Search results for: internal emergency
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3349

Search results for: internal emergency

2809 Characteristics of Acute Bacterial Prostatitis in Elderly Patients Attended in the Emergency Department

Authors: Carles Ferré, Ferran Llopis, Javier Jacob, Jordi Giol, Xavier Palom, Ignasi Bardés

Abstract:

Objective: To analyze the characteristics of acute bacterial prostatitis (ABP) in elderly patients attended in the emergency department (ED). Methods: Observational and cohort study with prospective follow-up including patients with ABP presenting to the ED from January-December 2012. Data were collected for demographic variables, comorbidities, clinical and microbiological findings, treatment, outcome, and reconsultation at 30 days follow up. Findings were compared between patients ≥ 75 years (study group) and < 75 years (control group). Results: During the study period 241 episodes of ABP were included for analysis. Mean age was 62,9 ± 16 years, and 64 (26.5%) were ≥ 75 years old. A history of prostate adenoma was reported in 54 cases (22,4%), diabetes mellitus in 47 patients (19,5%) and prior manipulation of the lower urinary tract in 40 (17%). Mean symptoms duration was 3.38 ± 4.04 days, voiding symptoms were present in 176 cases (73%) and fever in 154 (64%). From 216 urine cultures, 128 were positive (59%) and 24 (17,6%) out of 136 blood cultures. Escherichia coli was the main pathogen in 58.6% of urine cultures and 64% of blood cultures (with resistant strains to fluoroquinolones in 27,7%, cotrimoxazole in 22,9% and amoxicillin/clavulanic in 27.7% of cases). Seventy patients (29%) were admitted to the hospital, and 3 died. At 30-day follow-up, 29 patients (12%) returned to the ED. In the bivariate analysis previous manipulation of the urinary tract, history of cancer, previous antibiotic treatment, resistant E. coli strains to amoxicillin-clavulanate and ciprofloxacin and extended spectrum beta-lactamase (ESBL) producers, renal impairment, and admission to the hospital were significantly more frequent (p < 0.05) among patients ≥ 75 years compared to those younger than 75 years. Conclusions: Ciprofloxacin and amoxicillin-clavulanate appear not to be good options for the empiric treatment of ABP for patients ≥ 75 years given the drug-resistance pattern in our series, and the proportion of ESBL-producing strains of E. coli should be taken into account. Awaiting bacteria identification and antibiogram from urine and/or blood cultures, treatment on an inpatient basis should be considered in older patients with ABP.

Keywords: acute bacterial prostatitits, antibiotic resistance, elderly patients, emergency

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2808 Evaluation of the Patient Identification Process in Healthcare Facilities in a Brazilian City Area

Authors: Carmen Silvia Gabriel, Maria de Fátima Paiva Brito, Mariane de Paula Candido, Vanessa Barato Oliveira

Abstract:

Patient identification is a necessary practice to ensure patient safety in any healthcare environment, including emergency care units, test laboratories, home care and clinics. The present study aimed to provide evidence that can effectively contribute to practices concerning patient identification. Its objective was to investigate patient identification in basic healthcare units through patient safety standards. To do so, a descriptive and non-experimental research outline study was carried out to inquire how patient identification takes place in a particular situation. All technical manager nurses from the chosen healthcare facilities were included in the sample for the study. Data was collected in September of 2014 after approval from the Committee of Ethics. All researched institutions fit the same profile: they’re public facilities for general care with observation beds. None of them has a wristband identification protocol or policy. Only one institution mentioned using some kind of visual identification; namely, body tags separated by colors according to the type of care, but it still does not apply the recommended tags by the Brazilian Ministry of Health. This study allowed the authors to acknowledge how important the commitment from the whole healthcare team in the patient identification process is and also acknowledge how necessary it is to implement institutional policies that may aid the healthcare units in this area to promote a quality and safe patient care.

Keywords: patient safety, identification, nursing, emergency care units

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2807 Changing Trends in the Use of Induction Agents for General Anesthesia for Cesarean Section

Authors: Mahmoud Hassanin, Amita Gupta

Abstract:

Background: During current practice, Thiopentone is not cost-effectively added to resources wastage, risk of drug error with antibiotics, short shelf life, infection risk, and risk of delay while preparing during category one cesarean section. There is no significant difference or preference to the other alternative as per current use. Aims and Objectives: Patient safety, Cost-effective use of trust resources, problem awareness, Consider improvising on the current practice. Methods: In conjunction with the local department survey results, many studies support the change. Results: More than 50%(15 from 29) are already using Propofol, more than 75% of the participant are willing to shift to Propofol if it becomes standard, and the cost analysis also revealed that Thiopentone 10 X500=£60 Propofol 10X200= £5.20, Cost of Thiopentone/year =£2190. Approximately GA in a year =35-40 could cost approximately £20 Propofol, given it is a well-established practice. We could save not only money, but it will be environmentally friendly also to avoid adding any carbon footprints. Recommendation: Thiopentone is rarely used as an induction agent for the category one Caesarean section in our obstetric emergency theatres. Most obstetric anesthetists are using Propofol. Keep both Propofol and thiopentone(powder not withdrawn) in the cat one cesarean section emergency drugs tray ready until the department completely changes the practice protocol. A further retrospective study is required to compare the outcomes for these induction agents through the local database.

