Search results for: point of care testing (POCT)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10836

Search results for: point of care testing (POCT)

9576 The Effect of Vertical Integration on Operational Performance: Evaluating Physician Employment in Hospitals

Authors: Gary Young, David Zepeda, Gilbert Nyaga

Abstract:

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

Procedia PDF Downloads 385
9575 Assesment of Quality of Life among Iranian Male Amateur Athletes via WHOQOL-Brief

Authors: Shirko Ahmadi, Ahmad Fallahi, Marco C. Uchida, Gustavo L. Gutierrez

Abstract:

The aims of the present study are to assess and compare the health habits and quality of life (QoL) of Iranian amateur athletes in different sports. A total of 120 male amateur athletes between 17 and 31 years, engaged in 16 kinds of sports which include team (n=44), individual (n=40) and combat sports (n=36) from sports clubs in the west cities of Iran; and also those not involved in any competition in the past. Additionally, this is a cross-sectional, descriptive observational study, which the subjects completed the WHOQOL-brief questionnaire to evaluate QoL. The questionnaire is composed of 26 questions in four domains (physical health, psychological, social and environmental domains), that was applied in the Persian language. Information on the frequency and duration of training sessions were also collected. The Shapiro-Wilk test was used to verify normal distribution, followed by the chi-squared test for proportions and simple analysis of variance for comparisons between groups of sports. Pearson’s correlation was used to assess the relationships between the variables analyzed. According to the findings, those from individual sports obtained highest points in the all domains of QoL; physical domains (87.1 ± 8.1 point), psychological domains (87.6 ± 9.6 point), social domains (89.7 ± 9.2 point), environmental domains (75.5± 10.7 point) and overall QoL score (84.9 ± 9.4 point). Generally, social domains were the highest QoL index (84.3 ± 7.2 points), and environmental domains were the lowest QoL index (68.1 ± 10.8 points), in all of the sports. No correlations were found between QoL domains and time engaged in the sport (r = 0.01; p = 0.93), number of weekly training sessions (r = 0.09; p = 0.37) and session duration (r = -0.06; p= 0.58). Comparison of QoL results with those of the general population revealed higher levels in the physical and psychological components of amateur athletes. In the present study, engaging in sports was associated with higher QoL levels in amateur athletes, particularly in the physical and psychological domains. Moreover, correlations were found between the overall score and domains of QoL.

Keywords: amateur, domains, Iranian, quality of life

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9574 How Does Ethics Impact Marketing Decision Making of a Company: An Evidence from the Telecommunication Sector of Pakistan

Authors: Mohammad Daud Ali

Abstract:

For the past decade, marketing ethics has been a central point for academic researchers and practitioners. In particular, the development of frameworks and models to help in the analysis of marketing decisions are the focus of research. The current study aims at finding whether ethical decisions (honesty, fairness, responsibility, and respect) affect organizational marketing decisions. A selection of 250 respondents was purposely made from the telecommunication industry of Pakistan, out of which 204 responses were induced at an acceptable rate of 81.6%. A five-point Likert Scale, itemized with 12 items, was adopted from Taylor-Dunlop & Lester (2000) and used to draw responses regarding ethics.

Keywords: marketing, ethics, decisions making, telecommunication, Pakistan

Procedia PDF Downloads 76
9573 Hypotonia - A Concerning Issue in Neonatal Care

Authors: Eda Jazexhiu-Postoli, Gladiola Hoxha, Ada Simeoni, Sonila Biba

Abstract:

Background Neonatal hypotonia represents a commonly encountered issue in the Neonatal Intensive Care Unit and newborn nursery. The differential diagnosis is broad, encompassing chromosome abnormalities, primary muscular dystrophies, neuropathies and inborn errors of metabolism. Aim of study Our study describes some of the main clinical features of hypotonia in newborns and presents clinical cases of neonatal hypotonia we treated in our Neonatal unit in the last 3 years. Case reports Four neonates born in our hospital presented with hypotonia after birth, one preterm newborn 35-36 weeks of gestational age and three other term newborns (38-39 weeks of gestational age). Prenatal data revealed a decrease in fetal movements in both cases. Intrapartum meconium-stained amniotic fluid was found in 75% of our hypotonic newborns. Clinical features included inability to establish effective respiratory movements and need for resuscitation in the delivery room, respiratory distress syndrome, feeding difficulties and need for oro-gastric tube feeding, dysmorphic features, hoarse voice and moderate to severe muscular hypotonia. The genetic workup revealed the diagnosis of Autosomal Recessive Congenital Myasthenic Syndrome 1-B, Sotos Syndrome, Spinal Muscular Atrophy Type 1 and Transient Hypotonia of the Newborn. Two out of four hypotonic neonates were transferred to the Pediatric Intensive Care Unit and died at the age of three to five months old. Conclusion Hypotonia is a concerning finding in neonatal care and it is suggested by decreased intrauterine fetal movements, failure to establish first breaths, respiratory distress and feeding difficulties in the neonate. Prognosis is determined by its etiology and time of diagnosis and intervention.

