electricity lines for public lighting, etc. The paper shows the possibilities of a model in the field of information for the handover of premises, the following maintenance and decision making. The attributes and spatial representation of the individual elements make the model a reliable foundation for the creation of "Smart Cities". The paper analyses the current use of the BIM methodology and presents the state-of-the-art possibilities of development.

Keywords: BIM model, urban space, BIM methodology, facility management

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Authors: Jamilah Halina Abdul Halim, Norsiah Hassan, Azlina Aziz, Norhayati Mat Wajid, Mohd Saipul Asrafi

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There are various types of vertical greenery system (VGS) in Malaysia, but none is installed at government buildings, although the government is looking into energy efficient building design. This is due to lack of technical information that focus on the maintenance and care, issues, and challenges face by vertical greenery system under tropical climate conditions. This research aim to identify issues in implementation of vertical greenery system on existing government building in Malaysia. The methodology used are literature reviews (desktop study), observation on sites, and case studies. Initial findings indicates that design and maintenance issues of vertical greenery system are the main challenges faced mainly by designer, especially those who involved in decision-making process. It can be concluded that orientation, openings, maintenance, performance, longevity, structural load, access, wind resistance, design failure, system failure, and lack of maintenance foresight are the main factors that need to be considered. These factors should be holistically aligned towards the economic cost, effective time, and quality design in implementation of vertical greenery system on existing government building. A comprehensive implementation of vertical greenery system will lead to greater sustainable investment for government buildings and responsive action to climate change.

Keywords: issues, government building, maintenance, vertical greenery system

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Authors: Sogol Zarafshan

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The present study aimed to identify important factors affecting the effectiveness of quality control circles in a hospital, as well as rank them using a combination of fuzzy VIKOR and Grey Relational Analysis (GRA). The study population consisted of five academic members and five experts in the field of nursing working in a hospital, who were selected using a purposive sampling method. Also, a sample of 107 nurses was selected through a simple random sampling method using their employee codes and the random-number table. The required data were collected using a researcher-made questionnaire which consisted of 12 factors. The validity of this questionnaire was confirmed through giving the opinions of experts and academic members who participated in the present study, as well as performing confirmatory factor analysis. Its reliability also was verified (α=0.796). The collected data were analyzed using SPSS 22.0 and LISREL 8.8, as well as VIKOR–GRA and IPA methods. The results of ranking the factors affecting the effectiveness of quality control circles showed that the highest and lowest ranks were related to ‘Managers’ and supervisors’ support’ and ‘Group leadership’. Also, the highest hospital performance was for factors such as ‘Clear goals and objectives’ and ‘Group cohesiveness and homogeneity’, and the lowest for ‘Reward system’ and ‘Feedback system’, respectively. The results showed that although ‘Training the members’, ‘Using the right tools’ and ‘Reward system’ were factors that were of great importance, the organization’s performance for these factors was poor. Therefore, these factors should be paid more attention by the studied hospital managers and should be improved as soon as possible.

Keywords: Quality control circles, Fuzzy VIKOR, Grey Relational Analysis, Importance–Performance Analysis

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: anxiety, depression, sickle cell disease, socio-demographic quality of life, characteristics, Ghana

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Authors: Okafor Joan, Nwodo Uchechukwu

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Klebsiella pneumoniae (K. pneumoniae) is a significant pathogen responsible for opportunistic and nosocomial infection. One of the most significant antibiotic resistance mechanisms in K. pneumoniae isolates is efflux pumps. Our current study identified efflux genes (AcrAB, OqxAB, MacAB, and TolC) and regulatory genes (RamR and RarA) in multidrug-resistant (MDR) K. pneumoniae isolated from hospital effluents and investigated their relationship with antibiotic resistance. The sum of 145 K. pneumoniae isolates was established by PCR and screened for antibiotic susceptibility. PCR detected efflux pump genes, and their link with antibiotic resistance was statistically examined. However, 120 (83%) of the confirmed isolated were multidrug-resistant, with the largest percentage of resistance to ampicillin (88.3%) and the weakest rate of resistance to imipenem (5.5%). Resistance to the other antibiotics ranged from 11% to 76.6%. Molecular distribution tests show that AcrA, AcrB, MacA, oqxB oqxA, TolC, MacB were detected in 96.7%, 85%, 76.7%, 70.8%, 55.8%, 39.1%, and 29.1% respectively. However, 14.3% of the isolates harboured all seven genes screened. Efflux pump system AcrAB (83.2%) was the most commonly detected in K. pneumonia isolated across all the antibiotics class-tested. In addition, the frequencies of RamR and RarA were 46.2% and 31.4%, respectively. AcrAB and OqxAB efflux pump genes were significantly associated with fluoroquinolone, beta-lactam, carbapenem, and tetracycline resistance (p<0.05). The high rate of efflux genes in this study demonstrated that this resistance mechanism is the dominant way in K. pneumoniae isolates. Appropriate treatment must be used to reduce and tackle the burden of resistant Klebsiella pneumonia in hospital wastewater effluents.

