Search results for: hematology–oncology ward
368 Nursing System Development in Patients Undergoing Operation in 3C Ward
Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha
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Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.Keywords: development, nursing system, patients undergoing operation, 3C Ward
Procedia PDF Downloads 264367 Wind Velocity Climate Zonation Based on Observation Data in Indonesia Using Cluster and Principal Component Analysis
Authors: I Dewa Gede Arya Putra
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Principal Component Analysis (PCA) is a mathematical procedure that uses orthogonal transformation techniques to change a set of data with components that may be related become components that are not related to each other. This can have an impact on clustering wind speed characteristics in Indonesia. This study uses data daily wind speed observations of the Site Meteorological Station network for 30 years. Multicollinearity tests were also performed on all of these data before doing clustering with PCA. The results show that the four main components have a total diversity of above 80% which will be used for clusters. Division of clusters using Ward's method obtained 3 types of clusters. Cluster 1 covers the central part of Sumatra Island, northern Kalimantan, northern Sulawesi, and northern Maluku with the climatological pattern of wind speed that does not have an annual cycle and a weak speed throughout the year with a low-speed ranging from 0 to 1,5 m/s². Cluster 2 covers the northern part of Sumatra Island, South Sulawesi, Bali, northern Papua with the climatological pattern conditions of wind speed that have annual cycle variations with low speeds ranging from 1 to 3 m/s². Cluster 3 covers the eastern part of Java Island, the Southeast Nusa Islands, and the southern Maluku Islands with the climatological pattern of wind speed conditions that have annual cycle variations with high speeds ranging from 1 to 4.5 m/s².Keywords: PCA, cluster, Ward's method, wind speed
Procedia PDF Downloads 195366 Noise Pollution in Nigerian Cities: Case Study of Bida, Nigeria
Authors: Funke Morenike Jiyah, Joshua Jiyah
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The occurrence of various health issues have been linked to excessive noise pollution in all works of life as evident in many research efforts. This study provides empirical analysis of the effects of noise pollution on the well-being of the residents of Bida Local Government Area, Niger State, Nigeria. The study adopted a case study research design, involving cross-sectional procedure. Field observations and medical reports were obtained to support the respondents’ perception on the state of their well-being. The sample size for the study was selected using the housing stock in the various wards. One major street in each ward was selected. A total of 1,833 buildings were counted along the sampled streets and 10% of this was selected for the administration of structured questionnaire.The environmental quality of the wards was determined by measuring the noise level using Testo 815 noise meters. The result revealed that Bariki ward which houses the GRA has the lowest noise level of 37.8 dB(A)while the noise pollution levels recorded in the other thirteen wards were all above the recommended levels. The average ambient noise level in sawmills, commercial centres, road junctions and industrial areas were above 90 dB(A). The temporal record from the Federal Medical Centre, Bida revealed that, apart from malaria, hypertension (5,614 outpatients) was the most prevalent health issue in 2013 alone. The paper emphasised the need for compatibility consideration in the choice of residential location, the use of ear muffler and effective enforcement of zoning regulations.Keywords: bida, decibels, environmental quality, noise, well-being
Procedia PDF Downloads 133365 Dependence of Premature Births from Periodontal Status of Pregnant Women
Authors: Sonila Robo, Ilma Robo, Eduart Kapaj, Saimir Heta
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Background: Early birth is 37 weeks or less, pregnancy maturity! Clinically active presence, or positive culture of vaginal secretions, means excessive production of cytokines and prostaglandins also encountered in amniotic fluid. Bacterial vaginosis appears with their clinical outbreak in a combination of bacteria. Some of these bacteria are basic members in the creation of bacterial plaque. Objective: The purpose of this study is to find the link between the presence of specific bacteria in the mouth, bacterial vaginosis as one of the causes of premature birth, and the latter. Methods: The study was applied to 30 pregnant women in the burden pathology ward at Fier maternity, divided into two groups. The first group consisting of 20 women in the 2-month period, August-September. The number of women in the ward was 10 days maximum! All women were treated with cortisone and serum IV, magnesium sulphate, antibiotic prophylaxis! Results: 55% of women were under the age of 25 and 45% of women were over the age of 25. The age effect is mentioned for classifying the diseases that causes Actinomyces. Under the age of 25, a teenager and a 25-year-old are chronically ill. The final index was G2! All females were positive for the presence of salicylic acid in saliva and vaginal secretions. Conclusions:Premature birth is a complex process with some gynecological reasons, but in high percentage of cases there is coverage with the presence of infection by Actinomyces Actinomycetemcomitans in the oral cavity, which depending on the age causes two different types of periodontitis with special characteristics.Keywords: early birth, periodontal status, bacterial vaginosis, actinomyces actinomycetemcomitans
