Search results for: limited resources hospital

Authors: N. W. Paul, S. Michl

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In our globalized world we need to appreciate the fact that questions of health and justice need to be addressed on a global scale, too. The way in which diverse governmental and non-governmental initiatives are trying to answer the need for humanitarian medical aid has long since been a visible result of globalized responsibility. While the intention of humanitarian medical aids seems to be evident, the allocation of resources has become more and more an ethical and societal challenge. With a rising number and growing dimension of humanitarian catastrophes around the globe the search for ethically justifiable ways to decide who might benefit from limited resources has become a pressing question. Rooted in theories of justice (Rawls) and concepts of social welfare (Sen) we developed and implemented a model for an ethically sound distribution of a limited annual budget for humanitarian care in one of the largest medical universities of Germany. Based on our long lasting experience with civil casualties of war (Afghanistan) and civil war (Libya) as well as with under- and uninsured and/or stateless patients we are now facing the on-going refugee crisis as our most recent challenge in terms of global health and justice. Against this background, the paper strives to a) explain key issues of humanitarian medical aid in the 21st century, b) explore the problem of rationing from an ethical point of view, c) suggest a tool for the rational allocation of scarce resources in humanitarian medical aid, d) present actual cases of humanitarian care that have been managed with our toolbox, and e) discuss the international applicability of our model beyond local contexts.

Keywords: humanitarian care, medical ethics, allocation, rationing

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Authors: Mohamed Elshal, Hazim El-Mounayri, Omar El-Mounayri

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Emergency department (ED) is considered as a complex system of interacting entities: patients, human resources, software and hardware systems, interfaces, and other systems. This paper represents a research for implementing a detailed Systems Engineering (SE) approach in a mid-size hospital in central Indiana. This methodology will be applied by “The Initiative for Product Lifecycle Innovation (IPLI)” institution at Indiana University to study and solve the crowding problem with the aim of increasing throughput of patients and enhance their treatment experience; therefore, the nature of crowding problem needs to be investigated with all other problems that leads to it. The presented SE methods are workflow analysis and systems modeling where SE tools such as Microsoft Visio are used to construct a group of system-level diagrams that demonstrate: patient’s workflow, documentation and communication flow, data systems, human resources workflow and requirements, leadership involved, and integration between ER different systems. Finally, the ultimate goal will be managing the process through implementation of an executable model using commercialized software tools, which will identify bottlenecks, improve documentation flow, and help make the process faster.

Keywords: systems modeling, ED operation, workflow modeling, systems analysis

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Authors: Wisit Wichitkosoom

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

Keywords: critical, telemedicine, safety, non STEMI

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Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

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Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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Authors: Isah Mohammed Patizhiko

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This paper aimed at discussing the important role learning resources play in enhancing the teaching and learning of science and technology courses in post primary institution in Nigeria. The paper highlighted the importance learning resources contributed to the effective understanding of the learners. The use of learning resources in the teaching of these courses will encourage teachers to be more exploratory and the learners to have more understanding. In this paper, different range of learning resources particularly common learning resources (learning resources not design primarily for education purposes) to enrich their teaching. The paper also highlighted how ordinary resource can be turned into an educational resource. Recommendations were proffered in the sourcing of learning resources ie from the market, library, institutions, museums, and dump refuse and concluded that good demonstration on the use of resources will engage the learner’s interest and will develop higher level of conceptual understanding in the learning area.

Keywords: enhance, learning, resources, science and technology, teaching

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Authors: A. Samer Ezeldin, Sarah A. Fotouh

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Optimization of resources is very important in all fields, as in construction management. Project managers have to face problems regarding management of cost, time and available resources of single projects and more problems arise when managing multiple projects. Most of the studies focused on optimization of resources for a single project, but, this paper will discuss the design and modeling of multiple resources optimization for multiple projects using Genetic Algorithm. Most of the companies in construction industry optimize the resources for single projects only, but with the presence of several mega projects in several developing countries running at the same time, there is a need for a model to enhance the efficiency of available resources and decreases the fluctuation as much as possible. The proposed model calculates the cost of each resource, tries to minimize the cost of extra resources as much as possible and generates the schedule of each project within a selected program.

