Search results for: hospital management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10987

Search results for: hospital management

8257 The Impact of Audit Committee on Real Earnings Management: Evidence from Netherlands

Authors: Sana Masmoudi, Yosra Makni

Abstract:

Regulators highlight the importance of the Audit Committee (AC) as a key internal corporate governance mechanism. One of the most important roles of this committee is to oversee the financial reporting process. The purpose of this paper is to examine the link between the characteristics of an audit committee and the financial reporting quality by investigating whether the formation of audit committees and their characteristics are associated with improved financial reporting quality. This study provides empirical evidence of the association between audit committee independence, financial expertise, gender diversity, and meetings and Real Earnings Management (REM) as a proxy of financial reporting quality. Using data from, with a sample of 80 companies listed on the Amsterdam Stock Exchange during 2010-2017, the study finds that independence and AC Gender diversity are strongly related to financial reporting quality. In fact, these two characteristics constrain REM. The results also suggest that AC-financial expertise reduces to some extent, the likelihood of engaging in REM. These conclusions provide support then to the audit committee requirement under the Dutch Corporate Governance Code rules regarding gender diversity and AC meetings.

Keywords: audit committee, financial expertise, independence, real earnings management

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8256 Application of IED to Condition Based Maintenance of Medium Voltage GCB/VCB

Authors: Ming-Ta Yang, Jyh-Cherng Gu, Chun-Wei Huang, Jin-Lung Guan

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Time base maintenance (TBM) is conventionally applied by the power utilities to maintain circuit breakers (CBs), transformers, bus bars and cables, which may result in under maintenance or over maintenance. As information and communication technology (ICT) industry develops, the maintenance policies of many power utilities have gradually changed from TBM to condition base maintenance (CBM) to improve system operating efficiency, operation cost and power supply reliability. This paper discusses the feasibility of using intelligent electronic devices (IEDs) to construct a CB CBM management platform. CBs in power substations can be monitored using IEDs with additional logic configuration and wire connections. The CB monitoring data can be sent through intranet to a control center and be analyzed and integrated by the Elipse Power Studio software. Finally, a human-machine interface (HMI) of supervisory control and data acquisition (SCADA) system can be designed to construct a CBM management platform to provide maintenance decision information for the maintenance personnel, management personnel and CB manufacturers.

Keywords: circuit breaker, condition base maintenance, intelligent electronic device, time base maintenance, SCADA

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8255 A Comparative Evaluation of Stone Spout Management Systems in Heritage and Non-heritage Areas of the Kathmandu Valley, Nepal

Authors: Mira Tripathi, Ken Hughey, Hamish G. Rennie

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Management of water resources is a major challenge throughout the world and in many long-established societies people still use traditional water harvesting and management techniques. Despite often being seen as efficient and cost effective, traditional methods are in decline or have been abandoned in many countries. Nevertheless, traditional approaches continue to be useful in some countries such as Nepal. The extent to which such traditional measures, in this case via stone spouts, may survive modernization, while fulfilling socio-cultural, tourism, and other needs is the focus of the research. The research develops an understanding of the socio-cultural, tourism and other values of stone spouts for the people of urban and peri-urban heritage and non-heritage areas of the Kathmandu Valley to help ongoing sustainable management of remaining spouts. Three research questions are addressed: the impacts of changes in social and cultural norms and values; development activities; and, the incremental and ongoing loss of traditional stone spout infrastructure. A meta-theory framework has been developed which synthesizes Institutional, Attachment, Central Place and Common Property theories, which form analytical lenses for the mixed-method research approach. From the exploration of the meta-theory approach, it was found that no spouts are in pristine condition but those in non-heritage areas are in better condition than those in heritage areas. “Utility value” is the main driver that still motivates people to conserve spouts.

Keywords: stone spouts, social and cultural norms and values, meta-theory, Kathmandu Valley

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8254 Sponsorship Strategy, Its Visibility, and Return: A Case Study on Brazilian Olympic Games

Authors: Elizabeth F. Rodrigues, Julia da R. Mattos, Naira Q. Leitão, Roberta T. da Cunha

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The business strategy of many companies has two factors in common: the search for the competitive edge and its long term maintenance. The thing that differentiates the companies’ performance in their abilities to set the right strategy, which depends on their capacity to analyze and apply all sort of management support tools. In this context, the sponsorship of events stands out as an important way to increase brand awareness, especially when it is a worldwide event, such as Rio 2016 Olympic and Paralympic Games. This paper will present the case of a car maker company, which chose to invest on sponsorship as a way to reach its goals and grow in the brazilian market.