Procedia PDF Downloads 87364 Real World Cancer Pain Incidence and Treatment in Daily Hospital
Authors: Alexandru Grigorescu, Alexandra Protesanu
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Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.Keywords: cancer pain, opioids, medical oncology, palliative care
Procedia PDF Downloads 65363 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London
Authors: Michael Adebayo, Saheed Lawal
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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality
Procedia PDF Downloads 84362 Using Multiomic Plasma Profiling From Liquid Biopsies to Identify Potential Signatures for Disease Diagnostics in Late-Stage Non-small Cell Lung Cancer (NSCLC) in Trinidad and Tobago
Authors: Nicole Ramlachan, Samuel Mark West
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Lung cancer is the leading cause of cancer-associated deaths in North America, with the vast majority being non-small cell lung cancer (NSCLC), with a five-year survival rate of only 24%. Non-invasive discovery of biomarkers associated with early-diagnosis of NSCLC can enable precision oncology efforts using liquid biopsy-based multiomics profiling of plasma. Although tissue biopsies are currently the gold standard for tumor profiling, this method presents many limitations since these are invasive, risky, and sometimes hard to obtain as well as only giving a limited tumor profile. Blood-based tests provides a less-invasive, more robust approach to interrogate both tumor- and non-tumor-derived signals. We intend to examine 30 stage III-IV NSCLC patients pre-surgery and collect plasma samples.Cell-free DNA (cfDNA) will be extracted from plasma, and next-generation sequencing (NGS) performed. Through the analysis of tumor-specific alterations, including single nucleotide variants (SNVs), insertions, deletions, copy number variations (CNVs), and methylation alterations, we intend to identify tumor-derived DNA—ctDNA among the total pool of cfDNA. This would generate data to be used as an accurate form of cancer genotyping for diagnostic purposes. Using liquid biopsies offer opportunities to improve the surveillance of cancer patients during treatment and would supplement current diagnosis and tumor profiling strategies previously not readily available in Trinidad and Tobago. It would be useful and advantageous to use this in diagnosis and tumour profiling as well as to monitor cancer patients, providing early information regarding disease evolution and treatment efficacy, and reorient treatment strategies in, timethereby improving clinical oncology outcomes.Keywords: genomics, multiomics, clinical genetics, genotyping, oncology, diagnostics
Procedia PDF Downloads 161361 Exploring Cannabis for Cancer Symptom Relief: An Australian Perspective
Authors: Jenny Jin
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Background: The therapeutic use of cannabis for cancer symptom control in Australia is gaining momentum, reflecting a broader global acceptance of its medicinal potential. Objective: This overview examines the historical context, current regulations, and clinical applications of cannabis in oncology within Australia. Methods: A historical analysis outlines the ancient and 19th-century medicinal uses of cannabis, followed by its prohibition in the early 20th century and subsequent resurgence in the late 20th century. The current legal framework under the therapeutic gods administration (TGA) is discussed. Results: Research indicates that cannabinoids, particularly THC and CBD, effectively alleviate pain, reduce chemotherapy-induced nausea and vomiting, stimulate appetite, and enhance overall quality of life for cancer patients. Despite these benefits, challenges such as dosing standardization, stigma, and access barriers persist. Conclusion: Continued clinical research, policy development, and educational initiatives are essential to optimize the use of cannabis in cancer care. A patient-centred approach, emphasizing interdisciplinary collaboration and informed decision-making, is crucial for improving therapeutic outcomes in this evolving field.Keywords: historical context of cannabis, symptom control in oncology patients, therapeutic benefits, outcome and future
Procedia PDF Downloads 13360 Black-Legged Tick (Ixodes Scapularis) Impacts on Hematology and Ectoparasite Communities of Peromyscus Mice
Authors: Erica Fellin, Albrecht Schulte-Hostedde
