Search results for: humanized care service
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6859

Search results for: humanized care service

5269 The Role of Public Management Development in Enhancing Public Service Delivery in the South African Local Government

Authors: Andrew Enaifoghe

Abstract:

The study examined the role of public management development in enhancing public service delivery in the South African local government. The study believes that the ultimate empowerment of the third tier sphere of governments in South Africa remains the instrument required to enhance both national and continental development. This over the year has been overwhelmed with problems and imbalance related to ethical practice, accountability and the functional local government system and the machinery itself. The study finds that imbalances are being strengthened by a lack of understanding and unanimity as to what a public management development in a democratic system is and how it should work to achieve the dividends of democracy in delivering public goods. Studies indicated that the magnitudes are widespread corruption and misrepresentations of government priorities; both of which weaken the ability of governments to enhance broad-based economic growth and social well-being of the people. This study addressed the problem of public management and accountable local government. The study indicates the need for citizens’ participation in the decision-making process in delivering public service in South Africa and how its accountability mechanism supports good governance. The study concludes that good and ethical watersheds in South Africa have since reached such proportions that social pressure, the pressure from the government and various institutions have to re-consider where they stand regarding ethics, ethical behaviour, accountability and professionalism in delivering public goods to the people at the local municipal government.

Keywords: accountability, development, democratic system, South Africa

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5268 Resource Allocation Scheme For IEEE802.16 Networks

Authors: Elmabruk Laias

Abstract:

IEEE Standard 802.16 provides QoS (Quality of Service) for the applications such as Voice over IP, video streaming and high bandwidth file transfer. With the ability of broadband wireless access of an IEEE 802.16 system, a WiMAX TDD frame contains one downlink subframe and one uplink subframe. The capacity allocated to each subframe is a system parameter that should be determined based on the expected traffic conditions. a proper resource allocation scheme for packet transmissions is imperatively needed. In this paper, we present a new resource allocation scheme, called additional bandwidth yielding (ABY), to improve transmission efficiency of an IEEE 802.16-based network. Our proposed scheme can be adopted along with the existing scheduling algorithms and the multi-priority scheme without any change. The experimental results show that by using our ABY, the packet queuing delay could be significantly improved, especially for the service flows of higher-priority classes.

Keywords: IEEE 802.16, WiMAX, OFDMA, resource allocation, uplink-downlink mapping

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5267 Traumatic Brain Injury in Cameroon: A Prospective Observational Study in a Level 1 Trauma Centre

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

Abstract:

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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5266 Development of Technologies for the Treatment of Nutritional Problems in Primary Care

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

Abstract:

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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5265 Predicting Data Center Resource Usage Using Quantile Regression to Conserve Energy While Fulfilling the Service Level Agreement

Authors: Ahmed I. Alutabi, Naghmeh Dezhabad, Sudhakar Ganti

Abstract:

Data centers have been growing in size and dema nd continuously in the last two decades. Planning for the deployment of resources has been shallow and always resorted to over-provisioning. Data center operators try to maximize the availability of their services by allocating multiple of the needed resources. One resource that has been wasted, with little thought, has been energy. In recent years, programmable resource allocation has paved the way to allow for more efficient and robust data centers. In this work, we examine the predictability of resource usage in a data center environment. We use a number of models that cover a wide spectrum of machine learning categories. Then we establish a framework to guarantee the client service level agreement (SLA). Our results show that using prediction can cut energy loss by up to 55%.

Keywords: machine learning, artificial intelligence, prediction, data center, resource allocation, green computing

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5264 Non-Burn Treatment of Health Care Risk Waste

Authors: Jefrey Pilusa, Tumisang Seodigeng

Abstract:

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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5263 Identifying Strategies for Improving Railway Services in Bangladesh

Authors: Armana Sabiha Huq, Tahmina Rahman Chowdhury

Abstract:

In this paper, based on the stated preference experiment, the service quality of Bangladesh Railway has been assessed, and particular importance has been given to investigate if there exists a relationship between service quality and safety. For investigation purposes, environmental and organizational factors were assumed to determine the safety performance of the railway. Data collected from the survey has been analyzed by importance-performance analysis (IPA). In this paper, a modification of the well-known importance-performance analysis (IPA) has been done by adopting the importance of the weights determined through a structural equation modeling (SEM) approach and by plotting the gap between importance and performance on a visual graph. It has been found that there exists a relationship between safety and serviceability to some extent. Limited resources are an important factor to improve the safety and serviceability condition of the BD railway. Moreover, it is observed that the limited resources available to monitor and improve the safety performance of railway.