Keywords: strategy, sponsorship, events, management

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8253 Applicability of the Rapid Estimate of Adult Health Literacy in Medicine (Short Form) among Patients in Dakshina Kannada District, Karnataka, India

Authors: U. P. Rathnakar, Medha Urval, K. Ashok Shenoy

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Introduction: There are many tools available for the measurement of health literacy. REALM (Rapid Estimate of Adult Literacy in Medicine) is a very commonly used tool in advanced countries. It comes in two forms-one with 66 words and shorter version (REALM-SF) with seven words. We decided to test the applicability of shorter version of the REALM test among our patients. Methodology: REALM (SF) was tested among 200 patients in a tertiary hospital. Discussion and conclusion: From the analysis of results, when the results of pronunciation indicate adequate levels of HL skills, analysis of comprehension shows that mere reading skills is likely to be misleading. So it is proposed that in Indian population who have adequate reading skills without adequate comprehension the REALM-SF test tool in its present form may not be an ideal testing tool for assessing HL.

Keywords: health literacy, REALM, short form, India

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8252 Incident Management System: An Essential Tool for Oil Spill Response

Authors: Ali Heyder Alatas, D. Xin, L. Nai Ming

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An oil spill emergency can vary in size and complexity, subject to factors such as volume and characteristics of spilled oil, incident location, impacted sensitivities and resources required. A major incident typically involves numerous stakeholders; these include the responsible party, response organisations, government authorities across multiple jurisdictions, local communities, and a spectrum of technical experts. An incident management team will encounter numerous challenges. Factors such as limited access to location, adverse weather, poor communication, and lack of pre-identified resources can impede a response; delays caused by an inefficient response can exacerbate impacts caused to the wider environment, socio-economic and cultural resources. It is essential that all parties work based on defined roles, responsibilities and authority, and ensure the availability of sufficient resources. To promote steadfast coordination and overcome the challenges highlighted, an Incident Management System (IMS) offers an essential tool for oil spill response. It provides clarity in command and control, improves communication and coordination, facilitates the cooperation between stakeholders, and integrates resources committed. Following the preceding discussion, a comprehensive review of existing literature serves to illustrate the application of IMS in oil spill response to overcome common challenges faced in a major-scaled incident. With a primary audience comprising practitioners in mind, this study will discuss key principles of incident management which enables an effective response, along with pitfalls and challenges, particularly, the tension between government and industry; case studies will be used to frame learning and issues consolidated from previous research, and provide the context to link practice with theory. It will also feature the industry approach to incident management which was further crystallized as part of a review by the Joint Industry Project (JIP) established in the wake of the Macondo well control incident. The authors posit that a common IMS which can be adopted across the industry not only enhances response capacity towards a major oil spill incident but is essential to the global preparedness effort.

Keywords: command and control, incident management system, oil spill response, response organisation

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8251 Assessing the Benefits of Super Depo Sutorejo as a Model of integration of Waste Pickers in a Sustainable City Waste Management

Authors: Yohanes Kambaru Windi, Loetfia Dwi Rahariyani, Dyah Wijayanti, Eko Rustamaji

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Surabaya, the second largest city in Indonesia, has been struggling for years with waste production and its management. Nearly 11,000 tons of waste are generated daily by domestic, commercial and industrial areas. It is predicted that approximately 1,300 tons of waste overflew the Benowo Landfill daily in 2013 and projected that the landfill operation will be critical in 2015. The Super Depo Sutorejo (SDS) is a pilot project on waste management launched by the government of Surabaya in March 2013. The project is aimed to reduce the amount of waste dumped in landfill by sorting the recyclable and organic waste for composting by employing waste pickers to sort the waste before transported to landfill. This study is intended to assess the capacity of SDS to process and reduce waste and its complementary benefits. It also overviews the benefits of the project to the waste pickers in term of satisfaction to the job. Waste processing data-sheets were used to assess the difference between input and outputs waste. A survey was distributed to 30 waste pickers and interviews were conducted as a further insight on a particular issue. The analysis showed that SDS enable to reduce waste up to 50% before dumped in the final disposal area. The cost-benefits analysis using cost differential calculation revealed the economic benefit is considerable low, but composting may substitute tangible benefits for maintain the city’s parks. Waste pickers are mostly satisfied with their job (i.e. Salary, health coverage, job security), services and facilities available in SDS and enjoyed rewarding social life within the project. It is concluded that SDS is an effective and efficient model for sustainable waste management and reliable to be developed in developing countries. It is a strategic approach to empower and open up working opportunity for the poor urban community and prolong the operation of landfills.

