Search results for: hospital capacity planning

Authors: Greeshma Sharma, Sushil Chandra, Vijander Singh, Alok Prakash Mittal

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Navigational ability requires spatial representation, planning, and memory. It covers three interdependent domains, i.e. cognitive and perceptual factors, neural information processing, and variability in brain microstructure. Many attempts have been made to see the role of spatial representation in the navigational ability, and the individual differences have been identified in the neural substrate. But, there is also a need to address the influence of planning, memory on navigational ability. The present study aims to evaluate relations of aforementioned factors in the navigational ability. Total 30 participants volunteered in the study of a virtual shopping complex and subsequently were classified into good and bad navigators based on their performances. The result showed that planning ability was the most correlated factor for the navigational ability and also the discriminating factor between the good and bad navigators. There was also found the correlations between spatial memory recall and navigational ability. However, non-verbal episodic memory and spatial memory recall were also found to be correlated with the learning variable. This study attempts to identify differences between people with more and less navigational ability on the basis of planning and memory.

Keywords: memory, planning navigational ability, virtual reality

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Authors: Pascal Rey, Anaïs Weber

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Many mining projects are being developed in Africa the last decades. Due to the economic opportunities they offer, these projects result in a massive and rapid influx of migrants to the surrounding area. In areas where central government representation is low and local administration lack financial resources, urban development is often anarchical, beyond all public control. It leads to socio-spatial segregation, insecurity and the risk of social conflicts rising. Aware that their economic development is very correlated with local situation, mining companies get more and more involved in regional planning in setting up tools and Strategic Directions document. One of the commonly used tools in this regard is the “Influx Management Plan”. It consists in looking at the region’s absorption capacities in order to ensure its coherent development and by developing several urban centers than one macrocephalic city. It includes many other measures such as urban governance support, skills transfer, creation of strategic guidelines, financial support (local taxes, mining taxes, development funds etc.) local development projects. Through various examples of mining projects in Guinea, A country that is host to many large mining projects, we will look at the implications of regional and urban planning of which mining companies are key playor as well as public authorities. While their investment capacity offers advantages and accelerates development, their actions raise questions of the unilaterality of interests and local governance. By interfering in public affairs are mining companies not increasing the risk of central and local government shirking their responsibilities in terms of regional development, or even calling their legitimacy into question? Is such public-private collaboration really sustainable for the region as a whole and for all stakeholders?

Keywords: Africa, guinea, mine, urban planning

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Authors: Ibrahim A. Alkali

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There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: patient's family, inpatient setting, care giving, integration

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Authors: Mustarakh Gelfi, Poonam Taneja, Tiedo Vellinga, Delon Hamonangan

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The initial masterplan of New Priok in the Port of Tanjung Priok was developed in 2012 is being updated to cater to new developments and new demands. In the new masterplan (2017), Phase II of development will start from 2035-onwards, depending on the future conditions. This study is about creating a robust masterplan for Phase II, which will remain functional under future uncertainties. The methodology applied in this study is scenario-based planning in the framework of Adaptive Port Planning (APP). Scenario-based planning helps to open up the perspective of the future as a horizon of possibilities. The scenarios are built around two major uncertainties in a 2x2 matrix approach. The two major uncertainties for New Priok port are economics and sustainability awareness. The outcome is four plausible scenarios: Green Port, Business As Usual, Moderate Expansion, and No Expansion. Terminal needs in each scenario are analyzed through traffic analysis and identifying the key cargos and commodities. In conclusion, this study gives the wide perspective for Port of Tanjung Priok for the planning Phase II of the development. The port has to realize that uncertainties persevere and are very likely to influence the decision making as to the future layouts. Instead of ignoring uncertainty, the port needs to make the action plans to deal with these uncertainties.

