Search results for: armed forces general hospital

Authors: Anu S. Krishna

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The paper tries to analyse the UN involvement/intervention in the case of intra-state armed conflict of El Salvador and Nepal comparatively. The peace mission in El Salvador is considered to be the most successful missions of UN ever since it started involving in the peace-building activities. Meanwhile, in the armed conflict of South Asian country, Nepal, the result seemed to be disappointing in comparison with its counterpart. The study on this paper takes three variables as the success or failure of international mediation, i.e., a) signing of the peace agreement, b) disarmament/demobilization and c) constitutional mechanism. A significant amount of scholarship looks at the case of ONUSAL (United Nations Mission in El Salvador). Meanwhile, the armed conflict of Nepal and the role of UNMIN (United Nations Mediation in Nepal) are under researched so far. The paper thus tries to throw light on these cross-regional contexts that share certain similarities and dissimilarities in the nature of conflict. In addition, the international third-party involvement and their way of approaching both the cases differ, which again affected the mediation outcome. The paper tries to argue that, since the approach of the UN led international mediation in theses peace missions were contextual and varied from case to case, thus, finally affected the mediation outcome too.

Keywords: Nepal, UNMIN, El Salvador, ONUSAL, international mediation, armed conflict

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Authors: Halilu Babaji, Adamu Buba

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Illicit arms and the emergence of armed groups have witnessed unprecedented situations of political uncertainties in Nigeria, and the twenty-first century globalisation has established the process that has benefited a good number of militia groups and thereby boosting both illicit arms movement and the thriving of terrorist groups, which are largely responsible for the longstanding threat to the national security and stability of the country. This has unleashed unforeseen consequences on the entire Sub-region, following an inflow of weapons and armed fighter which are motivated by weak governance, insecurity and poverty. The social, economic and political environments make it a fertile breeding ground for the penetration and development of terrorist groups in Sub-Saharan Africa.

Keywords: arms, emergence, insecurity, groups

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Authors: Edmilson Nhambe, Belisario Machaieie

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Since the signing of the General Peace Agreement-GPA in 1992, Mozambique has seen successive setbacks in the search for effective peace, civil war, social conflicts, terrorism, and armed conflicts mix the reality of Mozambican democracy. The article seeks to understand the dynamics of conflict and peace in Mozambique. Specifically, it seeks to analyze the structural factors that lead to (violent) conflict situations and the factors that favor or promote peace. For this purpose, desk research was chosen to analyze studies of peace and conflict. This article develops the argument that the non-violation of the peace agreement, in particular the GPA in Rome, as it had a structuring effect on the Mozambican political system, no longer guarantees in itself the irreversibility of the pacification process. In fact, the country is currently stagnating in the category of a fragile peace process with the risk of slipping into a situation of war or open armed conflict.

Keywords: peace, conflict, GPA, instability

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Authors: Shivam Dwivedi, Saumya Kapoor

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The Israeli Supreme Court in Public Committee against Torture in Israel v. Government of Israel observed the presence of non-state actors in cross-border terrorist activities thereby making the role of non-state actors in terrorism the center of discussion under the scope of International Humanitarian Law. Non-state actors and their role in a conflict have also been traversed upon by the Tadic case decided by the International Criminal Tribunal for the former Yugoslavia. However, there still are lacunae in International Humanitarian Law when it comes to determining the nature of a conflict, especially when non-state groups act within the ambit of various states, for example, Taliban in Afghanistan or the groups operating in Ukraine and Georgia. Thus, the objective of writing this paper would be to observe the ways by which non-state actors particularly terrorist organizations could be brought under the ambit of Additional Protocol I. Additional Protocol I is a 1977 amendment protocol to the Geneva Conventions relating to the protection of victims of international conflicts which basically outlaws indiscriminate attacks on civilian populations, forbids conscription of children and preserves various other human rights during the war. In general, the Additional Protocol I reaffirms the provisions of the original four Geneva Conventions. Since provisions of Additional Protocol I apply only to cases pertaining to International Armed Conflicts, the answer to the problem should lie in including the scope for ‘transnational armed conflict’ in the already existing definition of ‘International Armed Conflict’ within Common Article 2 of the Geneva Conventions. This would broaden the applicability of the provisions in cases of non-state groups and render an international character to the conflict. Also, the non-state groups operating or appearing to operate should be determined by the test laid down in the Nicaragua case by the International Court of Justice and not under the Tadic case decided by the International Criminal Tribunal for Former Yugoslavia in order to provide a comprehensive system to deal with such groups. The result of the above proposal, therefore, would enhance the scope of the application of International Humanitarian Law to non-state groups and individuals.

