Search results for: hospital waste management (HWM)

Authors: Aisha Khodijah Kholib Jati, Suharni Mohamad, Azlan Husin, Wan Suriana Wan Ab Rahman

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Introduction: Toxoplasmosis is caused by an obligate intracellular parasite, Toxoplasma gondii (T. gondii). It is commonly asymptomatic in normal individual, but it can be fatal to immunocompromised patients as it can lead to severe complications such as encephalitis, chorioetinitis and myocarditis. Objective: The aim of the study was to determine the seroprevalence of toxoplasmosis and its association with socio-demographic and behavioral characteristics among hemato-oncology patients in Hospital USM. Methods: In this cross-sectional study, 56 hemato-oncology patients were screened for immunoglobulin M (IgM) antibodies, immunoglobulin G (IgG) antibodies, and IgG avidity of T. gondii by using ELISA Kit (BioRad, USA). For anti-T. gondii IgG antibody, titer ≥ 9 IU/ml was considered as recent infection, while for IgM, ratio ≥ 1.00 was considered as reactive for the anti-T. gondii IgM antibodies. Low avidity index is considered as recent infection within 20 weeks while high avidity considered as past infection. T. gondii exposure, socio-demographic and behavioral characteristics was assessed by a questionnaire and interview. Results: A total of 28 (50.0%) hemato-oncology patients were seropositive for T. gondii antibodies. Out of that total, 27 (48.21%) patients were IgG+/IgM- and one patient (1.79%) was IgG+/IgM+ with high avidity index. Univariate analysis showed that age, gender, ethnicity, marital status, educational level, employment status, stem cell transplant, blood transfusion, close contact with cats, water supply, and consumption of undercooked meat were not significantly associated with Toxoplasma seropositivity rate. Discussion: The seropositivity rate of IgG anti-T. gondii was high among hemato-oncology patients in Hospital USM. With impaired immune system, these patients might have a severe consequence if the infection reactivated. Therefore, screening for anti-T. gondii may be considered in the future. Moreover, health programme towards healthy food and good hygiene practice need to be implemented.

Keywords: immunocompromised, seroprevalence, socio-demographic, toxoplasmosis

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Authors: B. Sajeena Beevi, P. P. Jose, G. Madhu

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The aim of this study was to obtain the optimal conditions for biogas production from anaerobic digestion of organic fraction of municipal solid waste (OFMSW) using response surface methodology (RSM). The parameters studied were initial pH, substrate concentration and total organic carbon (TOC). The experimental results showed that the linear model terms of initial pH and substrate concentration and the quadratic model terms of the substrate concentration and TOC had significant individual effect (p < 0.05) on biogas yield. However, there was no interactive effect between these variables (p > 0.05). The highest level of biogas produced was 53.4 L/Kg VS at optimum pH, substrate concentration and total organic carbon of 6.5, 99gTS/L, and 20.32 g/L respectively.

Keywords: anaerobic digestion, biogas, optimization, response surface methodology

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Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

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Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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Authors: Abdullahi Mannir Rawayau

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This paper identifies the problems that have aided the decoy to adequate basic infrastructural amenities, sub-standard housing, over-crowding, poor ventilation in homes and work places, sanitation, and non-compliance with building bye-laws and regulation. The paper also asserts the efficient disposal of solid and liquid waste is one of the challenges in the informal areas due to threats on the environment and public health. Sanitation services in the informal settlements have been found to be much lower compared to the average for unban. Bearing in mind a factor which prevents sustainable sanitation in informal areas which include low incomes, insecure tenure, low education levels, difficulty topography and transitory populations, and this study aim to identify effective strategies for achieving sustainable sanitation with specific reference to the informal settlement. Using the Shanghai Low-Cost as a case study. The primary data collected was through observation and interview method. Similarly, the secondary data used for the study was collected through literature reviews from extent studies with specific reference to informal settlement. A number of strategies towards achieving sustainable sanitation in the study were identified here in classified into three (3):- Advocacy and capacity building, infrastructural provision and institutionalization of systems and processes. The paper concludes with the premise on the need to build alliances between the government and stakeholders concerned with sanitation provision through the creation of sanitation and employ adaptable technology. Provision of sanitation facilities in public areas and to establish a statutory body for timely response to sanitation waste management in Katsina. It is imperative to check and prevent further decay for harmonious living and sustainable development.