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As the climate warms, the black-legged tick’s (Ixodes scapularis) range expands further north in Ontario, Canada, reaching new host populations that have not previously interacted with this blood-feeding parasite. Peromyscus mice in these northern areas are unfamiliar and inexperienced to the effects of these ticks compared to their southern counterparts that have adapted to living with these organisms. The purpose of this study was to see if there is a difference in physiology between these two groups – deer mice living in areas where tick populations have established and deer mice living in black-legged tick-free environments – looking specifically to see if there is significant variation in hemoglobin levels, which can negatively impact how these mice function in their environment. Along with this, a comparison of the parasite community structure on these mice hosts was analyzed to see if ticks change the composition of these micro-environments. Blood samples were collected from individual mice from populations where black-legged ticks were either present or absent to assess haemoglobin levels. At the same time, ectoparasites were collected from these same mice to determine parasite loads and species diversity. Haemoglobin levels were found to be lower when tick loads were high, and parasite diversity appeared to be higher when ticks were absent. Since black-legged ticks are carriers of many pathogens that can be passed on to humans, including Lyme’s disease, it is important to understand their movement and distribution across Ontario as well as their interactions with their hosts (and co-occurring parasites) in their environments.Keywords: community ecology, hematology, hosts, parasites
Procedia PDF Downloads 141359 A Next Generation Multi-Scale Modeling Theatre for in silico Oncology
Authors: Safee Chaudhary, Mahnoor Naseer Gondal, Hira Anees Awan, Abdul Rehman, Ammar Arif, Risham Hussain, Huma Khawar, Zainab Arshad, Muhammad Faizyab Ali Chaudhary, Waleed Ahmed, Muhammad Umer Sultan, Bibi Amina, Salaar Khan, Muhammad Moaz Ahmad, Osama Shiraz Shah, Hadia Hameed, Muhammad Farooq Ahmad Butt, Muhammad Ahmad, Sameer Ahmed, Fayyaz Ahmed, Omer Ishaq, Waqar Nabi, Wim Vanderbauwhede, Bilal Wajid, Huma Shehwana, Muhammad Tariq, Amir Faisal
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Cancer is a manifestation of multifactorial deregulations in biomolecular pathways. These deregulations arise from the complex multi-scale interplay between cellular and extracellular factors. Such multifactorial aberrations at gene, protein, and extracellular scales need to be investigated systematically towards decoding the underlying mechanisms and orchestrating therapeutic interventions for patient treatment. In this work, we propose ‘TISON’, a next-generation web-based multiscale modeling platform for clinical systems oncology. TISON’s unique modeling abstraction allows a seamless coupling of information from biomolecular networks, cell decision circuits, extra-cellular environments, and tissue geometries. The platform can undertake multiscale sensitivity analysis towards in silico biomarker identification and drug evaluation on cellular phenotypes in user-defined tissue geometries. Furthermore, integration of cancer expression databases such as The Cancer Genome Atlas (TCGA) and Human Proteome Atlas (HPA) facilitates in the development of personalized therapeutics. TISON is the next-evolution of multiscale cancer modeling and simulation platforms and provides a ‘zero-code’ model development, simulation, and analysis environment for application in clinical settings.Keywords: systems oncology, cancer systems biology, cancer therapeutics, personalized therapeutics, cancer modelling
Procedia PDF Downloads 222358 Assessment of Urban Infrastructure and Health Using Principal Component Analysis and Geographic Information System: A Case of Ahmedabad, India
Authors: Anusha Vaddiraj Pallapu
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Across the globe, there is a steady increase in people residing in urban areas. Due to this increase in urban population, urban health is affecting. The major issues identified like overcrowding, air pollution, unhealthy diet, inadequate infrastructure, poor solid waste management systems and insufficient access to health facilities, these issues are gradually clearly observed in health statistics of diseases and deaths rapidly increase in urban areas. Therefore, the present study aims to assess the health statistics and infrastructure services at urban areas to know the cause and effect between Infrastructure, its management and diseases (water borne). Most of the Indian cities have the municipal boundaries, which authorized by their respective municipal corporations and development authorities. Generally, cities have various zones under which municipal wards exist. The paper focuses on the city Ahmedabad, at Gujarat state. Ahmedabad Municipal Corporation (AMC) is divided into six zones namely Central zone, West zone, New-West zone, East zone, North zone, and South zone. Each zone includes various wards within it. Incidence of diseases in Ahmadabad which are linked to infrastructure was identified such as water-borne diseases. Later on, the occurrence of water-borne diseases at urban area was examined at each zone