Keywords: thiopentone, propofol, category 1 caesarean, induction agents

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2806 Governance Structure of Islamic Philanthropic Institution: Analysis of Corporate WAQF in Malaysia

Authors: Nathasa Mazna Ramli, Nurul Husna Mohd Salleh, Nurul Aini Muhamed

Abstract:

This study focuses on the governance of an Islamic philanthropic institution in Malaysia. Specifically, the internal governance structure of corporate Islamic endowment, or waqf, is being analysed. The purposes of waqf are to provide continuous charity that could generate perpetual income flow for the needy. This study is based on the principle of MCCG 2012, Shariah Governance Framework and charity governance. This study utilises publicly available data to examine the internal governance structure of a corporate waqf. This study finds that the Islamic philanthropic Institution practices, to some extent, have a sound governance structure to discharge their transparency and accountability. Furthermore, findings also showed that though governance structure is in place, most of the structures are not disclosed in the annual reports of the company. Findings from the study could extend the knowledge in these areas and stimulate further research on the governance of Islamic philanthropic institutions, particularly for corporate waqf.

Keywords: accountability, governance, Islamic philanthropic, corporate waqf

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2805 Influence of Percentage and Melting Temperature of Phase Change Material on the Thermal Behavior of a Hollow-Brick

Authors: Zakaria Aketouane, Mustapha Malha, Abdellah Bah, Omar Ansari, Mohamed Asbik

Abstract:

The present paper deals with the thermal performance of a hollow-brick filled with Phase Change Material (PCM). The main objective is to study the effect of percentage and melting temperature of the PCM on the thermal inertia and internal surface temperature of the hollow-brick. A numerical model based on the heat transfer equation and the apparent heat capacity method has been validated using experimental study from the literature. The results show that increasing the percentage of the PCM has a significant effect on time lag and decrement factor that define the thermal inertia; the internal temperature is reduced by 1.36°C to 5.39°C for a percentage from 11% to 71% in comparison to a brick without PCM. In addition, an appropriate melting temperature of 37°C has been deduced for the horizontal wall orientation in Rabat in comparison to 27°C and 47°C.

Keywords: appropriate melting temperature, decrement factor, phase change material, thermal inertia, time lag

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2804 Reducing System Delay to Definitive Care For STEMI Patients, a Simulation of Two Different Strategies in the Brugge Area, Belgium

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

Abstract:

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

Procedia PDF Downloads 313
2803 Maternity Care Model during Natural Disaster or Humanitarian Emegerncy Setting in Rural Pakistan

Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

Abstract:

Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

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2802 Study of Dual Fuel Engine as Environmentally Friendly Engine

Authors: Nilam S. Octaviani, Semin

Abstract:

The diesel engine is an internal combustion engine that uses compressed air to combust. The diesel engines are widely used in the world because it has the most excellent combustion efficiency than other types of internal combustion engine.  However, the exhaust emissions of it produce pollutants that are harmful to human health and the environment. Therefore, natural gas used as an alternative fuel using on compression ignition engine to respond those environment issues. This paper aims to discuss the comparison of the technical characteristics and exhaust gases emission from conventional diesel engine and dual fuel diesel engine. According to the study, the dual fuel engine applications have a lower compression pressure and has longer ignition delay compared with normal diesel mode. The engine power is decreased at dual fuel mode. However, the exhaust gases emission on dual fuel engine significantly reduce the nitrogen oxide (NOx), carbon dioxide (CO2) and particular metter (PM) emissions.

Keywords: diesel engine, dual fuel diesel engine, emission reduction, technical characteristics

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2801 Hierarchically Modeling Cognition and Behavioral Problems of an Under-Represented Group

Authors: Zhidong Zhang, Zhi-Chao Zhang

Abstract:

This study examines adolescent psychological and behavioral problems. The Achenbach systems of empirically based assessment (ASEBA) were used as the instrument. The problem framework consists of internal, external and social behavioral problems which are theoretically developed based on about 113 items plus relevant background variables. In this study, the sample consist of 1,975 sixth and seventh grade students in Northeast China. Stratified random sampling method was used to collect the data, meaning that samples were from different school districts, schools, and classes. The researchers looked at both macro and micro effect. Therefore, multilevel analysis techniques were used in the data analysis. The parts of the research results indicated that the background variables such as extracurricular activities were directly related to students’ internal problems.

