Search results for: icu management and care

Authors: Anna Wszołek

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For a very long time, the doctor-patient relationship had a paternalistic character. The events of the II World War, as well as fast development of the biotechnology and medicine caused an important change in that relationship. Human beings and their dignity were put in the centre of philosophical and legal debate. The increasing frequency of clinical trials led to the emergence of bioethics, which dealt with the topic of the possibilities and boundaries of such research in relation to individual’s autonomy. Thus, there was a transformation from a paternalistic relationship to a more collaborative one in which the patient has more room for self-determination. Today, patients are more and more aware of their rights and the obligations placed on doctors and the health care system, which is linked to an increase in medical malpractice claims. Unfortunately, these claims are not always justified. There is a strong concentration around the topic of patient’s good, however, at the other side there are doctors who feel, on the example of Poland, they might be easily accused and sued for medical malpractice even though they fulfilled their duties. Such situation may have a negative impact on the quality of health care services and patient’s interests. This research is going to present doctor’s perspective on the topic of medical malpractice allegations. It is supposed to show possible damage to a doctor’s reputation caused by frivolous and weakly justified medical malpractice accusations, as well as means to protect this reputation.

Keywords: doctor's reputation, medical malpractice, personal rights, unjustified allegations

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Authors: Thanaphat Suwanaklang, Supaporn Suwannarongsri

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Presently, there are many industries in Thailand producing various products for both domestic distribution and export to foreign countries. Warehouse is one of the most important areas of business needing to store their products. Such businesses need to have a suitable warehouse management system for reducing the storage time and using the space as much as possible. This paper proposes the development of a web application for a warehouse management system. One of the ceramics factories in Thailand is conducted as a case study. By applying the ABC analysis, fixed location, commodity system, ECRS, and 7-waste theories and principles, the web application for the warehouse management system of the selected ceramics factory is developed to design the optimal storage area for groups of products and design the optimal routes of forklifts. From experimental results, it was found that the warehouse management system developed via the web application can reduce the travel distance of forklifts and the time of searching for storage area by 100% once compared with the conventional method. In addition, the entire storage area can be on-line and real-time monitored.

Keywords: warehouse management system, warehouse design method, logistics system, web application

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Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

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Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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Authors: Mubarak Jan Beebee Zeba Mahetaab, Sumera Bibi Keenoo

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Background: Covid-19 was first reported in Wuhan. On 13th March 2020, WHO declared Covid-19 as a pandemic disease with 140,936 cases globally. The outbreak of covid-19 occurred in over 184 countries, and it created a lot of medical and mental burdens. Aside from the physical problems, the mental health of the medical staff has been of critical concern. Aims and Objectives: To determine the prevalence of burnout among HCW dealing with COVID-19, identify the risk factors and find measures to support their mental health while dealing with the current and future pandemic. Methodology: A cross-sectional study was conducted among the HCW who fought against COVID-19 in SSRN Hospital in Mauritius. The HCWs were recruited using the snowballing sampling technique. Age, gender, job category, income, duration of vacation, working environment and importance of mental health were measured. Results: The prevalence of burnout was highest among HCA. Age had no significant association with pandemic-related burnout. In Mauritius, burnout during the pandemic is linked with lower income and having less vacation days. Conclusion: Burnout is prevalent among healthcare workers working during the Covid-19 Pandemic. Interventions such as psychological counselling, yoga and financial increments need to be implemented to help the healthcare workers.

Keywords: burnout, Covid-19, health care professionals, pandemic

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Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

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Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

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Authors: Arun Prasad Jaganathan

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In today's rapidly evolving technological landscape, the need for efficient and proactive maintenance management solutions has become increasingly evident across various industries. Traditional approaches often suffer from drawbacks such as reactive strategies, leading to potential downtime, increased costs, and decreased operational efficiency. In response to these challenges, this paper proposes an AI-enabled approach to object-based maintenance management aimed at enhancing reliability and efficiency. The paper contributes to the growing body of research on AI-driven maintenance management systems, highlighting the transformative impact of intelligent technologies on enhancing object reliability and operational efficiency.