Keywords: construction management, genetic algorithm, multiple projects, multiple resources, optimization

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Authors: Emmanouel Koumoulas, Aikaterini Rokkou, Marios Moschakis

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Theagenio" in Thessaloniki exists and works for three centuries now as a hospital. Since 1975, it has been operating as an Integrated Special Cancer Hospital and since 1985 it has been integrated into the National Health System. "Theagenio" Cancer Hospital is located at the central web of Thessaloniki residential complex and consists of two buildings, the "Symeonidio Research Center", which was completed in 1962 and the Nursing Ward, a project that was later completed in 1975. This paper examines the design of the Hospital Unit according to the requirements of the energy design of buildings. Initially, the energy characteristics of the Hospital are recorded, followed by a detailed presentation of the electromechanical installations. After the existing situation has been captured and with the help of the software TEE-KENAK, different scenarios for the energy upgrading of the buildings have been studied. Proposals for upgrading concern both the shell, e.g. installation of external thermal insulation, replacement of frames, addition of shading systems, etc. as well as electromechanical installations, e.g. use of ceiling fans, improvements in heating and cooling systems, interventions in lighting, etc. The simulation calculates the future energy status of the buildings and presents the economic benefits of the proposed interventions with reference to the environmental profits that arise.

Keywords: energy consumption in hospitals, energy saving interventions, energy upgrading, hospital facilities

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Authors: Eduardo Costa

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Hospital strikes in the Portuguese National Health Service (NHS) are becoming increasingly frequent, raising concerns in what respects patient safety. In fact, data shows that mortality rates for patients admitted during strikes are up to 30% higher than for patients admitted in other days. This paper analyses the effects of hospital strikes on patients’ outcomes. Specifically, it analyzes the impact of different strikes (physicians, nurses and other health professionals), on in-hospital mortality rates, readmission rates and length of stay. The paper uses patient-level data containing all NHS hospital admissions in mainland Portugal from 2012 to 2017, together with a comprehensive strike dataset comprising over 250 strike days (19 physicians-strike days, 150 nurses-strike days and 50 other health professionals-strike days) from 135 different strikes. The paper uses a linear probability model and controls for hospital and regional characteristics, time trends, and changes in patients’ composition and diagnoses. Preliminary results suggest a 6-7% increase in in-hospital mortality rates for patients exposed to physicians’ strikes. The effect is smaller for patients exposed to nurses’ strikes (2-5%). Patients exposed to nurses strikes during their stay have, on average, higher 30-days urgent readmission rates (4%). Length of stay also seems to increase for patients exposed to any strike. Results – conditional on further testing, namely on non-linear models - suggest that hospital operations and service levels are partially disrupted during strikes.

Keywords: health sector strikes, in-hospital mortality rate, length of stay, readmission rate

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Authors: Florge Francis A. Sy

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Acute pancreatitis (AP) is an inflammatory condition of the pancreas with local and systemic complications. Severe acute pancreatitis (SAP) has a higher mortality rate. Laboratory parameters like the neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), and mean platelet volume (MPV) have been associated with SAP but with conflicting results. This study aims to determine the predictive value of these parameters on the severity and in-hospital mortality of AP. This retrospective, cross-sectional study was done in a private hospital in Cebu City, Philippines. One-hundred five patients were classified according to severity based on the modified Marshall scoring. The admitting hemogram, including the NLR, RDW, and MPV, was obtained from the complete blood count (CBC). Cut-off values for severity and in-hospital mortality were derived from the ROC. Association between NLR, RDW, and MPV with SAP and mortality were determined with a p-value of < 0.05 considered significant. The mean age for AP was 47.6 years, with 50.5% being male. Most had an unknown cause (49.5%), followed by a biliary cause (37.1%). Of the 105 patients, 23 patients had SAP, and 4 died. Older age, longer in-hospital duration, congestive heart failure, elevated creatinine, urea nitrogen, and white blood cell count were seen in SAP. The NLR was associated with in-hospital mortality using a cut-off of > 10.6 (OR 1.133, 95% CI, p-value 0.003) with 100% sensitivity, 70.3% specificity, 11.76% PPV and 100% NPV (AUC 0.855). The NLR was not associated with SAP. The RDW and MPV were not associated with SAP and mortality. The admitting NLR is, therefore, an easily accessible parameter that can predict in-hospital mortality in acute pancreatitis. Although the present study did not show an association of NLR with SAP nor RDW and MPV with both SAP and mortality, further studies are suggested to establish their clinical value.