Keywords: Geneva Conventions, International Armed Conflict, International Humanitarian Law, non-state actors

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Authors: Kenneth Azaigba

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The history of post-colonial African States has been dubbed a history of endemic warfare in existing literature. Indeed, Africa political environment is characterized by a multiplicity of threats to peace and security. Africa's leading drivers of conflict include abundant (especially mineral) resources, personal rule and attendant political authoritarianism, manipulation of identity politics across ethnicity, marginalization of communities, as well as electoral mal-practices resulting in contested legitimacy and resultant violence. However, the character of armed conflicts in Africa is changing. This paper attempts to reconstruct the trajectory of armed conflicts in Africa and explain the changing pattern of armed conflict. The paper contends that large scale political violence in Africa is on the decline rendering the endemic thesis an inappropriate paradigm in explaining political conflicts in Africa. The paper also posits that though small scale conflicts are springing up and exhibiting trans-border dimensions, these patterns of armed conflicts are not peculiar to Africa but emerging waves of global conflicts. The paper explains that the shift in the scale of warfare in Africa is a function of a multiplicity of post-cold war global contradictions. Inclusive governance, social justice and economic security are articulated as workable panaceas for mitigating warfare in Africa.

Keywords: Africa, conflicts, pattern, war

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Authors: Deyadeen Ali Alshibani

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In the literature, the multi-armed bandit problem as a statistical decision model of an agent trying to optimize his decisions while improving his information at the same time. There are several different algorithms models and their applications on this problem. In this paper, we evaluate the Regret-regression through comparing with Q-learning method. A simulation on determination of optimal treatment regime is presented in detail.

Keywords: optimal, bandit problem, optimization, dynamic programming

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Authors: Preeti Madan, Shalini Malhotra, Nirmaljit Kaur, Charoo Hans, VK Sabarwal

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Hospital is one of the most diverse and complex institutions frequented by people from every walk of life without any distinction between age, sex, gender, religion or intellect. This is over and above the normal inhabitant of hospital i.e. doctors, patients, and paramedical staff. The hospital waste generated 85% is non hazardous, 10% infectious and around 5% are non-infectious but hazardous waste. The management of biomedical waste is still in its infancy. There is a lot of confusion with the problems among the generators, operators, decision makers, and general community about the safe management of biomedical waste prompt action initiated to seek new scientific, safe, and cost-effective management of waste.

Keywords: biomedical waste, nosocomial infection, waste management, hospitals

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Authors: S. Ali Ashrafizadeh, M. Amidpour, N. Hedayat

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Driving forces along with transfer coefficient affect on heat transfer rate, on the other hand, with regard to the relation of these forces with irriversibilities they are effective on exergy losses. Therefore, the driving forces can be used as a relation between heat transfer rate, transfer coefficients and exergy losses. In this paper, first, the relation of the exergetic efficiency and resistant forces is obtained, next the relation between exergy efficiency, relative driving force, heat transfer rate and heat resistances is considered. In all cases, results are argued graphically. Finally, a case study inspected by obtained results.