Keywords: importance-performance analysis, GAP-IPA, SEM, serviceability, safety, factor analysis

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5262 Electronic Government Services Adoption from Multi-Nationalities Perspectives

Authors: Isaac Kofi Mensah, Jianing Mi, Cheng Feng

Abstract:

Electronic government is the application of Information and Communication Technologies (ICTs) by the government to improve public service delivery to citizens and businesses. The purpose of this study is to investigate factors influencing the adoption and use of e-government services from different nationalities perspectives. The Technology Acceptance Model (TAM) will be used as the theoretical framework for the study. A questionnaire would be developed and administered to 500 potential respondents who are students from different nationalities in China. Predictors such as perceived usefulness, perceived ease of use, computer self-efficacy, trust in both the internet and government, social influence and perceived service quality would be examined with regard to their impact on the intention to use e-government services. This research is currently at the design and implementation stage. The completion of this study will provide useful insights into understanding factors impacting the decision to use e-government services from a cross and multi nationalities perspectives.

Keywords: different nationalities, e-government, e-government services, technology acceptance model (TAM)

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5261 Nosocomial Infections and Prevention in in Intensive Care Units and Intensive Care

Authors: Kaous Samira

Abstract:

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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5260 The Effect of Electronic Platform Service Usage on Customer Satisfaction and WOM

Authors: Shui Lien Chen, Yi-Fen Tsai, Jim Shih-Chiao Chin

Abstract:

—In this study, using Chunghwa Telecom as a case. The company accounted for the highest proportion of the telecommunications company in Taiwan. First, this paper would like to understand the effect of convenience performance on perceived ease of use and perceived usefulness. Further, the perceived ease of use and perceived usefulness of Technology Acceptance Model (TAM) are adopted as the factors on the company's brand perception. Afterward, the brand perception influence on customer satisfaction, and finally whether producing a good reputation and recommendation are tested. The study participants are people who have used electronic platform service of Chunghwa Telecom. A total of 478 valid questionnaires were used and AMOS 20.0 statistical software programs were adopted to analyze.

Keywords: technology acceptance model, brand association, brand awareness, brand attachment, customer satisfaction, word-of-mouth (WOM)

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5259 Data Analytics in Hospitality Industry

Authors: Tammy Wee, Detlev Remy, Arif Perdana

Abstract:

In the recent years, data analytics has become the buzzword in the hospitality industry. The hospitality industry is another example of a data-rich industry that has yet fully benefited from the insights of data analytics. Effective use of data analytics can change how hotels operate, market and position themselves competitively in the hospitality industry. However, at the moment, the data obtained by individual hotels remain under-utilized. This research is a preliminary research on data analytics in the hospitality industry, using an in-depth face-to-face interview on one hotel as a start to a multi-level research. The main case study of this research, hotel A, is a chain brand of international hotel that has been systematically gathering and collecting data on its own customer for the past five years. The data collection points begin from the moment a guest book a room until the guest leave the hotel premises, which includes room reservation, spa booking, and catering. Although hotel A has been gathering data intelligence on its customer for some time, they have yet utilized the data to its fullest potential, and they are aware of their limitation as well as the potential of data analytics. Currently, the utilization of data analytics in hotel A is limited in the area of customer service improvement, namely to enhance the personalization of service for each individual customer. Hotel A is able to utilize the data to improve and enhance their service which in turn, encourage repeated customers. According to hotel A, 50% of their guests returned to their hotel, and 70% extended nights because of the personalized service. Apart from using the data analytics for enhancing customer service, hotel A also uses the data in marketing. Hotel A uses the data analytics to predict or forecast the change in consumer behavior and demand, by tracking their guest’s booking preference, payment preference and demand shift between properties. However, hotel A admitted that the data they have been collecting was not fully utilized due to two challenges. The first challenge of using data analytics in hotel A is the data is not clean. At the moment, the data collection of one guest profile is meaningful only for one department in the hotel but meaningless for another department. Cleaning up the data and getting standards correctly for usage by different departments are some of the main concerns of hotel A. The second challenge of using data analytics in hotel A is the non-integral internal system. At the moment, the internal system used by hotel A do not integrate with each other well, limiting the ability to collect data systematically. Hotel A is considering another system to replace the current one for more comprehensive data collection. Hotel proprietors recognized the potential of data analytics as reported in this research, however, the current challenges of implementing a system to collect data come with a cost. This research has identified the current utilization of data analytics and the challenges faced when it comes to implementing data analytics.