Keywords: behavioral problems, anxious/depressed problems, internalizing problems, mental health, under-represented groups, empirically-based assessment, hierarchical modeling, ASEBA, multilevel analysis

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2800 Electrophoretic Light Scattering Based on Total Internal Reflection as a Promising Diagnostic Method

Authors: Ekaterina A. Savchenko, Elena N. Velichko, Evgenii T. Aksenov

Abstract:

The development of pathological processes, such as cardiovascular and oncological diseases, are accompanied by changes in molecular parameters in cells, tissues, and serum. The study of the behavior of protein molecules in solutions is of primarily importance for diagnosis of such diseases. Various physical and chemical methods are used to study molecular systems. With the advent of the laser and advances in electronics, optical methods, such as scanning electron microscopy, sedimentation analysis, nephelometry, static and dynamic light scattering, have become the most universal, informative and accurate tools for estimating the parameters of nanoscale objects. The electrophoretic light scattering is the most effective technique. It has a high potential in the study of biological solutions and their properties. This technique allows one to investigate the processes of aggregation and dissociation of different macromolecules and obtain information on their shapes, sizes and molecular weights. Electrophoretic light scattering is an analytical method for registration of the motion of microscopic particles under the influence of an electric field by means of quasi-elastic light scattering in a homogeneous solution with a subsequent registration of the spectral or correlation characteristics of the light scattered from a moving object. We modified the technique by using the regime of total internal reflection with the aim of increasing its sensitivity and reducing the volume of the sample to be investigated, which opens the prospects of automating simultaneous multiparameter measurements. In addition, the method of total internal reflection allows one to study biological fluids on the level of single molecules, which also makes it possible to increase the sensitivity and the informativeness of the results because the data obtained from an individual molecule is not averaged over an ensemble, which is important in the study of bimolecular fluids. To our best knowledge the study of electrophoretic light scattering in the regime of total internal reflection is proposed for the first time, latex microspheres 1 μm in size were used as test objects. In this study, the total internal reflection regime was realized on a quartz prism where the free electrophoresis regime was set. A semiconductor laser with a wavelength of 655 nm was used as a radiation source, and the light scattering signal was registered by a pin-diode. Then the signal from a photodetector was transmitted to a digital oscilloscope and to a computer. The autocorrelation functions and the fast Fourier transform in the regime of Brownian motion and under the action of the field were calculated to obtain the parameters of the object investigated. The main result of the study was the dependence of the autocorrelation function on the concentration of microspheres and the applied field magnitude. The effect of heating became more pronounced with increasing sample concentrations and electric field. The results obtained in our study demonstrated the applicability of the method for the examination of liquid solutions, including biological fluids.

Keywords: light scattering, electrophoretic light scattering, electrophoresis, total internal reflection

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2799 Structural Characterization of the 3D Printed Silicon Carbon/Carbon Fibers Nanocomposites

Authors: Saja M. Nabat Al-Ajrash, Charles Browning, Rose Eckerle, Li Cao

Abstract:

A process that utilizes a combination of additive manufacturing (AM), a preceramic polymer, and a chopped carbon fiber precursorto fabricate Silicon Carbon/ Carbon fibers (SiC/C) composites have been developed. The study has shown a promising, cost-effective, and efficient route to fabricate complex SiC/C composites using additive manufacturing. A key part of this effort was the mapping of the material’s microstructure through the thickness of the composite. Microstructural features in the pyrolyzed composites through the successive AM layers, such as defects, crystal size and their distribution, interatomic spacing, chemical bonds, were investigated using high-resolution scanning and transmission electron microscopy. As a result, the microstructure developed in SiC/C composites after printing, cure, and pyrolysis has been successfully mapped through the thickness of the derived composites. Dense and nearly defect-free parts after polymer to ceramic conversion were observed. The ceramic matrix composite displayed three coexisting phases, including silicon carbide, silicon oxycarbide, and turbostratic carbon. Lattice fringes imaging and X-Ray Diffraction analysis showed well-defined SiC and turbostratic carbon features. The cross-sectional mapping of the printed-then-pyrolyzed structures has confirmed consistent structural and chemical features within the internal layers of the AM parts. Noteworthy, however, is that a crust-like area with high crystallinity has been observed in the first and last external layers. Not only do these crust-like regions have structural characteristics distinct from the internal layers, but they also have elemental distributions different than the internal layers.

Keywords: SiC, preceramic polymer, additive manufacturing, ceramic

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2798 Currency Boards in Crisis: Experience of Baltic Countries

Authors: Gordana Kordić, Petra Palić

Abstract:

The European countries that during the past two decades based their exchange rate regimes on currency board arrangement (CBA) are usually analysed from the perspective of corner solution choice’s stabilisation effects. There is an open discussion on the positive and negative background of a strict exchange rate regime choice, although it should be seen as part of the transition process towards the monetary union membership. The focus of the paper is on the Baltic countries that after two decades of a rigid exchange rate arrangement and strongly influenced by global crisis are finishing their path towards the euro zone. Besides the stabilising capacity, the CBA is highly vulnerable regime, with limited developing potential. The rigidity of the exchange rate (and monetary) system, despite the ensured credibility, do not leave enough (or any) space for the adjustment and/or active crisis management. Still, the Baltics are in a process of recovery, with fiscal consolidation measures combined with (painful and politically unpopular) measures of internal devaluation. Today, two of them (Estonia and Latvia) are members of euro zone, fulfilling their ultimate transition targets, but de facto exchanging one fixed regime with another. The paper analyses the challenges for the CBA in unstable environment since the fixed regimes rely on imported stability and are sensitive to external shocks. With limited monetary instruments, these countries were oriented to the fiscal policies and used a combination of internal devaluation and tax policy measures. Despite their rather quick recovery, our second goal is to analyse the long term influence that the measures had on the national economy.