Keywords: AI, machine learning, predictive maintenance, object-based maintenance, expert team scheduling

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Authors: Mohammad Hadi Khorashadi Zadeh

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Many new applications and internet services have been emerged since the innovation of mobile networks and devices. However, these applications have problems of security, management, and performance in business environments. Cloud systems provide information transfer, management facilities, and security for virtual environments. Therefore, an innovative internet service and a business model are proposed in the present study for creating a secure and consolidated environment for managing the mobile information of organizations based on cloud virtual phones (CVP) infrastructures. Using this method, users can run Android and web applications in the cloud which enhance performance by connecting to other CVP users and increases privacy. It is possible to combine the CVP with distributed protocols and central control which mimics the behavior of human societies. This mix helps in dealing with sensitive data in mobile devices and facilitates data management with less application overhead.

Keywords: BYOD, mobile cloud computing, mobile security, information management

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Authors: Nkechi Neboh, Josiah Adeyemo, Abimbola Enitan, Oludayo Olugbara

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Evolutionary algorithms are techniques extensively used in the planning and management of water resources and systems. It is useful in finding optimal solutions to water resources problems considering the complexities involved in the analysis. River basin management is an essential area that involves the management of upstream, river inflow and outflow including downstream aspects of a reservoir. Water as a scarce resource is needed by human and the environment for survival and its management involve a lot of complexities. Management of this scarce resource is necessary for proper distribution to competing users in a river basin. This presents a lot of complexities involving many constraints and conflicting objectives. Evolutionary algorithms are very useful in solving this kind of complex problems with ease. Evolutionary algorithms are easy to use, fast and robust with many other advantages. Many applications of evolutionary algorithms, which are population based search algorithm, are discussed. Different methodologies involved in the modeling and simulation of water management problems in river basins are explained. It was found from this work that different evolutionary algorithms are suitable for different problems. Therefore, appropriate algorithms are suggested for different methodologies and applications based on results of previous studies reviewed. It is concluded that evolutionary algorithms, with wide applications in water resources management, are viable and easy algorithms for most of the applications. The results suggested that evolutionary algorithms, applied in the right application areas, can suggest superior solutions for river basin management especially in reservoir operations, irrigation planning and management, stream flow forecasting and real-time applications. The future directions in this work are suggested. This study will assist decision makers and stakeholders on the best evolutionary algorithm to use in varied optimization issues in water resources management.

Keywords: evolutionary algorithm, multi-objective, reservoir operation, river basin management

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Authors: Francis Kwesi Bondinuba, Seidu Abdullah, Mewomo Cecilia, Opoku Alex

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Purpose: The purpose of this research is to develop a framework for understanding how sustainable project management contributes to the construction industry's pursuit of sustainable development goals. Study design/methodology/approach: The study employed a theoretical methodology to review existing theories and models that support Sustainable Project Management (SPM) in the construction industry. Additionally, a comprehensive review of current literature on SPM is conducted to provide a thorough understanding of this study. Findings: Sustainable Project Management (SPM) practices, including stakeholder engagement and collaboration, resource efficiency, waste management, risk management, and resilience, play a crucial role in achieving the Sustainable Development Goals (SDGs) within the construction industry. Conclusion: Adopting Sustainable Project Management (SPM) practices in the Ghanaian construction industry enhances social inclusivity by engaging communities and creating job opportunities. The adoption of these practices faces significant challenges, including a lack of awareness and understanding, insufficient regulatory frameworks, financial constraints, and a shortage of skilled professionals. Recommendation: There should be a comprehensive approach to project planning and execution that includes stakeholders such as local communities, government bodies, and environmental organisations, the use of green building materials and technologies, and the implementation of effective waste management strategies, all of which will ensure the achievement of SDGs in Ghana's construction industry. Originality/value: This paper adds to the current literature by offering the various theories and models in Sustainable Project Management (SPM) and a detailed review of how Sustainable Project Management (SPM) contribute to the achievement of the Sustainable Development Goals (SDGs) in the Ghanaian Construction Industry.