Keywords: Klebsiella pneumonia, efflux pumps, regulatory genes, multidrug-resistant, hospital, PCR

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Authors: Jisun Mo, Paola Boarin

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The impact of common buildings on climate and environment has prompted people to get involved in the green building standards aimed at implementing rating tools or certifications. Thus, green building rating systems were introduced to the construction industry, and the demand for certified green buildings has increased gradually and succeeded considerably in enhancing people’s environmental awareness. However, the existing certification process has been unsatisfactory in attracting stakeholders and/or professionals who are actively engaged in adopting a rating system. It is because they have faced recurring barriers regarding limited information in understanding the rating process, time-consuming procedures and higher costs, which have a direct influence on pursuing green building rating systems. To promote the achievement of green building certifications within the building industry more successfully, this paper aims at designing a Pre-Assessment Tool (PAT) framework that can help stakeholders and/or professionals engaged in the construction industry to clarify their basic knowledge, timeframe and extra costs needed to activate a green building certification. First, taking the first steps towards the rating tool seems to be complicated because of upfront commitment to understanding the overall rating procedure is required. This conceptual PAT framework can increase basic knowledge of the rating tool and the certification process, mainly in terms of all resources or information of each credit requirements. Second, the assessment process of rating tools is generally known as a “lengthy and time-consuming system”, contributing to unenthusiastic reactions concerning green building projects. The proposed framework can predict the timeframe needed to identify how long it will take for a green project to process each credit requirement and the documentation required from the beginning of the certification process to final approval. Finally, most people often have the initial perception that pursuing green building certification costs more than constructing a non-green building, which makes it more difficult to execute rating tools. To overcome this issue, this PAT will help users to estimate the extra expenses such as certification fees and third-party contributions based on the track of the amount of time it takes to implement the rating tool throughout all the related stages. Also, it can prevent unexpected or hidden costs occurring in the process of assessment. Therefore, this proposed PAT framework can be recommended as an effective method to support the decision-making of inexperienced users and play an important role in promoting green building certification.

Keywords: green building rating tools, Pre-Occupancy Evaluation (PrOE), client’s decision-making, certification

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Authors: Antonio Lopez-Villegas, Daniel Catalan-Matamoros, Remedios Lopez-Liria

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Objectives: The purpose of this study was to analyze clinical data, health-related quality of life (HRQoL) and functional capacity of patients using a telemonitoring follow-up system (TM) compared to patients followed-up through standard outpatient visits (HM) 5 years after the implantation of a pacemaker. Methods: This is a controlled, non-randomised, nonblinded clinical trial, with data collection carried out at 5 years after the pacemakers implant. The study was developed at Hospital de Poniente (Almeria, Spain), between October 2012 and November 2013. The same clinical outcomes were analyzed in both follow-up groups. Health-Related Quality of Life and Functional Capacity was assessed through EuroQol-5D (EQ-5D) questionnaire and Duke Activity Status Index (DASI) respectively. Sociodemographic characteristics and clinical data were also analyzed. Results: 5 years after pacemaker implant, 55 of 82 initial patients finished the study. Users with pacemakers were assigned to either a conventional follow-up group at hospital (HM=34, 50 initials) or a telemonitoring system group (TM=21, 32 initials). No significant differences were found between both groups according to sociodemographic characteristics, clinical data, Health-Related Quality of Life and Functional Capacity according to medical record and EQ5D and DASI questionnaires. In addition, conventional follow-up visits to hospital were reduced in 44,84% (p < 0,001) in the telemonitoring group in relation to hospital monitoring group. Conclusion: Results obtained in this study suggest that the telemonitoring of users with pacemakers is an equivalent option to conventional follow-up at hospital, in terms of Health-Related Quality of Life and Functional Capacity. Furthermore, it allows for the early detection of cardiovascular and pacemakers-related problem events and significantly reduces the number of in-hospital visits. Trial registration: ClinicalTrials.gov NCT02234245. The PONIENTE study has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: cardiovascular diseases, health-related quality of life, pacemakers follow-up, remote monitoring, telemedicine