Keywords: cost-benefits, integration, satisfaction, waste management

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8250 A Case Study: Community Forestry in Nepal: Achievements and Challenges

Authors: Bhmika Raiu

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The community forestry programme in Nepal officially started in the late 1970s. Since then concerning movement has been evolving to involve local communities in the management and utilization of forests. The policy of the government was originally intended to meet the basic forest products required by the communities through active participation in forest development and management. Later, it was expanded to include the mobilization and empowerment of the members of community forest user groups in the development of their local communities. It was observed that the trend of forest degradation has decreased since the handing over of national forests to local communities, but a number of unintended social anomalies have also cropped up. Such anomalies essentially constitute of the inequity and unfairness in the local and national level and in terms of long-term sustainability of forest resources. This paper provides an overview of various issues of community forestry, especially focusing on the major achievements made in community forestry. It calls for rethinking the community forestry programme in order to face the present day challenges of linking community forestry with livelihood promotion, good governance, and sustainable forest management. It also lays out strategies for reforms in community forestry.

Keywords: community forest, livelihood promotion, challenges, achievements

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8249 Surgical Skills in Mulanje

Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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8248 Collective Bargaining Agreement with Its Related Factors and Employees’ Perceived Productivity: The Case of an Academic Institution in Davao City, Philippines

Authors: Amylyn F. Labasano, M. S. Econ

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The study predicts the impact of collective bargaining agreement and its related factors on employees’ perceived productivity in terms of union-management relation’s climate, income, fringe benefits, and job satisfaction of the employees. It also determines whether there are significant differences in the employees’ perceived productivity based on the demographic characteristics of the respondents. The results revealed that the relationship climate which exists between the union and the management is found to have significant adverse effect on the average unpaid hours spent by employees working within the college. On the other hand, the total monthly wage earnings of employees have negative effect on the average hours an employee spent in bringing his work home while job satisfaction positively influences the overall productivity level of employees. The result further shows significant differences in the productivity level of employees across civil status and current designation.

Keywords: perceived productivity, collective bargaining agreement, union, union-management relations climate, income, fringe benefits, job satisfaction

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8247 Surgical School Project: Implementation Educational Plan for Adolescents Awaiting Bariatric Surgery

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

Abstract:

Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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8246 An Integrated Approach to Cultural Heritage Management in the Indian Context

Authors: T. Lakshmi Priya

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With the widening definition of heritage, the challenges of heritage management has become more complex . Today heritage not only includes significant monuments but comprises historic areas / sites, historic cities, cultural landscapes, and living heritage sites. There is a need for a comprehensive understanding of the values associated with these heritage resources, which will enable their protection and management. These diverse cultural resources are managed by multiple agencies having their own way of operating in the heritage sites. An Integrated approach to management of these cultural resources ensures its sustainability for the future generation. This paper outlines the importance of an integrated approach for the management and protection of complex heritage sites in India by examining four case studies. The methodology for this study is based on secondary research and primary surveys conducted during the preparation of the conservation management plansfor the various sites. The primary survey included basic documentation, inventorying, and community surveys. Red Fort located in the city of Delhi is one of the most significant forts built in 1639 by the Mughal Emperor Shahjahan. This fort is a national icon and stands testimony to the various historical events . It is on the ramparts of Red Fort that the national flag was unfurled on 15th August 1947, when India became independent, which continues even today. Management of this complex fort necessitated the need for an integrated approach, where in the needs of the official and non official stakeholders were addressed. The understanding of the inherent values and significance of this site was arrived through a systematic methodology of inventorying and mapping of information. Hampi, located in southern part of India, is a living heritage site inscribed in the World Heritage list in 1986. The site comprises of settlements, built heritage structures, traditional water systems, forest, agricultural fields and the remains of the metropolis of the 16th century Vijayanagar empire. As Hampi is a living heritage site having traditional systems of management and practices, the aim has been to include these practices in the current management so that there is continuity in belief, thought and practice. The existing national, regional and local planning instruments have been examined and the local concerns have been addressed.A comprehensive understanding of the site, achieved through an integrated model, is being translated to an action plan which safeguards the inherent values of the site. This paper also examines the case of the 20th century heritage building of National Archives of India, Delhi and protection of a 12th century Tomb of Sultan Ghari located in south Delhi. A comprehensive understanding of the site, lead to the delineation of the Archaeological Park of Sultan Ghari, in the current Master Plan for Delhi, for the protection of the tomb and the settlement around it. Through this study it is concluded that the approach of Integrated Conservation has enabled decision making that sustains the values of these complex heritage sites in Indian context.

