Search results for: hospital management

Authors: Rimmy Yadav, Anmol Preet Kaur

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Big Data has demonstrated the vast potential in streamlining, deciding, spotting business drifts in different fields, for example, producing, fund, Information Technology. This paper gives a multi-disciplinary diagram of the research issues in enormous information and its procedures, instruments, and system identified with the privacy, data storage management, network and energy utilization, adaptation to non-critical failure and information representations. Other than this, result difficulties and openings accessible in this Big Data platform have made.

Keywords: big data, privacy, data management, network and energy consumption

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Authors: Katherine Arquio

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Community-based Forest Management (CBFM) is one of the integrative programs that slowly turned the course of forest management from traditional corporate to community-based practice resulting to people empowerment. As such, one of its goals is to promote socio-economic welfare among the people in the community in which social equity is included. This study aims to look at the equity aspect of the program, particularly if there are equity differences between two CBFM sites- Matikiw in Pakil, Laguna and Minayutan and Bacong Sigsigan in Famy, Laguna. Equity indicators were identified first, since these will be the basis of the questions that will be asked on the survey, after this, the survey proper was conducted, and finally, the analysis. Two tailed t-test was used as statistical tool since the difference between the two sites is the focus of the study. Statistical analysis was done through the use of STATA program, a statistical software. There were 32 indicators identified and results showed that, out of these indicators, only 13 were found significantly different between the two. The 13 indicators were significantly observed only in Matikiw; the other 19 indicators were commonly observed in both areas and are conducive as equity indicators for the CBFM program.

Keywords: social equity, CBFM, social forestry, equity indicators

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Authors: Omer Livvarcin, Mary Kay Park, Michael Miles

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The current literature includes a few studies that mention the impact of relations between teams, the business environment, and experiences from previous projects. There is, however, limited research that treats the phenomenon of project atmosphere (PA) as a whole. This is especially true of research identifying parameters and sub-parameters, which allow project management (PM) teams to build a project culture that ultimately imbues project success. This study’s findings identify a number of key project atmosphere parameters and sub-parameters that affect project management success. One key parameter identified in the study is a cluster related to cultural concurrence, including artifacts such as policies and mores, values, perceptions, and assumptions. A second cluster centers on motivational concurrence, including such elements as project goals and team-member expectations, moods, morale, motivation, and organizational support. A third parameter cluster relates to experiential concurrence, with a focus on project and organizational memory, previous internal PM experience, and external environmental PM history and experience). A final cluster of parameters is comprised of those falling in the area of relational concurrence, including inter/intragroup relationships, role conflicts, and trust. International and intercultural project management data was collected and analyzed from the following countries: Canada, China, Nigeria, South Korea and Turkey. The cross-cultural nature of the data set suggests increased confidence that the findings will be generalizable across cultures and thus applicable for future international project management success. The intent of the identification of project atmosphere as a critical project management element is that a clear understanding of the dynamics of its sub-parameters upon projects may significantly improve the odds of success of future international and intercultural projects.

Keywords: project management, project atmosphere, cultural concurrence, motivational concurrence, relational concurrence

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Authors: Jessy Rugeyo, William Donner

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This research delves into the resilience of Rwanda's public health infrastructure amidst natural disasters, a critical issue given that the Northern Province alone has witnessed no fewer than 1500 cases of disaster ranging from floods and landslides in the last five years, with more than 200 people killed and thousands of homes destroyed, according to MINEMA. In an era where climate change escalates the frequency and intensity of such disasters, fortifying the resilience of public health systems is paramount. This study offers a comprehensive analysis of the existing state of Rwanda's public health infrastructure and its ability to manage such crises. Employing a mix of literature review, case studies, and policy analysis, the study discerns key vulnerabilities and brings to light the intricacies of disaster management in Rwanda. Case studies centered around past natural disasters in Rwanda provide critical insights into the strengths and weaknesses of the existing disaster response mechanisms. A thorough critique of related disaster management and public health infrastructure policies reveals areas of commendable practice, along with gaps calling for policy enhancements. Findings guide the proposition of targeted strategies to bolster the resilience of Rwanda's public health infrastructure. This research serves as a significant contribution to the domains of disaster studies and public health, offering valuable insights for policymakers, public health and disaster management professionals in Rwanda and similar contexts. It presents actionable recommendations for improvement, underscoring the potential for enhancing Rwanda's disaster management capacity. By advocating for the strengthening of public health infrastructure resilience, the research highlights the potential for improved public health outcomes following natural disasters, thereby showcasing significant implications for public health and disaster management in the country, particularly in the face of a changing climate.

