Search results for: patient management

Authors: Joseph Roberson, Carina Kleynhans, Willie Coetzee

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The low entry barriers of the restaurant industry lead to an extremely competitive business environment. In this volatile business sector it is of the utmost importance to implement a strategy of quality differentiation. Vital aspects of a quality differentiation strategy are total quality management, benchmarking and service quality management. Ultimately, restaurant success depends on the continuous support of customers. Customers select restaurants based on their expectations of quality. If the customers' expectations are met, they perceive quality service and will re-patronize the restaurant. The restaurateur can manage perceptions of quality by influencing expectations while ensuring that those expectations are not inflated. The management of expectations can be done by communicating service quality to customers. The aim of this research paper is to describe the development of a grading process for restaurants. An assessment of the extensive body of literature on grading was conducted through content analysis. A standardized method for developing a grading system would assist in successful grading systems that could inform both customers and restaurateurs of restaurant quality.

Keywords: benchmarking, restaurants, grading, service quality, total quality management

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Authors: Bahram Asghari Aghdam, Ali Mahjoub

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The purpose of this study is to evaluate the effect of emotional intelligence on the motivation and performance of East Azarbaijan the Red Crescent staff. In this study, EI is determined as the independent variable component of self awareness, self management, social awareness, and relations management, motivation and performance as dependent variables. The research method is descriptive-survey. In this study, simple random sampling method is used and research sample consists of 130 East Azarbaijan the Red Crescent staff that uses Cochran's formula 100 of them were selected and questionnaires were filled by them. Three types of questionnaires were used in this study for emotional intelligence, consisting of the Bradbury Travis and Jane Greaves standard questionnaire; and for motivation and performance a questionnaire is regulated by the researcher with help of professionals and experts in this field that consists of 33 questions about the motivation and 15 questions about performance and content validity were used to obtain the necessary credit. Reliability by using the Cronbach's alpha coefficient /948 was approved. Also, in this study to test the hypothesis of the Spearman correlation coefficient and linear regressions and determine fitness of variables' of structural equation modeling is used. The results show that emotional intelligence with coefficient /865, motivation and performance of in East Azerbaijan the Red Crescent employees has a positive effect. Based on Friedman Test ranking the most influence in motivation and performance of staff in respondents' opinion is in order of self-awareness, relations management, social awareness and self-management.

Keywords: emotional intelligence, self-awareness, self-management, social awareness, relations management, motivation, performance

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Authors: Jochen Edmund Kerschenbauer, Roman Salinger, Daniel Strametz

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Insufficient informal communication systems can lead to the first crisis (‘Crisis of Leadership’) for start-ups. Management Control Systems (MCS) are one way for high-technology start-ups to successfully overcome these problems. So far the literature has investigated the incubation of a start-up, but focused less on the post-incubation stage. This paper focuses on the use of MCS in post-incubation and, if failed start-ups agree, on how MCS are used. We conducted 14 semi-structured interviews for this purpose, to obtain our results. The overall conclusion is that the majority of the companies were closed down due to a combination of strategic, operative and financial reasons.

Keywords: closed down, high-technology, incubation, levers of control, management control systems, post-incubation, start-ups

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Authors: Xuewei Li, Jingfeng Yuan, Jianliang Zhou

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The 21st century has been called the century of human exploitation of underground space. Due to the characteristics of large quantity, tight schedule, low safety reserve and high uncertainty of deep foundation pit engineering, accidents frequently occur in deep foundation pit engineering, causing huge economic losses and casualties. With the successful application of information technology in the construction industry, building information modeling has become a research hotspot in the field of architectural engineering. Therefore, the application of building information modeling (BIM) and other information communication technologies (ICTs) in construction safety management is of great significance to improve the level of safety management. This research summed up the mechanism of the deep foundation pit engineering accident through the fault tree analysis to find the control factors of deep foundation pit engineering safety management, the deficiency existing in the traditional deep foundation pit construction site safety management. According to the accident cause mechanism and the specific process of deep foundation pit construction, the hazard information of deep foundation pit engineering construction site was identified, and the hazard list was obtained, including early warning information. After that, the system framework was constructed by analyzing the early warning information demand and early warning function demand of the safety management system of deep foundation pit. Finally, the safety management system of deep foundation pit construction site based on BIM through combing the database and Web-BIM technology was developed, so as to realize the three functions of real-time positioning of construction site personnel, automatic warning of entering a dangerous area, real-time monitoring of deep foundation pit structure deformation and automatic warning. This study can initially improve the current situation of safety management in the construction site of deep foundation pit. Additionally, the active control before the occurrence of deep foundation pit accidents and the whole process dynamic control in the construction process can be realized so as to prevent and control the occurrence of safety accidents in the construction of deep foundation pit engineering.

