Search results for: patient management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11879

Search results for: patient management

11009 Transforming Health Information from Manual to Digital (Electronic) World: A Reference and Guide

Authors: S. Karthikeyan, Naveen Bindra

Abstract:

Introduction: To update ourselves and understand the concept of latest electronic formats available for Health care providers and how it could be used and developed as per standards. The idea is to correlate between the patients Manual Medical Records keeping and maintaining patients Electronic Information in a Health care setup in this world. Furthermore this stands with adapting to the right technology depending upon the organization and improve our quality and quantity of Healthcare providing skills. Objective: The concept and theory is to explain the terms of Electronic Medical Record (EMR), Electronic Health Record (EHR) and Personal Health Record (PHR) and selecting the best technical among the available Electronic sources and software before implementing. It is to guide and make sure the technology used by the end users without any doubts and difficulties. The idea is to evaluate is to admire the uses and barriers of EMR-EHR-PHR. Aim and Scope: The target is to achieve the health care providers like Physicians, Nurses, Therapists, Medical Bill reimbursements, Insurances and Government to assess the patient’s information on easy and systematic manner without diluting the confidentiality of patient’s information. Method: Health Information Technology can be implemented with the help of Organisations providing with legal guidelines and help to stand by the health care provider. The main objective is to select the correct embedded and affordable database management software and generating large-scale data. The parallel need is to know how the latest software available in the market. Conclusion: The question lies here is implementing the Electronic information system with healthcare providers and organisation. The clinicians are the main users of the technology and manage us to ‘go paperless’. The fact is that day today changing technologically is very sound and up to date. Basically the idea is to tell how to store the data electronically safe and secure. All three exemplifies the fact that an electronic format has its own benefit as well as barriers.

Keywords: medical records, digital records, health information, electronic record system

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11008 The Research on Human Resource Management Problem of Turkish Fast Food Company

Authors: Mai Maitiaili Tuerdi

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Turkey is one of the countries in which fast food service is growing increasingly in the world. The emergence of KFC and McDonald's to Turkish market is affecting every aspects of local fast-food services. The Turkey's famous catering companies named "Simit Sarayi" and "Güllüoğlu" are famous for accepting the Western fast food management service and skills in order to increase their market share. Also, they have created their unique management skills in this field. In this paper, through empirical and comparative study method we will analyze the famous Turkish local fast-food companies and western human resource management. We will argue how to create and adapt the human resource management while the company is economically and socially growing.

Keywords: human resources management, Turkey, fast food, management

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11007 A Modified Open Posterior Approach for the Fixation of Posterior Cruciate Ligament Tibial Avulsion Fractures

Authors: Babak Mirzashahi, Arvin Najafi, Pejman Mansouri, Mahmoud Farzan

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Background: The most effective treatment of posterior cruciate ligament (PCL) tears and the consequence of untreated PCL injuries remain controversial. Objectives: The aim of this study is to assess outcomes of fixation of tibial posterior cruciate ligament (PCL) avulsion fractures via a modified technique. Patients and Methods: From January, 2009 to March, 2012, there were 45 cases of PCL tibial avulsion fractures that were referred to our hospital and were managed through a modified open posterior approach. Fixation of Tibial PCL avulsion fractures were fixed by means of a lag screw and washer placed through our modified open posterior approach. Range of motion was begun on the first postoperative day. Clinical stability, range of motion, gastrocnemius muscle strength, radiographic investigation, and patient’s overall quality of life was analyzed at final follow up visit. Results: The average of overall musculoskeletal functional evaluation scores was 15 (range 3–35). All patients achieved union of their fracture and had clinically stable knees at the latest follow-up. The mean preoperative Lysholm score for 15 knees was 62 ± 8 (range, 50-75); the mean postoperative Lysholm score was 92± 7 (range, 75-101). A significant difference in Lysholm scores between preoperative and final follow-up evaluations was found (P < .05). At first-year follow-up, 42 (93%) patients revealed a difference of less than 10 mm in thigh circumference between their injured and healthy knees. Conclusions: The management of displaced large PCL avulsion fractures with placement of a cancellous lag screw with washer by means of the modified open posterior approach leads to satisfactory clinical, radiographic, and functional results and reduces the operation time and less blood loss. Level of evidence: IV.