Keywords: hypotonic neonate, respiratory distress, feeding difficulties, fetal movements

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9572 The Effectiveness of Warm-Water Footbath on Fatigue in Cancer Patient Undergoing Chemotherapy

Authors: Yu-Wen Lin, Li-Ni Liu

Abstract:

Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P < .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P < .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

Procedia PDF Downloads 128
9571 Wave Transmitting Boundary in Dynamic Analysis for an Elastoplastic Medium Using the Material Point Method

Authors: Chinh Phuong Do

Abstract:

Dynamic analysis of slope under seismic condition requires the elimination of spurious reflection at the bounded domain. This paper studies the performances of wave transmitting boundaries, including the standard viscous boundary and the viscoelastic boundary to the material point method (MPM) framework. First, analytical derivations of these non-reflecting conditions particularly to the implicit MPM are presented. Then, a number of benchmark and geotechnical examples will be shown. Overall, the results agree well with analytical solutions, indicating the ability to accurately simulate the radiation at the bounded domain.

Keywords: dynamic analysis, implicit, MPM, non-reflecting boundary

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9570 Role of Physiotherapist: How Their Job and Working Area Could Be Known

Authors: Juan Pablo Hervas-Perez, Jesus Guodemar-Perez, Montserrat Ruiz-Lopez, Elena Sonsoles Rodriguez-Lopez, Noemi Mayoral-Gonzalo, Eduardo Cimadevilla Fernandez-Pola, Mario Caballero-Corella

Abstract:

Physiotherapy is a healthcare discipline that covers many fields of action within the recovery and prevention of health. Some are well known, but others, such as working with newborns and premature children are not so. Physical therapist functions are well defined, but the impression of the population is that there are other professionals who can develop them, and a large part are unknown. Objective: To evaluate the level of knowledge of the sample on the role of the physiotherapist in general, and more specifically in the neonatal intensive care (NICU) units, and estimate your level of notions on the development centered care (DCC). Method: A descriptive, transversal, observational and prospective study developed on a 125 participants' sample. Results: From the sample studied, 87.2% had already had contact with physiotherapy previously. An 80.9% believed that the physiotherapist intervention was decisive for the cure, and 84.0% would recommend physiotherapy treatment to others. Of the total surveyed, 98.0% felt that the physiotherapist is who should run the physiotherapeutic treatments, but shares with other professions 71.0% of votes. The field's best-known work is rehabilitation (94.0%); Neonatology is on the 4th place (66.0% of votes). Conclusions: Many areas of work of physical therapy are unknown to a big part of the population, including the own health workers. Less than half of the sample meets the DCC, and only 58% of the interviewed physiotherapists know them.

Keywords: functions of physiotherapist, neonatal intensive care, physiotherapy, prematurity

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9569 New High Order Group Iterative Schemes in the Solution of Poisson Equation

Authors: Sam Teek Ling, Norhashidah Hj. Mohd. Ali

Abstract:

We investigate the formulation and implementation of new explicit group iterative methods in solving the two-dimensional Poisson equation with Dirichlet boundary conditions. The methods are derived from a fourth order compact nine point finite difference discretization. The methods are compared with the existing second order standard five point formula to show the dramatic improvement in computed accuracy. Numerical experiments are presented to illustrate the effectiveness of the proposed methods.

Keywords: explicit group iterative method, finite difference, fourth order compact, Poisson equation

Procedia PDF Downloads 417
9568 Economic Analysis of Post-Harvest Losses in Plantain (and Banana): A Case Study of South Western Nigeria

Authors: O. R. Adeniyi, A. Ayandiji

Abstract:

Losses are common in most vegetables because the fruit ripens rapidly and most plantain products can only be stored for a few days thereby limiting their utilization. Plantain (and banana) is highly perishable at the ambient temperature prevalent in the tropics. The specific objective of this study is to identify the socioeconomic characteristics of banana/plantain dealers and determine the perceived effect of the losses incurred in the process of marketing banana/plantain. The study was carried out in Ondo and Lagos states of south-western Nigeria. Purposive sampling technique was used to collect information from “Kolawole plantain depot”, the point of purchase in Ondo State and “Alamutu plantain market” in Mushin the point of sales in Lagos state. Preliminary study was conducted with the use of primary data collected through well-structured questionnaires administered on 60 respondents and 55 fully completed ones analysed. Budgeting, gross margin and multiple linear regression were used for analyses. Most merchants were found to be in the middle age class (30-50 years), majority of whom were female and completed their secondary school education, with eighty percent having more than 5 years’ experience of in banana/plantain marketing. The highest losses were incurred during transportation and these losses constitute about 5.62 percent of the potential total revenue. On the average, loss in gross margin is about ₦6,000.00 per merchant. The impacts of these losses are reflected in the continuously reducing level of their income. Age of the respondents played a major role in determining the level of care in the handling of the fruits. The middle age class tends to be more favoured. In conclusion, the merchants need adequate and sustainable transportation and storage facilities as a matter of utmost urgency. There is the need for government to encourage producers of the product (farmers) by giving them motivating incentives and ensuring that the environment is made conducive also for dealers by providing adequate storage facilities and ready markets locally and possibly for export.