Keywords: built environment, sanitation, facilities, settlement

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Authors: Ahmed M. Haddad, Hadeel S. El-Shaal, Gadallah M. Abu-Elreesh

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Some of filamentous fungi can be used for biodiesel production as they are able to accumulate high amounts of intracellular lipids when grown at stress conditions. Aspergillus fumigatus sp. was isolated from Nile delta soil in Egypt. The fungus was primarily screened for its capacity to accumulate lipids using Nile red staining assay. The fungus could accumulate more than 20% of its biomass as lipids when grown at optimized minimal medium. After lipid extraction, we could use fungal cell debris to remove some heavy metals from contaminated waste water. The fungal cell debris could remove Cd, Cr, and Zn with absorption efficiency of 73%, 83.43%, and 69.39% respectively. In conclusion, the Aspergillus fumigatus isolate may be considered as a promising biodiesel producer, and its biomass waste can be further used for bioremediation of wastewater contaminated with heavy metals.

Keywords: biodiesel, bioremediation, fungi, heavy metals, lipids, oleaginous

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Authors: Seyed Abdolreza Mosavi, Alireza Babakhan, Elham Sadat Hoseinifard

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Knowledge-based firms need to design mechanisms for continuous absorptive and creation of knowledge in order to ensure their survival in the competitive arena and to follow the path of development. Considering the project-oriented nature of product development activities in knowledge-based firms on the one hand and the importance of analyzing the factors affecting knowledge absorptive capacity in these firms on the other, the purpose of this study is to identify and classify the factors affecting project management practices on absorptive knowledge capacity. For this purpose, we have studied and reviewed the theoretical literature in the field of project management and absorptive knowledge capacity so as to clarify its dimensions and indexes. Then, using the ISM method, the relationship between them has been studied. To collect data, 21 questionnaires were distributed in project-oriented knowledge-based companies. The results of the ISM method analysis provide a model for the relationship between project management activities and knowledge absorptive capacity, which includes knowledge acquisition capacity, scope management, time management, cost management, quality management, human resource management, communications management, procurement management, risk management, stakeholders management and integration management. Having conducted the MICMAC analysis, we divided the variables into three groups of independent, relational and dependent variables and came up with no variables to be included in the group of autonomous variables.

Keywords: knowledge absorptive capacity, project management practices, knowledge-based firms, interpretive structural modeling

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Authors: Cheng Fang Hsu

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Call center is the core of building customer relationship management system. Under the strong competitive stress, it becomes a new profiting challenge for a successful enterprise. Call center is a department not only to provide customer service but also to bring business profit. This is the qualitative case study in Taiwan bank service industry which goes on deeper exploration, and analysis by business interviews and industrial analysis. This study starts from the establishment, development, and management after the reforming of the case call center. Through SWOT analysis, and industrial analysis, this study adopted 7S model to explain how the call center reforms from service oriented to profit oriented and from cost management to profit management. The results indicated how service innovation management promotes call center to be operated as a market profit competition center. The recommendations are indicated to support the call center on marketing profit by service innovation management.

Keywords: call center, 7S model, service innovation management, bioinformatics

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Authors: Sedef Sert, Paola Garrone, Marco Melacini, Alessandro Perego