Keywords: heat transfer, exergy losses, exergetic efficiency, driving forces

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Authors: Hashem Al Argha

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Cerebral Aneurysms are the ballooning and defect that occurs in the arteries of the brain. This ballooning might enlarge in size due to mechanical forces and could lead to rupture and death. Computational Fluid Dynamics has been used in the recent years in creating a link between engineering sciences and medical sciences. In this paper, the effects of mechanical forces on cerebral aneurysms will be studied. Results of this study show that mechanical forces could lead to rupture of the aneurysm and could lead to death. High mechanical forces including stresses up to 1.7 MPa could pop aneurysms and lead to a brain hemorrhage.

Keywords: computational fluid dynamics, numerical, aneurysm, mechanical forces

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Authors: Wisit Wichitkosoom

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Objectives: To find out the more effect of early cardiologist consultation using a simple technology on the diagnosis and early proper management of patients with Non-STEMI at emergency department of district hospitals without cardiologist on site before transferred. Methods: A cohort study was performed in Udonthani general hospital at Udonthani province. From 1 October 2012–30 September 2013 with 892 patients diagnosed with Non-STEMI. All patients mean aged 46.8 years of age who had been transferred because of Non-STEMI diagnosed, over a 12 week period of studied. Patients whose transferred, in addition to receiving proper care, were offered a cardiologist consultation with average time to Udonthani hospital 1.5 hour. The main outcome measure was length of hospital stay, mortality at 3 months, inpatient investigation, and transfer rate to the higher facilitated hospital were also studied. Results: Hospital stay was significantly shorter for those didn’t consult cardiologist (hazard ratio 1.19; approximate 95% CI 1.001 to 1.251; p = 0.039). The 136 cases were transferred to higher facilitated hospital. No statistically significant in overall mortality between the groups (p=0.068). Conclusions: Early cardiologist consultant can reduce length of hospital stay for patients with cardiovascular conditions outside of cardiac center. The new basic technology can apply for the safety patient.

Keywords: critical, telemedicine, safety, non STEMI

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Authors: Nur Faridatull Syafinaz Ahmad Tajudin

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A hospital is a setting where individuals who are ill or injured are treated and cared for by doctors and nurses. Sanatoriums are settings where people can receive treatment and rest, particularly when recovering from a protracted illness. According to the report, hospitals are primarily designed to meet the needs of medical personnel by maximising their functionality and workflow. Hospitals frequently do a poor job of determining the patients' physical and emotional requirements and expectations. The literature on hospital design has recently focused more on the seeming need to "humanise" medical facilities. Despite the popularity of this design objective, "humanising" a space has hardly ever been defined or critically examined. The term "humanistic design" covered a broad range of design elements and designer interpretations. In reality, the hospital's layout and design the hospital may have a massive effect on patients' feel experience things and heal.

Keywords: hospital retrofitting, hospital design, humanising hospital, spatial design

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Authors: Blanka Havlickova

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In the last ten years, there are growing numbers of troops with machine guns serving on streets of European cities. We can see them around government buildings, major transport hubs, synagogues, galleries and main tourist landmarks. As the main purpose of armed soldier’s presence in European cities authorities declare the prevention of terrorist attacks and psychological support for tourists and domestic population. The main objective of the following study is to find out whether the deployment of armed soldiers in European cities has a calming and reassuring effect on Czech citizens (if the presence at armed soldiers make the Czech population feel more secure) or rather becomes a stress factor (the presence of soldiers standing guard in full military fatigues recalls serious criminality and terrorist attacks which are reflected in the fears and insecurity of Czech population). The initial hypothesis of this study is connected with the priming theory, the idea that when we are exposed to an image (armed soldier), it makes us unconsciously focus on a topic connected with this image (terrorism). This paper is based on a quantitative public survey, which was carried out in the form of electronic questioning among the citizens of the Czech Republic. Respondents answered 14 questions about two European cities – London and Paris. Besides general questions investigating the respondents' awareness of these cities, some of the questions focused on the fear that the respondents had when picturing themselves leaving next Monday for the given city (London or Paris). The questions asking about respondent´s travel fears and concerns were accompanied by different photos. When answering the question about fear some respondents have been presented with a photo of Westminster Palace and the Eiffel with ordinary citizens while other respondents have been presented with a picture of the Westminster Palace, the and Eiffel's tower not only with ordinary citizens, but also with one soldier holding a machine gun. The main goal of this paper is to analyse and compare data about concerns for these two groups of respondents (presented with different pictures) and find out if and how an armed soldier with a machine gun in front of the Westminster Palace or the Eiffel Tower affects the public's concerns about visiting the site. In other words, the aim of this paper is to confirm or rebut the hypothesis that the look at a soldier with a machine gun in front of the Eiffel Tower or the Westminster Palace automatically triggers the association with a terrorist attack leading to an increase in fear and insecurity among Czech population.

