Search results for: general hospital

Authors: Bediru Abamecha

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Background: Domestic violence is a global problem that occurs regardless of culture, ethnicity or socio-economic class. It is known to be responsible for numerous hospital visits undertaken by women. Violence on pregnant women is a health and social problem that poses particular risks to the woman and her unborn child. Objective: The Objective of this study will be to assess prevalence of domestic violence and its correalates among pregnant women in Manna Woreda of Jimma Zone. Methods: Simple Random Sampling technique will be used to select 12 kebeles (48% of the study area) and Systematic Sampling will be used to reach to the house hold in selected kebeles in manna woreda of Jimma zone, south west Ethiopia from february 15-25, 2011. An in-depth interview will be conducted on Women affairs, police office and Nurses working and minimum of 4FGD with 6-8 members on pregnant women and selected male from the community. SPSS version 16.0 will be used to enter, clean and analyze the data. Descriptive statistics such as mean or median for continuous variables and percent for categorical variables will be made. Bivariate analysis will be used to check the association between independent variables and domestic violence. Variables found to have association with domestic violence will be entered to multiple logistic regressions for controlling the possible effect of confounders and finally the variables which had significance association will be identified on basis of OR, with 95% CI. All statistical significance will be considered at p<0.05. The qualitative data will be summarized manually and thematic analysis will be performed and finally both will be triangulated.

Keywords: ante natal care, ethiopian demographic and health survey, domestic violence, statistical package for social science

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Authors: Navid Daryasafar, Nima Farshidfar

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In this article, we make attempt to hide error in video with an emphasis on the time-wise use of autoregressive (AR) models. To resolve this problem, we assume that all information in one or more video frames is lost. Then, lost frames are estimated using analogous Pixels time information in successive frames. Accordingly, after presenting autoregressive models and how they are applied to estimate lost frames, two general methods are presented for using these models. The first method which is the same standard method of autoregressive models estimates lost frame in unidirectional form. Usually, in such condition, previous frames information is used for estimating lost frame. Yet, in the second method, information from the previous and next frames is used for estimating the lost frame. As a result, this method is known as bidirectional estimation. Then, carrying out a series of tests, performance of each method is assessed in different modes. And, results are compared.

Keywords: error steganography, unidirectional estimation, bidirectional estimation, AR linear estimation

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Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

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Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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Authors: Mawuli M. Sedegah, Emmanuel O. Sarpong, Ernest Y. Acheampong

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Sports injuries among student-athletes in high schools have become prevalent in most developing countries. The study explores the risk factors influencing sports injuries and identify those sustained among high schools’ competitions in the Akuapem Municipality. Drawing on literature from sports injuries, 610 student-athletes were used to understand how they sustained various injuries during schools’ sports and games. Using a cross-sectional survey, the study reveals how wounds, knee injury, muscle cramps, and thigh injury are common injuries in the municipality. The physiological factor was rampant, resulting from the number of games played by student-athletes, which significantly influenced sprain, strain, dislocation, and nose bleeding injuries among them. Results recorded a low correlation accounting for 9% occurrence of sports injuries in the Akuapem Municipality. Further study can be done in the other districts to have a general approach to remedy some of these sports injuries.

Keywords: common injuries, physiological factors, sports injuries, student-athletes

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Authors: Maryam Bakhtyar, Pegah Akrami

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Intuitional insight or mystical cognition is a different insight from common, concrete and intellectual insights. This kind of insight is not achieved by visionary contemplation but by the recitation of God, self-purification, and mystical life. In this insight, there is no distance or medium between the subject of cognition and its object, and they have a sort of unification, unison, and incorporation. As a result, knowledgeable consider this insight as direct, immediate, and personal. The goal of this insight is God, cosmos’ creatures, and the general inner and hidden aspect of the world that is nothing except God’s manifestations in the view of mystics. AS our common cognitions have diversity and stages, intuitional insight also has diversity and levels. As our senses are divided into concrete and rational, mystical discovery is divided into superficial discovery and spiritual one. Based on Islamic mystics, the preferable way to know God and believe in him is intuitional insight. There are two important criteria for evaluating mystical intuition, especially for beginner mystics of intellect and revelation. Indeed, the conclusion and a brief evaluation of Islamic mystics’ viewpoint is the main subject of this paper.