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Authors: Mohamed Youssef

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The proliferation of energy consumption in the built environment has made energy efficiency and savings strategies a priority objective for energy policies in most countries. Qatar is a clear example, where it has initiated several programs and institutions to mitigate the overuse of electricity consumption and control the energy load of the building by following global standards and spreading awareness campaigns. A Case study on the Office of Research and Graduate Studies at Qatar University has been investigated in this paper. The paper studied the rating load of existing buildings before and after retrofitting by using Carrier’s Hourly Analysis Program (HAP). The performance of the building has increased especially after using the LED light system instead of fluorescent light with a low payback period. GINAN paint and green roof have shown a considerable contribution to the reduction of electrical load in the building. In comparison, the double HR window had the least effect on the reduction of electricity consumption.

Keywords: energy conservation in Qatar, HAP, LED light, GINAN paint, green roof, double HR window

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Authors: Oghenerukome Akponovo, Lynda I. Onyebuchukwu

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Construction waste, along with that of many other industries, contributes significantly to the world's annual solid waste totals. Most of these materials, such as ash from rice hulls, slags, cement kiln dust, tire ash, plastic waste (PW), and silica fumes, end up in landfills or waterways. Some of them might even end up polluting the air from high in the atmosphere. It's sustainable, cheap, and environmentally friendly to recycle these items into new building supplies. When constructing a "Green" structure, the materials employed have the potential to either exacerbate environmental imbalance or maintain a stable ecosystem. The purpose of this research is to take stock of what is already known about recycling's potential in the construction industry and to identify its deficiencies. Therefore, this study systematically reviews the wide range of recycled materials that go into building construction. Recognizing that the construction industry's use of recycled materials has an influence on the environment and that investigating these materials may have a substantial economic impact if they were discovered

Keywords: building, construction, recycled materials, waste management

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Authors: Puntarikorn Rungrattanakasin

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Objectives: To develop the trigger tool to warn about the risk of bleeding as an adverse event from warfarin drug usage during admission in Medical Wards of Chumphae Hospital. Methods: A retrospective study was performed by reviewing the medical records for the patients admitted between June 1st,2020- May 31st, 2021. ADEs were evaluated by Naranjo’s algorithm. The international normalized ratio (INR) and events of bleeding during admissions were collected. Statistical analyses, including Chi-square test and Reciever Operating Characteristic (ROC) curve for optimal INR threshold, were used for the study. Results: Among the 139 admissions, the INR range was found to vary between 0.86-14.91, there was a total of 15 bleeding events, out of which 9 were mild, and 6 were severe. The occurrence of bleeding started whenever the INR was greater than 2.5 and reached the statistical significance (p <0.05), which was in concordance with the ROC curve and yielded 100 % sensitivity and 60% specificity in the detection of a bleeding event. In this regard, the INR greater than 2.5 was considered to be an optimal threshold to alert promptly for bleeding tendency. Conclusions: The INR value of greater than 2.5 (>2.5) would be an appropriate trigger tool to warn of the risk of bleeding for patients taking warfarin in Chumphae Hospital.

