Search results for: patient safety incidents

Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

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We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance

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Authors: E. H. Uguru, S. F. A. Sani, M. U. Khandaker, M. H. Rabir

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The beginning of cycle transient safety parameters is paramount for smooth reactor operation. The enhanced operational safety of UO₂ fuelled AP1000 reactor being the first using three fissile enrichment zones motivated this research for (Th, U)O₂ fuel. This study evaluated the impact of fissile enrichment, soluble boron, and gadolinia on the transient safety parameters to determine the basis for choosing the three fissile enrichment zones. Fuel assembly and core model of Westinghouse small modular reactor were investigated using different fuel and reactivity control arrangements. The Monte Carlo N-Particle eXtended (MCNPX) integrated with CINDER90 burn-up code was used for the calculations. The results show that the moderator temperature coefficient of reactivity (MTC) and the fuel temperature coefficient of reactivity (FTC) were respectively negative and decreased with increasing fissile enrichment. Soluble boron significantly decreased the MTC but slightly increased FTC while gadolinia followed the same trend with a minor impact. However, the MTC and FTC respectively decreased significantly with increasing change in temperature. These results provide a guide on the considerable factors in choosing the three fissile enrichment zones for (Th, U)O₂ fuel in anticipation of their impact on safety parameters. Therefore, this study provides foundational results on the factors that must be considered in choosing three fissile arrangement zones for (Th, U)O₂ fuel.

Keywords: reactivity, safety parameters, small modular reactor, soluble boron, thorium fuel cycle

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Authors: Sophia Shi

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Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

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Authors: Thippharat Wongsilarat, Parichat tuntilanon, Chonlakan Prataksitorn

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Recurrent adverse drug reactions are harmful to patients with mild to fatal illnesses, and affect not only patients but also their relatives, and organizations. To compare safe use of medicine among patients before and after using the recurrent adverse drug reaction prevention program . Quasi-experimental research with the target population of 598 patients with drug allergy history. Data were collected through an observation form tested for its validity by three experts (IOC = 0.87), and analyzed with a descriptive statistic (percentage). The research was conducted jointly with a multidisciplinary team to analyze and determine the weak points and strong points in the recurrent adverse drug reaction prevention system during the past three years, and 546, 329, and 498 incidences, respectively, were found. Of these, 379, 279, and 302 incidences, or 69.4; 84.80; and 60.64 percent of the patients with drug allergy history, respectively, were found to have caused by incomplete warning system. In addition, differences in practice in caring for patients with drug allergy history were found that did not cover all the steps of the patient care process, especially a lack of repeated checking, and a lack of communication between the multidisciplinary team members. Therefore, the recurrent adverse drug reaction prevention program was developed with complete warning points in the information technology system, the repeated checking step, and communication among related multidisciplinary team members starting from the hospital identity card room, patient history recording officers, nurses, physicians who prescribe the drugs, and pharmacists. Including in the system were surveillance, nursing, recording, and linking the data to referring units. There were also training concerning adverse drug reactions by pharmacists, monthly meetings to explain the process to practice personnel, creating safety culture, random checking of practice, motivational encouragement, supervising, controlling, following up, and evaluating the practice. The rate of prescribing drugs to which patients were allergic per 1,000 prescriptions was 0.08, and the incidence rate of recurrent drug reaction per 1,000 prescriptions was 0. Surveillance of recurrent adverse drug reactions covering all service providing points can ensure safe use of medicine for patients.