Keywords: intuition, discovery, mystical insight, personal knowledge, superficial discovery, spiritual discovery

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Authors: Mojtaba Valinataj

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Nowadays reversible logic has received many attentions as one of the new fields for reducing the power consumption. On the other hand, the processing systems have weaknesses against different external effects. In this paper, some error detecting reversible logic serial multipliers are proposed by incorporating the parity-preserving gates. This way, the new designs are presented for signed parity-preserving serial multipliers based on the Booth's algorithm by exploiting the new arrangements of existing gates. The experimental results show that the proposed 4×4 multipliers in this paper reach up to 20%, 35%, and 41% enhancements in the number of constant inputs, quantum cost, and gate count, respectively, as the reversible logic criteria, compared to previous designs. Furthermore, all the proposed designs have been generalized for n×n multipliers with general formulations to estimate the main reversible logic criteria as the functions of the multiplier size.

Keywords: Booth’s algorithm, error detection, multiplication, parity-preserving gates, quantum computers, reversible logic

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Authors: A. Bedük, k. Eryeşil, o. Eşmen, m. Onacak

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The mobbing is a process that is consisting of negative behaviors such as, systematically and continuously insulting, offending against personal dignity, preventing access to necessary information and disseminating rumors against employee by one or more than one individuals in a work environment through which disturbing the employee physically, psychologically and socially to cause to quit his/her job. This research is aiming to explore the results of mobbing (psychological violence) on employees’ organizational commitment in workplaces. Mobbing takes many forms and is often used to force an employee to leave the work environment. Two different types of scales have been reviewed and revised for use in the research. The Heinz Leymann scale is the first measure, which was developed to define causes and effects, in addition to characteristic behaviors of mobbing. The second scale was developed by Allen and Mayer and indicates levels of organizational commitment. In this research, a questionnaire were applied to 50 employees in a special glass factory in Konya to search mobbing itself and indicate the effects of mobbing to organizational commitments. One of the important findings of this research is that there was no relation between mobbing and general organizational commitment.

Keywords: mobbing, organizational commitment, affective commitment, normative commitment, continuance commitment

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Authors: Amhimmid Mohammed Saffour, Abdelkader Salama

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Filtering is a part of image enhancement techniques, it is used to enhance certain details such as edges in the image that are relevant to the application. Additionally, filtering can even be used to eliminate unwanted components of noise. Medical images typically contain salt and pepper noise and Poisson noise. This noise appears to the presence of minute grey scale variations within the image. In this paper, different filters techniques namely (Median, Wiener, Rank order3, Rank order5, and Average) were applied on CT medical images (Brain and chest). We using all these filters to remove salt and pepper noise from these images. This type of noise consists of random pixels being set to black or white. Peak Signal to Noise Ratio (PSNR), Mean Square Error r(MSE) and Histogram were used to evaluated the quality of filtered images. The results, which we have achieved shows that, these filters, are more useful and they prove to be helpful for general medical practitioners to analyze the symptoms of the patients with no difficulty.

Keywords: CT imaging, median filter, adaptive filter and average filter, MATLAB

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Authors: Sabine Pau, Sophia Volz, Emanuel Bauer, Amelie De Gregorio, Frank Reister, Wolfgang Janni, Florian Ebner

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Purpose: The umbilical cord pH is a well evaluated contributor for prediction of neonatal outcome. This study correlates nenonatal umbilical cord pH with the weekday of delivery, the time of birth as well as the staff hand over times (midwifes and doctors). Material and Methods: This retrospective study included all deliveries of a 20 year period (1994-2014) at our primary obstetric center. All deliveries with a newborn cord pH under 7,20 were included in this analysis (6929 of 48974 deliveries (14,4%)). Further subgroups were formed according to the pH (< 7,05; 7,05 – 7,09; 7,10 – 7,14; 7,15 – 7,19). The data were then separated in day- and night time (8am-8pm/8pm-8am) for a first analysis. Finally, handover times were defined at 6 am – 6.30 am, 2 pm -2.30 pm, 10 pm- 10.30 pm (midwives) and for the doctors 8-8.30 am, 4 – 4.30 pm (Monday- Thursday); 2 pm -2.30 pm (Friday) and 9 am – 9.30 am (weekend). Routinely a shift consists of at least three doctors as well as three midwives. Results: During the last 20 years, 6929 neonates were born with an umbilical cord ph < 7,20 ( < 7,05 : 7,1%; 7,05 – 7,09 : 10,9%; 7,10 – 7,14 : 30,2%; 7,15 – 7,19:51,8%). There was no significant difference between either night/day delivery (p = 0.408), delivery on different weekdays (p = 0.253), delivery between Monday to Thursday, Friday and the weekend (p = 0.496 ) or delivery during the handover times of the doctors as well as the midwives (p = 0.221). Even the standard deviation showed no differences between the groups. Conclusion: Despite an increased workload over the last 20 years, the standard of care remains high even during the handover times and night shifts. This applies for midwives and doctors. As the neonatal outcome depends on various factors, further studies are necessary to take more factors influencing the fetal outcome into consideration. In order to maintain this high standard of care, an adaption of work-load and changing conditions is necessary.

