Search results for: hospital site suitability

Authors: Gary Young, David Zepeda, Gilbert Nyaga

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This study investigated whether vertical integration of hospitals and physicians is associated with better care for patients with cardiac conditions. A dramatic change in the U.S. hospital industry is the integration of hospital and physicians through hospital acquisition of physician practices. Yet, there is little evidence regarding whether this form of vertical integration leads to better operational performance of hospitals. The study was conducted as an observational investigation based on a pooled, cross-sectional database. The study sample comprised over hospitals in the State of California. The time frame for the study was 2010 to 2012. The key performance measure was hospitals’ degree of compliance with performance criteria set out by the federal government for managing patients with cardiac conditions. These criteria relate to the types of clinical tests and medications that hospitals should follow for cardiac patients but hospital compliance requires the cooperation of a hospital’s physicians. Data for this measure was obtained from a federal website that presents performance scores for U.S. hospitals. The key independent variable was the percentage of cardiologists that a hospital employs (versus cardiologists who are affiliated but not employed by the hospital). Data for this measure was obtained from the State of California which requires hospitals to report financial and operation data each year including numbers of employed physicians. Other characteristics of hospitals (e.g., information technology for cardiac care, volume of cardiac patients) were also evaluated as possible complements or substitutes for physician employment by hospitals. Additional sources of data included the American Hospital Association and the U.S. Census. Empirical models were estimated with generalized estimating equations (GEE). Findings suggest that physician employment is positively associated with better hospital performance for cardiac care. However, findings also suggest that information technology is a substitute for physician employment.

Keywords: physician employment, hospitals, verical integration, cardiac care

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Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Taku Iwami, Takashi Kawamura, Takeshi Shimazu

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Background: Recently, the number of ambulance dispatches has been increasing in Japan and it is, therefore, difficult to accept emergency patients to hospitals smoothly and appropriately because of the limited hospital capacity. To facilitate the request for patient transport by ambulances and hospital acceptance, the emergency information system using information technology has been built up and introduced in various communities. However, its effectiveness has not been insufficiently revealed in Japan. In 2013, we developed a smartphone application system that enables the emergency-medical-service (EMS) personnel to share information about on-scene ambulance and hospital situation. The aim of this study was to assess the introduction effect of this application for EMS system in Osaka City, Japan. Methods: This study was a retrospective study with population-based ambulance records of Osaka Municipal Fire Department. This study period was six years from January 1, 2010 to December 31, 2015. In this study, we enrolled emergency patients that on-scene EMS personnel conducted the hospital selection for them. The main endpoint was difficulty in hospital acceptance at the scene. The definition of difficulty in hospital acceptance at the scene was to make >=5 phone calls by EMS personnel at the scene to each hospital until a decision to transport was determined. The definition of the smartphone application group was emergency patients transported in the period of 2013-2015 after the introduction of this application, and we assessed the introduction effect of smartphone application with multivariable logistic regression model. Results: A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 smartphone application group (50.0%) in 2010-2012 and 300,395 non-smartphone application group (50.0%) in 2013-2015. The proportion of the difficulty in hospital acceptance was 14.2% (42,585/300,131) in the smartphone application group and 10.9% (32,819/300,395) in the non-smartphone application group, and the difficulty in hospital acceptance significantly decreased by the introduction of the smartphone application (adjusted odds ration; 0.730, 95% confidence interval; 0.718-0.741, P<0.001). Conclusions: Sharing information between ambulance and hospital by introducing smartphone application at the scene was associated with decreasing the difficulty in hospital acceptance. Our findings may be considerable useful for developing emergency medical information system with using IT in other areas of the world.