Keywords: posterior cruciate ligament, tibial fracture, lysholm knee score, patient outcome assessment

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11006 Use of Dual-Energy CT Post Endovascular Treatment of Cerebral Aneurysm

Authors: Mitchell Stanton

Abstract:

Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

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11005 Management of Blood Exposure Risk: Knowledge and Attitudes of Caregivers in Pediatric Dapartments

Authors: Hela Ghali, Oumayma Ben Amor, Salwa Khefacha, Mohamed Ben Rejeb, Sirine Frigui, Meriam Tourki Dhidah, Lamine Dhidah, Houyem Said Laatiri

Abstract:

Background: Blood exposure accidents are the most common problem in hospitals that threaten healthcare professionals with a high risk of infectious complications which weighs heavily on health systems worldwide. Paramedics are the highest risk group due to the nature of their daily activities. We aimed to determine knowledge and attitudes about the management of blood-exposure accidents among nurses and technicians in two pediatric departments. Materials/Methods: This is a cross-sectional descriptive study conducted on March 2017, carried out with the care staff of the pediatric ward of the Farhat Hached Teaching Hospital of Sousse and pediatric surgery of the Fattouma Bourguiba University Hospital in Monastir, using a pre- tested and self-administered questionnaire. Data entry and analysis were performed using Excel software. Results: The response rate was 85.1%. A female predominance (82.5%) was reported among respondents with a sex ratio of 0.21. 80% of the participants were under 35 years old. Seniority of less than 10 years was found in 77.5% of respondents. Only 22.5% knew the definition of a blood- exposure accident. 100% and 95% of participants reported the relative risk, respectively, to hepatitis and AIDS viruses. However, only 15% recognized the severity factors of a blood-exposure accident. Hygiene compliance was the most important dimension for almost the entire population for the prevention. On the other hand, only 12.5% knew the meaning of 'standard precautions' and ¼ considered them necessary for at-risk patients only. 40% reported being exposed at least once, among them, 87.5% used betadine, and 77.5% said that anti-infectious chemoprophylaxis is necessary regardless of the patient's serological status. However, 52.5% did not know the official reporting circuit of management of blood-exposure accident in their institutions. Conclusion: For better management of risks in hospitals and an improvement of the safety of the care, a reinforcement of the sensibilization of the caregivers with regard to the risks of blood exposure accident is necessary, while developing their knowledge to act in security.

Keywords: attitudes, blood-exposure accident, knowledge, pediatric department

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11004 Enterprise Risk Management: A Future Outlook

Authors: Ruchi Agarwal, Jake Ansell

Abstract:

Austerity impacts on all aspects of society. Companies into the future will have to be more capable of dealing with the risks they face. Enterprise Risk Management (ERM) has widely been accepted in recent years as an approach to manage risks within businesses. ERM attempts to tackle risk holistically with gains from opportunities in a managing risk and reduction in the risk of failure. The paper reviews merits and demerits of approaches to risk management in regard to antifragility. A qualitative study has investigated current practices and the problems with ERM implementation by interviewing over 25 chief risk officers and senior management. The findings indicate the gap in ERM description, understanding, and implementation. The paper suggests risk learning and expertise knowledge supports development of effective enterprise risk management by designing systems with inherent resilience.

Keywords: risk management, interviews, antifragility, failure

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11003 Biomedical Waste Management an Unsung Hero

Authors: Preeti Madan, Shalini Malhotra, Nirmaljit Kaur, Charoo Hans, VK Sabarwal

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Hospital is one of the most diverse and complex institutions frequented by people from every walk of life without any distinction between age, sex, gender, religion or intellect. This is over and above the normal inhabitant of hospital i.e. doctors, patients, and paramedical staff. The hospital waste generated 85% is non hazardous, 10% infectious and around 5% are non-infectious but hazardous waste. The management of biomedical waste is still in its infancy. There is a lot of confusion with the problems among the generators, operators, decision makers, and general community about the safe management of biomedical waste prompt action initiated to seek new scientific, safe, and cost-effective management of waste.

