Search results for: care home management

Authors: Cinzia Valente

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Over the last few years, national legislators have been forced to deal with social changes that have had important repercussions in family law and children’s law. This growing focus on minors has provoked important reforms, specifically on issues relating to the welfare and protection of children. My presentation focuses on the issue of migrant children in particular I refer to unaccompanied children, or ‘children on the move’, or separate children or any other term defining migrant minors who cross national borders seeking protection or better opportunities. They arrive often illegally, on the European territory without a responsible adult who take care of them. There is a common assumption that migrants are running away from conflicts, poverty and human rights abuse and they arrive in a foreign country hoping a better life; children without persons who takes care of them encounter some difficulties in their integration in the host country. The migration flows recorded in recent decades towards EU countries, and Italy in particular, have imposed an intense pressure to modernize institutions, services and specific legal frameworks, with the aim of responding adequately to the needs of foreign individuals, as well as ensuring a good level of living standards and facilitating integration, especially for migrant children. The object of my paper is the analysis of the Italian rules, practices and services existing in favor of unaccompanied children (foster care, reunification, acquisition of citizenship and other) in comparison with other European legal systems on the same thematic with a comparative method. Highlighting European standards to find common principles for the best solution to children's problems is the conclusive aim of my presentation.

Keywords: Children , Family Law, Migration , Uniform Law

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Authors: Nouf Al Harthi

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Venous thromboembolism (VTE) is one of the most common causes of hospital-related deaths in critically ill patients. Guidelines recommended VTE prophylaxis with standardized, fixed doses for most patients. The underweight population has limited data to guide the appropriate drug and dosing regimen. The aim of this study was to describe the pattern of VTE prophylaxis dose regimens for underweighted critically ill adult patients and the prevalence of associated VTE and bleeding. This study is a retrospective cohort study, conducted in King Abdulaziz Medical City, Saudi Arabia. It included all critical patients admitted to the intensive care units and were above 14 years old with weight less than 50 kg or BMI of 18.5 kg/m2 or less and were on heparin as VTE prophylaxis for more than 72 hours from January 2016 until January 2020. After screening 270 patients, only 40 patients were included in this study according to our inclusion and exclusion criteria. Only 6 patients (15%) received VTE prophylaxis as an adjusted dose of heparin 2500 U Q12, while the rest of the patients were taking standard dosing of heparin, 5000 U Q12 was given to 21 (52.50%) patients and 5000 U Q8 was given to 13 (32.50%) patients. None of the adjusted doses developed any complications such as VTE or bleeding. There was no significant difference compared with the standard dose group. This study focused on describing the pattern of heparin doses as VTE prophylaxis in underweight patients. We also compared the standard dosing and adjusted dosage of VTE prophylaxis on underweight patients and any complications. There was no significant difference in the complication’s outcome or benefits between the two groups.

Keywords: venous thromboembolism prophylaxis, heparin, underweight patients, adult, critical care units

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Authors: Ahmed Al-Adaileh, Souheil Khaddaj

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Outcomes of exhaustion of natural resources started influencing each spirit on this planet. Energy is an essential factor in this aspect. To restore the circumstance to the appropriate track, all attempts must focus on two fundamental branches: producing electricity from clean and renewable reserves and decreasing the overall unnecessary consumption of energy. The focal point of this paper will be on lessening the power consumption in the household's segment. This paper is an attempt to give a clear understanding of a framework called Reduction of Energy Consumption in Household Sector (RECHS) and how it should help householders to reduce their power consumption by substituting their household appliances, turning-off the appliances when stand-by modus is detected, and scheduling their appliances operation periods. Technically, the framework depends on utilizing Z-Wave compatible plug-ins which will be connected to the usual house devices to gauge and control them remotely and semi-automatically. The suggested framework underpins numerous quality characteristics, for example, integrability, scalability, security and adaptability.

