Search results for: hospital industry

Authors: Shihab-Uz-Zaman Shah, Sanjeeb Roy, Habiba Akter

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Keeping the high impact of the Ready-Made Garments (RMG) on the country’s economic growth in mind, this research paves a way for the implementation of Industry 4.0 in the garments industry of Bangladesh. At present, Industry 4.0 is a common buzzword representing the adoption of digital technologies in the production process to transform the existing industries into smart factories and create a great change in the global value chain. The RMG industry is the largest industrial sector of Bangladesh which provides 12.26% to its National GDP (Gross Domestic Product). The work starts with identifying possible enablers of Industry 4.0. To evaluate the enablers, a Multiple-Criteria Decision-Making (MCDM) procedure named Fuzzy Analytical Hierarchy Process (FAHP) was used. A questionnaire was developed as a part of a survey for collecting and analyzing expert opinions from relevant academicians and industrialists. The responses were eventually used as the input for the FAHP which helped to assign weight matrices to the enablers. This weight matrix indicated the level of importance of these enablers. The full paper will discuss the way of a successful evaluation of the enablers and implementation of Industry 4.0 by using these enablers.

Keywords: enablers, fuzzy AHP, industry 4.0, RMG sector

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Authors: Ahasanul Haque, Noor Hazilah Abd Manaf, Zohurul Anis, Tarekol Islam

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Sustainable community health (SCH) is an example of a new healthcare concept formed from applying the Maqasid al-Shariah principle to hospital management and delivery services. Because the idea is novel, it needs comprehensive and ongoing investigation to be improved. However, there is a lack of research on the necessity of developing sustainable community health (SCH), particularly its organizational structure. Furthermore, there is a misconception about the order of components in Maqasid al-Shariah, particularly in a hospital setting. Furthermore, the use of medicines and treatment by conventional recommendations to carry out the treatment by the Maqasid al Shariah. As such, this study focuses on the essential prerequisite for establishing a sustainable community health system based on Maqasid al-Shariah. This study discusses the use of Maqasid al-Shariah in administration and treatment. In this qualitative research approach, a literature search and interviews with specialists are conducted. The gathered data is examined using content analysis, emphasizing inductive and deductive reasoning. The research reveals that the Shariah Advisory Council and Shariah Critical Point are necessary for sustainable community health. In conclusion, by discussing the causes for each instance, this research adds to the creation of methods for determining the level of Maasid al-Shariah in-hospital care.

Keywords: empowering, sustainability, community health, maqasid al shariah, hospital and malaysia

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Authors: Michael Kho Lim

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This paper examines the status of the film industry as an industry in the Philippines—where or how it is classified in the Philippine industrial classification system and how this positioning gives the film industry an identity (or not) and affects (film) policy development and impacts the larger national economy. It is important to look at how the national government recognises Philippine cinema officially, as this will have a direct and indirect impact on the industry in terms of its representation, conduct of business, international relations, and most especially its implications on policy development and implementation. Therefore, it is imperative that the ‘identity’ of Philippine cinema be clearly established and defined in the overall industrial landscape. Having a clear understanding of Philippine cinema’s industry status provides a better view of the bigger picture and helps us determine cinema’s position in the national agenda in terms of priority setting, future direction and how the state perceives and thereby values the film industry as an industry. This will then serve as a frame of reference that will anchor the succeeding discussion. Once the Philippine film industry status is identified, the paper will then clarify how cultural policy is defined, understood, and applied in the Philippines in relation to Philippine cinema by reviewing and analyzing existing policy documents and pending bills in the Philippine Congress and Senate. Lastly, the paper delves into the roles that (national) cultural institutions and industry organisations play as primary drivers or support mechanisms and how they become platforms (or not) for the upliftment of the independent film sector and towards the sustainability of the film industry. The paper concludes by arguing that the role of the government and how government officials perceive and treats culture is far more important than cultural policy itself, as these policies emanate from them.