Keywords: recurrent drug, adverse reaction, safety, use of medicine

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Authors: Fiorenza Misale

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The painful phenomenon of so-called white deaths and accidents at work, unfortunately, is always current. The key is to act on the culture of security through effective measures of attitudes and behaviors that go far beyond the knowledge and the know-how. It is necessary that there is an ‘introjection’ of safety culture through the conscious involvement of all workers. The legislation on work safety identifies the main tool to promote the culture of safety at work and prevention within the workplace. In law the term education is used to distinguish itself from the information with which they will simply theoretically transmit, and from the training with which they will provide the practical skills. The new decree fact fills several gaps in previous legislation and stresses the importance of training in the workplace, that is, the main activity through which it is possible to achieve the active participation of all workers in the company’s prevention system. This system is built only through the dissemination of risk information, the circulation of information, comparison and dialogue between all actors involved that are the necessary elements for a correct transmission of the culture of worker safety. Training activity should put the focus on work experience in order to bring out all the knowledge needed to identify and assess the risks in the work place, and especially the action to eliminate or control them, integrating, when necessary, the missing knowledge. In addition to traditional training and information systems can be utilized for the purpose of training that are able to affect both one emotionally and aesthetically, team-theatre is one of them. Among the methods of company theater that can be used in work safety we have: Lesson show, theater workshop, improvised theater, forum theater, theater playback. The theater can represent a complementary approach to traditional training and give information on safety measures, demonstrating that there are more engaging outreach tools. Team-theatre allows identification with the characters, a transmission of emotions and moods and it is through the staging of a story that the individual processes new information. It’ also s a means of experiential training that allows you to work with your mind, body, emotions.The aim of one work is the use of corporate theater on the personnel working in the health sector. Through a questionnaire we are able to analyze the knowledge of occupational safety and current risks; in particular in health care which is to be administered before and after the play.

Keywords: theater, training, occupational health, safety

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Authors: Mark Andrew Tu, Raymond Olazo, Cybele Abad

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Cryptococcosis is an invasive infection most commonly found in patients who are immuno compromised. However, patients with this infection usually present with meningitis and rarely pulmonary infection in isolation. We present a case of a Filipino HIV patient who developed cryptococcal pneumonia without meningitis.

Keywords: Cryptococcal Pneumonia, HIV, Filipino, immune system

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: K. Y. Shih, H. M. Lin, S. Y. Lee, T. L. Hong

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Recently a number of food safety scandals have been on the news. In view of the fact that in Taiwan the majority of undergraduate college students reside in the dorms and dine out, the problem of restaurant sanitation is of utmost importance in their lives. The purpose of this study is to analyze students' dining habit and their perception of food safety. Four universities in the city of Tainan were randomly selected, and from each selected university a class was then chosen to receive 50 questionnaires. The total of 200 questionnaires yielded 144 usable returns. Students were asked to respond to questions, and each question was graded on a scale from 1 to 5 according to the importance. There were 32 questions ranging over various aspects: cleanliness of surroundings, washroom, food sanitation, serving temperature, kitchen sanitation, and service personnel cleanliness. It is found that the food sanitation received the highest score, while the service personnel ranked the lowest. An incidental finding is that the students tend to dine out in groups and as such their choice of restaurants are mostly dictated by consensus.

Keywords: food safety, restaurant, risk perception, sanitation

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Authors: Daniel Y. Abebe, Jaehyouk Choi

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From the past earthquake events, many people get hurt at the exit while they are trying to go out of the buildings because of the exit doors are unable to be opened. The door is not opened because it deviates from its the original position. The aim of this research is to develop and evaluate a new type safety door that keeps the door frame in its original position or keeps its edge angles perpendicular during and post-earthquake. The proposed door is composed of three components: outer frame joined to the wall, inner frame (door frame) and circular hollow section connected to the inner and outer frame which is used as seismic energy dissipating device.

Keywords: safety-door, earthquake disaster, low yield point steel, passive energy dissipating device, FE analysis

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Authors: Sunday Moses Ojelabi