Keywords: smart energy management systems, internet of things, wireless mesh networks, microservices, cloud computing, big data

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Authors: C. Puangsawat, C. Limotai, P. Srikhachin

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Bio-psycho-social caring was required for promoting the quality of life of the patients with epilepsy (PWE), despite controlled seizures. Multifaceted issues emerge at the epilepsy clinic. Unpredicted seizures, antiepileptic drug compliance problems/adverse effects, psychiatric, and social problems are all needed to be explored and managed. The Nursing Service System (NSS) at the tertiary epilepsy clinic (TEC) was consequently developed for improving the clinical care for PWE. Case manager concept was integrated as the framework guiding the processes and strategies used for developing the NSS as well as the roles of the multidisciplinary team at the clinic. This study aimed to report the outcomes of the developed NSS integrated case manager concept. The processes of our developed NSS program included 1) screening for patient’s problems using questionnaire prior to seeing epileptologists i.e., assessing the patient’s risk to develop acute seizures at the clinic, issues related to medication use, and uncovered psychiatric and social problems; and 2) assigning the patients at risk to be evaluated and managed by appropriate team. Nurses specializing in epilepsy in coordination with the multidisciplinary team implemented the NSS to promote coordinated work among the team which consists of epileptologists, nurses, pharmacists, psychologists, and social workers. Determination of the role of each person and their responsibilities along with joint care plan were clearly established. One year after implementation, the rate of acute seizure occurrence at the clinic was decreased, and satisfactory feedback from the patients was received. In order to achieve an optimal goal to promote self-management behaviors in PWE, continuing the NSS and systematic assessment of its effectiveness is required.

Keywords: case manager concept, nursing service system, patients with epilepsy, quality of life

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Authors: N. Varsamis, M. Gerasimou, P. Christodoulou, S. Mantzoukis, G. Kolliopoulou, N. Zotos

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Purpose: Body fluids (pleural, peritoneal, synovial, pericardial, cerebrospinal) are an important element in the detection of microorganisms. For this reason, it is important to examine them in the Intensive Care Unit (ICU) patients. Material and Method: Body fluids are transported through sterile containers and enriched as soon as possible with Tryptic Soy Broth (TSB). After one day of incubation, the broth is poured into selective media: Blood, Mac Conkey No. 2, Chocolate, Mueller Hinton, Chapman and Saboureaud agar. The above selective media are incubated directly for 2 days. After this period, if any number of microbial colonies are detected, gram staining is performed. After that, the isolated organisms are identified by biochemical techniques in the automated Microscan system (Siemens) and followed by a sensitivity test on the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by Kirby Bauer-based plate test. Results: In 2017 the Laboratory of Microbiology received 60 samples of body fluids from the ICU. More specifically the Microbiology Department received 6 peritoneal fluid specimens, 18 pleural fluid specimens and 36 cerebrospinal fluid specimens. 36 positive cultures were tested. S. epidermidis was identified in 18 specimens, S. haemolyticus in 6, and E. faecium in 12. Conclusions: The results show low detection of microorganisms in body fluid cultures.

Keywords: body fluids, culture, intensive care unit, microorganisms

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Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: Marta Fernández Batalla, José María Santamaría García, Maria Lourdes Jiménez Rodríguez, Roberto Barchino Plata, Adriana Cercas Duque, Enrique Monsalvo San Macario

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Background: Primary Care Nursing is taking more autonomy in clinical decisions. One of the most frequent therapies to solve is related to the problems of maintaining a sufficient supply of food. Nursing diagnoses related to food are addressed by the nurse-family and community as the first responsible. Objectives and interventions are set according to each patient. To improve the goal setting and the treatment of these care problems, a technological tool is developed to help nurses. Objective: To evaluate the computational tool developed to support the clinical decision in feeding problems. Material and methods: A cross-sectional descriptive study was carried out at the Meco Health Center, Madrid, Spain. The study population consisted of four specialist nurses in primary care. These nurses tested the tool on 30 people with ‘need for nutritional therapy’. Subsequently, the usability of the tool and the satisfaction of the professional were sought. Results: A simple and convenient computational tool is designed for use. It has 3 main entrance fields: age, size, sex. The tool returns the following information: BMI (Body Mass Index) and caloric consumed by the person. The next step is the caloric calculation depending on the activity. It is possible to propose a goal of BMI or weight to achieve. With this, the amount of calories to be consumed is proposed. After using the tool, it was determined that the tool calculated the BMI and calories correctly (in 100% of clinical cases). satisfaction on nutritional assessment was ‘satisfactory’ or ‘very satisfactory’, linked to the speed of operations. As a point of improvement, the options of ‘stress factor’ linked to weekly physical activity. Conclusion: Based on the results, it is clear that the computational tools of decision support are useful in the clinic. Nurses are not only consumers of computational tools, but can develop their own tools. These technological solutions improve the effectiveness of nutrition assessment and intervention. We are currently working on improvements such as the calculation of protein percentages as a function of protein percentages as a function of stress parameters.

