Search results for: federal hospitals

Authors: Zahra Soltani Shal

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Introduction: The COVID-19 pandemic marks an extraordinary global public health crisis unseen in the last century, with its rapid spread worldwide and associated mortality burden. Healthcare resilience during a pandemic is crucial not only for continuous and safe patients care but also for control of any outbreak. Aim: The present study was conducted to discover the organizational variables effective in increasing resilience and continuing the work of nurses in critical and stressful pandemic conditions. Method: The study population is nurses working in hospitals for patients with coronavirus. Sampling was done purposefully and information was collected from 15 nurses through In-depth semi-structured interviews. The interview was conducted to analyze the data using the framework analysis method consisting of five steps and is classified in the table. Results: According to the findings through semi-structural interviews, among organizational variables, organizational commitment (Affective commitment, continuous commitment, normative commitment) has played a prominent role in nurses' resilience. Discussion: despite the non-withdrawal of nurses and their resilience, due to the negative quality of their working life, the mentioned variable has affected their level of performance and ability and leads to fatigue and physical and mental exhaustion. Implications for practice: By equipping hospitals and improving the facilities of nurses, their organizational commitment can be increased and lead to their resilience in critical situations. Supervisors and senior officials at the hospitals should be responsible for nurses' health and safety. A clear and codified program in critical situations and comprehensive management is effective in improving the quality of the work-life of nurses. Creating an empathetic and interactive environment can help promote nurses' mental health.

Keywords: organizational commitment, quality of work life, nurses resilience, pandemic, coronavirus

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Authors: Shannon Hearney, Jeffrey Hoch

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Pancreatic cancer is a notoriously costly and deadly form of cancer. Many types of treatment centers exist for patients to seek care from, including high-volume centers which have shown promise to provide the highest quality of care. While it may be true that this type of center provides the best care it is unclear if that care is cost-effective. Studies in the US have confirmed that high-volume hospitals do provide higher quality of care but have shown inconsistencies in the cost-effectiveness of that care. Other studies, like those from Finland have shown that high-volume centers had lower mortality and lower costs than low-volume centers. This paper thus seeks to review the current scientific literature to better understand if high-volume centers are cost-effective in delivering care in both a European setting and in the US. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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Authors: Abdurrauf M. Gusbi, Mahmud H. Arhima, Abdurrahim A. Elouzi, Ebtisam A. Benomran, Salsabeela Elmezwghi, Aram Elhatan, Nafesa Elgusbi

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Mass poisonings with methanol are rare but occur regularly both in developed and in non-developing countries. As a result of the tragedy that happened in the city of Tripoli Libya in March during year 2013 a number of patients were admitted to Tripoli Medical Center and Tripoli Central Hospital suffering from poisoning following ingestion of methanol by mistake. Our aims have been formulated to collect Information about those cases as much as we can from the archiving departments from the two hospitals including the number of cases that had been admitted, recovered patients and died victims. This retrospective study was planned to find out the reasons which allow those patients to drink methanol in our Muslim community and also the role of pharmacist to prevent such a disaster that claimed the lives of many people. During this tragedy 291 ospitalized patients their ages between 16-32 years old were admitted to both hospitals, total number of died 189 (121 at Tripoli medical center) and (68 at Tripoli central hospital), demographic data also shows that most of them are male (97%) and (3% female), about 4% of the patients foreigners and 96% were Libyans. There were a lot of obstacles and poor facilities at the time of patient admission as recognized in many cases including lack of first line of treatment. The morbidity was high due to the lack of antidote and availability of dialysis machines at this two main hospitals in Tripoli also according to survey done to the medical staff and also a random number of medical students shows about 28% have no idea about the first aid procedure used for methanol poisoning cases and this due to the absence of continuing education for all medical staff through the establishment of training courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.

Keywords: ethanol, fomepizole, methanol, poisoning

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Authors: Rachel deCatanzaro, Madeline Austen, Ken Tuininga, Kathy St. Laurent, Christina Rohe

