Search results for: hospital inventory

Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

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Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

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Authors: Lize Tibiriçá, Ronnie Lee, Samantha Behbahani

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Fibromyalgia (FM) is a musculoskeletal disorder affecting men and women of different ages and cultures. The cause of this disorder is unknown; however, studies suggest an etiology that involves biological and psychosocial factors. Few studies have shown that a personality type such as neuroticism is associated with chronic pain conditions. Past research has explored whether patients with FM present with a specific personality trait. However, studies have used different methods (i.e. Minnesota Multiphasic Personality Inventory (MMPI), Sociotropy and Autonomy Scale (SAS) and Dysfunctional Attitude Scale (DAS), Tridimensional Personality Questionnaire or Temperament and Character Inventory (TCI), Karolinska scale of personality, Big Five Inventory or NEO Personality Inventory) to explore the connection between FM and a personality type. They have identified personality types that present similar characteristics but vary in the name (i.e. high harm avoidance and low novelty seeking, psychasthenia/muscular tension/somatic anxiety, neuroticism). Although Zuckerman-Kuhlman Personality Questionnaire and the Big Five Inventory differ in terms of content and structure, both of them identify neuroticism as the personality type of FM patients, and the former also identifies these patients as having a low sociability personality trait. Previous research also shows a trend of sociotropic personality style with FM patients that also suffer from Major Depressive Disorder. Participants in these studies were, for the most part, adult female and researchers have recognized that as a limitation and whether their findings can be generalized to men and younger patients with FM. Furthermore, most studies reviewed were conducted in Europe (i.e. Spain) and had a cross-sectional design. Future research should replicate past studies in different countries and consider conducting a longitudinal study. Although it is suspected that FM course is modulated by FM patients’ personality, it is not known whether individuals with similar personalities will develop FM. This review sought to explain the differences and similarities between the personality types identified. Limitations in the studies reviewed were addressed, and considerations for future research and treatment were discussed.

Keywords: chronic pain, fibromyalgia, neuroticism, personality type

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Authors: Leon Holtzhausen, Emma Campbell

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This study aimed to explore the psychometric properties of the Youth Psychopathic Traits Inventory- short version (YPI-S) and the applicability of Psychopathy as a Unified Theory of Crime among 213 young adults in South Africa. The deviant behaviour variety scale and the YPI-S were used in this study. Results from factor analysis and reliability measures indicated the YPI-S seemed to have good psychometric properties when applied to the South African sample, however applicability of the behavioural dimension was a challenge. The results related to the association between deviant behaviours and psychopathic traits suggested that Psychopathy as a Unified Theory of Crime could be applied in the South African context. It is however important to note that future research should explore how the relevant scales could be culturally and contextually adapted for better psychometric outcomes.

Keywords: testing psychopathy, adverse childhood experiences, youth psychopathic traits inventory, young adults

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Authors: Merve Aydin, Mağfiret Kara Kaşikçi

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Aim: To determine the perceptions of inpatients about care at Farabi Hospital in KTU. Material and Method: This research was conducted by using the universe known examples of formulas and probability selected by sampling method with 277 chosen patients in the hospital at least 14 days in other internal and surgical clinics except for pediatric, psychiatry, and intensive care unit services between January-March 2014 in KTU Farabi Hospital. The data was collected through the forms of nursing care perception scale of patients and defining characteristics of patients. In the evaluation of data, percentage, mean, Mann Whitney U, Student t and Kurskall Wallis tests were applied. Results: The average point the patients got in nursing care perception scale is 62.64±10.08’dir. 48.7 % of patients regard nursing care well and 36.8 % of them regard it very well. 19 % of the patients regard nursing care badly. When the age, sex, occupation, marital status, educational background, residential place, income level, hospitalization period, hospitalization clinic and having a hospital attendant were compared with nursing care perception average point, the difference among point averages was not found meaningful statistically (p > 0.05). The average point of nursing care perception was found greater in those having chronic disease (p < 0.05). Conclusion: The perception point of patients about nursing care is above the average according to the average of the lowest and highest points. The great majority of patients regard nursing care well or very well.