Keywords: conservation, integrated, management, approach

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8245 A Cost Effective Approach to Develop Mid-Size Enterprise Software Adopted the Waterfall Model

Authors: Mohammad Nehal Hasnine, Md Kamrul Hasan Chayon, Md Mobasswer Rahman

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Organizational tendencies towards computer-based information processing have been observed noticeably in the third-world countries. Many enterprises are taking major initiatives towards computerized working environment because of massive benefits of computer-based information processing. However, designing and developing information resource management software for small and mid-size enterprises under budget costs and strict deadline is always challenging for software engineers. Therefore, we introduced an approach to design mid-size enterprise software by using the Waterfall model, which is one of the SDLC (Software Development Life Cycles), in a cost effective way. To fulfill research objectives, in this study, we developed mid-sized enterprise software named “BSK Management System” that assists enterprise software clients with information resource management and perform complex organizational tasks. Waterfall model phases have been applied to ensure that all functions, user requirements, strategic goals, and objectives are met. In addition, Rich Picture, Structured English, and Data Dictionary have been implemented and investigated properly in engineering manner. Furthermore, an assessment survey with 20 participants has been conducted to investigate the usability and performance of the proposed software. The survey results indicated that our system featured simple interfaces, easy operation and maintenance, quick processing, and reliable and accurate transactions.

Keywords: end-user application development, enterprise software design, information resource management, usability

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8244 Ocular Complications in Type 1 Diabetes Mellitus in Zahedan: A Tropical Region in Southeast of Iran

Authors: Mohammad Hossain Validad, Maryam Nakhaei-Moghadam, Monire Mahjoob

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Introduction: The prevalence of type 1 diabetes is increasing worldwide, and given the role of ethnicity and race in complications of diabetes, this study was designed to evaluate the ocular complications of type 1 diabetes mellitus in Zahedan. Methods: This prospective cross-sectional study was conducted on Type 1 diabetic children that referred to Alzahra Eye Hospital. All patients had a dilated binocular indirect ophthalmoscopy using a +90 D condensing lens and slit-lamp biomicroscopy. Age, gender, onset, duration of diabetes, and HbA1c level were recorded. Results: 76 type 1 diabetes patients with an age of 11.93 ± 3.76 years participated in this study. Out of 76 patients with diabetes, 19 people (25%) had ocular complications. There was a significant difference in age (P=0.01) and disease duration (P=0.07) between the two groups with and without ocular complications. Odd ratios for ocular complications with age and duration of diabetes were 1.32 and 1.32, respectively. Conclusion: Cataract was the most common ocular complication in type 1 diabetes in Zahedan, a tropical region that was significantly related to the duration of the disease and the age of the patients.

Keywords: diabet mellitus type one, cataract, ocular complication, hemoglobin A1C

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8243 Creating a Quasi-Folklore as a Tool for Knowledge Sharing in a Family-Based Business

Authors: Chico A. E. Hindarto

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Knowledge management practices are more contextual when they combine with the corporate culture. Each entity has a specific cultural climate that enables knowledge sharing in both functional and individual levels. The interactions between people within organization can be influenced by the culture and how the knowledge is transmitted. On the other hand, these interactions have impacts in culture modification as well. Storytelling is one of the methods in delivering the knowledge throughout the organization. This paper aims to explore the possibility in using a quasi-folklore in the family-based business. Folklore is defined as informal tradition culture that spreading through a word-of-mouth, without knowing the source of the story. In this paper, the quasi-folklore term is used to differentiate it with the original term of folklore. The story is created by somebody in the organization, not like the folklore with unknown source. However, the source is not disclosed, in order to avoid the predicted interest from the story origin. The setting of family-based business is deliberately chosen, since the kinship is considerably strong in this type of entity. Through a thorough literature review that relates to knowledge management, storytelling, and folklore, this paper determines how folklore can be an option for knowledge sharing within the organization.

Keywords: folklore, family business, organizational culture, knowledge management, storytelling

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8242 Knowledge Engineering Based Smart Healthcare Solution

Authors: Rhaed Khiati, Muhammad Hanif

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In the past decade, smart healthcare systems have been on an ascendant drift, especially with the evolution of hospitals and their increasing reliance on bioinformatics and software specializing in healthcare. Doctors have become reliant on technology more than ever, something that in the past would have been looked down upon, as technology has become imperative in reducing overall costs and improving the quality of patient care. With patient-doctor interactions becoming more necessary and more complicated than ever, systems must be developed while taking into account costs, patient comfort, and patient data, among other things. In this work, we proposed a smart hospital bed, which mixes the complexity and big data usage of traditional healthcare systems with the comfort found in soft beds while taking certain concerns like data confidentiality, security, and maintaining SLA agreements, etc. into account. This research work potentially provides users, namely patients and doctors, with a seamless interaction with to their respective nurses, as well as faster access to up-to-date personal data, including prescriptions and severity of the condition in contrast to the previous research in the area where there is lack of consideration of such provisions.