Keywords: cultural and creative industries, cultural policy, film industry, Philippine cinema

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Authors: Prudvi Paresi, Fatemeh Javidan

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In recent years, greenhouse gas, or in particular, carbon emissions, have received special attention from environmentalists and designers due to the fact that they significantly contribute to the temperature rise. The building industry is one of the top seven major industries contributing to embodied carbon emission. Signage systems are an integral part of the building industry and bring completeness to the space-building by providing the required information and guidance. A significant amount of building materials, such as steel, aluminium, acrylic, LED, etc., are utilized in these systems, but very limited information is available on their sustainability and carbon footprint. Therefore, there is an urgent need to assess the emissions associated with the signage industry and for controlling these by adopting different mitigation techniques without sacrificing the efficiency of the project. The present paper investigates the embodied carbon of two case studies in the Australian signage industry within the cradle – gate (A1-A3) and gate–site (A4-A5) stages. A material source-based database is considered to achieve more accuracy. The study identified that aluminium is the major contributor to embodied carbon in the signage industry compared to other constituents. Finally, an attempt is made to suggest strategies for mitigating embodied carbon in this industry.

Keywords: carbon accounting, small-scale construction, signage industry, construction materials

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Authors: Jing Jiang, Yuguang Gao, Yang Yu

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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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Authors: Dalia Bhattacharjee

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Motherhood as an institution is considered as sacred. Reproduction and motherhood have always been a concern of the private space of home. However, with the emergence of technologies like the Assisted Reproductive Technologies (ARTs), this intimate area has moved into the public. A woman can now become a mother with artificial insemination done by expert medical professionals in a hospital. With this development, the meanings of motherhood and childrearing have altered. Mothers have been divided into ‘ovarian mothers’ (those who provide the eggs), ‘uterine mothers’ (those who carry out the pregnancy and give birth), and ‘social mothers’ (those who raise the child). Thus, the ART business deconstructs motherhood by defining who the biological mother is and who the social mother is and who – despite contributing parts or processes of her body to the life of the child is not a mother, but merely the donor of a product, be it the egg or the womb, which is owned by those who are favoured by the contract. The industry of commercial surrogacy in India has been estimated to be of $2.3 billion as of 2012. There are many women who work as surrogate mothers in this industry for the exchange of money. It runs like a full-fledged business guided by a highly profit oriented capitalist market. The reproductive labourers are identified as mere womb renters or victims and not as active agents in such arrangements. Such a discourse undercuts the agency exercised by the women. The present study is an ethnography into the commercial surrogacy industry in India. This journey furthers the understanding of the dilemmas faced by the reproductive labourers. The paper emphasizes on the experiences of reproduction and motherhood outside the private space of the home in the commercial surrogacy industry in India, and, argues that this multiplicity of experiences need much focus and attention, where, the consumer becomes ‘the’ citizen and the women workers continue to be victims. The study draws on the narratives of the reproductive labourers, who remain at the center, and yet, at the periphery of such arrangements. This feminist ethnography is informed by the feminist standpoint theory to account for and analyse these varied experiences which further the understanding of the dilemmas faced by the reproductive labourers.

Keywords: commercial surrogacy, ethnography, motherhood, standpoint theory

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Authors: Anjelika Kremer, Irina Nachimov, Dan Justo

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Background: C-reactive protein (CRP) serum levels are commonly measured in hospitalized patients. Elevated admission CRP serum levels and in-hospital mortality has been seldom studied in the general population of elderly patients admitted to the acute Geriatrics department. Methods: A retrospective cross-sectional study was conducted at a tertiary medical center. Included were all elderly patients (age 65 years or more) admitted to a single acute Geriatrics department from the emergency room between April 2014 and January 2015. CRP serum levels were measured routinely in all patients upon the first 24 hours of admission. A logistic regression analysis was used to study if admission CRP serum levels were associated with in-hospital mortality independent of age, gender, functional status, and co-morbidities. Results: Overall, 498 elderly patients were included in the analysis: 306 (61.4%) female patients and 192 (38.6%) male patients. The mean age was 84.8±7.0 years (median: 85 years; IQR: 80-90 years). The mean admission CRP serum levels was 43.2±67.1 mg/l (median: 13.1 mg/l; IQR: 2.8-51.7 mg/l). Overall, 33 (6.6%) elderly patients died during the hospitalization. A logistic regression analysis showed that in-hospital mortality was independently associated with history of stroke (p < 0.0001), heart failure (p < 0.0001), and admission CRP serum levels (p < 0.0001) – and to a lesser extent with age (p = 0.042), collagen vascular disease (p=0.011), and recent venous thromboembolism (p=0.037). Receiver operating characteristic (ROC) curve showed that admission CRP serum levels predict in-hospital mortality fairly with an area under the curve (AUC) of 0.694 (p < 0.0001). Cut-off value with maximal sensitivity and specificity was 19.7 mg/L. Conclusions: Admission CRP serum levels may be used to predict in-hospital mortality in the general population of elderly patients admitted to the acute Geriatrics department.