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Safety is the protection of the crew, passenger and equipment itself, as well as those living and working near bodies of water, from hazardous situations. To assure safety, watch keeping is paramount because neglecting your watchkeeping can lead to hazardous situations. Navigation is the assignment of a sailor to a specific route on a vessel to operate. Navigation is the process of planning, managing, and directing a vessel safely to the desired destination with the aid of intense and efficient watch keeping. Safety, i,e, all measures done to preserve the welfare of marine life, maritime infrastructure, facilities, ships, offshore installations, crew, and passengers, as well as the preservation of navigation and the ease of maritime trade, are referred to as safety measures;. When it comes to health, the absence of a proper first aid kit will affect injured sailors and passengers. Not using goggles while shipping, ear muffs, etc., in the course of maintenance can be hazardous. Watchkeeping: i.e the specific dutiies assigned to a personnel in a vessel to see to its continous smooth functionality. Your lookout or watch officer [officer on navigational duty] must be active at all times in the course of duty. Navigation refers to the technique of precisely determining a craft or vehicle's position and directing its motion along a particular course. The seafarers are not being put through regular seminars, training, and orientations. In parts of West Africa, sailors go to school without being able to secure jobs until their papers expire. For that, they won’t go for another Standard Trainning Certification and Watch keeping for Seafarers to upgrade their certificate. In light of this, they are not familiar with the new vessels in the country, and for this, they can`t meet the safety, watch keeping, and navigation standards. Also, shipping companies and ship owners are being selfish by not putting the proper things needed onboard regarding safety, watchkeeping, and navigational equipment. The questions raised in these presentations are the breakdown of the safety activities, watch keeping effectiveness, and navigational accuracy. All safety and watch keeping regulations should be applied efficiently. The problem identified includes a lack of safety instruments onboard vessels in African waters. Also, inadequate proper watchkeeping due to the excess workload on the seafarers can lead to an improper lookout, which gives room to collision, hijacking, and piracy. The impact of this research is to inform African seafarers, shipping companies, and ship owners of the necessary information concerning the safety of their lives and that of their passengers, cargo, and equipment.

Keywords: standard of training, certification, watch keeping for seafarers, navigation, safety, watchkeeping

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Authors: Ines Zemni, Maher Slimane, Jamel Ben Hassouna, Khaled Rahal

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Background: Neurofibromatosis type 1 (NF1) is a genetic disease, which is associated with an increased risk of developing different malignancies including breast cancer. The association between NF1 band breast sarcoma is a rare entity. Herein we present a 25-year-old woman with NF1 who had fibrosarcoma of the left breast. Case presentation: The patient has multiple thoraco-abdominal 'café au lait' spots. Clinical examination showed a lump of the left breast measuring 9 cm of diameter, which was noticed for 6 months. There was a left inguinal mass of 6 cm of diameter. The patient underwent first a left lumpectomy. Histopathological exam revealed a high-grade fibrosarcoma of the left breast measuring 7.5 cm. Three months later, the patient underwent a left mastectomy and excision of the inguinal mass, which was a neurofibroma. An adjuvant chemotherapy and radiation therapy were indicated, but not applied because of the timeout. The patient is now alive after a follow up of 6 years, with no loco-regional recurrence or metastasis. Conclusion: The relationship between NF1 and breast cancer need to be more clarified by further studies. Establishing a specific screening program of these patients may help to make an earlier diagnosis of breast cancer.

Keywords: neurofibromatosis, breast, sarcoma, cancer

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Authors: Thomas P. Jones

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Overview: Drowning is an important cause of accidental death, particularly in children and young people. Although many survive drowning incidents, it is a relatively rare presenting complaint in Emergency Departments. When cases do present, they can be complex and unpredictable. For patients to receive the best care, it is important that their management is standardized and evidence based, however this can be difficult in a topic area with limited studies and inconsistencies in case reporting. Objectives: To review recent cases to assess the performance of Manchester Royal Infirmary Emergency Department in the management of near drowning. To produce evidence based guideline on the management of drowning victims in the ED. Methods: Emergency department records were searched for patients with the diagnosis of ‘fatal drowning’ or ‘nearly drowning’ and two relevant case notes reviewed. To produce the guideline a literature review was conducted and a series of structured short cut systematic reviews known as Best BETs carried out. This information was used to produce a clear treatment pathway. Results: The case studies emphasized the variety in presentation of drowning victims whilst highlighting inconsistencies in management and documentation. An evidence-based guideline is presented as a flowchart, which illustrates the relevant investigations and treatment that victims of a drowning incident should receive, based on the best available evidence. Conclusion: It is hoped that when put into practice, the guideline will improve and standardize patient care in cases of near drowning. An audit is recommended to assess its effectiveness.