Keywords: feeding behavior health, nutrition therapy, primary care nursing, technology assessment

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Authors: Tio Novita Efriani

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Public sector organizations work in a complex and risky environment. Since the beginning of 2000s, the public sector has paid attention to the need for an effective risk management. The Indonesian public sector has also concerned about this issue and in 2008 it enacted the Government Regulation that gives mandate for the implementation of risk management in government organizations. This paper investigates risk management implementation in the Indonesian public sector organizations and the role of transformational leadership and internal audit activities. Data was collected via survey. A total of 202 effective responses (30% response rate) from employees in 34 government ministries were statistically analyzed by using Partial least square structural equation modelling (PLS-SEM) and the software was SmartPLS 3.0. All the constructs were lower order, except for the risk management implementation construct, which was treated as a second-order construct. A two-stage approach was employed in the analysis of the higher order component. The findings revealed that transformational leadership positively influence risk management implementation. The findings also found that the core and legitimate roles of internal audit in risk management positively affect the implementation of risk management. The final finding showed that internal auditing mediates a relationship between transformational leadership and risk management implementation. These results suggest that the implementation of risk management in the Indonesian public sector was significantly supported by internal auditors and leadership. The findings confirm the importance of transformational leadership and internal audit in the public sector risk management strategies.

Keywords: Indonesian public sector, internal audit, risk management, transformational leadership

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Authors: Aydin Sipahioglu, Gokhan Celik

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Helicopter routing problem (HRP) is finding good tours for helicopter so as to pick up and deliver personnel or material among specified nodes, mutually. It can be encountered in case of being lots of supply and demand points for different commodities and requiring delivering commodities with helicopter. For instance, to deliver personnel or material from shore to oil rig is a good example. In fact, HRP is a branch of vehicle routing problem with pickup and delivery (VRPPD). However, it has additional constraints such that fuel capacity, performance of helicopter in different altitude and temperature, and the number of maximum takeoff and landing allowed. This kind of pickup and delivery problems can be classified into 3 groups, basically. 1-1 (one to one), M-M (many to many) and 1-M-1 (one to many to one). 1-1 means each commodity has only one supply and one demand point. M-M means there can be more than one supply and demand points for each kind of commodity. 1-M-1 means commodities at depot are delivered to demand points and commodities at customers are delivered to depot. In this case helicopter takes off from its own base, complete its tour and return to its own base. In this study, we define 1-M-M-1 type HRP. That means helicopter takes off from its home base, deliver commodities among the nodes as well as between depot and customers and return to its home base. These problems have NP-hard nature. Therefore, obtaining a good solution in a reasonable time is not easy. In this study, a model is offered for 1-M-M-1 type HRP. It is shown on small scale test instances that the model can find the optimal solution.

Keywords: helicopter routing problem, vehicle routing with pickup and delivery, integer programming

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Authors: Jefrey Pilusa, Tumisang Seodigeng

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This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: autoclave, disposal, fuel, incineration, medical waste

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Authors: Obaidullah Molakhail, R. Reshmi

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Objective: This study explains the impact of talent management on employee loyalty in the IT sector in Kerala, India. Methods: A descriptive investigation was conducted within the confines of this paper to gain insight into the ramifications of talent management on enhancing employee allegiance to the organization. A quantitative study was conducted by distributing questionnaires to respondents in three IT companies. One hundred and seventy questionnaires were distributed, with `150 being utilized and the remainder being discarded. Data was collected from various departments within the companies, and the selection of respondents was conducted randomly. statistical software SPSS (version 26) was used to analyze the data and determine the outcomes. Results: The objective was examined through Pearson correlation to find the relation, and linear regression was used to find the strength of variables as talent management is independent and employee loyalty is the dependent variable. The results reveal that talent management is essential to employee loyalty. If there is a high-level implementation of talent management practices, there will be low turnover rate, it reflected employee loyalty towards the organization. Conclusion: Strategic planners ought to devote their attention to the realm of talent management due to the existence of a correlation between talent management and the loyalty exhibited by employees. The results of this study suggest that there is a favorable correlation between talent management and employee loyalty.