Keywords: Web-BIM, safety management, deep foundation pit, construction

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Authors: Nyasha Agnes Gurira, Petronella Katekwe

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Traditional management systems (TMS) are a vital source of knowledge for conserving cultural and natural heritage. TMS’s are renowned for their ability to preserve both tangible and intangible manifestations of heritage. They are a construct of the intricate relationship that exists between heritage and host communities, where communities are recognized as owners of heritage and so, set up management mechanisms to ensure its adequate conservation. Multiple heritage condition surveys were conducted to assess the effectiveness of using TMS in the conservation of both natural and cultural heritage. Surveys were done at Nharira Hills, Mahwemasimike, Dzimbahwe, Manjowe Rock art sites and Norumedzo forest which are heritage places in Zimbabwe. It assessed the state of conservation of the five case studies and assessed the role that host communities play in the management of these heritage places. It was revealed that TMS’s are effective in the conservation of natural heritage, however in relation to heritage forms with cultural manifestations, there are major disparities. These range from differences in appreciation and perception of value within communities leading to vandalism, over emphasis in the conservation of the intangible element as opposed to the tangible. This leaves the tangible element at risk. Despite these issues, TMS are a reliable knowledge base which enables more holistic conservation approaches for cultural and natural heritage.

Keywords: communities, cultural intangible, tangible heritage, traditional management systems, natural

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Authors: Yutong Xu, Wanting Zhang, Jia Wang, Zihan Guo, Weiguang Ma

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Background: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. Aims: To evaluate the resilience level of Chinese nursing interns and identify the factors affecting resilience early in their careers. Methods: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment scale for Nurse, and the Career Adapt-Abilities Scale. Structural equation modeling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped Confidence Intervals. Results: The nursing interns showed a moderately high level of resilience[M(SD)=70.15(19.90)]. Gender, scholastic attainment, had a scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns’ resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.58, 0.12, respectively, p＜0.01). career adaptability also positively affected career adaptability (β = 0.26, p < 0.01), and played a fully mediating role in the relationship between clinical learning environment and resilience. Conclusion: Career adaptability can enhance the influence of clinical learning environment on resilience. The promotion of career adaptability and the clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for those female nursing interns with low academic performance. Implications for Nursing Educators Nursing educators should pay attention to the cultivation of nursing students' resilience; for example, by helping them integrate to the clinical learning environment and improving their career adaptability. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution No patient or public contribution.

Keywords: resilience, clinical learning environment, career adaptability, nursing interns

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Authors: Erinetta P. Anjani, Karina Mariz, Rifqi K. Fathianto

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While Islam teaches its’ followers to be mindful of God’s creation, including the environment, Indonesia as one of the world’s largest Muslim country, is now also world’s second-largest plastic waste contributor. The problem of waste is a complicated matter in Indonesia and is worsening because many landfills are now on verge of overcapacity. The causes of this problem are at least due to two things. First is Indonesia’s bad waste management. Second, people’s low of eco-literacy, as can be seen in massive use of non-degradable materials, low rate of waste separation, low rate of recycling and up cycling, whereas households are the largest source of waste in Indonesia. Mostly dealing with patriarchal culture, women in Indonesia play big and important role in their households, from family matter to household management (including waste management), to economic matter. Uniquely, the majority of Muslim women in Indonesia are engaged in -arisan- women social gathering or in -majelis ta’lim- women community in Islamic prayer, which serves as a social mechanism. As many NGOs are working on tackling environmental issues by raising awareness in order for the people to adapt a more environmentally-friendly household management practices, the problem of waste in Indonesia is meeting a bright light. Using qualitative data and descriptive analysis, the following is a proposal for a program intended to spread eco-literacy for waste management to women in Indonesia through their social gathering in order for them to gain awareness and start implementing eco-actions in their households. We attempt Waste4Change, a social company which provides environmentally-friendly waste management services, to reach women with modules that consist of environmental education, trainings, and workshops. We will then monitor and counsel the women to make sure if the lesson is going to be fully applied in their houses. The program will take place nearby University of Indonesia, Depok, West Java.

