Search results for: hospital service

Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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Authors: Hugo de Tarragon, Martine Hlady-Rispal, Gauthier Casteran

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Rooted in ethnographic research on city logistics, our paper examines how Logistics Service Providers (LSP) can move from a "subservient" posture to one of instigating the sustainable transformation of city logistics, using literature on sustainable city logistics. To do so, we start by providing a representation of the subservient posture adopted by LSPs during their interactions with stakeholders. We then mobilize ecosystem theories to analyze the follower posture LSP can adopt to ensure their financial, human, and environmental sustainability in a city logistics ecosystem. This study contributes to local authorities’ greater consideration/involvement of LSP in the definition of their city logistics strategy. It can also provide LSP with an insight into the transformations to be carried out to improve their sustainability. Finally, it encourages research projects aimed at exploring more precisely the value relationships between LSP and their stakeholders.

Keywords: city logistics, logistics service providers, sustainability, ecosystems, value creation

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Authors: Mehrshad Khosraviani, Sepehr Najjarpour

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Considering the usage of graph-based approaches in systems and synthetic biology, and the various types of ‎the graphs employed by them, a comprehensive graph library based ‎on the three-tier architecture (3TA) was previously introduced for full representation of the biological systems. Although proposing a 3TA-based graph library, three following reasons motivated us to redesign the graph ‎library based on the service-oriented architecture (SOA): (1) Maintaining the accuracy of the data related to an input graph (including its edges, its ‎vertices, its topology, etc.) without involving the end user:‎ Since, in the case of using 3TA, the library files are available to the end users, they may ‎be utilized incorrectly, and consequently, the invalid graph data will be provided to the ‎computer algorithms. However, considering the usage of the SOA, the operation of the ‎graph registration is specified as a service by encapsulation of the library files. In other words, overall control operations needed for registration of the valid data will be the ‎responsibility of the services. (2) Partitioning of the library product into some different parts: Considering 3TA, a whole library product was provided in general. While here, the product ‎can be divided into smaller ones, such as an AND/OR graph drawing service, and each ‎one can be provided individually. As a result, the end user will be able to select any ‎parts of the library product, instead of all features, to add it to a project. (3) Reduction of the complexities: While using 3TA, several other libraries must be needed to add for connecting to the ‎database, responsibility of the provision of the needed library resources in the SOA-‎based graph library is entrusted with the services by themselves. Therefore, the end user ‎who wants to use the graph library is not involved with its complexity. In the end, in order to ‎make ‎the library easier to control in the system, and to restrict the end user from accessing the files, ‎it was preferred to use the service-oriented ‎architecture ‎‎(SOA) over the three-tier architecture (3TA) and to redevelop the previously proposed graph library based on it‎.

Keywords: Bio-Design Automation, Biological System, Graph Library, Service-Oriented Architecture, Systems and Synthetic Biology

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Authors: Vithaya Intaraphimol

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This study investigates the relationship between employee’s job satisfaction and job performance of hotel’s employees in five-star hotels in Bangkok. This study used self-administration data collection from a sample of 400 employees of five-star hotels in Bangkok. The results indicated that there was a relationship between job satisfaction and job performance. In addition, dysfunctional conflict was related negatively to job satisfaction; meanwhile, functional conflict was related positively to job satisfaction. Moreover, there was a positive relationship between integrating, obliging, avoiding and compromising style and job satisfaction; however; dominating style had a negative relationship with job satisfaction and proved that job satisfaction tend to increase the positive emotion on job satisfaction in the service setting, consequently, employee has ability to deal with problems with more effectively and predictor of job satisfaction due to employee who satisfied with the job seems to remain in the organization and appearing to gain rewarding beneficial.