Keywords: c-reactive protein, elderly, mortality, prediction

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Authors: Shireesha Devraj, Vishwanath Kokkonda

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Information Technology Industry is one of the fastest up-and-coming, knowledge and skill concentrated industries in India. India preserves its position as the world’s notable global sourcing terminus for IT services. The swift progress in the competitive age is possible only through effective human resource development practices. In the IT industry attracting, nurturing talent, retaining and managing human resources have been the principal issues. The sustenance and growth of IT companies worldwide depends on the intellectual capital it possesses. The IT sector cannot be effectively managed through traditional human resource development practices. In order to stay competitive in future, the IT sector in India has to enrich the skilled talent pool through pertinent HRD practices. An attempt is made in this paper to study the trends in Indian IT Industry.

Keywords: HRD practices, IT industry, India, competitive age

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Authors: Ahmed Stifi, Sascha Gentes, Fritz Gehbauer

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The construction industry is perhaps one of the oldest industry of the world. The ancient monuments like the egyptian pyramids, the temples of Greeks and Romans like Parthenon and Pantheon, the robust bridges, old Roman theatres, the citadels and many more are the best testament to that. The industry also has a symbiotic relationship with other . Some of the heavy engineering industry provide construction machineries, chemical industry develop innovative construction materials, finance sector provides fund solutions for complex construction projects and many more. Construction Industry is not only mammoth but also very complex in nature. Because of the complexity, construction industry is prone to various tribulations which may have the propensity to hamper its growth. The comparitive study of this industry with other depicts that it is associated with a state of tardiness and delay especially when we focus on the managerial aspects and the study of triple constraint (time, cost and scope). While some institutes says the complexity associated with it as a major reason, others like lean construction, refers to the wastes produced across the construction process as the prime reason. This paper introduces corruption as one of the prime factors for such delays.To support this many international reports and studies are available depicting that construction industry is one of the most corrupt sectors worldwide, and the corruption can take place throught the project cycle comprising project selection, planning, design, funding, pre-qualification, tendering, execution, operation and maintenance, and even through the reconstrction phase. It also happens in many forms such as bribe, fraud, extortion, collusion, embezzlement and conflict of interest and the self-sufficient. As a solution to cope the corruption in construction industry, the paper introduces the integrity as a key factor and build a new integrity framework to develop and implement an integrity management system for construction companies and construction projects.

Keywords: corruption, construction industry, integrity, lean construction

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Authors: Ayanfulu Yekini

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The hotel and tourism industry remains male-dominated, particularly in the upper echelons of management and ICT remained underutilized. While there is a massive revolution in this trend across the globe, it appears much progress has not been made in our nation Nigeria. This paper aimed at evaluating the relevance of ICT and Gender Participation to Sustainability of Hospitality and Tourism Industry in Nigeria. The research study was conducted in tourism organizations, travel agents, hotels, restaurants, resorts, professionals in tourism, travel and hospitality industry within Nigeria. The respondents are from the tourism/hospitality industries employees and entrepreneurs only.

Keywords: ICT, hotel, gender participation, Nigeria, tourism

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Authors: H. K. V. Narayan

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This study was conducted at Tata Memorial Hospital (TMH), Mumbai, India. The study was to evaluate the impact of adapting Smart Card (SC) for clinical and business transactions in order to reduce Lead times and to enforce business rules of the hospital. The objective for implementing the Smart Card was to improve the patient perception of quality in terms of structures process and outcomes and also to improve the productivity of the Institution. The Smart Card was implemented in phases from 2011 and integrated with the Hospital Information System (HIS/EMR). The implementation was a learning curve for all the stake holders as software obviated the need to use hardcopies of transactions. The acceptability to the stake holders was challenge in change management. The study assessed the impact 3 years into the implementation and the observed trends have suggested that it has decreased the lead times for services and increased the no of transactions and thereby the productivity. Patients who used to complain of multiple queues and cumbersome transactions now compliment the administration for effective use of Information and Communication Technology.