Keywords: difficulty in hospital acceptance, emergency medical service, infomation technology, smartphone application

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Authors: Revai Boterere

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The study explores the decolonial theory in the context of engaging with living heritages in the formally colonised through the case of the Great Zimbabwe World Heritage Site. It followed a qualitative research paradigm in the form of a situational analysis, with both primary and secondary data sources examined to enable an analysis focusing on the decolonial discourse and practice at Great Zimbabwe. Unlike the dominant model (in terms of interpretation) used at Great Zimbabwe, that of Thomas Huffman, which views the site as ruins, new literature (Ashton Sinamai, 2017, 2020; Webber Ndoro, 1994, 2005; ShadreckChirikure 2008, etal 2016; Njabulo Chipanguraetal 2019) on zimbabwe culture, Great Zimbabwe World Heritage Site is a living site, a shrine, and a cultural landscape. it argue that the new literature, perhaps decolonial, remain in the hands of academics and not synthesised down to the interpreters. This is a problem, and it needs to be addressed. There is need of a pragmatic thrust to decolonisation at the Great Zimbabwe World Heritage Site. Though there are efforts to involve local communities at Great Zimbabwe as a decolonial approach, there is need to reorder the current system of producing knowledge in place. This paper will unpack these debates of decoloniality between what Huffman’s propositions of the interpretation of Great Zimbabwe vis-a-vis the new decolonial school of thought by local researchers.

Keywords: cultural tourism, decoloniality, living heritage, local community

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Authors: C. Asha Poorna, P. G. Vinod, A. R. R. Menon

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Currently increasing population and their activities like urbanization and industrialization generating the greatest environmental, issue called Waste. And the major problem in waste management is selection of an appropriate site for waste disposal. The selection of suitable site have constrains like environmental, economical and political considerations. In this paper we discuss the strategies to be followed while selecting a site for decentralized system for solid waste disposal, using Geographic Information System (GIS), the Analytical Hierarchy Process (AHP) and the remote sensing method for Thiruvananthapuram corporation area. It is located on the west coast of India near the extreme south of the mainland. It lies on the shores of Killiyar and Karamana River. Being on the basin the waste managements must be regulated with the water body. The different criteria considered for waste disposal site selection are lithology, surface water, aquifer, groundwater, land use, contours, aspect, elevation, slope, and distance to road, distance from settlement are examined in relation to land fill site selection. Each criterion was identified and weighted by AHP score and mapped using GIS technique and suitable map is prepared by overlay analysis.

Keywords: waste disposal, solid waste management, Geographic Information System (GIS), Analytical Hierarchy Process (AHP)

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Authors: Benhammadi Hocine, Djamel Boubaya, Chaffai Hicham

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Meskiana Area is characterized by a semi-arid climate where the water supply for irrigation and industry is not sufficient as the priority goes for domestic use. To meet the increasing population growth and development, the authorities have considered building a new water retaining structure on some major temporary water streams. For this purpose Chebabta site on Oued Meskiana was chosen as the future dam site. It is large enough to store the desired volume of water. This study comes to investigate the conditions of the site and the adequacy of the ground as a foundation for the projected dam. The conditions of the site include the geological structure and mainly the presence of discontinuities in the formation on which the dam will be built, the nature of the lithologies under the foundation and the future lake, and the presence of any hazard. This site characterization is usually carried out using different methods in order to highlight any underground buried problematic structure. In this context, the different geophysical technics remain the most used ones. Three geophysical methods were used in the case of the Chebabta dam site, namely, electric survey, seismic refraction, and tomography. The choice of the technics and the location of the scan line was made on the basis of the available geological data. In this sense, profiles have been established on both banks of Oued Meskiana. The obtained results have allowed a better characterization of the geological structure, defining the limit between the surface cover and the bedrock, which is, in other words, the limit between the weathered zone and the bedrock. Their respective thicknesses were also determined by seismic refraction and electrical resistivity sounding. However, the tomography imaging technic has succeeded in positioning a fault structure passing through the right bank of the wadi.