Keywords: trigger tool, warfarin, risk of bleeding, medical wards

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Authors: Jihene Jlassi, Ahmed Frikha, Wazna Kortli

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The objectives of Nurse-Patient Assignment are the minimization of the overall hospital cost and the maximization of nurses ‘preferences. This paper aims to assess nurses' satisfaction related to the implementation of patient acuity tool-based assignments. So, we used an integer linear program that assigns patients to nurses while balancing nurse workloads. Then, the proposed model is applied to the Paediatrics Department at Kasserine Hospital Tunisia. Where patients need special acuities and high-level nursing skills and care. Hence, numerical results suggested that proposed nurse-patient assignment models can achieve a balanced assignment

Keywords: nurse-patient assignment, mathematical model, logistics, pediatrics department, balanced assignment

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Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

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Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

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Authors: Mathieu Bourdeau, Philippe Basset, Julien Waeytens, Elyes Nefzaoui

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As residential buildings account for a third of the overall energy consumption and greenhouse gas emissions in Europe, building energy modeling is an essential tool to reach energy efficiency goals. In the energy modeling process, calibration is a mandatory step to obtain accurate and reliable energy simulations. Nevertheless, the comparison between simulation results and the actual building energy behavior often highlights a significant performance gap. The literature discusses different origins of energy performance gaps, from building design to building operation. Then, building operation description in energy models, especially energy usages and users’ behavior, plays an important role in the reliability of simulations but is also the most accessible target for post-occupancy energy management and optimization. Therefore, the present study aims to discuss results on the calibration ofresidential building energy models using real operation data. Data are collected through a sensor network of more than 180 sensors and advanced energy meters deployed in three collective residential buildings undergoing major retrofit actions. The sensor network is implemented at building scale and in an eight-apartment sample. Data are collected for over one year and half and coverbuilding energy behavior – thermal and electricity, indoor environment, inhabitants’ comfort, occupancy, occupants behavior and energy uses, and local weather. Building energy simulations are performed using a physics-based building energy modeling software (Pleaides software), where the buildings’features are implemented according to the buildingsthermal regulation code compliance study and the retrofit project technical files. Sensitivity analyses are performed to highlight the most energy-driving building features regarding each end-use. These features are then compared with the collected post-occupancy data. Energy-driving features are progressively replaced with field data for a step-by-step calibration of the energy model. Results of this study provide an analysis of energy performance gap on an existing residential case study under deep retrofit actions. It highlights the impact of the different building features on the energy behavior and the performance gap in this context, such as temperature setpoints, indoor occupancy, the building envelopeproperties but also domestic hot water usage or heat gains from electric appliances. The benefits of inputting field data from an extensive instrumentation campaign instead of standardized scenarios are also described. Finally, the exhaustive instrumentation solution provides useful insights on the needs, advantages, and shortcomings of the implemented sensor network for its replicability on a larger scale and for different use cases.

Keywords: calibration, building energy modeling, performance gap, sensor network

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Authors: R. Stoyanova, R. Dimova, M. Tarnovska, T. Boeva, R. Dimov, I. Doykov

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Patient safety culture (PSC) is an essential component of quality of healthcare. Improving PSC is considered a priority in many developed countries. Specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods: The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. To quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the x²-test was applied. The research hypothesis assumed that there are no significant differences between the Bulgarian, Croatian and US PSCs. Results: The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: ‘Staff worries that their mistakes are kept in their personnel file’ (RA16), ‘Things ‘fall between the cracks’ when transferring patients from one unit to another’ (RF3) and ‘Shift handovers are problematic for patients in this hospital’ (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions: Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

Keywords: patient safety culture, healthcare, HSOPSC, medical error

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Authors: Najah Majouri, Mohamed El Mankibi, Jalila Sghaier

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This study examined the geotechnical, mineralogical, thermal and physical characterization of clays in south-west Tunisia. Its aims are to elaborate an insulator material based on the clay used in the field of building materials. The geotechnical study showed that the clay studied is characterized by a high degree of plasticity of 30.83%. High mineralogical findings showed that the sample consisted mainly of kaonolite and other clay minerals. The thermal and physical properties of the different samples are obtained by mixing clays, which indicates a promising future for the use of this type of clays in the production of insulating building materials.

Keywords: clay, energy-saving, insulator material, and South-West Tunisia.

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Authors: Nadeem Yousuf Khan

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This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.

Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology

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Authors: Amal A. Abdel-Sattar

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The curriculum of architecture department in Prince Sultan University includes ‘Building Surveying’ course which is usually a part of civil engineering courses. As a fundamental requirement of the course, it requires a strong background in mathematics and physics, which are not usually preferred subjects to the architecture students and many of them are not giving the required and necessary attention to these courses during their preparation year before commencing their architectural study. This paper introduces the concept and the methodology of the student-centered learning approach in the course of building surveying for architects. One of the major outcomes is the improvement in the students’ involvement in the course and how this will cover and strength their analytical weak points and improve their mathematical skills. The study is conducted through three semesters with a total number of 99 students. The effectiveness of the student-centered learning approach is studied using the student survey at the end of each semester and teacher observations. This survey showed great acceptance of the students for these methods. Also, the teachers observed a great improvement in the students’ mathematical abilities and how keener they became in attending the classes which were clearly reflected on the low absence record.

Keywords: architecture, building surveying, student-centered learning, teaching and learning

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Authors: Subramanyam Devarakonda Hanumantharao, Udayendu Prakash Sharma, Mahesh Garg

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Introduction: Gomabai Netralaya a reputed eye hospital is located in Neemuch a small city of Madhya Pradesh, India. The hospital is established in 1992 by Late. G.D Agrawal a renowned educationist, freedom fighter and philanthropist. The eye hospital was established to serve all sections of the society in affordable manner. To provide comprehensive eye care services to the rural poor the hospital started organizing outreach camps since 1994. Purpose: To study the cost effectiveness of outreach eye camps for addressing the sustainability issues of the outreach program. Methods: One year statistics of outreach eye camps were collected from Hospital Management Information System software to analyze the productivity of camps. Income and expenses report was collected from outreach department records to analyze per camp expenses and per patient expenses against the income generated. All current year records were analyzed to have accuracy of information and results. Information was collected in two ways: 1)Actual camp performance records and expenses from book of accounts. 2)Cross verification was done through one to one discussion with outreach staff. Results: Total 17534 outpatients were examined through 52 outreach eye camps. Total 6042 (34% of total outpatients) patients were advised with cataracts and 4651 (77% of advice) operations were performed. The average OPD per camp was 337 and per camp 116 patients was advised for cataract surgery and 89 surgeries were performed per camp. Total 18200 US$ incurred on organizing 52 outreach camps in the radius of 100 k.ms. Considering the total outpatients screened through camps the screening cost per patient was 1.00 US$ and considering the surgical output the per surgery expenses was 4.00 US$. The cost recovery of the total expenses was through Government grant of US$ 16.00 per surgery (that includes surgical grant). All logistics cost of camps and patients transportation cost was taken care by local donors. Conclusion: The present study demonstrates that with people’s participation, successful high volume outreach eye camps can be organized. The cost effectiveness of the outreach camps is totally depended on volume of outpatient’s turn-up at camp site and per camp surgical output. The only solution to sustainability of outreach eye camps is sharing of cost with local donors and increasing productivity.

Keywords: camps, outreach, productivity, sustainable

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Authors: Eman Nagi Gowid Selim

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Nowadays, the relevance of places to people has been questioned from different perspectives. This is attributed to the fact that many international concrete blocks were used to create multi-use public spaces in neighborhoods based on the techniques of mass-productions concepts that became one of the most effective ways in building construction, replacing the local and traditional built environment. During the last decades, the world has become increasingly globalized and citizen more mobilized, and thus, ignoring the social and environmental dimensions of the local identity. The main enquiries of the research are “How did building technologies affect urban settlement’s identity?” and “What are the impacts of technologies and globalization on local identities in urban spaces? “From this perspective, the research presents firstly, a historical review that shows how old civilizations enhance their local identities using the newly discovered building materials in each era in different urban settlement and fabrics without losing the identity. The second part of the research highlights the different approaches of building technologies and urban design to present a clear understanding of ways of applying and merging between different methodologies to achieve the most efficient urban space design. The third part aims at analyzing some international and national case studies where the form and structure of particular spaces are vital to identifying the morphological elements of urban settlements and the links existing between them. In addition, it determines how the building materials are used to enrich the vocabulary of the local identity. This part ends with the deduction of the guidelines for the integration of the environmental and social dimensions within the building technologies` approaches to enhance the sustainability of local identities and thus, ending up with redefining "Urban Identity" to guide future research in such cultural areas. Finally, the research uses the comparative methodology for applying the deduced guidelines on a national case study namely “Othman`s Towers” in corniche El Maadi, and then ends up by some results in the form of strategies for future researcher, that identifies how to ensure local identity in urban settlements using new building materials and technologies to achieve social and environmental comfort within the cultural areas.