Keywords: terrorism, security measures, priming, risk perception

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Authors: Ahmed Hamza Yache

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The main purpose of this study is to estimate the distribution of shear forces in building structures with asymmetries in the plan submitted to seismic forces can cause, in this case, simultaneous deformations of translation and torsion. To this end, the distribution of shear forces is obtained by seismic forces calculated from the equivalent static method of the Algerian earthquake code RPA 99 (2003 version) and spectral modal analysis for an irregular building plan without kinks. Comparison of the results obtained by these two methods used to highlight the difference in terms of distributions of shear forces in such structures.

Keywords: structure, irregular, code, seismic, method, force, period

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Authors: Anjelika Kremer, Irina Nachimov, Dan Justo

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Background: C-reactive protein (CRP) serum levels are commonly measured in hospitalized patients. Elevated admission CRP serum levels and in-hospital mortality has been seldom studied in the general population of elderly patients admitted to the acute Geriatrics department. Methods: A retrospective cross-sectional study was conducted at a tertiary medical center. Included were all elderly patients (age 65 years or more) admitted to a single acute Geriatrics department from the emergency room between April 2014 and January 2015. CRP serum levels were measured routinely in all patients upon the first 24 hours of admission. A logistic regression analysis was used to study if admission CRP serum levels were associated with in-hospital mortality independent of age, gender, functional status, and co-morbidities. Results: Overall, 498 elderly patients were included in the analysis: 306 (61.4%) female patients and 192 (38.6%) male patients. The mean age was 84.8±7.0 years (median: 85 years; IQR: 80-90 years). The mean admission CRP serum levels was 43.2±67.1 mg/l (median: 13.1 mg/l; IQR: 2.8-51.7 mg/l). Overall, 33 (6.6%) elderly patients died during the hospitalization. A logistic regression analysis showed that in-hospital mortality was independently associated with history of stroke (p < 0.0001), heart failure (p < 0.0001), and admission CRP serum levels (p < 0.0001) – and to a lesser extent with age (p = 0.042), collagen vascular disease (p=0.011), and recent venous thromboembolism (p=0.037). Receiver operating characteristic (ROC) curve showed that admission CRP serum levels predict in-hospital mortality fairly with an area under the curve (AUC) of 0.694 (p < 0.0001). Cut-off value with maximal sensitivity and specificity was 19.7 mg/L. Conclusions: Admission CRP serum levels may be used to predict in-hospital mortality in the general population of elderly patients admitted to the acute Geriatrics department.

Keywords: c-reactive protein, elderly, mortality, prediction

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Authors: Matthew Pleshaw, Caroline Lynch, Caleb Eaton, Ali Kiapour

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The problem addressed in this proposal is that of the lacking comfort and safety of inpatient rooms, specifically at Boston Children’s Hospital, with the implementation of a system that will allow inpatient children to feel more comfortable in the unfamiliar environment of a hospital. The focus is that of advancing and enhancing the healing process for children in a long-term inpatient stay at the hospital, though a combination of announcing a clinician or hospital staff’s arrival utilizing RFID (Fig. 1), and improving communication between clinicians, parents/guardians, patients, etc. by integrating a mobile application.