Keywords: conflict management, job satisfaction, job performance, service sector

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Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

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A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

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Authors: Modupe Beatrice Adeyinka

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French, as a foreign language in Nigeria, is pronounced to be the second official language and a compulsory subject in the primary school level; hence, colleges of education across the nation are saddled with the responsibility of training teachers for the subject. However, it has been observed that this policy has not been fully implemented, for French teachers in training, do face many challenges, of which translation is chief. In a bid to investigate the major cause of the perceived translation problem, this study examined French translation problems of pre-service teachers in selected colleges of education in the southwest, Nigeria. This study adopted a descriptive survey research design. The simple random sampling technique was used to select four colleges of education in the southwest, where 100 French students were randomly selected by selecting 25 from each school. The pre-service teachers’ French translation problems’ questionnaire (PTFTPQ) was used as an instrument while four research questions were answered and three null hypotheses were tested. Among others, the findings revealed that students do have problems with false friends, though mainly with its interpretation when attempting French-English translation and vice versa; majority of the students make use of French dictionary as a way out and found the material very useful for their understanding of false friends. Teachers were, therefore, urged to attend in-service training where they would be exposed to new and emerging strategies, approaches and methodologies of French language teaching that will make students overcome the challenge of translation in learning French.

Keywords: false friends, French language, pre-service teachers, source language, target language, translation

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Authors: Hanan M. Taleb

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Energy consumption associated with buildings has a significant impact on the environment. To that end, and as a transaction between the inside and outside and between the building and urban space, the building skin plays an especially important role. It provides protection from the elements; demarcates private property and creates privacy. More importantly, it controls the admission of solar radiation. Therefore, designing the building skin sustainably will help to achieve optimal performance in terms of both energy consumption and thermal comfort. Unfortunately, with accelerating construction expansion, many recent buildings do not pay attention to the importance of the envelope design. This piece of research will highlight the importance of this part of the creation of buildings by providing evidence of a significant reduction in energy consumption if the envelopes are redesigned. Consequently, the aim of this paper is to enhance the performance of the hospital envelope in order to achieve sustainable performance. A hospital building sited in Abu Dhabi, in the UAE, has been chosen to act as a case study. A detailed analysis of the annual energy performance of the case study will be performed with the use of a computerised simulation; this is in order to explore their energy performance shortcomings. The energy consumption of the base case will then be compared with that resulting from the new proposed building skin. The results will inform architects and designers of the savings potential from various strategies.

Keywords: ASHREA, building skin, building envelopes, hospitals, Abu Dhabi, UAE, IES software

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Authors: Ndukwe, Chinedu O.

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

Keywords: geriatric, skin, Nigeria, histopathology

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Authors: Firdaous Zair, Zoubir Elfelsoufi, Mohammed Fourka

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The allocation of resources is an issue that is needed on the tactical and operational strategic plan. This work considers the allocation of resources in the case of pure players, manufacturers and Click & Mortars that have launched online sales. The aim is to improve the level of customer satisfaction and maintaining the benefits of e-retailer and of its cooperators and reducing costs and risks. Our contribution is a decision support system and tool for improving the allocation of resources in logistics chains e-commerce B2C context. We first modeled the B2C chain with all operations that integrates and possible scenarios since online retailers offer a wide selection of personalized service. The personalized services that online shopping companies offer to the clients can be embodied in many aspects, such as the customizations of payment, the distribution methods, and after-sales service choices. In addition, every aspect of customized service has several modes. At that time, we analyzed the optimization problems of supply chain resource allocation in customized online shopping service mode, which is different from the supply chain resource allocation under traditional manufacturing or service circumstances. Then we realized an optimization model and algorithm for the development based on the analysis of the allocation of the B2C supply chain resources. It is a multi-objective optimization that considers the collaboration of resources in operations, time and costs but also the risks and the quality of services as well as dynamic and uncertain characters related to the request.