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In Canada, the federal Species at Risk Act (SARA) provides protection for wildlife species at risk and a national legislative framework for the conservation or recovery of species that are listed as endangered, threatened, or special concern under Schedule 1 of SARA. Key aspects of the federal species at risk program include the development of recovery documents (recovery strategies, action plans, and management plans) outlining threats, objectives, and broad strategies or measures for conservation or recovery of the species; the identification and protection of critical habitat for threatened and endangered species; and working with groups and organizations to implement on-the-ground recovery actions. Environment Canada’s progress on the development of recovery documents and on the identification and protection of critical habitat in Ontario will be presented, along with successes and challenges associated with on-the ground implementation of recovery actions. In Ontario, Environment Canada is currently involved in several recovery and monitoring programs for at-risk bird species such as the Loggerhead Shrike, Piping Plover, Golden-winged Warbler and Cerulean Warbler and has provided funding for a wide variety of recovery actions targeting priority species at risk and geographic areas each year through stewardship programs including the Habitat Stewardship Program, Aboriginal Fund for Species at Risk, and the Interdepartmental Recovery Fund. Key research needs relevant to the recovery of species at risk have been identified, and include: surveys and monitoring of population sizes and threats, population viability analyses, and addressing knowledge gaps identified for individual species (e.g., species biology and habitat needs). The engagement of all levels of government, the local and international conservation communities, and the scientific research community plays an important role in the conservation and recovery of species at risk in Ontario– through surveying and monitoring, filling knowledge gaps, conducting public outreach, and restoring, protecting, or managing habitat – and will be critical to the continued success of the federal species at risk program.

Keywords: conservation biology, habitat protection, species at risk, wildlife recovery

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Authors: Gabriel Dolabella, Henrique Rangel, Stella Araújo, Carlos Bolonha, Igor de Lazari

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Public security is a common subject on the Brazilian political agenda. The seventh largest economy in the world has high crime and insecurity rates. Specialists try to explain this social picture based on poverty, inequality or public policies addressed to drug trafficking. This excerpt approaches State measures to handle that picture. Therefore, the public security - law enforcement institutions - is at the core of this paper, particularly the relationship among federal and state law enforcement agencies, mainly ruled by a system of urgency. The problems are informal changes on law enforcement management and public opinion collaboration to these changes. Whenever there were huge international events, Brazilian armed forces occupied streets to assure law enforcement - ensuring the order. This logic, considered in the long time, could impact the federal structure of the country. The post-madisonian theorists verify that urgency is often associated to delegation of powers, which is true for Brazilian law enforcement, but here there is a different delegation: States continuously delegate law enforcement powers to the federal government throughout the use of Armed Forces. Therefore, the hypothesis is: Brazil is under a political process of federalization of public security. The political framework addressed here can be explained by the disrespect of legal constraints and the failure of rule of law theoretical models. The methodology of analysis is based on general criteria. Temporally, this study investigates events from 2003, when discussions about the disarmament statute begun. Geographically, this study is limited to Brazilian borders. Materially, the analysis result from the observation of legal resources and political resources (pronouncements of government officials). The main parameters are based on post-madisonianism and federalization of public security can be assessed through credibility and popularity that allow evaluation of this political process of constitutional change. The objective is to demonstrate how the Military Forces are used in public security, not as a random fact or an isolated political event, in order to understand the political motivations and effects that stem from that use from an institutional perspective.

Keywords: public security, governability, rule of law, federalism

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Authors: Joachim Onyike

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The Federal Government of Nigeria in 2012 came up with a new National Housing Policy; one of its major objectives was to make housing affordable to the poor. Six years down the line, this study was carried out to find out whether the poor have fared better under the new housing policy. Owerri, the capital of Imo State, was adopted as a case study to mirror the situation nationwide. The study population was made up of low-income civil servants, i.e., grade levels 1–6 in the Imo State Civil Service. The study looked at household size, household income, rental levels, house prices, costs of major building materials, land values, land tenure, the interest rate on mortgages, inflation rate, and the status of government interventions, owing to their obvious effect on housing affordability by the low-income earners. The study made use of physical observations, questionnaires, and interviews as well as library studies to elicit relevant information. Housing affordability by the subject population did not improve. It rather dropped. The study came to the conclusion that in spite of the new National Housing Policy, housing affordability by the low-income earners has not improved. The policy as it affects the poor has not been duly implemented by both Federal and State Governments.

Keywords: house prices, housing affordability, housing policy, land values, low-income earners

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Authors: Lateef Bamidele

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Over the years, radiographic examinations are the most used diagnostic tools in the Nigerian health care system, but most diagnostic examinations carried out do not have records of patient doses. Lack of adequate information on patient doses has been a major hindrance in quantifying the radiological risk associated with radiographic examinations. This study aimed at estimating dose–area product (DAP) of patient examined in X-Ray units in selected hospitals in Southern Nigeria. The standard projections selected are chest posterior-anterior (PA), abdomen anterior-posterior (AP), pelvis AP, pelvis lateral (LAT), skull AP/PA, skull LAT, lumbar spine AP, lumbar spine, LAT. Measurement of entrance surface dose (ESD) was carried out using thermoluminescent dosimeter (TLD). Measured ESDs were converted into DAP using the beam area of patients. The results show that the mean DAP ranged from 0.17 to 18.35 Gycm². The results obtained in this study when compared with those of NRPB-HPE were found to be higher. These are an indication of non optimization of operational conditions.