Keywords: sustainable development, sustainable development goals, construction industry, ghana, sustainable project management

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Authors: A. Farhad Sadri, B. Ali Farhadi, C. Nasim Shalamzari

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Waste management is a principle of urban and environmental governance. Waste management in Tehran metropolitan requires good strategies for better governance. Using of good urban governance principles together with eight main indexes can be an appropriate base for this aim. One of the reasonable tools in this field is usage of SWOT methods which provides possibility of comparing the opportunities, threats, weaknesses, and strengths by using IFE and EFE matrixes. The results of the above matrixes, respectively 2.533 and 2.403, show that management system of Tehran metropolitan wastes has performed weak regarding to internal factors and has not have good performance regarding using the opportunities and dealing with threats. In this research, prioritizing and describing the real value of each 24 strategies in waste management in Tehran metropolitan have been surveyed considering good governance derived from Quantitative Strategic Planning Management (QSPM) by using Kolomogrof-Smirnoff by 1.549 and significance level of 0.073 in order to define normalization of final values and all of the strategies utilities and Variance Analysis of ANOVA has been calculated for all SWOT strategies. Duncan’s test results regarding four WT, ST, WO, and SO strategies show no significant difference. In addition to mean comparison by Duncan method in this research, LSD (Lowest Significant Difference test) has been used by probability of 5% and finally, 7 strategies and final model of Tehran metropolitan waste management strategy have been defined. Increasing the confidence of people with transparency of budget, developing and improving the legal structure (rule-oriented and law governance, more responsibility about requirements of private sectors, increasing recycling rates and real effective participation of people and NGOs to improve waste management (contribution) and etc, are main available strategies which have been achieved based on good urban governance management principles.

Keywords: waste, strategy, environmental management, urban good governance, SWOT

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Authors: Mohammad Lemar Zalmai, Osman Hurol Turkakin, Cemil Akcay, Ekrem Manisali

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Most of the construction projects are exposed to time and cost overruns due to various factors and this is a major problem. As a solution to this, the Earned Value Management (EVM) method is considered. EVM is a powerful and well-known method used in monitoring and controlling the project. EVM is a technique that project managers use to track the performance of their project against project baselines. EVM gives an early indication that either project is delayed or not, and the project is either over budget or under budget at any particular day by tracking it. Thus, it helps to improve the management control system of a construction project, to detect and control the problems in potential risk areas and to suggest the importance and purpose of monitoring the construction work. This paper explains the main parameters of the EVM system involved in the calculation of time and cost for construction projects. In this study, the project management software Primavera P6 is used to deals with the project monitoring process of a seven-storeyed (G+6) faculty building whose construction is in progress at Istanbul, Turkey. A comparison between the planned progress of construction activities and actual progress is performed, and the analysis results are interpreted. This case study justifies the benefits of using EVM for project cash flow analysis and forecasting.

Keywords: earned value management (EVM), construction cost management, construction planning, primavera P6, project management, project scheduling

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Authors: Naim Ismajli, Ilir Rexhepi

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The article presents the results of the study about the motives and efficiency of quality management system (Quality System, QS) implementation in Kosovo companies. The main purpose of the study was to find out why Kosovo companies seek the implementation and certification of QS in accordance with the requirements of the ISO 9001 series of the standards and what has changed after the QS implementation. Furthermore, the results of the research were compared with similar performed in the other European countries. The performed research revealed that the implementation of QS mostly results in the benefits of an intangible nature that are internal to the company. In addition, although the main reasons to start implementing QS are the expectations of the external advantages, the implementation results mostly in the increase of the internal benefits such as an improvement in the definition of the responsibilities and obligations of the employees, a decrease in the nonconformities, better communication among the employees, and increased efficiency.