level. The study methodology follows four steps i.e. 1) Pre-Field literature study: Study on Sewerage system in urban areas and its best practices and public health status globally and Indian scenario; 2) Field study: Data collection and interviews of stakeholders regarding heal status and issues at each zone and ward level; 3) Post field: Data analysis with qualitative description of each ward of zones, followed by correlation coefficient analysis between sewerage coverage, diseases and density of each ward using geographic information system mapping (GIS); 4) Identification of reasons: Affected health on each of zone and wards followed by correlation analysis on each reason. The results reveal that the health conditions in Ahmedabad municipal zones or boundaries are effected due to the slums created by the migrated people from various rural and urban areas. It is also observed that due to increase in population water supply and sewerage management is affecting. The overall effect on infrastructure is creating the health diseases which detailed in the paper using geographical information system in Indian city.Keywords: infrastructure, municipal wards, GIS, water supply, sewerage, medical facilities, water borne diseases
Procedia PDF Downloads 210357 Assessing the Impact of Pharmacist-Led Medication Therapy Management on Treatment Adherence and Clinical Outcomes in Cancer Patients: A Prospective Intervention Study
Authors: Omer Ibrahim Abdallh Omer
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Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.Keywords: cancer, medications adherence, medication therapy management, pharmacist
Procedia PDF Downloads 63356 Effects of Vitamin C and Spondias mombin Supplementation on Hematology, Growth, Egg Production Traits, and Eggshell Quality in Japanese Quails (Coturnix coturnix japonica) in a Hot-Humid Tropics
Authors: B. O. Oyebanji, I. O. Dudusola, C. T. Ademola, S. A. Olaniyan
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A 56 day study was conducted to evaluate the effect of dietary inclusion of Spondias mombin on hematological, growth, egg parameters and egg shell quality of Japanese quails, Cortunix cortunix japonica. One hundred birds were used for this study, and they were allocated randomly into 5 groups and replicated twice. Group 1 animals served as control without inclusion of extract, groups 2, 3, and 4 had 200 mg/kg, 400 mg/kg and 800 mg/kg inclusion of SM, group 5 had 600 mg/kg of vitamin C respectively. The birds were weighed weekly to determine weight change, the blood parameters analyzed at the completion of the experiment were PCV, Hb, RBC WBC, differential WBC count, MCH, MCH, and MCV were afterwards calculated from these parameters. 5 eggs were collected from each group and egg weight, eggshell weight, eggshell diameter, yolk weight, albumen weight, yolk diameter, yolk height, albumen percentage, yolk percentage and shell percentage were determined. There was no significant difference among the group for the hematological parameters measured and calculated. The egg weight and albumen weight of quails on 800 mg/kg was highest of all the groups, all other egg parameters measured showed no significant difference. The birds supplemented with Vitamin C had the highest weight gain (40.8±2.5 g) and the lowest feed conversion ratio (2.25). There was no mortality recorded in all the groups except in the SM800 group with 10% mortality. It can be concluded from this experiment that Vitamin C supplementation has positive effect on quail production in humid tropics and the inclusion of Spondias mombin leaf extract has a dose-dependent toxicity in quails.Keywords: hematology, quails, Spondias mombin, vitamin C
Procedia PDF Downloads 356355 The Effect of Loud Working Environment on Incidence of Back Pain
Authors: Marcel Duh, Jadranka Stricevic, David Halozan, Dusan Celan
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Back pain is not only the result of structural or biomechanical abnormalities of the spine but is also associated with cognitive and behavioral aspects of pain and thus represents biopsychosocial problem. Stressors are not only interpersonal conflicts, negative life events, and dangerous situations but also noise. Effects of noise on human beings are psychological (excitement, stress), sensory, and physiological. The harmful effects of noise can be seen in the 40-65 dB range and are manifested as fatigue, irritability, poor sleep and psychological discomfort of the worker. Within 65-90 dB range, body metabolism increases, oxygen consumption is higher, tachycardia and hypertension appear, and the tone of skeletal muscles increases. The purpose of the study was to determine whether the stress caused by noise at the work place increases the incidence of back pain. Measurements of noise levels were carried out in three different wards of social care institution. The measurement on each ward was repeated 3 times (total of 9 measurements) for 8 hours during the morning shift. The device was set up in the room where clients spent most of the day. The staff on the ward replied to the questionnaire consisting of closed type questions about basic demographic information and information about back pain. We find that noise levels as measured in our study had no statistically significant effect on the incidence of back pain (p = 0.90). We also find that health care workers who perceive their work as stressful, have more back pain than those who perceive their job as unstressful, but correlation is statistically insignificant (p = 0.682). With our study, we have proven findings of other authors, that noise level below 65 dB does not have a significant influence on the incidence of back pain.Keywords: health care workers, musculoskeletal disorder, noise, sick leave