Keywords: talent management, employee loyalty, IT sector, quantitative study

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Authors: Kaous Samira

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The lack of hand hygiene can contribute to nosocomial infections, including Central-venous-catheter-related bloodstream infections (CRBSI). An investigation from severally hospitals examined the frequency of hand hygiene in an OR among perioperative staff members who did not perform a surgical scrub. Among 50 operations (120 hours) that were observed, only 2% of staff members performed hand hygiene practices upon entering the OR, and 8.4% of staff performed hand hygiene upon leaving the OR. In addition, when performing radial arterial catheter placement, 0% of staff members wore gloves. Another study (A1170) surveyed healthcare providers regarding hand hygiene compliance. All of the 107 providers surveyed agreed that they should maintain hand hygiene, and most respondents believed that their own compliance was high. The author suggests that the low compliance problem associated with hand hygiene worldwide is a behavioral one among healthcare providers that requires acknowledgment and change.

Keywords: aneshesia, investigation, IOP, SBP

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Authors: Seree Chadcham, Niphon Sukvilai

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This study is the research and development which is intended to: 1) design of the Intelligent Scaffolding Learning Management System (ISLMS) for vocational education, 2) assess the suitability of the Design of Intelligent Scaffolding Learning Management System for Vocational Education. Its methods are divided into 2 phases. Phase 1 is the design of the ISLMS for Vocational Education and phase 2 is the assessment of the suitability of the design. The samples used in this study are work done by 15 professionals in the field of Intelligent Scaffolding, Learning Management System, Vocational Education, and Information and Communication Technology in education selected using the purposive sampling method. Data analyzed by arithmetic mean and standard deviation. The results showed that the ISLMS for vocational education consists of 2 main components which are: 1) the Intelligent Learning Management System for Vocational Education, 2) the Intelligent Scaffolding Management System. The result of the system suitability assessment from the professionals is in the highest range.

Keywords: intelligent, scaffolding, learning management system, vocational education

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Authors: S. H. R. Sadeghi, A. Sadoddin, A. Najafinejad

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Expansionism and ever-increasing population menace all different resources worldwide. The issue, hence, is critical in developing countries like Iran where new technologies are rapidly luxuriated and unguardedly applied, resulting in unexpected outcomes. However, uncommon and comprehensive approaches are introduced to take all the different aspects involved into consideration. In the last decade, few approaches such as community-based, stakeholders-oriented, adaptive and ultimately integrated management, have emerged and are developing for efficient, Co-management or best management, economic and sustainable development and management of watershed resources in Iran. In the present paper, an attempt has been made to focus on state-of-the-art approaches for the management of watershed resources applied in Iran. The study has been then supported by reports of some case studies conducted throughout the country involving previously mentioned approaches. Scrutinizing results of the researches verified a progressive tendency of the managerial approaches in watershed management strategies leading to a general approaching balance situation. The approaches are firmly rooted in educational, research, executive, legal and policy-making sectors leading to some recuperation at different levels. However, there is a long way ahead to naturalize detrimental effects of unscientific, illegal and over exploitation of the watershed resources in Iran.

Keywords: comprehensive management, ecosystem balance, integrated watershed management, land resources optimization

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Authors: Genevieve R. Kan, Jolyon Ford