Keywords: dose–area product, radiographic examinations, patient doses, optimization

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Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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Authors: F. N. Bolu-Steve, T. A. Ajiboye

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A study was carried out on the awareness of counselling needs of psychiatric patients as perceived by medical personnel in the Federal Neuropsychiatric hospital, Aro, Abeokuta, Nigeria. The respondents comprised of medical personnel of the Neuropsychiatric hospital in Aro. Purposive sampling technique was used to select the respondents. The target population of the study consisted of all medical doctors treating the psychiatric patients. A total of 200 respondents participated in the study out of which 143 were males and 57 of them were females. With their years of experience as a medical doctors, 49.5% of them have worked between 1-5 years, 30.5% of the respondents have 6-10 years’ experience while those with 16 years and above experience are 7.0%. The major counselling need of psychiatric patients as expressed by medical doctors is the need to have information about the right balance diet. The data were analyzed using percentages, mean, frequency, Analysis of Variance (ANOVA) and t-test statistical tools. The instrument used for data collection was the structured questionnaire titled “Counselling Needs of Psychiatric Patients Questionnaire” (CNPPQ). This instrument was drafted by the researchers through the review of related literature. The reliability of the instrument was established using test-retest method. A reliability index of 0.74 was obtained. Three of the hypotheses were rejected while two of them were accepted at 0.05 alpha level of significance. Based on the findings of the study, it was recommended that broad based counselling services should be provided to psychiatric patients in order to assist them to develop positive self- image and to cope with their challenges.

Keywords: counselling, needs, psychiatric, medical personnel, patients

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Authors: B. Unnikrishnan, Tanuj Kanchan, Ramesh Holla, Nithin Kumar

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Euthanasia has been debated for the ethical, legal, social, and religious implications associated with it. The present research was conducted to study the perceptions of doctors and nurses about ethical and legal aspects of Euthanasia in Indian scenario. The study was carried out at three tertiary care hospitals of Kasturba Medical College (KMC), Mangalore, India. Practicing doctors and nurses working in the hospitals associated with KMC were included in the study after taking written informed consent from the participants. The data was analyzed using SPSS version 11.5. Mann-Whitney U test was used to compare the responses of doctors and nurses. P-value of <0.05 was taken as statistically significant. A total of 144 doctors and nurses participated in the study. Both doctors and nurses agreed that if a terminally ill patient wishes to die, the wish cannot be honored ethically and legally. A significantly larger number of nurses agreed that patient’s wish for euthanasia cannot be honored ethically and legally when compared to the doctors. Though the doctors and nurses were broadly in agreement with the existing legal and ethical views on the issue, their knowledge on the issue with regard to the legal status of euthanasia in India and ethical aspects relating to it needs to be strengthened.

Keywords: euthanasia, ethical aspects, legal aspects, India

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Authors: Alokananda Ghosh, Shraban Sarkar

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The study aims to identify suitable sites for new hospitals with critical obstetric care facilities in Birbhum, one of the vulnerable and underserved districts of Eastern India, considering six main and 14 sub-criteria, using GIS-based Analytic Hierarchy Process (AHP) and Multi-Attribute Utility Theory (MAUT) approach. The criteria were identified through field surveys and previous literature. After collecting expert decisions, a pairwise comparison matrix was prepared using the Saaty scale to calculate the weights through AHP. On the contrary, objective weighting methods, i.e., Entropy and Criteria Importance through Interaction Correlation (CRITIC), were used to perform the MAUT. Finally, suitability maps were prepared by weighted sum analysis. Sensitivity analyses of AHP were performed to explore the effect of dominant criteria. Results from AHP reveal that ‘maternal death in transit’ followed by ‘accessibility and connectivity’, ‘maternal health care service (MHCS) coverage gap’ were three important criteria with comparatively higher weighted values. Whereas ‘accessibility and connectivity’ and ‘maternal death in transit’ were observed to have more imprint in entropy and CRITIC, respectively. While comparing the predictive suitable classes of these three models with the layer of existing hospitals, except Entropy-MAUT, the other two are pointing towards the left-over underserved areas of existing facilities. Only 43%-67% of existing hospitals were in the moderate to lower suitable class. Therefore, the results of the predictive models might bring valuable input in future planning.

