Search results for: hospital birth

Authors: Abosede Mosunmola Odeseye

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The sustainability of nations’ economies today have proven to be unrealistic in a constantly changing world without appropriate accordance to entrepreneurship role and its processes. This role has therefore proven to be a product of the available and discoverable opportunities by an individual/organisation in any pattern – innovation, discovery, diffusion, imitation amidst possible challenges. In light of these, this paper examined the relationship between opportunity development and entrepreneurial processes as well as the factors determining individual’s opportunity development and the success of entrepreneurial processes. Systematic review method was adopted for selecting relevant academic materials. The theoretical base of this paper was anchored on Schumpeter’s entrepreneurial innovation model and Drucker and Stevenson’s opportunity-based entrepreneurship theory. Based on the reviewed literature, it was discovered that rough business idea “opportunity” in any form – techniques/product encounter various obstacles to achieve its development, acceptability and sustainability. In essence, the findings revealed that the birth of every opportunity is as a result of the individual/organisation and environmental factors to be able to scale through the whole process successfully. Due to the outcome of this paper, it was recommended that the organisations/government should endeavour to create an enabling environment for a rough business idea to come to life amidst the hurdles of the entrepreneurial process.

Keywords: entrepreneurial process, entrepreneurship, opportunity, opportunity development, organisation, sustainability

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Authors: Aboekwe, Mary Emilia

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Jesus’ mission was not only a religious one but had social and political implications. From the birth to the death of Jesus, God’s message of liberation is proclaimed in and through Jesus. This work studied Jesus’ inaugural mission in Luke 4: 18 -19 in the context of Nigerian leaders. A theological interpretation was adopted and it was discovered that Luke 4: 18-19 unfolded Jesus’ mission statement. This mission statement centered in preaching the good news to the poor, the release of the captives, healing the sick, liberation to the oppressed, and favour and abundance in the land. Related to the Jewish-Roman world of Jesus and the Nigerian nation, it was discovered that most of the maladies enumerated in Jesus’ inaugural mission statement were prevalent in Nigerian society. Maladies like poverty, oppression, violence, sickness and diseases are widespread in Nigeria. Poverty affects all, irrespective of gender, religion, or ethnicity. There is insecurity everywhere. Unemployment bites harder on Nigeria’s youthful population, and they are unable to find a job at the prevailing wage rate. To this effect, therefore, this study proposes Jesus’ liberative technique as a solution to these maladies prevalent in the country. The work equally challenged the Nigerian leaders to emulate Jesus’ mission statement and take proactive measures in fighting against these social challenges resident in Nigeria today.

Keywords: liberation, leadership, maladies, poverty

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Akeel Noori Al-Mulla Hwaish

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The environmental impact, economics, social and cultural factors, and the processes by which people define history and meaning had influenced the dynamic shape and character of the traditional Islamic Arabic city. Therefore, in regard to the period when Islam was at its peak (7th- 13th Centuries), Islamic city wasn’t the highly dynamited at the scale of buildings and city planning that demonstrates a distinguished city as an ‘Islamic’ as appeared after centuries when the function of the buildings and their particular arrangement and planning scheme in relation to one another that defined an Islamic city character. The architectural features of the urban fabric of the traditional Arabic Islamic city are a ‎reflection of the spiritual, social, and cultural characteristics of the people. It is a ‎combination of Islamic values ‘Din’ and life needs ‘Dunia’ as Prophet Muhammad built the first Mosque in ‎Madinah in the 1st year of his migration to it, then the Suq or market on 2nd of Hijrah, attached to ‎the mosque to signify the birth of a new Muslims community which considers both, ‎‎’Din’ and ‘Dunia’ and initiated nucleus for what which called after that as an ‘Islamic’ city. This research will discuss the main characteristics and components of the traditional Arab cities and demonstrate the impact of the Islamic values on shaping the planning layout and general built environment features of the early traditional Arab cities.

Keywords: urban, Islamic, Arabic, city

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Authors: Kamrun Nahar Koly, Saimul Islam