Keywords: hospital, patient, perception of nursing care, nursing care

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Authors: Oral S. Saulters, Shanon D. Goldberg, Wendy A. Staples, Ellena I. Martinez, Lorie M. Sanchez, Diego E. Archuleta, Deborah L. Williams, Scot D. Johnson

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To address an important set of unverified field conditions, the Los Alamos National Laboratory Waste Compliance and Tracking System (WCATS) Wall-to-Wall Team performed an unprecedented and advanced inventory. This reconciliation involved confirmation analysis for approximately 5850 hazardous, low-level, mixed low-level, and transuranic waste containers located in more than 200 staging and storage areas across 33 technical areas. The interdisciplinary team scoped, planned, and developed the multidimensional assessments. Through coordination with cross-functional site hosts, they were able to verify and validate data while resolving discrepancies identified in WCATS. The results were extraordinary with an updated inventory, tailored outreach, more cohesive communications, and timely closed-loop feedback.

Keywords: circular economy, environmental performance data, social-ecological-technological systems, waste management

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Authors: Gláucio de Castro Júnior, Daniela Prometi, Patrícia Tuxi

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The project 'Inventory Signs-terms of the cultural heritage field in Libras' provides for the establishment of an inventory of signs, terms relating to the field of cultural heritage in Libras, from the results of research in progress as the pilot project' Accessibility Communication, Translation and Interpretation to the Application Portal Libras Heritage 'and the Pilot Project' registration-signal terms for the preparation of bilingual lexicon Libras / Portuguese terms available in the Portal Heritage. The project's goal is to spread the lexicographical rules on the use of technologies in video graphic records of sign language and foster the training of undergraduate students and graduate to the registration of the linguistic diversity of Libras through social and communicative interaction with the community deaf and enable access to Deaf information relating to the field of cultural heritage in Libras. As a result, we expect the spread of the inventory of cultural heritage-signs in terms Libras in application usage 'Portal Heritage'. To achieve the proposed objectives are accomplished technical consulting and continuous training for the production of academic material through theoretical and practical meetings, taught by experts Libras LIP / UNB in partnership with some institutions. The Inventory project signals-Terms under Heritage in Libras field initially took place in Rio de Janeiro in order to allow its development in the Midwest region, due to technical, elected some cities in Brazil, including Manaus in Amazon Macapa in Amapa, Salvador Bahia, Goiás and Goiânia in Florianopolis in Santa Catarina. At the end of all this process, the assessment by preparing a technical report presenting all the advances and points achieved in the project looking for social improvement, economic, environmental and language in the use of technology will be conducted.

Keywords: signs-terms, equity-cultural accessibility, technology, sign language

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Authors: Temitope O. Tokosi

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Healthcare is a human right. The sensitivity of health issues has necessitated the introduction of Enterprise Content Management (ECM) at district hospitals in the Western Cape Province of South Africa. The objective is understanding clinicians’ perception of ECM at their workplace. It is a descriptive case study design of constructivist paradigm. It employed a phenomenological data analysis method using a pattern matching deductive based analytical procedure. Purposive and s4nowball sampling techniques were applied in selecting participants. Clinicians expressed concerns and frustrations using ECM such as, non-integration with other hospital systems. Inadequate access points to ECM. Incorrect labelling of notes and bar-coding causes more time wasted in finding information. System features and/or functions (such as search and edit) are not possible. Hospital management and clinicians are not constantly interacting and discussing. Information turnaround time is unacceptably lengthy. Resolving these problems would involve a positive working relationship between hospital management and clinicians. In addition, prioritising the problems faced by clinicians in relation to relevance can ensure problem-solving in order to meet clinicians’ expectations and hospitals’ objective. Clinicians’ perception should invoke attention from hospital management with regards technology use. The study’s results can be generalised across clinician groupings exposed to ECM at various district hospitals because of professional and hospital homogeneity.

Keywords: clinician, electronic content management, hospital, perception, technology

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Authors: Nermine A. Harraz, Aliaa Abouali

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The retail stores put up for sale multiple items while the spaces in the backroom and display areas constitute a scarce resource. Availability, volume, and location of the product displayed in the showroom influence the customer’s demand. Managing these operations individually will result in sub-optimal overall retail store’s profit; therefore, a non-linear integer programming model (NLIP) is developed to determine the inventory replenishment and shelf space allocation decisions that together maximize the retailer’s profit under shelf space and backroom storage constraints taking into consideration that the demand rate is positively dependent on the amount and location of items displayed in the showroom. The developed model is solved using LINGO® software. The NLIP model is implemented in a real world case study in a large retail outlet providing a large variety of products. The proposed model is validated and shows logical results when using the experimental data collected from the market.