Keywords: currency board arrangement, internal devaluation, exchange rate regime, great recession

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2797 A Study on Employer Branding and Its Impact on Employee

Authors: Kvnkc Sharma

Abstract:

Globalization, coupled with increase in competition is compelling organizations to adopt innovative strategies and identify core competencies in order to distinguish themselves from the competition. The capability of an organization is no longer determined by their products or services alone. The intellectual assets and quality of the human resource are fast emerging as key differentiators. Corporations are now positioning themselves as ‘brands’ not solely to market their products and services, but also to lure and to retain the best talent in the business. This paper identifies leadership as the ‘key element’ in developing an organization’s brand, which has a significant influence on the employee’s eventual perception of this external brand as portrayed by the organization. External branding incorporates innovation, consumer concern, trust, quality and sustainability. The paper contends that employees are indeed an organization’s ‘brand ambassadors. Internal branding involves taking care of these ambassadors of corporate brand i.e. human resource. If employees of an organization are not exposed to the organization’s branding (an ongoing process that functionally aligns, motivates and empower employees at all levels to consistently provide a satisfying customer experience), the external brand could be jeopardized. Internal branding, on the other hand, refers to employee’s perception of the organization’s brand. The current business environment can at best, be termed as volatile. Employees with the right technical and behavioral skills remain a scarce resource and the employers need to be ready to capture the attention, interest and commitment of the best and brightest candidates. This paper attempts to review and understand the relationship between employer branding and employee retention. The paper also seeks to identify potential impact of employer branding across all the factors affecting employees.

Keywords: external branding, human resource, internal branding, leadership

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2796 An Exploration of the Emergency Staff’s Perceptions and Experiences of Teamwork and the Skills Required in the Emergency Department in Saudi Arabia

Authors: Sami Alanazi

Abstract:

Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

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2795 Internal Corrosion Rupture of a 6-in Gas Line Pipe

Authors: Fadwa Jewilli

Abstract:

A sudden leak of a 6-inch gas line pipe after being in service for one year was observed. The pipe had been designed to transport dry gas. The failure had taken place in 6 o’clock position at the stage discharge of the flow process. Laboratory investigations were conducted to find out the cause of the pipe rupture. Visual and metallographic observations confirmed that the pipe split was due to a crack initiated in circumferential and then turned into longitudinal direction. Sever wall thickness reduction was noticed on the internal pipe surface. Scanning electron microscopy observations at the fracture surface revealed features of ductile fracture mode. Corrosion product analysis showed the traces of iron carbonate and iron sulphate. The laboratory analysis resulted in the conclusion that the pipe failed due to the effect of wet fluid (condensate) caused severe wall thickness dissolution resulted in pipe could not stand the continuation at in-service working condition.

Keywords: gas line pipe, corrosion prediction ductile fracture, ductile fracture, failure analysis

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2794 Empirical Investigation for the Correlation between Object-Oriented Class Lack of Cohesion and Coupling

Authors: Jehad Al Dallal

Abstract:

The design of the internal relationships among object-oriented class members (i.e., attributes and methods) and the external relationships among classes affects the overall quality of the object-oriented software. The degree of relatedness among class members is referred to as class cohesion and the degree to which a class is related to other classes is called class coupling. Well designed classes are expected to exhibit high cohesion and low coupling values. In this paper, using classes of three open-source Java systems, we empirically investigate the relation between class cohesion and coupling. In the empirical study, five lack-of-cohesion metrics and eight coupling metrics are considered. The empirical study results show that class cohesion and coupling internal quality attributes are inversely correlated. The strength of the correlation highly depends on the cohesion and coupling measurement approaches.

Keywords: class cohesion measure, class coupling measure, object-oriented class, software quality

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2793 Context-Aware Alert Method in Hajj Pilgrim Location-Based Tracking System

Authors: Syarif Hidayat

Abstract:

As millions of people with different backgrounds perform hajj every year in Saudi Arabia, it brings out several problems. Missing people is among many crucial problems need to be encountered. Some people might have had insufficient knowledge of using tracking system equipment. Other might become a victim of an accident, lose consciousness, or even died, prohibiting them to perform certain activity. For those reasons, people could not send proper SOS message. The major contribution of this paper is the application of the diverse alert method in pilgrims tracking system. It offers a simple yet robust solution to send SOS message by pilgrims during Hajj. Knowledge of context aware computing is assumed herein. This study presents four methods that could be utilized by pilgrims to send SOS. The first method is simple mobile application contains only a button. The second method is based on behavior analysis based off GPS location movement anomaly. The third method is by introducing pressing pattern to smartwatch physical button as a panic button. The fourth method is by identifying certain accelerometer pattern recognition as a sign of emergency situations. Presented method in this paper would be an important part of pilgrims tracking system. The discussion provided here includes easy to use design whilst maintaining tracking accuracy, privacy, and security of its users.