Keywords: drowning, near drowning, non fatal drowning, fatal drowning

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Authors: Calvince Okome Odeny

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There is a current action to increase radiotherapy services in Kenya. The National government of Kenya, in collaboration with the county governments, has embarked on building radiotherapy centers in all 47 regions of the country. As these new centers are established in Kenya, it has to be ensured that minimum radiation safety standards are in place prior to operation. For full implementation of this, it is imperative that more Research and training for regulators are done on radiation protection, and safety and national regulatory infrastructure is geared towards ensuring radiation protection and safety in all aspects of the use of external radiotherapy practices. The present work aims at reviewing the level of protection and safety for patients and staff during external beam radiotherapy using Linac in Kenya and provides relevant guidance to improve protection and safety. A retrospective evaluation was done to verify whether those occupationally exposed workers and patients are adequately protected from the harmful effect of radiation exposure during the treatment procedures using Linac. The project was experimental Research, also including an analysis of resource documents obtained from the literature and international organizations. The critical findings of the work revealed that the key elements of protection of occupationally exposed workers and patients include a comprehensive quality Management system governing all planned activities from siting, safety, and design of the Facility, construction, acceptance testing, commissioning, operation, and decommissioning of the Facility; Government empowering the Regulatory Authority to license Medical Linear facilities and to enforce the applicable regulations to ensure adequate protection; A comprehensive Radiation Protection and Safety program must be established to ensure adequate safety and protection of workers and patients during treatment planning and treatment delivery of patients and categories of staff associated with the Facility must be well educated and trained to perform professionally with a commitment to sound safety culture. Relevant recommendations from the findings are shared with the Medical Linear Accelerator facilities and the regulatory authority to provide guidance and continuous improvement of protection and safety to improve regulatory oversight.

Keywords: oncology, radiotherapy, protection, staff

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Authors: Lluís Bermúdez, Isabel Morillo

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Road safety involves carrying out a determined and explicit policy to reduce accidents. In the city of Barcelona, through the Local Road Safety Plan 2013-2018, in line with the framework that has been established at the European and state level, a series of preventive, corrective and technical measures are specified, with the priority objective of reducing the number of serious injuries and fatalities. In this work, based on the data from the accidents managed by the local police during the period 2010-2019, an analysis is carried out to verify whether the measures established in the Plan to reduce the accident rate have had an effect or not and to what extent. The analysis focuses on the type of accident and the type of vehicles involved. Different count regression models have been fitted, from which it can be deduced that the number of serious and fatal victims of the accidents that have occurred in the city of Barcelona has been reduced as the measures approved by the authorities.

Keywords: accident reduction, count regression models, road safety, urban traffic

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Authors: Zahra Ali Abbasi, Syed Muhammad Saqib Saleem

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This research explores the relationship between social media and awareness about climate change amongst the university students of Lahore, Pakistan. The aim is to understand how the people of Pakistan perceive climate change, especially on the social media. A deductive and quantitative method is applied on the research to find out the awareness of climate change in the people using social media. For this purpose, a survey method is used, to analyze the response from 167 online respondents through stratified random sampling technique. The relation between multiple variables including awareness about important climatic events like Paris agreement, GreenTube, Smog in Lahore, Floods in Pakistan and other eminent incidents of climate change and social media are calculated by analyzing social media as a source to impart information about climate change. The results show that as people get aware of climate change, they post about different national and international events/incidents of climate which reveal a significant relationship between respondents' awareness about climate change and their posting and sharing of content about climate change. Another test indicates that respondents’ post/share/comment (impart) information about climate change when there is a shift in the climate both globally and nationally. However, the significance of both these correlations has been found to be negligible. Social media being an independent platform holds greater influencing power, hence, as consumers of the environment the users hold the responsibility of producing and sharing content at a global platform about climate. However, matters of politics, economy and religion seem to have overshadowed the significance of climate.