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This paper is aimed at enhancing our current understanding of motivations behind corporate in-kind donations and to find out whether economic efficiency may be a major driver. Our empirical setting is consisted of surplus food recovery and donation by companies from food supply chain. This choice of empirical setting is motivated by growing attention on the paradox of food insecurity and food waste i.e. a total of 842 million people worldwide were estimated to be suffering from regularly not getting enough food, while approximately 1.3 billion tons per year food is wasted globally. Recently, many authors have started considering surplus food donation to nonprofit organizations as a way to cope with social issue of food insecurity and environmental issue of food waste. In corporate philanthropy literature the motivations behind the corporate donations for social purposes, such as altruistic motivations, enhancements to employee morale, the organization’s image, supplier/customer relationships, local community support, have been examined. However, the relationship with economic efficiency is not studied and in many cases the pure economic efficiency as a decision making factor is neglected. Although in literature there are some studies give us the clue on economic value creation of surplus food donation such as saving landfill fees or getting tax deductions, so far there is no study focusing deeply on this phenomenon. In this paper, we develop a conceptual framework which explores the economic barriers and drivers towards alternative surplus food management options i.e. discounts, secondary markets, feeding animals, composting, energy recovery, disposal. The case study methodology is used to conduct the research. Protocols for semi structured interviews are prepared based on an extensive literature review and adapted after expert opinions. The interviews are conducted mostly with the supply chain and logistics managers of 20 companies in food sector operating in Italy, in particular in Lombardy region. The results shows that in current situation, the food manufacturing companies can experience cost saving by recovering and donating the surplus food with respect to other methods especially considering the disposal option. On the other hand, retail and food service sectors are not economically incentivized to recover and donate surplus food to disfavored population. The paper shows that not only strategic and moral motivations, but also economic motivations play an important role in managerial decision making process in surplus food management. We also believe that our research while rooted in the surplus food management topic delivers some interesting implications to more general research on corporate in-kind donations. It also shows that there is a huge room for policy making favoring the recovery and donation of surplus products.

Keywords: corporate philanthropy, donation, recovery, surplus food

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Authors: Mwafak Shakoor

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The purpose of this study was to reduce patient waiting times, improve system throughput and improve resources utilization in radiology department. A discrete event simulation model was developed using Arena simulation software to investigate different alternatives to improve the overall system delivery based on adding resource scenarios due to the linkage between patient waiting times and resource availability. The study revealed that there is no addition investment need to procure additional scanner but hospital management deploy managerial tactics to enhance machine utilization and reduce the long waiting time in the department.

Keywords: discrete event simulation, radiology department, arena, waiting time, healthcare modeling, computed tomography

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Authors: Recep Sait Arpat, Hakan Güreşci

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Emergency, disaster and crisis management terms are generally perceived as the same processes. This conflict effects the approach and delegating policy of the political order. Crisis management starts in the aftermath of the mismanagement of disaster and emergency. In the light of the information stated above in this article Turkey and United Kingdom(UK)’s crisis management systems are analyzed. This article’s main aim is to clarify the main points of the emergency management system of United Kingdom and Turkey’s disaster management system by comparing them. To do this: A prototype model of the political decision making processes of the countries is drawn, decision making mechanisms and the planning functions are compared. As a result it’s found that emergency management policy in Turkey is reactive whereas it’s proactive in UK; as the delegating policy Turkey’s system is similar to UK; levels of emergency situations are similar but not the same; the differences are stemming from the civil order and nongovernmental organizations effectiveness; UK has a detailed government engagement model to emergencies, which shapes the doctrine of the approach to emergencies, and it’s successful in gathering and controlling the whole state’s efforts; crisis management is a sub-phase of UK emergency management whereas it’s accepted as a outmoded management perception and the focal point of crisis management perception in UK is security crisis and natural disasters while in Turkey it is natural disasters. In every anlysis proposals are given to Turkey.

Keywords: crisis management, disaster management, emergency management, turkey, united kingdom

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Authors: Oluwafemi Babatunde Oduntan, Isaac A. Bamgboye

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The solid waste disposal and its management from pineapple juice processing constitute environmental contamination affecting public health. The use of this by-product called pomace has potentials to reduce cost of aquafeed. Pineapple pomace collected after juice extraction was dried and milled. The interactive effects of feeding rate (1.28, 1.44 and 1.60kg/min), screw speed (305, 355 and 405rpm), moisture content (16, 19 and 22%), temperatures (60, 80, 100 and 120°C), cutting speed (1300, 1400 and 1500rpm), pomace inclusion ratio (5, 10, 15, 20%) and open surface die (50, 75 and 100%) on the extrudate physical properties (bulk density, unit density, expansion ratio, durability and floatability) were investigated using optimal custom design (OCD) matrix and response surface methodology. The predicted values were found to be in good agreement with the experimental values for, expansion ratio, durability and floatability (R2 = 0.7970; 0.9264; 0.9098 respectively) with the exceptions of unit density and bulk density (R2 = 0.1639; 0.2768 respectively). All the extrudates showed relatively high floatability, durability. The inclusion of pineapple pomace produced less expanded and more compact textured extrudates. Results indicated that increased in the value of pineapple pomace, screw speed, feeding rate decreased unit density, bulk density, expansion ratio, durability and floatability of the extrudate. However, increasing moisture content of feed mash resulted in increase unit density and bulk density. Addition of extrusion temperature and cutting speed increased the floatability and durability of extrudate. The proportion of pineapple pomace in aquafeed extruded product was observed to have significantly lower effect on the selected responses.