Keywords: e-commerce, supply chain, B2C, optimisation, resource allocation

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Authors: Ji Young Lee, Jong Woon Kim

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It is essential to secure high availability of railway vehicles to realize high quality and efficiency of railway service. Once the availability decreased, planned railway service could not be provided or more cars need to be reserved. additional cars need to be purchased or the frequency of railway service could be decreased. Such situation would be a big loss in terms of quality and cost related to railway service. Therefore, we make various efforts to get high availability of railway vehicles. Because it is a big loss to operators, we make various efforts to get high availability of railway vehicles. To secure high availability, the idle time of the vehicle needs to be reduced and the following methods are applied to railway vehicles. First, through modularization design, exchange time for line replaceable units is reduced which makes railway vehicles could be put into the service quickly. Second, to reduce periodic preventive maintenance time, preventive maintenance with short period would be proceeded test oriented to minimize the maintenance time, and reliability is secured through overhauls for each main component. With such design changes for railway vehicles, modularized components are exchanged first at the time of vehicle failure or overhaul so that vehicles could be put into the service quickly and exchanged components are repaired or overhauled. Therefore, spare components are required for any future failures or overhauls. And, as components are modularized and costs for components are high, it is considerably important to get reasonable quantities of spare components. Especially, when a number of railway vehicles were put into the service simultaneously, the time of overhauls come almost at the same time. Thus, for some vehicles, components need to be exchanged and overhauled before appointed overhaul period so that these components could be secured as spare parts for the next vehicle’s component overhaul. For this reason, components overhaul time and spare parts quantities should be decided at the same time. This study deals with the time of overhauls for repairable components of railway vehicles and the calculation of spare parts quantities in consideration of future failure/overhauls. However, as railway vehicles are used according to the service schedule, maintenance work cannot be proceeded after the service was closed thus it is quite difficult to resolve this situation mathematically. In this study, Simulation software system is used in this study for analyzing the time of overhauls for repairable components of railway vehicles and the spare parts for the railway systems.

Keywords: overhaul time, rolling stocks, simulation, spare parts

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Authors: M. Velasco, D. While, P. Raju, J. Krasniewicz, A. Amini, L. Hernandez-Munoz

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Web service adaptation involves the creation of adapters that solve Web services incompatibilities known as mismatches. Since the importance of Web services adaptation is increasing because of the frequent implementation and use of online Web services, this paper presents a literature review of web services to investigate the main methods of adaptation, their theoretical underpinnings and the metrics used to measure adapters performance. Eighteen publications were reviewed independently by two researchers. We found that adaptation techniques are needed to solve different types of problems that may arise due to incompatibilities in Web service interfaces, including protocols, messages, data and semantics that affect the interoperability of the services. Although adapters are non-invasive methods that can improve Web services interoperability and there are current approaches for service adaptation; there is, however, not yet one solution that fits all types of mismatches. Our results also show that only a few research projects incorporate theoretical frameworks and that metrics to measure adapters’ performance are very limited. We conclude that further research on software adaptation should improve current adaptation methods in different layers of the service interoperability and that an adaptation theoretical framework that incorporates a theoretical underpinning and measures of qualitative and quantitative performance needs to be created.

Keywords: Web Services Adapters, software adaptation, web services mismatches, web services interoperability

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Authors: Fares Mahdi

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

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

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Authors: Moon-Tak Oh, Kyung-Min Park, Tae-Eun Yoon, Hoon Choi, Chil-Woo Lee

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This paper is about middle-ware which enables group-user applications on mobile devices in physical proximity to interact with other devices without intervention of a central server. Requirements of the middle-ware are identified from service usage scenarios, and the functional architecture of the middle-ware is specified. These requirements include group management, synchronization, and resource management. Group Management needs to provide various capabilities to such applications with respect to managing multiple users (e.g., creation of groups, discovery of group or individual users, member join/leave, election of a group manager and service-group association) using D2D communication technology. We designed the middle-ware for the above requirements on the Android platform.

Keywords: group user, middleware, mobile service, physical proximity

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Authors: Dimas Tri Anantyo, Zsa-Zsa Ayu Laksmi, Adhie Nur Radityo, Arsita Eka Rini, Gatot Irawan Sarosa

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A six-point-two-magnitude earthquake rocked Mamuju District, West Sulawesi Province, Indonesia, on 15 January 2021, causing significant health issues for the affected community, particularly among vulnerable populations such as neonates and children. The aim of this study is to examine and describe the diseases diagnosed in the pediatric population in Mamuju 14 days after the earthquake. This study uses a prospective observational study of the pediatric population presenting at West Sulawesi Regional Hospital, Mamuju Regional Public Hospital, and Bhayangkara Hospital for the period of 14 days after the earthquake. Demographic and clinical information were recorded. One hundred and fifty-three children were admitted to the health center. Children younger than six years old were the highest proportion (78%). Out of 153 children, 82 of them were male (54%). The most frequently diagnosed disease during the first and second weeks after the earthquake was respiratory problems, followed by gastrointestinal problems that showed an increase in incidence in the second week. This study found that age has a correlation with frequent disease in children after an earthquake. Respiratory and gastrointestinal problems were found to be the most common diseases among the pediatric population in Mamuju after the earthquake.