Keywords: eco-literacy, environmental education, household waste management, Muslim women social gathering, Waste4Change

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Authors: M. A. Rahman, A. T. Ohta, H. V. Trinh, J. Hyvl

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Atmospheric pressure and oxygen (O2) concentration are critical life support parameters for human-occupied aerospace vehicles and habitats. Various medical conditions may require medical O2; for example, the American Medical Association has determined that commercial air travel exposes passengers to altitude-related hypoxia and gas expansion. It may cause some passengers to experience significant symptoms and medical complications during the flight, requiring supplemental medical-grade O2 to maintain adequate tissue oxygenation and prevent hypoxemic complications. Although supplemental medical grade O2 is a successful lifesaver for respiratory and cardiac failure, O2-enriched exhaled air can contain more than 95 % O2, increasing the likelihood of a fire. In an aerospace environment, a localized high concentration O2 bubble forms around a patient being treated for hypoxia, increasing the cabin O2 beyond the safe limit. To address this problem, this work describes a medical O2 delivery system that can reduce the O2 concentration from patient-exhaled O2-rich air to safe levels while maintaining the prescribed O2 administration to the patient. The O2 delivery system is designed to be a part of the medical O2 kit. The system uses cationic multimetallic cobalt complexes to reversibly, selectively, and stoichiometrically chemisorb O2 from the exhaled air. An air-release sub-system monitors the exhaled air, and as soon the O2 percentage falls below 21%, the air is released to the room air. The O2-enriched exhaled air is channeled through a layer of porous, thin-film heaters coated with the cobalt complex. The complex absorbs O2, and when saturated, the complex is heated to 100°C using the thin-film heater. Upon heating, the complex desorbs O2 and is once again ready to absorb or remove the excess O2 from exhaled air. The O2 absorption is a sub-second process, and desorption is a multi-second process. While heating at 0.685 °C/sec, the complex desorbs ~90% O2 in 110 sec. These fast reaction times mean that a simultaneous absorb/desorb process in the O2 delivery system will create a continuous absorption of O2. Moreover, the complex can concentrate O2 by a factor of 160 times that in air and desorb over 90% of the O2 at 100°C. Over 12 cycles of thermogravimetry measurement, less than 0.1% decrease in reversibility in O2 uptake was observed. The 1 kg complex can desorb over 20L of O2, so simultaneous O2 desorption by 0.5 kg of complex and absorption by 0.5 kg of complex can potentially continuously remove 9L/min O2 (~90% desorbed at 100°C) from exhaled air. The complex is synthesized and characterized for reversible O2 absorption and efficacy. The complex changes its color from dark brown to light gray after O2 desorption. In addition to thermogravimetric analysis, the O2 absorption/desorption cycle is characterized using optical imaging, showing stable color changes over ten cycles. The complex was also tested at room temperature in a low O2 environment in its O2 desorbed state, and observed to hold the deoxygenated state under these conditions. The results show the feasibility of using the complex for reversible O2 absorption in the proposed fire safe medical O2 delivery system.

Keywords: fire risk, medical oxygen, oxygen removal, reversible absorption

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Authors: Guldana Zhigerbayeva, Ming Yang

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Transportation of hazardous materials (HAZMAT) is inevitable in the process industries. The statistics show a significant number of accidents has occurred during the transportation of HAZMAT. This makes risk management of HAZMAT transportation an important topic. The tree-based methods including fault-trees, event-trees and cause-consequence analysis, and Bayesian network, have been applied to risk management of HAZMAT transportation. However, there is limited work on the development of a systematic approach. The existing approaches fail to build up the linkages between the regulatory requirements and the safety measures development. The analysis of historical data from the past accidents’ report databases would limit our focus on the specific incidents and their specific causes. Thus, we may overlook some essential elements in risk management, including regulatory compliance, field expert opinions, and suggestions. A systematic approach is needed to translate the regulatory requirements of HAZMAT transportation into specified safety measures (both technical and administrative) to support the risk management process. This study aims to first adapt the House of Quality (HoQ) to House of Safety (HoS) and proposes a new approach- Safety Function Deployment (SFD). The results of SFD will be used in a multi-criteria decision-support system to develop find an optimal route for HazMats transportation. The proposed approach will be demonstrated through a hypothetical transportation case in Kazakhstan.