Keywords: quality management systems, ISO 9001, total quality management, environmental management system, ISO 14000, competitiveness, efciency

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Authors: Mohamed Saad Ahmed Hussien

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This paper discusses the risk management in Islamic banks and aims to determine the difference in the practices and methods of risk management in those banks compared to the conventional banks, and to make a case study of the biggest Islamic bank in Egypt (Faisal Islamic Bank of Egypt) to identify the most important financial risks faced and how to manage those risks. It was found that Islamic banks face two types of risks. The first type is similar to the risks in conventional banks; the second type is the additional risks which facing the Islamic banks only as a result of some Islamic modes of financing. With regard to the risk management, Islamic banks such as conventional banks applied the regulatory rules issued by the Central Banks and the Basel Committee; Islamic banks also applied the instructions and procedures issued by the Islamic Financial Services Board (IFSB). Also, Islamic banks are similar to the conventional banks in the practices and methods which they use to manage the risks. And there are some factors that may affect the risk management in Islamic banks, such as the size of the bank and the efficiency of the administration and the staff of the bank.

Keywords: conventional banks, Faisal Islamic Bank of Egypt, Islamic banks, risk management

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Authors: Yuhiro Mizunuma, Keita Tsuji

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In Japan, local governments have long managed public libraries; however, organizations including private enterprises took over their management with the introduction of an outsourcing system in 2003. Now, whether local governments should apply this system to public libraries is under discussion, and many argue that it is inappropriate for public libraries. In this study, to provide basic data for such discussions, the differences between public libraries managed by outsourcing (henceforth, 'outsourcing libraries') and those managed directly by local governments (henceforth 'direct management libraries') were examined, focusing on bestsellers. We chose the 435 books on the top-20 bestseller lists published from 1996 to 2015 inclusive, as our sample bestseller books; and 413 outsourcing libraries' and 2,619 direct management libraries' holdings of them were investigated using the Calil API (a free Web service that can perform cross-library searches on libraries in Japan). Results show that outsourcing libraries tend to hold fewer bestsellers than direct management libraries. It was also found that direct management libraries tend to hold many duplicates of bestsellers, and that, in many cases, many of those were not being borrowed in direct management libraries.

Keywords: bestseller books, book collection, Japanese public libraries, outsourcing

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Authors: Fardis Teifoori, Mehdi Dehghani, Idoia Postigo, Jorge Martinez

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Introduction: Many skin disorders, such as atopic dermatitis (AD), is characterized by inflammation, infection, and hyperplasia. In this work, keratinocytes from AD patients are used to study the pomegranate seed oil properties for skin care. Material and methods: Isolated keratinocytes from patients with AD were cultured and stimulated by IL-9 (20 ng/ml) and TNF-α (50ng/ml) for 48h to induce vascular endothelial growth factor (VEGF) and Regulated upon activation, normal T cell expressed and secreted (RANTES) production, respectively, in the presence of different concentrations of pomegranate seed oil (20, 50, 100, and 200 µM). Finally, the concentrations of RANTES and VEGF in the cell culture supernatant were quantified according to the standard protocol of commercial ELISA kits. Results: The results indicated that pomegranate seed oil concentrations of 50, 100, and 200 µM could significantly inhibit the production of VEGF and RANTES by stimulating keratinocytes with IL-9 (20 ng/ml) and TNF-α (50ng/ml), respectively. The decrease in VEGF and RANTES concentration in the presence of the pomegranate seed oil concentrations of 20 and 50 uM was not significant. Conclusion: It was concluded that pomegranate seed oil (PSO) counteracts atopic dermatitis conditions dose-dependently: with the highest effect at the concentration of 200 µM. We suggest that the inexpensive and easily available pomegranate seed oil is a good candidate for cosmetics and clinical utilization for skin care.