Keywords: public health infrastructure, disaster resilience, natural disaster, disaster management, emergency preparedness, health policy

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Authors: Mojtaba Valinejadshoubi, Azin Shakibabarough, Ashutosh Bagchi

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Facilities such as residential buildings, office buildings, and hospitals house large density of occupants. Therefore, a low-cost facility management program (FMP) should be used to provide a satisfactory built environment for these occupants. Facility management (FM) has been recently used in building projects as a critical task. It has been effective in reducing operation and maintenance cost of these facilities. Issues of information integration and visualization capabilities are critical for reducing the complexity and cost of FM. Building information modeling (BIM) can be used as a strong visual modeling tool and database in FM. The main objective of this study is to examine the applicability of BIM in the FM process during a building’s operational phase. For this purpose, a seven-storey office building is modeled Autodesk Revit software. Authors integrated the cloud-based environment using a visual programming tool, Dynamo, for the purpose of having a real-time cloud-based communication between the facility managers and the participants involved in the project. An appropriate and effective integrated data source and visual model such as BIM can reduce a building’s operational and maintenance costs by managing the building life cycle properly.

Keywords: building information modeling, facility management, operational phase, building life cycle

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Authors: Poramet Saeng-On

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This research aims to develop ways of lodging business management of Bang Khonthi community in Samut Songkram province that are appropriate with the cultural context of the Bang Khonthi community. Eight lodging business owners were interviewed. It was found that lodging business that are family business must be done with passion, correct understanding of self, culture, nature, Thai way of life, thorough, professional development, environmentally concerned, building partnerships with various networks both community level, and public sector and business cohorts. Public relations should be done through media both traditional and modern outlets, such as websites and social networks to provide customers convenience, security, happiness, knowledge, love and value when travel to Bang Khonthi. This will also help them achieve sustainability in business, in line with the 10 Home Stay Standard Thailand. Suggestions for operators are as follows: Operators need to improve their public relations work. They need to use technology in public relations such as the internet. Management standards must be improved. Souvenir and local products shops should be arranged in the compound. Product pricing must be set accordingly. They need to join hands to help each other. Quality of the business operation should be raised to meet the standards. Educational measures to reduce the impact caused by tourism on the community such as efforts to reduce energy consumption.

Keywords: homestay, lodging business, management, standard

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Authors: Mohamed Redha Menani

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The Northern Saharan aquifer system “SASS” shared by Algeria, Libya, and Tunisia, covers a surface of about 1 100 000 km². It is composed of superposed aquifers; the upper one is the “Continental terminal – CT” (Eocene calcareous formation) situated at 400 m depth in average, while the” Continental Intercalaire – CI”(clay sands from Albian to Lower Cretaceous) is generally at 1500 m depth. This aquifer system is situated in a dry zone with a very weak current recharge but with a non-renewable big volume stored, estimated between 20 000 and 31 000 km³. From 1970 to nowadays, the exploitation of the SASS has increased from 0.6 to more than 2.5 km³/year. This situation provoked risks of water salinisation, reduction of the artesianisme, an increase of drawdowns, etc. which seriously threaten the sustainable socioeconomic development engaged in the SASS zone. Face the water shortage induced by the alarming dryness noted these last years, particularly in the MENA region, the joint management of this system by the three concerned countries, engaged for many years, needs a long-term strategy of integrated water resources management to meet the expected socio-economic goals projected not only in the SASS zone but also in other places, by water transfers. The sustainable management of this extensive aquifer system, aiming to satisfy various needs not only in the areas covered by the SASS but also in other areas through hydraulic transfers, can only be considered if this management is genuinely coordinated, incorporating schemes that primarily address the major constraint of climate change, which has been observed worldwide over the past two decades and is intensifying. In this particular climate context, management schemes must necessarily target several aspects, including (i) Updating the state of water resource exploitation in the SASS. (ii) Guiding agricultural usage as the primary consumer to ensure significant water savings. (iii) Constant monitoring through a network of piezometers to control the physicochemical parameters of the exploited aquifers. (iv) Other aspects related to governance within the framework of integrated management must also be taken into consideration, particularly environmental aspects and conflict resolution. However, problems, especially political ones as currently seen in Libya, may limit or at least disrupt the prospects of coordinated and sustainable management of this aquifer system, which is vital for the three countries.