Keywords: data analytics, hospitality industry, customer relationship management, hotel marketing

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5258 Innovative Practices That Have Significantly Scaled up Depot Medroxy Progesterone Acetate-SC Self-Inject Services

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

Abstract:

Background The Delivering Innovations in Selfcare (DISC) project promotes universal access to quality selfcare services beginning with subcutaneous depot medroxy progesterone acetate (DMPA-SC) contraceptive self-injection (SI) option. Self-inject (SI) offers women a highly effective and convenient option that saves them frequent trips to providers. Its increased use has the potential to improve the efficiency of an overstretched healthcare system by reducing provider workloads. State Social and Behavioral Change Communications (SBCC) Officers lead project demand creation and service delivery innovations that have resulted in significant increases in SI uptake among women who opt for injectables. Strategies Service Delivery Innovations The implementation of the "Moment of Truth (MoT)" innovation helped providers overcome biases and address client fear and reluctance to self-inject. Bi-annual program audits and supportive mentoring visits helped providers retain their competence and motivation. Proper documentation, tracking, and replenishment of commodities were ensured through effective engagement with State Logistics Units. The project supported existing state monitoring and evaluation structures to effectively record and report subcutaneous depot medroxy progesterone acetate (DMPA-SC) service utilization. Demand creation Innovations SBCC Officers provide oversight, routinely evaluate performance, trains, and provides feedback for the demand creation activities implemented by community mobilizers (CMs). The scope and intensity of training given to CMs affect the outcome of their work. The project operates a demand creation model that uses a schedule to inform the conduct of interpersonal and group events. Health education sessions are specifically designed to counter misinformation, address questions and concerns, and educate target audience in an informed choice context. The project mapped facilities and their catchment areas and enlisted the support of identified influencers and gatekeepers to enlist their buy-in prior to entry. Each mobilization event began with pre-mobilization sensitization activities, particularly targeting male groups. Context-specific interventions were informed by the religious, traditional, and cultural peculiarities of target communities. Mobilizers also support clients to engage with and navigate online digital Family Planning (FP) online portals such as DiscoverYourPower website, Facebook page, digital companion (chat bot), interactive voice response (IVR), radio and television (TV) messaging. This improves compliance and provides linkages to nearby facilities. Results The project recorded 136,950 self-injection (SI) visits and a self-injection (SI) proportion rate that increased from 13 percent before the implementation of interventions in 2021 to 62 percent currently. The project cost-effectively demonstrated catalytic impact by leveraging state and partner resources, institutional platforms, and geographic scope to scale up interventions. The project also cost effectively demonstrated catalytic impact by leveraging on the state and partner resources, institutional platforms, and geographic scope to sustainably scale-up these strategies. Conclusion Using evidence-informed iterations of service delivery and demand creation models have been useful to significantly drive self-injection (SI) uptake. It will be useful to consider this implementation model during program design. Contemplation should also be given to systematic and strategic execution of strategies to optimize impact.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, innovation, service delivery, demand creation.

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5257 Modeling Operating Theater Scheduling and Configuration: An Integrated Model in Health-Care Logistics

Authors: Sina Keyhanian, Abbas Ahmadi, Behrooz Karimi

Abstract:

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

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

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5256 Breech Versus Cephalic Elective Caesarean Deliveries – A Comparison of Immediate Neonatal Outcomes

Authors: Genevieve R. Kan, Jolyon Ford

Abstract:

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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5255 Plant Layout Analysis by Computer Simulation for Electronic Manufacturing Service Plant

Authors: D. Visuwan, B. Phruksaphanrat

Abstract:

In this research, computer simulation is used for Electronic Manufacturing Service (EMS) plant layout analysis. The current layout of this manufacturing plant is a process layout, which is not suitable due to the nature of an EMS that has high-volume and high-variety environment. Moreover, quick response and high flexibility are also needed. Then, cellular manufacturing layout design was determined for the selected group of products. Systematic layout planning (SLP) was used to analyse and design the possible cellular layouts for the factory. The cellular layout was selected based on the main criteria of the plant. Computer simulation was used to analyse and compare the performance of the proposed cellular layout and the current layout. It is found that the proposed cellular layout can generate better performances than the current layout. In this research, computer simulation is used for Electronic Manufacturing Service (EMS) plant layout analysis. The current layout of this manufacturing plant is a process layout, which is not suitable due to the nature of an EMS that has high-volume and high-variety environment. Moreover, quick response and high flexibility are also needed. Then, cellular manufacturing layout design was determined for the selected group of products. Systematic layout planning (SLP) was used to analyse and design the possible cellular layouts for the factory. The cellular layout was selected based on the main criteria of the plant. Computer simulation was used to analyse and compare the performance of the proposed cellular layout and the current layout. It found that the proposed cellular layout can generate better performances than the current layout.

Keywords: layout, electronic manufacturing service plant, computer simulation, cellular manufacturing system

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5254 Implementation of an Accessible State-Wide Trauma Education Program

Authors: Christine Lassen, Elizabeth Leonard, Matthew Oliver

Abstract:

The management of trauma is often complex and outcomes dependent on clinical expertise, effective teamwork, and a supported trauma system. The implementation of a statewide trauma education program should be accessible to all clinicians who manage trauma, but this can be challenging due to diverse individual needs, trauma service needs and geography. The NSW Institute of Trauma and Injury Management (ITIM) is a government funded body, responsible for coordinating and supporting the NSW Trauma System. The aim of this presentation is to describe how education initiatives have been implemented across the state. Simulation: In 2006, ITIM developed a Trauma Team Training Course - aimed to educate clinicians on the technical and non-technical skills required to manage trauma. The course is now independently coordinated by trauma services across the state at major trauma centres as well as in regional and rural hospitals. ITIM is currently in the process of re-evaluating and updating the Trauma Team Training Course to allow for the development of new resources and simulation scenarios. Trauma Education Evenings: In 2013, ITIM supported major trauma services to develop trauma education evenings which allowed the provision of free education to staff within the area health service and local area. The success of these local events expanded to regional hospitals. A total of 75 trauma education evenings have been conducted within NSW, with over 10,000 attendees. Wed-Based Resources: Recently, ITIM commenced free live streaming of the trauma education evenings which have now had over 3000 live views. The Trauma App developed in 2015 provides trauma clinicians with a centralised portal for trauma information and works on smartphones and tablets that integrate with the ITIM website. This supports pre-hospital and bedside clinical decisions and allows for trauma care to be more standardised, evidence-based, timely, and appropriate. Online e-Learning modules have been developed to assist clinicians, reduce unwarranted clinical variation and provide up to date evidence based education. The modules incorporate clinically focused education content with summative and formative assessments. Conclusion: Since 2005, ITIM has helped to facilitate the development of trauma education programs for doctors, nurses, pre-hospital and allied health clinicians. ITIM has been actively involved in more than 100 specialized trauma education programs, seminars and clinical workshops - attended by over 12,000 staff. The provision of state-wide trauma education is a challenging task requiring collaboration amongst numerous agencies working towards a common goal – to provide easily accessible trauma education.

Keywords: education, simulation, team-training, trauma

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5253 Ambivalence as Ethical Practice: Methodologies to Address Noise, Bias in Care, and Contact Evaluations

Authors: Anthony Townsend, Robyn Fasser

Abstract:

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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5252 Catastrophic Spending on Health: A Determinant of Access to Health Care by Migrant Slum Population

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

Abstract:

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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5251 Identifying Business Opportunities Based on Patent and Trademark Portfolios: a Technology-Based Service Industry Case

Authors: Mingook Lee, Sungjoo Lee

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As technology-based service industries grow drastically worldwide; companies are recognizing the importance of market preoccupancy and have made an effort to capture a large market to gain the upper hand. To this end, a focus on patents can be used to determine the properties of a technology, as well as to capture advantages in technical skills, in comparison with the firm’s competitors. However, technology-based services largely depend not only on their technological value but also their economic value, due to the recognized worth that is passed to a plurality of users. Thus, it is important to determine whether there are any competitors in the target areas and what services they provide in any field. Despite this importance, little effort has been made to systematically benchmark competitors in order to identify business opportunities. Thus, this study aims to not only identify each position of technology-centered service companies in complex market dynamics, but also to discover new business opportunities. For this, we try to consider both technology and market environments simultaneously by utilizing patent data as a representative proxy for technology and trademark dates as an index for a firm’s target goods and services. Theoretically, this is one of the earliest attempts to combine patent data and trademark data to analyze corporate strategies. In practice, the research results are expected to be used as a decision criterion to diagnose the economic value that companies can obtain by entering the market, as well as the technological value to be passed onto their customers. Thus, the proposed approach can be useful to support effective technology and business strategies in a firm.