Keywords: post-harvest, losses, plantain, banana, simple regression

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9567 Flow Control Optimisation Using Vortex Generators in Turbine Blade

Authors: J. Karthik, G. Vinayagamurthy

Abstract:

Aerodynamic flow control is achieved by interaction of flowing medium with corresponding structure so that its natural flow state is disturbed to delay the transition point. This paper explains the aerodynamic effect and optimized design of Vortex Generators on the turbine blade to achieve maximum flow control. The airfoil is chosen from NREL [National Renewable Energy Laboratory] S-series airfoil as they are characterized with good lift characteristics and lower noise. Vortex generators typically chosen are Ogival, Rectangular, Triangular and Tapered Fin shapes attached near leading edge. Vortex generators are typically distributed from the primary to tip of the blade section. The design wind speed is taken as 6m/s and the computational analysis is executed. The blade surface is simulated using k- ɛ SST model and results are compared with X-FOIL results. The computational results are validated using Wind Tunnel Testing of the blade corresponding to the design speed. The effect of Vortex generators on the flow characteristics is studied from the results of analysis. By comparing the computational and test results of all shapes of Vortex generators; the optimized design is achieved for effective flow control corresponding to the blade.

Keywords: flow control, vortex generators, design optimisation, CFD

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9566 Impression Evaluation by Design Change of Anthropomorphic Agent

Authors: Kazuko Sakamoto

Abstract:

Anthropomorphic agents have been successful in areas where there are many human interactions, such as education and medical care. The persuasive effect is also expected in e-shopping sites on the web. This indicates that customer service is not necessarily human but can play that role. However, the 'humanity' in anthropomorphism sometimes has a risk of working negatively. In general, as the appearance of anthropomorphic agents approaches humans, it is thought that their affinity with humans increases. However, when the degree of similarity reaches a certain level, it gives the user a weird feeling. This is the 'eerie valley' phenomenon. This is a concept used in the world of robotics, but it seems to be applicable to anthropomorphic agents such as characters. Then what kind of design can you accept as an anthropomorphic agent that gives you a feeling of friendliness or good feeling without causing discomfort or fear to people? This study focused on this point and examined what design and characteristics would be effective for marketing communication. As a result of the investigation, it was found that there is no need for gaze and blinking, the size of the eyes is normal or large, and the impression evaluation is higher when the structure is as simple as possible. Conversely, agents with high eye-gaze and white-eye ratios had low evaluations, and the negative impact on eye-gaze was particularly large.

Keywords: anthropomorphicgents, design evaluation, marketing communication, customer service

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9565 Effect of Surfactant Concentration on Dissolution of Hydrodynamically Trapped Sparingly Soluble Oil Micro Droplets

Authors: Adil Mustafa, Ahmet Erten, Alper Kiraz, Melikhan Tanyeri

Abstract:

Work presented here is based on a novel experimental technique used to hydrodynamically trap oil microdroplets inside a microfluidic chip at the junction of microchannels known as stagnation point. Hydrodynamic trapping has been recently used to trap and manipulate a number of particles starting from microbeads to DNA and single cells. Benzyl Benzoate (BB) is used as droplet material. The microdroplets are trapped individually at stagnation point and their dissolution was observed. Experiments are performed for two concentrations (10mM or 10µM) of AOT surfactant (Docusate Sodium Salt) and two flow rates for each case. Moreover, experimental data is compared with Zhang-Yang-Mao (ZYM) model which studies dissolution of liquid microdroplets in the presence of a host fluid experiencing extensional creeping flow. Industrial processes like polymer blending systems in which heat or mass transport occurs experience extensional flow and an insight into these phenomena is of significant importance to many industrial processes. The experimental technique exploited here gives an insight into the dissolution of liquid microdroplets under extensional flow regime. The comparison of our experimental results with ZYM model reveals that dissolution of microdroplets at lower surfactant concentration (10µM) fits the ZYM model at saturation concentration (Cs) value reported in literature (Cs = 15×10⁻³Kg\m³) while for higher surfactant concentration (10mM) which is also above the critical micelle concentration (CMC) of surfactant (5mM) the data fits ZYM model at (Cs = 45×10⁻³Kg\m³) which is 3X times the value reported in literature. The difference in Cs value from the literature shows enhancement in dissolution rate of sparingly soluble BB microdroplets at surfactant concentrations higher than CMC. Enhancement in the dissolution of sparingly soluble materials is of great importance in pharmaceutical industry. Enhancement in the dissolution of sparingly soluble drugs is a key research area for drug design industry. The experimental method is also advantageous because it is robust and has no mechanical contact with droplets under study are freely suspended in the fluid as compared existing methods used for testing dissolution of drugs. The experiments also give an insight into CMC measurement for surfactants.