Keywords: hospital site suitability, analytic hierarchy process, multi-attribute utility theory, entropy, criteria importance through interaction correlation, multi-criteria decision analysis

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Authors: Jalal Abdulkareem Sultan, Abdulhakeem Luqman Hasan

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With the development of health care systems competition, hospitals face more and more pressures. Meanwhile, resource allocation has a vital effect on achieving competitive advantages in hospitals. Selecting the appropriate number of beds is one of the most important sections in hospital management. However, in real situation, bed allocation selection is a multiple objective problem about different items with vagueness and randomness of the data. It is very complex. Hence, research about bed allocation problem is relatively scarce under considering multiple departments, nursing hours, and stochastic information about arrival and service of patients. In this paper, we develop a fuzzy multiobjective bed allocation model for overcoming uncertainty and multiple departments. Fuzzy objectives and weights are simultaneously applied to help the managers to select the suitable beds about different departments. The proposed model is solved by using Artificial Bee Colony (ABC), which is a very effective algorithm. The paper describes an application of the model, dealing with a public hospital in Iraq. The results related that fuzzy multi-objective model was presented suitable framework for bed allocation and optimum use.

Keywords: bed allocation problem, fuzzy logic, artificial bee colony, multi-objective optimization

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Authors: Francesco Lubrano, Fabrizio Bertone, Federico Stirano

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Modern societies strongly depend on Critical Infrastructures (CI). Hospitals, power supplies, water supplies, telecommunications are just few examples of CIs that provide vital functions to societies. CIs like hospitals are very complex environments, characterized by a huge number of cyber and physical systems that are becoming increasingly integrated. Ensuring a high level of security within such critical infrastructure requires a deep knowledge of vulnerabilities, threats, and potential attacks that may occur, as well as defence and prevention or mitigation strategies. The possibility to remotely monitor and control almost everything is pushing the adoption of network-connected devices. This implicitly introduces new threats and potential vulnerabilities, posing a risk, especially to those devices connected to the Internet. Modern medical devices used in hospitals are not an exception and are more and more being connected to enhance their functionalities and easing the management. Moreover, hospitals are environments with high flows of people, that are difficult to monitor and can somehow easily have access to the same places used by the staff, potentially creating damages. It is therefore clear that physical and cyber threats should be considered, analysed, and treated together as cyber-physical threats. This means that an integrated approach is required. SAFECARE, an integrated cyber-physical security solution, tries to respond to the presented issues within healthcare infrastructures. The challenge is to bring together the most advanced technologies from the physical and cyber security spheres, to achieve a global optimum for systemic security and for the management of combined cyber and physical threats and incidents and their interconnections. Moreover, potential impacts and cascading effects are evaluated through impact propagation models that rely on modular ontologies and a rule-based engine. Indeed, SAFECARE architecture foresees i) a macroblock related to cyber security field, where innovative tools are deployed to monitor network traffic, systems and medical devices; ii) a physical security macroblock, where video management systems are coupled with access control management, building management systems and innovative AI algorithms to detect behavior anomalies; iii) an integration system that collects all the incoming incidents, simulating their potential cascading effects, providing alerts and updated information regarding assets availability.

Keywords: cyber security, defence strategies, impact propagation, integrated security, physical security

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Authors: M. Aruna, Uma Gunasilan

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Hospitals play an ample role in securing the health of a country. Nevertheless, they also have an unhealthy side. Ecological issues strengthen ill-health throughout the domain which subsequently puts pressure on hospital supply chains. Medical waste indeed is hazardous for environment and subsequently for human. The hospital waste management is of immense prominence due to its infectious and hazardous nature that can source many effects on human health and the environment. Government regulations and public cognizance regarding hospital waste issues have imposed hospital units to admit these strategies. The innovative technologies and instruments have been developed to handle hospital wastes. Green supply chain management practices are common in the United States. In India, Green Supply Chain management (GSCM) has just started to be recognized and practiced. GSCM are green, integrated and ecologically optimized. In Green supply chain management environmental sustainability is found to be an important driver. Eleven barriers are identified in this work. Interpretive Structural Modeling (ISM) technique is used for ranking the obstructions.