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Overweight and obesity is increasing at an alarming rate and a leading risk factor for morbidity throughout the world. In a country like Bangladesh where under nutrition and overweight both co-exist at the same time, but this issue has been underexplored as expected. The aim of the present study was to assess the knowledge, attitudes and identify the barriers of the physicians regarding overweight and obesity management on an urban hospital of Dhaka city in Bangladesh. A simple cross sectional study was conducted at two selected government and two private hospital to assess the knowledge, attitude and common barriers regarding overweight and obesity management among healthcare professionals. One hundred and fifty five physicians were surveyed. A standard questionnaire was constructed in local language and interview was administrated. Among the 155 physicians, majority 53 (34.20%) were working on SMC, 36 (23.20%) from DMC, 33 (21.30%) were based on SSMC and the rest 33 (21.30%) were from HFRCMH. Mean age of the study physicians were 31.88±5.92. Majority of the physicians 80 (51.60%) were not able to answer the correct prevalence of obesity but also a substantial number of them 75(48.40%) could mark the right answer. Among the physicians 150 (96.77%) reported BMI as a diagnostic index for overweight and obesity, where as 43 (27.74%) waist circumference, 30 (19.35%) waist hip ratio and 26 (16.77%) marked mid-arm circumference. A substantial proportion 71 (46.70%) of the physicians thought that they do not have much to do controlling weight problem in Bangladesh context though it has been opposed by 42 (27.60%) of the physicians and 39(25.70%) was neutral to comment. The majority of them 147 (96.1%) thought that a family based education program would be beneficial followed by 145 (94.8%) physicians mentioned about raising awareness among mothers as she is the primary caregiver. The idea of a school based education program will also help to early intervene referred by 142 (92.8%) of the physicians. Community based education program was also appreciated by 136 (89.5%) of the physicians. About 74 (47.7%) of them think that the patients still lack in motivation to maintain their weight properly at the same time too many patients to deal with can be a barrier as well assumed by 73 (47.1%) of them. Lack of national policy or management guideline can act as an obstacle told by 60 (38.7%) of the physicians. The relationship of practicing as a part of the general examination and chronic disease management was statistically significant (p<0.05) with physician occupational status. As besides, perceived barriers like lack of parents support, lack of a national policy was statistically significant (p<0.05) with physician occupational status. For the young physician, more training programme will be needed to transform their knowledge and attitude into practice. However, several important barriers interface for the physician treatment efforts and need to address.

Keywords: obesity management, physician, awareness, barriers, Bangladesh

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Authors: Yunqi Wang

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Benefiting from the demographic dividend, China has enjoyed export-led economic growth since 1978. While Lewis's model marks the structural transformation from the low-wage 'subsistence' sector to the 'modern sector' as the end of labour surplus, the Chinese government seems eager to extend such benefit by promoting a series of fertility encouragement policies, contrasting to its firm and strict birth control since last century. Based on a Attride-Stirling’s thematic analysis of interviews with unmarried female millennials in China, this paper argues that the young female generation responded to current fertility policies negatively, where the policy ineffectiveness and irresponsiveness have further worsened their marriage and childbirth reluctance. Instead of focusing on changes in wage level, this research contributes a qualitative perspective to the existing theoretical debate on the Lewis turning point, implying an inevitable end of demographic dividend in China. Highlighting the greater focus on female consciousness among the younger generation, it also suggests a policy orientation towards resolving outdated social norms to accommodate the rising female consciousness since millennials will become the childbirth mainstay in forthcoming years.

Keywords: lewis model, fertility policy, demographic dividend, one-child policy

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Authors: Catherine Bernard, Paul Ransom

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Recent events have prompted emergency planners to re-evaluate their emergency response to major incidents and mass casualties. At the Royal Sussex County Hospital, we have adopted a tiered system comprised of three levels, anticipating an increasing P1, P2 or P3 load. This will aid planning in the golden period between Major Incident ‘Standby,’ and ‘Declared’. Each tier offers step-by-step instructions on appropriate patient movement within and out of the department, as well as suggestions for overflow areas and additional staffing levels. This system can be adapted to individual hospitals and provides concise instructions to be followed in a potentially overwhelming situation.

Keywords: disaster planning, emergency preparedness, major incident planning, mass casualty event

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Authors: Mengestie Mulugeta Belay, Serebe Abay Gebrie, Biruk Lambbiso Wamisho, Amare Worku

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Background: Low back pain (LBP) related to nursing profession, is a very common public health problem throughout the world. Various risk factors have been implicated in the etiology and LBP is assumed to be of multi-factorial origin as individual, work-related and psychosocial factors can contribute to its development. Objectives: To determine the prevalence and to identify risk factors of LBP among nurses working in Addis Ababa City Public Hospitals, Ethiopia, in the year 2015. Settings: Addis Ababa University, Black-Lion (‘Tikur Anbessa’) Hospital-BLH, is the country’s highest tertiary level referral and teaching Hospital. The three departments in connection with this study: Radiology, Pathology and Orthopedics, run undergraduate and residency programs and receive referred patients from all over the country. Methods: A cross-sectional study with internal comparison was conducted throughout the period October-December, 2015. Sample was chosen by simple random sampling technique by taken the lists of nurses from human resource departments as a sampling frame. A well-structured, pre-tested and self-administered questionnaire was used to collect quantifiable information. The questionnaire included socio-demographic, back pain features, consequences of back pain, work-related and psychosocial factors. The collected data was entered into EpiInfo version 3.5.4 and was analyzed by SPSS. A probability level of 0.05 or less and 95% confidence level was used to indicate statistical significance. Ethical clearance was obtained from all respected administrative bodies, Hospitals and study participants. Results: The study included 395 nurses and gave a response rate of 91.9%. The mean age was 30.6 (±8.4) years. Majority of the respondents were female (285, 72.2%). Nearly half of the participants (n=181, 45.8% (95% CI (40.8%- 50.6%))) were complained low back pain. There was statistical significant association between low back pain and working shift, physical activities at work; sleep disturbance and felt little pleasure by doing things. Conclusion: A high prevalence of low back pain was found among nurses working in Addis Ababa Public Hospitals. Recognition and preventive measures like providing resting periods should be taken to reduce the risk of low back pain in nurses working in Public hospitals.