Keywords: extensional flow, hydrodynamic trapping, Zhang-Yang-Mao, CMC

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9564 Improve B-Tree Index’s Performance Using Lock-Free Hash Table

Authors: Zhanfeng Ma, Zhiping Xiong, Hu Yin, Zhengwei She, Aditya P. Gurajada, Tianlun Chen, Ying Li

Abstract:

Many RDBMS vendors use B-tree index to achieve high performance for point queries and range queries, and some of them also employ hash index to further enhance the performance as hash table is more efficient for point queries. However, there are extra overheads to maintain a separate hash index, for example, hash mapping for all data records must always be maintained, which results in more memory space consumption; locking, logging and other mechanisms are needed to guarantee ACID, which affects the concurrency and scalability of the system. To relieve the overheads, Hash Cached B-tree (HCB) index is proposed in this paper, which consists of a standard disk-based B-tree index and an additional in-memory lock-free hash table. Initially, only the B-tree index is constructed for all data records, the hash table is built on the fly based on runtime workload, only data records accessed by point queries are indexed using hash table, this helps reduce the memory footprint. Changes to hash table are done using compare-and-swap (CAS) without performing locking and logging, this helps improve the concurrency and avoid contention. The hash table is also optimized to be cache conscious. HCB index is implemented in SAP ASE database, compared with the standard B-tree index, early experiments and customer adoptions show significant performance improvement. This paper provides an overview of the design of HCB index and reports the experimental results.

Keywords: B-tree, compare-and-swap, lock-free hash table, point queries, range queries, SAP ASE database

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9563 Support Provided by Midwives to Women during Labour in a Public Hospital, Limpopo Province, South Africa: A Participant Observation Study

Authors: Sonto Maputle

Abstract:

Background: Support during labour increase women's chances of having positive childbirth experiences as well as childbirth outcomes. The purpose of this study was to determine the support provided by midwives to women during labour at the public hospital in Limpopo Province. The study was conducted at the Tertiary hospital in Limpopo Province. Methods: A qualitative, participant observation approach was used. Population consisted of all women that were admitted to deliver their babies and the midwives who provided midwifery care in the obstetric unit of one tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data was analysed qualitatively but were presented in the tables and bar graphs. Results: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. Conclusion: The communication was occurring when the midwife was rendering midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers’ participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Keywords: communication between women and midwives, labour pains, informational and emotional support, physical comforting measures

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9562 Existence of Positive Solutions to a Dirichlet Second Order Boundary Value Problem

Authors: Muhammad Sufian Jusoh, Mesliza Mohamed

Abstract:

In this paper, we investigate the existence of positive solutions for a Dirichlet second order boundary value problem by applying the Krasnosel'skii fixed point theorem on compression and expansion of cones.

Keywords: Krasnosel'skii fixed point theorem, positive solutions, Dirichlet boundary value problem, Dirichlet second order boundary problem

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9561 Air-Coupled Ultrasonic Testing for Non-Destructive Evaluation of Various Aerospace Composite Materials by Laser Vibrometry

Authors: J. Vyas, R. Kazys, J. Sestoke

Abstract:

Air-coupled ultrasonic is the contactless ultrasonic measurement approach which has become widespread for material characterization in Aerospace industry. It is always essential for the requirement of lightest weight, without compromising the durability. To archive the requirements, composite materials are widely used. This paper yields analysis of the air-coupled ultrasonics for composite materials such as CFRP (Carbon Fibre Reinforced Polymer) and GLARE (Glass Fiber Metal Laminate) and honeycombs for the design of modern aircrafts. Laser vibrometry could be the key source of characterization for the aerospace components. The air-coupled ultrasonics fundamentals, including principles, working modes and transducer arrangements used for this purpose is also recounted in brief. The emphasis of this paper is to approach the developed NDT techniques based on the ultrasonic guided waves applications and the possibilities of use of laser vibrometry in different materials with non-contact measurement of guided waves. 3D assessment technique which employs the single point laser head using, automatic scanning relocation of the material to assess the mechanical displacement including pros and cons of the composite materials for aerospace applications with defects and delaminations.