Keywords: transboundary water resources, SASS, governance, climatic changes

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Authors: Muna Mohamed Omer Mirghani

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This paper responds to one of the key national development strategies and a typical challenge in the Gash Basin as well as in different parts of Sudan, namely managing water scarcity in view of climate change impacts in minor water systems sustaining over 50% of the Sudan population. While now focusing on the Gash river basin, the ultimate aim is to replicate the same approach in similar water systems in central and west Sudan. The key objective of the paper is the identification of outcome-based water governance interventions in Gash Basin, guided by the global Sustainable Development Goal six (SDG 6 on water and sanitation) and the Sudan water resource policy framework. The paper concluded that improved water resources management of the Gash Basin is a prerequisite for ensuring desired policy outcomes of groundwater use and flood risk management purposes. Analysis of various water governance dimensions in the Gash indicated that the operationalization of a Basin-level institutional reform is critically focused on informed actors and adapted practices through knowledge and technologies along with the technical data and capacity needed to make that. Adapting the devolved Institutional structure at state level is recommended to strengthen the Gash basin regulatory function and improve compliance of groundwater users.

Keywords: water governance, Gash Basin, integrated groundwater management, Sudan

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Authors: Elizaveta Petelina, Anton Sizo

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Environmental remediation projects deal with a wide spectrum of data, including data collected during site assessment, execution of remediation activities, and environmental monitoring. Therefore, an appropriate data management is required as a key factor for well-grounded decision making. The Environmental Data Management System (EDMS) was developed to address all necessary data management aspects, including efficient data handling and data interoperability, access to historical and current data, spatial and temporal analysis, 2D and 3D data visualization, mapping, and data sharing. The system focuses on support of well-grounded decision making in relation to required mitigation measures and assessment of remediation success. The EDMS is a combination of enterprise and desktop level data management and Geographic Information System (GIS) tools assembled to assist to environmental remediation, project planning, and evaluation, and environmental monitoring of mine sites. EDMS consists of seven main components: a Geodatabase that contains spatial database to store and query spatially distributed data; a GIS and Web GIS component that combines desktop and server-based GIS solutions; a Field Data Collection component that contains tools for field work; a Quality Assurance (QA)/Quality Control (QC) component that combines operational procedures for QA and measures for QC; Data Import and Export component that includes tools and templates to support project data flow; a Lab Data component that provides connection between EDMS and laboratory information management systems; and a Reporting component that includes server-based services for real-time report generation. The EDMS has been successfully implemented for the Project CLEANS (Clean-up of Abandoned Northern Mines). Project CLEANS is a multi-year, multimillion-dollar project aimed at assessing and reclaiming 37 uranium mine sites in northern Saskatchewan, Canada. The EDMS has effectively facilitated integrated decision-making for CLEANS project managers and transparency amongst stakeholders.

Keywords: data management, environmental remediation, geographic information system, GIS, decision making

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Authors: Isabela Thomas Mkude

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This research was done to assess how the community is involved in waste management activities and their willingness to pay for services. Mnadani and Madukani are among the old wards in Dodoma urban. These two areas are similar and face numerous environmental problems, poor solid waste management practices being among them. People realize problems because they live with them daily but the study advice that the only way to stay off problems is to find appropriate measures. The findings recognized some problems that led to poor community involvement solid waste management the study areas. Lack of community education on how to deal with solid wastes, poor responsibility of ward leaders in issues concerning the environment and in active participation of communities in environmental meeting are among other major problems found during the research. The research also revealed that there is low willingness to pay for waste collection among communities and financial problems that make environmental committee inactive; that leading to a poor disposal and unavailable collection facilities in urban area. Although the municipal improves disposal activities by increasing amount of waste to be disposed off by 11% in three years, the amount of waste that collected is also increasing by 41% each day. It is advised that some corrective measures need to be put in place so that the communities are well involved in managing solid wastes as the best way to attain achievement in keeping the urban free from solid waste. Environmental education dissemination to the communities is needed so that they become responsible and dedicated citizen on the environment. There should be some incentives from government to the wards local government and CBOs so that they can practically implement solid waste management programs and to attract formation of more groups and motivate the present groups. Capacity building programs to the ward leaders need to be given priority so that leaders are well organized and able to plan, coordinate and cooperate with various governmental institutions, and NGOs responsible for development and environmental management.