Keywords: big data, smart healthcare, distributed systems, bioinformatics

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8241 The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) Process: An Audit of Its Utilisation on a UK Tertiary Specialist Intensive Care Unit

Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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8240 Bridging Minds, Building Success Beyond Metrics: Uncovering Human Influence on Project Performance: Case Study of University of Salford

Authors: David Oyewumi Oyekunle, David Preston, Florence Ibeh

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The paper provides an overview of the impacts of the human dimension in project management and team management on projects, which is increasingly affecting the performance of organizations. Recognizing its crucial significance, the research focuses on analyzing the psychological and interpersonal dynamics within project teams. This research is highly significant in the dynamic field of project management, as it addresses important gaps and offers vital insights that align with the constantly changing demands of the profession. A case study was conducted at the University of Salford to examine how human activity affects project management and performance. The study employed a mixed methodology to gain a deeper understanding of the real-world experiences of the subjects and project teams. Data analysis procedures to address the research objectives included the deductive approach, which involves testing a clear hypothesis or theory, as well as descriptive analysis and visualization. The survey comprised a sample size of 40 participants out of 110 project management professionals, including staff and final students in the Salford Business School, using a purposeful sampling method. To mitigate bias, the study ensured diversity in the sample by including both staff and final students. A smaller sample size allowed for more in-depth analysis and a focused exploration of the research objective. Conflicts, for example, are intricate occurrences shaped by a multitude of psychological stimuli and social interactions and may have either a deterrent perspective or a positive perspective on project performance and project management productivity. The study identified conflict elements, including culture, environment, personality, attitude, individual project knowledge, team relationships, leadership, and team dynamics among team members, as crucial human activities to minimize conflict. The findings are highly significant in the dynamic field of project management, as they address important gaps and offer vital insights that align with the constantly changing demands of the profession. It provided project professionals with valuable insights that can help them create a collaborative and high-performing project environment. Uncovering human influence on project performance, effective communication, optimal team synergy, and a keen understanding of project scope are necessary for the management of projects to attain exceptional performance and efficiency. For the research to achieve the aims of this study, it was acknowledged that the productive dynamics of teams and strong group cohesiveness are crucial for effectively managing conflicts in a beneficial and forward-thinking manner. Addressing the identified human influence will contribute to a more sustainable project management approach and offer opportunities for exploration and potential contributions to both academia and practical project management.

Keywords: human dimension, project management, team dynamics, conflict resolution

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8239 Corporate Governance Mechanisms, Whistle-Blowing Policy and Earnings Management Practices of Firms in Malaysia

Authors: Mujeeb Saif Mohsen Al-Absy, Ku Nor Izah Ku Ismail, Sitraselvi Chandren

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This study examines whether corporate governance (CG) mechanisms in firms that have a whistle-blowing policy (WHBLP) are more effective in constraining earnings management (EM), than those without. A sample of 288 Malaysian firms for the years 2013 to 2015, amounting to 864 firm-years were grouped into firms with and without WHBLP. Results show that for firms without WHBLP, the board chairman tenure would minimize EM activities. Meanwhile, for firms with WHBLP, board chairman independence, board chairman tenure, audit committee size, audit committee meeting and women in the audit committees are found to be associated with less EM activities. Further, it is found that ownership concentration and Big 4 auditing firms help to reduce EM activities in firms with WHBLP, while not in firms without WHBLP. Hence, functional and effective governance can be achieved by having a WHBLP, which is in line with agency and resource dependent theories. Therefore, this study suggests that firms should have a WHBLP in place, and policymakers should come up with enhanced criteria to strengthen the mechanisms of WHBLP.

Keywords: corporate governance, earnings management, whistle-blowing policy, audit committee, board of directors

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8238 Legal Regulation and Critical Analysis for an Effectively Treatment of Pharmaceutical Waste

Authors: Merita Dauti, Edita Alili-Idrizi, Sihana Ahmeti –Lika, Ledjan Malaj

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The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people’s health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection.