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Background: Caesarean section has become the routine route of delivery for breech fetuses, but breech cesarean deliveries are hypothesized to have poorer immediate neonatal outcomes when compared to cephalic deliveries. In accordance with this, in many Australian hospitals, the pediatric team is routinely required to attend every elective breech cesarean section in case urgent resuscitation is required. Our study aimed to determine whether term elective breech deliveries indeed had worse immediate neonatal outcomes at delivery, which will justify the necessity of pediatric staff presence at every elective breech cesarean delivery and influence the workload for the pediatric team. Objective: Elective breech cesarean deliveries were compared to elective cephalic cesarean deliveries at 37 weeks gestation or above to evaluate the immediate neonatal outcomes (Apgar scores <7 at 5 minutes, and Special Care Nursery admissions on Day 1 of life) of each group. Design: A retrospective cohort study Method: This study examined 2035 elective breech and cephalic singleton cesarean deliveries at term over 5 years from July 2017 to July 2022 at Frankston Hospital, a metropolitan hospital in Melbourne, Australia. There were 260 breech deliveries and 1775 cephalic deliveries. De-identified patient data were collected retrospectively from the hospital’s electronically integrated pregnancy and birth records to assess demographics and neonatal outcomes. Results: Apgar scores <7 at 5 minutes of life were worse in the breech group compared to the cephalic group (3.4% vs 1.6%). Special Care Nursery admissions on Day 1 of life were also higher for the breech cohort compared to the cephalic cohort (9.6% vs 8.7%). Conclusions: Our results support the expected findings that breech deliveries are associated with worse immediate neonatal outcomes. It, therefore, suggests that routine attendance at elective breech cesarean deliveries by the pediatric team is indeed required to assist with potentially higher needs for neonatal resuscitation and special care nursery admission.

Keywords: breech, cesarean section, Apgar scores, special care nursery admission

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Authors: Ganatsios Vassilios, Terpou Antonia, Maria Kanellaki, Bekatorou Argyro, Athanasios Koutinas

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In this study, a new fermentation technology is proposed with potential application in home wine-making. Delignified cellulosic material was used to preserve Tubular Cellulose (TC), an effective fermentation support material in high osmotic pressure, low temperature, and alcohol concentration. The psychrotolerant yeast strain Saccharomyces cerevisiae AXAZ-1 was immobilized on TC to preserve a novel home wine making biocatalyst (HWB) and the entrapment was examined by SEM. Various concentrations of HWB was added in high-density grape must and the mixture was dried immediately. The dried mixture was stored for various time intervals and its fermentation examined after addition of potable water. The percentage of added water was also examined to succeed high alcohol and residual sugar concentration. The effect of low temperature (1-10 oC) on fermentation kinetics was studied revealing the ability of HBW on low-temperature sweet wine making. Sweet wines SPME GC-MS analysis revealed the promotion effect of TC on volatile by-products formation in comparison with free cells. Kinetics results and aromatic profile of final product encouraged the efforts of high-quality sweet wine making in domestic refrigerator and potential marketable opportunities are also assessed and discussed.

Keywords: tubular cellulose, sweet wine, Saccharomyces cerevisiae AXAZ-1, residual sugar concentration

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Authors: Anthony Townsend, Robyn Fasser

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While complete objectivity is a desirable scientific position from which to conduct a care and contact evaluation (CCE), it is precisely the recognition that we are inherently incapable of operating objectively that is the foundation of ethical practice and skilled assessment. Drawing upon recent research from Daniel Kahneman (2021) on the differences between noise and bias, as well as different inherent biases collectively termed “The Elephant in the Brain” by Kevin Simler and Robin Hanson (2019) from Oxford University, this presentation addresses both the various ways in which our judgments, perceptions and even procedures can be distorted and contaminated while conducting a CCE, but also considers the value of second order cybernetics and the psychodynamic concept of ‘ambivalence’ as a conceptual basis to inform our assessment methodologies to limit such errors or at least better identify them. Both a conceptual framework for ambivalence, our higher-order capacity to allow for the convergence and consideration of multiple emotional experiences and cognitive perceptions to inform our reasoning, and a practical methodology for assessment relying on data triangulation, Bayesian inference and hypothesis testing is presented as a means of promoting ethical practice for health care professionals conducting CCEs. An emphasis on widening awareness and perspective, limiting ‘splitting’, is demonstrated both in how this form of emotional processing plays out in alienating dynamics in families as well as the assessment thereof. In addressing this concept, this presentation aims to illuminate the value of ambivalence as foundational to ethical practice for assessors.