Keywords: building technologies, cultural context, environmental approach, participatory design, social dimension, urban spaces

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Authors: Svetlana Pushkar

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Eco-indicator 99 (EI99) considers fundamental life cycle assessment (LCA) uncertainties via egalitarian/egalitarian (e/e), hierarchist/hierarchist (h/h), individualist/individualist (i/i), individualist/average (i/a), egalitarian/average (e/a), and hierarchist/average (h/a) methodological options. The objective of this study is to provide a reliable two-stage nested mixed balanced Analysis of Variance (ANOVA) test as a supplemental test to EI99 to address the problematic combination of similarly and not similarly produced materials usually found in building technologies. The robustness of the test was determined from both the “EI99 (all options)” stage (including e/e, i/i, h/h, e/a, i/a, and h/a - all methodological options) and the “EI99 (perspectives)” stage (including e/e, i/i, and h/h methodological options of EI99 - the methodological options with their particular weighting set or e/a, i/a, and h/a methodological options of EI99 - the methodological options with the average weighting set) of evaluating building technologies.

Keywords: building technologies, LCA uncertainty, Eco-indicator 99, two-stage nested mixed ANOVA test

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Authors: Mohammed Seid, Aklilu Azazh, Fikre Enquselassie, Engida Yisma

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Background: Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world’s roads, and the risk of dying as a result of a road traffic injury is highest in the Africa. Methods: A prospective hospital-based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Results: A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims’ ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Long-distance travelling Minibus (16.5%) was responsible for the majority of road traffic crash followed by followed by Taxi (14.8%) and pedestrians (62.6%) accounted for the majority of road traffic accident. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. Treatment of fracture was the most common procedure performed in 57.7 % of the victims. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4 %. A significant higher proportion of victims aged 14-55 years were had less likelihood of death compared to those victims aged more than 55 years of age [Adjusted OR = 0.1 (95% CI: 0.01, 0.82)]. Conclusions: This study showed diverse injury characteristics and high morbidity and mortality among the victims attending Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. The findings reflect that road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.

Keywords: road traffic accident, injury characteristics, outcome, Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia

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Authors: Giuliana Scuderi, Patrick Teuffel

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The proven vulnerability of the existing social housing building heritage to natural or induced earthquakes requires the development of new design concepts and conceptual method to preserve materials and object, at the same time providing new performances. An integrate intervention between civil engineering, building physics and architecture can convert the social housing districts from a critical part of the city to a strategic resource of revitalization. Referring to bio-mimicry principles the present research proposes a taxonomy with the exoskeleton of the insect, an external, light and resistant armour whose role is to protect the internal organs from external potentially dangerous inputs. In the same way, a “building exoskeleton”, acting from the outside of the building as an enclosing cage, can restore, protect and support the existing building, assuming a complex set of roles, from the structural to the thermal, from the aesthetical to the functional. This study evaluates the structural efficiency of shape memory alloys devices (SMADs) connecting the “building exoskeleton” with the existing structure to rehabilitate, in order to prevent the out-of-plane collapse of walls and for the passive dissipation of the seismic energy, with a calibrated operability in relation to the intensity of the horizontal loads. The two case studies of a masonry structure and of a masonry structure with concrete frame are considered, and for each case, a theoretical social housing building is exposed to earthquake forces, to evaluate its structural response with or without SMADs. The two typologies are modelled with the finite element program SAP2000, and they are respectively defined through a “frame model” and a “diagonal strut model”. In the same software two types of SMADs, called the 00-10 SMAD and the 05-10 SMAD are defined, and non-linear static and dynamic analyses, namely push over analysis and time history analysis, are performed to evaluate the seismic response of the building. The effectiveness of the devices in limiting the control joint displacements resulted higher in one direction, leading to the consideration of a possible calibrated use of the devices in the different walls of the building. The results show also a higher efficiency of the 00-10 SMADs in controlling the interstory drift, but at the same time the necessity to improve the hysteretic behaviour, to maximise the passive dissipation of the seismic energy.