Keywords: green supply chain management (GSCM), hospital waste management (HWM), interpretive structural modeling (ISM), medical waste (MW)

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Authors: Matthew Olanrewaju Ibiyomi

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The study examined the abundance of free-range natural inhabitants of the Federal University of Agriculture, Abeokuta (FUNAAB) Zoo Park. A baseline data of free-ranging inhabitants of the Park is essential to monitor trends and institute conservation plans through unsustainable natural resources exploitation and habitat destruction. Four transects were selected across the study area. Each transect was traversed for a period of four months and observations was carried out twice a day. The Four existing tracks explored during the study were the aviary, reptile, carnivore and primate tracks. Data were analyzed using descriptive statistics. The findings from this study revealed that 8 species of natural inhabitants were identified, which were the Vervet monkey (Chlorocebuspygerythrus), Maxwell duiker(Philantombamaxwellii), Mongoose (Herpestidaespp), Bushbuck(Tragelaphusscriptus), Cobra (Najanaja), Ground squirrel (Marmotinispp), Senegal coucal(Centropus senegalensis), Black kite (Milvus migrans). The result further showed that a total of 115 animals were encountered in the primate transect, 77 animals in the carnivores transect, 46 animals in the aviary transect and 34 animals in the ungulates transect by the representative of 43.3%, 28.3%, 15.8% and 12.5% respectively. Human activities and level of disturbance were observed to have affected the abundance and distribution of animals at Funaab Zoo Park. Continuous field inventory is recommended to ascertain the dynamics of animals observed as free-range inhabitants in this study.

Keywords: abundance, ecosystem, extinction, free-range

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Authors: Michael Adedotun Oke

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This paper, therefore, under study the various multiplier usages of the different Animal Dungs, from the animals such as Rabbits, Cows, Fishes, Sheep, and Poultry manure in the areas council of the Federal Capital Territory Abuja, Nigeria. Thus the various observations, with the pictorial representation, that was taken with the field survey from the different farms in Gwagawalada. Shows that the rabbits dungs are being used in some of the vegetables and crop farms, which serves as the nutrients, reduces the cost of production, ensure profitability, which also increases the different vegetative growth, early maturity, and the development of the crop and this is also applicable to some crops like maize, sweet potatoes. While the manure of the poultry products are being incorporated to fish ponds and the cows dungs are being used to serve as some manure to some certain crops, e.g. Okro, Maize, Pepper. Which provides the necessary nutritious values, but the various number of quantity of different bags of the various application are lacking, and the time of usage, it is also a life germane questions, which there are needs for further adaptive research, that will be involved and the reintroduction of new technology, that will be used in terms of the different methodology such as broadcasting and ring applications, of the dungs at large, while the seasons of the various applications. Thus the paper, therefore, suggested a training programs and production of manuals that will guide the various applications and usage and the effective dissemination of the various used of the simple technology, that will advances and teaching of a new mode of and the time of applications and the various quantity to used, during the applications.

Keywords: animals, usage, livestock, dungs, feaces, gwagawalada

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Authors: Md. Minhazul Islam, Shah Ashisul Abed Nipun, Majharul Islam, Md. Abdur Rakib Rahat, Jonayet Miah, Salsavil Kayyum, Anwar Shadaab, Faiz Al Faisal

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The target of this research is to predict Myocardial Infarction using unsupervised Machine Learning algorithms. Myocardial Infarction Prediction related to heart disease is a challenging factor faced by doctors & hospitals. In this prediction, accuracy of the heart disease plays a vital role. From this concern, the authors have analyzed on a myocardial dataset to predict myocardial infarction using some popular Machine Learning algorithms K-Means and Hierarchical Clustering. This research includes a collection of data and the classification of data using Machine Learning Algorithms. The authors collected 345 instances along with 26 attributes from different hospitals in Bangladesh. This data have been collected from patients suffering from myocardial infarction along with other symptoms. This model would be able to find and mine hidden facts from historical Myocardial Infarction cases. The aim of this study is to analyze the accuracy level to predict Myocardial Infarction by using Machine Learning techniques.

Keywords: Machine Learning, K-means, Hierarchical Clustering, Myocardial Infarction, Heart Disease

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Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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Authors: Salako Emmanuel Adekunle

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Computer education is referred to as the knowledge and ability to use computers and related technology efficiently, with a range of skills covering levels from basic use to advance. Computer continues to make an ever-increasing impact on all aspect of human endeavours such as education. With numerous benefits of computer education, what are the insights of students on computer education? This study investigated the perception of senior secondary school students on computer education in Federal Capital Territory (FCT), Abuja, Nigeria. A sample of 7500 senior secondary schools students was involved in the study, one hundred (100) private and fifty (50) public schools within FCT. They were selected by using simple random sampling technique. A questionnaire [PSSSCEQ] was developed and validated through expert judgement and reliability co-efficient of 0.84 was obtained. It was used to gather relevant data on computer education. Findings confirmed that the students in the FCT had positive perception on computer education. Some factors were identified that affect students’ perception on computer education. The null hypotheses were tested using t-test and ANOVA statistical analyses at 0.05 level of significance. Based on these findings, some recommendations were made which include competent teachers should be employed into all secondary schools; this will help students to acquire relevant knowledge in computer education, technological supports should be provided to all secondary schools; this will help the users (students) to solve specific problems in computer education and financial supports should be provided to procure computer facilities that will enhance the teaching and the learning of computer education.