Keywords: context aware computing, emergency alert system, GPS, hajj pilgrim tracking, location-based services

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2792 Arc Flash Analysis: Technique to Mitigate Fire Incidents in Substations

Authors: M. H. Saeed, M. Rasool, M. A. Jawed

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Arc Flash Analysis has been a subject of great interest since the electrical fire incidents have been reduced to a great extent after the implementation of arc flash study at different sites. An Arc flash in substations is caused by short circuits over the air or other melted conductors and small shrapnel. Arc flash incidents result in the majority of deaths in substations worldwide. Engro Fertilizers Limited (EFERT) site having a mix of vintage non-internal arc rated and modern arc rated switchgears, carried out an arc flash study of the whole site in accordance with NFPA70E standard. The results not only included optimizing site protection coordination settings but also included marking of Shock and Arc flash protection boundaries in all switchgear rooms. Work permit procedures upgradation is also done in accordance with this study to ensure proper arc rated PPEs and arc flash boundaries protocols are fully observed and followed. With the new safety, protocols working on electrical equipment will be much safer than ever before.

Keywords: Arc flash, non-internal arc rated, protection coordination, shock boundary

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2791 Role of Internal and External Factors in Preventing Risky Sexual Behavior, Drug and Alcohol Abuse

Authors: Veronika Sharok

Abstract:

Research relevance on psychological determinants of risky behaviors is caused by high prevalence of such behaviors, particularly among youth. Risky sexual behavior, including unprotected and casual sex, frequent change of sexual partners, drug and alcohol use lead to negative social consequences and contribute to the spread of HIV infection and other sexually transmitted diseases. Data were obtained from 302 respondents aged 15-35 which were divided into 3 empirical groups: persons prone to risky sexual behavior, drug users and alcohol users; and 3 control groups: the individuals who are not prone to risky sexual behavior, persons who do not use drugs and the respondents who do not use alcohol. For processing, we used the following methods: Qualitative method for nominative data (Chi-squared test) and quantitative methods for metric data (student's t-test, Fisher's F-test, Pearson's r correlation test). Statistical processing was performed using Statistica 6.0 software. The study identifies two groups of factors that prevent risky behaviors. Internal factors, which include the moral and value attitudes; significance of existential values: love, life, self-actualization and search for the meaning of life; understanding independence as a responsibility for the freedom and ability to get attached to someone or something up to a point when this relationship starts restricting the freedom and becomes vital; awareness of risky behaviors as dangerous for the person and for others; self-acknowledgement. External factors (prevent risky behaviors in case of absence of the internal ones): absence of risky behaviors among friends and relatives; socio-demographic characteristics (middle class, marital status); awareness about the negative consequences of risky behaviors; inaccessibility to psychoactive substances. These factors are common for proneness to each type of risky behavior, because it usually caused by the same reasons. It should be noted that if prevention of risky behavior is based only on elimination of external factors, it is not as effective as it may be if we pay more attention to internal factors. The results obtained in the study can be used to develop training programs and activities for prevention of risky behaviors, for using values preventing such behaviors and promoting healthy lifestyle.

Keywords: existential values, prevention, psychological features, risky behavior

Procedia PDF Downloads 250
2790 A Study on Employer Branding and Its Impacts on Employee’s

Authors: KVNKC Sharma, Soujanya Pasumarthi

Abstract:

Globalization, coupled with increase in competition is compelling organizations to adopt innovative strategies and identify core competencies in order to distinguish themselves from the competition. The capability of an organization is no longer determined by their products or services alone. The intellectual assets and quality of the human resource are fast emerging as key differentiators. Corporations are now positioning themselves as ‘brands’ not solely to market their products and services, but also to lure and to retain the best talent in the business. This paper identifies leadership as the ‘key element’ in developing an organization’s brand, which has a significant influence on the employee’s eventual perception of this external brand as portrayed by the organization. External branding incorporates innovation, consumer concern, trust, quality and sustainability. The paper contends that employees are indeed an organization’s ‘brand ambassadors. Internal branding involves taking care of these ambassadors of corporate brand i.e. human resource. If employees of an organization are not exposed to the organization’s branding (an ongoing process that functionally aligns, motivates and empower employees at all levels to consistently provide a satisfying customer experience), the external brand could be jeopardized. Internal branding, on the other hand, refers to employee’s perception of the organization’s brand. The current business environment can at best, be termed as volatile. Employees with the right technical and behavioral skills remain a scarce resource and the employers need to be ready to capture the attention, interest and commitment of the best and brightest candidates. This paper attempts to review and understand the relationship between employer branding and employee retention. The paper also seeks to identify potential impact of employer branding across all the factors affecting employees.