Keywords: dam site, fault, geophysic, investigation, Meskiana

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Authors: Ikumapayi Catherine Mayowa

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The well-being of humans on a construction site is critical; abundant manpower had been lost through accidents which kill or make workers physically unfit to carry out construction activities, these, in turn, have multiple effects on the whole economy. Thus, it is necessary to put all safety items and regulations in place before construction activities can commence. This study was carried out in the Ondo state of Nigeria to investigate and analyze the state of health and safety of construction workers in the state. The study was done using first-hand observations, 50 construction project sites were visited in ten major towns of Ondo state, questionnaires were distributed, and the results were analyzed. The result shows that construction workers are being exposed to many construction site hazards due to lack of inadequate safety programs and lack of appropriate safety equipment for workers on site. From the data gotten from each site visited and the statistical analysis, it can be concluded that occurrences of an accident on construction sites depend significantly on the available safety facilities on the sites. The result of the regression statistics shows that the dependence of the frequency of occurrence of an accident on the availability of safety items on the site is 0.0362 which is less than 0.05 maximum significant level allowed. Therefore, a vital way of sustaining our building strategy is given a detail attention to the provision of adequate health and safety items on construction sites which will reduce the occurrence of accident, loss of manpower and death of skilled workers.

Keywords: construction sites, health, safety, welfare

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Authors: Routsukol Sunalai

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This research was to study the relationship between the organizational culture like bureaucratic system, and patronage system in government hospitals with hospital accreditation and its impact on the quality of service in the government hospital accredited. Qualitative research was applied in this study by in-depth interviews with samples containing 20 public welfare service providers, i.e. doctors, nurses and practical nurses and 20 service recipients in the units of study. It was found that the bureaucracy still existed and was evidenced by the structure of the line of command; work systems, clear cut duty divisions, procedures and plans, and the patronage system hindered the quality of service in the government hospitals under the process of development and accreditation. The administrators should encourage and support the creation of a learning process in the organization for self-improvement and work development.

Keywords: hospital in Dusit Area, organization culture, the quality of service, economics and financial engineering

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Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

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Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

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Authors: Ghazaleh Monazami Tehrani, Zhamak Monazami Tehrani, Raziyeh Hadavand

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Optimal site selection for temporary housing is one of the most important issues in crisis management. In this research, district six of Tehran city with high frequency and geographical distribution of earthquakes has been selected as a case study for positioning temporary housing after a probable earthquake. For achieving this goal this study tries to identify and evaluate distribution of location according to some standards such as compatible and incompatible urban land uses with utility of GIS and AHP. The results of this study show the most susceptible parts of this region in the center. According to the maps, north eastern part of Kordestan, Shaheed Gomnam intersection possesses the highest pixels value in terms of areal extent, therefore these places are recommended as an optimum site location for construction of emergency evacuation base.

Keywords: optimal site selection, temporary housing , crisis management, AHP, GIS

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Authors: Lesley Clack, Rachel Ellison, Elizabeth Chambers

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A belief exists that there are huge gender and racial disparities among hospital CEO’s in the United States, and historically, male, Caucasian healthcare executives have made significantly larger salaries than females and other races. With a recent focus on reducing barriers and disparities in healthcare, it remains to be seen whether there have been changes in these disparities over time. The purpose of this study was to explore disparities among salaries of hospital executives in the United States. Analysis of salary data was conducted utilizing online hospital salary databases. Statistical analysis was conducted to examine the significance of the differences. Results indicated that there had been improvements in disparities among some ethnicities. Gender disparities remain the largest gap. The implications of this study are significant for the field of healthcare management as disparities can affect both social dynamics and organizational culture. Understanding where disparities lie is the first step towards bridging the gap and reducing barriers for cultural diversity within healthcare management.

Keywords: health care, disparities, management, executives

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Authors: Ayesha Asif, Muhammad Zeeshan

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The sensitivity of hospital-microenvironments for all types of pollutants, due to the presence of patients with immune deficiencies, makes them complex indoor spaces. Keeping in view, this study investigated indoor air quality (IAQ) of two most sensitive places, i.e., operation theater (OT) and intensive care unit (ICU), of a publically managed hospital. Taking CO₂ concentration as air quality indicator and temperature (T) and relative humidity (RH) as thermal comfort parameters, continuous monitoring of the three variables was carried out. Measurements were recorded at an interval of 1 min for weekdays and weekends, including occupational and non-occupational hours. Outdoor T and RH measurements were also used in the analysis. Results show significant variation (p < 0.05) in CO₂, T and RH values over the day during weekdays while no significant variation (p > 0.05) have been observed during weekends of both the monitored sites. Maximum observed values of CO₂ in OT and ICU were found to be 2430 and 624 ppm, T as 24.7ºC and 28.9ºC and RH as 29.6% and 32.2% respectively.