Keywords: acute pancreatitis, mean platelet volume, neutrophil-lymphocyte ratio, red cell distribution width

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Authors: Khaled Al-Mansour, Nawaf Esmael, Abdulaziz Al-Zaid, Mohammed Al Ateeqi, Ali Al-Yousfi, Sayed Al-Zalzalah

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In this project we will create the new schedule of nurse according to the preference of them. We did our project in Mubarak Al Kabeer Hospital (in Kuwait). The project aims to optimize the schedule of nurses in Mubarak Al Kabeer Hospital. The schedule of the nurses was studied and understood well to do any modification for their schedule to make the nurses feel as much comfort as they are. First constraints were found to know what things we can change and what things we can’t, the hard constraints are the hospital and ministry policies where we can’t change anything about, and the soft constraints are things that make nurses more comfortable. Data were collected and nurses were interviewed to know what is more better for them. All these constraints and date have been formulated to mathematical equations. This report will first contain an introduction to the topic which includes details of the problem definition. It will also contain information regarding the optimization of a nurse schedule and its contents and importance; furthermore, the report will contain information about the data needed to solve the problem and how it was collected. The problem requires formulation and that is also to be shown. The methodology will be explained which will state what has already been done. We used the lingo software to find the best schedule for the nurse. The schedule has been made according to what the nurses prefer, and also took consideration of the hospital policy when we make the schedule.

Keywords: nurse schedule problem, Kuwait, hospital policy, optimization of schedules

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Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

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Over the past decade, the non-elective admissions in the UK have increased significantly. Taking into account limited resources (i.e. beds), the related service managers are obliged to manage their resources effectively due to the non-elective admissions which are mostly admitted to inpatient specialities via A&E departments. Geriatric medicine is one of specialities that have long length of stay for the non-elective admissions. This study aims to develop a discrete event simulation model to understand how possible increases on non-elective demand over the next 12 months affect the bed occupancy rate and to determine required number of beds in a geriatric medicine speciality in a UK hospital. In our validated simulation model, we take into account observed frequency distributions which are derived from a big data covering the period April, 2009 to January, 2013, for the non-elective admission and the length of stay. An experimental analysis, which consists of 16 experiments, is carried out to better understand possible effects of case studies and scenarios related to increase on demand and number of bed. As a result, the speciality does not achieve the target level in the base model although the bed occupancy rate decreases from 125.94% to 96.41% by increasing the number of beds by 30%. In addition, the number of required beds is more than the number of beds considered in the scenario analysis in order to meet the bed requirement. This paper sheds light on bed management for service managers in geriatric medicine specialities.

Keywords: bed management, bed occupancy rate, discrete event simulation, geriatric medicine, non-elective admission

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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: Yunus Emre Kara, Atilla Kuzu, Levent Cirpici

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Recently, in the interior design of hospitals, the effect of the physical environment on the healing process has been frequently emphasized, and the importance of psychological and behavioral factors has increased day by day. When designing new hospital interiors, it became important to create spaces that not only meet medical requirements but also support the healing process of patients with interior design. In this study, the patient rooms, corridor, atrium area, waiting area, and entrance counter in a hospital were handled with patient-centered design, evidence-based design, and remedial architectural approaches, and it was seen that the healing and reassuring elements in hospitals were extremely important.