Procedia PDF Downloads 120354 Validation of an Acuity Measurement Tool for Maternity Services
Authors: Cherrie Lowe
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The TrendCare Patient Dependency System is currently utilized by a large number of Maternity Services across Australia, New Zealand and Singapore. In 2012, 2013, and 2014 validation studies were initiated in all three countries to validate the acuity tools used for Women in Labour, and Postnatal Mothers and Babies. This paper will present the findings of the validation study. Aim: The aim of this study was to; Identify if the care hours provided by the TrendCare Acuity System was an accurate reflection of the care required by Women and Babies. Obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of Maternity care models in three countries. Method: A non-experimental action research methodology was used across four District Health Boards in New Zealand, two large public Australian Maternity services and a large tertiary Maternity service in Singapore. Standardized data collection forms and timing devices were used to collect Midwife contact times with Women and Babies included in the study. Rejection processes excluded samples where care was not completed/rationed. The variances between actual timed Midwife/Mother/Baby contact and actual Trend Care acuity times were identified and investigated. Results: 87.5% (18) of TrendCare acuity category timings matched the actual timings recorded for Midwifery care. 12.5% (3) of TrendCare night duty categories provided less minutes of care than the actual timings. 100% of Labour Ward TrendCare categories matched actual timings for Midwifery care. The actual times given for assistance to New Zealand independent Midwives in Labour Ward showed a significant deviation to previous studies demonstrating the need for additional time allocations in Trend Care. Conclusion: The results demonstrated the importance of regularly validating the Trend Care category timings with the care hours required, as variances to models of care and length of stay in Maternity units have increased Midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the Independent Midwife has increased substantially. Outcomes: As a consequence of this study changes were made to the night duty TrendCare Maternity categories, additional acuity indicators developed and times for assisting independent Midwives increased. The updated TrendCare version was delivered to Maternity services in 2014.Keywords: maternity, acuity, research, nursing workloads
Procedia PDF Downloads 378353 Socio Economy of Migrant Women Domestic Workers in India: A Study in Context of Mumbai City
Authors: Sunita Kumari, Abhishek Thakur
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Focusing on female migrant domestic workers from Jharkhand, this study looks at their life before and after migration in Mumbai city. Girls coming from the marginalised communities migrate through different means and organizations like placement agencies, religious institutions such as church, with the help of group of friends or relatives and so forth. Most of them due to low educational attainment get into the unorganized sector jobs such as domestic work. In this backdrop, the paper tries to understand the socio-economic condition of tribal migrant women engaged as the domestic workers in the M ward of Mumbai city. The paper tries to investigate the early life of migrant women domestic workers, explores the reasons behind their migration and also examines the changes in their status after their engagement as domestic workers. The paper argues that though the economic and political reasons are quite explicit but the role of social institutions is also significant in the process of migration of women domestic workers. The study was qualitative in nature where fifteen in depth interviews were conducted and to develop a profound understanding one Focus Group Discussion was carried out at M ward of Mumbai Municipal Corporation (Chembur East). To substantiate the findings, the secondary data was taken from the available resources. The findings of the study shows that situation in the family, lack of education, non availability of better economic opportunities and other factors forced them to migrate. The factors such as income in form of cash rather than in kind, attraction towards the Mumbai city and so on was also the reason behind migration. Finally, this study gives the ample opportunity to look at the lives of the women who are the part of the unorganised sector of our country. It further unbolts exploration in terms of social security legislation at the national level.Keywords: paid domestic work, women, migration, Mumbai city