Keywords: health outcomes, pediatric population, earthquake, Mamuju

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Authors: Javad Sadidi, Ehsan Babaei, Hani Rezayan

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The advent of web 2.0 gives a possibility to scale down the costs of data collection and mapping, specifically if the process is done by volunteers. Every volunteer can be thought of as a free and ubiquitous sensor to collect spatial, descriptive as well as multimedia data for tourist services. The lack of large-scale information, such as real-time climate and weather conditions, population density, and other related data, can be considered one of the important challenges in developing countries for tourists to make the best decision in terms of time and place of travel. The current research aims to design and implement a spatiotemporal web map service using volunteer-submitted data. The service acts as a tourist-guide service in which tourists can search interested places based on their requested time for travel. To design the service, three tiers of architecture, including data, logical processing, and presentation tiers, have been utilized. For implementing the service, open-source software programs, client and server-side programming languages (such as OpenLayers2, AJAX, and PHP), Geoserver as a map server, and Web Feature Service (WFS) standards have been used. The result is two distinct browser-based services, one for sending spatial, descriptive, and multimedia volunteer data and another one for tourists and local officials. Local official confirms the veracity of the volunteer-submitted information. In the tourist interface, a spatiotemporal search engine has been designed to enable tourists to find a tourist place based on province, city, and location at a specific time of interest. Implementing the tourist-guide service by this methodology causes the following: the current tourists participate in a free data collection and sharing process for future tourists, a real-time data sharing and accessing for all, avoiding a blind selection of travel destination and significantly, decreases the cost of providing such services.

Keywords: VGI, tourism, spatiotemporal, browser-based, web mapping

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Authors: Mazoun Nasser Rashid Al Kharusi, Nada Al Siyabi

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Objectives: The main aim of this study is to Find the rate of susceptibility of ESBL E. coli causing UTI to oral antibiotics. Secondary objectives: Prevalence of ESBL E. coli from community urine samples, identify the best empirical oral antibiotics with the least resistance rate for UTI and identify alternative oral antibiotics for testing and utilization. Methods: This study is a retrospective descriptive study of the last three years in five major hospitals in Oman (Khowla Hospital, AN’Nahdha Hospital, Rustaq Hospital, Nizwa Hospital, and Ibri Hospital) equipped with a microbiologist. Inclusion criteria include all eligible outpatient urine culture isolates, excluding isolates from admitted patients with hospital-acquired urinary tract infections. Data was collected through the MOH database. The MOH hospitals are using different types of testing, automated methods like Vitek2 and manual methods. Vitek2 machine uses the principle of the fluorogenic method for organism identification and a turbidimetric method for susceptibility testing. The manual method is done by double disc diffusion for identifying ESBL and the disc diffusion method is for antibiotic susceptibility. All laboratories follow the clinical laboratory science institute (CLSI) guidelines. Analysis was done by SPSS statistical package. Results: Total urine cultures were (23048). E. coli grew in (11637) 49.6% of the urine, whereas (2199) 18.8% of those were confirmed as ESBL. As expected, the resistance rate to amoxicillin and cefuroxime is 100%. Moreover, the susceptibility of those ESBL-producing E. coli to nitrofurantoin, trimethoprim+sulfamethoxazole, ciprofloxacin and amoxicillin-clavulanate is progressing over the years; however, still low. ESBL E. coli was predominating in the female gender and those aged 66-74 years old throughout all the years. Other oral antibiotic options need to be explored and tested so that we add to the pool of oral antibiotics for ESBL E. coli causing UTI in the community. Conclusion: High rate of ESBL E. coli in urine from the community. The high resistance rates to oral antibiotics highlight the need for alternative treatment options for UTIs caused by these bacteria. Further research is needed to identify new and effective treatments for UTIs caused by ESBL-E. Coli.