Keywords: air-coupled ultrasonics, contactless measurement, laser interferometry, NDT, ultrasonic guided waves

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9560 Factors Associated with Commencement of Non-Invasive Ventilation

Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

Abstract:

Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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9559 Behavioral Mapping and Post-Occupancy Evaluation of Meeting-Point Design in an International Airport

Authors: Meng-Cong Zheng, Yu-Sheng Chen

Abstract:

The meeting behavior is a pervasive kind of interaction, which often occurs between the passenger and the shuttle. However, the meeting point set up at the Taoyuan International Airport is too far from the entry-exit, often causing passengers to stop searching near the entry-exit. When the number of people waiting for the rush hour increases, it often results in chaos in the waiting area. This study tried to find out what is the key factor to promote the rapid finding of each other between the passengers and the pick-ups. Then we implemented several design proposals to improve the meeting behavior of passengers and pick-ups based on behavior mapping and post-occupancy evaluation to enhance their meeting efficiency in unfamiliar environments. The research base is the reception hall of the second terminal of Taoyuan International Airport. Behavioral observation and mapping are implemented on the entry of inbound passengers into the welcome space, including the crowd distribution of the people who rely on the separation wall in the waiting area, the behavior of meeting and the interaction between the inbound passengers and the pick-ups. Then we redesign the space planning and signage design based on post-occupancy evaluation to verify the effectiveness of space plan and signage design. This study found that passengers ignore existing meeting-point designs which are placed on distant pillars at both ends. The position of the screen affects the area where the receiver is stranded, causing the pick-ups to block the passenger's moving line. The pick-ups prefer to wait where it is easy to watch incoming passengers and where it is closest to the mode of transport they take when leaving. Large visitors tend to gather next to landmarks, and smaller groups have a wide waiting area in the lobby. The location of the meeting point chosen by the pick-ups is related to the view of the incoming passenger. Finally, this study proposes an improved design of the meeting point, setting the traffic information in it, so that most passengers can see the traffic information when they enter the country. At the same time, we also redesigned the pick-ups desk to improve the efficiency of passenger meeting.

Keywords: meeting point design, post-occupancy evaluation, behavioral mapping, international airport

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9558 A Four-Step Ortho-Rectification Procedure for Geo-Referencing Video Streams from a Low-Cost UAV

Authors: B. O. Olawale, C. R. Chatwin, R. C. D. Young, P. M. Birch, F. O. Faithpraise, A. O. Olukiran

Abstract:

Ortho-rectification is the process of geometrically correcting an aerial image such that the scale is uniform. The ortho-image formed from the process is corrected for lens distortion, topographic relief, and camera tilt. This can be used to measure true distances, because it is an accurate representation of the Earth’s surface. Ortho-rectification and geo-referencing are essential to pin point the exact location of targets in video imagery acquired at the UAV platform. This can only be achieved by comparing such video imagery with an existing digital map. However, it is only when the image is ortho-rectified with the same co-ordinate system as an existing map that such a comparison is possible. The video image sequences from the UAV platform must be geo-registered, that is, each video frame must carry the necessary camera information before performing the ortho-rectification process. Each rectified image frame can then be mosaicked together to form a seamless image map covering the selected area. This can then be used for comparison with an existing map for geo-referencing. In this paper, we present a four-step ortho-rectification procedure for real-time geo-referencing of video data from a low-cost UAV equipped with multi-sensor system. The basic procedures for the real-time ortho-rectification are: (1) Decompilation of video stream into individual frames; (2) Finding of interior camera orientation parameters; (3) Finding the relative exterior orientation parameters for each video frames with respect to each other; (4) Finding the absolute exterior orientation parameters, using self-calibration adjustment with the aid of a mathematical model. Each ortho-rectified video frame is then mosaicked together to produce a 2-D planimetric mapping, which can be compared with a well referenced existing digital map for the purpose of georeferencing and aerial surveillance. A test field located in Abuja, Nigeria was used for testing our method. Fifteen minutes video and telemetry data were collected using the UAV and the data collected were processed using the four-step ortho-rectification procedure. The results demonstrated that the geometric measurement of the control field from ortho-images are more reliable than those from original perspective photographs when used to pin point the exact location of targets on the video imagery acquired by the UAV. The 2-D planimetric accuracy when compared with the 6 control points measured by a GPS receiver is between 3 to 5 meters.