Keywords: retailing management, inventory replenishment, shelf space allocation, showroom, backroom

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Authors: NeisaKuonuo Tungoe

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Tenyidie, also known as Angami, is spoken by the Angami tribe of Nagaland, North-East India, bordering Myanmar (Burma). It belongs to the Tibeto-Burman language group, falling under the Kuki-Chin-Naga sub-family. Tenyidie studies have seen random attempts at explaining the phonemic inventory of Tenyidie. Different scholars have variously emphasized the grammar or the history of Tenyidie. Many of these claims have been stimulating, but they were often based on a small amount of merely suggestive data or on auditory perception only. The principal objective of this paper is to analyse the affricate segments of Tenyidie as an acoustic study. There are seven categories to the inventory of Tenyidie; Plosives, Nasals, Affricates, Laterals, Rhotics, Fricatives, Semi vowels and Vowels. In all, there are sixty phonemes in the inventory. As mentioned above, the only prominent readings on Tenyidie or affricates in particular are only reflected through auditory perception. As noted above, this study aims to lay out the affricate segments based only on acoustic conclusions. There are seven affricates found in Tenyidie. They are: 1) Voiceless Labiodental Affricate - / pf /, 2) Voiceless Aspirated Labiodental Affricate- / pfh /, 3) Voiceless Alveolar Affricate - / ts /, 4) Voiceless Aspirated Alveolar Affricate - / tsh /, 5) Voiced Alveolar Affricate - / dz /, 6) Voiceless Post-Alveolar Affricate / tʃ / and 7) Voiced Post- Alveolar Affricate- / dʒ /. Since the study is based on acoustic features of affricates, five informants were asked to record their voice with Tenyidie phonemes and English phonemes. Throughout the study of the recorded data, PRAAT, a scientific software program that has made itself indispensible for the analyses of speech in phonetics, have been used as the main software. This data was then used as a comparative study between Tenyidie and English affricates. Comparisons have also been drawn between this study and the work of another author who has stated that there are only six affricates in Tenyidie. The study has been quite detailed regarding the specifics of the data. Detailed accounts of the duration and acoustic cues have been noted. The data will be presented in the form of spectrograms. Since there aren’t any other acoustic related data done on Tenyidie, this study will be the first in the long line of acoustic researches on Tenyidie.

Keywords: tenyidie, affricates, praat, phonemic inventory

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Authors: Elif Bakkaloglu, Necdet Torunbalci

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The fact of earthquakes in Turkiye is an inevitable natural disaster. Therefore, buildings must be prepared for this natural hazard. Especially in hospital buildings, earthquake resistance is an essential point because hospitals are one of the first places where people come after an earthquake. Although hospital buildings are more suitable for horizontal architecture, it is necessary to construct and expand multi-storey hospital buildings due to difficulties in finding suitable places as a result of excessive urbanization, difficulties in obtaining appropriate size land and decrease in suitable places and increase in land values. In Turkiye, using seismic isolators in public hospitals, which are placed in first-degree earthquake zone and have more than 100 beds, is made obligatory by general instruction. As a result of this decision, it may sometimes be necessary to construct seismic isolated multi-storey hospital buildings in cities where those problems are experienced. Although widespread use of seismic isolators in Japan, there are few multi-storey buildings in which seismic isolators are used in Turkiye. As it is known, base isolation systems are the most effective methods of earthquake resistance, as number of floors increases, center of gravity moves away from base in multi-storey buildings, increasing the overturning effect and limiting the use of these systems. In this context, it is aimed to investigate structural systems of multi-storey buildings which built using seismic isolation methods in the World. In addition to this, a working principle is suggested for disseminating seismic isolators in multi-storey hospital buildings. The results to be obtained from the study will guide architects who design multi-storey hospital buildings in their architectural designs and engineers in terms of structural system design.

Keywords: earthquake, energy absorbing systems, hospital, seismic isolation systems

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Authors: Tulio Sulbaran, Sandeep Langar

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Architects are an integral part of the construction industry and are continuously incorporating decisions that influence projects during their life cycle. These decisions aim at selecting best alternative from the ones available. Unfortunately, this decision making process is mainly unexplored in the construction industry. No instrument to measure construction decision, based on knowledgebase of decision-makers, has existed. Additionally, limited literature is available on the topic. Recently, an instrument to gain an understanding of the construction decision-making process was developed by Dr. Tulio Sulbaran from the University of Texas, San Antonio. The instrument’s name is 'Construction Decision Making Inventory (CDMI)'. The CDMI is an innovative idea to measure the 'What? When? How? Moreover, Who?' of the construction decision-making process. As an innovative idea, its statistical validity (accuracy of the assessment) is yet to be assessed. Thus, the purpose of this paper is to describe the results of a case study with architects in the south-east of the United States aimed to determine the CDMI validity. The results of the case study are important because they assess the validity of the tool. Furthermore, as the architects evaluated each question within the measurements, this study is also guiding the enhancement of the CDMI.