Keywords: smart card, high availability of health care information, reduction in potential medical errors due to elimination of transcription errors, reduction in no of queues, increased transactions, augmentation of revenue

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: Emad Alenany, M. Adel El-Baz

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In this paper, the flow of different classes of patients into a hospital is modelled and analyzed by using the queueing network analyzer (QNA) algorithm and discrete event simulation. Input data for QNA are the rate and variability parameters of the arrival and service times in addition to the number of servers in each facility. Patient flows mostly match real flow for a hospital in Egypt. Based on the analysis of the waiting times, two approaches are suggested for improving performance: Separating patients into service groups, and adopting different service policies for sequencing patients through hospital units. The separation of a specific group of patients, with higher performance target, to be served separately from the rest of patients requiring lower performance target, requires the same capacity while improves performance for the selected group of patients with higher target. Besides, it is shown that adopting the shortest processing time and shortest remaining processing time service policies among other tested policies would results in, respectively, 11.47% and 13.75% reduction in average waiting time relative to first come first served policy.

Keywords: queueing network, discrete-event simulation, health applications, SPT

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Authors: Sumrina Kousar

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Objective: The aim of this study was to observe the effect of fortification of expressed human breast milk with olive oil and skimmed milk in improving weight gain in very low birth weight neonates and shortening their length of hospital stay. Study Design and place: A randomized controlled trial was carried out at the Combined Military Hospital Lahore from March 2018 to March 2019. Methods: Neonates admitted with very low birth weight and gestational age of < 34 weeks were included in the study. Sixty babies were enrolled using non-probability consecutive sampling; a random number table was used to allocate them into a fortification group and a control group. The control group received expressed milk alone, while olive oil 1 ml twice daily and skimmed milk 1 gram in every third feed were added to expressed milk in the fortification group. Data was analyzed on SPSS 20. Proportions were compared by applying the chi-square test. An independent sample t-test was applied for comparing means. A p-value of ≤ 0.05 was considered significant. Results: The study comprised of 60 neonates, with 30 in each of the groups. Weight gain was 24.83±5.63 in the fortification group and 11.72±3.95 in the control group (p =< 0.001). Mean hospital stay was 20.5716.511 in the fortification group and 27.678.89 in the control group (p =< 0.043). Conclusion: Olive oil and skimmed milk fortification of breast milk was effective for weight gain and reducing the length of hospital stay in very low birth weight neonates.

Keywords: fortification, olive oil, skimmed milk, weight gain

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Authors: Abdulaziz Alzeban

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This study examines whether internal audit function is indeed greater when audit committee members have industry expertise combined with auditing expertise. Data from a survey of 64 chief internal auditors from companies registered on the Saudi Stock Exchange TADAWL, provides results that suggest that when audit committee members possess both industry expertise and auditing expertise, the committee’s role in improving the quality of internal audit is enhanced. This outcome is concluded as one that can be generalized beyond the Saudi Arabian context.

Keywords: internal audit, audit committee, industry expertise, function

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Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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Authors: Mkhitaryan Davit

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The tourism and hospitality industry plays a significant role in China's economy, but it also poses environmental, social, and economic challenges. This paper examines the concept of sustainability within the context of China's tourism and hospitality industry, exploring best practices from 26 Hotels in 15 cities and identifying key challenges. Drawing upon a comprehensive review of existing literature, case studies, and interviews with industry experts, the paper highlights successful sustainability initiatives implemented by various stakeholders, including government bodies, businesses, and non-governmental organizations. Additionally, it discusses the barriers and obstacles hindering the widespread adoption of sustainable practices in the sector, such as lack of awareness, financial constraints, and regulatory issues. The findings provide insights for policymakers, industry practitioners, and researchers to develop strategies and solutions for promoting sustainable tourism and hospitality practices in China, ultimately contributing to the long-term viability and resilience of the industry.