Keywords: alignment, external branding, internal branding, leadership

Procedia PDF Downloads 285
2789 A Review of the Potential Impact of Employer Branding on Employee

Authors: K. V. N. K. C. Sharma

Abstract:

Globalization, coupled with increase in competition is compelling organizations to adopt innovative strategies and identify core competencies in order to distinguish themselves from the competition. The capability of an organization is no longer determined by their products or services alone. The intellectual assets and quality of the human resource are fast emerging as key differentiators. Corporations are now positioning themselves as ‘brands’ not solely to market their products and services, but also to lure and to retain the best talent in the business. This paper identifies leadership as the ‘key element’ in developing an organization’s brand, which has a significant influence on the employee’s eventual perception of this external brand as portrayed by the organization. External branding incorporates innovation, consumer concern, trust, quality and sustainability. The paper contends that employees are indeed an organization’s ‘brand ambassadors. Internal branding involves taking care of these ambassadors of corporate brand i.e. human resource. If employees of an organization are not exposed to the organization’s branding (an ongoing process that functionally aligns, motivates and empower employees at all levels to consistently provide a satisfying customer experience), the external brand could be jeopardized. Internal branding, on the other hand, refers to employee’s perception of the organization’s brand. The current business environment can at best, be termed as volatile. Employees with the right technical and behavioral skills remain a scarce resource and the employers need to be ready to capture the attention, interest and commitment of the best and brightest candidates. This paper attempts to review and understand the relationship between employer branding and employee retention. The paper also seeks to identify potential impact of employer branding across all the factors affecting employees.

Keywords: external branding, organisation personnel, internal branding, leadership

Procedia PDF Downloads 228
2788 Upgrades for Hydric Supply in Water System Distribution: Use of the Bayesian Network and Technical Expedients

Authors: Elena Carcano, James Ball

Abstract:

This work details the strategies adopted by the Italian Water Utilities during the distribution of water in emergency conditions which glide from earthquakes and droughts to floods and fires. Several water bureaus located over the national territory have been interviewed, and the collected information has been used in a database of potential interventions to be taken. The work discusses the actions adopted by water utilities. These are generally prioritized in order to minimize the social, temporal, and economic burden that the damaged and nearby areas need to support. Actions are defined relying on the Bayesian Network Approach, which constitutes the hard core of any decision support system. The Bayesian Networks give answers to interventions to real and most likely risky cases. The added value of this research consists in supplying the National Bureau, namely Protezione Civile, in charge of managing havoc and catastrophic situations with a univocal plot outline so as to be able to handle actions uniformly at the expense of different local laws or contradictory customs which squander any recovery conditions, proper technical service, and economic aids. The paper is organized as follows: in section 1, the introduction is stated; section 2 provides a brief discussion of BNNs (Bayesian Networks), section 3 introduces the adopted methodology; and in the last sections, results are presented, and conclusions are drawn.

Keywords: hierarchical process, strategic plan, water emergency conditions, water supply

Procedia PDF Downloads 143
2787 Recovery of an Area Degraded by Gullies in the Municipality of Monte Alto (SP), Brazil

Authors: Layane Sara Vieira, Paulo Egidio Bernardo, Roberto Saverio Souza Costa

Abstract:

Anthropogenic occupations and agricultural explorations without concern for the preservation and sustainability of the activity result in soil degradation that can make rural activity unfeasible. The objective of this work was to characterize and evaluate the recovery costs of an area degraded by major erosion (gully) in the municipality of Monte Alto (SP). Topographic characterization was carried out by means of a planialtimetric survey with a total station. The contours of the gully, internal area, slope height, contribution area, volume, and costs of operations for the recovery of the gully were delimited. The results obtained showed that the gully has a length of 145.56 m, a maximum width of 36.61 m, and a gap of 19.48 m. The external area of the gully is 1,039.8741 m², and the internal area is 119.3470 m². The calculated volume was 3,282.63 m³. The intervention area for breaking slopes was measured at 8,471.29 m², requiring the construction of 19 terraces in this area, vertically spaced at 2.8 m. The estimated costs for mechanical recovery of the gully were R$ 19,167.84 (US$ 3.657,98).

Keywords: erosion, volumetric assessment, soil degradation, terraces

Procedia PDF Downloads 91
2786 Evaluation of the Safety and Performance of Blood Culture Practices Using BD Safety-Lokᵀᴹ Blood Collection Sets in the Emergency Room

Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

Abstract:

Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

Procedia PDF Downloads 190
2785 The Impact of HRM Practices and Brand Performance on Financial Institution Performance: An Empirical Study

Authors: M. Khasro Miah, Chowdhury Hossan Golam, Muhammed Siddique Hossain

Abstract:

Recently, financial institution brand image is turning out to be pretty weak due to the presence of strong local competitors and this in term is affecting their firm performance also. In this study, four major HR practices, namely employee commitment, empowerment, loyalty, and engagement are considered in order to measure its effects on the brand and financial performance of banking organization. This study finds that the banking institutions of Bangladesh are more customer oriented rather than internal employee oriented, which makes it quite obvious that the internal HR practices will have little or no effect on the banks brand performance. Employee Commitment has emerged out to be the most important predictor, followed by employee loyalty and empowerment. The employees are well-empowered, engaged, and shows loyalty towards the organization, but their activities are not well linked with the brand. Firms should concentrate to create a congenial working atmosphere and employees should feel like a part of the organization.