Keywords: decision, support, inventory, architect

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Authors: Riyadh Jamegh, Alla Eldin Kassam, Sawsan Sabih

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In order to overcome uncertainty conditions and inability to meet customers' requests due to these conditions, organizations tend to reserve a certain safety stock level (SSL). This level must be chosen carefully in order to avoid the increase in holding cost due to excess in SSL or shortage cost due to too low SSL. This paper used soft computing fuzzy logic to identify optimal SSL; this fuzzy model uses the dynamic concept to cope with high complexity environment status. The proposed model can deal with three input variables, i.e., demand stability level, raw material availability level, and on hand inventory level by using dynamic fuzzy logic to obtain the best SSL as an output. In this model, demand stability, raw material, and on hand inventory levels are described linguistically and then treated by inference rules of the fuzzy model to extract the best level of safety stock. The aim of this research is to provide dynamic approach which is used to identify safety stock level, and it can be implanted in different industries. Numerical case study in the dairy industry with Yogurt 200 gm cup product is explained to approve the validity of the proposed model. The obtained results are compared with the current level of safety stock which is calculated by using the traditional approach. The importance of the proposed model has been demonstrated by the significant reduction in safety stock level.

Keywords: inventory optimization, soft computing, safety stock optimization, dairy industries inventory optimization

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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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Authors: Wissem Abdaoui, Ilhem Mokhtari, Adel Gouri, Benouareth Djamel Eddine

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Contracted in a health facility, hospital-acquired infections are a major public health problem in recent years. The increase of nosocomial infections is partly related to diagnostic and therapeutic advances in medicine. The aim of our study was to isolate and diagnose some types of bacteria that are circulating in the hospital by performing different samples at two medical services: Pulmonary and Infectious Diseases. The antibiotic susceptibility tests were performed for bacterial isolates. The results have shown that there is a predominance of enterobacteria followed by the staphylococcus with its two species epidermidis ans saprophyticus. The study of the antibiogramme identified that some of these bacteria have a resistant profile against all the tested antibiotics. The fight against nosocomial infections is difficult because it must act on several factors: quality of care, safety of the hospital environment, hygiene, wearing gloves etc. are all areas that should be of heightened vigilance and preventive measures.

Keywords: nosocomial infection, isolation, identification, sensitivity and resistance to antibiotics

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Authors: Nikk Leavitt, Peter Kellett, Cheryl Currie, Richard Larouche

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Background: Masculinity has been associated with poor mental health outcomes in adult men and is colloquially referred to as toxic. Masculinity is traditionally measured using the Male Role Norms Inventory, which examines behaviors that may be common in men but that are themselves associated with poor mental health regardless of gender (e.g., aggressiveness). The purpose of this study was to examine if masculinity is associated with generalized anxiety among men using this inventory vs. a man’s personal definition of it. Method: An online survey collected data from 1,200 men aged 18-65 across Canada in July 2022. Masculinity was measured using: 1) the Male Role Norms Inventory Short Form and 2) by asking men to self-define what being masculine means. Men were then asked to rate the extent they perceived themselves to be masculine on a scale of 1 to 10 based on their definition of the construct. Generalized anxiety disorder was measured using the GAD-7. Multiple linear regression was used to examine associations between each masculinity score and anxiety score, adjusting for confounders. Results: The masculinity score measured using the inventory was positively associated with increased anxiety scores among men (β = 0.02, p < 0.01). Masculinity subscales most strongly correlated with higher anxiety were restrictive emotionality (β = 0.29, p < 0.01) and dominance (β = 0.30, p < 0.01). When traditional masculinity was replaced by a man’s self-rated masculinity score in the model, the reverse association was found, with increasing masculinity resulting in a significantly reduced anxiety score (β = -0.13, p = 0.04). Discussion: These findings highlight the need to revisit the ways in which masculinity is defined and operationalized in research to better understand its impacts on men’s mental health. The findings also highlight the importance of allowing participants to self-define gender-based constructs, given they are fluid and socially constructed.