Keywords: sustainability, waste management, renewable energy, hospitality

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Authors: Temidayo. O. Osunsanmi, Clinton Aigbavboa, Ayodeji Oke

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The construction industry is a renowned latecomer to the efficiency offered by the adoption of information technology. Whereas, the banking, manufacturing, retailing industries have keyed into the future by using digitization and information technology as a new approach for ensuring competitive gain and efficiency. The construction industry has yet to fully realize similar benefits because the adoption of ICT is still at the infancy stage with a major concentration on the use of software. Thus, this study evaluates the awareness and readiness of construction professionals towards embracing a full digitalization of the construction industry using construction 4.0. The term ‘construction 4.0’ was coined from the industry 4.0 concept which is regarded as the fourth industrial revolution that originated from Germany. A questionnaire was utilized for sourcing data distributed to practicing construction professionals through a convenience sampling method. Using SPSS v24, the hypotheses posed were tested with the Mann Whitney test. The result revealed that there are no differences between the consulting and contracting organizations on the readiness for adopting construction 4.0 concepts in the construction industry. Using factor analysis, the study discovers that adopting construction 4.0 will improve the performance of the construction industry regarding cost and time savings and also create sustainable buildings. In conclusion, the study determined that construction professionals have a low awareness towards construction 4.0 concepts. The study recommends an increase in awareness of construction 4.0 concepts through seminars, workshops and training, while construction professionals should take hold of the benefits of adopting construction 4.0 concepts. The study contributes to the roadmap for the implementation of construction industry 4.0 concepts in the South African construction industry.

Keywords: building information technology, Construction 4.0, Industry 4.0, smart site

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Authors: Hsiao-Tseng Lin, Nguyen Ngoc Dat, Szu-Mei Hsiao, R. J. Hernández-Díaz

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The practitioner system has become an important tool for universities working to shrink the gap between industry and vocational education. Beginning in 2015, Meiho University conducted a consecutive three-year program for teaching excellence, funded in part by Taiwan’s Ministry of Education, with a total project funding of over $2.5 million USD. One of the highlights of this program is the recruitment of 300 industry practitioners to participate in collaborative teaching, a dual-mentor system, and curriculum planning. More than 60% of the practitioners boast more than 10 years of practical industry experience, and 52% of them have earned master's degree or higher. Students rated their overall program satisfaction over 4.5(out of 5.0) on average. This study explores the perspectives of academics and industry practitioners using in-depth interviews and surveys, along with an examination of the challenges of the practitioner system. The paper enables the framing of practitioner system policies by vocational education institutions and industry to facilitate more effective and efficient transfer of knowledge between academics and practitioners, leading to enhanced university competitive advantage, which would ultimately benefit society.

Keywords: collaborative teaching, industry practitioners, practitioner system, vocational education

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Authors: Jessica Chukwuyem Molua, Collins O Molua

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The effective dose of selected health care workers who are constantly exposed to X-ray radiation was measured using thermoluminescence dosimeters (TLD) placed over the lead apron at the chest region in all categories of medical personnel investigated. To measure radiation in all the selected hospitals to ascertain the exposure of x-ray machines at exactly 1m from the primary source. The work was carried out within a year in each of the selected centers. The personnel examination records containing the type of examination each day, peak tube voltage, tube current, and exposure time, including the actual number of films used, were obtained. A total of 40personel were examined in government hospital Agbor, 21 in central hospital Owa Alero and 18 in Okonye hospital The method used here has also been used by other researchers. Findings showed that the results obtained from the three hospitals investigated in this work were found to conform with the recommendations of the National Commission on radiological and protection {NCRP} 70 and 116 protocols. The Radiologist in the three study areas has the highest dose level, but of particular note is the dosage of the radiologist in Okonye hospital. This, as observed, is because the protective shielding parameters were inadequate and this could result in severe health consequences over time.

Keywords: radiology, health, Agbor, Owa

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Authors: Yuhan Wu, CTB (Kees) Ahaus, Martina Buljac-Samardzic

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Patient aggression and violence is a complex occupational hazards for physicians working in hospitals, and it can have multiple severe negative effects for physicians and hospitals. Although there is a range of interventions in the healthcare sector applied in various countries, China lacks a comprehensive set of interventions at the hospital level in this area. Therefore, due to cultural differences, this study investigates whether international interventions are important and feasible in the Chinese cultural context by conducting a Delphi study. Based on a literature search, a list of 47 hospital interventions to prevent and manage patient aggression and violence was constructed, including 8 categories: hospital environment design, access and entrance, staffing and work practice, training and education, leadership and culture, support, during/after-the-event actions, and hospital policy. The list of interventions will be refined, extended and brought back during a three-round Delphi study. The panel consists of 17 Chinese experts, including physicians experiencing patient aggression and violence, hospital management team members, scientists working in this research area, and policymakers in the healthcare sector. In each round, experts will receive the possible interventions with the instruction to indicate the importance and feasibility of each intervention for preventing and managing patient violence and aggression in Chinese hospitals. Experts will be asked about the importance and feasibility of interventions for patient violence and aggression at the same time. This study will exclude or include interventions based on the score of importance. More specifically, an intervention will be included after each round if >80% of the experts judged it as important or very important and excluded if >50% judged an intervention as not or moderately important. The three-round Delphi study will provide a list of included interventions and assess which of the 8 categories of interventions are considered as important. It is expected that this study can bring new ideas and inspiration to Chinese hospitals in the prevention and management of patient aggression and violence.