Keywords: adaptive structure, biomimetic design, building exoskeleton, social housing, structural envelope, structural retrofitting

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Authors: Atitallah Sofien, Bouyahia Olfa, Mohsen S., Boussetta Khadija, Khemiri Monia, Fitouri Zohra, Boukthir Samir

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Introduction: Megaloblastic anemia (MA) is rare in children. The diversity of its etiologies can lead to misdiagnosis and may, therefore, delay the treatment. The aim of this study was to describe the epidemiological and etiological characteristics of children followed for MA at the Tunis children's hospital. Methodology: This is a retrospective study over a period of 25 years of all cases of MA in children in the Children's Hospital of Tunis. The diagnosis of MA was confirmed by myelogram in all patients. Results: We collected 29 observations, with an incidence of 1.2 cases/year and a sex ratio of 1. Sixty percent of the children were aged between 3 months and 2 years. The consultation time was between 15 and 30 days in a third of the patients. The clinical examination showed hypotrophy in 13% of cases, hepatosplenomegaly in 6% of cases, neurological or neurosensory damage in 23% of cases, and cardiac damage in 10% of children. MA was associated with thrombocytopenia in 65% of cases and leukoneutropenia in 24% of cases. One in 5 children had pancytopenia. The etiologies were mainly thiamine deficiency, Immerslund disease (20%), nutritional deficiency (13%), and Biermer anemia (13%). One of the patients presented an MA revealing visceral leishmaniasis. The outcome under vitamin B12, the dose of which was adapted to each etiology, was favorable for all patients. Conclusion: MA is rare in children with multiple etiologies that are mainly dominated by hereditary conditions and nutritional deficiencies, mainly in vitamin B12. The association with visceral leishmaniasis seems to be a particularity in our country not reported in the literature.

Keywords: megaloblastic anemia, children, vitamin B12, anemia

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Authors: Nadine Yehya, Chantal Maatouk

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Low energy buildings have been developed to achieve global climate commitments in reducing energy consumption. They comprise energy efficient buildings, zero energy buildings, positive buildings and passive house buildings. The reduced energy demands in Low Energy buildings call for advanced building energy modeling that focuses on studying active building systems such as heating, cooling and ventilation, improvement of systems performances, and development of control systems. Modeling and building simulation have expanded to cover different modeling approach i.e.: detailed physical model, dynamic empirical models, and hybrid approaches, which are adopted by various simulation tools. This paper uses DesignBuilder with EnergyPlus simulation engine in order to; First, study the impact of efficiency measures on building energy behavior by comparing Low energy residential model to a conventional one in Beirut-Lebanon. Second, choose the appropriate energy systems for the studied case characterized by an important cooling demand. Third, study dynamic modeling of Variable Refrigerant Flow (VRF) system in EnergyPlus that is chosen due to its advantages over other systems and its availability in the Lebanese market. Finally, simulation of different energy systems models with different modeling approaches is necessary to confront the different modeling approaches and to investigate the interaction between energy systems and building envelope that affects the total energy consumption of Low Energy buildings.

Keywords: physical model, variable refrigerant flow heat pump, dynamic modeling, EnergyPlus, the modeling approach

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Authors: Ibrahim Malik, M. Ikramullah al Kambuna

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Today the crisis of understanding in Islamic values has been extended to the architectural design. The majority of Muslim Architects when they designed Islamic Architectural building always stuck in cultural symbols, forms of facade, carvings calligraphy, and all of things which intimately associated with middle eastern culture. As well as the interpretation of symbols form, by designing a dome in every mosque, calligraphy carving in the interior of the mosque, and the other elements in the building which interpreted to the middle east culture. So here there are problems in understanding the meaning of Islam with Kaffah (overall), which appeared a distortion of understanding to distinguish between cultural and theological values in a design. This paper will try to evaluate the design of a contemporary mosque in Indonesia, with case studies in Jogokariyan Mosque Yogyakarta Indonesia. The building evaluation are focused in building function , aesthetic, comfort, and security. And finally from this research should be found the results of the integrated design evaluation of a contemporary mosque which based on the study of the Quran and Hadith.