Keywords: climate change, diffusion of innovation, environment, social media, Pakistan

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Authors: Muizz Sanni-Anibire

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The 21st century has witnessed growing concerns for the protection of built facilities against natural and man-made disasters. Studies in earthquake resistant buildings, fire, and explosion resistant buildings now dominate the arena. To protect people and facilities from the effects of the explosion, reinforced concrete walls have been designed to be blast resistant. Understanding the performance of these walls is a key step in ensuring the safety of built facilities. Blast walls are mostly designed using simple techniques such as single degree of freedom (SDOF) method, despite the increasing use of multi-degree of freedom techniques such as the finite element method. This study is the first stage of a continuous research into the safety and reliability of blast walls. It presents the SDOF approach applied to the analysis of a concrete wall panel under three representative bomb situations. These are motorcycle 50 kg, car 400kg and also van with the capacity of 1500 kg of TNT explosive.

Keywords: blast wall, safety, protection, explosion

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Authors: Adinarayana Badveeti, Mohammad Shafi Mir

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In Srinagar city, in India, road safety is an important aspect that creates ecological balance and social well being. A road accident creates a situation that leaves behind distress, sorrow, and sufferings. Therefore identification of causes of road accidents becomes highly essential for adopting necessary preventive measures against a critical event. The damage created by road accidents to large extent is unrepairable and therefore needs attention to eradicate this continuously increasing trend of awful 'epidemic'. Road accident in India is among the highest in the world, with at least approximately 142.000 people killed each year on the road. Kashmir region is an ecologically sensitive place but lacks necessary facilities and infrastructure regarding road transportation, ultimately resulting in the critical event-road accidents creating a major problem for common people in the region. The objective of this project is to study the safety aspect of Srinagar City and also model the accidents with different aspect that causes accidents and also to suggest the possible remedies for lessening/eliminating the road accidents.

Keywords: road safety, road accident, road infrastructure, accident modeling

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Authors: C. Kuoh, C. Lucas, T. Lopes, I. Mechie, J. Yoong, W. Yoong

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For all surgeons, there is one preventable but still highly occurring complication – wrong site surgeries. They can have potentially catastrophic, irreversible, or even fatal consequences on patients. With the exponential development of microsurgery and the use of advanced technological tools, the consequences of operating on the wrong side, anatomical part, or even person is seen as the most visible and destructive of all surgical errors and perhaps the error that is dreaded by most clinicians as it threatens their licenses and arouses feelings of guilt. Despite the implementation of the WHO surgical safety checklist more than a decade ago, the incidence of wrong-site surgeries remains relatively high, leading to tremendous physical and psychological repercussions for the clinicians involved, as well as a financial burden for the healthcare institution. In this presentation, the authors explore various factors which can lead to wrong site surgery – a combination of environmental and human factors and evaluate their impact amongst patients, practitioners, their families, and the medical industry. Major contributing factors to these “never events” include deviations from checklists, excessive workload, and poor communication. Two real-life cases are discussed, and systems that can be implemented to prevent these errors are highlighted alongside lessons learnt from other industries. The authors suggest that reinforcing speaking-up, implementing medical professional trainings, and higher patient’s involvements can potentially improve safety in surgeries and electrosurgeries.

Keywords: wrong side surgery, never events, checklist, workload, communication

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Authors: Abhijitsinh Gohil, Kaushal Wadhvaniya, Kuldipsinh Jadeja

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Road Safety is a multi-sectoral and multi-dimensional issue. An effective model can assess the risk associated with highway safety. A questionnaire survey is very essential to identify the events or activities which are causing unsafe condition for traffic on an urban highway. A questionnaire of standard questions including vehicular, human and infrastructure characteristics can be made. Responses from the age wise group of road users can be taken on field. Each question or an event holds a specific risk weightage, which contributes in creating an inappropriate and unsafe flow of traffic. The probability of occurrence of an event can be calculated from the data collected from the road users. Finally, the risk score can be calculated by considering the risk factor and the probability of occurrence of individual event and addition of all risk score for the individual event will give the total risk score of a particular road. Standards for risk score can be made and total risk score can be compared with the standards. Thus road can be categorized based on risk associated and traffic safety on it. With this model, one can assess the need for traffic safety improvement on a given road, and qualitative data can be analysed.