Keywords: solid waste, waste management, public involvement, rapid urbanized region

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Authors: Miang Hong Ngerng, Noor Diyana Jasme, May Jin Theong

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Volatile market environment is inevitable. Fund managers are struggling to choose the right strategy to survive and overcome uncertainties and adverse market movement. Therefore, finding certainty in the mist of uncertainty future is one of the key performance objectives for fund managers. Current available theoretical results are not practical due to strong reliance on the investment assumption made. This paper is to identify the component that can be forecasted in Ex-ante setting which is the realistic situation facing a fund manager in the actual execution of asset allocation in portfolio management. Partial lease square method was used to generate an index with 10 years accounting data from 191 companies listed in KLSE. The result shows that the index reflects the inner nature of the business and up to 30% of the stock return can be explained by the index.

Keywords: active portfolio management, asset allocation ex-ante investment, asset class, partial lease square

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Authors: Imam Asrowardi, Septafiansyah Dwi Putra, Eko Subyantoro

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Process assessments can improve IT service management system (IT SMS) processes but the assessment method is not always transparent. This paper outlines a project to develop a solution- mediated process assessment tool to enable transparent and objective SMS process assessment. Using the international standards for SMS and process assessment, the tool is being developed following the International standard approach in collaboration and evaluate by expert judgment from committee members and ITSM practitioners.

Keywords: SMS, tools evaluation, ITIL, ISO service

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Authors: Faraz Ali Memon

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Stakeholders are a vital part of any organisation. It includes working on the demands of different stakeholders within the projects. However, the reality of construction projects is slightly different when it comes to practice. The UK construction projects have a history of failing to complete projects on time and within the budget. The purpose of this qualitative study is to enhance knowledge of stakeholder engagement. Semi-structured interviews will be carried out using a purposive sampling technique. It includes interviewing and getting knowledge from industry practitioners from top UK construction firms on how to manage stakeholders effectively. The findings from this study will help in understanding stakeholders' impact and how the engagement of stakeholders can affect construction projects. The conclusions of this study add value to the existing body of knowledge on stakeholder management, especially in the UK, where academic studies on construction projects are few. As a contribution, this study will provide a practical guide for the practitioners to engage stakeholders within the scope of the project. In addition, this study is limited to UK construction projects. Therefore, the outcome may not be generalised to other developing and underdeveloped countries.

Keywords: stakeholders, UK construction, project management, cost and time

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Authors: Lihong Wu, Raymond Young

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The ability to learn is one of the most critical skills in the information age. However, many students do not have a clear understanding of what learning is, what they are learning, and why they are learning. Many students study simply to pass rather than to learn something useful for their career and their life. They have a misconception about learning and a wrong attitude towards learning. This research explores student attitudes to study in management education and explores how to intercede to lead students from shallow to deeper modes of learning.

Keywords: knowledge, surface learning, deep learning, education

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Authors: Mohamed Haffar, Khalil Al-Hyari, Mohammed Khair Abu Zaid, Ramadane Djbarni, Mohammed Hamdan

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While employee readiness for change (ERFC) is recognised as critical for total quality management (TQM) implementation, there is a lack of systematic and empirical studies regarding the relationship between ERFC dimensions and TQM. Therefore, this study proposes to fill this gap by providing empirical evidence leading to advancement in the understanding of the influences of ERFC components on TQM implementation. The empirical data for this study was drawn from a survey of 400 middle and senior managers of Jordanian firms. The analysis of the collected data, which was conducted using Structural Equation Modeling technique, revealed that three of the ERFC components, namely personally beneficial, change self-efficacy and management support are the most supportive ERFC dimensions for TQM implementation. Therefore, this paper makes a novel contribution by providing a refined and deeper comprehension of the relationships between ERFCs and TQM implementation.