Keywords: HR in bank, employee commitment, empowerment, finance, employee commitment, loyalty and engagement

Procedia PDF Downloads 464
2784 Analysis of the Acoustic Performance of Vertical Internal Seals with Pet Wool as NBR 15.575-4NO Green Towers Building-DF

Authors: Lucas Aerre, Wallesson Faria, Roberto Pimentel, Juliana Santos

Abstract:

An extremely disturbing and irritating element in the lives of people and organizations is the noise, the consequences that can bring us has a lot of connection with human health as well as financial and economic aspects. In order to improve the efficiency of buildings in Brazil in general, a performance standard was created, NBR 15.575 in which all buildings are seen in a more systemic and peculiar way, while following the requirements of the standard. The acoustic performance present in these buildings is one such requirement. Based on this, the present work was elaborated with the objective of evaluating through acoustic measurements the acoustic performance of vertical internal fences that are under the incidence of aerial noise of a building in the city of Brasilia-DF. A short theoretical basis is made and soon after the procedures of measurement are described through the control method established by the standard, and its results are evaluated according to the parameters of the same. The measurement performed between rooms of the same unit, presented a standardized sound pressure level difference (D nT, w) equal to 40 dB, thus being classified within the minimum performance required by the standard in question.

Keywords: airborne noise, performance standard, soundproofing, vertical seal

Procedia PDF Downloads 288
2783 A Comparative Analysis of Evacuation Behavior in Case of Cyclone Sidr, Typhoon Yolanda and the Great East Japan Earthquake

Authors: Swarnali Chakma, Akihiko Hokugo

Abstract:

Research on three case studies reviewed here explains many aspects and complications of evacuation behavior during an emergency period. The scenario and phenomenon of the disaster were different, but the similarities are that after receiving the warning peoples does not take it seriously. Many individuals evacuated after taking some kind of action, for example; return to home, searching for family members, prepared valuable things etc. Based on a review of the literature, the data identified a number of factors that help explain evacuation behavior during the disaster. In the case of Japan, cultural inhibitors impact people’s behavior; for example, following the traffic rules, some people lost their time to skip because of the slow-moving car makes overcrowded traffic and some of them were washed away by the tsunami. In terms of Bangladeshi culture, women did not want to evacuate without men because staying men and women who do not know each other under the same roof together is not regular practice or comfortable. From these three case studies, it is observed that early warning plays an important role in cyclones, typhoons and earthquakes. A high level of trust from residents in the warning system is important to real evacuation. It is necessary to raise awareness of disaster and provide information on the vulnerability to cyclones, typhoons and earthquakes hazards at community levels. The local level may help decision makers and other stakeholders to make a better decision regarding an effective disaster management.

Keywords: disaster management, emergency period, evacuation, shelter, typhoon

Procedia PDF Downloads 149
2782 Evaluation of Internal Friction Angle in Overconsolidated Granular Soil Deposits Using P- and S-Wave Seismic Velocities

Authors: Ehsan Pegah, Huabei Liu

Abstract:

Determination of the internal friction angle (φ) in natural soil deposits is an important issue in geotechnical engineering. The main objective of this study was to examine the evaluation of this parameter in overconsolidated granular soil deposits by using the P-wave velocity and the anisotropic components of S-wave velocity (i.e., both the vertical component (SV) and the horizontal component (SH) of S-wave). To this end, seventeen pairs of P-wave and S-wave seismic refraction profiles were carried out at three different granular sites in Iran using non-invasive seismic wave methods. The acquired shot gathers were processed, from which the P-wave, SV-wave and SH-wave velocities were derived. The reference values of φ and overconsolidation ratio (OCR) in the soil deposits were measured through laboratory tests. By assuming cross-anisotropy of the soils, the P-wave and S-wave velocities were utilized to develop an equation for calculating the coefficient of lateral earth pressure at-rest (K₀) based on the theory of elasticity for a cross-anisotropic medium. In addition, to develop an equation for OCR estimation in granular geomaterials in terms of SH/SV velocity ratios, a general regression analysis was performed on the resulting information from this research incorporated with the respective data published in the literature. The calculated K₀ values coupled with the estimated OCR values were finally employed in the Mayne and Kulhawy formula to evaluate φ in granular soil deposits. The results showed that reliable values of φ could be estimated based on the seismic wave velocities. The findings of this study may be used as the appropriate approaches for economic and non-invasive determination of in-situ φ in granular soil deposits using the surface seismic surveys.