Keywords: biomedical waste, nosocomial infection, waste management, hospitals

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11002 Analysis of Solid Waste Management Practices and the Implications for Human Health and the Environment: A Case Study of Kayamandi Informal Settlement

Authors: Peter Iyobosa Asemota

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This study on solid waste management practices addressed aspects of environmental and health impacts resulting from poor management of solid waste. The study was occasioned by the observed rate and volume of illegal and indiscriminate dumping of solid waste materials especially in informal settlements. The main focus of this study was to establish the impact of waste management practices on human health and the environment. The study, therefore, presents a critical analysis of the state of solid waste management in the study area and the implications for human health and the environment. The study was carried out in Kayamandi informal settlement within Stellenbosch municipality. The sustainable management of solid waste is very important in order to minimize the environmental and public health risks associated with improper solid waste management. There is no denying the fact that the problems of waste management will become critical as time goes on because of improper and inefficient waste management practices. Towns and cities exhibit the burdens of waste management which is a characteristics feature of most African cities. The study critically assess the implementation of waste management practices by the residents of the informal settlement; identify the factors affecting management issues in the operation of solid waste management system by the municipality; identify factors militating against the implementation of waste management policies and legislation. Furthermore, a waste assessment study was carried out to assess the generation; composition of the waste stream and also determine the attitudes and behavior of the residents with regard to waste management practices. Findings from the study revealed that Kayamandi is not different from other informal settlements with regards to waste management. People are of the opinion that solid waste management is the sole responsibility of municipal authorities and as such, the government should be responsible for bearing the cost of solid waste management.

Keywords: environment, waste, waste composition, waste stream, policy, waste categories, sanitary landfill, waste collection, integrated solid waste management

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11001 Level of Application of Integrated Talent Management According To IBM Institute for Business Value Case Study Palestinian Governmental Agencies in Gaza Strip

Authors: Iyad A. A. Abusahloub

Abstract:

This research aimed to measure the level of perception and application of Integrated Talent Management according to IBM standards, by the upper and middle categories in Palestinian government institutions in Gaza, using a descriptive-analytical method. Using a questionnaire based on the standards of the IBM Institute for Business Value, the researcher added a second section to measure the perception of integrated talent management, the sample was 248 managers. The SPSS package was used for statistical analysis. The results showed that government institutions in Gaza apply Integrated Talent Management according to IBM standards at a medium degree did not exceed 59.8%, there is weakness in the perception of integrated talent management at the level of 53.6%, and there is a strong correlation between (Integrated Talent Management) and (the perception of the integrated talent management) amounted to 92.9%, and 88.9% of the change in the perception of the integrated talent management is by (motivate and develop, deploy and manage, connect and enable, and transform and sustain) talents, and 11.1% is by other factors. Conclusion: This study concluded that the integrated talent management model presented by IBM with its six dimensions is an effective model to reach your awareness and understanding of talent management, especially that it must rely on at least four basic dimensions out of the six dimensions: 1- Stimulating and developing talent. 2- Organizing and managing talent. 3- Connecting with talent and empowering it. 4- Succession and sustainability of talent. Therefore, this study recommends the adoption of the integrated talent management model provided by IBM to any organization across the world, regardless of its specialization or size, to reach talent sustainability.

Keywords: HR, talent, talent management, IBM

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11000 Challenges of Effective Management in Tetiary Institutions in Nigeria

Authors: Simon Oga Egboja, Agi Sunday

Abstract:

The government of Nigeria have invested so much in our tertiary education but the desire qualitative goals and objectives are yet to be achieved because management at all level are not efficient and effective in implementing the desired educational policies and programmes due to some management challenges. This paper investigates some of the major challenges to effective management of tertiary institution in Nigeria some variable that are important to effective management includes political stability, adequate funding, establishment of information system, recruitment and appointment of qualified teachers and condition of service.