Keywords: masculinity, generalized anxiety disorder, race, intersectionality

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Authors: Adel Nikfarjam, Hamed Tayebi, Sadoullah Ebrahimnejad

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This paper considers a two-echelon inventory system with a number of warehouses and a single retailer. The retailer replenishes its required items from warehouses, and assembles them into a single final product. We assume that each warehouse supplies only one kind of the raw material for the retailer. The demand process of the final product is assumed to be Poissson, and unsatisfied demand of the final product will be lost. The retailer applies one-for-one-period ordering policy which is also known as (1, T) ordering policy. In this policy the retailer orders to each warehouse a fixed quantity of each item at fixed time intervals, which the fixed quantity is equal to the utilization of the item in the final product. Since, this policy eliminates all demand uncertainties at the upstream echelon, the standard lot sizing model can be applied at all warehouses. In this paper, we calculate the total cost function of the inventory system. Then, based on this function, we present a procedure to obtain the optimal time interval between two consecutive order placements from retailer to the warehouses, and the optimal order quantities of warehouses (assuming that there are positive ordering costs at warehouses). Finally, we present some numerical examples, and conduct numerical sensitivity analysis for cost parameters.

Keywords: two-echelon supply chain, multi-vendor-single-buyer inventory system, lost sales, Poisson demand, one-for-one-period policy, lot sizing model

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Authors: Dimitrios J. Dimitriou

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Airport’s serving a tourist destination are an essential counterpart of the tourist demand supply chain, and their productivity is related to the region’s attractiveness and is enhanced by the air transport business. In this paper, the evaluation framework of the scheduled flights between two tourist airports is taken into consideration. By adopting a systemic approach, the arrivals from an airport that its connectivity heavily depended on the departures of another major airport are reviewed. The methodology framework, based on inventory control theory and the numerical example, promotes the use of the modelling formulation. The results would be essential for comparison and exercising to other similar cases.

Keywords: airport connectivity, inventory control, optimization, optimum allocation

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Authors: Riccardo Patriarca, Giulio Di Gravio, Francesco Costantino, Massimo Tronci

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An accurate inventory management policy acquires a crucial role in the several high-availability sectors. In these sectors, due to the high-cost of spares and backorders, an (S-1, S) replenishment policy is necessary for high-availability items. The policy enables the shipment of a substitute efficient item anytime the inventory size decreases by one. This policy can be modelled following the Multi-Echelon Technique for Recoverable Item Control (METRIC). The METRIC is a system-based technique that allows defining the optimum stock level in a multi-echelon network, adopting measures in line with the decision-maker’s perspective. The METRIC defines an availability-cost function with inventory costs and required service levels, using as inputs data about the demand trend, the supplying and maintenance characteristics of the network and the budget/availability constraints. The traditional METRIC relies on the hypothesis that a Poisson distribution well represents the demand distribution in case of items with a low failure rate. However, in this research, we will explore the effects of using a Poisson distribution to model the demand of low failure rate items characterized by an irregular demand trend. This characteristic of a demand is not included in the traditional METRIC formulation leading to the need of revising its traditional formulation. Using the CV (Coefficient of Variation) and ADI (Average inter-Demand Interval) classification, we will define the inherent flaws of Poisson-based METRIC for irregular demand items, defining an innovative ad hoc distribution which can better fit the irregular demands. This distribution will allow defining proper stock levels to reduce stocking and backorder costs due to the high irregularities in the demand trend. A case study in the aviation domain will clarify the benefits of this innovative METRIC approach.

Keywords: METRIC, inventory management, irregular demand, spare parts

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Authors: Bita Payami-Shabestari, Dariush Eslami

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The purpose of this paper is to develop a multi-product economic production quantity model under vendor management inventory policy and restrictions including limited warehouse space, budget, and number of orders, average shortage time and maximum permissible shortage. Since the “costs” cannot be predicted with certainty, it is assumed that data behave under uncertain environment. The problem is first formulated into the framework of a bi-objective of multi-product economic production quantity model. Then, the problem is solved with three multi-objective decision-making (MODM) methods. Then following this, three methods had been compared on information on the optimal value of the two objective functions and the central processing unit (CPU) time with the statistical analysis method and the multi-attribute decision-making (MADM). The results are compared with statistical analysis method and the MADM. The results of the study demonstrate that augmented-constraint in terms of optimal value of the two objective functions and the CPU time perform better than global criteria, and goal programming. Sensitivity analysis is done to illustrate the effect of parameter variations on the optimal solution. The contribution of this research is the use of random costs data in developing a multi-product economic production quantity model under vendor management inventory policy with several constraints.