Keywords: computer education, perception, secondary school, students

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Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

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Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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Authors: Jessica Chukwuyem Molua, Collins O Molua

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The effective dose of selected health care workers who are constantly exposed to X-ray radiation was measured using thermoluminescence dosimeters (TLD) placed over the lead apron at the chest region in all categories of medical personnel investigated. To measure radiation in all the selected hospitals to ascertain the exposure of x-ray machines at exactly 1m from the primary source. The work was carried out within a year in each of the selected centers. The personnel examination records containing the type of examination each day, peak tube voltage, tube current, and exposure time, including the actual number of films used, were obtained. A total of 40personel were examined in government hospital Agbor, 21 in central hospital Owa Alero and 18 in Okonye hospital The method used here has also been used by other researchers. Findings showed that the results obtained from the three hospitals investigated in this work were found to conform with the recommendations of the National Commission on radiological and protection {NCRP} 70 and 116 protocols. The Radiologist in the three study areas has the highest dose level, but of particular note is the dosage of the radiologist in Okonye hospital. This, as observed, is because the protective shielding parameters were inadequate and this could result in severe health consequences over time.

Keywords: radiology, health, Agbor, Owa

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Authors: Shaykh-Luqman Jimoh

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In Nigeria, aside the eight Government hospitals designated Psychiatric hospitals, there are also many local psychiatric centers managed by muslims and non-muslim individuals. These centers have been heavily criticized for human right abuses. This study is an inquiry into the truth or otherwise of the criticism. The study focuses on the activities of local centers managed by muslim individuals in South-West Nigeria with a view to determining the extent they uphold or violate their patients’ fundamental human rights as guaranteed by Islam. Information about the activities of the centers were collected through oral interviews. Both descriptive and analytical methods were used in the study. The study revealed that while there are some activities of the local centers managed by muslims in the study area that could be regarded as outright violation of patients’ fundamental human rights, some others, in view of the rationale behind them, may not necessarily constitute outright violation of the patients’ fundamental human rights as hitherto painted except where excesses are committed. The study therefore, using Islamic paradigm, suggests general measures that could be taken to improve on the activities of the centers.

Keywords: local psychiatric centers, muslim exorcists, patients’ rights, South-West Nigeria

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Authors: Young Kwon Yang, In Sung Kang, Jung Ha Hwang, Jin Chul Park

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The present study is a foundational study for performance improvements on isolation wards to prevent proliferation of secondary infection of infectious diseases such as SARS, H1N1, and MERS inside hospitals. Accordingly, the present study conducted an analysis of the effect of sealing mechanisms and filling of openings on ensuring air tightness performance in isolation wards as well as simulation on air currents in improved isolation wards. The study method is as follows. First, previous studies on aerial infection type and mechanism were reviewed, and the review results were utilized as basic data of analysis on simulation of air current. Second, national and international legislations and regulations in relation to isolation wards as well as case studies on developed nations were investigated in order to identify the problems in isolation wards in Korea and improvement plans. Third, construction and facility plans were compared and analyzed between general and isolation wards focusing on large general hospitals in Korea, thereby conducting comparison and analysis on the performance and effects of air-tightness of general and isolation wards through CFD simulations. The study results showed that isolation wards had better air-tightness performance than that of general wards.

Keywords: AII Room, air-borne infection, CFD, computational fluid dynamics

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Authors: Fatemeh Roostaee, Zahra Nikmanesh

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This study was done to investigate the role of religious coping components on occupational stress and the quality of working life of midwives. The method of study was descriptive-correlation. The sample was comprised of all midwives in maternity hospitals in Zahedan during 1393. Participants were selected through applying census method. The instruments of data collection were three questionnaires: the quality of working life, occupational stress, and religious opposition. For statistical analysis, Pearson correlation and step by step regression analysis methods were used. The results showed that there is a significant negative relationship between the component of religious activities (r=-0/454) and occupational stress, and regression analysis was also shown that the variable of religious activities has been explained 45% of occupational stress variable changes. The Pearson correlation test showed that there isn't any significant relationship between religious opposition components and the quality of life. Therefore, it is necessary to present essential trainings on (the field of) strengthening compatibility strategies and religious activities to reduce occupational stress.