Keywords: total quality management, employee readiness for change, manufacturing organisations, Jordan

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Authors: Richa Grover, Rahul Grover, V. Balaji Rao, Kavish Kejriwal

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Selection of suppliers is a crucial problem in the supply chain management. On top of that, sustainable supplier selection is the biggest challenge for the organizations. Environment protection and social problems have been of concern to society in recent years, and the traditional supplier selection does not consider about this factor; therefore, this research work focuses on introducing sustainable criteria into the structure of supplier selection criteria. Sustainable Supply Chain Management (SSCM) is the management and administration of material, information, and money flows, as well as coordination among business along the supply chain. All three dimensions - economic, environmental, and social - of sustainable development needs to be taken care of. Purpose of this research is to maximize supply chain profitability, maximize social wellbeing of supply chain and minimize environmental impacts. Problem statement is selection of suppliers in a sustainable supply chain network by ranking the suppliers against sustainable criteria identified. The aim of this research is twofold: To find out what are the sustainable parameters that can be applied to the supply chain, and to determine how these parameters can effectively be used in supplier selection. Multicriteria decision making tools will be used to rank both criteria and suppliers. AHP Analysis will be used to find out ratings for the criteria identified. It is a technique used for efficient decision making. TOPSIS will be used to find out rating for suppliers and then ranking them. TOPSIS is a MCDM problem solving method which is based on the principle that the chosen option should have the maximum distance from the negative ideal solution (NIS) and the minimum distance from the ideal solution.

Keywords: sustainable supply chain management, sustainable criteria, MCDM tools, AHP analysis, TOPSIS method

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Authors: Sundaresan Soundararajan, George Ezekiel Silvananthan, Chor Ngee Tan

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Introduction: Transforaminal Interbody Fusion (TLIF) has been adopted for many decades now, however, XLIF, still in relative infancy, has grown to be accepted as a new Minimally Invasive Surgery (MIS) option. There is a paucity of reports directly comparing lateral approach surgery to other MIS options such as TLIF in the treatment of lumbar degenerative disc diseases. Aims/Objectives: The objective of this study was to compare the efficacy and clinical outcomes between Minimally Invasive Transforaminal Interbody Fusion (TLIF) and Minimally Invasive Lateral Interbody Fusion (XLIF) in the treatment of patients with degenerative disc disease of the lumbar spine. Methods: A single center, retrospective cohort study involving a total of 38 patients undergoing surgical intervention between 2010 and 2013 for degenerative disc disease of lumbar spine at single L4/L5 level. 18 patients were treated with MIS TLIF, and 20 patients were treated with XLIF. Results: The XLIF group showed shorter duration of surgery compared to the TLIF group (176 mins vs. 208.3 mins, P = 0.03). Length of hospital stay was also significantly shorter in XLIF group (5.9 days vs. 9 days, p = 0.03). Intraoperative blood loss was favouring XLIF as 85% patients had blood loss less than 100cc compared to 58% in the TLIF group (P = 0.03). Radiologically, disc height was significantly improved post operatively in the XLIF group compared to the TLIF group (0.56mm vs. 0.39mm, P = 0.01). Foraminal height increment was also higher in the XLIF group (0.58mm vs. 0.45mm , P = 0.06). Clinically, back pain and leg pain improved in 85% of patients in the XLIF group and 78% in the TLIF group. Post op hip flexion weakness was more common in the XLIF group (40%) than in the TLIF group (0%). However, this weakness resolved within 6 months post operatively. There was one case of dural tear and surgical site infection in the TLIF group respectively and none in the XLIF group. Visual Analog Scale (VAS) score 6 months post operatively showed comparable reduction in both groups. TLIF group had Owsterty Disability Index (ODI) improvement on 67% while XLIF group showed improvement of 70% of its patients. Conclusions: Lateral approach surgery shows comparable clinical outcomes in resolution of back pain and radiculopathy to conventional MIS techniques such as TLIF. With significantly shorter duration of surgical time, minimal blood loss and shorter hospital stay, XLIF seems to be a reasonable MIS option compared to other MIS techniques in treating degenerative lumbar disc diseases.