Keywords: Indonesia Port, port's layout, port planning, scenario-based planning

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Authors: Chitrangi Gupta, Arvind Bhardwaj

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This study seeks to investigate and quantify the influence of various dimensions of supply chain management (namely, supplier relationships, compatibility, specifications and standards, delivery processes, and after-sales service) on distinct dimensions of healthcare service quality (specifically, responsiveness, trustworthiness, and security) within the operational framework of XYZ Superspeciality Hospital, situated in Delhi. The name of the Hospital is not being mentioned here because of the privacy policy of the hospital. The primary objective of this research is to elucidate the impact of supply chain management practices on the overall quality of healthcare services offered within hospital settings. Employing a quantitative research design, this study utilizes a hypothesis-testing approach to systematically discern the relationship between supply chain management dimensions and the quality of health services. The findings of this study underscore the significant influence exerted by supply chain management dimensions, specifically supplier relationships, specifications and standards, delivery processes, and after-sales service, on the enhancement of healthcare service quality. Moreover, the study's results reveal that demographic factors such as gender, qualifications, age, and experience do not yield discernible disparities in the relationship between supply chain management and healthcare service quality.

Keywords: supply chain management, healthcare, hospital operations, service delivery

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Authors: Joanne F. Hayek

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This study explores the use of gamification to promote citizen e-participation in urban planning. The research departs from a case study: the ‘Shape Your City’ web app designed and programmed by the author and presented as part of the 2021 Dubai Design Week to engage citizens in the co-creation of the future of their city through a gamified experience. The paper documents the design and development methodology of the web app and concludes with the findings of its pilot release. The case study explores the use of mobile interactive mapping, real-time data visualization, augmented reality, and machine learning as tools to enable co-planning. The paper also details the user interface design strategies employed to integrate complex cross-sector e-planning systems and make them accessible to citizens.

Keywords: gamification, co-planning, citizen e-participation, mobile interactive mapping, real-time data visualization

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Authors: Amal Sellami, Ahlem Ammar

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Writing is acknowledged to be a cognitively demanding and complex task. Indeed, the writing process is composed of three iterative sub-processes, namely planning, translating (writing), and reviewing. Not only do second or foreign language learners need to write according to this process, but they also need to respect the norms and rules of language and writing in the text to-be-produced. Accordingly, researchers have suggested to approach writing as a collaborative task in order to al leviate its complexity. Consequently, collaboration has been implemented during the whole writing process or only during planning orreviewing. Researchers report that implementing collaboration during the whole process might be demanding in terms of time in comparison to individual writing tasks. Consequently, because of time constraints, teachers may avoid it. For this reason, it might be pedagogically more realistic to limit collaboration to one of the writing sub-processes(i.e., planning or reviewing). However, previous research implementing collaboration in planning or reviewing is limited and fails to explore the effects of the seconditionson the written text. Consequently, the present study examines the effects of collaboration in planning and collaboration in reviewing on the written text. To reach this objective, quantitative as well as qualitative methods are deployed to examine the written texts holistically and in terms of fluency, complexity, and accuracy. Participants of the study include 4 pairs in each group (n=8). They participated in two experimental conditions, which are: (1) collaborative planning followed by individual writing and individual reviewing and (2) individual planning followed by individual writing and collaborative reviewing. The comparative research findings indicate that while collaborative planning resulted in better overall text quality (precisely better content and organization ratings), better fluency, better complexity, and fewer lexical errors, collaborative reviewing produces better accuracy and less syntactical and mechanical errors. The discussion of the findings suggests the need to conduct more comparative research in order to further explore the effects of collaboration in planning or in reviewing. Pedagogical implications of the current study include advising teachers to choose between implementing collaboration in planning or in reviewing depending on their students’ need and what they need to improve.

Keywords: collaboration, writing, collaborative planning, collaborative reviewing

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Authors: Akinwale S. O., Koya O. A.