Keywords: geo-referencing, ortho-rectification, video frame, self-calibration

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9557 Role of mHealth in Effective Response to Disaster

Authors: Mohammad H. Yarmohamadian, Reza Safdari, Nahid Tavakoli

Abstract:

In recent years, many countries have suffered various natural disasters. Disaster response continues to face the challenges in health care sector in all countries. Information and communication management is a significant challenge in disaster scene. During the last decades, rapid advances in information technology have led to manage information effectively and improve communication in health care setting. Information technology is a vital solution for effective response to disasters and emergencies so that if an efficient ICT-based health information system is available, it will be highly valuable in such situation. Of that, mobile technology represents a nearly computing technology infrastructure that is accessible, convenient, inexpensive and easy to use. Most projects have not yet reached the deployment stage, but evaluation exercises show that mHealth should allow faster processing and transport of patients, improved accuracy of triage and better monitoring of unattended patients at a disaster scene. Since there is a high prevalence of cell phones among world population, it is expected the health care providers and managers to take measures for applying this technology for improvement patient safety and public health in disasters. At present there are challenges in the utilization of mhealth in disasters such as lack of structural and financial issues in our country. In this paper we will discuss about benefits and challenges of mhealth technology in disaster setting considering connectivity, usability, intelligibility, communication and teaching for implementing this technology for disaster response.

Keywords: information technology, mhealth, disaster, effective response

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9556 Experimental and Numerical Analysis of Mustafa Paşa Mosque in Skopje

Authors: Ozden Saygili, Eser Cakti

Abstract:

The masonry building stock in Istanbul and in other cities of Turkey are exposed to significant earthquake hazard. Determination of the safety of masonry structures against earthquakes is a complex challenge. This study deals with experimental tests and non-linear dynamic analysis of masonry structures modeled through discrete element method. The 1:10 scale model of Mustafa Paşa Mosque was constructed and the data were obtained from the sensors on it during its testing on the shake table. The results were used in the calibration/validation of the numerical model created on the basis of the 1:10 scale model built for shake table testing. 3D distinct element model was developed that represents the linear and nonlinear behavior of the shake table model as closely as possible during experimental tests. Results of numerical analyses with those from the experimental program were compared and discussed.

Keywords: dynamic analysis, non-linear modeling, shake table tests, masonry

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9555 Modified Bat Algorithm for Economic Load Dispatch Problem

Authors: Daljinder Singh, J.S.Dhillon, Balraj Singh

Abstract:

According to no free lunch theorem, a single search technique cannot perform best in all conditions. Optimization method can be attractive choice to solve optimization problem that may have exclusive advantages like robust and reliable performance, global search capability, little information requirement, ease of implementation, parallelism, no requirement of differentiable and continuous objective function. In order to synergize between exploration and exploitation and to further enhance the performance of Bat algorithm, the paper proposed a modified bat algorithm that adds additional search procedure based on bat’s previous experience. The proposed algorithm is used for solving the economic load dispatch (ELD) problem. The practical constraint such valve-point loading along with power balance constraints and generator limit are undertaken. To take care of power demand constraint variable elimination method is exploited. The proposed algorithm is tested on various ELD problems. The results obtained show that the proposed algorithm is capable of performing better in majority of ELD problems considered and is at par with existing algorithms for some of problems.

Keywords: bat algorithm, economic load dispatch, penalty method, variable elimination method

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9554 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana

Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

Abstract:

Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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9553 A Bicycle Based Model of Prehospital Care Implanted in Northeast of the Brazil: Initial Experience

Authors: Odaleia de O. Farias, Suzelene C. Marinho, Ecleidson B. Fragoso, Daniel S. Lima, Francisco R. S. Lira, Lara S. Araújo, Gabriel dos S. D. Soares

Abstract:

In populous cities, prehospital care services that use vehicles alternative to ambulances are needed in order to reduce costs and improve response time to occurrences in areas with large concentration of people, such as leisure and tourism spaces. In this context, it was implanted a program called BIKE VIDA, that is innovative quick access and assistance program. The aim of this study is to describe the implantation and initial profile of occurrences performed by an urgency/emergency pre-hospital care service through paramedics on bicycles. It is a cross-sectional, descriptive study carried out in the city of Fortaleza, Ceara, Brazil. The data included service records from July to August 2017. Ethical aspects were respected. The service covers a perimeter of 4.5 km, divided into three areas with perimeter of 1.5 km for each paramedic, attending from 5 am to 9 pm. Materials transported by bicycles include External Automated Defibrillator - DEA, portable oxygen, oximeter, cervical collar, stethoscope, sphygmomanometer, dressing and immobilization materials and personal protective equipment. Occurrences are requested directly by calling the emergency number 192 or through direct approach to the professional. In the first month of the program, there were 93 emergencies/urgencies, mainly in the daytime period (71,0%), in males (59,7%), in the age range of 26 to 45 years (46,2%). The main nature was traumatic incidents (53.3%). Most of the cases (88,2%) did not require ambulance transport to the hospital, and there were two deaths. Pre-hospital service through bicycles is an innovative strategy in Brazil and has shown to be promising in terms of reducing costs and improving the quality of the services offered.