Keywords: pharmaceutical waste, legal regulation, proper disposal, environment pollution

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8237 The Burden and the Consequences of Waste Management in Nigeria: Geophysical Approach

Authors: Joseph Omeiza Alao

Abstract:

The wobbly state of waste management and the high level of environmental irresponsibility is a threat to environmental security, which invariably endangered public health, regional groundwater systems and atmospheric condition. The dumping of waste materials in water bodies and gutters and the frequent burning of waste materials heaped at dumpsites as well depict the highest level of environmental indiscipline. These unruly human factors have compelled this study to apply four different techniques for environmental impact assessment and the possible public health risks of poor waste management in Nigeria. The techniques include a geophysical survey (resistivity data acquisition), dispatched questionnaire surveys, physiochemical water analysis and a physical survey of several dumpsites. While the resistivity data indicates high-level dumpsite leachate invading the ground soil down to the water table, the physiochemical water analysis depicts high content of BOD (401 – 711) mg/l, COD (731 – 1312) mg/l, TDS (419 – 1871) mg/l and heavy metals (0.014 – 1.971) mg/l present in the regional groundwater systems, which have altered the chemistry of the regional groundwater. The resistivity data shows that the overburdened soil layer overlaying the regional groundwater systems was very low (4.5 Ωm – 151 Ωm) as against the existing data (180 Ωm – 3500 Ωm). However, the physical surveys and the dispatched questionnaire surveys explore the depth of environmental irresponsibility among the citizen. While the imprints of gross environmental indiscipline may be absolutely irreversible, adequate knowledge of the environmental implications of careless waste disposal. After a critical examination of the current waste management strategies in Nigeria, the study suggests a future direction for environmental security and sustainability. Several influential regional factors, such as geology, climatic conditions, and hydrology, were also discussed.

Keywords: groundwater, environmental indiscipline, waste management, water analysis, leachate plumes, public health

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8236 Mechanical Simulation with Electrical and Dimensional Tests for AISHa Containment Chamber

Authors: F. Noto, G. Costa, L. Celona, F. Chines, G. Ciavola, G. Cuttone, S. Gammino, O. Leonardi, S. Marletta, G. Torrisi

Abstract:

At Istituto Nazionale di Fisica Nucleare – Laboratorio Nazionale del Sud (INFN-LNS), a broad experience in the design, construction and commissioning of ECR and microwave ion sources is available. The AISHa ion source has been designed by taking into account the typical requirements of hospital-based facilities, where the minimization of the mean time between failures (MTBF) is a key point together with the maintenance operations, which should be fast and easy. It is intended to be a multipurpose device, operating at 18 GHz, in order to achieve higher plasma densities. It should provide enough versatility for future needs of the hadron therapy, including the ability to run at larger microwave power to produce different species and highly charged ion beams. The source is potentially interesting for any hadron therapy facility using heavy ions. In this paper, we analyzed the dimensional test and electrical test about an innovative solution for the containment chamber that allows us to solve our isolation and structural problems.

Keywords: FEM analysis, electron cyclotron resonance ion source, dielectrical measurement, hadron therapy

Procedia PDF Downloads 278
8235 The Breast Surgery Movement: A 50 Year Development of the Surgical Specialty

Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman

Abstract:

The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.

Keywords: breast cancer, breast fellowship, breast surgery, surgical history

Procedia PDF Downloads 117
8234 A Feasibility Study of Crowdsourcing Data Collection for Facility Maintenance Management

Authors: Mohamed Bin Alhaj, Hexu Liu, Mohammed Sulaiman, Osama Abudayyeh

Abstract:

An effective facility maintenance management (FMM) system plays a crucial role in improving the quality of services and maintaining the facility in good condition. Current FMM heavily relies on the quality of the data collection function of the FMM systems, at times resulting in inefficient FMM decision-making. The new technology-based crowdsourcing provides great potential to improve the current FMM practices, especially in terms of timeliness and quality of data. This research aims to investigate the feasibility of using new technology-driven crowdsourcing for FMM and highlight its opportunities and challenges. A survey was carried out to understand the human, data, system, geospatial, and automation characteristics of crowdsourcing for an educational campus FMM via social networks. The survey results were analyzed to reveal the challenges and recommendations for the implementation of crowdsourcing for FMM. This research contributes to the body of knowledge by synthesizing the challenges and opportunities of using crowdsourcing for facility maintenance and providing a road map for applying crowdsourcing technology in FMM. In future work, a conceptual framework will be proposed to support data-driven FMM using social networks.