Keywords: delivery, fetal umbilical cord pH, day time, hand over times

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Authors: A. Bortkiewcz, A. Dudarewicz, P. Małecki, M. Kłaczyński, T. Wszołek, Małgorzata Pawlaczyk-Łuszczyńska

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Low-frequency noise (LFN) has been recognized as a special environmental pollutant. It is usually considered a broadband noise with the dominant content of low frequencies from 10 Hz to 250 Hz. A growing body of data shows that LFN differs in nature from other environmental noises, which are at comparable levels but not dominated by low-frequency components. The primary and most frequent adverse effect of LFN exposure is annoyance. Moreover, some recent investigations showed that LFN at relatively low A-weighted sound pressure levels (40−45 dB) occurring in office-like areas could adversely affect the mental performance, especially of high-sensitive subjects. It is well documented that high-frequency noise disturbs various types of human functions; however, there is very little data on the impact of LFN on well-being and health, including the cardiovascular system. Heart rate variability (HRV) is a sensitive marker of autonomic regulation of the circulatory system. Walker and co-workers found that LFN has a significantly more negative impact on cardiovascular response than exposure to high-frequency noise and that changes in HRV parameters resulting from LFN exposure tend to persist over time. The negative reactions of the cardiovascular system in response to LFN generated by wind turbines (20-200 Hz) were confirmed by Chiu. The scientific aim of the study is to assess the relationship between the spectral-temporal characteristics of LFN and the activity of the autonomic nervous system, considering the subjective assessment of annoyance, sensitivity to this type of noise, and cognitive and general health status. The study will be conducted in 20 male students in a special, acoustically prepared, constantly supervised room. Each person will be tested 4 times (4 sessions), under conditions of non-exposure (sham) and exposure to noise of wind turbines recorded at a distance of 250 meters from the turbine with different frequencies and frequency ranges: acoustic band 20 Hz-20 kHz, infrasound band 5-20 Hz, acoustic band + infrasound band. The order of sessions of the experiment will be randomly selected. Each session will last 1 h. There will be a 2-3 days break between sessions to exclude the possibility of the earlier session influencing the results of the next one. Before the first exposure, a questionnaire will be conducted on noise sensitivity, general health status using the GHQ questionnaire, hearing organ status and sociodemographic data. Before each of the 4 exposures, subjects will complete a brief questionnaire on their mood and sleep quality the night before the test. After the test, the subjects will be asked about any discomfort and subjective symptoms during the exposure. Before the test begins, Holter ECG monitoring equipment will be installed. HRV will be analyzed from the ECG recordings, including time and frequency domain parameters. The tests will always be performed in the morning (9-12) to avoid the influence of diurnal rhythm on HRV results. Students will perform psychological tests 15 minutes before the end of the test (Vienna Test System).

Keywords: neurovegetative control, heart rate variability (HRV), cognitive processes, low frequency noise

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Authors: S. F. Bayona, J. Nunez, D. Paez

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The diagnostic processes have been consolidated as fundamental tools in the adequate knowledge of organizations and their processes. The diagnosis is related to the interpretation of the data, findings and the relevant information, to determine problems, causes, or the simple state and behavior of a process, without including a solution to the problems detected. The objective of this work is to identify the necessary stages to diagnose the logistic processes in a metalworking company, from the literary revision of different disciplines. A total of 62 articles were chosen to identify, through bibliometric analysis, the most cited articles, as well as the most frequent authors and journals. The results allowed to identify the two fundamental stages in the diagnostic process: a primary phase (general) based on the logical subjectivity of the knowledge of the person who evaluates, and the secondary phase (specific), related to the interpretation of the results, findings or data. Also, two phases were identified, one related to the definition of the scope of the actions to be developed and the other, as an initial description of what was observed in the process.