Keywords: hazardous materials, risk assessment, risk management, quality function deployment

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Authors: Naylya Djumaeva

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Since the end of 2019, the world has been shaken by an infection that has claimed the lives of more than six and a half million patients. Currently, SARS-CoV-2 not only causes acute damage but has long-term consequences affecting every organ and has brought a wave of a new chronic disabling condition called Long-Covid..This preliminary study describes an application of un-explored properties of low-level laser radiation with laser- light emitter in the field of which is placed Copegus (Ribavirin) with the aim of treatment of patients with Long-Covid syndrome. The difference from the traditional use of the drug is that Copegus was not prescribed to the patient by the traditional method - orally or intravenously, and the medicinal properties of the drug were introduced into the patient’s body using the un-explored properties of low-power laser radiation. Ninety eight patients with Long- Covid syndrome were observed. The obtained findings suggest that under the influence of the field formed into the laser- light emitter with a Copegus placed inside the field, the remote transfer of pharmacological properties of Сopegus occurs. Conclusions about the produced effect of exposure were made based on improvement in the condition of patients, the disappearance of complaints, and positive changes in various diagnostic tests performed by the patients. Biography: Djumaeva N completed her PhD from the Institute of Epidemiology, Microbiology and Infectious Diseases in 2000. In her dissertation work devoted to the treatment of patients with chronic hepatitis B virus infection, she presented data on the possible influence of Complex Homeopathic Preparations on the organization of bound intracellular water in the cells of the body. She is the Consultant (Neurologist) at the Scientific-Research Institute for Virology, Uzbekistan, and an expert in “medicament testing” method (30 years). She has published 43 papers, including 2 patents.

Keywords: long covid, low level laser, copegus, laser- light emmiter

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Authors: Bernasconi Matteo, Grothkopp Mark, Friedli Thomas

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The objective of this paper is to examine the relationships between technical and social lean bundles as well as operational performance in the context of the pharmaceutical industry. We investigate the direct and mediating effects of the lean bundles total productive maintenance (TPM), total quality management (TQM), Just-In-Time (JIT), and human resource management (HRM) on operational performance. Our analysis relies on 113 manufacturing facilities from the St.Gallen OPEX benchmarking database. The results show that HRM has a positive indirect effect on operational performance mediated by the technical lean bundles.

Keywords: human resource management, operational performance, pharmaceutical industry, technical lean practices

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Authors: Suwaiba Sabiu Bako, Yaw Debrah

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In spite of the extensive literature available on the human resource management (HRM) systems and practices of multinational companies (MNCs) from developed countries, there are gaps concerning emerging countries’ multinational companies’ (EMNCs) HRM systems and practices. This study examines the transfer of HRM practices in Nigerian subsidiaries of MNCs from South Africa. It reveals that South MNCs hybridise their recruitment and selection processes and localise their compensation and employee relations. It also proves that performance appraisal, talent management and code of conduct practices are largely transferred to subsidiaries with minimal adaptation.

Keywords: EMNCs, HRM practices, HRM systems, Nigeria, South Africa

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Authors: Abdelsalam Omran Gebril

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Pollution and solid waste are the most important environmental problems plaguing the city of Benghazi as well as other cities and towns in Libya. These problems are caused by the lack of environmental planning and sound environmental management. Environmental planning is very important at present for the development of projects that preserve the environment, therefore, the planning process should be prioritized over the management process. Pollution caused by poor planning and environmental management exists not only in Benghazi but also in all other Libyan cities. This study was conducted through various field visits to several neighborhoods and areas within Benghazi as well as its neighboring regions. Follow-ups in these areas were conducted from March 2013 to October 2013 and documented by photographs. The existing methods of waste collection and means of transportation were investigated. Interviews were conducted with relevant authorities, including the Environment Public Authority in Benghazi and the Public Service Company of Benghazi. The objective of this study is to determine the causes of solid waste pollution in Benghazi City and its surrounding areas. Results show that solid waste pollution in Benghazi and its surrounding areas is the result of poor planning and environmental management, population growth, and the lack of hardware and equipment for the collection and transport of waste from the city to the landfill site. One of the most important recommendations in this study is the development of a complete and comprehensive plan that includes environmental planning and environmental management to reduce solid waste pollution.