Keywords: low back pain, risk factors, nurses, public hospitals

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Authors: Moumen Souad, Melizi Mohamed

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In order to characterize rabbits does of an Aures local population raised in Algeria, a study of their milk yield was realized in the experimental rabbitry of El Hadj Lakhdhar University. Milk production of does was measured every day during the days following 215 parturitions. It was estimated by weighing the female before and after the single daily suckling (10–15 min between the two weighing operations). The various calculated parameters were the quantity of milk produced per day, per week and the total quantity produced in 21 days, as well as the intake of milk by young rabbits. The analysis concerned the effects of the number of successive litters (3 classes: 1 to 3 and more) and of the average number of the number of young rabbits suckled per litter (6 classes: from 1-2 kits to more than 6). During the 21 days of controlled lactation, the average litter size was 6±3. The rabbits of the Aures area produced on average 2544.34±747 g in 21 days that is 121 g of milk/day or 21 g of milk/kit/day. The milk yield increased from 526, 1035, 1240 and 2801 g to 760, 1365, 1715 and 3840 for week 1, 2, 3 and the total period of lactation, respectively. Nevertheless, milk production available per kit and per day decreased linearly with kits number in the litter for each of the 3 weeks considered. On the other hand the milk yield was not affected by the weight at birth of kits.

Keywords: milk production, litter size, rabbit, Aures area, Algeria

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Authors: Rebeca V. Tholen, Elaine Bundy

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Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

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Authors: Abdus-Samii Imam Arikewuyo

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The human rights phenomenon increasingly gains universal prominence in the contemporary age. This embraces the clamour for a just treatment of individuals in society. The human rights agitation is a global pursuit which virtually gave birth to many national and international human rights organizations. In particular, Nigeria accedes to a number of human rights covenants. Invariably, there are some provisions which are recognized as inalienable rights of man in his society by which his intrinsic worth and dignity are protected by law. Nonetheless, the constituents of human rights differ in various societies. Conversely, Islam, as a complete code of life, guarantees the rights of a man vis-à-vis the rights of others in his environment regardless of place and time. Human rights pressure in Nigeria in recent times prompted proactive steps to address the issue through various legal instruments. Amazingly, the struggle appears to be a rhetorical noise because the human rights violation subsists. This provokes the present research on a comparative study of the Nigerian legal provisions and the Islamic law perspectives on human rights. It is discovered that the first is simply theoretical, while the other contains both the theoretical framework and the practical measures for its enforcement. The study adopts analytical and descriptive methods. It concludes with the assertion that the Islamic law provisions are all-embracing, universal and more efficacious. Hence, it recommends the adoption of the Islamic law approach to human rights issues.

Keywords: human rights, Nigerian legal provisions, shariah law, comparative study, charter

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Authors: Aena Iqbal

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The lack of access to maternal and reproductive health in Pakistan poses a great threat to global public health. Obstetric issues, including vesicovaginal fistulas (VVF), are the most common in South Asian countries, leaving women in a more vulnerable state. Koohi Goth Women’s Hospital offers free VVF operations, which draws in women from all over Pakistan. Although reproductive health is being handled, mental health is often neglected in these scenarios. Using a series of questions inspired by the Warwick Edinburgh Model, this paper builds on the results from interviewing women who have received vesicovaginal fistula repair surgery on their mental health, a taboo topic in Pakistan.