Keywords: UTI, ESBL, oral antibiotics, E. coli, susceptibility

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Authors: Sandra Baßler, Peter Dünow, Mathias Marquardt

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A Fourier series based learning control (FSBLC) algorithm for tracking trajectories of mechanical systems with unknown nonlinearities is presented. Two processes are introduced to which the FSBLC with PD controller is applied. One is a simplified service robot capable of climbing stairs due to special wheels and the other is a propeller driven pendulum with nearly the same requirements on control. Additionally to the investigation of learning the feed forward for the desired trajectories some considerations on the implementation of such an algorithm on low cost microcontroller hardware are made. Simulations of the service robot as well as practical experiments on the pendulum show the capability of the used FSBLC algorithm to perform the task of improving control behavior for repetitive task of such mechanical systems.

Keywords: climbing stairs, FSBLC, ILC, service robot

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Authors: Silas Webb, Joseph Hartland

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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

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Authors: Babak Mohajeri

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In recent years, the conventional business model of ownership has been changed towards accessibility in a variety of markets. Two trends can be observed in the evolution of this rental-like business model. Firstly, the technological development that enables the emergence of new business models. These new business models increasingly become agile and flexible. For example Spotify, an online music stream company provides consumers access to over millions of music tracks, conveniently through the smartphone, tablet or computer. Similarly, Car2Go, the car sharing company accesses its members with flexible and nearby sharing cars. The second trend is the increasing communication and connections via social networks. This trend enables a shift to peer-to-peer accessibility based business models. Conventionally, companies provide access for their customers to own companies products or services. In peer-to-peer model, nonetheless, companies facilitate access and connection across their customers to use other customers owned property or skills, competencies or services .The is so-called the sharing economy business model. The aim of this study is to investigate into a new and emerging type of the sharing economy model in which role of customers and service providers may dramatically change. This new model is called Collaborative Service Networks. We propose a mechanism for Collaborative Service Networks business model. Uber and Airbnb, two successful growing companies, have been selected for our case studies and their business models are analyzed. Finally, we study the emergence of the collaborative service networks in the manufacturing domain. Our finding results to a new manufacturing paradigm called social manufacturing.

Keywords: sharing economy, collaborative service networks, social manufacturing, manufacturing development

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Authors: E. Tugba Topcu

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The emergency services are usually the first places to encounter forensic cases. Hence, it is important to consider forensics from the perspective of the emergency services staff and the physiological and psychological consequences that may arise as a result of behaviour by itself or another person. Accurate and detailed documentation of the situation in which the patient first arrives at the emergency service and preservation of the forensic findings is pivotal for the subsequent forensic investigation. The first step in determining whether or not a forensic case exists is to perform a medical examination of the patient. For each individual suspected to be part of a forensic case, police officers should be informed at the same time as the medical examination is being conducted. Violent events are increasing every year and with an increase in the number of forensic cases, emergency service workers have increasing responsibility and consequently play a key role in protecting, collecting and arranging the forensic evidence. In addition, because the emergency service workers involved in forensic events typically have information about the accused and/or victim, as well as evidence related to the events and the cause of injuries, police officers often require their testimony. However, both nurses and other health care personnel do not typically have adequate expertise in forensic medicine. Emergency nurses should take an active role for determining that whether any patient admitted to the emergency services is a clinical forensic patient the emergency service with injury and requiring possible punishment and knowing of their roles and responsibilities in this area provides legal protection as well as the protection of the judicial affair. Particularly, in emergency services, where rapid patient turnover and high workload exists, patient registration and case reporting may not exist. In such instances, the witnesses, typically the nurses, are often consulted for information. Knowledge of forensic medical matters plays a vital role in achieving justice. According to the Criminal Procedure Law, Article 75, Paragraph 3, ‘an internal body examination or the taking of blood or other biological samples from the body can be performed only by a doctor or other health professional member’. In favour of this item, the clinic nurse and doctor are mainly responsible for evaluating forensic cases in emergency departments, performing the examination, collecting evidence, and storing and reporting data. The courts place considerable importance on determining whether a suspect is the victim or accused and, thus, in terms of illuminating events, it is crucial that any evidence is gathered carefully and appropriately. All the evidence related to the forensic case including the forensic report should be handed over to the police officers. In instances where forensic evidence cannot be collected and the only way to obtain the evidence is the hospital environment, health care personnel in emergency services need to have knowledge about the diagnosis of forensic evidence, the collection of evidence, hiding evidence and provision of the evidence delivery chain.