Keywords: ambivalence, forensic, psychology, noise, bias, ethics

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Authors: Saira Mehnaz, Ali Jafar Abedi, Shazia Farooq Fazli, Sakeena Mushfiq, Zulfia Khan, M. Athar Ansari

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Introduction: Public health spending is a necessity in an underdeveloped country like India. The people are already suffering from poverty and that clubbed with out of pocket expenditure leads them to a very catastrophic situation, reducing the overall access to healthcare. Objectives: This study was designed to determine the usual source of medical care opted, the illness pattern, the expenditure incurred on illness and its source of procurement by the study population. It also intended to assess this expenditure as a determinant of access to health care. Methodology: Cities like Aligarh, which are classified as B grade cities in India are thought to be ripe sites for getting livelihood and hence are almost half filled with migrants living in urban slums. A cross sectional study was done to study the newer slum pockets. 3409 households with a population of 16,978 were studied with the help of pretested questionnaire; SPSS 20 was used for statistical analysis. Results and Conclusions: In our study, we found that almost all the households suffered from catastrophic health expenditure. The study population, which was already vulnerable owing to their low socio-economic and migrant status was further being forced with into poverty and indebtedness on account of expenditure on illness. This lead to a significant decrease in access to health. National health financing systems should be designed to protect households from financial catastrophe, by reducing out-of-pocket spending.

Keywords: access to healthcare, catastrophic health expenditure, new urban slums, out of pocket expenditure

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Authors: Amir Ghasem Norouzi, Mahdi Zowghi

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This study propose a framework based on the fuzzy T-Norms, T-conorm, a novel operator, and multi-expert approach to help organizations build awareness of the critical influential factors on the success of knowledge management (KM) implementation, analysis the failure of knowledge management. This study considers the complex uncertainty concept that is in knowledge management implementing capability (KMIC) and it is used by fuzzy logic for this reason. The contribution of our paper is shown with an empirical study in a nonprofit educational organization evaluation.

Keywords: fuzzy logic, knowledge management, multi expert analysis, consensus oriented average operator

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Authors: Selda Uzal Seyfi

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Goat and sheep milk is quite significant in human nutrition. It is considered as more important day by day. This study was carried out in order to determine applied manure management system and their possibilities of improvement in goat and sheep farm in between 2012 and 2013 years. In the study, it was investigated manure management systems of 25 pieces of sheep and goat farms. It was analyzed the manure collecting, storage and treatment features of farms and whether or not they are suitable for animal breeding. As a result of the study, it was determined that the applied manure management systems in the farm were insufficient. Planning the manure management systems in goat and sheep breeding is appropriate technical criteria is useful in respect of the animal welfare, animal health, the health of workers in the barn and environmental pollution.

Keywords: goat farm, sheep farm, manure storage, manure management

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Authors: Zulkifli Zainal Abidin, Ahmad Shahril Mohd Ghani

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Agent-based systems technology has been addressed as a new paradigm for conceptualizing, designing, and implementing software systems. Agents are sophisticated systems that act autonomously across open and distributed environments in solving problems. Nevertheless, it is impractical to rely on a single agent to do all computing processes in solving complex problems. An increasing number of applications lately require multiple agents to work together. A multi-agent system (MAS) is a loosely coupled network of agents that interact to solve problems that are beyond the individual capacities or knowledge of each problem solver. However, the network of MAS still requires a main system to govern or oversees the operation of the agents in order to achieve a unified goal. We had developed a fleet management system (FMS) in order to manage the fleet of agents, plan route for the agents, perform real-time data processing and analysis, and issue sets of general and specific instructions to the agents. This FMS should be able to perform real-time data processing, communicate with the autonomous surface vehicle (ASV) agents and generate bathymetric map according to the data received from each ASV unit. The first algorithm is developed to communicate with the ASV via radio communication using standard National Marine Electronics Association (NMEA) protocol sentences. Next, the second algorithm will take care of the path planning, formation and pattern generation is tested using various sample data. Lastly, the bathymetry map generation algorithm will make use of data collected by the agents to create bathymetry map in real-time. The outcome of this research is expected can be applied on various other multi-agent systems.

Keywords: autonomous surface vehicle, fleet management system, multi agent system, bathymetry

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Authors: Yuthapoom Thanakijborisut

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This paper studies consumption insurance against the chronic illness in Thailand. The study estimates the impact of household consumption in the chronic illness on consumption growth. Chronic illness is the health care costs of a person or a household’s decision in treatment for the long term; the causes and effects of the household’s ability for smooth consumption. The chronic illnesses are measured in health status when at least one member within the household faces the chronic illness. The data used is from the Household Social Economic Panel Survey conducted during 2007 and 2012. The survey collected data from approximately 6,000 households from every province, both inside and outside municipal areas in Thailand. The study estimates the change in household consumption by using an ordinary least squares (OLS) regression model. The result shows that the members within the household facing the chronic illness would reduce the consumption by around 4%. This case indicates that consumption insurance in Thailand is quite sufficient against chronic illness.