Keywords: Pediatrics, Hospital, RFID, Technology

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Authors: Alessandro Falconieri, Sara De Vincentiis, Vittoria Raffa

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Mechanical force regulates axonal growth, elongation and maturation processes. This force is opening new frontiers in the field, contributing to a general understanding of the mechanisms of axon growth that, in the past, was thought to be governed exclusively by the growth cone and its ability to influence axonal growth in response to chemical signals. A method recently developed in our laboratory allows, through the labeling of neurons with magnetic nanoparticles (MNPs) and the use of permanent magnets, to apply extremely low mechanical forces, similar to those generated endogenously by the growth cone or by the increase of body mass during the organism growth. We found that these extremely low forces strongly enhance the spontaneous axonal elongation rate as well as neuronal sprouting. Data obtained don’t exclude that local phenomena, such as local transport and local translation, may be involved. These new advances could shed new light on what happens when the cell is subjected to external mechanical forces, opening new interesting scenarios in the field of mechanobiology.

Keywords: axon, external mechanical forces, magnetic nanoparticles, mechanotransduction

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Authors: Surendra Mund

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At the beginning, the physical entity force was defined mathematically by Sir Isaac Newton in his Principia Mathematica as F ⃗=(dp ⃗)/dt in form of his second law of motion. Newton also defines his Universal law of Gravitational force exist in same outstanding book, but at the end of 20th century and beginning of 21st century, we have tried a lot to specify and unify four or five Fundamental forces or Interaction exist in universe, but we failed every time. Usually, Gravity creates problems in this unification every single time, but in my previous papers and presentations, I defined and derived Field and force equations for Gravitational like Interactions for each and every kind of central systems. This force is named as Variational Force by me, and this force is generated by variation in the scalar field density around the body. In this particular paper, at first, I am specifying which type of Interactions are Fundamental in Universal sense (or in all type of central systems or bodies predicted by my N-time Inflationary Model of Universe) and then unify them in Universal framework (defined and derived by me as Universal Mechanics in a separate paper) as well. This will also be valid in Universal dynamical sense which includes inflations and deflations of universe, central system relativity, Universal relativity, ϕ-ψ transformation and transformation of spin, physical perception principle, Generalized Fundamental Dynamical Law and many other important Generalized Principles of Generalized Quantum Mechanics (GQM) and Central System Theory (CST). So, In this article, at first, I am Generalizing some Fundamental Principles, and then Unifying Variational Forces (General form of Gravitation like Interactions) and Flow Generated Force (General form of EM like Interactions), and then Unify all Fundamental Forces by specifying Weak and Strong Interactions in form of more basic terms - Variational, Flow Generated and Transformational Interactions.

Keywords: Central System Force, Disturbance Force, Flow Generated Forces, Generalized Nuclear Force, Generalized Weak Interactions, Generalized EM-Like Interactions, Imbalance Force, Spin Generated Forces, Transformation Generated Force, Unified Force, Universal Mechanics, Uniform And Non-Uniform Variational Interactions, Variational Interactions

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Authors: Lotsmart Fonjong

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The livelihood of rural communities in the West African state of Cameroon, which is largely dictated by natural forces (rainfall, temperatures, and soil), is today threatened by climate change and armed conflict. This paper investigates the extent to which rural communities are aware of climate change, how their perceptions of changes across different agro-ecological zones have impacted farming practices, output, and lifestyles, on the one hand, and the extent to which local armed conflicts are confounding their efforts and adaptation abilities. The paper is based on a survey conducted among small farmers in selected localities within the forest and savanna ecological zones of the conflict-ridden Northwest and Southwest Cameroon. Attention is paid to farmers’ gender, scale, and type of farming. Farmers’ perception of/and response to climate change are analysed alongside local rainfall and temperature data and mobilization for climate justice. Findings highlight the fact that farmers’ perception generally corroborates local climatic data. Climatic instability has negatively affected farmers’ output, food prices, standards of living, and food security. However, the vulnerability of the population varies across ecological zones, gender, and crop types. While these factors also account for differences in local response and adaptation to climate change, ongoing armed conflicts in these regions have further complicated opportunities for climate-driven agricultural innovations, inputs, and exchange of information among farmers. This situation underlines how poor communities, as victims, are forced into many complex problems outsider their making. It is therefore important to mainstream farmers’ perceptions and differences into policy strategies that consider both climate change and Anglophone conflict as national security concerns foe sustainable development in Cameroon.