Keywords: atopic dermatitis, pomegranate, Punica granatum, RANTES, VEGF

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Authors: Zahra Salehi Shahrbabaki, Zahra Chavoshzadeh, Fahimeh Abdollahimajd, Samin Sharafian, Tolue Mahdavi, Mahnaz Jamee

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Background: Inborn errors of immunity (IEIs) are monogenic diseases of the immune the system with broad clinical manifestations. Despite the increasing genetic advancements, the diagnosis of IEIs still leans on clinical diagnosis. Dermatologic manifestations are observed in a large number of IEI patients and can lead to proper approach, prompt intervention and improved prognosis. Methods: This cross-sectional study was carried out between 2018 and 2020 on IEIs at a Children's tertiary care center in Tehran, Iran. Demographic details (including age, sex, and parental consanguinity), age at onset of symptoms and family history of IEI with were recorded. Results :212 patients were included. Cutaneous findings were reported in (95 ,44.8%) patients. and 61 of 95 (64.2%) reported skin lesions as the first clinical presentation. Skin infection (69, 72.6%) was the most frequent cutaneous manifestation, followed by an eczematous rash (24, 25 %). Conclusions: Skin manifestations are common feature in IEI patients and can be readily recognizable by healthcare providers. This study tried to provide information on prognostic consequences.

Keywords: primary immuno deficiency, inborn errror of metabolism, skin manifestation, skin infection

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Authors: N. M. Sani, I. Bitrus, A. M. Sarki, N. S. Mujahid

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Hepatitis is one of the neglected infectious diseases in sub Saharan Africa, and most of the available data is based on blood donors. Health care workers (HCWs) often get infected as a result of their close contact with patients. A cross-sectional study was conducted to determine the prevalence of hepatitis B and C among this group of professionals with a view to improving the quality of care to their patients. Hepatitis B and C infections pose a major public health problem worldwide. While infection is highest in the developing world particularly Asia and sub-Saharan Africa, healthcare workers are at higher risk of acquiring blood-borne viral infections, particularly Hepatitis B and C which are mostly asymptomatic. This study was aimed at determining the prevalence of Hepatitis B and C infections and associated risk factors among health care workers in Dutse Metropolis, Jigawa State - Nigeria. A standard rapid immuno-chromatographic technique i.e. rapid ELISA was used to screen all sera for Hepatitis B surface antigen (HBsAg) and Hepatitis C viral antibody (HCVAb) respectively. Strips containing coated antibodies and antigens to HBV and HCV respectively were removed from the foil. Strips were labeled according to samples. Using a separate disposable pipette, 2 drops of the sample (plasma) were added into each test strip and allowed to run across the absorbent pad. Results were read after 15 minutes. The prevalence of HBV and HCV infection in 100 healthcare workers was determined by testing the plasma collected from the clients during their normal checkup using HBsAg and HCVAb test strips. Results were subjected to statistical analysis using chi-square test. The prevalence of HBV among HCWs was 19 out of 100 (19.0%) and that of HCV was 5 out of 100 (5.0%) where in both cases, higher prevalence was observed among female nurses. It was also observed that all HCV positive cases were recorded among nurses only. The study revealed that nurses are at greater risk of contracting HBV and HCV due to their frequent contact with patients. It is therefore recommended that effective vaccination and other infection control measures be encouraged among healthcare workers.

Keywords: prevalence, hepatitis, viruses, healthcare workers, infection

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Authors: Azar Baghtaghi

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Financial risk management is critically important as it enables companies to maintain stability and profitability amidst market fluctuations and unexpected events. It involves the precise identification of risks that could impact investments, assets, and potential revenues. By implementing effective risk management strategies, companies can insure themselves against adverse market changes and prevent potential losses. In today's era, where markets are highly complex and influenced by various factors such as macroeconomic policies, exchange rate fluctuations, and natural disasters, the need for meticulous planning to cope with these uncertainties is more pronounced. Ultimately, financial risk management means being prepared for the future and the ability to sustain business in changing environments. A company capable of managing its risks not only achieves sustainable profitability but also gains the confidence of shareholders, investors, and business partners, enhancing its competitive position in the market. In this article, the types of financial risk and risk management strategies for improving financial performance were investigated. By identifying the risks stated in this article and their evaluation techniques, it is possible to improve the organization's financial performance.