Keywords: solid waste, pollution, environmental planning, management, Benghazi, Libya

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Authors: Mohammad Kargar Shouraki, Naji Yazdi, Mohsen Emami

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The environmental and social challenges have caused the organizations to put further attention and emphasis on sustainable growth and developing strategies for sustainability. Since human is both the target of development and the agent of development at the same time, one of the most important factors in the development of the sustainability strategy in organizations is the human factor. In addition, organizations have been facing the new challenge of digital transformation which impacts the human factor, meanwhile, undeniably, the human factor contributes to such transformation. Therefore, organizations are facing the challenge of digital human resource management (HRM). Thus, the present study aims to investigate how an HRM model should be so that it not only can help the consideration and of the business sustainability requirements but also can make the highest and the most appropriate positive, not destructive, utilization of the digital transformations. Furthermore, the success of the HRM regarding the two sustainability and digital transformation challenges requires dynamic human competencies, which are addressed as digital/sustainable human dynamic capabilities in this paper. The present study is conducted using a hybrid methodology consisting of the qualitative methods of meta-synthesis and content analysis and the quantitative method of interpretive-structural model (ISM). Finally, a rotatory model, including 3 approaches, 3 perspectives, and 9 dimensions, is presented.

Keywords: sustainable human resource management, digital human resource management, digital/sustainable human dynamic capabilities, talent management

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Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

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Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

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Authors: Huey-Fang Sun, Wei-Kai Weng, Mei-Kuang Chao, Hui-Shan Hsu, Tsai-Yin Shih

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Psycho-social stress is important for mental illness and the presence of emotional and behavioral symptoms to an identifiable event is the central feature of adjustment disorders. However, whether patients with adjustment disorders have been raised in family with poor family functions and social supports and have higher stress perception than their peer group when they both experienced a similar stressful environment remains unknown. The specific aims of the study are to investigate the correlation among the family function, social supports and the level of stress perception and to test the hypothesis that military patients with adjustment disorders would have lower family function, lower social supports and higher stress perception than their healthy colleagues recruited in the same cohort for military services given their common exposure to similar stressful environments. Methods: The study was conducted in four hospitals of northern part of Taiwan from July 1, 2015 to June 30, 2017 and a matched case-control study design was used. The inclusion criteria for potential patient participants were psychiatric inpatients that serviced in military during the study period and met the diagnosis of adjustment disorders. Patients who had been admitted to psychiatric ward before or had illiteracy problem were excluded. A healthy military control sample matched by the same military service unit, gender, and recruited cohort was invited to participate the study as well. Totally 74 participants (37 patients and 37 controls) completed the consent forms and filled out the research questionnaires. Questionnaires used in the study included Perceived Stress Scale (PSS) as a measure of stress perception; Family APGAR as a measure of family function, and Multidimensional Scale of Perceived Social Support (MSPSS) as a measure of social supports. Pearson correlation analysis and t-test were applied for statistical analysis. Results: The analysis results showed that PSS level significantly negatively correlated with three social support subscales (family subscale, r= -.37, P < .05; friend subscale, r= -.38, P < .05; significant other subscale, r= -.39, P < .05). A negative correlation between PSS level and Family APGAR only reached a borderline significant level (P= .06). The t-test results for PSS scores, Family APGAR levels, and three subscale scores of MSPSS between patient and control participants were all significantly different (P < .001, P < .05, P < .05, P < .05, P < .05, respectively) and the patient participants had higher stress perception scores, lower social supports and lower family function scores than the healthy control participants. Conclusions: Our study suggested that family function and social supports were negatively correlated with patients’ subjective stress perception. Military patients with adjustment disorders tended to have higher stress perception and lower family function and social supports than those military peers who remained healthy and still provided services in their military units.

Keywords: adjustment disorders, family function, social support, stress perception

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Authors: Amarjit S Tanda

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Integrated Pest Management Technology (IPMT) offers a crop protection model with sustainable agriculture production with minimum damage to the environment and human health. A concept of agro-ecological crop protection seems unsuitable under dynamic environmental systems. To remedy this, we are proposing Genetically Engineered Crop Protection System (GECPS), as an alternate concept in IPMT that suggests how GE cultivars can be optimally put to the service of crop protection. Genetically engineered cultivars which are developed by gene editing biotechnology may provide a preventive defense against the insect pests and plant diseases, a suitable alternative crop system for blending in IPMT program, in the future agro-industry.

Keywords: integrated, pest, management, technology

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Authors: Lee Ock-Sun

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The effective development of a geoscience education and training program takes account of the rapidly changing environment in the geoscience market, includes information about resource-rich countries which have international education demands. In this paper, we introduce the geoscience program run bythe International School for Geoscience Resources at the Korea Institute of Geoscience and Mineral Resources (IS-Geo of KIGAM),and show its remarkable performance. To further effective geoscience program planning and operation, we present recommendations for strategic management for customer-oriented operation with a more favorable program format and advanced training aids. Above all, the IS-Geo of KIGAM should continue improve through‘plan-do-see-feedback’activities based on the recommendations.