Keywords: business, diagnostic, management, process

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Authors: Yoonah Lee, Richard Kyung

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With technological advances in the computational biomedical field, the ability to measure neurotransmitters’ chemical imbalances that affect depression and anxiety has been established. By comparing the thermodynamics stability of amino acid supplements, such as glutamine, tyrosine, phe-nylalanine, and methionine, this research analyzes mood-regulating neurotransmitters, amino acid supplements, and antipsychotic substances (ie. Reserpine molecule and CRF complexes) in relation to depression and anxiety and suggests alternative complexes that are low in energy to act as more efficient treatments for mood disorders. To determine a molecule’s thermodynamic stability, this research examines the molecular energy using Avogadro, a software for building virtual molecules and calculating optimized geometry using GAFF (General Amber Force Field) and UFF (Universal Force Field). The molecules, built using Avogadro, is analyzed using their theoretical values and atomic properties.

Keywords: amino acids, anxiety, depression, neurotransmitters

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Authors: Mihai Rebenciuc, Simona Mihaela Bibic

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Branch of modern mathematics, graphs represent instruments for optimization and solving practical applications in various fields such as economic networks, engineering, network optimization, the geometry of social action, generally, complex systems including contemporary urban problems (path or transport efficiencies, biourbanism, & c.). In this paper is studied the interconnection of some urban network, which can lead to a simulation problem of a digraph through another digraph. The simulation is made univoc or more general multivoc. The concepts of fragment and atom are very useful in the study of connectivity in the digraph that is simulation - including an alternative evaluation of k- connectivity. Rough set approach in (bi)digraph which is proposed in premier in this paper contribute to improved significantly the evaluation of k-connectivity. This rough set approach is based on generalized rough sets - basic facts are presented in this paper.

Keywords: (bi)digraphs, rough set theory, systems of interacting agents, complex systems

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Authors: Naglaa Baskhroun Thabet Wasef

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Specific education services for students with Autism remains in its early developmental stages in Egypt. In spite of many more children with autism are attending schools since The Egyptian government introduced the Education Provision for Students with Disabilities Act in 2010, the services students with autism and their families receive are generally not enough. This pointed study used Attitude and Reaction to Teach Students with Autism Scale to investigate 50 primary school teachers’ attitude and reaction to teach students with autism in the general education classroom. Statistical analysis of the data found that student behavior was the most noticeable factor in building teachers’ wrong attitudes students with autism. The minority of teachers also indicated that their service education did not prepare them to meet the learning needs of children with autism in special, those who are non-vocal. The study is descriptive and provides direction for increasing teacher awareness for inclusivity in Egypt.

Keywords: attitude, autism, teachers, sports activates, movement skills, motor skills, autism attitude

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Authors: Faith G. Ehiemua, Chandra E. Ulinfun

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This work presents two approaches that use competing models to combat criminality in human trafficking. It argues that oath-taking is an approach used to combat and repress crime by natives of African descent. Therefore, certain value choices reflected explicitly or implicitly in its habitual functioning are features of crime control, a model of the criminal process used to repress and prevent crime. By pitting the approaches against each other, the work examines the utility of the purpose of each approach with the aim of assessing moral worthiness. The approaches adopted are descriptive, normative, and theoretical. The findings reveal that oath-taking is effective in human trafficking mainly because Africans believe that the African traditional system is efficient. However, the utilitarian ethical theory applied to the use of oath-taking in human trafficking shows oath-taking as protecting the interest of human traffickers against the general good of society.

Keywords: human rights, human trafficking, oath taking, utilitarianism, victim-centered approach

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Authors: I. Ramalho, S. Campos, M. Dias

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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.