Keywords: strategy, risk, risk management, financial performance

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Authors: Nazia Jabeen, Denis Hyams-Ssekasi

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The study focuses on the determinants of food waste management (FWM) in one of the urban areas of Pakistan. One hundred and two households from the urban areas of Pakistan took part in the study via self-completed questionnaires, and data were analyzed. The research findings indicate that food waste management is a recurring issue, and households must do more to minimize or create business opportunities. Most households agree that food waste has significant implications for the community if not utilized and managed correctly. The value creation deriving from this zero-value resource provides a platform where householders see the benefit of food waste management. Based on the findings, this study acknowledges that food waste has significant economic and social impacts on the community. It concludes that minimization and optimum utilization of food waste create a pathway to business opportunities in urban areas.

Keywords: economic, social, food waste management, business opportunities, value creation

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Authors: Madeleine Cox

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Objective; analyse patient choices in management of first trimester miscarriage, rates of complications including repeat procedure. Design: all first trimester miscarriages from a tertiary institution on the Gold Coast in a 6 month time frame (July to December 2021) were reviewed, including choice of management, histopathology, any representations or admissions, and potential complications. Results: a total of 224 first trimester miscarriages were identified. Of these, 183 (81%) opted to have surgical management in the first instance. Of the remaining patients, 18 (8%) opted to have medical management, and 28 (12.5%) opted to have expectant management. In total, 33(15%) patients required a repeat treatment for retained products. 1 had medical management for a small volume PROC post suction curette. A significant number of these patients initially opted for medical management but then elected to have shorter follow up than usual and went on to have retained products noted. 5 women who had small volumes of RPOC post medical or surgical management had repeat suction curette, however, had very small volumes of products on scan and on curette and may have had a good result with repeated misoprostol administration. It is important to note that whilst a common procedure, suction curettes are not without risk. 2 women had significant blood loss of 1L and 1.5L. A third women had a uterine perforation, a rare but recognised complication, she went on to require a laparoscopy which identified a small serosal bowel injury which was closed by the colorectal team. Conclusion: Management of first trimester miscarriage should be guided by patient preference. It is important to be able to provide patients with their choice of management, however, it is also important to have a good understanding of the risks of each management choice, chances of repeated procedure, appropriate time frame for follow up. Women who choose to undertake medical or expectant management should be supported through this time, with appropriate time frame between taking misoprostol and repeat scan so that the true effects can be evaluated. Patients returning for scans within 2-3 days are more likely to be booked for further surgery, however, may reflect patients who did not have adequate counselling or simply changed their mind on their preferred management options.

Keywords: miscarriage, gynaecology, obstetrics, first trimester

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Authors: Małgorzata Smolarek

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One of the barriers to the development of small and medium-sized enterprises (SME) are difficulties connected with management of human resources. The first part of article defines the specifics of staff management in small and medium enterprises. The practical part presents results of own studies in the area of diagnosis of the state of the human resources management in small and medium-sized enterprises in Poland. It takes into account its impact on the functioning of SME in a variable environment. This part presents findings of empirical studies, which enabled verification of the hypotheses and formulation of conclusions. The findings presented in this paper were obtained during the implementation of the project entitled 'Tendencies and challenges in strategic managing SME in Silesian Voivodeship.' The aim of the studies was to diagnose the state of strategic management and human resources management taking into account its impact on the functioning of small and medium enterprises operating in Silesian Voivodeship in Poland and to indicate improvement areas of the model under diagnosis. One of the specific objectives of the studies was to diagnose the state of the process of strategic management of human resources and to identify fundamental problems. In this area, the main hypothesis was formulated: The enterprises analysed do not have comprehensive strategies for management of human resources. The survey was conducted by questionnaire. Main Research Results: Human resource management in SMEs is characterized by simplicity of procedures, and the lack of sophisticated tools and its specificity depends on the size of the company. The process of human resources management in SME has to be adjusted to the structure of an organisation, result from its objectives, so that an organisation can fully implement its strategic plans and achieve success and competitive advantage on the market. A guarantee of success is an accurately developed policy of human resources management based on earlier analyses of the existing procedures and possessed human resources.