Keywords: demand survey, geoscience program, program performance, strategic management

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Authors: Itsuo Yokoyama, Rikako Kikuti, Miti Sekikawa, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Vascular access for hemodialysis therapy is often difficult, even for experienced medical personnel. Ultrasound guided needle placement have been performed occasionally but is not always helpful in certain cases with complicated vascular anatomy. Obtaining precise anatomical knowledge of the vascular structure is important to prevent access-related complications. With augmented reality (AR) device such as AR glasses, the virtual vascular structure is shown superimposed on the actual patient vessels, thus enabling the operator to maneuver catheter placement easily with free both hands. We herein report our method of AR guided vascular access method in dialysis treatment Methods: Three dimensional (3D) object of the arm with arteriovenous fistula is computer graphically created with 3D software from the data obtained by computer tomography, ultrasound echogram, and image scanner. The 3D vascular object thus created is viewed on the screen of the AR digital display device (such as AR glass or iPad). The picture of the vascular anatomical structure becomes visible, which is superimposed over the real patient’s arm, thereby the needle insertion be performed under the guidance of AR visualization with ease. By this method, technical difficulty in catheter placement for dialysis can be lessened and performed safely. Considerations: Virtual reality technology has been applied in various fields and medical use is not an exception. Yet AR devices have not been widely used among medical professions. Visualization of the virtual vascular object can be achieved by creation of accurate three dimensional object with the help of computer graphical technique. Although our experience is limited, this method is applicable with relative easiness and our accumulating evidence has suggested that our method of vascular access with the use of AR can be promising.

Keywords: abdominal-aorta, calcification, extraskeletal, dialysis, computer graphics, 3DCG, CT, calcium, phosphorus

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Authors: Anyia Nduka, Aslan Bin Amad Senin

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Environmental degradation and infrastructure abuse in the Niger Delta have received increasing attention over the last two decades in several sectors, like strategic management, societal impacts, etc. Resilience strategy in human capital development and technology has inspired the formulation and implementation of strategies, policies, or activities to mitigate risks while taking advantage of opportunities to respond to crisis management. This research hopes to add to the debate on the resilient strategic model in the Niger Delta region, which is plagued with environmental and infrastructure mismanagement. It further proposes a conceptual framework of robust strategy and open technology model on bibliometric analysis. This article is intended to be a starting point for an in-depth discussion of the factors that lead to these mismanagements. Four factors were discovered for a resilient strategy leading to a more efficient and effective management procedure.

Keywords: resilience strategy, infrastructural mismanagement, human capital development., strategic management

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Authors: Ciaran Smiddy, Fergus Nugent, Karen Fitzmaurice

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A measure of prescribing and administration of Antimicrobial Prophylaxis before and during Covid-19(2019 vs. 2021) was desired to assess how these were affected by Covid-19. Antimicrobial Prophylaxis was assessed for 60 patients, under 3 Orthopaedic Consultants, against local guidelines. The study found that compliance with guidelines improved significantly, from 60% to 83%, but Appropriate use of Vancomycin reduced from 37% to 29%.

Keywords: antimicrobial stewardship, prescribing, spinal surgery, vancomycin

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Authors: Yasaman Samie

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The ever-increasing rate of textile and clothing (T&C) waste generation and the common ineffective waste management practices have been for long a challenge for civic waste management. This challenge stems from not only the complexity in the T&C material components but also the heterogeneous nature of the T&C waste management sector and the disconnection between the stakeholders. To date, there is little research that investigates the importance of a governmental structure and its role in T&C waste managerial practices and decision makings. This paper reflects on the impacts and involvement of governments, the Acts, and legislation on the effectiveness of T&C waste management practices, which are carried out by multiple players in a city context. In doing so, this study first develops a methodical framework for holistically analyzing a city’s T&C waste ecosystem. Central to this framework are six dimensions: social, environmental, economic, political, cultural, and educational, as well as the connection between these dimensions such as Socio-Political and Cultural-Political. Second, it delves into the political dimension and its interconnections with varying aspects of T&C waste. In this manner, this case-study takes metropolitan Melbourne as a case and draws on social theories of Actor-Network Theory and the principals of supply chain design and planning. Data collection was through two rounds of semi-structured interviews with 18 key players of T&C waste ecosystem (including charities, city councils, private sector providers and producers) mainly within metropolitan Melbourne and also other Australian and European cities. Research findings expand on the role of the politics of waste in facilitating a proactive approach to T&C waste management in the cities. That is achieved through a revised definition for T&C waste and its characteristics, discussing the varying perceptions of value in waste, prioritizing waste types in civic waste management practices and how all these aspects shall be reflected in the in-placed acts and legislations.