Keywords: emergency department, emergency nursing, forensic cases, forensic nursing

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Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass

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Authors: A. Robbin

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In a multilingual setting like Nigeria, the success of service encounters is enhanced by the use of a language that ensures the linguistic and persuasive demands of the interlocutors. This study examined motivations for code switching as a negotiation strategy in bank-hall desk service encounters in Ìbàdàn metropolis using Myers-Scotton’s exploration on markedness in language use. The data consisted of transcribed audio recording of bank-hall service encounters, and direct observation of bank interactions in two purposively sampled commercial banks in Ìbàdàn metropolis. The data was subjected to descriptive linguistic analysis using Myers Scotton’s Markedness Model.  Findings reveal that code switching is frequently employed during different stages of service encounter: greeting, transaction and closing to fulfil relational, bargaining and referential functions. Bank staff and customers code switch to make unmarked, marked and explanatory choices. A strategy used to identify with customer’s cultural affiliation, close status gap, and appeal to begrudged customer; or as an explanatory choice with non-literate customers for ease of communication. Bankers select English to maintain customers’ perceptions of prestige which is retained or diverged from depending on their linguistic preference or ability.  Yoruba is seen as an efficient negotiation strategy with both bankers and their customers, making choices within conversation to achieve desired conversational and functional aims.

Keywords: banking, bilingualism, code-switching, markedness, service encounter

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Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Tuğçe Yavaş Akış

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In recent years, due to an increased use of radioactive materials, radioactive sources are constantly being transported via air, road and ocean ways for medical, industrial, research etc. purposes throughout the world. The quantity of radioactive materials transported all around the world varies from negligible quantities in shipments of consumer products to very large quantities in shipments of irradiated nuclear fuel. Radioactive materials have been less attractive for social science researchers in literature. In this study, it is aimed to discover desired flow of radioactive materials from logistics service quality (LSQ) perspective. In doing so, case study approach will be employed by using secondary data collected from one of the world’s leading transportation companies’ customer care system reports. Movement of radioactive cargoes containing IR-192 and logistics process will be analyzed with the help of logistics service quality dimensions. Based on the case study that will be conducted, interaction between dimensions, the importance of each dimension in desired flow, and their relevance with desired flow of radioactive materials will be explained. This study will bring out the desired flow of radioactive materials transportation and be a guide for all other companies, employees and researchers.

Keywords: logistics service quality, LSQ dimension , radioactive material, transportation

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Authors: K. Iskandar, N. H. Radzi, R. Aziz, M. S. Kamaruddin, M. N. Abdullah, S. A. Jumaat

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Nowadays many developing countries have been undergoing a restructuring process in the power electricity industry. This process has involved disaggregating former state-owned monopoly utilities both vertically and horizontally and introduced competition. The restructuring process has been implemented by the Australian National Electricity Market (NEM) started from 13 December 1998, began operating as a wholesale market for supply of electricity to retailers and end-users in Queensland, New South Wales, the Australian Capital Territory, Victoria and South Australia. In this deregulated market, one of the important issues is the transmission pricing. Transmission pricing is a service that recovers existing and new cost of the transmission system. The regulation of the transmission pricing is important in determining whether the transmission service system is economically beneficial to both side of the users and utilities. Therefore, an efficient transmission pricing methodology plays an important role in the Australian NEM. In this paper, the transmission pricing methodologies that have been implemented by the Australian NEM which are the Cost Reflective Network Pricing (CRNP) and Modified Cost Reflective Network Pricing (MCRNP) methods are investigated for allocating the transmission service charges to the transmission users. A case study using 6-bus system is used in order to identify the best method that reflects a fair and equitable transmission service charge.