Keywords: economic production quantity, random cost, supply chain management, vendor-managed inventory

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Authors: Sina Keyhanian, Abbas Ahmadi, Behrooz Karimi

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We present a multi-objective binary programming model which considers surgical cases are scheduling among operating rooms and the configuration of surgical instruments in limited capacity hospital trays, simultaneously. Many mathematical models have been developed previously in the literature addressing different challenges in health-care logistics such as assigning operating rooms, leveling beds, etc. But what happens inside the operating rooms along with the inventory management of required instruments for various operations, and also their integration with surgical scheduling have been poorly discussed. Our model considers the minimization of movements between trays during a surgery which recalls the famous cell formation problem in group technology. This assumption can also provide a major potential contribution to robotic surgeries. The tray configuration problem which consumes surgical instruments requirement plan (SIRP) and sequence of surgical procedures based on required instruments (SIRO) is nested inside the bin packing problem. This modeling approach helps us understand that most of the same-output solutions will not be necessarily identical when it comes to the rearrangement of surgeries among rooms. A numerical example has been dealt with via a proposed nested simulated annealing (SA) optimization approach which provides insights about how various configurations inside a solution can alter the optimal condition.

Keywords: health-care logistics, hospital tray configuration, off-line bin packing, simulated annealing optimization, surgical case scheduling

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Authors: Mariela Gonzalez, Zoraide Lugli, Eleonora Vivas, Rosana Guzmán

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The objective was to determine the predictive capacity of self-efficacy perceived for weight control, locus of weight control and skills of weight self-management in the dissatisfaction of the body image in obese people who attend treatment. Sectional study conducted in the city of Maracay, Venezuela, with 243 obese who attend to treatment, 173 of the feminine gender and 70 of the male, with ages ranging between 18 and 57 years old. The sample body mass index ranged between 29.39 and 44.14. The following instruments were used: The Body Shape Questionnaire (BSQ), the inventory of body weight self-regulation, The Inventory of self-efficacy in the regulation of body weight and the Inventory of the Locus of weight control. Calculating the descriptive statistics and of central tendency, coefficients of correlation and multiple regression; it was found that a low ‘perceived Self-efficacy in the weight control’ and a high ‘Locus of external control’, predict the dissatisfaction with body image in obese who attend treatment. The findings are a first approximation to give an account of the importance of the personal control variables in the study of the psychological grief on the overweight individual.

Keywords: dissatisfaction with body image, obese people, personal control, psychological variables

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Authors: Wisit Wichitkosoom

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Objective:The majority of the hisk-risk patients (ST-elevation myocardial infarction (STEMI), Acute cerebrovascular accident, Sepsis, Acute Traumatic patient ) are admitted to district or lacal hospitals (average 1-1.30 hr. from Udonthani general hospital, Northeastern province, Thailand) without proper facilities. The referral system was support to early care and early management at pre-hospital stage and prepare for the patient data to higher hospital. This study assessed the reduction in treatment delay achieved by pre-hospital diagnosis and referral directly to Udonthani General Hospital. Methods and results: Four district or local hospitals without proper facilities for treatment the very high-risk patient were serving the study region. Pre-hospital diagnoses were established with the simple technology such as LINE, SMS, telephone and Fax for concept of LEAN process and then the telemedicine, by ambulance monitoring (ECG, SpO2, BT, BP) in both real time and snapshot mode was administrated during the period of transfer for safety transfer concept (inter-hospital stage). The standard treatment for patients with STEMI, Intracranial injury and acute cerebrovascular accident were done. From 1 October 2012 to 30 September 2013, the 892 high-risk patients transported by ambulance and transferred to Udonthani general hospital were registered. Patients with STEMI diagnosed pre-hospitally and referred directly to the Udonthani general hospital with telemedicine closed monitor (n=248). The mortality rate decreased from 11.69% in 2011 to 6.92 in 2012. The 34 patients were arrested on the way and successful to CPR during transfer with the telemedicine consultation were 79.41%. Conclusion: The proper innovation could apply for health care system. The very high-risk patients must had the closed monitoring with two-way communication for the “safety transfer period”. It could modified to another high-risk group too.