Keywords: obstetrics, VVF, Pakistan, reproductive health

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Authors: Alexandra Emmanuelle Membangbi, Jacky Njiki Bikoï, Esther Del-florence Moni Ndedi, Marie Joseph Nkodo Mindimi, Donatien Serge Mbaga, Elsa Nguiffo Makue, André Chris Mikangue Mbongue, Martha Mesembe, George Ikomey Mondinde, Eric Walter Perfura-yone, Sara Honorine Riwom Essama

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Background: Tuberculosis (TB) is one of the top lethal infectious diseases worldwide. In recent years, interferon-γ (INF-γ) release assays (IGRAs) have been established as routine tests for diagnosing TB infection. However, produced INF-γ assessment failed to distinguish active TB (ATB) from latent TB infection (LTBI), especially in TB epidemic areas. In addition to IFN-γ, interleukin-2 (IL-2), another cytokine secreted by activated T cells, is also involved in immune response against Mycobacterium tuberculosis. The aim of the study was to assess the capacity of IFN-γ and IL2 to evaluate the therapeutic response of patients on anti-tuberculosis treatment. Material and Methods: We conducted a cross-sectional study in the Pneumonology Departments of the Jamot Hospital in Yaoundé between May and August 2021. After signed the informed consent, the sociodemographic data, as well as 5 mL of blood, were collected in the crook of the elbow of each participant. Sixty-one subjects were selected (n= 61) and divided into 4 groups as followed: group 1: resistant tuberculosis (n=13), group 2: active tuberculosis (n=19), group 3 cured tuberculosis (n=16), and group 4: presumed healthy persons (n=13). The cytokines of interest were determined using an indirect Enzyme-linked Immuno-Sorbent Assay (ELISA) according to the manufacturer's recommendations. P-values < 0.05 were interpreted as statistically significant. All statistical calculations were performed using SPSS version 22.0 Results: The results showed that men were more 14/61 infected (31,8%) with a high presence in active and resistant TB groups. The mean age was 41.3±13.1 years with a 95% CI = [38.2-44.7], the age group with the highest infection rate was ranged between 31 and 40 years. The IL-2 and INF-γ means were respectively 327.6±160.6 pg/mL and 26.6±13.0 pg/mL in active tuberculosis patients, 251.1±30.9 pg/mL and 21.4±9.2 pg/mL in patients with resistant tuberculosis, while it was 149.3±93.3 pg/mL and 17.9±9.4 pg/mL in cured patients, 15.1±8.4 pg/mL and 5.3±2.6 pg/mL in participants presumed healthy (p <0.0001). Significant differences in IFN-γ and IL-2 rates were observed between the different groups. Conclusion: Monitoring the serum levels of INF-γ and IL-2 would be useful to evaluate the therapeutic response of anti-tuberculosis patients, particularly in the both cytokines association case, that could improve the accuracy of routine examinations.

Keywords: antibiotic therapy, interferon gamma, interleukin 2, tuberculosis

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Authors: Ortega Ivan, De La Plaza Edurne

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Background: Spain and other European countries have implemented Uncontrolled Donation after Cardiac Death (uDCD) programs. After 15 years of experience in Spain, many things have changed. Recent evidence and technical breakthroughs achieved in resuscitation are relevant for uDCD programs and raise some ethical concerns related to these protocols. Aim: To rethink current uDCD programs in the light of recent evidence on available therapeutic procedures applicable to victims of out-of-hospital cardiac arrest (OHCA). To address the following question: What is the current standard of treatment owed to victims of OHCA before including them in an uDCD protocol? Materials and Methods: Review of the scientific and ethical literature related to both uDCD programs and innovative resuscitation techniques. Results: 1) The standard of treatment received and the chances of survival of victims of OHCA depend on whether they are classified as Non-Heart Beating Patients (NHBP) or Non-Heart-Beating-Donors (NHBD). 2) Recent studies suggest that NHBPs are likely to survive, with good quality of life, if one or more of the following interventions are performed while ongoing CPR -guided by suspected or known cause of OHCA- is maintained: a) direct access to a Cath Lab-H24 or/and to extra-corporeal life support (ECLS); b) transfer in induced hypothermia from the Emergency Medical Service (EMS) to the ICU; c) thrombolysis treatment; d) mobile extra-corporeal membrane oxygenation (mini ECMO) instituted as a bridge to ICU ECLS devices. 3) Victims of OHCA who cannot benefit from any of these therapies should be considered as NHBDs. Conclusion: Current uDCD protocols do not take into account recent improvements in resuscitation and need to be adapted. Operational criteria to distinguish NHBDs from NHBP should seek a balance between the technical imperative (to do whatever is possible), considerations about expected survival with quality of life, and distributive justice (costs/benefits). Uncontrolled DCD protocols can be performed in a way that does not hamper the legitimate interests of patients, potential organ donors, their families, the organ recipients, and the health professionals involved in these processes. Families of NHBDs’ should receive information which conforms to the ethical principles of respect of autonomy and transparency.