Keywords: effective management includes political stability, adequate funding, establishment of information system, recruitment and appointment of qualified teachers

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10999 High Techno-Parks in the Economy of Azerbaijan and Their Management Problems

Authors: Rasim M. Alguliyev, Alovsat G. Aliyev, Roza O. Shahverdiyeva

Abstract:

The paper investigated the role and position of high techno-parks, which is one of the priorities of Azerbaijan. The main objectives, functions and features of the establishment of high-techno parks, as well as organization of the activity of the structural elements, which are the parking complex and their interactions were analyzed. The development, organization and management of high techno-parks were studied. The key features and functions of innovative structures’ management were explained. The need for a comprehensive management system for the development of high-techno parks was emphasized and the major problems were analyzed. In addition, the methods were proposed for the development of information systems supporting decision making in systematic and sustainable management of the parks.

Keywords: innovative development, innovation processes, innovation economy, innovation infrastructure, high technology park, efficient management, management decisions, information insurance

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10998 IT-Aided Business Process Enabling Real-Time Analysis of Candidates for Clinical Trials

Authors: Matthieu-P. Schapranow

Abstract:

Recruitment of participants for clinical trials requires the screening of a big number of potential candidates, i.e. the testing for trial-specific inclusion and exclusion criteria, which is a time-consuming and complex task. Today, a significant amount of time is spent on identification of adequate trial participants as their selection may affect the overall study results. We introduce a unique patient eligibility metric, which allows systematic ranking and classification of candidates based on trial-specific filter criteria. Our web application enables real-time analysis of patient data and assessment of candidates using freely definable inclusion and exclusion criteria. As a result, the overall time required for identifying eligible candidates is tremendously reduced whilst additional degrees of freedom for evaluating the relevance of individual candidates are introduced by our contribution.

Keywords: in-memory technology, clinical trials, screening, eligibility metric, data analysis, clustering

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10997 Interdisciplinary Teaching for Nursing Students: A Key to Understanding Teamwork

Authors: Ilana Margalith, Yaron Niv

Abstract:

One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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10996 A Histopathological Study on Leech (Hirudo medicinalis) Application in the Management of Vicarcikā (Eczema)

Authors: K. M. Pratap Shankar, Dattatreya Rao, Sai Prasad

Abstract:

Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with Histopathological study. Methods: For the present study 10 patients having the classical symptoms of Vicarcikā, were randomly selected as per the inclusion and exclusion criteria from O.P.D. & I.P.D. sections of Śalya department, S.V. Āyurvedic Hospital, Tirupati. Minimum 4 sittings of Leech application was carried out with seven days interval. Total duration of treatment was 6 weeks. Biopsy samples were collected from the lesion site before and after treatment. Histopathological examination was done by the pathologist. Results: In eczema (dermatitis) the leech application therapy gives excellent response by reducing the inflammatory component, hyperkeratosis, spongiosis, irregular acanthosis and by evoking a granulation tissue response in the dermis and in most of the cases with complete recovery from the lesion. Most of the cases in the study were chronic dermatitis and sebhoric keratosis, almost all local/focal pigmented lesions is totally relieved by leech therapy especially in cases of sebhoric keratosis. Conclusion: In the present study it was found that, leech application evokes significant changes at histological level specifically in reduction of inflammatory component, hyperkeratosis, spongiosis and irregular acanthosis. It was also found that there was a considerable formation of granulation tissue, which helps in formation of healthy new tissues.