Keywords: safety transfer, telemedicine, critical patients, medical and health sciences

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Authors: Geng Cui, Naoto Imura, Katsuhiro Nishinari, Takahiro Ezaki

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The bullwhip effect, which refers to the amplification of demand variance as one moves up the supply chain, has been observed in various industries and extensively studied through analytic approaches. Existing methods to mitigate the bullwhip effect, such as decentralized demand information, vendor-managed inventory, and the Collaborative Planning, Forecasting, and Replenishment System, rely on the willingness and ability of supply chain participants to share their information. However, in practice, information sharing is often difficult to realize due to privacy concerns. The purpose of this study is to explore new ways to mitigate the bullwhip effect without the need for information sharing. This paper proposes a 'bullwhip absorption strategy' (BAS) to alleviate the bullwhip effect by absorbing it downstream in the supply chain. To achieve this, a two-stage supply chain system was employed, consisting of a single retailer and a single manufacturer. In each time period, the retailer receives an order generated according to an autoregressive process. Upon receiving the order, the retailer depletes the ordered amount, forecasts future demand based on past records, and places an order with the manufacturer using the order-up-to replenishment policy. The manufacturer follows a similar process. In essence, the mechanism of the model is similar to that of the beer game. The BAS is implemented at the retailer's level to counteract the bullwhip effect. This strategy requires the retailer to reduce the uncertainty in its orders, thereby absorbing the bullwhip effect downstream in the supply chain. The advantage of the BAS is that upstream participants can benefit from a reduced bullwhip effect. Although the retailer may incur additional costs, if the gain in the upstream segment can compensate for the retailer's loss, the entire supply chain will be better off. Two indicators, order variance and inventory variance, were used to quantify the bullwhip effect in relation to the strength of absorption. It was found that implementing the BAS at the retailer's level results in a reduction in both the retailer's and the manufacturer's order variances. However, when examining the impact on inventory variances, a trade-off relationship was observed. The manufacturer's inventory variance monotonically decreases with an increase in absorption strength, while the retailer's inventory variance does not always decrease as the absorption strength grows. This is especially true when the autoregression coefficient has a high value, causing the retailer's inventory variance to become a monotonically increasing function of the absorption strength. Finally, numerical simulations were conducted for verification, and the results were consistent with our theoretical analysis.

Keywords: bullwhip effect, supply chain management, inventory management, demand forecasting, order-to-up policy

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Authors: Gary Young, David Zepeda, Gilbert Nyaga

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This study investigated whether vertical integration of hospitals and physicians is associated with better care for patients with cardiac conditions. A dramatic change in the U.S. hospital industry is the integration of hospital and physicians through hospital acquisition of physician practices. Yet, there is little evidence regarding whether this form of vertical integration leads to better operational performance of hospitals. The study was conducted as an observational investigation based on a pooled, cross-sectional database. The study sample comprised over hospitals in the State of California. The time frame for the study was 2010 to 2012. The key performance measure was hospitals’ degree of compliance with performance criteria set out by the federal government for managing patients with cardiac conditions. These criteria relate to the types of clinical tests and medications that hospitals should follow for cardiac patients but hospital compliance requires the cooperation of a hospital’s physicians. Data for this measure was obtained from a federal website that presents performance scores for U.S. hospitals. The key independent variable was the percentage of cardiologists that a hospital employs (versus cardiologists who are affiliated but not employed by the hospital). Data for this measure was obtained from the State of California which requires hospitals to report financial and operation data each year including numbers of employed physicians. Other characteristics of hospitals (e.g., information technology for cardiac care, volume of cardiac patients) were also evaluated as possible complements or substitutes for physician employment by hospitals. Additional sources of data included the American Hospital Association and the U.S. Census. Empirical models were estimated with generalized estimating equations (GEE). Findings suggest that physician employment is positively associated with better hospital performance for cardiac care. However, findings also suggest that information technology is a substitute for physician employment.