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The need to provide ecologically-friendly and effective lawn mowing solution is crucial for the well-being of humans. This study involved the modification of a human-powered lawn mower designed to cut tall grasses in residential areas. This study designed and fabricated a reel-type mower blade system and a pedal-powered test rig for the blade system. It also evaluated the performance of the machine. The machine was tested on some overgrown grass plots at College of Education Staff School Ilesa. Parameters such as theoretical field capacity, field efficiency and effective field capacity were determined from the data gathered. The quality of cut achieved by the unit was also documented. Test results showed that the fabricated cutting system produced a theoretical field capacity of 0.11 ha/h and an effective field capacity of 0.08ha/h. Moreover, the unit’s cutting system showed a substantial improvement over existing reel mower designs in its ability to cut on both the forward and reverse phases of its motion. This study established that the blade system described herein has the capacity to cut tall grasses. Hence, this device can therefore eliminate the need for powered mowers entirely on small residential lawns.

Keywords: effective field capacity, field efficiency, theoretical field capacity, quality of cut

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Authors: Hooshang Mohammad Alikhani, Javad Nikoukar

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Restructuring and deregulation of power industry have changed the objectives of transmission expansion planning and increased the uncertainties. Due to these changes, new approaches and criteria are needed for transmission planning in deregulated power systems. The objective of this research work is to present a new approach for transmission expansion planning with considering new objectives and uncertainties in deregulated power systems. The approach must take into account the desires of all stakeholders in transmission expansion planning. Market based criteria must be defined to achieve the new objectives. Combination of market based criteria, technical criteria and economical criteria must be used for measuring the goodness of expansion plans to achieve market requirements, technical requirements, and economical requirements altogether.

Keywords: deregulated power systems, transmission network, stakeholder, energy systems

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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: R. Litt, A. Kana, K. House

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The primary aim of this patient-related experience questionnaire was to gain a better understanding of our patients' experience as inpatients when they undergo orthognathic surgery. The secondary aim of this study was to identify ways in which we can improve the orthognathic inpatient experience and to share this with other units. All patients who received orthognathic surgery at an NHS hospital - Bristol Royal Infirmary, England, over the course of 6 months were asked to complete a questionnaire regarding their care. This data was then analysed and compared to the same questionnaire given to patients treated in a private hospital where orthognathic surgery was completed. All treatment was completed by the same surgeon. The design of the questions took into account NICE (National Institute for Health and Care Excellence) guidance on improving the experience of patient care. Particularly taking into account patients' essential requirements of care, for example, assessing and managing pain, ensuring adequate and appropriate nutrition, and ensuring the patients' personal needs are regularly reviewed and addressed. Overall the patient-related experience after orthognathic surgery was comparable in both the NHS and private hospitals. However, the questionnaire highlighted aspects of inpatient care after orthognathic surgery that can easily be improved in order to provide our patients with the best possible care.

Keywords: orthognathic surgery, patient feedback, jaw surgery, inpatient experience

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Authors: An-Yi Wang, Wei-Fong Kao, Shin-Han Tsai

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Introduction: Information as patient characteristics, resuscitation scene, resuscitation provider perspectives and families wish affects on resuscitation decision-making for out-of-hospital cardiac arrest (OHCA). There is no consistency consensus on how families and emergency physicians approach this decision. The main purpose of our study is to evaluate the characteristics of withholding resuscitation efforts arrival at the hospital. Methods: We retrospectively analyzed patients with OHCA without pre-hospital return-of-spontaneous circulation (ROSC) who was sent to our emergency department (ED) between January 2014 and December 2015. Baseline characteristics, pre-hospital course, and causes of the cardiopulmonary arrest among patients were compared. Results: In 2 years, total 155 arrest patients without pre-hospital ROSC was included. 33(21.3%) patients withhold the resuscitation efforts in ED with mean resuscitation duration 4.45 ± 7.04 minutes after ED arrival. In withholding group, the initial rhythm of arrests was all non-shockable. 9 of them received endotracheal intubation before decision-making. None of the patients in withhold resuscitation group survived to discharge. There was no significant difference among gender, underlying cardiovascular disease, malignancy, chronic renal disease, nor witness collapse between withhold and continue resuscitation groups. Univariate analysis showed there was lower percentage of bystander resuscitation (32.3% vs. 50.4%, p=0.071), and the lower percentage of transport via emergency medical service (EMS) (78.8% vs. 91.8%, p=0.054) in withholding group. Multivariate analysis showed old age (adjusted odds ratio=1.06, 95% C.I.=[1.02-1.11], p<0.05), with underlying respiratory insufficiency (adjusted odds ratio=12.16, 95% C.I.=[3.34-44.29], p<0.05), living at home compared with nursing home (adjusted odds ratio=37.75, 95% C.I.=[1.09-1110.70], p<0.05) were more likely to withhold resuscitation. Transport via EMS was more likely to continue resuscitation (adjusted odds ratio=0.11, 95% C.I.=[0.02-0.71], p<0.05). Conclusion: The decision-making for families and emergency physicians to withhold or continue resuscitation for out-of-hospital cardiac arrest is complex and multi-factorial. Continue resuscitation efforts in nursing home residents is high, and further study among this population is warranted.