Keywords: evidence based design, healing architecture, hospital, organic design, parametric design

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Authors: Collen Tebogo Masilo, Erik Schmikl

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The demand for the DataMiner product by customers has presented a great challenge for the vendor in Skyline Communications in deploying its limited resources in the form of human resources, financial resources, and office space, to achieve high organisational performance in all its international operations. The rapid growth of the organisation has been unable to efficiently support its existing customers across the globe, and provide services to new customers, due to the limited number of approximately one hundred employees in its employ. The combined descriptive and explanatory case study research methods were selected as research design, making use of a survey questionnaire which was distributed to a sample of 100 respondents. A sample return of 89 respondents was achieved. The sampling method employed was non-probability sampling, using the convenient sampling method. Frequency analysis and correlation between the subscales (the four themes) were used for statistical analysis to interpret the data. The investigation was conducted into mechanisms that can be deployed to balance the high demand for products and the limited production capacity of the company’s Belgian operations across four aspects: demand management strategies, capacity management strategies, communication methods that can be used to align a sales management department, and reward systems in use to improve employee performance. The conclusions derived from the theme ‘demand management strategies’ are that the company is fully aware of the future market demand for its products. However, there seems to be no evidence that there is proper demand forecasting conducted within the organisation. The conclusions derived from the theme 'capacity management strategies' are that employees always have a lot of work to complete during office hours, and, also, employees seem to need help from colleagues with urgent tasks. This indicates that employees often work on unplanned tasks and multiple projects. Conclusions derived from the theme 'communication methods used to align sales management department with operations' are that communication is not good throughout the organisation. This means that information often stays with management, and does not reach non-management employees. This also means that there is a lack of smooth synergy as expected and a lack of good communication between the sales department and the projects office. This has a direct impact on the delivery of projects to customers by the operations department. The conclusions derived from the theme ‘employee reward systems’ are that employees are motivated, and feel that they add value in their current functions. There are currently no measures in place to identify unhappy employees, and there are also no proper reward systems in place which are linked to a performance management system. The research has made a contribution to the body of research by exploring the impact of the four sub-variables and their interaction on the challenges of organisational productivity, in particular where an organisation experiences a capacity problem during its growth stage during tough economic conditions. Recommendations were made which, if implemented by management, could further enhance the organisation’s sustained competitive operations.

Keywords: high demand for products, high organisational performance, limited production capacity, limited resources

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Authors: Soha A. Bahanshal, Byung G. Kim

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Identification of patients at high risk for hospital readmission is of crucial importance for quality health care and cost reduction. Predicting hospital readmissions among diabetic patients has been of great interest to many researchers and health decision makers. We build a prediction model to predict hospital readmission for diabetic patients within 30 days of discharge. The core of the prediction model is a modified k Nearest Neighbor called Hybrid Fuzzy Weighted k Nearest Neighbor algorithm. The prediction is performed on a patient dataset which consists of more than 70,000 patients with 50 attributes. We applied data preprocessing using different techniques in order to handle data imbalance and to fuzzify the data to suit the prediction algorithm. The model so far achieved classification accuracy of 80% compared to other models that only use k Nearest Neighbor.

Keywords: machine learning, prediction, classification, hybrid fuzzy weighted k-nearest neighbor, diabetic hospital readmission

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Authors: Ahmet Kurklu, Abdussamed Sarp, Gokmen Arikan, Akin Eren, Arif Ulu, Ferit Cakir

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Our natural resources are diminishing day by day with the needs of the growing world population. There is a danger that these resources will be depleted if they are not used in a controlled manner. As a result of the rapid increase in the consumption of limited natural resources, one of the issues where studies have gained importance is recycling. Many countries have carried out various research and development activities on recycling and reuse to prevent wastage of resources. For sustainable and healthy living, the limited amount of raw material resources in nature should be consumed consciously, and the necessary awareness should be given for recycling activities. One of the sectors where the consumption of raw materials is high is the construction sector. With the changing consumption habits of the evolving technology in the construction sector, the need to use special concrete along with the normal concrete has arisen. With the increasing need for specialty concretes, polymer concrete, which was discovered in the early 1900s, has evolved to the present day. Polymer concretes are special concretes with high strength, water impermeability, resistance to chemical action, and low surface roughness. Thanks to these properties, they find wide applications in many fields such as swimming pools, drainage systems, repair works. In the study, the effect of using recycled aggregates instead of natural aggregates in the production of polymer concrete on the performance of polymer concrete is investigated. In the experiments conducted for this purpose, the use of natural aggregate is reduced at certain rates, and instead, recycled aggregate is added at the same rate. The recycled aggregate to be used in the study is obtained from the polymer concrete drainage channel production facility of Mert Casting Co., Istanbul, Turkey. In order to clearly observe the effect of recycled materials on the product in the study, the other components (resin, hardener, accelerator, and additive) are kept constant in the concrete mix. In the study, fresh and hardened concrete tests are to be carried out on the mixes to be prepared.