Keywords: physician employment, hospitals, verical integration, cardiac care

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Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Taku Iwami, Takashi Kawamura, Takeshi Shimazu

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Background: Recently, the number of ambulance dispatches has been increasing in Japan and it is, therefore, difficult to accept emergency patients to hospitals smoothly and appropriately because of the limited hospital capacity. To facilitate the request for patient transport by ambulances and hospital acceptance, the emergency information system using information technology has been built up and introduced in various communities. However, its effectiveness has not been insufficiently revealed in Japan. In 2013, we developed a smartphone application system that enables the emergency-medical-service (EMS) personnel to share information about on-scene ambulance and hospital situation. The aim of this study was to assess the introduction effect of this application for EMS system in Osaka City, Japan. Methods: This study was a retrospective study with population-based ambulance records of Osaka Municipal Fire Department. This study period was six years from January 1, 2010 to December 31, 2015. In this study, we enrolled emergency patients that on-scene EMS personnel conducted the hospital selection for them. The main endpoint was difficulty in hospital acceptance at the scene. The definition of difficulty in hospital acceptance at the scene was to make >=5 phone calls by EMS personnel at the scene to each hospital until a decision to transport was determined. The definition of the smartphone application group was emergency patients transported in the period of 2013-2015 after the introduction of this application, and we assessed the introduction effect of smartphone application with multivariable logistic regression model. Results: A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 smartphone application group (50.0%) in 2010-2012 and 300,395 non-smartphone application group (50.0%) in 2013-2015. The proportion of the difficulty in hospital acceptance was 14.2% (42,585/300,131) in the smartphone application group and 10.9% (32,819/300,395) in the non-smartphone application group, and the difficulty in hospital acceptance significantly decreased by the introduction of the smartphone application (adjusted odds ration; 0.730, 95% confidence interval; 0.718-0.741, P<0.001). Conclusions: Sharing information between ambulance and hospital by introducing smartphone application at the scene was associated with decreasing the difficulty in hospital acceptance. Our findings may be considerable useful for developing emergency medical information system with using IT in other areas of the world.

Keywords: difficulty in hospital acceptance, emergency medical service, infomation technology, smartphone application

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Authors: Nusrat T. Chowdhury

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Green Supply Chain Management (GSCM) is becoming a key to success for profitable businesses. The various activities contributing to carbon emissions in a supply chain are transportation, ordering and holding of inventory. This research work develops a mixed-integer nonlinear programming (MINLP) model that considers the scenario of a supply chain with multiple periods, multiple products and multiple suppliers. The model assumes that the demand is deterministic, the buyer has a limited storage space in each period, the buyer is responsible for the transportation cost, a supplier-dependent ordering cost applies for each period in which an order is placed on a supplier and inventory shortage is permissible. The model provides an optimal decision regarding what products to order, in what quantities, with which suppliers, and in which periods in order to maximize the profit. For the purpose of evaluating the carbon emissions, three different carbon regulating policies i.e., carbon cap-and-trade, the strict cap on carbon emission and carbon tax on emissions, have been considered. The proposed MINLP has been validated using a randomly generated data set.

Keywords: green supply chain, carbon emission, mixed integer non-linear program, inventory shortage, carbon cap-and-trade

Procedia PDF Downloads 239

Authors: Abdulaziz Afandi

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Minimizing the inventory cost, optimizing the inventory quantities, and increasing system operational availability are the main motivations to enhance forecasting demand of spare parts in a major power utility company in Medina. This paper reports in an effort made to optimize the orders quantities of spare parts by improving the method of forecasting the demand. The study focuses on equipment that has frequent spare parts purchase orders with uncertain demand. The pattern of the demand considers a lumpy pattern which makes conventional forecasting methods less effective. A comparison was made by benchmarking various methods of forecasting based on experts’ criteria to select the most suitable method for the case study. Three actual data sets were used to make the forecast in this case study. Two neural networks (NN) approaches were utilized and compared, namely long short-term memory (LSTM) and multilayer perceptron (MLP). The results as expected, showed that the NN models gave better results than traditional forecasting method (judgmental method). In addition, the LSTM model had a higher predictive accuracy than the MLP model.

Keywords: neural network, LSTM, MLP, forecasting demand, inventory management

Procedia PDF Downloads 127

Authors: Routsukol Sunalai

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This research was to study the relationship between the organizational culture like bureaucratic system, and patronage system in government hospitals with hospital accreditation and its impact on the quality of service in the government hospital accredited. Qualitative research was applied in this study by in-depth interviews with samples containing 20 public welfare service providers, i.e. doctors, nurses and practical nurses and 20 service recipients in the units of study. It was found that the bureaucracy still existed and was evidenced by the structure of the line of command; work systems, clear cut duty divisions, procedures and plans, and the patronage system hindered the quality of service in the government hospitals under the process of development and accreditation. The administrators should encourage and support the creation of a learning process in the organization for self-improvement and work development.

Keywords: hospital in Dusit Area, organization culture, the quality of service, economics and financial engineering

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Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

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Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

Procedia PDF Downloads 304