Keywords: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, termination resuscitation, withhold resuscitation

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Authors: Shankar M. Bakkannavar, Smitha Nayak, Vinod C. Nayak, Ravi Bagali

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Attendance rate for hospital outpatient appointments plays a pivotal role in operational efficiency of a hospital. Strategic interventions like ‘reminder systems’ prior to the scheduled appointment has proved to be an effective strategy for outpatient appointment ‘show-ups’. This study is designed with an objective to assess the effectiveness of SMS reminders as an intervention to enhance the effectiveness of hospital outpatient attendance. Method: The survey was conducted at Columbia Asia Hosiptal, Bangalore. We surveyed 60 patients who had a scheduled outpatient appointment in Department of General Medicine, Department of Obstetrics and Gynecology and the Orthopedics department, as these departments had a heavy patient flow and had higher contributions to the top line of the hospital. Results: Majority (64%) of the patients preferred to be sent an SMS reminder on the outpatient appointment schedule. 37 (61%) respondents stated that the ideally, reminders could be effective only if they are sent 24-48 hours prior to the appointment schedule. 41(68%) respondents were of the opinion that a minimum of two reminders would be necessary to ensure patients show up for the appointment. 1% level of significance. It also observed that there is strong association between age and preference on mode of reminder (P=0.002).

Keywords: reminder systems, appointment show-ups, SMS reminders, health Information

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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Authors: J. Koiso-Kanttila, A. Soikkeli, A. Aapaoja

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Construction in Finland is focusing increasingly on renovation instead of conventional new construction, and this trend will continue to grow in the coming years and decades. Renovation of the large number of suburban residential apartment buildings built in the 1960s and 1970s poses a particular challenge. However, renovation projects are demanding for the residents of these buildings, since they usually are uninitiated in construction issues. On the other hand, renovation projects generally apply the operating models of new construction. Nevertheless, the residents of an existing residential apartment building are some of the best experts on the site. Thus, in this research project we applied a relational model in developing and testing at case sites a planning process that employs interactive planning methods. Current residents, housing company managers, the city zoning manager, the contractor’s and prefab element supplier’s representatives, professional designers and researchers all took part in the planning. The entire interactive planning process progressed phase by phase as the participants’ and designers’ concerted discussion and ideation process, so that the end result was a renovation plan desired by the residents.

Keywords: apartment building renovation, interactive planning, project alliance, user-orientedness

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Authors: Mustafa El-Halabi

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A general model of wiretap channel with states is considered, where the legitimate receiver and the wiretapper’s observations depend on three states S1, S2 and S3. State S1 is non-causally known to the encoder, S2 is known to the receiver, and S3 remains unknown. A secure coding scheme, based using structured-binning, is proposed, and it is shown to achieve the secrecy capacity when the signal at legitimate receiver is a deterministic function of the input.