Keywords: probability of occurrence, questionnaire, risk factor, risk score

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Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a terminal lung cancer patient who received palliative care after tracheal intubation. The patient was nearing death, and the family experienced sadness and grief as they faced the patient’s deteriorating condition and impending death. Methods: The patient was diagnosed with lung cancer in 2018 and received chemotherapy and radiation therapy with regular outpatient follow-ups. Due to brain metastasis and recent poor pain control and treatment outcomes, the patient was admitted to the intensive care unit (ICU), where the tracheal tube was removed, and palliative care was initiated. During the care period, a holistic assessment was conducted, addressing the physical, psychological, social, and spiritual aspects of care. Medical records were reviewed, interviews and family meetings were held, and a comprehensive assessment was carried out by the critical care team in collaboration with the palliative care team. The primary nursing issues identified included pain, ineffective breathing patterns, fear of death, and altered tissue perfusion. Results: Throughout the care process, the palliative care nurse, along with the family, utilized listening, caring, companionship, pain management, essential oil massage, distraction, and comfortable positioning to alleviate the patient’s pain and breathing difficulties. The use of Morphine 6mg in 0.9% N/S 50ml IV drip q6h reduced the FLACC pain score from 6 to 3. The patient’s respiratory rate improved from 28 breaths/min to 18-22 breaths/min, and sleep duration increased from 4 to 7 uninterrupted hours. The holistic palliative care approach, coupled with the involvement of the palliative care team, facilitated expressions of gratitude, apologies, and love between the patient and family. Visiting hours were extended, and with the nurse’s assistance, these moments were recorded and shared with the patient’s consent, providing cherished memories for the family. The patient’s end-of-life experience was thus improved, and the family was able to find peace. This case also served to promote the concept of palliative care, ensuring that more patients and families receive high-quality nursing care. Conclusion: When caring for terminal patients, collaboration with the palliative care team, including social workers, clergy, psychologists, and nutritionists, is essential. Involving the family in decision-making and providing opportunities for closeness and expressions of gratitude improve personalized care and enhance the patient's quality of life. Upon transferring to the ward, the patient’s hemodynamic stability was maintained, including SBP 110-130 mmHg, respiratory rate 20-22 breaths/min, and pain score <3. The patient was later discharged and transitioned to home hospice care for ongoing support.

Keywords: intensive care, lung cancer, palliative care, ICU

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Authors: Gergely Horváth

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The study presents the complexity of food safety dividing it into two layers. Beyond the basic layer of requirements, there is a more demanding higher level linked with quality and purity aspects. It would be important to give special prominence to both layers, given that massive illnesses are caused by foods even though officially licensed. Then the study discusses an exciting safety challenge stemming from the risks of genetically modified organisms (GMOs). Furthermore, it features legal case examples that illustrate how certain liability questions are solved or not yet decided in connection with the production of genetically modified crops. In addition, a special kind of land grabbing, more precisely land grabbing from non-GMO farming systems can also be noticed as well as a new phenomenon eroding food sovereignty. Coexistence, the state where organic, conventional, and GM farming systems are standing alongside each other is an unsuitable experiment that cannot be successful, because of biophysical reasons (such as cross-pollination). Agricultural and environmental lawyers both try to find the optimal solution. Agri-environmental measures are introduced as a special subfield of law maintaining also food safety. The important steps of agri-environmental legislation are aiming at the protection of natural values, the environmental media and strengthening food safety as well, practically the quality of agricultural products intended for human consumption. The major findings of the study focus on searching for the appropriate approach capable of solving the security and safety problems of food production. The most interesting concepts of the Hungarian national and EU food law legislation are analyzed in more detail with descriptive, analytic and comparative methods.