Keywords: adaptation policies, climate change, conflict, small farmers, cameroon

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Authors: Elif Bakkaloglu, Necdet Torunbalci

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The fact of earthquakes in Turkiye is an inevitable natural disaster. Therefore, buildings must be prepared for this natural hazard. Especially in hospital buildings, earthquake resistance is an essential point because hospitals are one of the first places where people come after an earthquake. Although hospital buildings are more suitable for horizontal architecture, it is necessary to construct and expand multi-storey hospital buildings due to difficulties in finding suitable places as a result of excessive urbanization, difficulties in obtaining appropriate size land and decrease in suitable places and increase in land values. In Turkiye, using seismic isolators in public hospitals, which are placed in first-degree earthquake zone and have more than 100 beds, is made obligatory by general instruction. As a result of this decision, it may sometimes be necessary to construct seismic isolated multi-storey hospital buildings in cities where those problems are experienced. Although widespread use of seismic isolators in Japan, there are few multi-storey buildings in which seismic isolators are used in Turkiye. As it is known, base isolation systems are the most effective methods of earthquake resistance, as number of floors increases, center of gravity moves away from base in multi-storey buildings, increasing the overturning effect and limiting the use of these systems. In this context, it is aimed to investigate structural systems of multi-storey buildings which built using seismic isolation methods in the World. In addition to this, a working principle is suggested for disseminating seismic isolators in multi-storey hospital buildings. The results to be obtained from the study will guide architects who design multi-storey hospital buildings in their architectural designs and engineers in terms of structural system design.

Keywords: earthquake, energy absorbing systems, hospital, seismic isolation systems

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Authors: Sani Mohammed Adam

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This work seeks to review the security challenges facing Nigeria and explore the relevance of laws and policies in tackling the menace. The work looks at the adequacy of available legislations and the functionality of relevant institutions such as the Armed Forces, the Nigeria Police Force, the State Security Service, the Defence Intelligence Agency and the Nigerian Intelligence Agency etc. Comparisons would be made with other jurisdictions, such as inter alia, the Homeland Security in the USA and Counter Terrorism Laws of the United Kingdom. Recommendations would be made on how to strengthen both institutions and laws to curtail the growth of Terrorism in Nigeria.

Keywords: legislations, Nigeria, security, terrorism

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Authors: Rahimah Abdulrahman, A. Eardle, Wilfred Alan, Abdel Hamid Soliman

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With the rapid development in technology, and advances in learning technologies, m-learning has begun to occupy a great part of our lives. The pace of the life getting together with the need for learning started mobile learning (m-learning) concept. In 2008, Saudi Arabia requested a national plan for the adoption of information technology (IT) across the country. Part of the recommendations of this plan concerns the implementation of mobile learning (m-learning) as well as their prospective applications to higher education within the Kingdom of Saudi Arabia. The overall aim of the research is to explore the main issues that impact the deployment of m-learning in nursing institutes in Saudi Arabia, at the Armed Force Hospitals (AFH), Alhada. This is in order to be able to develop a generic model to enable and assist the educational policy makers and implementers of m-learning, to comprehend and treat those issues effectively. Specifically, the research will explore the concept of m-learning; identify and analyse the main organisational; technological and cultural issue, that relate to the adoption of m-learning; develop a model of m-learning; investigate the perception of the students of the Nursing Institutes to the use of m-learning technologies for their nursing diploma programmes based on their experiences; conduct a validation of the m-learning model with the use of the nursing Institute of the AFH, Alhada in Saudi Arabia, and evaluate the research project as a learning experience and as a contribution to the body of knowledge. Activity Theory (AT) will be adopted for the study due to the fact that it provides a conceptual framework that engenders an understanding of the structure, development and the context of computer-supported activities. The study will be adopt a set of data collection methods which engage nursing students in a quantitative survey, while nurse teachers are engaged through in depth qualitative studies to get first-hand information about the organisational, technological and cultural issues that impact on the deployment of m-learning. The original contribution will be a model for developing m-learning material for classroom-based learning in the nursing institute that can have a general application.