Keywords: patient aggression and violence, hospital interventions, feasibility, importance

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Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

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Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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Authors: Kharina Budiman, Adinda Syifa Azhari, Eleonora Agustine

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Industrial activities get increase in this globalization era, one of the major impacts of industrial activities is a problem to the environment. This can happen because at the industrial production term will bring out pollutant in the shape of solid, liquid or gas. Normally this pollutant came from some dangerous materials for environment. However not every industry produces the same amount of pollutant, every industry produces different kind of pollution. To compare the pollution impact of industrial activities, soil sample has been taken around the animal feed industry and the fertilizer industry. This study applied the rock magnetic method and used Bartington MS2B to measured magnetic susceptibility (χ) as the physical parameter. This study tested soil samples using the value of susceptibility low frequency (χ lf) and Frequency Dependent (χ FD). Samples only taken in the soil surface with 0-5 cm depth and sampling interval was 20 cm. The animal feed factory has susceptibility low frequency (χ lf) = 111,9 – 325,7 and Frequency Dependent (χ FD) = 0,8 – 3,57 %. And the fertilizer factory has susceptibility low frequency (χ lf) = 187,1 – 494,8 and Frequency Dependent (χ FD) = 1,37 – 2,46 %. Based on the results, the highest value of susceptibility low frequency (χ lf) is the fertilizer factory, but the highest value of Frequency Dependent (FD) is the animal feed factory.

Keywords: industrial, pollution, magnetic susceptibility, χlf, χfd, animal feed industry and fertilizer industry

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Authors: Bouami Hind, Millot Patrick

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The implementation of automated devices in life-critical systems such as hospitals can bring a new set of challenges related to automation malfunctions. While automation has been identified as great leverage for the medication dispensing system’s security and efficiency, it also increases the complexity of the organization. In particular, the installation and operation stage of automated devices can be complex when malfunctions related to automated systems occur. This paper aims to document operators’ situation awareness about the malfunctions of automated drug delivery systems (ADCs) during their implementation through Saint Brieuc hospital’s feedback. Our evaluation approach has been deployed in Saint Brieuc hospital center’s pharmacy, which has been equipped with automated nominative drug dispensing systems since January of 2021. The analysis of Saint Brieuc hospital center pharmacy’s automation revealed numerous malfunctions related to the implementation of Automated Delivery Cabinets. It appears that the targeted performance is not reached in the first year of implementation in this case study. Also, errors have been collected in patients' automated treatments’ production such as lack of drugs in pill boxes or nominative carnets, excess of drugs, wrong location of the drug, drug blister damaged, non-compliant sachet, or ticket errors. Saint Brieuc hospital center’s pharmacy is doing a tremendous job of setting up and monitoring performance indicators from the beginning of automation and throughout ADC’s operation to control ADC’s malfunctions and meet the performance targeted by the hospital. Health professionals, including pharmacists, biomedical engineers and directors of work, technical services and safety, are heavily involved in an automation project. This study highlights the importance of the evaluation of ADCs’ performance throughout the implementation process and the hospital’s team involvement in automation supervision and management.

Keywords: life-critical systems, situation awareness, automated delivery cabinets, implementation, risks and malfunctions

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Authors: Vineet Agrawal, Deepanjali S., Medha R., Subitha L.