Keywords: aquafeed, extrusion, physical properties, pineapple pomace, waste

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Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

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It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

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Authors: Shyam lamsal

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Introduction: Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal, in Jumla, to provide health services in easy way in backward areas, to produce skilled health professionals & conduct research. The backward areas mentioned in act of KAHS are Humla, Jumla, Kalikot, Dolpa, Mugu districts of Karnali zone, Jajarkot district of Bheri zone & Bajura, Baghang & Achham districts of Seti zone in Nepal occupying around 25 % of the total national geography. Backward area of Nepal is specific to having worst health indicators with life expectancy (47 years), HDI (0.35), Literacy rate (58%), global acute malnutrition (13%), crude birth rate (33.6), crude death rate (9.6), Total fertility rate (4.2), infant mortality rate (61.5 per 1000 live births), under five mortality rate (59 per 1000 live births) and maternal mortality ratio (400 per 1000 live births). History of health facilities in backward region: All the nine districts of this region have a district hospital with very few grass root level health manpower. Government of Nepal regularly deploys one or two medical officers to each district who generally are not regular to their care. Jumla district itself was having one medical officer before the establishment of KAHS. Development activities: Establishment of 100 bedded specialty teaching hospital with 10 medical officers and five specialists, accredited its own nursing school for running diploma nursing programme, started “Karnali health survey” which covers 55 thousand households of backward region, started community care and school health camps, planning phase completed for 300 bedded teaching hospital construction. Future Plan: Expansion of the teaching hospital to 300 beds within 3 years, start health assistant and bachelor midwifery course in 2015 AD, start bachelor in laboratory and bachelor in public health course in 2016 AD and start MBBS course in 2018 AD. Deploy the medical officers and family physicians to all the district hospitals within 3 years. KAHS provides reservation up to 45% students from backward region with the commitment to stay for at least five years of their service period. Conclusion: This institution may be the example for the rest of the world in providing nursing care, education in remote areas as well as the best model for nursing manpower retention in remote areas of developing countries.

Keywords: backward area, nursing school

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Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

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Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

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Authors: Ali Asghar Asad Sangabi, Afsaneh Aeen, Mohammad Behroozi

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Knowledge management is vital in today's world as one of the most valuable intangible assets regarded by companies. This study aimed to identify factors that affect the application of knowledge management in the Iranian Oil Terminals Company in 2022. In this study, 12 of the factors affecting the application of knowledge management have been studied, and implement practical solutions, and reuse has been studied. This study is descriptive data from the questionnaire factors affecting knowledge management application used by Cronbach's Coefficient Alpha equal to 0.85. The population of this study consisted of 1500 IOTC employees. The sample is determined by the Cochran formula sample; the results of this study showed that between the application of knowledge management and factors, there is a significant correlation. Among the factors that have been studied, valuable teamwork and organizational culture were the most effective, and the infrastructure of information systems had the least impact on Knowledge management.