Keywords: physical layer security, interference, side information, secrecy capacity

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Authors: Bindhiya Thomas, Rehana Hafeez

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Background: The Surgical Ambulatory Unit (SAU) also known as the Same Day Emergency Care (SDEC) is an established part of many hospitals providing same day emergency care service to surgical patients who would have otherwise required admission through the A&E. Prior to Covid, the SAU was functioning as a 12-hour service, but during the Covid crisis this service was transformed to a 24 hour functioning Surgical Ambulatory Assessment unit (SAAU). We studied the effects that this change brought about in-patient care in our hospital. Objective: The objective of the study was to assess the impact of a 24-hour Surgical Ambulatory Assessment unit on patient care during the time of Covid, in particular its role in freeing A&E capacity and delivering effective patient care. Methods: We collected two sets of data retrospectively. The first set was collected over a 6-week period when the SAU was functioning at the Princess Royal University Hospital. On March 23rd, 2020, the SAU was transformed into a 24-hour SAAU. Following this transformation, a second set of patient data was collected over a period of 6 weeks. A comparison was made between data collected from when the hospital had a 12-hour Surgical Ambulatory unit and later when it was transformed into a 24-hour facility. Its effects on the change in the number of patients breaching the four hour waiting period and the number of emergency surgical admissions. Results: The 24-hour Surgical Ambulatory Assessment unit brought significant reductions in the number of patients breaching the waiting period of 4 hours in A&E from 44% during the period of the 12-hour Surgical Ambulatory care facility to 0% from when the 24-hour Surgical Ambulatory Assessment Unit was established. A 28% reduction was also seen in the number of surgical patients' admissions from A&E. Conclusions: The 24-hour SAAU was found to have a profound positive impact on emergency care of surgical patients. Especially during the Covid crisis, it played a crucial role in providing not only effective and accessible patient care but also in reducing the A&E workload and admissions. It thus proved to be a strategic tool that helped to deal with the immense workload in emergency care during the Covid crisis and helped free much needed headspace at a time of uncertainty for the A&E to better configure their services. If sustained, the 24-hour SAAU could be relied on to augment the NHS emergency services in the future, especially in the event of another crisis.

Keywords: Princess Royal University Hospital, surgical ambulatory assessment unit, surgical ambulatory unit, same day emergency care

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Authors: Rihab Ben Lamine, Raoudha Ben Jemaa, Ikram Amous Ben Amor

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This paper proposes a graph planning technique for semantic adaptable Web Services composition. First, we use an ontology based context model for extending Web Services descriptions with information about the most suitable context for its use. Then, we transform the composition problem into a semantic context aware graph planning problem to build the optimal service composition based on user's context. The construction of the planning graph is based on semantic context aware Web Service discovery that allows for each step to add most suitable Web Services in terms of semantic compatibility between the services parameters and their context similarity with the user's context. In the backward search step, semantic and contextual similarity scores are used to find best composed Web Services list. Finally, in the ranking step, a score is calculated for each best solution and a set of ranked solutions is returned to the user.

Keywords: semantic web service, web service composition, adaptation, context, graph planning

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Authors: Lucie Litvack, Malaz Elsaddig, Kevin Jones

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There is strong evidence to support the efficacy of the World Health Organization (WHO) Surgical Safety Checklist in improving patient safety; however, its use can be associated with difficulties. This study uses qualitative data collected in Kitovu Healthcare Complex, a rural Ugandan hospital, to identify factors that may influence the use of the checklist in a low-income setting. Potential barriers to and motivators for the hospital’s use of this checklist are identified and explored through observations of current patient safety practices; semi-structured interviews with theatre staff; a focus group with doctors; and trial implementation of the checklist. Barriers identified include the institutional context; knowledge and understanding; patient safety culture; resources and checklist contents. Motivators for correct use include prior knowledge; team attitudes; and a hospital advocate. Challenges are complex and unique to this socioeconomic context. Stepwise change to improve patient safety practices, local champions, whole team training, and checklist modification may assist the implementation and sustainable use of the checklist in an effective way.