Keywords: uncontrolled donation after cardiac death resuscitation, refractory cardiac arrest, out of hospital cardiac, arrest ethics

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Authors: Leela Lakshmi Sai Srinivas Parasa, Pushpavalli Naidu, Bhaskar Kambhampati

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Background: Obstructive Sleep Apnea (OSA) is a common but underdiagnosed sleep disorder characterized by repeated upper airway collapse during sleep. It frequently coexists with Type 2 Diabetes Mellitus (T2DM), a chronic metabolic condition with significant global and national health implications. The interplay between these conditions increases the risk of severe complications such as stroke, hypertension, and cardiovascular diseases. Understanding the prevalence of high-risk OSA in T2DM patients is essential for improving clinical outcomes and guiding public health interventions. Objective: This study aimed to assess the prevalence of high-risk OSA among T2DM patients using the Berlin questionnaire and to identify demographic and clinical predictors of risk. Methodology: This cross-sectional study of 100 patients with Type2 diabetes was undertaken at a tertiary care hospital in India for a period of 2 months. OSA was evaluated using the Berlin questionnaire. Diabetes mellitus was diagnosed according to WHO criteria as fasting blood sugar level > 7 mmol/L or random blood sugar >126 mg/dl on 2 separate occasions. Particulars of patients were recorded following which detailed history and physical examination were done. Data was analyzed using spss version 21. Results: The prevalence of high-risk OSA was 72% among the study population. The mean age was 54.9 +- 12.47 years. Age groups were divided into 3 groups (less than 50, 50-65, and greater than 65) The highest prevalence was observed in the 50-65 age group, accounting for 59.7% of high-risk cases. Gender distribution revealed a higher proportion of high-risk females (88.46%) compared to males (66.21%). Normal-weight individuals (BMI 18.5–24.9 kg/m²) represented 74.02% of high-risk OSA cases, while overweight individuals (BMI 25–29.9 kg/m²) accounted for 65.21%. Additionally, 90.9% of hypertensive patients were identified as high-risk for OSA. Conclusion: The study highlights a high prevalence of OSA risk among T2DM patients, especially those with hypertension and those in the middle-aged group. These findings emphasize the importance of routine OSA screening and tailored interventions for diabetic patients to reduce associated health risks. Proactive management can help mitigate the compounded effects of these two conditions, improving overall patient outcomes and reducing the burden on healthcare systems.

Keywords: obstructive sleep apnea, type 2 diabetes mellitus, berlin questionnaire, prevalence, hypertension

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Authors: Ritu Nambiar, Shazia Tariq, Sumaira Jamil, Farida Munawar, Imelda Israell

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GBS has emerged as a leading cause of neonatal infections worldwide and clinical trials have demonstrated that giving IAP was effective in reducing early onset GBS (EOGBS) disease of the newborn. There is no available data on the prevalence of GBS in the UAE, therefore, a retrospective chart analysis of our parturients were done to look at our prevalence. The aim of this study is: 1. To study the prevalence of GBS colonization of parturients at al Rahba Hospital following universal screening between 35-37 week. 2. To look at efficacy of GBS intrapartum antibiotic prophylaxis by NICU admission for EO GBS disease of the newborn. 1) The prevalence of GBS in our patient population is 24.15%. 2) Incidence of EO GBS disease of the newborn was 0.6%.

Keywords: GBS Screening, universal intrapartum antibiotic prophylaxis, parturients, newborn

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Authors: Boumesbah Asma, Chergui Mohamed El-amine

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Since it has been shown that the multi-objective minimum spanning tree problem (MOST) is NP-hard even with two criteria, we propose in this study a hybrid NSGA-II algorithm with an exact mutation operator, which is only used with low probability, to find an approximation to the Pareto front of the problem. In a connected graph G, a spanning tree T of G being a connected and cycle-free graph, if k edges of G\T are added to T, we obtain a partial graph H of G inducing a reduced size multi-objective spanning tree problem compared to the initial one. With a weak probability for the mutation operator, an exact method for solving the reduced MOST problem considering the graph H is then used to give birth to several mutated solutions from a spanning tree T. Then, the selection operator of NSGA-II is activated to obtain the Pareto front approximation. Finally, an adaptation of the VNS metaheuristic is called for further improvements on this front. It allows finding good individuals to counterbalance the diversification and the intensification during the optimization search process. Experimental comparison studies with an exact method show promising results and indicate that the proposed algorithm is efficient.

Keywords: minimum spanning tree, multiple objective linear optimization, combinatorial optimization, non-sorting genetic algorithm, variable neighborhood search

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Authors: Anshul Raja

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Cystic lesions of the spleen are rare and splenic hydatid cysts account for only 0.5% to 8% of all hydatidosis. Authors hereby report a case where a 50-year-old female presented to our hospital with the complains of heaviness and pain over left upper abdomen over the past 8-10 years. On radiological examination, ultrasonography revealed findings consistent with isolated splenic hydatid cyst and was later on confirmed on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). No other organ or system involvement was seen. The patient underwent splenectomy and hydatid cyst was confirmed on histopathology. Owing to its rarity, it offers a diagnostic challenge to physicians but can reliably be diagnosed with great confidence employing various imaging modalities like CT and MRI.