Keywords: the quality of working life, occupational stress, religious, midwife

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Authors: Rudra Prasad Khanal

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Introduction: Non-communicable disease, such as cancer, has spread all over the world for some last decades. However, every nation has experienced a burden from the development of technology. In the context of Nepal, 10 to 15 thousand new cancer incidences are being registered in different hospitals for treatment. Since the date of starting nuclear medicine at Bir Hospital in 1998, cancer patients have been getting treatment regularly. According to the data of the population-based cancer registry, approximately 60% of the population having a middle-class income is being affected by cancer in Nepal. Methods and Materials: The study is aimed to find out the particular place where the population density of new cancer incidence is highest in Nepal and to inform the concerned regulatory body that is working on cancer screening and early detection for the proper treatment from the beginning. In order to identify the areas with the highest population density of new cancer incidence, all the data of cancer patients were collected from five different renowned hospitals and also from the population-based cancer registry center and then analyzed the data. The history of cancer patients was studied from 2003 to 2020, but here the data are analyzed from 2015 to 2020 only to find the latest trend in cancer incidence. Results: In the five major hospitals in Nepal, the total new cancer incidence was 61783 from 2015 to 2020. Out of those, 34617 were female, and 27176 were male. This research shows that female cancer patients were more every year. In the male, lung cancer patients more than cancer of other organs, but in females, the number of breast cancer patients was greatest. The age-adjusted mortality rate for males in Kathmandu valley was 36.3, and for females was 27.0 per 100,000 population. The cancer incidence and mortality rate were slightly lesser in other districts of Nepal. This rate increased with the increase in the age of people. Over 60 years, cancer incidence and mortality rates have been found to increase rapidly. Conclusion: This research supports conducting the program of cancer screening and early detection at Kathmandu valley with high priority and then Morang, Rukum, SSDM, etc., to control cancer.

Keywords: cancer incidence, research scholar, Tribhuvan University, Bhaktapur Cancer Hospital, Nepal

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Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospital Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre- EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors that are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality, and the data were analyzed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system that can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analyzed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospital staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: emergency medical teams, communication, information and communication technologies, disaster

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Authors: Debalkie Demissie Addisu, Ejigu Alemu Abebe, Tsegay Tensay Assefa

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This study examines the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics moderated by political skill. This study reports the responses of 321 respondents from six federal public service organizations in Ethiopia. A multi-stage random sampling procedure was employed to select the sampled federal public service organizations. To test hypotheses, the study employed structural equation modeling using AMOS version-26 software. The result revealed that all direct effects have a significant effect. Specifically, servant leadership has a positive effect on organizational citizenship behavior. Likewise, servant leadership has a negative effect on perceptions of organizational politics. Also, a perception of organizational politics has a negative effect on organizational citizenship behavior. Moreover, perceptions of organizational politics competitively mediated the effect of servant leadership on organizational citizenship behavior. As well, political skill moderated the effect of perceptions of organizational politics on organizational citizenship behavior but not the indirect effect. To the best of our knowledge, no one else employs perceptions of organizational politics as a mediating effect between servant leadership and organizational citizenship behavior. Furthermore, we are not aware of anyone else employing political skill as a moderating role in the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics.

Keywords: servant leadership, organizational citizenship behavior, perceptions of organizational politics, political skill, public service organization, Ethiopia

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Authors: Samson Olusegun Apantaku, Adetayo K. Aromolaran, Giyatt Hammed