Keywords: anaesthesia, patient safety, Uganda, WHO surgical safety checklist

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: Attaullah Khawaja, Amna Shabbir

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Channel inversion is one of the simplest techniques for multiuser downlink systems with single-antenna users. In this paper regularized channel inversion under equal power constraint in the multiuser multiple input multiple output (MU-MIMO) broadcast channels has been considered. Sum capacity with plain channel inversion also known as Zero Forcing Beam Forming (ZFBF) and optimum sum capacity using Dirty Paper Coding (DPC) has also been investigated. Analysis and simulations show that regularization enhances the system performance and empower linear growth in Sum Capacity and specially work well at low signal to noise ratio (SNRs) regime.

Keywords: broadcast channel, channel inversion, multiple antenna multiple-user wireless, multiple-input multiple-output (MIMO), regularization, dirty paper coding (DPC), sum capacity

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Authors: Ahmed Al Khamisi

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The Disaster Preparedness Standard (DPS) is one of the elements that is evaluated by the Accreditation Canada International (ACI). ACI emphasizes to train and educate all staff, including service providers and senior leaders, on emergency and disaster preparedness upon the orientation and annually thereafter. Lack of awareness and deficit of knowledge among the healthcare providers about DPS have been noticed in a tertiary hospital where ACI standards were implemented. Therefore, this paper aims to introduce a video-based e-learning (VB-EL) module that explains the hospital’s disaster plan in a simple language which will be easily accessible to all healthcare providers through the hospital’s website. The healthcare disaster preparedness coordinator in the targeted hospital will be responsible to ensure that VB-EL is ready by 25 April 2019. This module will be developed based on the Kirkpatrick evaluation method. In fact, VB-EL combines different data forms such as images, motion, sounds, text in a complementary fashion which will suit diverse learning styles and individual learning pace of healthcare providers. Moreover, the module can be adjusted easily than other tools to control the information that healthcare providers receive. It will enable healthcare providers to stop, rewind, fast-forward, and replay content as many times as needed. Some anticipated limitations in the development of this module include challenges of preparing VB-EL content and resistance from healthcare providers.

Keywords: Accreditation Canada International, Disaster Preparedness Standard, Kirkpatrick evaluation method, video-based e-learning

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Authors: O. I. Nkwonta, B. Dzwairo, J. Adeyemo, A. Jaiyola, N. Sawyerr, F. Otieno

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The effective management of water resources is of great importance to ensure the supply of water resources to support changing water requirements over a selected planning horizon and in a sustainable and cost-effective way. Essentially, the purpose of the water resources planning process is to balance the available water resources in a system with the water requirements and losses to which the system is subjected. In such situations, Water resources yield and planning model can be used to solve those difficulties. It has an advantage over other models by managing model runs, developing a representative system network, modelling incremental sub-catchments, creating a variety of standard system features, special modelling features, and run result output options.

Keywords: complex, water resources, planning, cost effective and management

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Authors: Ashley Barnes

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This paper will consider the ways in which varied notions of Space played a central role in a 12-week drama project with patients in a Medium Secure Hospital in the UK. In the project, the patients devised and performed a series of sketches, inspired by Science Fiction films, which echoed their own experience of alienation. During the project, the familiar and rigorously regulated Activity Room became a site of imagination, adventure and laughter; transforming the atmosphere of the hospital and allowing the patients to be transported to another space entirely. A space that was as much in their heads as in the physical domain. It will be argued that, although work created in an institution such as a Medium Secure Hospital is infused with hegemonic associations and meanings, the starting point for such work should be to seek an empty space in which the participants can allow their imaginations to be released. This work sits within a range of contexts and will be consciously interdisciplinary. It will draw from Human Geography and Criminology, as well as Performance and Applied Theatre Literature. It is hoped that this paper will build upon the literature that relates to the very particular environment of Secure Hospitals and to provide a starting point for further practical exploration.