Keywords: indoor air quality, CO₂ concentration, hospital building, comfort assessment

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Authors: Erina Wulansari, Bambang Soemardiono, Ispurwono Soemarno

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Designing sustainable tourism area is defined as an attempt to design an area, that brings the natural environmental conditions as components are available with a wealth of social conditions and the conservation of natural and cultural heritage. To understanding tourism area in this study is not only focus on the location of the tourist object, but rather to a tourist attraction around the area, tourism objects such as the existence of residential area (settlement), a commercial area, public service area, and the natural environmental area. The principle of success in designing a sustainable tourism area is able to integrate and balance between the limited space and the variety of activities that’s always continuously to growth up. The limited space in this area of tourism needs to be managed properly to minimize the damage of environmental as a result of tourism activities hue. This research aims to identify space in this area of tourism through land suitability approach as an effort to create a sustainable design, especially in terms of ecological. This study will be used several analytical techniques to achieve the research objectives as superimposing analysis with GIS 9.3 software and Analysis Hierarchy Process. Expected outcomes are in the form of classification and criteria of usable space in designing embodiment tourism area. In addition, this study can provide input to the order of settlement patterns as part of the environment in the area of sustainable tourism.

Keywords: sustainable tourism area, land suitability, limited space, environment, criteria

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Authors: I. Mentziou, C. Delezos, D. Krikidis, A. Nestoridou, G. Boskou

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Introduction: The systems of production and distribution of meals can have a significant impact on the food intake of hospital patients who are likely to develop malnutrition. In hospitals, the consequences of food borne infections can range from annoying to life-threatening for a patient, since they can lead up to death in vulnerable groups Aim: The aim of the present study was the evaluation of food safety management systems implementation, as well as the general evaluation of the total quality management systems in Greek hospitals. Methods: This is a multifocal study on the implementation and evaluation of the food safety management systems in the Greek hospitals of Attica region. Eleven hospitals from the city of Athens were chosen for this purpose. The sample was derived from the high rank personnel of the nutritional department (dietician, head-chef, food technologist, public health inspector). Tailor made questionnaires on hygiene regulations were used as tools for the interviews. Results: Overall, 30 employees in the field of hospital nutrition participated. Most of the replies implied that almost always the hygiene regulations are implemented. Nevertheless, only 30% stated that there is a Hazard Analysis Critical Control Points HACCP system (HACCP) in the hospital. In a small number of questionnaires there were proposals for changes by the staff. Conclusion: Measurement of the opinion of the personnel about the provided food services within a hospital can further lead to continuous improvement of the hospital nutrition.

Keywords: evaluation, food service, HACCP, hospital, personnel

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Authors: Eduwin Eko Franjaya, Andi Gunawan, Wahju Qamara Mugnisjah

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Sustainable agriculture in the form of integrated farming with its LEISA (Low External Input Sustainable Agriculture) concept has brought a positive impact on agriculture development and ambient amelioration. But, most of the small farmers in Indonesia did not know how to put the concept of it and how to combine agricultural commodities on the site effectively and efficiently. This research has an aim to promote integrated farming (agrofisheries, etc) to the farmers by designing the agricultural landscape to become integrated farming landscape as medium of education for the farmers. The method used in this research is closely related with the rule of design in the landscape architecture science. The first step is inventarization for the existing condition on the research site. The second step is analysis. Then, the third step is concept-making that consists of base concept, design concept, and developing concept. The base concept used in this research is sustainable agriculture with LEISA. The concept design is related with activity base on site. The developing concept consists of space concept, circulation, vegetation and commodity, production system, etc. The fourth step as the final step is planning and design. This step produces site plan of integrated farming based on LEISA. The result of this research is site plan of integrated farming with its explanation, including the energy flow of integrated farming system on site and the production calendar of integrated farming commodities for education and agri-tourism opportunity. This research become the right way to promote the integrated farming and also as a medium for the farmers to learn and to develop it.