Keywords: crowdsourcing, facility maintenance management, social networks

Procedia PDF Downloads 150
8233 Characterization of Vegetable Wastes and Its Potential Use for Hydrogen and Methane Production via Dark Anaerobic Fermentation

Authors: Ajay Dwivedi, M. Suresh Kumar, A. N. Vaidya

Abstract:

The problem of fruit and vegetable waste management is a grave one and with ever increasing need to feed the exponentially growing population, more and more solid waste in the form of fruit and vegetables waste are generated and its management has become one of the key issues in protection of environment. Energy generation from fruit and vegetables waste by dark anaerobic fermentation is a recent an interesting avenue effective management of solid waste as well as for generating free and cheap energy. In the present study 17 vegetables were characterized for their physical as well as chemical properties, these characteristics were used to determine the hydrogen and methane potentials of vegetable from various models, and also lab scale batch experiments were performed to determine their actual hydrogen and methane production capacity. Lab scale batch experiments proved that vegetable waste can be used as effective substrate for bio hydrogen and methane production, however the expected yield of bio hydrogen and methane was much lower than predicted by models, this was due to the fact that other vital experimental parameters such as pH, total solids content, food to microorganism ratio was not optimized.

Keywords: vegetable waste, physico-chemical characteristics, hydrogen, methane

Procedia PDF Downloads 413
8232 Prevalence of Oral Mucosal Lesions in Malaysia: A Teaching Hospital Based Study

Authors: Renjith George Pallivathukal, Preethy Mary Donald

Abstract:

Asymptomatic oral lesions are often ignored by the patients and usually will be identified only in advanced stages. Early detection of precancerous lesions is important for better prognosis. It is also important for the oral health care person to be aware of the regional prevalence of oral lesions in order to provide early care for the same. We conducted a retrospective study to assess the prevalence of oral lesions based on the information available from patient records in a teaching dental school. Dental records of patients who attended the department of Oral medicine and diagnosis between September 2014 and September 2016 were retrieved and verified for oral lesions. Results: The ages of the patients ranged from 13 to 38 years with a mean age of 21.8 years. The lesions were classified as white (40.5%), red (23%), ulcerated (10.5%), pigmented (15.2%) and soft tissue enlargements (10.8%). 52% of the patients were unaware of the oral lesions before the dental visit. Overall, the prevalence of lesions in dental patients lower to national estimates, but the prevalence of some lesions showed variations.

Keywords: oral mucosal lesion, pre-cancer, prevalence, soft tissue lesion

Procedia PDF Downloads 340
8231 Deep Learning-Based Classification of 3D CT Scans with Real Clinical Data; Impact of Image format

Authors: Maryam Fallahpoor, Biswajeet Pradhan

Abstract:

Background: Artificial intelligence (AI) serves as a valuable tool in mitigating the scarcity of human resources required for the evaluation and categorization of vast quantities of medical imaging data. When AI operates with optimal precision, it minimizes the demand for human interpretations and, thereby, reduces the burden on radiologists. Among various AI approaches, deep learning (DL) stands out as it obviates the need for feature extraction, a process that can impede classification, especially with intricate datasets. The advent of DL models has ushered in a new era in medical imaging, particularly in the context of COVID-19 detection. Traditional 2D imaging techniques exhibit limitations when applied to volumetric data, such as Computed Tomography (CT) scans. Medical images predominantly exist in one of two formats: neuroimaging informatics technology initiative (NIfTI) and digital imaging and communications in medicine (DICOM). Purpose: This study aims to employ DL for the classification of COVID-19-infected pulmonary patients and normal cases based on 3D CT scans while investigating the impact of image format. Material and Methods: The dataset used for model training and testing consisted of 1245 patients from IranMehr Hospital. All scans shared a matrix size of 512 × 512, although they exhibited varying slice numbers. Consequently, after loading the DICOM CT scans, image resampling and interpolation were performed to standardize the slice count. All images underwent cropping and resampling, resulting in uniform dimensions of 128 × 128 × 60. Resolution uniformity was achieved through resampling to 1 mm × 1 mm × 1 mm, and image intensities were confined to the range of (−1000, 400) Hounsfield units (HU). For classification purposes, positive pulmonary COVID-19 involvement was designated as 1, while normal images were assigned a value of 0. Subsequently, a U-net-based lung segmentation module was applied to obtain 3D segmented lung regions. The pre-processing stage included normalization, zero-centering, and shuffling. Four distinct 3D CNN models (ResNet152, ResNet50, DensNet169, and DensNet201) were employed in this study. Results: The findings revealed that the segmentation technique yielded superior results for DICOM images, which could be attributed to the potential loss of information during the conversion of original DICOM images to NIFTI format. Notably, ResNet152 and ResNet50 exhibited the highest accuracy at 90.0%, and the same models achieved the best F1 score at 87%. ResNet152 also secured the highest Area under the Curve (AUC) at 0.932. Regarding sensitivity and specificity, DensNet201 achieved the highest values at 93% and 96%, respectively. Conclusion: This study underscores the capacity of deep learning to classify COVID-19 pulmonary involvement using real 3D hospital data. The results underscore the significance of employing DICOM format 3D CT images alongside appropriate pre-processing techniques when training DL models for COVID-19 detection. This approach enhances the accuracy and reliability of diagnostic systems for COVID-19 detection.