Keywords: endometriosis, histology, observational study, ovarian cancer

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Authors: J. Gabrielczyk, J. Kluitmann, T. Dammeyer, H. J. Jördening

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High-level expression of proteins in bacteria often causes production of insoluble protein aggregates, called inclusion bodies (IB). They contain mainly one type of protein and offer an easy and efficient way to get purified protein. On the other hand, proteins in IB are normally devoid of function and therefore need a special treatment to become active. Most refolding techniques aim at diluting the solubilizing chaotropic agents. Unfortunately, optimal refolding conditions have to be found empirically for every protein. For large-scale applications, a simple refolding process with high yields and high final enzyme concentrations is still missing. The constructed plasmid pASK-IBA63b containing the sequence of fructosyltransferase (FTF, EC 2.4.1.162) from Bacillus subtilis NCIMB 11871 was transformed into E. coli BL21 (DE3) Rosetta. The bacterium was cultivated in a fed-batch bioreactor. The produced FTF was obtained mainly as IB. For refolding experiments, five different amounts of IBs were solubilized in urea buffer with protein concentration of 0.2-8.5 g/L. Solubilizates were refolded with batch or continuous dialysis. The refolding yield was determined by measuring the protein concentration of the clear supernatant before and after the dialysis. Particle size was measured by dynamic light scattering. We tested the solubilization properties of fructosyltransferase IBs. The particle size measurements revealed that the solubilization of the aggregates is achieved at urea concentration of 5M or higher and confirmed by absorption spectroscopy. All results confirm previous investigations that refolding yields are dependent upon initial protein concentration. In batch dialysis, the yields dropped from 67% to 12% and 72% to 19% for continuous dialysis, in relation to initial concentrations from 0.2 to 8.5 g/L. Often used additives such as sucrose and glycerol had no effect on refolding yields. Buffer screening indicated a significant increase in activity but also temperature stability of FTF with citrate/phosphate buffer. By adding citrate to the dialysis buffer, we were able to increase the refolding yields to 82-47% in batch and 90-74% in the continuous process. Further experiments showed that in general, higher ionic strength of buffers had major impact on refolding yields; doubling the buffer concentration increased the yields up to threefold. Finally, we achieved corresponding high refolding yields by reducing the chamber volume by 75% and the amount of buffer needed. The refolded enzyme had an optimal activity of 12.5±0.3 x104 units/g. However, detailed experiments with native FTF revealed a reaggregation of the molecules and loss in specific activity depending on the enzyme concentration and particle size. For that reason, we actually focus on developing a process of simultaneous enzyme refolding and immobilization. The results of this study show a new approach in finding optimal refolding conditions for inclusion bodies at high concentrations. Straightforward buffer screening and increase of the ionic strength can optimize the refolding yield of the target protein by 400%. Gentle removal of chaotrope with continuous dialysis increases the yields by an additional 65%, independent of the refolding buffer applied. In general time is the crucial parameter for successful refolding of solubilized proteins.

Keywords: dialysis, inclusion body, refolding, solubilization

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Authors: Georgiana Ciobotaru

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The vocabulary that foreign students assimilate once they start studying the Romanian language must allow them to develop the linguistic competence of oral and written expression, but also the intercultural one, necessary for their integration into the new socio-cultural environment. Therefore, the familiarization courses with Romanian as a foreign language aim at fundamental language acquisitions in order to obtain the expected level of Romanian language. They also relate differently to the new culture and the new language they come in contact with, having a distinct way of expressing themselves. Foreign students want to continue their university and postgraduate studies at specialized faculties in the country; therefore, they need both a general language for their integration into society and for interaction with others, Romanians or students from countries other than their own, but also from a specialized language that facilitates didactic communication and professional development. The complexity of the vocabulary must thus cover the daily communication needs, but also the subsequent evolution of each one. This paper aims to illustrate the most important semantic fields that students must assimilate in order to crystallize a linguistic identity in the new context of their personal and professional development and to help them cope with the culture shock.