Keywords: acanthosis, eczema, hyperkeratosis, leech application, spongiosis

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10995 Antepartum and Postpartum Pulmonary Cryptococcosis: A Case Report and Systematic Review

Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

Abstract:

Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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10994 Designing a Combined Outpatient and Day Treatment Eating Disorder Program for Adolescents and Transitional Aged Youth: A Naturalistic Case Study

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

Abstract:

Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

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10993 Teaching Method in Situational Crisis Communication Theory: A Literature Review

Authors: Proud Arunrangsiwed

Abstract:

Crisis management strategies could be found in various curriculums, not only in schools of business, but also schools of communication. Young students, such as freshmen and sophomores of undergraduate schools, may not care about learning crisis management strategies. Moreover, crisis management strategies are not a topic art students are familiar with. The current paper discusses a way to adapt entertainment media into a crisis management lesson, and the importance of learning crisis management strategies in the school of animation. Students could learn crisis management strategies by watching movies with content about a crisis and responding to crisis responding. The students should then participate in follow up discussions related to the strategies that were used to address the crisis, as well as their success in solving the crisis.

Keywords: situational crisis communication theory, crisis response strategies, media effect, unintentional effect

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10992 The Project Management for Quality Services in Special Education Schools

Authors: Aysegul Salikutluk, Zehra Altinay, Gokmen Dagli, Fahriye Altinay

Abstract:

The aim of the study is to reveal the performance of special education schools as regards the service quality and management within the school culture. The project management and school climate are the fundamental elements for the quality in organisations. Having strategic plans, activities and funded projects improve service quality and satisfaction for the families who have children with disabilities. The research has qualitative nature, self-reports were used to examine the perceptions of teachers upon project management and school climate for service quality. The results show that special education schools' teachers are aware of essence of school climate and flow of communication for service quality and project management.

Keywords: disability, education, service quality, project management

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10991 A Copula-Based Approach for the Assessment of Severity of Illness and Probability of Mortality: An Exploratory Study Applied to Intensive Care Patients

Authors: Ainura Tursunalieva, Irene Hudson

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Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

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10990 Investigating Knowledge Management in Financial Organisation: Proposing a New Model for Implementing Knowledge Management

Authors: Ziba R. Tehrani, Sanaz Moayer

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In the age of the knowledge-based economy, knowledge management has become a key factor in sustainable competitive advantage. Knowledge management is discovering, acquiring, developing, sharing, maintaining, evaluating, and using right knowledge in right time by right person in organization; which is accomplished by creating a right link between human resources, information technology, and appropriate structure, to achieve organisational goals. Studying knowledge management financial institutes shows the knowledge management in banking system is not different from other industries but because of complexity of bank’s environment, the implementation is more difficult. The bank managers found out that implementation of knowledge management will bring many advantages to financial institutes, one of the most important of which is reduction of threat to lose subsequent information of personnel job quit. Also Special attention to internal conditions and environment of the financial institutes and avoidance from copy-making in designing the knowledge management is a critical issue. In this paper, it is tried first to define knowledge management concept and introduce existing models of knowledge management; then some of the most important models which have more similarities with other models will be reviewed. In second step according to bank requirements with focus on knowledge management approach, most major objectives of knowledge management are identified. For gathering data in this stage face to face interview is used. Thirdly these specified objectives are analysed with the response of distribution of questionnaire which is gained through managers and expert staffs of ‘Karafarin Bank’. Finally based on analysed data, some features of exiting models are selected and a new conceptual model will be proposed.

Keywords: knowledge management, financial institute, knowledge management model, organisational knowledge

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10989 Efficient Management of Construction Logistics: A Challenge to Both Conventional and Technological Systems in the Developing Nations

Authors: Nuruddeen Usman, Ahmad Muhammad Ibrahim

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Management of construction logistics at construction sites becomes increasingly complex with rising construction volume, which made it relatively inefficient in the developing nations even with the technological advancement. The objective of this research is to conceptually synthesise the approaches and challenges befall in the course of construction logistic management, with the aim to proffer possible solution to it. Therefore, this study appraised the glitches associated with both conventional and technological methods of construction logistic management that result in its inefficiency. Thus, this investigation found that, both conventional and the technological issues were due to certain obstacles that affect the construction logistic management which resulted into delays, accidents, fraudulent activities, time and cost overrun. Therefore, this study has developed a framework that might bring a lasting solution to the challenges of construction logistic management.