Keywords: civic waste management, multi-stakeholder ecosystem, textile and clothing waste, waste and governments

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Authors: Todor Nickolov Stoyanov

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Cooperatives are present in all countries and in almost all sectors, including agriculture, forestry, food, finance, health, marketing, insurance and credit. Strong cooperatives are able to overcome many of the difficulties faced by private owners. Cooperatives use seven principles, including the 'Community Concern" principle, which enables cooperatives to work for the sustainable development of the community. The members of cooperatives may use different systems for generating year-round employment and for receiving sustainable income through performing different forestry activities. Various methods are used during the preparation of the report. These include literature reviews, statistics, secondary data and expert interviews. The members of the cooperatives are benefits exclusively from increasing the efficiency of the various products and from the overall yield of the harvest, and ultimately from achieving better profit through cooperative efforts. Cooperatives also use other types of activities that are an additional opportunity for cooperative income. There are many heterogeneous activities in the production and service sectors of the forest cooperatives under consideration. Some cooperatives serve dairies, distilleries, woodworking enterprises, tourist homes, hotels and motels, shops, ski slopes, sheep breeding, etc. Through the revenue generated by the activity, cooperatives have the opportunity to carry out various environmental and protective activities - recreation, water protection, protection of endangered and endemic species, etc., which in the case of small-scale forests cannot be achieved and the management is not sustainable. The conclusions indicate the results received in the analysis. Cooperative management of forests and forest lands gives higher incomes to individual owners. The management of forests and forest lands through cooperatives helps to carry out different environmental and protective activities. Cooperative forest management provides additional means of subsistence to the owners of poor forest lands. Cooperative management of forests and forest lands support owners to implement the forest management plans and to apply sustainable management of these territories.

Keywords: cooperative, forestry, forest owners, principles of cooperation

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Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

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The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

Procedia PDF Downloads 131

Authors: Bremmy Laksono, Riksa Parikrama, Nur A. Rosyada, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

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Down syndrome (DS) is a chromosomal abnormality characterised by complete 21 chromosome trisomy (classical or non-disjunction), or partial 21 chromosome trisomy (mosaicism), or chromosome rearrangement involving chromosome 21 (translocation). This study was carried out to describe the frequency of DS patients in a research institution in the city of Bandung, Indonesia. This descriptive study also provides a picture of the residential location and surrounding area of their dwellings. This study involved people with DS in various age whose chromosome were evaluated by conventional karyotyping method and FISH. Data were collected from 60 patients with DS from a total 150 patients during the period of September 2015 to August 2016 who were referred to Cell Culture and Cytogenetics Laboratory, Faculty of Medicine Universitas Padjadjaran, Indonesia. Results showed that the most common type of DS was non-disjunction (93%), followed by mosaicism (5%), no patient with translocation DS (0%), and a very rare type of tetrasomy 21 (2%). There were 39 males (65%) and 21 females (35%) of DS patient. Most of them live in suburban area beyond Bandung city (55%) while the rest live inside urban area of Bandung city (45%). They live mostly in dense area of greater Bandung area (65%) and only a few live in mid-density area (25%) and the least live in sparse populated area (10%). Their houses are mostly located in residential estate area (55%), nearby industrial area (37%), and around agricultural area (8%). Based on the study, it could be concluded that non-disjunction DS is the most common type. DS patients referred to the laboratory mostly came from dense residential zone in suburban area outside Bandung city. The low number of DS patients referred to the laboratory for chromosome analysis was the highlight to improve health service for people with genetic disorder. This study offered several information regarding area of DS patients’ residence and the condition of neighbourhood in Bandung city where they live as well.