Keywords: business opportunity, patent, Portfolio analysis, trademark

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5250 Consumption Insurance against the Chronic Illness: Evidence from Thailand

Authors: Yuthapoom Thanakijborisut

Abstract:

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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5249 Design and Performance Analysis of Resource Management Algorithms in Response to Emergency and Disaster Situations

Authors: Volkan Uygun, H. Birkan Yilmaz, Tuna Tugcu

Abstract:

This study focuses on the development and use of algorithms that address the issue of resource management in response to emergency and disaster situations. The presented system, named Disaster Management Platform (DMP), takes the data from the data sources of service providers and distributes the incoming requests accordingly both to manage load balancing and minimize service time, which results in improved user satisfaction. Three different resource management algorithms, which give different levels of importance to load balancing and service time, are proposed for the study. The first one is the Minimum Distance algorithm, which assigns the request to the closest resource. The second one is the Minimum Load algorithm, which assigns the request to the resource with the minimum load. Finally, the last one is the Hybrid algorithm, which combines the previous two approaches. The performance of the proposed algorithms is evaluated with respect to waiting time, success ratio, and maximum load ratio. The metrics are monitored from simulations, to find the optimal scheme for different loads. Two different simulations are performed in the study, one is time-based and the other is lambda-based. The results indicate that, the Minimum Load algorithm is generally the best in all metrics whereas the Minimum Distance algorithm is the worst in all cases and in all metrics. The leading position in performance is switched between the Minimum Distance and the Hybrid algorithms, as lambda values change.

Keywords: emergency and disaster response, resource management algorithm, disaster situations, disaster management platform

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5248 Logistics Support as a Key Success Factor in Gastronomy

Authors: Hanna Zietara

Abstract:

Gastronomy is one of the oldest forms of commercial activity. It is currently one of the most popular and still dynamically developing branches of business. Socio-economic changes, its widespread occurrence, new techniques, or culinary styles affect the almost unlimited possibilities of its development. Importantly, regardless of the form of business adopted, food service is strongly related to logistics processes, and areas of food service that are closely linked to logistics are of strategic importance. Any inefficiency in logistics processes results in reduced chances for success and achieving competitive advantage by companies belonging to the catering industry. The aim of the paper is to identify the areas of logistic support occurring in the catering business, affecting the scope of the logistic processes implemented. The aim of the paper is realized through a plural homogeneous approach, based on: direct observation, text analysis of current documents, in-depth free targeted interviews.

Keywords: gastronomy, competitive advantage, logistics, logistics support

Procedia PDF Downloads 158
5247 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

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

Abstract:

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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5246 Guillain Barre Syndrome in Children

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

Abstract:

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

Procedia PDF Downloads 66
5245 Contribution of Automated Early Warning Score Usage to Patient Safety

Authors: Phang Moon Leng

Abstract:

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

Procedia PDF Downloads 175
5244 Assessment of Level of Sedation and Associated Factors Among Intubated Critically Ill Children in Pediatric Intensive Care Unit of Jimma University Medical Center: A Fourteen Months Prospective Observation Study, 2023

Authors: Habtamu Wolde Engudai

Abstract:

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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5243 The Importance of Self-Efficacy and Collective Competence Beliefs in Managerial Competence of Sports Managers'

Authors: Şenol Yanar, Sinan Çeli̇kbi̇lek, Mehmet Bayansalduz, Yusuf Can

Abstract:

Managerial competence defines as the skills that managers in managerial positions have in relation to managerial responsibilities and managerial duties. Today's organizations, which are in a competitive environment, have the desire to work with effective managers in order to be more advantageous position than the other organizations they are competing with. In today's organizations, self-efficacy and collective competence belief that determine managerial competencies of managers to assume managerial responsibility are of special importance. In this framework, the aim of this study is to examine the effects of sports managers' perceptions of self-efficacy and collective competence in managerial competence perceptions. In the study, it has also been analyzed if there is a significant difference between self-efficacy, collective competence and managerial competence levels of sports managers in terms of their gender, age, duty status, year of service and level of education. 248 sports managers, who work at the department of sports service’s central and field organization at least as a chief in the manager position, have been chosen with random sampling method and they have voluntarily participated in the study. In the study, the self-efficacy scale which was developed by Schwarzer, R. & Jerusalem, M. (1995), collective competence scale developed by Goddard, Hoy and Woolfolk-Hoy (2000) and managerial competence scale developed by Cetinkaya (2009) have been used as a data collection tool. The questionnaire form used as a data collection tool in the study includes a personal information form consisting of 5 questions; questioning gender, age, duty status, years of service and level of education. In the study, Pearson Correlation Analysis has been used for defining the correlation among self-efficacy, collective competence belief, and managerial competence levels in sports managers and regression analysis have been used to define the affect of self-efficacy and collective competence belief on the perception of managerial competence. T-test for binary grouping and ANOVA analysis have been used for more than binary groups in order to determine if there is any significant difference in the level of self-efficacy, collective and managerial competence in terms of the participants’ duty status, year of service and level of education. According to the research results, it has been found that there is a positive correlation between sports managers' self-efficacy, collective competence beliefs, and managerial competence levels. According to the results of the regression analysis, it is understood that the managers’ perception of self-efficacy and collective competence belief significantly defines the perception of managerial competence. Also, the results show that there is no significant difference in self-efficacy, collective competence, and level of managerial competence of sports managers in terms of duty status, year of service and level of education.

Keywords: sports manager, self-efficacy, collective competence, managerial competence

Procedia PDF Downloads 229
5242 Utilization of Cloud-Based Learning Platform for the Enhancement of IT Onboarding System

Authors: Christian Luarca

Abstract:

The study aims to define the efficiency of e-Trainings by the use of cloud platform as part of the onboarding process for IT support engineers. Traditional lecture based trainings involves human resource to guide and assist new hires as part of onboarding which takes time and effort. The use of electronic medium as a platform for training provides a two-way basic communication that can be done in a repetitive manner. The study focuses on determining the most efficient manner of learning the basic knowledge on IT support in the shortest time possible. This was determined by conducting the same set of knowledge transfer categories in two different approaches, one being the e-Training and the other using the traditional method. Performance assessment will be done by the use of Service Tracker Assessment (STA) Tool and Service Manager. Data gathered from this ongoing study will promote the utilization of e-Trainings in the IT onboarding process.

Keywords: cloud platform, e-Training, efficiency, onboarding

Procedia PDF Downloads 148
5241 Threat Analysis: A Technical Review on Risk Assessment and Management of National Testing Service (NTS)

Authors: Beenish Urooj, Ubaid Ullah, Sidra Riasat

Abstract:

National Testing Service-Pakistan (NTS) is an agency in Pakistan that conducts student success appraisal examinations. In this research paper, we must present a security model for the NTS organization. The security model will depict certain security countermeasures for a better defense against certain types of breaches and system malware. We will provide a security roadmap, which will help the company to execute its further goals to maintain security standards and policies. We also covered multiple aspects in securing the environment of the organization. We introduced the processes, architecture, data classification, auditing approaches, survey responses, data handling, and also training and awareness of risk for the company. The primary contribution is the Risk Survey, based on the maturity model meant to assess and examine employee training and knowledge of risks in the company's activities.

Keywords: NTS, risk assessment, threat factors, security, services

Procedia PDF Downloads 67
5240 Enhanced Automated Teller Machine Using Short Message Service Authentication Verification

Authors: Rasheed Gbenga Jimoh, Akinbowale Nathaniel Babatunde

Abstract:

The use of Automated Teller Machine (ATM) has become an important tool among commercial banks, customers of banks have come to depend on and trust the ATM conveniently meet their banking needs. Although the overwhelming advantages of ATM cannot be over-emphasized, its alarming fraud rate has become a bottleneck in it’s full adoption in Nigeria. This study examined the menace of ATM in the society another cost of running ATM services by banks in the country. The researcher developed a prototype of an enhanced Automated Teller Machine Authentication using Short Message Service (SMS) Verification. The developed prototype was tested by Ten (10) respondents who are users of ATM cards in the country and the data collected was analyzed using Statistical Package for Social Science (SPSS). Based on the results of the analysis, it is being envisaged that the developed prototype will go a long way in reducing the alarming rate of ATM fraud in Nigeria.

Keywords: ATM, ATM fraud, e-banking, prototyping

Procedia PDF Downloads 315