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Background. Hospital malnutrition is a highly prevalent issue and is known to increase the morbidity, mortality, length of hospital stay, and cost of care. In India, studies on hospital malnutrition have been restricted to ICU, post-surgical, and cancer patients. We designed this study to assess the impact of hospital malnutrition on 30-day post-discharge and in-hospital mortality in patients admitted in the general medicine department, irrespective of diagnosis. Methodology. All patients aged above 18 years admitted in the medicine wards, excluding medico-legal cases, were enrolled in the study. Nutritional assessment was done within 72 h of admission, using Subjective Global Assessment (SGA), which classifies patients into three categories: Severely malnourished, Mildly/moderately malnourished, and Normal/well-nourished. Anthropometric measurements like Body Mass Index (BMI), Triceps skin-fold thickness (TSF), and Mid-upper arm circumference (MUAC) were also performed. Patients were followed-up during hospital stay and 30 days after discharge through telephonic interview, and their final diagnosis, comorbidities, and cause of death were noted. Multivariate logistic regression and cox regression model were used to determine if the nutritional status at admission independently impacted mortality at one month. Results. The prevalence of malnourishment by SGA in our study was 67.3% among 395 hospitalized patients, of which 155 patients (39.2%) were moderately malnourished, and 111 (28.1%) were severely malnourished. Of 395 patients, 61 patients (15.4%) expired, of which 30 died in the hospital, and 31 died within 1 month of discharge from hospital. On univariate analysis, malnourished patients had significantly higher morality (24.3% in 111 Cat C patients) than well-nourished patients (10.1% in 129 Cat A patients), with OR 9.17, p-value 0.007. On multivariate logistic regression, age and higher Charlson Comorbidity Index (CCI) were independently associated with mortality. Higher CCI indicates higher burden of comorbidities on admission, and the CCI in the expired patient group (mean=4.38) was significantly higher than that of the alive cohort (mean=2.85). Though malnutrition significantly contributed to higher mortality on univariate analysis, it was not an independent predictor of outcome on multivariate logistic regression. Length of hospitalisation was also longer in the malnourished group (mean= 9.4 d) compared to the well-nourished group (mean= 8.03 d) with a trend towards significance (p=0.061). None of the anthropometric measurements like BMI, MUAC, or TSF showed any association with mortality or length of hospitalisation. Inference. The results of our study highlight the issue of hospital malnutrition in medicine wards and reiterate that malnutrition contributes significantly to patient outcomes. We found that SGA performs better than anthropometric measurements in assessing under-nutrition. We are of the opinion that the heterogeneity of the study population by diagnosis was probably the primary reason why malnutrition by SGA was not found to be an independent risk factor for mortality. Strategies to identify high-risk patients at admission and treat malnutrition in the hospital and post-discharge are needed.

Keywords: hospitalization outcome, length of hospital stay, mortality, malnutrition, subjective global assessment (SGA)

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Authors: Saurav Dhawan, Sanchit Bansal

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Background T-MACS is a computer-based decision aid that ‘rules in’ and ‘rules out’ ACS using a combination of the presence or absence of six clinical features with only one biomarker measured on arrival: hs-cTnT. T-MACS had 99.3% negative predictive value and 98.7% sensitivity for ACS, ‘ruling out’ ACS in 40% of patients while ‘ruling in’ 5% at the highest risk. We aim at benchmarking the use of T-MACS which could help to conserve healthcare resources, facilitate early discharges, and ensure safe practice. Methodology Randomized retrospective data collection (n=300) was done from ED electronic records across 3 hospital sites within MFT over a period of 2 months. Data was analysed and compared by percentage for the usage of T-MACS, number of admissions/discharges, and in days for length of stay in hospital. Results MRI A&E had the maximum compliance with the use of T-MACS in the trust at 66%, with minimum admissions (44%) and an average length of stay of 1.825 days. NMG A&E had an extremely low compliance rate (8 %), with 75% admission and 3.387 days as the average length of stay. WYT A&E had no TMACS recorded, with a maximum of 79% admissions and the longest average length of stay at 5.07 days. Conclusion All three hospital sites had a RAG rating of ‘RED’ as per the compliance levels. The assurance level was calculated as ‘Very Limited’ across all sites. There was a positive correlation observed between compliance with TMACS and direct discharges from ED, thereby reducing the average length of stay for patients in the hospital.