Keywords: knowledge management, knowledge-based organization, Iranian Oil Terminals

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Authors: Abdul Murad Zainal Abidin, Tuan Suhaimi Salleh, Siti Nor Azila Khalid, Noryati Mustapa

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Quarry dust is a quarry end product from rock crushing processes, which is a concentrated material used as an alternative to fine aggregates for concreting purposes. In quarrying activities, the rocks are crushed into aggregates of varying sizes, from 75mm until less than 4.5 mm, the size of which is categorized as quarry dust. The quarry dust is usually considered as waste and not utilized as a recycled aggregate product. The dumping of the quarry dust at the quarry plant poses the risk of environmental pollution and health hazard. Therefore, the research is an attempt to identify the potential of quarry dust as an alternative building material that would reduce the materials and construction costs, as well as contribute effort in mitigating depletion of natural resources. The objectives are to conduct material characterization and evaluate the properties of fresh and hardened engineering brick with quarry dust mix proportion. The microstructures of quarry dust and the bricks were investigated using scanning electron microscopy (SEM), and the results suggest that the shape and surface texture of quarry dust is a combination of hard and angular formation. The chemical composition of the quarry dust was also evaluated using X-ray fluorescence (XRF) and compared against sand and concrete. The quarry dust was found to have a higher presence of alumina (Al₂O₃), indicating the possibility of an early strength effect for brick. They are utilizing quarry dust waste as replacement material has the potential of conserving non-renewable resources as well as providing a viable alternative to disposal of current quarry waste.

Keywords: building materials, cement replacement, quarry microstructure, quarry product, sustainable materials

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Authors: Ahmed Al Ansari, Khalid Al Khalifa

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Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.

Keywords: MSF system, emergency, validity, generalizability

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Authors: Gabriel Jinga, Madalina Dumitru

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The objective of this paper is to present the process of change in management accounting in Romania, a former communist country from Eastern Europe. In order to explain this process, we used the contingency and institutional theories. We focused on the following directions: the presentation of the scientific context and motivation of this research and the case study. We presented the state of the art in the process of change in the management accounting from the international and national perspective. We also described the evolution of management accounting in Romania in the context of economic and political changes. An important moment was the fall of communism in 1989. This represents a starting point for a new economic environment and for new management accounting. Accordingly, we developed a case study which presented this evolution. The conclusion of our research was that the changes in the management accounting system of the company analysed occurred in the same time with the institutionalization of some elements (e.g. degree of competition, training and competencies in management accounting). The management accounting system was modeled by the contingencies specific to this company (e.g. environment, industry, strategy).

Keywords: management accounting, change, Romania, contingency, institutional theory

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Authors: Rahul Magazine, Shobitha Rao

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The aim of this study was to study the prescribing pattern of drugs in patients with ARDS (Acute Respiratory Distress Syndrome) managed at a tertiary care hospital. This observational study was conducted at Kasturba Hospital, Karnataka, India. Data of patients admitted from January 2010 to December 2012 was collected. A total of 150 patients of ARDS were included. Data included patients’ age, gender, clinical disorders precipitating ARDS, and prescribing pattern of drugs. The mean age of the study population was 42.92±13.91 years. 48% of patients were less than 40 years of age. Infection was the cause of ARDS in 81.3% of subjects. Antibiotics were prescribed in all the subjects and beta-lactams were prescribed in 97.3%. 41.3% were prescribed corticosteroids, 39.3% diuretics and 89.3% intravenous fluids. Infection was the commonest etiology for ARDS, and beta-lactams were the commonest antibiotics prescribed. Corticosteroids and diuretics were prescribed in a significant number of patients. Most of the patients received intravenous fluids.

Keywords: acute respiratory syndrome, beta lactams, corticosteroids, Acute Respiratory Distress Syndrome (ARDS)

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Authors: Sung Uk Park, Young Su Kang, Sangmo Kang, Young Kweon Suh

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Mineral product, waste concrete (fine aggregates), waste in the optical field, industry, and construction employ separators to separate solids and classify them according to their size. Various sorting machines are used in the industrial field such as those operating under electrical properties, centrifugal force, wind power, vibration, and magnetic force. Study on separators has been carried out to contribute to the environmental industry. In this study, we perform CFD analysis for understanding the basic mechanism of the separation of waste concrete (fine aggregate) particles from air with a machine built with a rotor with blades. In CFD, we first performed two-dimensional particle tracking for various particle sizes for the model with 1 degree, 1.5 degree, and 2 degree angle between each blade to verify the boundary conditions and the method of rotating domain method to be used in 3D. Then we developed 3D numerical model with ANSYS CFX to calculate the air flow and track the particles. We judged the capability of particle separation for given size by counting the number of particles escaping from the domain toward the exit among 10 particles issued at the inlet. We confirm that particles experience stagnant behavior near the exit of the rotating blades where the centrifugal force acting on the particles is in balance with the air drag force. It was also found that the minimum particle size that can be separated by the machine with the rotor is determined by its capability to stay at the outlet of the rotor channels.