Keywords: consumption insurance, chronic illness, health care, Thailand

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Authors: Ishmael Tingbani

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This paper adopts a contingency theory approach to investigate the relationship between working capital management and profitability using data of 225 listed British firms on the London Stock Exchange for the period 2001-2011. The paper employs a panel data analysis on a series of interactive models to estimate this relationship. The findings of the study confirm the relevance of the contingency theory. Evidence from the study suggests that the impact of working capital management on profitability varies and is constrained by organizational contingencies (environment, resources, and management factors) of the firm. These findings have implications for a more balanced and nuanced view of working capital management policy for policy-makers.

Keywords: working capital management, profitability, contingency theory approach, interactive models

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Authors: Thidarath Rungruangchaikongmi, Duangsamorn Rungsawanpho

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This research aims to investigate the efficiency of storehouse management and collect problems of the process of storehouse work of Faculty of Management Science, Suan Sunandha Rajabhat University. The subjects consisting of head of storehouse section and staffs, sampled through the Convenience Sampling Technique for 97 sampling were included in the study and the Content Analysis technique was used in analysis of data. The results of the study revealed that the management efficiency of the storehouse work on the part of work process was found to be relevant to university’s rules and regulations. The delay of work in particular steps had occurred due to more rules and regulations or practice guidelines were issued for work transparency and fast and easy inspection and control. The key problem of the management of storehouse work fell on the lack of knowledge and understanding regarding university’s rules and regulations or practice guidelines of the officers.

Keywords: efficiency of storehouse management, faculty of management science, process of storehouse work, Suan Sunandha Rajabhat University

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Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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Authors: A. Erragh, K. Amanzoui, M. Elharit, H. Salem, M. Ababneh, K. Elfakhr, S. Kalouch, A. Chlilek

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Guillain-Barre syndrome (GBS) is the most common form of acute polyradiculoneuritis (PRNA). It is a medical emergency in pediatrics that requires rapid diagnosis and immediate assessment of the severity criteria for the implementation of appropriate treatment. Retrospective, descriptive study in 24 patients under the age of 18 who presented with GBS between September 2017 and July 2021 and were hospitalized in the multipurpose pediatric intensive care unit of the Abderrahim EL Harouchi children's hospital in Casablanca. The average age was 7.91 years, with extremes ranging from 18 months and 14 years and a male predominance of 75%. After a prodromal event, most often infectious (80%) and a free interval of 12 days on average, 2 types of motor disorders begin either hypo or arereflectic flaccid paralysis of the lower limbs (45.8%) or flaccid quadriplegia hypo or arereflectic (54.2%). During GBS, the most formidable complication is respiratory distress, which can occur at any time. In our study, respiratory impairment was observed in 70.8% of cases. In addition, other signs of severity, such as swallowing disorders (75%) and dysautonomic disorders (8.33%), were also observed, which justified care in the intensive care unit for all of our patients. The use of invasive ventilation was necessary in 76.5% of cases, and specific treatments based on immunoglobulins were administered in all our patients. Despite everything, the death rate remains high (25%) and is mainly due to complications related to hospitalization. Guillain Barré syndrome is, therefore, a pediatric emergency that requires rapid diagnosis and immediate assessment of severity criteria for the implementation of appropriate treatment.

Keywords: guillain barre syndrome, emergency, children, medical

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Authors: Pradakshina Sharma, Jagriti Narang