Keywords: construction, conventional, logistic, technological

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10988 Comparison of the Efficacy of Ketamine-Propofol versus Thiopental Sodium-Fentanyl in Procedural Sedation in the Emergency Department: A Randomized Double-Blind Clinical Trial

Authors: Maryam Bahreini, Mostafa Talebi Garekani, Fatemeh Rasooli, Atefeh Abdollahi

Abstract:

Introduction: Procedural sedation and analgesia have been desirable to handle painful procedures. The trend to find the agent with more efficacy and less complications is still controversial; thus, many sedative regimens have been studied. This study tried to assess the effectiveness and adverse effects of thiopental sodium-fentanyl with the known medication, ketamine-propofol for procedural sedation in the emergency department. Methods: Consenting patients were enrolled in this randomized double-blind trial to receive either 1:1 ketamine-propofol (KP) or thiopental-fentanyl (TF) 1:1 mg: Mg proportion on a weight-based dosing basis to reach the sedation level of American Society of Anesthesiologist class III/IV. The respiratory and hemodynamic complications, nausea and vomiting, recovery agitation, patient recall and satisfaction, provider satisfaction and recovery time were compared. The study was registered in Iranian randomized Control Trial Registry (Code: IRCT2015111325025N1). Results: 96 adult patients were included and randomized, 47 in the KP group and 49 in the TF group. 2.1% in the KP group and 8.1 % in the TF group experienced transient hypoxia leading to performing 4.2 % versus 8.1 % airway maneuvers for 2 groups, respectively; however, no statistically significant difference was observed between 2 combinations, and there was no report of endotracheal placement or further admission. Patient and physician satisfaction were significantly higher in the KP group. There was no difference in respiratory, gastrointestinal, cardiovascular and psychiatric adverse events, recovery time and patient recall of the procedure between groups. The efficacy and complications were not related to the type of procedure or patients’ smoking or addiction trends. Conclusion: Ketamine-propofol and thiopental-fentanyl combinations were effectively comparable although KP resulted in higher patient and provider satisfaction. It is estimated that thiopental fentanyl combination can be as potent and efficacious as ketofol with relatively similar incidence of adverse events in procedural sedation.

Keywords: adverse effects, conscious sedation, fentanyl, propofol, ketamine, safety, thiopental

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10987 Knowledge Management and Motivation Management: Important Constituents of Firm Performance

Authors: Yassir Mahmood, Nadia Ehsan

Abstract:

In current research stream, empirical work regarding knowledge and motivation management along their dimensions is sparse. This study partially filled this void by investigating the influence of knowledge management (tacit and explicit) and motivation management (intrinsic and extrinsic) on firm performance with the mediating effects of innovative performance. Based on the quantitative research method, data were collected through questionnaire from 284 employees working in 18 different firms across the citrus industry located in Sargodha region (Pakistan). The proposed relationships were tested through regression analysis while mediation relations were analyzed through Barron and Kenny (1986) technique. The results suggested that knowledge management (KM) and motivation management (MM) have significant positive impacts on innovative performance (IP). In addition, the role of IP as full mediator between KM and firm performance (FP) is confirmed. Also, IP proved to be a partial mediator between MM and FP. From the managerial perspective, the findings of the study are vital as some of the important constituents of FP have been highlighted. The study produced important underpinnings for managers. In last, implications for policymakers along with future research directions are discussed.

Keywords: innovative performance, firm performance, knowledge management, motivation management, Sargodha

Procedia PDF Downloads 153
10986 Application of Facilities Management Practice in High Rise Commercial Properties: Jos in Perpective

Authors: Aliyu Ahmad Aliyu, Abubakar Ahmad, Muhammad Umar Bello, Rozilah Kasim, David Martin

Abstract:

The article studied the application of facilities management practice in high rise commercial properties. Convenience sampling technique was used in administering questionnaires to the 60 respondents who responded to the survey. It was found out that the extent of application of facilities management in the subject properties is better described as below average. Similarly, the most frequently tools of facilities management in use and employed in the properties were outsourcing and in-house sourcing. This was influenced by the level of their familiarity with the tools. Planned and Preventive maintenance should be taken regularly in other to enhance the effectiveness of the facilities management and to satisfy both the owner and customers of the organization.