Keywords: gastrointestinal radiology, abdominal imaging, hydatid cyst, medical and health sciences

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Authors: Mina Sadat Orooje, Mohammad Mehdi Latifi, Behnam Fereydooni Eftekhari

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The integration of cutting-edge Internet of Things (IoT) technologies with advanced Artificial Intelligence (AI) systems is revolutionizing healthcare facility management. However, the current landscape of hospital building maintenance suffers from slow, repetitive, and disjointed processes, leading to significant financial, resource, and time losses. Additionally, the potential of Building Information Modeling (BIM) in facility maintenance is hindered by a lack of data within digital models of built environments, necessitating a more streamlined data collection process. This paper presents a robust framework that harmonizes AI with BIM-IoT technology to elevate healthcare Facility Maintenance Management (FMM) and address these pressing challenges. The methodology begins with a thorough literature review and requirements analysis, providing insights into existing technological landscapes and associated obstacles. Extensive data collection and analysis efforts follow to deepen understanding of hospital infrastructure and maintenance records. Critical AI algorithms are identified to address predictive maintenance, anomaly detection, and optimization needs alongside integration strategies for BIM and IoT technologies, enabling real-time data collection and analysis. The framework outlines protocols for data processing, analysis, and decision-making. A prototype implementation is executed to showcase the framework's functionality, followed by a rigorous validation process to evaluate its efficacy and gather user feedback. Refinement and optimization steps are then undertaken based on evaluation outcomes. Emphasis is placed on the scalability of the framework in real-world scenarios and its potential applications across diverse healthcare facility contexts. Finally, the findings are meticulously documented and shared within the healthcare and facility management communities. This framework aims to significantly boost maintenance efficiency, cut costs, provide decision support, enable real-time monitoring, offer data-driven insights, and ultimately enhance patient safety and satisfaction. By tackling current challenges in healthcare facility maintenance management it paves the way for the adoption of smarter and more efficient maintenance practices in healthcare facilities.

Keywords: artificial intelligence, building information modeling, healthcare facility maintenance, internet of things integration, maintenance efficiency

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Authors: Rahah Hasan, Faridah Sahari

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This paper describes the development of modern art in Borneo, particularly in Sarawak, Sabah, and Brunei, after the Second World War until the 1970s. This was the period when the British Colonial government dictated the education system, which consequentially inculcated visual art through art and craft subjects imposed on all vernacular schools in Borneo. British influence within the state governance, social, and education system designed with Western ideology created not only a westernized society and mindset but at the same time generated artistic opportunities for emerging local painters to be involved in the initiation of Modern Art in Borneo. Through the historical method and analysis of primary and secondary data, it was obvious that the existence of colonial government departments and institutions such as museums and teaching colleges, and other social organizations in Borneo at that time contributed significantly to the artistic movement. The similar structure and motivation of development in other areas of Borneo confirmed that artistic affirmation of modern art advanced homogenously. Their understanding of easel painting as well as a unique interpretation of culture once distanced from traditional art, resulting in a new visual image that transcended their ethnicity and identity through new mediums and tools. These meticulous interventions modestly visualized in each painting, as discussed in this paper, hopefully, will give a deeper understanding and appreciation of the history of modern art in Borneo.

Keywords: art history, Borneo art, fine art, modern art

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Authors: Ahmed M. Jamel

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Electronic government initiatives and public participation to them are among the indicators of today's development criteria of the countries. After consequent two wars, Iraq's current position in, for example, UN's e-government ranking is quite concerning and did not improve in recent years, either. In the preparation of this work, we are motivated with the fact that handling geographic data of the public facilities and resources are needed in most of the e-government projects. Geographical information systems (GIS) provide most common tools not only to manage spatial data but also to integrate such type of data with nonspatial attributes of the features. With this background, this paper proposes that establishing a working GIS in the health sector of Iraq would improve e-government applications. As the case study, investigating hospital locations in Erbil is chosen.

Keywords: e-government, GIS, Iraq, Erbil

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Authors: Md. Abu Yousuf

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Islamic social financing (ISF) refers to the fair distribution of wealth and financial dealings and prevents economic exploitation at all levels. ISF instruments include Islamic institutions Zakat (obligatory charity), Sadaqah (voluntary charity) and Waqf (endowment) based on philanthropy such and Qard-al Hasan (beautiful loan), micro takaful (insurance) and social investments through Sukuk (bonds) based on cooperation. ISF contributes to socio-economic development, end poverty, protects environmental sustainability, promotes education, equality, social justice and above all, establishes social well-being since the birth of Islam. ISF tools are instrumental towards achieving sustainable development goals (SDGs) set by United Nations (UN). The present study will explore the scope of ISF for community development in Bangladesh and examine the challenges in implementing ISF tools and will provide the most practical model of ISF. The study will adopt a mixed-method (MM) design in the process of data collection and analysis. The researcher will consider all issues related to ethics, reliability, validity and feasibility while conducting the study.