Keywords: criminal justice, mental health, science fiction films, space and place

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Authors: Gülnar Bayramoğlu Barman

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Since the industrial revolution, technological developments and increased population have caused environmental damages. To protect the nature and architectural environment, firstly, green architecture, ecological architecture and then sustainability occurred. This term has been proposed not to be a new term but a response to environmental disturbances caused by human activities and it is re-conceptualization of architecture. Sustainable architecture or sustainability is lot more extensive than ecological and green architecture. It contains the imbalance between environmental problems that is natural environment and consumption that occurred all around the world. An important part of sustainability debate focused on urban planning and design for more sustainable forms and patterns. In particular, it is discussed that planning and design of urban areas have a major effect on transport and therefore can help reduce car usage, emissions, global warming and climate change. There are many planning and design approaches and movement that introduce certain criteria and strategies to prevent car dependency and encourage people to use public transportation and walking. However, when review the literature, it is seen that planning movements, such as New Urbanism and Transit Oriented Development originated and were implemented mostly in West European and North American Cities. The purpose of this study is to find out whether all those criteria, principles and strategies are also relevant planning approaches for more non-western cities like Baku, which has a very different planning background and therefore possibly different urban form and transport issues. In order to answer the above mentioned question, planning and design approaches in the literature and these recent planning movements were studied and a check list was formed which indicate planning and design approaches that can help attain a more sustainable transport outcome. The checklist was then applied to the case of Baku.

Keywords: sustainability, sustainable development, sustainable transportation, transport, urban design

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Authors: Siddhartha Paul, Aman Harlalka, Ashim K. Dey

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Soft clayey soil possesses poor bearing capacity and high compressibility because of which foundations cannot be directly placed over soft clay. Normally pile foundations are constructed to carry the load through the soft soil up to the hard stratum below. Pile construction is costly and time consuming. In order to increase the properties of soft clay, many ground improvement techniques like stone column, preloading with and without sand drains/band drains, etc. are in vogue. Time is a constraint for successful application of these improvement techniques. Another way to improve the bearing capacity of soft clay and to reduce the settlement possibility is to apply geocells below the foundation. The geocells impart rigidity to the foundation soil, reduce the net load intensity on soil and thus reduce the compressibility. A well designed geocell reinforced soil may replace the pile foundation. The present paper deals with the applicability of geocells on improvement of the bearing capacity. It is observed that a properly designed geocell may increase the bearing capacity of soft clay up to two and a half times.

Keywords: bearing capacity, geo-cell, ground improvement, soft clay

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Authors: Ahasanul Haque, Noor Hazilah Abd Manaf, Zohurul Anis, Tarekol Islam

Abstract:

Sustainable community health (SCH) is an example of a new healthcare concept formed from applying the Maqasid al-Shariah principle to hospital management and delivery services. Because the idea is novel, it needs comprehensive and ongoing investigation to be improved. However, there is a lack of research on the necessity of developing sustainable community health (SCH), particularly its organizational structure. Furthermore, there is a misconception about the order of components in Maqasid al-Shariah, particularly in a hospital setting. Furthermore, the use of medicines and treatment by conventional recommendations to carry out the treatment by the Maqasid al Shariah. As such, this study focuses on the essential prerequisite for establishing a sustainable community health system based on Maqasid al-Shariah. This study discusses the use of Maqasid al-Shariah in administration and treatment. In this qualitative research approach, a literature search and interviews with specialists are conducted. The gathered data is examined using content analysis, emphasizing inductive and deductive reasoning. The research reveals that the Shariah Advisory Council and Shariah Critical Point are necessary for sustainable community health. In conclusion, by discussing the causes for each instance, this research adds to the creation of methods for determining the level of Maasid al-Shariah in-hospital care.

Keywords: empowering, sustainability, community health, maqasid al shariah, hospital and malaysia

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Authors: Ledi Neçaj

Abstract:

Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities.