Keywords: emergency, response time, prehospital care, urgency

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9552 The Organization of Multi-Field Hospital’s Work Environment in the Republic of Sakha, Yakutia

Authors: Inna Vinokurova, N. Savvina

Abstract:

The goal of research: to study the organization of multi-field hospital’s work environment in the Republic of Sakha (Yakutia), Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine. Results: Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine is a multidisciplinary, specialized hospital complex that provides specialized and high-tech medical care to children and adults in the Republic of Sakha (Yakutia) of the Russian Federation. There are 5 diagnostic and treatment centers (advisory and diagnostic, clinical, pediatric, perinatal, Republican cardiologic dispensary) with 45 clinical specialized departments with 727 cots, 5 resuscitation departments, 20 operating rooms and out-patient department with 905 visits in alternation in the National Center of Medicine. Annually more than 20,000 patients receive treatment in the hospital of the Republican Hospital of the Republic of Sakha (Yakutia), more than 70,000 patients visit out-patient sections, more than 2 million researches are done, more than 12,000 surgeries are performed, more than 2 thousand babies are delivered. National Center of Medicine has a great influence with such population’s health indicators as total mortality, birth rate, maternal, infant and perinatal mortality, circulatory system incidence. The work environment of the Republican Hospital of the Republic of Sakha (Yakutia) is represented by the following structural departments: pharmacy, blood transfusion department, sterilization department, laundry, dietetic department, infant-feeding centre, material and technical supply. More than 200 employees work in this service. The main function of these services is to provide on-time and fail-safe supply with all necessary: wear parts, medical supplies, donated blood and its components, foodstuffs, hospital linen , sterile instruments, etc. Thus, the activity of medical organization depends on the work environment, including quality health care, so it is a main part of multi-field hospital activity.

Keywords: organization of multi-field hospital’s, work environment, quality health care, pharmacy, blood transfusion department, sterilization department

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9551 Determining Abnomal Behaviors in UAV Robots for Trajectory Control in Teleoperation

Authors: Kiwon Yeom

Abstract:

Change points are abrupt variations in a data sequence. Detection of change points is useful in modeling, analyzing, and predicting time series in application areas such as robotics and teleoperation. In this paper, a change point is defined to be a discontinuity in one of its derivatives. This paper presents a reliable method for detecting discontinuities within a three-dimensional trajectory data. The problem of determining one or more discontinuities is considered in regular and irregular trajectory data from teleoperation. We examine the geometric detection algorithm and illustrate the use of the method on real data examples.

Keywords: change point, discontinuity, teleoperation, abrupt variation

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9550 Impact of Series Reactive Compensation on Increasing a Distribution Network Distributed Generation Hosting Capacity

Authors: Moataz Ammar, Ahdab Elmorshedy

Abstract:

The distributed generation hosting capacity of a distribution network is typically limited at a given connection point by the upper voltage limit that can be violated due to the injection of active power into the distribution network. The upper voltage limit violation concern becomes more important as the network equivalent resistance increases with respect to its equivalent reactance. This paper investigates the impact of modifying the distribution network equivalent reactance at the point of connection such that the upper voltage limit is violated at a higher distributed generation penetration, than it would without the addition of series reactive compensation. The results show that series reactive compensation proves efficient in certain situations (based on the ratio of equivalent network reactance to equivalent network resistance at the point of connection). As opposed to the conventional case of capacitive compensation of a distribution network to reduce voltage drop, inductive compensation is seen to be more appropriate for alleviation of distributed-generation-induced voltage rise.

Keywords: distributed generation, distribution networks, series compensation, voltage rise

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9549 Bioethanol Production from Wild Sorghum (Sorghum arundinacieum) and Spear Grass (Heteropogon contortus)

Authors: Adeyinka Adesanya, Isaac Bamgboye

Abstract:

There is a growing need to develop the processes to produce renewable fuels and chemicals due to the economic, political, and environmental concerns associated with fossil fuels. Lignocellulosic biomass is an excellent renewable feedstock because it is both abundant and inexpensive. This project aims at producing bioethanol from lignocellulosic plants (Sorghum Arundinacieum and Heteropogon Contortus) by biochemical means, computing the energy audit of the process and determining the fuel properties of the produced ethanol. Acid pretreatment (0.5% H2SO4 solution) and enzymatic hydrolysis (using malted barley as enzyme source) were employed. The ethanol yield of wild sorghum was found to be 20% while that of spear grass was 15%. The fuel properties of the bioethanol from wild sorghum are 1.227 centipoise for viscosity, 1.10 g/cm3 for density, 0.90 for specific gravity, 78 °C for boiling point and the cloud point was found to be below -30 °C. That of spear grass was 1.206 centipoise for viscosity, 0.93 g/cm3 for density 1.08 specific gravity, 78 °C for boiling point and the cloud point was also found to be below -30 °C. The energy audit shows that about 64 % of the total energy was used up during pretreatment, while product recovery which was done manually demanded about 31 % of the total energy. Enzymatic hydrolysis, fermentation, and distillation total energy input were 1.95 %, 1.49 % and 1.04 % respectively, the alcoholometric strength of bioethanol from wild sorghum was found to be 47 % and the alcoholometric strength of bioethanol from spear grass was 72 %. Also, the energy efficiency of the bioethanol production for both grasses was 3.85 %.