Keywords: evaluation, islamic concept, mosque, Hadith, Quran

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Authors: Firouz Amani, Adalat Hoseinian, Sajjad Hakimian

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Background: The mortality due to Myocardial Infarction (MI) is often occur during the first hours after onset of symptom. So, for taking the necessary treatment and decreasing the mortality rate, timely visited of the hospital could be effective in this regard. The aim of this study was to investigate the impact of effective factors in mortality of MI patients by using Linear Logistic Regression. Materials and Methods: In this case-control study, all patients with Acute MI who referred to the Ardabil city hospital were studied. All of died patients were considered as the case group (n=27) and we select 27 matched patients without Acute MI as a control group. Data collected for all patients in two groups by a same checklist and then analyzed by SPSS version 24 software using statistical methods. We used the linear logistic regression model to determine the effective factors on mortality of MI patients. Results: The mean age of patients in case group was significantly higher than control group (75.1±11.7 vs. 63.1±11.6, p=0.001).The history of non-cardinal diseases in case group with 44.4% significantly higher than control group with 7.4% (p=0.002).The number of performed PCIs in case group with 40.7% significantly lower than control group with 74.1% (P=0.013). The time distance between hospital admission and performed PCI in case group with 110.9 min was significantly upper than control group with 56 min (P=0.001). The mean of delay time from Onset of symptom to hospital admission (patient delay) and the mean of delay time from hospital admissions to receive treatment (system delay) was similar between two groups. By using logistic regression model we revealed that history of non-cardinal diseases (OR=283) and the number of performed PCIs (OR=24.5) had significant impact on mortality of MI patients in compare to other factors. Conclusion: Results of this study showed that of all studied factors, the number of performed PCIs, history of non-cardinal illness and the interval between onset of symptoms and performed PCI have significant relation with morality of MI patients and other factors were not meaningful. So, doing more studies with a large sample and investigated other involved factors such as smoking, weather and etc. is recommended in future.

Keywords: acute MI, mortality, heart failure, arrhythmia

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Authors: A. Latif Karimi

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Since 2001, construction works, especially the construction of new homes and residential buildings, witnessed a dramatic boom across Afghanistan. More so, the construction industry and house builders are relied upon as important players in the country’s job market, economy and infrastructural development schemes. However, a lack of innovation, quality assurance mechanism, substandard construction and market dominance by traditional methods push all the parties in house building sector to shift for more advanced construction techniques and mass production technologies to meet the rising demands for proper accommodation. Meanwhile, rapid population growth and urbanization are widening the gap between the demand and supply of new and modern houses in urban areas like Kabul, Herat, etc. This paper investigates about current condition of construction practices in house building projects, the associated challenges, and the outcomes of transition to more reasonable and sustainable building methods. It is obvious, the introduction and use of Modern Methods of Construction (MMC) can help construction industry and house builders in Afghanistan to tackle the challenges and meet the desired standards for modern houses. This paper focuses on prefabrication, a popular MMC that is becoming more common, improving in quality and available in a variety of budgets. It is revealed that this method is the way forward to improving house building practices as it has been proven to reduce construction time, minimize waste and improve environmental performance of construction developments.

Keywords: modern houses, traditional construction, modern methods of construction, prefabrication, sustainable building

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Authors: Shadi Motamedighazvini, Roohollah Taherkhani, Mahdi Mahdikhani, Najme Hashempour

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Nowadays, green building rating systems are an inevitable necessity for managing environmental considerations to achieve green buildings. The aim of this paper is to deliver a detailed recognition of what has been the focus of green building policymakers around the world; It is important to conduct this study in a way that can provide a context for researchers who intend to establish or upgrade existing rating systems. In this paper, fifteen rating systems including four worldwide well-known plus eleven local rating systems which have been selected based on the answers to the questionnaires were examined. Their similarities and differences in mandatory and prerequisite clauses, highest and lowest scores for each criterion, the most frequent criteria, and most frequent sub-criteria are determined. The research findings indicated that although the criteria of energy, water, indoor quality (except Homestar), site and materials (except GRIHA) were common core criteria for all rating systems, their sub-criteria were different. This research, as a roadmap, eliminates the lack of a comprehensive reference that encompasses the key criteria of different rating systems. It shows the local systems need to be revised to be more comprehensive and adaptable to their own country’s conditions such as climate.

Keywords: environmental assessment, green buildings, green building criteria, green building rating systems, sustainability, rating tools

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