Keywords: integrated farming, LEISA, planning and design, site plan

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Authors: Pengwei Qiao, Sucai Yang, Wenxia Wei

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Soil pollution has become an important issue in China. Accurate spatial distribution prediction of pollutants with interpolation methods is the basis for soil remediation in the site. However, a relatively strong variability of pollutants would decrease the prediction accuracy. Theoretically, partition interpolation can result in accurate prediction results. In order to verify the applicability of partition interpolation for a site, benzo (b) fluoranthene (BbF) in four soil layers was adopted as the research object in this paper. IDW (inverse distance weighting)-, RBF (radial basis function)-and OK (ordinary kriging)-based partition interpolation accuracies were evaluated, and their influential factors were analyzed; then, the uncertainty and applicability of partition interpolation were determined. Three conclusions were drawn. (1) The prediction error of partitioned interpolation decreased by 70% compared to unpartitioned interpolation. (2) Partition interpolation reduced the impact of high CV (coefficient of variation) and high concentration value on the prediction accuracy. (3) The prediction accuracy of IDW-based partition interpolation was higher than that of RBF- and OK-based partition interpolation, and it was suitable for the identification of highly polluted areas at a contaminated site. These results provide a useful method to obtain relatively accurate spatial distribution information of pollutants and to identify highly polluted areas, which is important for soil pollution remediation in the site.

Keywords: accuracy, applicability, partition interpolation, site, soil pollution, uncertainty

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Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

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Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

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Authors: Abdelkader Ababneh

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Heritage management planning is increasingly important throughout the international context, particularly in the developing countries. Jordan has important and unique heritage resources due to its natural topography and climate, but also to its history and old sites. A high number of these archaeological sites are in very good state of preservation. Most natural sites and resources are privately managed while archaeological heritage sites are publicly managed within national legal texts and with some referencing to international legal documents. This study examines the development of cultural heritage management in Jarash, and questions if this heritage has been managed in an appropriate manner. The purpose of this paper is to define and review the stakeholders in charge of the management of the archaeological site of Jarash, the legal texts, laws and documents adopted to apply the site management. Relations and coordination between stakeholders and the challenge of the planning process is also the focus of this paper. A review of pertinent academic, technical studies, reports and projects literature pertaining to the heritage management planning in general and related to the site of Jarash in particular coupled with field study of the site served as the background of the information base for the study. Current context of actors, legislative framework, planning policies and initiatives for the site of Jarash reveal important and continuous challenge for managing the site. Recommendations suggest reviewing and restructuring the entity responsible of the sites management. It is also recommended to review their applied policies and a redevelopment of the legislative frame work.

Keywords: heritage management, stakeholders, legal protection, Jarash

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Authors: Muhammad Umar Hassan

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Renal cell carcinoma is a subset of kidney cancer that arises in the lining of DCT and is present in parenchymal tissue. Diagnosis is based on lab reports, including urinalysis, renal function tests (RFTs), and electrolyte balance, along with imaging techniques. Organ failure and other complications have been commonly observed in these cases. Over the years, the presentation of patients has varied, so carcinoma was classified on the basis of site, shape, and consistency for detailed analysis. Lifestyle patterns and occupational history were inquired about and recorded. Methods: Data from 100 patients presenting to the oncology and nephrology department of Mayo Hospital in the year 2015-2020 were included in this retrospective study on a random basis. The study was specifically focused on three risk factors. Smoking, occupational exposures, and Hakim medicine are taken by the patient for any cause. After procurement of data, follow-up contacts of these patients were established, resulting in a detailed analysis of lifestyle. Conclusion: The inference drawn is a direct causal link between smoking, industrial workplace exposure, and Hakim medicine with the development of Renal Cell Carcinoma. It was shown in the majority of the patients and hence confirmed our hypothesis.