Keywords: environmental industry, separator, CFD, fine aggregate

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Authors: Farrukh Jamil, Ala'A H. Al-Muhtaseb, Lamya Al-Haj, Mohab A. Al-Hinai

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Environmental problems and the security of energy supply have motivated the attention in the expansion of alternatives for fossil based fuels. Biomass has been recognized as a capable resource because it is plentifully available and in principle carbon dioxide neutral. Present study focuses on utilization date seeds oil for synthesizing high value fuels formulations such as green diesel and jet fuel. The hydrodeoxygenation of date seeds oil occurred to be highly efficient at following operating conditions temperature 300°C pressure 10bar with continuous stirring at 500 rpm. Products characterization revealed the efficiency of hydrodeoxygenation by formation of linear hydrocarbons (paraffin) in larger fraction. Based on the type of components in product oil it was calculated that maximum fraction lies within the range of green diesel 72.78 % then jet fuel 28.25 % by using Pt/C catalyst. It can be concluded that waste date seeds oil has potential to be used for obtaining high value products.

Keywords: date seeds, hydrodeoxygenation, paraffin, deoxygenation

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Authors: Alhassan Dahiru

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Value management is widely accepted technique of eliminating unnecessary cost at different stages of project development that maximizes the functional value of a project by managing its evolution and development from concept to completion. Many construction industry practitioners are not aware of Value Management practice, and its use is less widespread in Nigeria. The aim of this research is to identify the level of awareness on value management practice amongst construction practitioners with a view to contribute to the improvement of the implementation of value management practice in the Nigerian construction industry. In this study, construction practitioners have been chosen as respondents from the 6 geopolitical zones of the federation including FCT Abuja. Through the survey, a total number of 360 semi-structured questionnaires were administered and 284 were returned and remained good for the analysis. The results indicate that most of the respondents were aware of the value management concept and issues surrounding construction industry in Nigeria, while about 32% of the respondents were not aware of its potential benefits. Therefore, organisations should review their techniques and processes from time to time for improvement on effective service delivery. Additionally, a change management strategy should also be part of every organization to ease the introduction of new techniques such as value management. There is also the need for more value management training workshops and seminars in order to enlighten the participants of the construction industry on the principles, concept, and techniques involved in the value management process.

Keywords: sustainability, value management, construction practitioners, Nigeria

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Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

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Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

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Authors: Abdessamad Dali-Ali, Houaria Beldjillali, Fouzia Agag, Asmaa Oukebdane, Ramzi Tidjani, Arslane Bettayeb, Khadidja Meddeber, Radia Dali-Yahia, Nori Midoun

Abstract:

Healthcare-associated infections are a real public health problem, especially in intensive care units. The aim of our study was to describe the epidemiological profile and to estimate the incidence of these infections at the intensive care unit of our teaching hospital. A prospective study was conducted, from June 2012 to December 2013. During this period, 305 patients having a duration of hospitalization equal or more than 48 hours were included in the study. In terms of the incidence of healthcare associated infections, nosocomial pneumonia occupied the first position with a cumulative incidence rate of 20.0%, followed by bacteremia (5.6%), central venous catheter infections (4%), and urinary tract infections (3%). In the case of isolated microorganisms, Gram-negative bacilli not enterobacteriaceae occupied the first place with 48.5%, followed by enterobacteria (32.1%). Acinetobacter baumannii was the most common germ (27.6%). Our study showed that the rate of health-care-associated infections was relatively high in the intensive care unit. A control program to reduce all infections is a priority for the Infection Control Associated Committee.