Keywords: activity theory (at), mobile learning (m-learning), nursing institute, Saudi Arabia (sa)

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Authors: A. Wahid Uddin

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Obstetric anal sphincter injury carries significant morbidity for a woman and affects the quality of life to the extent of permanent damage to anal sphincter musculature. The study was undertaken in a district general hospital by retrospectively reviewing random 63 case notes of patients diagnosed with a significant third or fourth-degree perineal tear admitted between the year of 2015 to 2018. The observations were collected by a pre-designed questionnaire. All variables were expressed as percentages. The major risk factors noted were nulliparity (37%), instrumental delivery (25%), and birth weight of more than 4 kg (14%). Forceps delivery with or without episiotomy was the major contributing factor (75%). In the majority of the cases (71%), no record of any perineal protection measures undertaken. The study concluded that recommended perineal protection measures should be adopted as a routine practise.

Keywords: forceps, obstetrics, perineal, sphincter

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Authors: Ibrahim Elnour Abdelrahman Eltayeb

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Computational modelling is a method used to investigate joint forces during a movement. It can get high accuracy in the joint forces via subject-specific models. However, the construction of subject-specific models remains time-consuming and expensive. The purpose of this paper was to identify what alterations we can make to generic computational models to get a better estimation of the joint forces. It appraised the impact of these alterations on the accuracy of the estimated joint forces. It found different strategies of alterations: joint model, muscle model, and an optimisation problem. All these alterations affected joint contact force accuracy, so showing the potential for improving the model predictions without involving costly and time-consuming medical images.

Keywords: joint force, joint model, optimisation problem, validation

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Authors: Abdulrahman H. Alrashidi

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Kuwait Oil Company provides health care services through Ahmadi hospital for oil sector employee and their families. Due to increasing number of entitled patients in Ahmadi hospital, the company starts health insurance option in 2010. In addition, a new Ahmadi hospital decided to build to accumulate all entitled patients. Operation and management of new Ahmadi hospital investigated in this research. In order to maintain the high quality of medical services and satisfaction rate among oil sector community and reducing the operation cost. Six operation and management options evaluated in order to implement in new Ahmadi hospital. Qualitative Risk assessment method used to investigate proposed options for operation and management of new Ahmadi hospital. Evaluation criteria consist of quality of medical services, operation cost and satisfaction rate among oil sector community. Results show that using the same operation and management system in existing Ahmadi hospital with new Ahmadi hospital will bring cost higher. This approach brings risk to KOC. Results from risk assessment show that partially operated new Ahmadi hospital is the best opportunity to meet the objectives of KOC’s medical group.

Keywords: Kuwait Oil Company, new Ahmadi hospital, operation and management, risk assessment

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

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

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

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Authors: Saba Ebrahimi, Saeed Ahmadian, Hedie Ashrafi

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World-wide spread of coronavirus grows the concern about planning for the excess demand of hospital services in response to COVID-19 pandemic. The surge in the hospital services demand beyond the current capacity leads to shortage of ICU beds and ventilators in some parts of US. In this study, we forecast the required number of hospital beds and possible shortage of beds in US during COVID-19 pandemic to be used in the planning and hospitalization of new cases. In this paper, we used a data on COVID-19 deaths and patients’ hospitalization besides the data on hospital capacities and utilization in US from publicly available sources and national government websites. we used a novel ensemble modelling of deep learning networks, based on stacking different linear and non-linear layers to predict the shortage in hospital beds. The results showed that our proposed approach can predict the excess hospital beds demand very well and this can be helpful in developing strategies and plans to mitigate this gap.