Keywords: food law, food safety, food security, GMO, Genetically Modified Organisms, agri-environmental measures

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Authors: Francine Siy, Stephen Buñi

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Safety plays a significant role in everyone’s life on a day-to-day basis. We wish ourselves and our loved ones their safety as we all venture out on our daily commute. The road is undeniably dangerous and unpredictable, with abundant traffic collisions and pedestrians experiencing various injuries. For bicycle users, the risk of accidents is even more exacerbated, and injuries may be severe. Even when cyclists try their best to be safe and protected, the possibility of encountering danger is always there. Despite being equipped with protective gear, safety is never guaranteed. Cyclists often settle for helmets and standard reflector vests to establish a presence on the road. There are different types of vests available, depending on the profession. However, traditional reflector vests, mostly seen on construction workers and traffic enforcers, were not designed for riders and their protection from injuries. With insufficient protection for riders, they need access to ergonomically designed equipment and accessories that suit the riders and cater to their needs. This research aimed to offer a protective vest with safety features for riders that is comfortable, effective, durable, and intuitive. This sheds light and addresses the safety of the biker population, which continuously grows through the years. The product was designed and developed by gathering data and using the cognitive mapping method to ensure that all qualitative and quantitative data were considered in this study to improve other existing products that do not have the proper design considerations. It is known that available equipment for cyclists is often sold separately or lacks the safety features for cyclists traversing open roads. Each safety feature like the headlights, reflectors, signal or rear lights, zipper pouch, body camera attachment, and wireless remote control all play a particular role in helping cyclists embark on their daily commute. These features aid in illumination, visibility, easy maneuvering, convenience, and security, allowing cyclists to go for a safer ride that is of use throughout the day. The product is designed and produced effectively and inexpensively without sacrificing the quality and purpose of its usage.

Keywords: bicycle accessory, protective gear, safety, transport, visibility

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Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

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Authors: Khorief Ouissem, Sassi Boudmagh Souad, Mahimoud Aissa

Abstract:

The health and safety problem in the construction companies has been a major subject of research in Algeria for many years. The latest statistics of the Algerian National Social Security Fund (CNAS) shows that a third of accidents recorded at the national level are originated from construction activities. It is becoming increasingly essential and urgent to investigate and address its causes in order to find measures to overcome the deficiencies in this area. Thus, this paper takes in investigating this problem through a study conducted in the city of Skikda, Algeria. The study was carried out through questionnaire where twenty construction companies were taking into consideration. First, the study identifies the regulations and the laws related to the health and safety in the construction sector in Algeria. Then it goes on to assess and evaluate the implementation of the identified regulations in the companies selected. The result of the assessment indicates that the majority of the construction companies considered do not meet the health and safety standards and regulations. To extract the main causes of the failure of the system to control this industry, the observations and the evaluation were analyzed using the 5M or Ichikawa diagram method. This method is based on identifying the causes of the problem in terms of purpose, the list of potential causes for families. These families often correspond to 5M (Labor, Material, Methods, Middle, and Management). Finally, having identified the primary motives, the present authors propose a list of actions to move towards a more controlled and effective health and safety system for the construction industry.

Keywords: health and safety, construction industry, performance measurement, Algeria

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Authors: R. A. Qawasma, F. M. Haddad, H. O. Salhab

Abstract:

Hemodialysis is a life-preserving treatment for a number of patients with kidney failure. The standard procedure of hemodialysis is three times a week during the hemodialysis procedure, the patient usually suffering from many inconvenient, exhausting feeling and effect on the heart and cardiovascular system are the most common signs. This paper provides a solution to reduce the previous problems by designing a wearable artificial kidney (WAK) taking in consideration a minimization the size of the dialysis machine. The WAK system consists of two circuits: blood circuit and dialysate circuit. The blood from the patient is filtered in the dialyzer before returning back to the patient. Several parameters using an advanced microcontroller and array of sensors. WAK equipped with visible and audible alarm system to aware the patients if there is any problem.