Keywords: angle of internal friction, overconsolidation ratio, granular soils, P-wave velocity, SV-wave velocity, SH-wave velocity

Procedia PDF Downloads 149
2781 The Yield of Neuroimaging in Patients Presenting to the Emergency Department with Isolated Neuro-Ophthalmological Conditions

Authors: Dalia El Hadi, Alaa Bou Ghannam, Hala Mostafa, Hana Mansour, Ibrahim Hashim, Soubhi Tahhan, Tharwat El Zahran

Abstract:

Introduction: Neuro-ophthalmological emergencies require prompt assessment and management to avoid vision or life-threatening sequelae. Some would require neuroimaging. Most commonly used are the CT and MRI of the Brain. They can be over-used when not indicated. Their yield remains dependent on multiple factors relating to the clinical scenario. Methods: A retrospective cross-sectional study was conducted by reviewing the electronic medical records of patients presenting to the Emergency Department (ED) with isolated neuro-ophthalmologic complaints. For each patient, data were collected on the clinical presentation, whether neuroimaging was performed (and which type), and the result of neuroimaging. Analysis of the performed neuroimaging was made, and its yield was determined. Results: A total of 211 patients were reviewed. The complaints or symptoms at presentation were: blurry vision, change in the visual field, transient vision loss, floaters, double vision, eye pain, eyelid droop, headache, dizziness and others such as nausea or vomiting. In the ED, a total of 126 neuroimaging procedures were performed. Ninety-four imagings (74.6%) were normal, while 32 (25.4%) had relevant abnormal findings. Only 2 symptoms were significant for abnormal imaging: blurry vision (p-value= 0.038) and visual field change (p-value= 0.014). While 4 physical exam findings had significant abnormal imaging: visual field defect (p-value= 0.016), abnormal pupil reactivity (p-value= 0.028), afferent pupillary defect (p-value= 0.018), and abnormal optic disc exam (p-value= 0.009). Conclusion: Risk indicators for abnormal neuroimaging in the setting of neuro-ophthalmological emergencies are blurred vision or changes in the visual field on history taking. While visual field irregularities, abnormal pupil reactivity with or without afferent pupillary defect, or abnormal optic discs, are risk factors related to physical testing. These findings, when present, should sway the ED physician towards neuroimaging but still individualizing each case is of utmost importance to prevent time-consuming, resource-draining, and sometimes unnecessary workup. In the end, it suggests a well-structured patient-centered algorithm to be followed by ED physicians.

Keywords: emergency department, neuro-ophthalmology, neuroimaging, risk indicators

Procedia PDF Downloads 165
2780 3D-Printing Compressible Macroporous Polymer Using Poly-Pickering-High Internal Phase Emulsions as Micromixer

Authors: Hande Barkan-Ozturk, Angelika Menner, Alexander Bismarck

Abstract:

Microfluidic mixing technology grew rapidly in the past few years due to its many advantages over the macro-scale mixing, especially the ability to use small amounts of internal volume and also very high surface-to-volume ratio. The Reynold number identify whether the mixing is operated by the laminar or turbulence flow. Therefore, mixing with very fast kinetic can be achieved by diminishing the channel dimensions to decrease Reynold number and the laminar flow can be accomplished. Moreover, by using obstacles in the micromixer, the mixing length and the contact area between the species have been increased. Therefore, the channel geometry and its surface property have great importance to reach satisfactory mixing results. Since poly(-merised) High Internal Phase Emulsions (polyHIPEs) have more than 74% porosity and their pores are connected each other with pore throats, which cause high permeability, they are ideal candidate to build a micromixer. The HIPE precursor is commonly produced by using an overhead stirrer to obtain relatively large amount of emulsion in batch process. However, we will demonstrate that a desired amount of emulsion can be prepared continuously with micromixer build from polyHIPE, and such HIPE can subsequently be employed as ink in 3D printing process. In order to produce the micromixer a poly-Pickering(St-co-DVB)HIPE with 80% porosity was prepared with modified silica particles as stabilizer and surfactant Hypermer 2296 to obtain open porous structure and after coating of the surface, the three 1/16' ' PTFE tubes to transfer continuous (CP) and internal phases (IP) and the other is to collect the emulsion were placed. Afterwards, the two phases were injected in the ratio 1:3 CP:IP with syringe dispensers, respectively, and highly viscoelastic H(M)IPE, which can be used as an ink in 3D printing process, was gathered continuously. After the polymerisation of the resultant emulsion, polyH(M)IPE has interconnected porous structure identical to the monolithic polyH(M)IPE indicating that the emulsion can be prepared constantly with poly-Pickering-HIPE as micromixer and it can be used to prepare desired pattern with a 3D printer. Moreover, the morphological properties of the emulsion can be adjustable by changing flow ratio, flow speed and structure of the micromixer.

Keywords: 3D-Printing, emulsification, macroporous polymer, micromixer, polyHIPE

Procedia PDF Downloads 153