Procedia PDF Downloads 384352 Preliminary Results of Psychiatric Morbidity for Oncology Outpatients
Authors: Camille Plant, Katherine McGill, Pek Ang
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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry
Procedia PDF Downloads 146351 The Effectiveness of Warm-Water Footbath on Fatigue in Cancer Patient Undergoing Chemotherapy
Authors: Yu-Wen Lin, Li-Ni Liu
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Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P < .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P < .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory
Procedia PDF Downloads 142350 Impact of Geomagnetic Variation over Sub-Auroral Ionospheric Region during High Solar Activity Year 2014
Authors: Arun Kumar Singh, Rupesh M. Das, Shailendra Saini
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The present work is an attempt to evaluate the sub-auroral ionospheric behavior under changing space weather conditions especially during high solar activity year 2014. In view of this, the GPS TEC along with Ionosonde data over Indian permanent scientific base 'Maitri', Antarctica (70°46′00″ S, 11°43′56″ E) has been utilized. The results suggested that the nature of ionospheric responses to the geomagnetic disturbances mainly depended upon the status of high latitudinal electro-dynamic processes along with the season of occurrence. Fortunately, in this study, both negative and positive ionospheric impact to the geomagnetic disturbances has been observed in a single year but in different seasons. The study reveals that the combination of equator-ward plasma transportation along with ionospheric compositional changes causes a negative ionospheric impact during summer and equinox seasons. However, the combination of pole-ward contraction of the oval region along with particle precipitation may lead to exhibiting positive ionospheric response during the winter season. Other than this, some Ionosonde based new experimental evidence also provided clear evidence of particle precipitation deep up to the low altitudinal ionospheric heights, i.e., up to E-layer by the sudden and strong appearance of E-layer at 100 km altitudes. The sudden appearance of E-layer along with a decrease in F-layer electron density suggested the dominance of NO⁺ over O⁺ at a considered region under geomagnetic disturbed condition. The strengthening of E-layer is responsible for modification of auroral electrojet and field-aligned current system. The present study provided a good scientific insight on sub-auroral ionospheric to the changing space weather condition.Keywords: high latitude ionosphere, space weather, geomagnetic storms, sub-storm
Procedia PDF Downloads 169349 Designing and Enacting an Adjunct Faculty Self-Study of Teaching Community
Authors: Anastasia P. Samaras, Allison Ward-Parsons, Beth Dalbec, Paula Cristina Azevedo, Anya Evmenova, Arvinder Johri, Lynne Scott Constantine, Lesley Smith
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Two cycles of qualitative data were collected. Cycle One sources included participant survey results, participant postings on Blackboard forums, facilitator memos, and meeting notes as well as reflections and notes from whole-group meetings.Keywords: adjunct faculty, professional development, self-study methodology, teaching
Procedia PDF Downloads 162348 Effectiveness of Using Multiple Non-pharmacological Interventions to Prevent Delirium in the Hospitalized Elderly
Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu
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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium
Procedia PDF Downloads 78347 Psychosocial Determinants of Quality of Life After Treatment For Colorectal Cancer - A Systematic Review
Authors: Lakmali Anthony, Madeline Gillies
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Purpose: Long-term survivorship in colorectal cancer (CRC) is increasing as mortality decreases, leading to increased focus on patient-reported outcomes such as quality of life (QoL). CRC patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment CRC patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 6,272 total participants (mean = 392, 58% male) with a mean age of 60.6 years. The European Organisation for Research and Treatment of Cancer QLQ-C30 was the most common measure of QoL (n=14, 82.3%). Most studies (n=15, 88.2%) found that emotional distress correlated with poor global QoL. This was most commonly measured with the Hospital Anxiety & Depression Scale (n=11, 64.7%). Other psychosocial factors associated with QoL were lack of social support, body image, and financial difficulties. Clinicopathologic determinants included presence of stoma and metastasis. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment CRC patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.Keywords: colorectal cancer, cancer surgery, quality of life, oncology, social determinants
Procedia PDF Downloads 89346 Inpatient Neonatal Deaths in Rural Uganda: A Retrospective Comparative Mortality Study of Labour Ward versus Community Admissions