Keywords: extreme lateral interbody fusion, lateral approach, minimally invasive, XLIF

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Authors: Olivia R. Rendon

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More than half of the world population lives in cities, in the UK, for example, 82% of the population was urban by 2013. Cities concentrate valuable and numerous infrastructure and sectors of the national economies. Cities are particularly vulnerable to climate change which will lead to higher damage costs in the future. There is thus a need to develop and invest in adaptation measures for cities to reduce the impact of flooding and other extreme weather events. Recent flood episodes present a significant and growing challenge to the UK and the estimated cost of urban flood damage is 270 million a year for England and Wales. This study aims to carry out cost-benefit analysis (CBA) of a nature-based approach for flood risk management in cities, focusing on the city of Leeds and the wider Aire catchment as a case study. Leeds was chosen as a case study due to its being one of the most flood vulnerable cities in the UK. In Leeds, over 4,500 properties are currently vulnerable to flooding and approximately £450 million of direct damage is estimated for a potential major flood from the River Aire. Leeds is also the second largest Metropolitan District in England with a projected population of 770,000 for 2014. So far the city council has mainly focused its flood risk management efforts on hard infrastructure solutions for the city centre. However, the wider Leeds district is at significant flood risk which could benefit from greener adaptation measures. This study presents estimates of a nature-based adaptation approach for flood risk management in Leeds. This land use management estimate is based on generating costings utilising primary and secondary data. This research contributes findings on the costs of different adaptation measures to flood risk management in a UK city, including the trade-offs and challenges of utilising nature-based solutions. Results also explore the potential implementation of the adaptation measures in the case study and the challenges of data collection and analysis for adaptation in flood risk management.

Keywords: green infrastructure, ecosystem services, woodland, adaptation, flood risk

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Authors: D. Bąk-Grabowska, K. Grzesik, A. Iwanicka, A. Jagoda

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The process of human resources management in the structures of corporate groups demonstrates certain specificity, resulting from the division of decision-making and executive competencies, which occurs within these structures between a parent company and its subsidiaries. The subprocess of employee assessment is considered crucial, since it provides information for the implementation of personnel function. The empirical studies conducted in corporate groups, within which at least one company is located in Poland, confirmed the critical significance of employee assessment systems in the process of human resources management in corporate groups. Parent companies, most often, retain their decision-making authority within the framework of the discussed process and introduce uniform employee assessment and personnel controlling systems to subsidiary companies. However, the instruments for employee assessment applied in corporate groups do not present such specificity.

Keywords: corporate groups, employee periodical assessment system, holding, human resources management

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Authors: Mamman Jimoh Ahmadu, Sanusi Abubakar Sadiq, Eldah Ephraim Buba

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In modern societies, stress has become a widespread phenomenon and therefore an issue of major concern to employees, organizations, and the state. As senior management of an organization, executives are not immune to this problem because they carry out lots of activities while on duty. This paper is centered on the benefits of Tourism, Leisure and Recreation to the management of executive stress. Executives work has always been considered to be stressful. The key objective of the research is to gain a better understanding of the causes of stress among executives and to find out how tourism, leisure, and recreational activities could be used as a means to managing stress. Interview and observation data were analyzed using SPSS. The major finding revealed that that human system has specific limitations and nature cannot be cheated. It is recommended that executives should take regular and mandatory vacation of least forty days in a year. The only answer then is rest. The research recommends that a break tends to improves and relaxes, refreshes the mind and enhances performance.

Keywords: executive, recreation, stress, tourism

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Authors: Fatma Keskin Arabul, Ibrahim Senol, Ahmet Yigit Arabul, Ali Rifat Boynuegri

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On account of the concern of the fossil fuel is depleting and its negative effects on the environment, interest in alternative energy sources is increasing day by day. However, considering the importance of transportation in human life, instead of oil and its derivatives fueled vehicles with internal combustion engines, electric vehicles which are sensitive to the environment and working with electrical energy has begun to develop. In this study, simulation was carried out for providing energy management and recovering regenerative braking in fuel cell-battery hybrid electric vehicle. The main power supply of the vehicle is fuel cell on the other hand not only instantaneous power is supplied by the battery but also the energy generated due to regenerative breaking is stored in the battery. Obtained results of the simulation is analyzed and discussed.