Keywords: COVID-19, deep learning, ensembled models, hospital capacity planning

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Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

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Authors: Getachew Belay, Getachew Kahsu, Brhane Berhe, Kebede Tesfay, Fitsum Mardu, Nigus Shishay, Hadush Negash, Aster Tsegaye

Abstract:

Background: Malaria kills million people around the world, and it is still a serious public health problem in Ethiopia. Over the past years, the disease has been consistently reported as leading cause of outpatient visits, hospitalization and death in health facilities across the country. This study assessed malaria trend in Humera Town Kahsay Abera Hospital Tigrai region, Northern Ethiopia. Method: A Health facility retrospective cross sectional study was conducted in Kahsay Abera General Hospital from January 2011 to December 2019. Data of Malaria cases were reviewed from Health Management Information System with the help of experts in the office. The nine year data were extracted and analyzed using Excel by excluding those which lack demographic data. Result: A total of 36,604 smear positive malaria cases were confirmed in last nine years in the study area. Plasmodim falcifarum was the most prevalent reported species. Higher number of malaria cases were reported during October season.Males were more infected by the disese (63.1%) than females and males aged 15 years and above were the most iffected ones. The percentage proportion of P.falcifarum and P.vivax were 61.6% to 38.4%, respectively. There was a decreasing trend over the nine years following the peak in 2013. Conclusion: Malaria smear positivity, with highest cases being recorded in October, was declined over the nine years after peaking in 2013. Males aged 15 years and above were more affected, and P falciparum was the predominat species. Strengtheing the prevention and control activities is warranted in the study area.

Keywords: trend, malaria, kahsay abera general hospital, tigray, ethiopia

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Authors: Khadija Ali

Abstract:

Prosecution of sexual violence in international criminal law requires not only an understanding of the mechanisms employed to prosecute sexual violence but also a critical analysis of the factors facilitating perpetuation of such crimes in armed conflicts. The extrapolations laid out in this essay delve into the jurisprudence of international criminal law pertaining to sexual and gender based violence followed by the core question of this essay: Has the entrenchment of sexual violence as international crimes in the Rome Statute been successful to address such violence in armed conflicts?

Keywords: conflict, gender, international criminal law, sexual violence

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Authors: Ermal Xhelilaj

Abstract:

International practice has revealed that many maritime conflicts have been initiated as a direct result of coastal states’ disagreements over maritime boundaries and other related maritime issues. These disagreements embrace relevant problematic matters reflecting international conflicts, which in order to prevent further escalation into international crises or even armed conflicts have to be legally resolved. The most challenging cases in international system involve regional or bilateral disputes regarding maritime boundaries delimitations between states, which may result in the activation of respective armed forces, considered crucial elements for the protection of territorial sovereignty. Taken under considerations the legal issues that Law of the Sea Convention (1982) reflects, including the legal provisions over disputes settlements, the importance of analyzing this paramount issue might be considered relevant at present. Therefore, this study will be focused in discussing legal and practical issues that concern the resolution of international maritime disputes seen from international relations point of view, by initially analyzing UN Convention on the Law of the Sea (UNCLOS 1982) relevant legal provisions, further discussing several notable cases over maritime boundaries delimitations as well as concluding with some recommendations related to this issue. The author is of the opinion that although the boundaries delimitation’s legal regime of UNCLOS reflects important standards for dispute settlements, yet considering the complex situation that represents this issue, relevant amendments might be necessary to be undertaken by international maritime organizations in order to further clarify the aforementioned legal matter.

Keywords: Law of the Sea, maritime conflicts, dispute settlements, international relations

Procedia PDF Downloads 179