Keywords: ACS, discharges, ED, T-MACS

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Authors: Julian Donovan, Jessica Brealey, Matthew Bowker, Marianne Feghali, Gregory Smith, Lee Thompson, Deborah Henderson

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This article details the development of the X-ray response team (XRT), a service that utilises innovative technology to safely deliver acute and elective imaging and medical assessment service in the pre-hospital and community setting. This involves a partnership between Northumbria Healthcare NHS Foundation Trust’s Radiology and Emergency Medicine departments and the North East Ambulance Service to create a multidisciplinary prehospital team. The team committed to the delivery of a two-day acute service every week, alongside elective referrals, starting in November 2020. The service was originally made available to a 15-mile radius surrounding the Northumbria Hospital. Due to demand, this was expanded to include the North Tyneside and Northumberland regions. The target population was specified as frail and vulnerable patients, as well as those deemed to benefit from staying in their own environment. Within the first two months, thirty-six percent of patients assessed were able to stay at home due to the provision of off-site imaging. In the future, this service aims to allow patient transfer directly to an appropriate ward or clinic, bypassing the emergency department to improve the patient journey and reduce emergency care pressures.

Keywords: frailty, imaging, pre-hospital, X-ray

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Authors: Olalekan Bamidele Aruleba

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This research assessed the impact of manpower training and development in the construction industry. The aim is to determine the effect of training and development on employees for effective organizational growth in the construction industry to identify the training method for each category of employee in the construction industry, challenges to training and development of workers in the construction industry and impact of manpower training and development on employees and employers. Data for the study were obtained through a well-structured questionnaire administered to building professionals in Nigeria construction firm. Eighty (80) questionnaires were distributed among building professionals in three selected local governments within Ondo State and sixty-four (64) were returned. Data collected were analysed using descriptive statistics and ranking. Findings of the study revealed that in house training and in-service training methods were preferred by most construction industry. It concluded that the attitude of top management and lack of fund was seen as the significant challenges militating against training of employees. The study recommended that manpower training and development must be sustained by all stakeholders in the industry in order to improve workers' productivity; the organization should adopt the right method in training each category of employees and carry out the need assessment for training to avoid training wrong employees.

Keywords: construction, development, manpower, training

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Authors: Y. Y. Babanyara, D. B. Ibrahim, T. Garba

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Proper management of medical waste is a crucial issue for maintaining human health and the environment. The waste generated in the hospitals has the potential for spreading infections and causing diseases. The study is aimed at assessing the medical waste management practices in Nigeria. Three instruments, questionnaire administration, in-depth interview and observation method for data collection were adopted in the study. The results revealed that the hospital does not quantify medical waste. Segregation of medical wastes is not conducted according to definite rules and standards. Wheeled trolleys are used for on-site transportation of waste from the points of production to the temporary storage area. Offsite transportation of the hospital waste is undertaken by a private waste management company. Small pickups are mainly used to transport waste daily to an off-site area for treatment and disposal. The main treatment method used in the final disposal of infectious waste is incineration. Non-infectious waste is disposed off using land disposal method. The study showed that the hospital does not have a policy and plan in place for managing medical waste. The study revealed number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collections and disposal of waste, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting the bags to only one colour for all waste, the absence of a dedicated waste manager, and no committee responsible for monitoring the management of medical waste. Recommendations are given with the aim of improving medical waste management in the hospital.

Keywords: medical waste, treatment, disposal, public health

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Authors: Nida Amin, Fahad Tanveer, Hina Shabbir, Ayesha Saeed, Attiqa Riaz

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The gradual progression of corneal disorder keratoconus significantly impairs eyesight and quality of life, increasing the likelihood of depression. Using the Hospital Anxiety and Depression Scale (HADS) at the AL-Ibrahim Eye Hospital in Karachi, this study aimed to evaluate the occurrence of depression and anxiety symptoms in patients with keratoconus and to suggest better treatment. A descriptive-analytical study was conducted at Al-Ibrahim Eye Hospital Karachi from March to April 2022, and patients diagnosed with symptomatic keratoconus were recruited using a non-probability convenient sampling technique. After obtaining written informed consent from patients, keratoconus severity was assessed using visual acuity and corneal topography. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression (HADS) Scale. The data were analyzed using SPSS version 20.0. Spearman correlation coefficient. Of the 108 participants, 60 (56%) were female and 48 (44%) were male. Using the HADS scale, 44 (40.7%) patients were classified as normal with a HADS score of (0-7), 23 (21.3%) as borderline with a HADS score of (8-10) and 41 (38%) patients were diagnosed with anxiety and depression with a HADS score of (11-21). Depression and anxiety are highly prevalent among patients in advanced stages of the disease.

Keywords: cornea, keratoconus, anxiety, depression, corneal topography, mental health

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