Keywords: cost-reflective network pricing method, modified cost-reflective network pricing method, restructuring process, transmission pricing

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Authors: Won-Seok Kim, Hyung-Ik Shin

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Self-rated health (SRH) is a subjective assessment of individual health and has been identified as a strong predictor for mortality and morbidity. However few studies have been directed to the factors associated with SRH in persons with disabilities (PWD). We used data of 7th Korean national survey for 5307 PWD in 2008. Multiple logistic regression analysis was performed to find out independent risk factors for poor SRH in PWD. As a result, indicators of physical condition (poor instrumental ADL), socioeconomic disadvantages (poor education, economically inactive, low self-rated social class, medicaid in health insurance, presence of unmet need for hospital use) and social participation and networks (no use of internet service) were selected as independent risk factors for poor SRH in final model. Findings in the present study would be helpful in making a program to promote the health and narrow the gap of health status between the PWD.

Keywords: disabilities, risk factors, self-rated health, socioeconomic disadvantages, social networks

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Authors: Sumalee Tientongdee

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In this study, it was aimed to investigate Physics achievement of the pre-service science teacher studying in general science program at Suan Sunandha Rajabhat University, Bangkok, Thailand. The program has provided the new curriculum that focuses on 21st-century skills development. Active learning approaches are used to teach in all subjects. One of the active learning approaches Peer Instruction, or PI was used in this study to teach physics of waves as a compulsory course. It was conducted in the second semester from January to May of 2017. The concept test was given to evaluate pre-service science teachers’ understanding in concept of waves. Problem-solving assessment form was used to evaluate their problem-solving skill. The results indicated that after they had learned through Peer Instruction in physics of waves course, their concepts in physics of waves was significantly higher at 0.05 confident levels. Their problem-solving skill from the whole class was at the highest level. Based on the group interview on the opinions of using Peer Instruction in Physics class, they mostly felt that it was very useful and helping them understand more about physics, especially for female students.

Keywords: peer instruction, physics of waves, pre-service science teacher, Suan Sunandha Rajabhat university

Procedia PDF Downloads 340

Authors: Mohammed Abubakar Ndanusa, A. A. Hassan, R. W. Gimba, A. M. Alfa, M. T. Abari

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This study investigated the Impact of Mathematical Modeling on Mathematics Achievement, Attitude and Interest of Pre-Service Teachers in Niger States, Nigeria. It was an attempt to ease students’ difficulties in comprehending mathematics. The study used randomized pretest, posttest control group design. Two Colleges of Education were purposively selected from Niger State with a sample size of eighty-four 84 students. Three research instruments used are Mathematical Modeling Achievement Test (MMAT), Attitudes Towards Mathematical Modeling Questionnaire (ATMMQ) and Mathematical Modeling Students Interest Questionnaire (MMSIQ). Pearson Product Moment Correlation (PPMC) formula was used for MMAT and Alpha Cronbach was used for ATMMQ and MMSIQ to determine their reliability coefficient and the values the following values were obtained respectively 0.76, 0.75 and 0.73. Independent t-test statistics was used to test hypothesis One while Mann Whitney U-test was used to test hypothesis Two and Three. Findings revealed that students taught Mathematics using Mathematical Modeling performed better than their counterparts taught using lecture method. However, there was a significant difference in the attitude and interest of pre-service mathematics teachers after being exposed to mathematical modeling. The strategy, therefore, was recommended to be used by Mathematics teachers with a view to improving students’ attitude and interest towards Mathematics. Also, modeling should be taught at NCE level in order to prepare pre-service teachers towards real task in the field of Mathematics.

Keywords: achievement, attitude, interest, mathematical modeling, pre-service teachers

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Authors: Nadeem Yousuf Khan

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

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

Procedia PDF Downloads 115