Keywords: electric vehicles, fuel cell, battery, regenerative braking, energy management

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Authors: A B M Enamol Hassan

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The forest storing up in Bangladesh is of deep concern to policy analysts because of increasing encroachment that results in deforestation and degradation of the ecosystem. To address these problems, forest-dependent people, as responsible for encroachment, could be involved in the co-management process along with other local stakeholders through a participatory approach. On the basis of this premise, this paper conceptualizes and empirically assesses the integration of all stakeholders in the co-management process through two lenses such as participation and collaboration. The study also analyzed the issues of sustainability in local communities along with examining constraints that limit the processes of integration. The study used a qualitative research method, which included face-to-face interviews with semi-structured questionnaires and field notes following the purposive sampling technique focusing on Comilla Sadar South Upazila (CSSU), Bangladesh. The findings of this paper reveal beneficiaries, Bangladesh Forest Department (BFD) and Union Parishad (UP), come together as leading actors, while NGOs and business entrepreneurs are ignored in the co-management process of social forestry. However, integrated management contributes to the strength of community sustainability, although it has some major limitations causing the matter of concerns among the local communities and policy analysts.

Keywords: integration, participation, collaboration, stakeholders, community sustainability

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Authors: Nicolas Koslover, Tamara Levene

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Aims: Tonsilitis is one of the most common presentations to the A+E department. We aimed to assess whether patients presenting with tonsilitis are being managed in-line with current guidance. We then set out to educate A+E staff about tonsilitis management and then assessed for improvement in management. Methods: All patients presenting to A+E in one fortnight with a documented diagnosis of tonsilitis were included. We reviewed the notes to assess the choice of treatment in each case and whether a clinical score (CENTOR or FEVERPain score) was used to guide choice of treatment (in accordance with NICE guideline [NG84]). We designed and delivered an educational intervention for A+E staff covering tonsilitis guidelines. The audit was repeated two weeks later. Results: Over the study period, 49 patients were included; only 35% (n=17) had either a clinical score documented or had all components of a score recorded. In total, 39% (n=19) were treated with antibiotics. Of these, 63% (n=12) should not have been prescribed an antibiotic and 37% (n=7) were prescribed an inappropriate antibiotic. At re-audit, (n=50 cases), 58% (n=29) had a clinical score documented and 28% (n=14) were treated with antibiotics. Of these, 29% (n=4) should not have been prescribed antibiotics and 21% (n=3) were prescribed an inappropriate antibiotic. Thus, after this teaching session, there was a significant improvement in antibiotic prescribing practices (63% vs. 29%, p=0.026). Conclusions: A+E assessment and management of tonsilitis frequently deviated from guidelines, but a single teaching session vastly improved clinical scoring and antibiotic prescribing practices.

Keywords: tonsilitis, education, emergency medicine, ENT

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Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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Authors: Lur N. Dreier

Abstract:

Spontaneous transformation in Ursus maritimus is generally considered to be seldom, albeit not, to this author's best knowledge, previously unpublished in the medical literature. However, no case series has to date described transformative spontaneous processes to filios hominum species. Norwegian public hospital system, is, however, especially the grounds of the specific climate in the Northern hemisphere, and because of a high suited to observe such transformations, both on income level. Hence, this paper describes, to our knowledge, the first case series of 25 patients undergoing treatment for spontaneous transformation in four Norwegian hospitals. The methodology was to include patients on a consecutive basis, identifying clinically and laboratory the typology in each of the four hospitals. The major findings were that the archetypes were heterogeneous, with coercive laboratory findings, with a high degree of redundancy of the process. This might potentially lead to many advances in the diagnostics.

Keywords: case series, transformation, hominum species, maritimus species

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Authors: Dung Nguyen, Yu Wei, Eric Henderson

Abstract:

Analytical tools have been used for decades to assist in the development of forest plans. In 2016, a new decision support system, PRISM, was jointly developed by United States Forest Service (USFS) Northern Region and Colorado State University to support the forest planning process. Prism has a friendly user interface with functionality for database management, model development, data visualization, and sensitivity analysis. The software is tailored for USFS planning, but it is flexible enough to support planning efforts by other forestland owners and managers. Here, the core capability of PRISM and its applications in developing plans for several United States national forests are presented. The strengths of PRISM are also discussed to show its potential of being a preferable tool for managers and experts in the domain of forest management and planning.

Keywords: decision support, forest management, forest plan, graphical user interface, software

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Authors: Chia-Ling Chang, Hao-Bo Chang

Abstract:

Global climate change alters rainfall characteristics, while the variation of these characteristics further influences environmental conditions, such as hydrologic responses, landslide areas, and the amounts of diffuse pollution. The variations of environmental conditions may impact the stability of water resource systems. The objective of this study is to assess the present conditions of major water resource systems in Taiwan. The impact of climate change on each system is also discussed herein. Compared to the water resource systems in northern Taiwan, the ratio of the precipitation during the rainy season to that during the dry season has a larger increase in southern Taiwan. This variation of hydrologic condition impacts the stability of water resource systems and increases the risk of normal water supply. The findings in this work can be important references for water resource management.