Keywords: human resources management, human resources policy, personnel strategy, small and medium enterprises

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Authors: Mulalo Mushaisano

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It has been revealed in the existing literature that specific knowledge management practices can be implemented and utilized in organizations to enable sustaining service innovation. This kind of innovation is of crucial importance in service environments such as institutions of higher education because it allows the delivery of enhanced services which are designed to add value and deliver better services to clients. However, there is a widespread lack of the necessary implementation of essential knowledge practices in higher education institutions owing to a variety of internal challenges and barriers. The primary objective of the study was to identify the essential knowledge management practices required for the enablement of service innovation. The main outcome was the development of a framework of knowledge management practice which can be applied in institutions of higher education to achieve service innovation. The study will address the gap in where existing literature mostly explored the aforementioned processes in the context of commercial and corporate organizations and not in the higher education environment.

Keywords: higher education, innovation, knowledge management, service innovation

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Authors: Tim Wollert, Fabian Behrendt

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Value Stream Management (VSM) is a widely used methodology in the context of Lean Management for improving end-to-end material and information flows from a supplier to a customer from a company’s perspective. Whereas the design principles, e.g. Pull, value-adding, customer-orientation and further ones are still valid against the background of an increasing digitalized and dynamic environment, the methodology itself for mapping a value stream is characterized as time- and resource-intensive due to the high degree of manual activities. The digitalization of processes in the context of Industry 4.0 enables new opportunities to reduce these manual efforts and make the VSM approach more agile. The paper at hand aims at providing a modular data and calculation framework, utilizing the available business data, provided by information and communication technologies for automizing the value stream mapping process with focus on the manufacturing process.

Keywords: lean management 4.0, value stream management (VSM) 4.0, dynamic value stream mapping, enterprise resource planning (ERP)

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Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

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Authors: Vinodhini Elangovan, Jen Heng Pek

Abstract:

Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

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Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

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Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

Procedia PDF Downloads 299

Authors: Robin C. Ladwig

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Diversity Management, as a substantial element of Human Resource Management, aims to secure the economic benefit that assumingly comes with a diverse workforce. Consequently, diversity managers focus on the protection of employees and securing equality measurements to assure organisational gender diversity. Gender diversity as one aspect of Diversity Management seems to adhere to gender binarism and cis-normativity. Workplaces are gendered spaces which are echoing the binary gender-normativity presented in Diversity Management, sold under the label of gender diversity. While the expectation of Diversity Management implies the inclusion of a multiplicity of marginalised groups, such as trans and gender diverse people, in current literature and practice, the reality is curated by gender binarism and cis-normativity. The qualitative multi-method research showed a lack of knowledge about trans and gender diverse matters within the profession of Diversity Management and Human Resources. The semi-structured interviews with trans and gender diverse individuals from various backgrounds and occupations in Australia exposed missing considerations of trans and gender diverse experiences in the inclusivity and gender equity of various workplaces. Even if practitioners consider trans and gender diverse matters under gender diversity, the practical execution is limited to gender binary structures and cis-normative actions as the photo-elicit questionnaire with diversity managers, human resource officers, and personnel management demonstrates. Diversity Management should approach a broader source of informed practice by extending their business focus to the knowledge of humanity studies. Humanity studies could include diversity, queer, or gender studies to increase the inclusivity of marginalised groups such as trans and gender diverse employees and people. Furthermore, the definition of gender diversity should be extended beyond the gender binary and cis-normative experience. People may lose trust in Diversity Management as a supportive ally of marginalised employees if the understanding of inclusivity is limited to a gender binary and cis-normativity value system that misrepresents the richness of gender diversity.