Keywords: renal cell carcinoma, kidney cancer, clear cell carcinoma

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Authors: Manar Aslan, Ayse Yildiz

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The study was conducted descriptively to assess their hospital institutionalization of upper and mid-level managers of 18 hospitals affiliated to Public Hospitals Association. In its simplest form institutionalization is whatever the subject matter, is dominated by the rules of articulated and determined behavior in all kinds of business, interaction, and communication. Hospital service is a type of service carried out chained together. It should not be forgotten that this kind of services is carried out without barrier, and who and what to do with definite lines, hospital management is a process, and this process can be achieved through institutionalization. With the establishment of the Public Hospitals Unions in Turkey, all the state hospitals in the provinces have been gathered under this roof. One of the goals is to establish control mechanisms to ensure that hospitals reach pre-determined financial, medical, and administrative standards. In this way, the preparations for the institutionalization of units and hospital enterprises will be completed. The data of the study were collected by institutionalization management attitude scale (cronbach alpha: 0.98) of composed of 5 sub-dimensions and 52 questions in 18 hospitals’ managers (N=310) in the largest province in Turkey. The results of the study revealed that the total score taken by managers at the institutionalization scale was 200.80, and this was close to the maximum score. In addition, it was determined that the difference between the mean score of the scale and its sub-dimensions with the gender, the hospitals, and the management position.

Keywords: institutionalization, hospital, manager, evaluation

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Authors: A. Fordham, A. Hudson

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Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.

Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma

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Authors: Anthony Barker, Roland Jiang

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Dupuytren’s contractures are a debilitating condition affecting the palmar fascia of the hand reducing its function. This case series looks at the minimally-invasive technique of Xiaflex injections and the outcome in a public health setting. 15 patients undertook collagenase injection (Xiaflex, C. histolyticum) injection over the period from September 2015 to May 2017 at Fairfield Hospital, NSW. Their reported outcome post injection and in follow-up was recorded as well as their satisfaction and likelihood to request the procedure in the future. Other treatment modalities include percutaneous needle aponeurotomy, limited palmar fasciotomy, and palmar fasciectomy. A literature review of cost-effectiveness was performed to compare Xiaflex suitability for waitlist reduction in a public setting given average waiting times in the public setting extend past 365 days.

Keywords: Dupuytrens Disease, xiaflex, collagenase, plastic surgery

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Authors: F. Ben Abdelghani, W. Maherezi

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Dredging operations generate, each year, a great quantity of marine sediments. These raw materials can not be used in road construction without a specific treatment process. Sediments suitability tests has shown that most of studied sediments are not suitable to be used in road construction. In order to improve their compacity and their mechanical performance, addition of a granular material is recommended. The use of a dredged sand, to improve the granular mixture containing sediments, allows a better management of the two types of dredge materials (sand and sediment). In this study, a new road material containing dredged marine sediments and dredged sand is formulated and treated by adding various binders. Mechanical performance investigation of different mixtures by measuring Proctor-IPI values and simple compressive strengths is realized.

Keywords: dredged sediments, suitability tests, road construction, hydraulic binder, mechanical performance

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Authors: Moizza Tahir, Uzma Bashir, Aisha Akhtar, Zainab Ansari, Sameen Ansari, Muhammad Ali Tahir