Keywords: integration, intercultural, language, linguistic, vocabulary

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Authors: Angelis P. Barlampas

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PURPOSE: Presentation of an interesting finding in an asymptomatic patient. MATERIAL: A patient came at hospital because of dysuric complaints and after a urologist’s prescription of a US exam of the urogenital system. The simple ultrasound examination of the lower abdomen revealed a moderate hypertrophy of the prostate and a solitary large bladder stone. The kidneys were normal. Then, the patient underwent a CT scan, which depicted the bladder stone and, as an incidental finding, a cystic lesion in contact with the upper anterior right surface of the bladder, with mural calcifications. METHOD: Abdominal ultrasound and abdominal computed tomography before and after intravenous contrast administration. RESULTS: The repeated US exam showed a cylindrical cystic lesion with a double wall and two mural hyperechoic foci, with partial posterior shadowing. Blood flow was not recognized on color doppler. The CT exam confirmed the cystic-like anechoic lesion, in the right iliac fossa, with the presence of two foci of mural calcifications. The differential diagnosis includes cases of enteric cyst, intestinal duplication cyst, chronic abscess, urachal cyst, Meckel's diverticulum, bladder diverticulum, old hematoma, thrombosed vascular aneurysm, diverticular abscess, etc. The patient refused surgical removal and is being monitored by ultrasound. CONCLUSIONS: The careful examination of the wider peri-abdominal area, especially during the routine ultrasound examination, can contribute to the identification of important asymptomatic findings. The radiologist must not be solely focused in a certain area of examination, even if the clinical doctor asks so, but should give attention to the neighboring areas, too.

Keywords: enteric cyst, US, CT, urogenital tract, miscellaneous findings

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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Authors: D. Pinto, L. Castro, M. L. Cruzat, S. Barros, J. Gironás, C. Oberli, M. Torres, C. Escauriaza, A. Cipriano

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Flash floods, together with landslides, are a common natural threat for people living in mountainous regions and foothills. One way to deal with this constant menace is the use of Early Warning Systems, which have become a very important mitigation strategy for natural disasters. In this work, we present our proposal for a pilot Flash Flood Early Warning System for Santiago, Chile, the first stage of a more ambitious project that in a future stage shall also include early warning of landslides. To give a context for our approach, we first analyze three existing Flash Flood Early Warning Systems, focusing on their general architectures. We then present our proposed system, with main focus on the decision support system, a system that integrates empirical models and fuzzy expert systems to achieve reliable risk estimations.

Keywords: decision support systems, early warning systems, flash flood, natural hazard

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Authors: Giriraj Achari, Malay Bhattacharyya

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In this paper, the effectiveness of Copula Markov Switching Multifractal (MSM) models at forecasting Value-at-Risk of a two-stock portfolio is studied. The innovations are allowed to be drawn from distributions that can capture skewness and leptokurtosis, which are well documented empirical characteristics observed in financial returns. The candidate distributions considered for this purpose are Johnson-SU, Pearson Type-IV and α-Stable distributions. The two univariate marginal distributions are combined using the Student-t copula. The estimation of all parameters is performed by Maximum Likelihood Estimation. Finally, the models are compared in terms of accurate Value-at-Risk (VaR) forecasts using tests of unconditional coverage and independence. It is found that Copula-MSM-models with leptokurtic innovation distributions perform slightly better than Copula-MSM model with Normal innovations. Copula-MSM models, in general, produce better VaR forecasts as compared to traditional methods like Historical Simulation method, Variance-Covariance approach and Copula-Generalized Autoregressive Conditional Heteroscedasticity (Copula-GARCH) models.

Keywords: Copula, Markov Switching, multifractal, value-at-risk

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

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Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix

Abstract:

In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.

Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference

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Authors: Nora Yusma Bte Mohamed Yusoff, Hussain Ali Bekhet

Abstract:

The rationalization of a gradual subsidies reforms plan has been set out by the Malaysian government to achieve the high-income nation target. This paper attempts to analyze the impacts of energy subsidy reform policy on fiscal deficit and macroeconomics variables in Malaysia. The Computable General Equilibrium (CGE) Model is employed. Three simulations based on different groups of scenarios have been developed. Importantly, the overall results indicate that removal of fuel subsidy has significantly improved the real GDP and reduced the government fiscal deficit. On the other hand, the removal of the fuel subsidy has increased most of the local commodity prices, especially energy commodities. The findings of the study could provide some imperative inputs for policy makers, especially to identify the right policy mechanism. This is especially ensures the subsidy savings from subsidy removal could be transferred back into the domestic economy in the form of infrastructure development, compensation and increases in others sector output contributions towards a sustainable economic growth.