Keywords: cis-normativity, diversity management, gender binarism, trans and gender diversity

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Authors: Farzad Yavari, Fereydoun Ohadi

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Today, with the development and growth of technology and extreme environmental changes, organizations need to identify opportunities and create creativity and innovation in order to be able to maintain or improve their position in competition with others. In this regard, it is necessary that the resources and assets of the organization are coordinated and reviewed in accordance with the orientation of the strategy. One of the competitive advantages of the present age is knowledge management, which is to equip the organization with the knowledge of the day and disseminate among employees and use it in the development of products and services. Therefore, in the forthcoming research, the impact of dynamic capabilities components (sense, seize, and reconfiguration) has been investigated on knowledge management processes (acquisition, integration and knowledge utilization) in the MAPNA Engineering and Construction Company using a field survey and applied research method. For this purpose, a questionnaire was filled out in the form of 15 questions for dynamic components and 15 questions for measuring knowledge management components and distributed among 46 employees of the knowledge management organization. Validity of the questionnaire was evaluated through content validity and its reliability with Cronbach's coefficient. Pearson correlation test and structural equation technique were used to analyze the data. The results of the research indicate a positive significant correlation between the components of dynamic capabilities and knowledge management.

Keywords: dynamic capabilities, knowledge management, sense capability, seize capability, reconfigurable capability, knowledge acquisition, knowledge integrity, knowledge utilization

Procedia PDF Downloads 108

Authors: Anandita Mitro, Archana Srivastava, Bidisha Banerjee

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The present paper attempts to analyze the hierarchy and interconnection of factors responsible for the uptake of BCG vaccination in India. The study uses National Family Health Survey (NFHS-5) data which was conducted during 2019-21. The univariate logistic regression method is used to understand the univariate effects while the interconnection effects have been studied using the Categorical Inference Tree (CIT) which is a non-parametric Machine Learning (ML) model. The hierarchy of the factors is further established using Conditional Inference Forest which is an extension of the CIT approach. The results suggest that BCG vaccination coverage was influenced more by system-level factors and awareness than education or socio-economic status. Factors such as place of delivery, antenatal care, and postnatal care were crucial, with variations based on delivery location. Region-specific differences were also observed which could be explained by the factors. Awareness of the disease was less impactful along with the factor of wealth and urban or rural residence, although awareness did appear to substitute for inadequate ANC. Thus, from the policy point of view, it is revealed that certain subpopulations have less prevalence of vaccination which implies that there is a need for population-specific policy action to achieve a hundred percent coverage.

Keywords: vaccination, NFHS, machine learning, public health

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Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki, Simoni K. Lintzerakou

Abstract:

Air transport links markets and individuals, promoting social and economic development. The review of management direction towards social responsibility and especially for the enhancement of passengers with autism is the key objective of this paper. According to a top-down approach, the key dimensions that affect the basic principles and directions of airport enterprises management towards social responsibility for the case of passengers with autism are presented. Conventional wisdom is to present actions undertaken in improving accessibility for special population groups and highlight the social dimension in the management of transport hubs. The target is to focus on transport hubs serving special groups of passengers such as passengers with autism and highlight good practices and motivate transport infrastructure management authorities and decision makers to promote the social footprint of transport. The highlights and key findings are essential for managers and decision makers to support actions and plans towards management of airport enterprises towards social responsibility, focusing on the case of passengers traveling with Autism Spectrum Disorder (ASD).

Keywords: social responsibility, special groups, airport enterprises, AUTISM

Procedia PDF Downloads 116