Authors: Najade Sheriff, Malaz Elsaddig, Kevin Jones
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Background: Death in the first month of life accounts for an increasing proportion of under-five mortality. Advancement to reduce this number is being made across the globe; however, progress is slowest in sub-Saharan Africa. Objectives: The study aims to identify differences between neonatal deaths of inpatient babies born in a hospital facility in rural Uganda to those of neonates admitted from the community and to explore whether they can be used to risk stratify neonatal admissions. Results: A retrospective chart review was conducted on records for neonates admitted to the Special Care Baby Unit (SCBU) Kitovu Hospital from 1st July 2016 to 21st July 2017. A total of 442 babies were admitted and the overall neonatal mortality was 24.8% (40% inpatient, 37% community, 23% hospital referrals). 40% of deaths occurred within 24 hours of admission and the majority were male (63%). 43% of babies were hypothermic upon admission, a significantly greater proportion of which were inpatient babies born in labour ward (P=0.0025). Intrapartum related death accounted for ½ of all inpatient babies whereas complications of prematurity were the predominant cause of death in the community group (37%). Severe infection does not seem like a significant factor of mortality for inpatients (2%) as it does for community admissions (29%). Furthermore, with 52.5% of community admissions weighing < 1500g, very low birth weight (VLBW) may be a significant risk factor for community neonatal death. Conclusion: The neonatal mortality rate in this study is high, and the leading causes of death are all largely preventable. A high rate of inpatient birth asphyxiation indicates the need for good quality facility-based perinatal care as well as a greater focus on the management of hypothermia, such as Kangaroo care. Moreover, a reduction in preterm deliveries is necessary to reduce associated comorbidities, and monitoring for signs of infection is especially important for community admissions.Keywords: community, mortality, newborn, Uganda
Procedia PDF Downloads 187345 Rehabilitation Approach for Cancer Patients: Indication, Management and Outcome
Authors: Juliani Rianto, Emma Lumby, Tracey Smith
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Cancer patients’ survival are growing with the new approach and therapy in oncology medicine. Cancer is now a new chronic disease, and rehabilitation program has become an ongoing program as part of cancer care. The focus of Cancer rehabilitation is maximising person’s physical and emotional function, stabilising general health and reducing unnecessary hospital admission. In Australia there are 150000 newly diagnosed cancer every year, and the most common Cancer are prostate, Breast, Colorectal, Melanoma and Lung Cancer. Through referral from the oncology team, we recruited cancer patient into our cancer rehabilitation program. Patients are assessed by our multi-disciplinary team including rehabilitation specialist, physiotherapist, occupational therapist, dietician, exercise physiologist, and psychologist. Specific issues are identified, including pain, side effect of chemo and radiation therapy and mental well-being. The goals were identified and reassessed every fortnight. Common goals including nutritional status, improve endurance and exercise performance, working on balance and mobility, improving emotional and vocational state, educational program for insomnia and tiredness, and reducing hospitalisation are identified and assessed. Patients are given 2 hours exercise program twice a week for 6 weeks with focus on aerobic and weight exercises and education sessions. Patients are generally benefited from the program. The quality of life is improved, support and interaction from the therapist has played an important factor in directing patient for their goals.Keywords: cancer, exercises, benefit, mental health
Procedia PDF Downloads 60344 Sustaining Language Learning: A Case Study of Multilingual Writers' ePortfolios
Authors: Amy Hodges, Deanna Rasmussen, Sherry Ward
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This paper examines the use of ePortfolios in a two-course sequence for ESL (English as a Second Language) students at an international branch campus in Doha, Qatar. ePortfolios support the transfer of language learning, but few have examined the sustainability of that transfer across an ESL program. Drawing upon surveys and interviews with students, we analyze three case studies that complicate previous research on metacognition, language learning, and ePortfolios. Our findings have implications for those involved in ESL programs and assessment of student writing.Keywords: TESOL, electronic portfolios, assessment, technology
Procedia PDF Downloads 261343 Traumatic Spinal Cord Injury; Incidence, Prognosis and the Time-Course of Clinical Outcomes: A 12 Year Review from a Tertiary Hospital in Korea
Authors: Jeounghee Kim
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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.Keywords: spinal cord injury, complication, nursing, rehabilitation