Keywords: Islamic social financing, sustainable development goals, poverty eradication, zakat, waqf, sadaqah, Islamic microfinance

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Authors: Yusuf Bala

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The last decades of the 20th Centaury witnessed renewed hope about the birth of democracy and development in Africa the interface between democracy and development in Africa has long engaged the sustained interest of scholars and researchers across Africa. The process was actively supported by all segment of society, labour students market women, rural dweller who saw in it, the prospects of reversing the trend of political despair and in disillusionment that hither to characterized political life in Africa. The political tyranny and dictatorship while having it own clientele and beneficiaries had negative and suffocating effect on the majority of the people. The democratic aspiration of the Africa people is not only confined to the Arena of political Democracy of election and granting of civil and political rights, but it involves the demand for economic empowerment better living standards of the people and adequate social welfare indeed, for the majority of the people democracy is meaningful only when it delivers socio-economic goods. However, democracy and development have generated enormous interest no conclusive evidence seems to be shared in Africa. In the course of this research emphasis shall be made on certain issues, such as issues of corruption in democracy in Africa, ethnic conflict and democracy in Africa contribution of women to democratic practice and women participation in political arena, is still very low, democratization process and industrial relation in Africa as factor that hinder the development of Democracy in Africa, a case study of Nigeria.

Keywords: democracy, development, dictatorship, conflict, ethnicity

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Authors: Xiao-lei Wang

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The Novel Concept Combination (NCC) refers to the unique ability of multilingual children to creatively merge and integrate different linguistic and cultural elements to form innovative and original concepts. Children raised with more than one language often exhibit this skill in their daily communication, such as creating innovative metaphors that enrich their communication, showcasing their creativity in conveying the essence of their messages. This paper explores NCC abilities in multilingual children by focusing on two male trilingual siblings exposed to Chinese, French, and English from birth. The siblings were observed for 19 years in their daily context. Seventy-six hours of video-recorded data were used for this study (38 hours for each participant). A coding scheme developed by Wang et al. was employed to code the recorded data. The results suggest that these multilingual siblings proportionally increased their NCC skills over the years, emerging at age 3 and peaking at age 15. The characteristic of their NCC lies in their capacity to not merely replicate linguistic elements of different languages but to recreate, reshape, and reconstruct novel ideas in communication, enriching their interactions. The paper also addresses the educational implications for educators and parents, emphasizing the importance of valuing these novel ideas in everyday environments to encourage NCC development. This, in turn, contributes to cognitive and social development.

Keywords: multilingual children, novel concept combination, multilingual creativity, linguistic richness

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Authors: Y. Tiamaz, N. Souissi

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The purpose of this paper is to present a classification of Lean models which aims to capture all the concepts related to this approach and thus facilitate its implementation. This classification allows the identification of the most relevant models according to several dimensions. From this perspective, we present a review and an analysis of Lean models literature and we propose dimensions for the classification of the current proposals while respecting among others the axes of the Lean approach, the maturity of the models as well as their application domains. This classification allowed us to conclude that researchers essentially consider the Lean approach as a toolbox also they design their models to solve problems related to a specific environment. Since Lean approach is no longer intended only for the automotive sector where it was invented, but to all fields (IT, Hospital, ...), we consider that this approach requires a generic model that is capable of being implemented in all areas.

Keywords: lean approach, lean models, classification, dimensions, holistic view

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Authors: Syed Ali Taqi, Muhammad Ismail

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A comparative study of estimators of population means in two phase sampling in the presence of non-response when Unknown population means of the auxiliary variable(s) and incomplete information of study variable y as well as of auxiliary variable(s) is made. Three real data sets of University students, hospital and unemployment are used for comparison of all the available techniques in two phase sampling in the presence of non-response with the newly generalized ratio estimators.