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Due to the critical significance in the early identification of infectious diseases, electrochemical sensors have garnered considerable interest. Here, we develop a detection platform for the chikungunya virus by rationally implementing the extremely high charge-transfer efficiency of a ternary nanocomposite of graphene oxide, silver, and gold (G/Ag/Au) (CHIKV). Because paper is an inexpensive substrate and can be produced in large quantities, the use of electrochemical paper analytical device (EPAD) origami further enhances the sensor's appealing qualities. A cost-effective platform for point-of-care diagnostics is provided by paper-based testing. These types of sensors are referred to as eco-designed analytical tools due to their efficient production, usage of the eco-friendly substrate, and potential to reduce waste management after measuring by incinerating the sensor. In this research, the paper's foldability property has been used to develop and create 3D multifaceted biosensors that can specifically detect the CHIKVX-ray diffraction, scanning electron microscopy, UV-vis spectroscopy, and transmission electron microscopy (TEM) were used to characterize the produced nanoparticles. In this work, aptamers are used since they are thought to be a unique and sensitive tool for use in rapid diagnostic methods. Cyclic voltammetry (CV) and linear sweep voltammetry (LSV), which were both validated with a potentiostat, were used to measure the analytical response of the biosensor. The target CHIKV antigen was hybridized with using the aptamer-modified electrode as a signal modulation platform, and its presence was determined by a decline in the current produced by its interaction with an anionic mediator, Methylene Blue (MB). Additionally, a detection limit of 1ng/ml and a broad linear range of 1ng/ml-10µg/ml for the CHIKV antigen were reported.

Keywords: biosensors, ePAD, arboviral infections, point of care

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Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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Authors: Habtamu Wolde Engudai

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Background: Sedation can be provided to facilitate a procedure or to stabilize patients admitted in pediatric intensive care unit (PICU). Sedation is often necessary to maintain optimal care for critically ill children requiring mechanical ventilation. However, if sedation is too deep or too light, it has its own adverse effects, and hence, it is important to monitor the level of sedation and maintain an optimal level. Objectives: The objective is to assess the level of sedation and associated factors among intubated critically ill children admitted to PICU of JUMC, Jimma. Methods: A prospective observation study was conducted in the PICU of JUMC in September 2021 in 105 patients who were going to be admitted to the PICU aged less than 14 and with GCS >8. Data was collected by residents and nurses working in PICU. Data entry was done by Epi data manager (version 4.6.0.2). Statistical analysis and the creation of charts is going to be performed using SPSS version 26. Data was presented as mean, percentage and standard deviation. The assumption of logistic regression and the result of the assumption will be checked. To find potential predictors, bi-variable logistic regression was used for each predictor and outcome variable. A p value of <0.05 was considered as statistically significant. Finally, findings have been presented using figures, AOR, percentages, and a summary table. Result: in this study, 105 critically ill children had been involved who were started on continuous or intermittent forms of sedative drugs. Sedation level was assessed using a comfort scale three times per day. Based on this observation, we got a 44.8% level of suboptimal sedation at the baseline, a 36.2% level of suboptimal sedation at eight hours, and a 24.8% level of suboptimal sedation at sixteen hours. There is a significant association between suboptimal sedation and duration of stay with mechanical ventilation and the rate of unplanned extubation, which was shown by P < 0.05 using the Hosmer-Lemeshow test of goodness of fit (p> 0.44).

Keywords: level of sedation, critically ill children, Pediatric intensive care unit, Jimma university

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Authors: Alireza Fard Kashani

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This study reports on the experiences and attitudes of six Iranian migrant families, from two groups of asylum seekers and skilled workers, with regard to their language, identity, and acculturation in Australia. The participants included first generation parents and 1.5-generation adolescents, who had lived in Australia for a minimum of three years. For this investigation, Mendoza’s (1984, 2016) acculturation model, as well as poststructuralist views of identity, were employed. The semi-structured interview results have highlighted that Iranian parents and adolescents face low degrees of intergenerational conflicts in most domains of their acculturation. However, the structural and lawful patterns in Australia have caused some internal conflicts for the parents, especially fathers (e.g., their power status within the family or their children’s freedom). Furthermore, while most participants reported ‘cultural eclecticism’ as their preferred acculturation orientation, female participants seemed to be more eclectic than their male counterparts who showed inclination towards keeping more aspects of their home culture. This finding, however, highlights a meaningful effort on the part of husbands that in order to make their married lives continue well in Australia they need to re-consider the traditional male-dominated customs they used to have in Iran. As for identity, not only the parents but also the adolescents proudly identified themselves as Persians. In addition, with respect to linguistic behaviour, almost all adolescents showed enthusiasm to retain the Persian language at home to be able to maintain contacts with their relatives and friends in Iran and to enjoy many other benefits the language may offer them in the future.

Keywords: acculturation, asylum seekers, identity, intergenerational conflicts, language, skilled workers, 1.5 generation

Procedia PDF Downloads 239