Keywords: cardio-respiratory rehabilitation, physical exercise, quality of life, diseases

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Authors: Samantha Ramachandra, Avanthi Rupasinghe

Abstract:

Demographic transition from lower to higher percentage of elderly population eventually coupled with epidemiological transition from communicable to non-communicable diseases (NCD). Higher percentage of NCD overload the health system as NCD survivors claims continuous health care. The demands are challenging to a resource constrained setting but reorganizing the system may find solutions. The study focused on the facilities available and their utilization at outpatient department (OPD) setting of the public hospitals of Sri Lanka for continuous medical care. This will help in identifying steps of reorganizing the system to provide better care with the maximum utilization of available facilities. The study was conducted as a situation analysis with secondary data at hospital planning units. Variable were identified according to the world health organization (WHO) recommendation on continuous health care for elders in “age-friendly primary health care toolkit”. Data were collected from secondary and tertiary care hospitals of Sri Lanka where most of the continuous care services are available. Out of 58 secondary and tertiary care hospitals, 16 were included in the study to represent each hospital categories. Average number of patient attending for episodic treatment at OPD and Clinical follow-up of chronic conditions shows vast disparity according to the category of the hospital ranging from 3750 – 800 per day at OPD and 1250 – 200 per clinic session. Average time spent per person at OPD session is low, range from 1.54 - 2.28 minutes, the time was increasing as the hospital category goes down. 93.7% hospitals had special arrangements for providing acute care on chronic conditions such as catheter, feeding tube and wound care. 25% hospitals had special clinics for elders, 81.2% hospitals had healthy lifestyle clinics (HLC), 75% hospitals had physical rehabilitation facilities and 68.8% hospitals had facilities for counselling. Elderly clinics and HLC were mostly available at lower grade hospitals where as rehabilitation and counselling facilities were mostly available at bigger hospitals. HLC are providing health education for both patients and their family members, refer patients for screening of complication but not provide medical examinations, investigations or treatments even though they operate in the hospital setting. Physical rehabilitation is basically offered for patients with rheumatological conditions but utilization of centers for injury rehabilitation and rehabilitation of survivors following major illness such as myocardial infarctions, stroke, cancer is not satisfactory (12.5%). Human Resource distribution within hospital shows vast disparity and there are 103 physiotherapists in the biggest hospital where only 36 physiotherapists available at the next level hospital. Counselling facilities also provided mainly for the patient with psychological conditions (100%) but they were not providing counselling for newly diagnosed patients with major illnesses (0%). According to results, most of the public-sector hospitals in Sri Lanka have basic facilities required in providing continuous care but the utilization of services need more focus. Hospital administration or the government need to have initial steps in proper utilization of them in improving continuous health care incorporating team approach of rehabilitation. The author wishes to acknowledge that this paper was made possible by the support and guidance given by the “Australia Awards Fellowships Program for Sri Lanka – 2017,” which was funded by the Department of Foreign Affairs and Trade, Australia, and co-hosted by Monash University, Australia and the Sri Lanka Institute of Development Administration.

Keywords: continuous care, outpatient department, non communicable diseases, rehabilitation

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Authors: Seyed Abolhasan Naeini, M. Mortezaee

Abstract:

Various factors such as the method of installation, the pile type, the pile material and the pile shape, can affect the final bearing capacity of a pile executed in the soil; among them, the method of installation is of special importance. The physical modeling is among the best options in the laboratory study of the piles behavior. Therefore, the current paper first presents and reviews the frustum confining vesel (FCV) as a suitable tool for physical modeling of deep foundations. Then, by describing the loading tests of two open-ended and closed-end steel piles, each of which has been performed in two methods, “with displacement" and "without displacement", the effect of end conditions and installation method on the final bearing capacity of the pile is investigated. The soil used in the current paper is silty sand of Firoozkooh. The results of the experiments show that in general the without displacement installation method has a larger bearing capacity in both piles, and in a specific method of installation the closed ended pile shows a slightly higher bearing capacity.

Keywords: physical modeling, frustum confining vessel, pile, bearing capacity, installation method

Procedia PDF Downloads 107