Keywords: CGE, deficit, energy, reform, subsidy

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Authors: A. Falenski, A. Kaesbohrer, M. Filter

Abstract:

Introduction: Risk assessments can be performed in various ways and in different degrees of complexity. In order to assess risks associated with imported foods additional information needs to be taken into account compared to a risk assessment on regional products. The present review is an overview on currently available best practise approaches and data sources used for food import risk assessments (IRAs). Methods: A literature review has been performed. PubMed was searched for articles about food IRAs published in the years 2004 to 2014 (English and German texts only, search string “(English [la] OR German [la]) (2004:2014 [dp]) import [ti] risk”). Titles and abstracts were screened for import risks in the context of IRAs. The finally selected publications were analysed according to a predefined questionnaire extracting the following information: risk assessment guidelines followed, modelling methods used, data and software applied, existence of an analysis of uncertainty and variability. IRAs cited in these publications were also included in the analysis. Results: The PubMed search resulted in 49 publications, 17 of which contained information about import risks and risk assessments. Within these 19 cross references were identified to be of interest for the present study. These included original articles, reviews and guidelines. At least one of the guidelines of the World Organisation for Animal Health (OIE) and the Codex Alimentarius Commission were referenced in any of the IRAs, either for import of animals or for imports concerning foods, respectively. Interestingly, also a combination of both was used to assess the risk associated with the import of live animals serving as the source of food. Methods ranged from full quantitative IRAs using probabilistic models and dose-response models to qualitative IRA in which decision trees or severity tables were set up using parameter estimations based on expert opinions. Calculations were done using @Risk, R or Excel. Most heterogeneous was the type of data used, ranging from general information on imported goods (food, live animals) to pathogen prevalence in the country of origin. These data were either publicly available in databases or lists (e.g., OIE WAHID and Handystatus II, FAOSTAT, Eurostat, TRACES), accessible on a national level (e.g., herd information) or only open to a small group of people (flight passenger import data at national airport customs office). In the IRAs, an uncertainty analysis has been mentioned in some cases, but calculations have been performed only in a few cases. Conclusion: The current state-of-the-art in the assessment of risks of imported foods is characterized by a great heterogeneity in relation to general methodology and data used. Often information is gathered on a case-by-case basis and reformatted by hand in order to perform the IRA. This analysis therefore illustrates the need for a flexible, modular framework supporting the connection of existing data sources with data analysis and modelling tools. Such an infrastructure could pave the way to IRA workflows applicable ad-hoc, e.g. in case of a crisis situation.

Keywords: import risk assessment, review, tools, food import

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Authors: Chih Chin Yang, Chung Shan Sun

Abstract:

In this paper, the relationships between professional competences and school curricula in IC design industry are explored. The semi-structured questionnaire survey and focus group interview is the research method. Study participants are graduates of microelectronics engineering professional departments who are currently employed in the IC industry. The IC industries are defined as the electronic component manufacturing industry and optical-electronic component manufacturing industry in the semiconductor industry and optical-electronic material devices, respectively. Study participants selected from IC design industry include IC engineering and electronic & semiconductor engineering. The human training with IC design professional competence in microelectronics engineering professional departments is explored in this research. IC professional competences of human resources in the IC design industry include general intelligence and professional intelligence.

Keywords: IC design, curricula, competence, task, duty

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Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

Abstract:

Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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Authors: Mohammad Saeed Bahramy

Abstract:

Transition metal dichalcogenides have experienced a resurgence of interest in the past few years owing to their rich properties, ranging from metals and superconductors to strongly spin-orbit-coupled semiconductors and charge-density-wave systems. In all these cases, the transition metal d-electrons mainly determine the ground state properties. This presentation focuses on the chalcogen-derived states. Combining density-functional theory calculations with spin- and angle-resolved photoemission, it is shown that these states generically host a coexistence of type I and type II three-dimensional bulk Dirac fermions as well as ladders of topological surface states and surface resonances. It will be discussed how these naturally arise within a single p-orbital manifold as a general consequence of a trigonal crystal field, and as such can be expected across many compounds. Our finding opens a new route to design topological materials with advanced functionalities.

Keywords: topology, electronic structure, Dirac semimetals, transition metal dichalcogenides

Procedia PDF Downloads 171