Keywords: epidemiological profile, healthcare associated infections, intensive care units, teaching hospital of Oran, Algeria

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Authors: Armin Samarghandi, Amirreza Jafari, Mohamad Ghiasi

Abstract:

Numerous assertions and some empirical evidence imply that 'green' buildings ought to be more productive and healthier (mentally and physiologically) than conventional structures. Since then, empirical data has been equivocal, indicating either that the studies are inaccurate or that the research has just scratched the surface of green buildings in offices, accommodation, and hospital settings and not taken the aforementioned holistically. This study compared four green-certified buildings -one residential green building, one green hospital, and one green school- with conventional structures in Tehran, Iran, by means of a questionnaire spread among those utilizing these buildings, and assessing their productivity and health rate as opposed to the time they resided, worked in conventional buildings. The results demonstrated higher scores pertaining to productivity and physical and mental wellness as a consequence of better indoor environmental quality (IEQ), natural lighting, design, and sustainability of these buildings against non-green buildings. In addition, ancillary matters -environmental, financial, intellectual, emotional, social, and spiritual dimensions of participants- were indirectly evaluated, and the same results were produced.

Keywords: green building, LEED, productivity, physical and mental health, indoor environmental quality

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Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

Abstract:

The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: data integrity, data integrity challenges, hospital information systems, South Africa

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Authors: Prangya Ranjan Rout, Puspendu Bhunia, Rajesh Roshan Dash

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In a developing country like India, providing reliable and affordable wastewater treatment facilities in rural areas is a huge challenge. With the aim of enhancing the nutrient removal from rural domestic wastewater while reducing the cost of treatment process, a novel, integrated treatment system consisting of a multistage bio-filter with drop aeration and a post positioned attached growth carbonaceous denitrifying-bioreactor was designed and developed in this work. The bio-filter was packed with ‘dolochar’, a sponge iron industry waste, as an adsorbent mainly for phosphate removal through physiochemical approach. The Denitrifying bio-reactor was packed with many waste organic solid substances (WOSS) as carbon sources and substrates for biomass attachment, mainly to remove nitrate in biological denitrification process. The performance of the modular system, treating real domestic wastewater was monitored for a period of about 60 days and the average removal efficiencies during the period were as follows: phosphate, 97.37%; nitrate, 85.91%, ammonia, 87.85%, with mean final effluent concentration of 0.73, 9.86, and 9.46 mg/L, respectively. The multistage bio-filter played an important role in ammonium oxidation and phosphate adsorption. The multilevel drop aeration with increasing oxygenation, and the special media used, consisting of certain oxides were likely beneficial for nitrification and phosphorus removal, respectively, whereas the nitrate was effectively reduced by biological denitrification in the carbonaceous bioreactor. This treatment system would allow multipurpose reuse of the final effluent. Moreover, the saturated dolochar can be used as nutrient suppliers in agricultural practices and the partially degraded carbonaceous substances can be subjected to composting, and subsequently used as an organic fertilizer. Thus, the system displays immense potential for treating domestic wastewater significantly decreasing the concentrations of nutrients and more importantly, facilitating the conversion of the waste materials into usable ones.

Keywords: nutrient removal, denitrifying bioreactor, multi-stage bio-filter, dolochar, waste organic solid substances

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Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir

Abstract:

The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.

Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin

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Authors: Pataraporn Kheawwan

Abstract:

Preceptorship represents an important aspect in new nurse orientation. However, there was no formal preceptor training program developed for nurse preceptor in Thailand. The purposes of this study were to develop and evaluate formal preceptor training program for nurse preceptors in King Chulalongkorn Memorial Hospital, Thailand. A research and development study design was utilized in this study. Participants were 37 nurse preceptors. The program contents were delivered by e-learning material, class lecture, group discussion followed by simulation training. Knowledge of the participants was assessed pre and post program. Skill and critical thinking were assessed using Preceptor Skill and Decision Making Evaluation form at the end of program. Statistical significant difference in knowledge regarding preceptor role and coaching strategies between pre and post program were found. All participants had satisfied skill and decision making score after completed the program. Most of participants perceived benefits of preceptor training course. In conclusion, The results of this study reveal that the newly developed preceptorship course is an effective formal training course for nurse preceptors.

Keywords: preceptor, preceptorship, new nurse, clinical education

Procedia PDF Downloads 249