Keywords: two-phase sampling, ratio estimator, product estimator, generalized estimators

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Authors: Zeytu G. Asfaw, Serkalem K. Abrha, Demisew G. Degefu

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Background: HIV/AIDS remains a major public health problem in Ethiopia and heavily affecting people of productive and reproductive age. We aimed to compare the performance of Parametric Survival Analysis and Bayesian Survival Analysis using simulations and in a real dataset application focused on determining predictors of HIV patient survival. Methods: A Parametric Survival Models - Exponential, Weibull, Log-normal, Log-logistic, Gompertz and Generalized gamma distributions were considered. Simulation study was carried out with two different algorithms that were informative and noninformative priors. A retrospective cohort study was implemented for HIV infected patients under Highly Active Antiretroviral Therapy in Alamata General Hospital, North Ethiopia. Results: A total of 320 HIV patients were included in the study where 52.19% females and 47.81% males. According to Kaplan-Meier survival estimates for the two sex groups, females has shown better survival time in comparison with their male counterparts. The median survival time of HIV patients was 79 months. During the follow-up period 89 (27.81%) deaths and 231 (72.19%) censored individuals registered. The average baseline cluster of differentiation 4 (CD4) cells count for HIV/AIDS patients were 126.01 but after a three-year antiretroviral therapy follow-up the average cluster of differentiation 4 (CD4) cells counts were 305.74, which was quite encouraging. Age, functional status, tuberculosis screen, past opportunistic infection, baseline cluster of differentiation 4 (CD4) cells, World Health Organization clinical stage, sex, marital status, employment status, occupation type, baseline weight were found statistically significant factors for longer survival of HIV patients. The standard error of all covariate in Bayesian log-normal survival model is less than the classical one. Hence, Bayesian survival analysis showed better performance than classical parametric survival analysis, when subjective data analysis was performed by considering expert opinions and historical knowledge about the parameters. Conclusions: Thus, HIV/AIDS patient mortality rate could be reduced through timely antiretroviral therapy with special care on the potential factors. Moreover, Bayesian log-normal survival model was preferable than the classical log-normal survival model for determining predictors of HIV patients survival.

Keywords: antiretroviral therapy (ART), Bayesian analysis, HIV, log-normal, parametric survival models

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Authors: Zehra Gencel Efe, Fatma Susam Ozsayın, Satı Tas

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Background and Aim: It is not possible to teach all the knowledge related to operating room nursing in the nursing education process. Certified courses are organized by the Ministry of Health to compensate the lack of postgraduate training and the theoretical and practical training needs of working nurses. In this study; It is aimed to investigate the participants’ opinions and recommendations attending the certified course of operating room nursing that organized in İKCU AtaturkTraining and Research Hospital. Method: Two operating room nursing courses were organized in 2016. The 1st Operating Room Nursing Certified Course Program was organized between March 07, 2016 and April 6, 2016and the 2nd Operating Room Nursing Certified Course Program was organized between 07 November 2016 - 06 December 2016 at the İKCU Ataturk Training and Research Hospital. The first program was accepted for 29 participants, the second program was accepted for 30 participants. In the collection of the data, the 'Operating Room Nursing Certified Training Program Evaluation Form', 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' were used. Three point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Evaluation Form’ (1=verygood, 2=good, 3=poor). Data is collected in five areas related to training program, operation room practice, communication, responsibility, experiences of learning. Four point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' (1=verysatisfied, 2=quitesatisfied, 3=satisfied, 4=dissatisfied). Data is collected in two areas include presentation and content. Data were analyzed with SPSS 16 program. Findings and Conclusion: It was found that 93,22% of participants were female in addition, 62,7% had bachelor degree. It was seen that 33,87% of the work group had 1-5 years of experience in their field. It was found that; 88% of trainees participating in the first group to the operating room nursing-certified course program stated the training program was very good, 12% of them stated the training program was good. Nobody was signed the ‘poor’ choice. 81% of the trainees who participated in the 2nd group to the operating room nursing-certified course program stated the training program was very good, 19% of them stated the training program was good. Nobody was signed the ‘poor’ choice. It was found that there was no meaningful difference between the achievement ratios of the trainees and the learning status of the trainees when compared with the t test in the groups with success level of the operating room nursing certified course program according to the learning status of the participants (p ˃ 0,05). The trainees noted that the course was satisfied with theoretical and practical steps but the support services (lunch, coffee breaks etc.) were in adequate.

Keywords: certified courses, nursing certified courses, operating room nursing, training program

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Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

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Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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Authors: Xuzhen Yang, Yan Shan, Yabo Ding, Keke DIao, Yanjun Zhang, Yijia Huang

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Purpose: Our aim is to understand the unique experiences of patients with peritoneal dialysis and how they deal with issues brought on by disease and dialysis. Patients and Methods: Semi-structured interview was designed to collect information, and inpatients with peritoneal dialysis in a university-based tertiary hospital in the central province of China were purposively chosen as interviewees. The content analysis method was used to analyze the data. Results: Nine patients participated in the study, and three themes and eight subthemes were generated. Conclusion: Patients using peritoneal dialysis encounter numerous challenges and problems in the process of disease and dialysis, and they took attempt to cope with them well to adapt to living with peritoneal dialysis.

Keywords: peritoneal dialysis, experience, patient, coping strategy

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