Keywords: chromosome, descriptive, Down syndrome, prevalence

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Authors: Durjoy Lahiri, Vishal Madhukar Sawale, Ashwani Bhat, Souvik Dubey, Gautam Das, Biman Kanti Roy, Suparna Chatterjee, Goutam Gangopadhyay

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Crossed aphasia has been an area of considerable interest for cognitive researchers as it offers a fascinating insight into cerebral lateralization for language function. We conducted an observational study in the stroke unit of a tertiary care neurology teaching hospital in eastern India on subjects with crossed aphasia over a period of four years. During the study period, we detected twelve cases of crossed aphasia in strongly right-handed patients, caused by ischemic stroke. The age, gender, vernacular language and educational status of the patients were noted. Aphasia type and severity were assessed using Bengali version of Western Aphasia Battery (validated). Computed tomography, magnetic resonance imaging and angiography were used to evaluate the location and extent of the ischemic lesion in brain. Our series of 12 cases of crossed aphasia included 7 male and 5 female with mean age being 58.6 years. Eight patients were found to have Broca’s aphasia, 3 had trans-cortical motor aphasia and 1 patient suffered from global aphasia. Nine patients were having very severe aphasia and 3 suffered from mild aphasia. Mirror-image type of crossed aphasia was found in 3 patients, whereas 9 had anomalous variety. In our study crossed aphasia was found to be more frequent in males. Anomalous pattern was more common than mirror-image. Majority of the patients had motor-type aphasia and no patient was found to have pure comprehension deficit. We hypothesize that in Bengali-speaking right-handed population, lexical-semantic system of the language network remains loyal to the left hemisphere even if the phonological output system is anomalously located in the right hemisphere.

Keywords: aphasia, crossed, lateralization, language function, vascular

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Authors: I. Dumand, C. Clesse, M. Decker, C. Savini, J. Lighezzolo-Alnot

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In the landscape of French psychiatry, long-term institutionalization of patients with severe and disabling chronics disorders is common. Faced with the failures of classical reinsertion, sometimes these users are hurriedly considered as 'insortables'. However, this representation is often swayed by the current behavior of the patient observed through the clinical observation. Unfortunately, it seems that this way of proceeding can not integrate the potentialities of the institutionalized patients and their possible evolution. Therefore, in order not to make hasty conclusions about the life perspectives of these individuals, it seems essential to associate with clinical observation a psycho social rehabilitation diagnosis. Multidisciplinary, it combine all the aspects that make up the life of the subject (the life aspirations, psycho social determinants, family support, cognitive potential, symptoms ...). In this paper, we will rank these different aspects necessary prerequisites to the realization of a psycho social rehabilitation diagnosis. Then, we will specifically speak of the issue of psychological evaluation. By adopting an integrative approach combining neuro psychological tools (Grober and Buschke, Stroop, WCST, AIPSS, WAIS, Eyes test ...) and projective tools interpreted under a psycho dynamic angle (Rorschach, TAT ..) we think that we can grasp the patient in his globality. Thus, during this process we will justify the interest of combining a cognitive and a psycho affective approach, we will identify the different items assessed and their future implications on the everyday life of the users. Finally, we show that this diagnosis can give a chance to reintegration to 30% of patients considered as ''insortables''. In conclusion, we will highlight the importance of this process dear to the community psychology emphasizing in the same time the interests of this approach in terms of empowerment, recovery and quality of life.

Keywords: assessment, potentiality, psychosocial rehabilitation diagnosis, tools

Procedia PDF Downloads 366

Authors: Jamunarani Appalasamy, Tha Kyi Kyi, Quek Kia Fatt, Joyce Pauline Joseph, Anuar Zaini M. Zain

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Background: The Health Belief Theory had always been associated with chronic disease management. Various health behaviour concepts and perception branching from this Health Belief Theory had involved with medication understanding, use, and self-efficacy which directly link to medication adherence. In a previous quantitative and qualitative study, stroke patients in Malaysia were found to be strongly believing information obtained by various sources such as the internet and social communication. This action leads to lower perception of their stroke preventative medication benefit which in long-term creates non-adherence. Hence, this study intends to pilot an intervention which uses audio-visual concept incorporated with mHealth service to enhance learning and self-reflection among stroke patients to manage their disease. Methods/Design: Twenty patients will be allocated to a proposed intervention whereas another twenty patients are allocated to the usual treatment. The intervention involves a series of developed audio-visual videos sent via mobile phone which later await for responses and feedback from the receiver (patient) via SMS or recorded calls. The primary outcome would be the medication understanding, use and self-efficacy measured over two months pre and post intervention. Secondary outcome is measured from changes of blood parameters and other self-reported questionnaires. Discussion: This study shall also assess uptake/attrition, feasibility, and acceptability of this intervention. Trial Registration: NMRR-15-851-24737 (IIR)

Keywords: health belief, medication understanding, medication use, self-efficacy

Procedia PDF Downloads 216