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Cancer burden has globally increased. Among cutaneous cancers basal cell carcinoma constitute vast majority of skin cancer. There is need for appropriate diagnostic, therapeutic and prognostic significance evaluation for skin cancers Present study report intraoperative frozen section (FS) histopathological clearance for excision of BCC in a tertiary care center and find the frequency of involvement of surgical margin with reference to anatomical site, with size and surgical technique. It was prospective open label interventional study conducted at Dermatology department of tertiary care hospital Rawalpindi Pakistan in lais on with histopathology department from January 2023 to April 2024. Total of thirty-six (n = 36) patients between age 45-80 years with basal cell carcinoma of 10-20mm on face were included following inclusion exclusion criteria by purposive sampling technique. Informed consent was taken. Surgical excision was performed and intraoperative frozen section histopathology clearance of tumor margin was taken from histopathologist on telephone. Surgical reconstruction was done. Final Histopathology report was reexamined on day 10th for margin and depth clearance. Descriptive statistics were calculated for age, gender, sun exposure, reconstructive technique, anatomical site, and tumor free margin report on frozen section analysis. Chi square test was employed for statistical significance of involvement of surgical margin with reference to anatomical site, size and decision on reconstructive surgical technique, p value of <0.05 was considered significant. Total of 36 patients of BCC were enrolled, males 12 (33.3%) and females were 24 (66.6%). Age ranged from 45 year to 80 year mean of 58.36 ±SD7.8. Size of BCC ranged from 10mm to 35mm mean of 25mm ±SD 0.63. Morphology was nodular 18 (50%), superficial spreading 11(30.6%), morphoeic 1 (2.8%) and ulcerative in 6(16.7%) cases. Intraoperative frozen section for histopathological margin clearance with 2-3 mm safety margin and surgical technique has p-value0.51, for anatomical site p value 0.24 and size p-0.84. Intraoperative frozen section (FS) histopathological clearance for BCC face with 2-3mm safety margin with reference to reconstructive technique, anatomical site and size of BCC were insignificant.

Keywords: basal cell carcinoma, tumor free amrgin, basal cell carcinoma and frozen section, safety margin

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Authors: Inna Vinokurova, N. Savvina

Abstract:

The goal of research: to study the organization of multi-field hospital’s work environment in the Republic of Sakha (Yakutia), Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine. Results: Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine is a multidisciplinary, specialized hospital complex that provides specialized and high-tech medical care to children and adults in the Republic of Sakha (Yakutia) of the Russian Federation. There are 5 diagnostic and treatment centers (advisory and diagnostic, clinical, pediatric, perinatal, Republican cardiologic dispensary) with 45 clinical specialized departments with 727 cots, 5 resuscitation departments, 20 operating rooms and out-patient department with 905 visits in alternation in the National Center of Medicine. Annually more than 20,000 patients receive treatment in the hospital of the Republican Hospital of the Republic of Sakha (Yakutia), more than 70,000 patients visit out-patient sections, more than 2 million researches are done, more than 12,000 surgeries are performed, more than 2 thousand babies are delivered. National Center of Medicine has a great influence with such population’s health indicators as total mortality, birth rate, maternal, infant and perinatal mortality, circulatory system incidence. The work environment of the Republican Hospital of the Republic of Sakha (Yakutia) is represented by the following structural departments: pharmacy, blood transfusion department, sterilization department, laundry, dietetic department, infant-feeding centre, material and technical supply. More than 200 employees work in this service. The main function of these services is to provide on-time and fail-safe supply with all necessary: wear parts, medical supplies, donated blood and its components, foodstuffs, hospital linen , sterile instruments, etc. Thus, the activity of medical organization depends on the work environment, including quality health care, so it is a main part of multi-field hospital activity.

Keywords: organization of multi-field hospital’s, work environment, quality health care, pharmacy, blood transfusion department, sterilization department

Procedia PDF Downloads 242

Authors: Wiyanti Fransisca Simanullang, Shinya Yamanaka

Abstract:

Grinding method was used to control the active site and to improve the specific surface area (SSA) of calcium oxide (CaO) derived from scallop shell as a sustainable resource. The dry grinding of CaO with acetone and tertiary butanol as a liquid additive was carried out using a planetary ball mill with a laboratory scale. The experiments were operated by stepwise addition with time variations to determine the grinding limit. The active site of CaO was measured by X-Ray Diffraction and FT-IR. The SSA variations of products with grinding time were measured by BET method. The morphology structure of CaO was observed by SEM. The use of liquid additive was effective for increasing the SSA and controlling the active site of CaO. SSA of CaO was increased in proportion to the amount of the liquid additive and the grinding time. The performance of CaO as a solid base catalyst for biodiesel production was tested in the transesterification reaction of used cooking oil to produce fatty acid methyl ester (FAME).