Keywords: deep learning, COVID-19 detection, NIFTI format, DICOM format

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8230 Internal Assessment of Satisfaction with the Quality of the Learning Process

Authors: Bulatbayeva A. A., Maxutova I. O., Ergalieva A. N.

Abstract:

This article presents a study of the practice of self-assessment of the quality of training cadets in a military higher specialized educational institution. The research was carried out by means of a questionnaire survey aimed at identifying the degree of satisfaction of cadets with the organization of the educational process, quality of teaching, the quality of the organization of independent work, and the system of their assessment. In general, the results of the study are of an intermediate nature. Proven tools will be incorporated into the planning and effective management of the learning process. The results of the study can be useful for the administrators and managers of the military education system for teachers of military higher educational institutions for adjusting the content and technologies of training future specialists. The publication was prepared as part of applied grant research for 2020-2022 by order of the Ministry of Education and Science of the Republic of Kazakhstan on the topic "Development of a comprehensive methodology for assessing the quality of education of graduates of military special educational institutions."

Keywords: teaching quality, quality satisfaction, learning management, quality management, process approach, classroom learning, interactive technologies, teaching quality

Procedia PDF Downloads 115
8229 A 3-Year Evaluation Study on Fine Needle Aspiration Cytology and Corresponding Histology

Authors: Amjad Al Shammari, Ashraf Ibrahim, Laila Seada

Abstract:

Background and Objectives: Incidence of thyroid carcinoma has been increasing world-wide. In the present study, we evaluated diagnostic accuracy of Fine needle aspiration (FNA) and its efficiency in early detecting neoplastic lesions of thyroid gland over a 3-year period. Methods: Data have been retrieved from pathology files in King Khalid Hospital. For each patient, age, gender, FNA, site & size of nodule and final histopathologic diagnosis were recorded. Results: Study included 490 cases where 419 of them were female and 71 male. Male to female ratio was 1:6. Mean age was 43 years for males and 38 for females. Cases with confirmed histopathology were 131. In 101/131 (77.1%), concordance was found between FNA and histology. In 30/131 (22.9%), there was discrepancy in diagnosis. Total malignant cases were 43, out of which 14 (32.5%) were true positive and 29 (67.44%) were false negative. No false positive cases could be found in our series. Conclusion: FNA could diagnose benign nodules in all cases, however, in malignant cases, ultrasound findings have to be taken into consideration to avoid missing of a microcarcinoma in the contralateral lobe.

Keywords: FNA, hail, histopathology, thyroid

Procedia PDF Downloads 323
8228 Screening of New Antimicrobial Agents from Heterocyclic Derivatives

Authors: W. Mazari, K. Boucherit, Z. Boucherit-Otmani, M. N. Rahmoun, M. Benabdallah

Abstract:

The hospital or any other establishment of care can be considered as an ecosystem where the patient comes into contact with a frightening microbial universe and a risk to contract infection that is referred to as nosocomial or health care-associated. In these last years, the incidence of these infections has risen sharply. Several microorganisms are the cause of these nosocomial infections and the emergence of resistance of the microbial strains against antibiotics creates a danger to public health. The search for new antimicrobial agents to overcome this problem has produced interesting compounds through chemical synthesis, which plays a very important role in the research and discovery of new drugs. It is in this framework that our study was conducted at our laboratory and it involves evaluating the antibacterial activity of thirteen 2-pyridone derivatives synthesized by two methods, the diffusion disc method and the dilution method against eight Gram negative bacterial strains. The results seem interesting especially for two products that have shown the best activities against Escherichia coli ATCC 25922 and Enterobacter cloacae ATCC 13047 with CMI of 512µg/ml.

Keywords: heterocyclic derivatives, chemical synthesis, antimicrobial activity, biotechnology

Procedia PDF Downloads 346