Keywords: basin management, climate change, water resource system, water resource management

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Authors: Martin Böhmer, Agatha Dabrowski, Boris Otto

Abstract:

The trend of digitization significantly changes the role of data for enterprises. Data turn from an enabler to an intangible organizational asset that requires management and qualifies as a tradeable good. The idea of a networked economy has gained momentum in the data domain as collaborative approaches for data management emerge. Traditional organizational knowledge consequently needs to be extended by comprehensive knowledge about data. The knowledge about data is vital for organizations to ensure that data quality requirements are met and data can be effectively utilized and sovereignly governed. As this specific knowledge has been paid little attention to so far by academics, the aim of the research presented in this paper is to conceptualize it by proposing a “data knowledge model”. Relevant model entities have been identified based on a design science research (DSR) approach that iteratively integrates insights of various industry case studies and literature research.

Keywords: data management, digitization, industry 4.0, knowledge engineering, metamodel

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Authors: Alokananda Nath

Abstract:

Land is an important issue anywhere in the world as it is one of the fundamental elements in human settlements. Since the urban areas are considered to be the drivers of economy for any country across the world and the phenomenon of ‘urbanization’ happening everywhere, there is always a greater pressure on urban land and its management. Many states in India have realized the importance of land as a valuable resource and have implemented certain framework for managing and developing land. But in West Bengal no such statutory framework has been formulated till now and a very out dated model of land acquisition for public purpose is practiced. Due to the lop-sided character of urban growth in the entire eastern region of India, the city of Kolkata continues to bear the burden of excessive growth of population and consequent urbanization of the adjoining areas at a rapid pace. This research tries to look into these conflicts with respect to the present pattern of development in the context of Kolkata and suggest a system for land management in order to implement the planning processes. For this purpose, five case study areas were taken up within the Kolkata Metropolitan Area and subsequent analysis of their present land management and development techniques was done. The findings reveal that there is a lack of political will as well as administrative inefficiency on part of both the development authority and the local bodies. Mostly the local bodies lack the financial resources and technical expertise to work out any kind of land management framework or work out any kind of model in order to manage the development that is happening. All these place undue strain on city infrastructure systems and reduce the potential of cities to contribute as engines of economic growth. The focus of reforms, therefore, ought to be on streamlining the urban planning process, judicious and optimal land use, efficient plan implementation mechanisms, improvement of titling and registration processes.

Keywords: urbanization, land management framework, land development, policy reforms, land-use planning processes

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Authors: Saidou Hassidou, Laminou Ary Mahaman Moustapha

Abstract:

Uncontrolled urbanization of African cities, plus the lack of municipal waste management services in these cities, generate landscapes become places of multiple and varied interactions between health and environment. In this sense, under strong urban growth in a context of sub-equipment sanitation, the city of Maradi doesn’t escape to this situation which results in the spread of pollution (release of unpleasant odors, proliferation of mosquitoes) and many diseases posing multiple health problems. Our study focuses only on liquid waste especially domestic wastewater. To study the different domestic wastewater management options in the town of Maradi, a survey was conducted among 340 households in 17 districts. We note in most cases a crucial of waste management infrastructure (drainage and wastewater treatment) at the city. Thus, only the individual sanitation facilities are used. In the town of Maradi, in addition to the storm drains, there are, in old districts, ditches that discharge wastewater and unfortunately end up in rivers without treatment. Domestic wastewater total production is estimated at 86,761.28 m3 per day. This water is mostly from laundry activities, bathing, dishes, and is discharged in large part through the streets, by more than 60% of households. Also, pit emptying is performed at 39.11% by the vehicle Peugeot tank. The quality of service rendered by an actor is very important to encourage households to join. Existing autonomous sanitation facilities are poorly designed and poorly maintained. Fecal sludge is dumped in a hole near saturated latrines; this work is mainly done by manual scavengers or dumped in fields or on nearby vacant land concessions.

Keywords: management, urban wastewater, domestic wastewater, Maradi, Niger

Procedia PDF Downloads 257