Keywords: lignocellulosic biomass, wild sorghum, spear grass, biochemical conversion

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9548 On the System of Split Equilibrium and Fixed Point Problems in Real Hilbert Spaces

Authors: Francis O. Nwawuru, Jeremiah N. Ezeora

Abstract:

In this paper, a new algorithm for solving the system of split equilibrium and fixed point problems in real Hilbert spaces is considered. The equilibrium bifunction involves a nite family of pseudo-monotone mappings, which is an improvement over monotone operators. More so, it turns out that the solution of the finite family of nonexpansive mappings. The regularized parameters do not depend on Lipschitz constants. Also, the computations of the stepsize, which plays a crucial role in the convergence analysis of the proposed method, do require prior knowledge of the norm of the involved bounded linear map. Furthermore, to speed up the rate of convergence, an inertial term technique is introduced in the proposed method. Under standard assumptions on the operators and the control sequences, using a modified Halpern iteration method, we establish strong convergence, a desired result in applications. Finally, the proposed scheme is applied to solve some optimization problems. The result obtained improves numerous results announced earlier in this direction.

Keywords: equilibrium, Hilbert spaces, fixed point, nonexpansive mapping, extragradient method, regularized equilibrium

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9547 National Accreditation Board for Hospitals and Healthcare Reaccreditation, the Challenges and Advantages: A Qualitative Case Study

Authors: Narottam Puri, Gurvinder Kaur

Abstract:

Background: The National Accreditation Board for Hospitals & Healthcare Providers (NABH) is India’s apex standard setting accrediting body in health care which evaluates and accredits healthcare organizations. NABH requires accredited organizations to become reaccredited every three years. It is often though that once the initial accreditation is complete, the foundation is set and reaccreditation is a much simpler process. Fortis Hospital, Shalimar Bagh, a part of the Fortis Healthcare group is a 262 bed, multi-specialty tertiary care hospital. The hospital was successfully accredited in the year 2012. On completion of its first cycle, the hospital underwent a reaccreditation assessment in the year 2015. This paper aims to gain a better understanding of the challenges that accredited hospitals face when preparing for a renewal of their accreditations. Methods: The study was conducted using a cross-sectional mixed methods approach; semi-structured interviews were conducted with senior leadership team and staff members including doctors and nurses. Documents collated by the QA team while preparing for the re-assessment like the data on quality indicators: the method of collection, analysis, trending, continual incremental improvements made over time, minutes of the meetings, amendments made to the existing policies and new policies drafted was reviewed to understand the challenges. Results: The senior leadership had a concern about the cost of accreditation and its impact on the quality of health care services considering the staff effort and time consumed it. The management was however in favor of continuing with the accreditation since it offered competitive advantage, strengthened community confidence besides better pay rates from the payors. The clinicians regarded it as an increased non-clinical workload. Doctors felt accountable within a professional framework, to themselves, the patient and family, their peers and to their profession; but not to accreditation bodies and raised concerns on how the quality indicators were measured. The departmental leaders had a positive perception of accreditation. They agreed that it ensured high standards of care and improved management of their functional areas. However, they were reluctant in sparing people for the QA activities due to staffing issues. With staff turnover, a lot of work was lost as sticky knowledge and had to be redone. Listing the continual quality improvement initiatives over the last 3 years was a challenge in itself. Conclusion: The success of any quality assurance reaccreditation program depends almost entirely on the commitment and interest of the administrators, nurses, paramedical staff, and clinicians. The leader of the Quality Movement is critical in propelling and building momentum. Leaders need to recognize skepticism and resistance and consider ways in which staff can become positively engaged. Involvement of all the functional owners is the start point towards building ownership and accountability for standards compliance. Creativity plays a very valuable role. Communication by Mail Series, WhatsApp groups, Quizzes, Events, and any and every form helps. Leaders must be able to generate interest and commitment without burdening clinical and administrative staff with an activity they neither understand nor believe in.

Keywords: NABH, reaccreditation, quality assurance, quality indicators

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