Procedia PDF Downloads 210342 Therapeutic Potential of mAb KP52 in Human and Feline Cancers
Authors: Abigail Tan, Heng Liang Tan, Vanessa Ding, James Hui, Eng Hin Lee, Andre Choo
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Introduction: Comparative oncology investigates the similarities in spontaneous carcinogenesis between humans and animals, in order to identify treatments that can benefit these patients. Companion animals (CA), like canines and felines, are of special interest when it comes to studying human cancers due to their exposure to the same environmental factors and develop tumours with similar features. The purpose of this study is to explore the cross-reactivity of monoclonal antibodies (mAbs) across cancers in humans and CA. Material and Methods: A panel of CA mAbs generated in the lab was screened on multiple human cancer cell lines through flow cytometry to identify for positive binders. Shortlisted candidates were then characterised by biochemical and functional assays e.g., antibody-drug conjugate (ADC) and western blot assays, including glycan studies. Results: Candidate mAb KP52 was generated from whole-cell immunisation using feline mammary carcinoma. KP52 showed strong positive binding to human cancer cells, such as breast cancer and ovarian cancer. Furthermore, KP52 demonstrated strong killing ( > 50%) as an ADC with Saporin as the payload. Western blot results revealed the molecular weight of the antigen targets to be approximately 45kD and 50kD under reduced conditions. Glycan studies suggest that the epitope is glycan in nature, specifically an O-linked glycan. Conclusion: Candidate mAb KP52 has a therapeutic potential as an ADC against feline mammary cancer, human ovarian cancer, human mammary cancer, human pancreatic cancer, and human gastric cancer.Keywords: ADC, comparative oncology, mAb, therapeutic
Procedia PDF Downloads 173341 Evaluation of Antimicrobial Activity of Different Dithiolethiones
Authors: Zehour Rahmani, Messouda Dekmouche, Mohamed Hadjadj, Mokhtar Saidi
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In the last decades of the nineteenth century, the study of disease – causing microorganisms became concentrated on bacteria and largely institutionalized. In earlier years, the scientists interested in bacteria had originally been chemists like Pasteur, physicists like Tyndall, or botanists like Cohn and ward. For this reason, the objective of this research was to evaluate the potential of some dithiolethiones on standard microorganism strains as well as multi-drug resistant bacteria, which were isolated from hospitals. Recent studies have demonstrated, that several dithiolethione compounds, particularly (3H-1,2-dithiole-3-thione), exhibit the biological activities against several bacteria.Keywords: bacteria, dithiolethiones, microorganism, potential
Procedia PDF Downloads 318340 Outcome of Bowel Management Program in Patient with Spinal Cord Injury
Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan
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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program
Procedia PDF Downloads 243339 Improving Patient-Care Services at an Oncology Center with a Flexible Adaptive Scheduling Procedure
Authors: P. Hooshangitabrizi, I. Contreras, N. Bhuiyan
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This work presents an online scheduling problem which accommodates multiple requests of patients for chemotherapy treatments in a cancer center of a major metropolitan hospital in Canada. To solve the problem, an adaptive flexible approach is proposed which systematically combines two optimization models. The first model is intended to dynamically schedule arriving requests in the form of waiting lists whereas the second model is used to reschedule the already booked patients with the goal of finding better resource allocations when new information becomes available. Both models are created as mixed integer programming formulations. Various controllable and flexible parameters such as deviating the prescribed target dates by a pre-determined threshold, changing the start time of already booked appointments and the maximum number of appointments to move in the schedule are included in the proposed approach to have sufficient degrees of flexibility in handling arrival requests and unexpected changes. Several computational experiments are conducted to evaluate the performance of the proposed approach using historical data provided by the oncology clinic. Our approach achieves outstandingly better results as compared to those of the scheduling system being used in practice. Moreover, several analyses are conducted to evaluate the effect of considering different levels of flexibility on the obtained results and to assess the performance of the proposed approach in dealing with last-minute changes. We strongly believe that the proposed flexible adaptive approach is very well-suited for implementation at the clinic to provide better patient-care services and to utilize available resource more efficiently.Keywords: chemotherapy scheduling, multi-appointment modeling, optimization of resources, satisfaction of patients, mixed integer programming
Procedia PDF Downloads 167