Keywords: artificial kidney, home dialysis, renal failure, wearable kidney

Procedia PDF Downloads 231

Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

Abstract:

The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Martin Juhas, Bohuslava Juhasova, Igor Halenar, Andrej Elias

Abstract:

This article deals with the possibility of increasing efficiency, reliability and safety of the system for teledosimetric data collection management and their evaluation as a part of complex study for activity “Research of data collection, their measurement and evaluation with mobile and autonomous units” within project “Research of monitoring and evaluation of non-standard conditions in the area of nuclear power plants”. Possible weaknesses in existing system are identified. A study of available cluster solutions with possibility of their deploying to analysed system is presented.

Keywords: teledosimetric data, efficiency, reliability, safety, cluster solution

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Authors: Ferawati, H. Purwanto, Y. F. Kurnia, E. Purwati

Abstract:

The aim of this study was to evaluate the microbiological quality and safety of meatball obtained from five different manufacturers around Payakumbuh City, West Sumatra, Indonesia. Microbiological analysis of meatball sample resulted in aerobic plate count range from 7 log CFU/gr to 8.623 log CFU/gr, respectively. Total coliform ranges from 1.041 log Most Probable Number (MPN)/gr to 3.380 log MPN/gr, respectively. Chemical analysis of meatball sample consisted of borax and formalin content. The result of qualitative detection of borax and formalin content on all meatball samples were not detected. Thus, it remains essential to include the significance of effective hygiene practices as an important safety measure in consumer education programmes.

Keywords: borax, formalin, meatball, microbiological quality

Procedia PDF Downloads 285

Authors: Chris Phan, Yong Seok Park

Abstract:

The Toyota Camry is one of the best-selling cars in America. It is economical, reliable, and most importantly, safe. These attributes allowed the Camry to be the trustworthy choice when choosing dependable vehicle. However, a new finding brought question to the Camry’s safety. Since 1997, the Camry received a “good” rating on its moderate overlap front crash test through the Insurance Institute of Highway Safety. In 2012, the Insurance Institute of Highway Safety introduced a frontal small overlap crash test into the overall evaluation of vehicle occupant safety test. The 2012 Camry received a “poor” rating on this new test, while the 2015 Camry redeemed itself with a “good” rating once again. This study aims to find a possible solution that Toyota implemented to reduce the severity of a frontal small overlap crash in the Camry during a mid-cycle update. The purpose of this study is to analyze and evaluate the performance of various A-pillar shapes as energy absorbing structures in improving passenger safety in a frontal crash. First, A-pillar structures of the 2012 and 2015 Camry were modeled using CAD software, namely SolidWorks. Then, a crash test simulation using ANSYS software, was applied to the A-pillars to analyze the behavior of the structures in similar conditions. Finally, the results were compared to safety values of cabin intrusion to determine the crashworthy behaviors of both A-pillar structures by measuring total deformation. This study highlights that it is possible that Toyota improved the shape of the A-pillar in the 2015 Camry in order to receive a “good” rating from the IIHS safety evaluation once again. These findings can possibly be used to increase safety performance in future vehicles to decrease passenger injury or fatality.

Keywords: A-pillar, Crashworthiness, Design Synthesis, Finite Element Analysis

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Authors: Zainul Huda, Mohammed Hani Ajani

Abstract:

The design, manufacture, and operation of thin-walled pressure vessels must be based on maximum safe operating pressure and an adequate factor of safety (FoS). This research paper first reports experimental evaluation of longitudinal and hoops stresses based on working pressure as well as maximum pressure; and then includes a critical study of factor of safety (FoS) in the design of a glass fiber pressure vessel. Experimental work involved the use of measuring instruments and the readings from pressure gauges. Design calculations involved the computations of design stress and FoS; the latter was based on breaking strength of 55 MPa for the glass fiber (pressure-vessel material). The experimentally determined FoS value has been critically compared with the general FoS allowed in the design of glass fiber pressure vessels.

Keywords: thin-walled pressure vessel, hoop stress, longitudinal stress, factor of safety (FoS), fiberglass

Procedia PDF Downloads 481