Keywords: commercial properties, facilities management, high-rise buildings, Jos metropolis and outsourcing

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10985 Strategies for E-Waste Management: A Literature Review

Authors: Linh Thi Truc Doan, Yousef Amer, Sang-Heon Lee, Phan Nguyen Ky Phuc

Abstract:

During the last few decades, with the high-speed upgrade of electronic products, electronic waste (e-waste) has become one of the fastest growing wastes of the waste stream. In this context, more efforts and concerns have already been placed on the treatment and management of this waste. To mitigate their negative influences on the environment and society, it is necessary to establish appropriate strategies for e-waste management. Hence, this paper aims to review and analysis some useful strategies which have been applied in several countries to handle e-waste. Future perspectives on e-waste management are also suggested. The key findings found that, to manage e-waste successfully, it is necessary to establish effective reverse supply chains for e-waste, and raise public awareness towards the detrimental impacts of e-waste. The result of the research provides valuable insights to governments, policymakers in establishing e-waste management in a safe and sustainable manner.

Keywords: e-waste, e-waste management, life cycle assessment, recycling regulations

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10984 Shared Decision-Making in Holistic Healthcare: Integrating Evidence-Based Medicine and Values-Based Medicine

Authors: Ling-Lang Huang

Abstract:

Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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10983 Potential of Comparative Management and Aspects of Its Application in Georgia

Authors: Evgeni Baratashvili, Nino Pailodze, Ana Bolkvadze, Giorgi Sulashvili

Abstract:

At the present stage in our country intensifies cooperation with different business cultures, actively developing the process of implementation of Georgia in the global business system that requires us to develop a specific concept, including in the field of management. With the entry of Georgia into the international community, exchange of experience will only intensify. It is clear that the achievement of goals such as the doubling of the National Product increase the competitiveness of Georgian enterprises can’t be recorded without foreign management experience. On the other hand, knowledge of the areas of comparative management can be used in the process of choosing the path of socio-economic development of Georgia.

Keywords: business cultures, comparative management, corporate culture, Georgian business, Anglo-Saxon model, Georgian civilization, anti-capitalist mentality, culture management

Procedia PDF Downloads 467
10982 The Current Home Hemodialysis Practices and Patients’ Safety Related Factors: A Case Study from Germany

Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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10981 Management Accounting Revolution: Developed and Developing Country

Authors: Puwanenthiren Pratheepkanth

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The main aim of this paper is to analyse existing literature (1960 -2016) on management accounting revolution by firms in a comparative perspective to see whether any differences between developed and developing countries context. The significant role that management accounting practices play in corporate finance is well established by reams of research articles. The study reveals that there are clear limitations to the literature review, it suggests that a majority of management accounting practices’ studies are focused on developed markets and that there is a scarcity of serious analyses of the situation in emerging markets.

Keywords: developed countries, developing countries, literature review, management accounting practices

Procedia PDF Downloads 272
10980 Heart Ailment Prediction Using Machine Learning Methods

Authors: Abhigyan Hedau, Priya Shelke, Riddhi Mirajkar, Shreyash Chaple, Mrunali Gadekar, Himanshu Akula

Abstract:

The heart is the coordinating centre of the major endocrine glandular structure of the body, which produces hormones that profoundly affect the operations of the body, and diagnosing cardiovascular disease is a difficult but critical task. By extracting knowledge and information about the disease from patient data, data mining is a more practical technique to help doctors detect disorders. We use a variety of machine learning methods here, including logistic regression and support vector classifiers (SVC), K-nearest neighbours Classifiers (KNN), Decision Tree Classifiers, Random Forest classifiers and Gradient Boosting classifiers. These algorithms are applied to patient data containing 13 different factors to build a system that predicts heart disease in less time with more accuracy.

Keywords: logistic regression, support vector classifier, k-nearest neighbour, decision tree, random forest and gradient boosting

Procedia PDF Downloads 41