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The study assessed the use of participatory research methods among Federal University of Agriculture Abeokuta, Nigeria (FUNAAB) researchers. Simple random sampling technique was used to select one hundred and twenty respondents from the study area. Data were collected using a questionnaire. Data collected were subjected to descriptive and inferential statistical analyses. Results showed that 75.8% of the respondents were males while only 21.3% were female. The mean age of the respondents was 38.8 years and most (77.5%) of them were married. 15% of the respondents were in professorial cadre, 21.7% and 20% of the respondents were senior lecturers/fellow and lecturer/research fellow I&II respectively. The results further revealed that 93.3% of the respondents were aware of participatory research methods and 82.5% of the respondents have utilized it before. The average period of usage was 2.7 years and participation by consultation (86.7%) and interactive participation (76.7%) were mostly used. Most (94.2%) indicated that fund was the major hindrance to the use of participatory research methods. The result of correlation analysis showed that there was significant relationship between the years of research experience, designation post (status) of the respondents and usage of participatory research methods (r = 0.034, 0.031, p < 0.05). The study concluded that most of the researchers were aware of and used participatory research methods, which could influence the quality of their research or make it acceptable to the end users. It was recommended that more funds should be made available and accessible for participatory research. All researchers should be trained and encouraged to make use of participatory research methods in their research activities so as to achieve effective research and capacity building that could enhance adoption of technologies and increase agricultural production in the country. Farmers’ capacity to participate in agricultural research should also be enhanced.

Keywords: participatory research, participatory research methods, awareness, utilization

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Authors: Patricia Martinez Lanz, Patricia Hernandez Valdez

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Over the last decade, crime has reached unprecedented levels and has caused much violent death in Mexico. To establish factors that potentially can facilitate crime, as well as the status of the emotional wellbeing presented in prison population, the present study was realized with a sample composed of 299 inmates of the Federal Center for Social Reinsertion in Oaxaca, Mexico. A questionnaire was specifically developed designed and applied to this population, evaluating sociodemographic factors and four Likert scales: substance consumption (drugs and alcohol), domestic violence and depressive symptoms. Reliability was adequate (Cronbach's Alpha= .703) and validity of the instrument showed appropriate relations between the reagents of each scale. Results showed through Chi Square analysis, statistically significant differences in the correlations between sociodemographic factors, domestic violence, addictions and depressive symptoms. Results reported that most of the inmates were between 28 and 47 years old (51.8%), had a low educational level (elementary school 42.5%), were in consensual union (42.5%), had high and severe levels of alcohol consumption (43.5% of the cases) and reported the presence of high and severe level of depression (28.9% of the cases). The results of this research are part of a national study of all Federal Centers for Social Reinsertion System in Mexico, in order to developed intervention strategies used in prison to prevent crime.

Keywords: delinquency, addictions, violence, depression, crime, criminal behavior

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Authors: A. Poukens, I. Sluyts, A. Krings, J. Swartenbroekx, D. Geeroms, J. Poukens

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Introduction and Objectives: It has been known for many years that with the administration of intravenous medication, a rather significant part of the planned to be administered infusion solution, the residual volume ( the volume that remains in the IV line and or infusion bag), does not reach the patient and is wasted. This could possibly result in under dosage and diminished therapeutic effect. Despite the important impact on the patient, the reduction of residual volume lacks attention. An optimized and clearly stated protocol concerning the reduction of residual volume in an IV line is necessary for each hospital. As described in my Master’s thesis, acquiring the degree of Master in Hospital Pharmacy, administration of intravenous medication can be optimized by reduction of the residual volume. Herewith effectiveness, user-friendliness, cost efficiency and safety were taken into account. Material and Methods: By usage of a literature study and an online questionnaire sent out to all Flemish hospitals and hospitals in the Netherlands (province Limburg), current flush methods could be mapped out. In laboratory research, possible flush methods aiming to reduce the residual volume were measured. Furthermore, a self-developed experimental method to reduce the residual volume was added to the study. The current flush methods and the self-developed experimental method were compared to each other based on cost efficiency, user-friendliness and safety. Results: There is a major difference between the Flemish and the hospitals in the Netherlands (Province Limburg) concerning the approach and method of flushing IV lines after administration of intravenous medication. The residual volumes were measured and laboratory research showed that if flushing was done minimally 1-time equivalent to the residual volume, 95 percent of glucose would be flushed through. Based on the comparison, it became clear that flushing by use of a pre-filled syringe would be the most cost-efficient, user-friendly and safest method. According to laboratory research, the self-developed experimental method is feasible and has the advantage that the remaining fraction of the medication can be administered to the patient in unchanged concentration without dilution. Furthermore, this technique can be applied regardless of the level of the residual volume. Conclusion and Recommendations: It is recommendable to revise the current infusion systems and flushing methods in most hospitals. Aside from education of the hospital staff and alignment on a uniform substantiated protocol, an optimized and clear policy on the reduction of residual volume is necessary for each hospital. It is recommended to flush all IV lines with rinsing fluid with at least the equivalent volume of the residual volume. Further laboratory and clinical research for the self-developed experimental method are needed before this method can be implemented clinically in a broader setting.

Keywords: intravenous medication, infusion therapy, IV flushing, residual volume

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