Keywords: active site, calcium oxide, grinding, specific surface area

Procedia PDF Downloads 288

Authors: Erdal Akyol, Mutlu Alkan

Abstract:

Multi criteria decision analysis (MDCA) covers both data and experience. It is very common to solve the problems with many parameters and uncertainties. GIS supported solutions improve and speed up the decision process. Weighted grading as a MDCA method is employed for solving the geotechnical problems. In this study, geotechnical parameters namely soil type; SPT (N) blow number, shear wave velocity (Vs) and depth of underground water level (DUWL) have been engaged in MDCA and GIS. In terms of geotechnical aspects, the settlement suitability of the municipal area was analyzed by the method. MDCA results were compatible with the geotechnical observations and experience. The method can be employed in geotechnical oriented microzoning studies if the criteria are well evaluated.

Keywords: GIS, spatial analysis, multi criteria decision analysis, geotechnics

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Authors: Gholam Reza Mirzaei, Mehran Roost

Abstract:

This research was conducted with the aim of predicting the relationship between coronavirus anxiety and psychological hardiness in employees working at Shahid Beheshti Hospital in Shiraz. The current research design was descriptive and correlational. The statistical population of the research consisted of all the employees of Shahid Beheshti Hospital in Shiraz in 2021. From among the statistical population, 220 individuals were selected and studied based on available sampling. To collect data, Kobasa's psychological hardiness questionnaire and coronavirus anxiety questionnaire were used. After collecting the data, the scores of the participants were analyzed using Pearson's correlation coefficient multiple regression analysis and SPSS-24 statistical software. The results of Pearson's correlation coefficient showed that there is a significant negative correlation between psychological hardiness and its components (challenge, commitment, and control) with coronavirus anxiety; also, psychological hardiness with a beta coefficient of 0.20 could predict coronavirus anxiety in hospital employees. Based on the results, plans can be made to enhance psychological hardiness through educational workshops to relieve the anxiety of the healthcare staff.

Keywords: the corona virus, commitment, hospital employees, psychological hardiness

Procedia PDF Downloads 61

Authors: Keri Alhadi Ighwela

Abstract:

In this research some physiochemical properties represented by temperature, pH, total hardness (TH), electrical conductivity (EC), total dissolved solids (TDS), chloride and hardness of calcium (Ca-H) and magnesium (Mg-H) were measured in the water of Ain Kaam Zliten in Libya (South side of the lagoon). A comparison of water quality with the values adopted internationally was accomplished to demonstrate the suitability for human and irrigation use. The experimental results showed that the values of pH and EC of the studied for water samples did not exceed the allowed range for drinking water. While TDS, TH, (Mg-H) and chloride values have exceeded the acceptable limit for drinking water internationally, calcium (Ca-H) results have shown a decrease in values of all samples except the first sample which record a marginal increase.

Keywords: physiochemical properties, Ain Kaam lagoon, Zliten, Libya

Procedia PDF Downloads 348

Authors: Mohammad Raihan Mukhlis, M. Abdur Rahman Bhuiyan

Abstract:

Bangladesh is a developing country in which a lot of multi-span simply/continuous supported flyovers are being constructed in its major cities. Being situated in a seismically active region, seismic safety evaluation of flyovers is essential for seismic risk reduction. Effects of site amplification on seismic safety evaluation of flyover piers are the main concern of this study. In this regard, failure mode, lateral strength and displacement ductility of piers of a typical multi-span simply supported flyover have been evaluated by Japan Road Association (JRA) recommended guidelines, with and without considering site amplification. Ultimate flexural strengths of piers have been computed using the pushover analysis results. Shear capacity of piers has been calculated using the guidelines of JRA. Lateral strengths have been determined depending on the failure modes of the piers. Displacement ductility of piers has been computed using yield and ultimate displacements of the piers obtained from the pushover analysis results. Selected earthquake time history is used in seismic safety evaluation of the flyover piers. Finally, the ductility design method is used to conduct the seismic safety evaluation of the piers with and without considering site amplification. From the numerical results, it has been revealed that the effects of site amplification on seismic safety evaluation of bridge structures should be carefully taken into account.

Keywords: displacement ductility, flyover pier, lateral strength, safety evaluation, site amplification

Procedia PDF Downloads 170