Keywords: concrete, mechanical properties, polymer concrete, recycle aggregate

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Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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Authors: Mahmoud Abdel Hameed Shahin

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Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.

Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress

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Authors: Bhawat Chiamjinnawat

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The agri-food market transformation has implied market growth for the fruit industry in Thailand. This article focuses on analysis of farmer competence and farm resources which affect market strategies used by fruit farmers in Chanthaburi province of Thailand. The survey data were collected through the use of face-to-face interviews with structured questionnaires. This study identified 14 drivers related to farmer competence and farm resources of which some had significant effect on the decision to use either high-value markets or traditional markets. The results suggest that farmers who used high-value markets were better educated and they had longer experience and larger sized business. Identifying the important factors that match with the market transformation provides policy with opportunities to support the fruit farmers to increase their market power. Policies that promote business expansion of agricultural cooperatives and knowledge sharing among farmers are recommended to reduce limitations due to limited knowledge, low experience, and small business sizes.

Keywords: farmer competence, farm resources, fruit industry, high-value markets, Thailand

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Authors: Mamatha M. N.

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Traffic problems, congested traffic, and flow management were recognized as major problems mostly in all the areas, which have caused a problem for the ambulance which carries the emergency patient. The proposed paper aims in the development of ambulance which reaches the nearby hospital faster even in heavy traffic scenario. This process is activated by implementing hardware in an ambulance as well as in traffic post thus allowing a smooth flow to the ambulance to reach the hospital in time. 1) The design of the vehicle to have a communication between ambulance and traffic post. 2)Electronic Health Record with Data-acquisition system 3)Telemetry of acquired biological parameters to the nearest hospital. Thus interfacing all these three different modules and integrating them on the ambulance could reach the hospital earlier than the present ambulance. The system is accurate and efficient of 99.8%.

Keywords: bio-telemetry, data acquisition, patient database, automatic traffic control

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Authors: Marie-Helena Docherty, Sion Edryd Williams

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The prevalence of diabetes mellitus is increasing worldwide. In Sub-Saharan Africa, type 2 diabetes represents over 90% of all types of diabetes with the number of diabetic patients expected to rise. This represents a huge economic burden in an area already contending with high rates of other significant diseases, including the highest worldwide prevalence of HIV. Diabetic complications considerably impact on morbidity and mortality. The epidemiological data for the region quotes high rates of retinopathy (7-63%), neuropathy (27-66%) and microalbuminuria (10-83%). It is therefore imperative that diabetic screening programmes are established. It is recognised that in many parts of the developing world the implementation and management of such programmes is limited by a lack of available resources. The International Diabetes Federation produced guidelines in 2012 taking these limitations into account suggesting that all diabetic patients should have access to basic screening. These guidelines are consistent with the national diabetic guidelines produced by the Lesotho Medical Council. However, diabetic care in Lesotho is delivered at the local level, with variable levels of quality. A cross sectional study was performed in the outpatient department of Maluti Hospital in Mapoteng, Lesotho, a busy rural hospital in the Berea district. Demographic data on gender, age and modality of treatment were collected over a six-week time period. Information regarding 3 basic screening parameters was obtained. These parameters included eye screening (defined as a documented ophthalmology review within the last 12 months), foot screening (defined as a documented foot health assessment by any health care professional within the last 12 months) and secondary prevention (defined as a documented blood pressure and lipid profile reading within the last 12 months). These parameters were selected on the basis of the absolute minimum level of resources in Maluti Hospital. Renal screening was excluded, as the hospital does not have access to reliable renal profile checks or urinalysis. There is however a fully functioning on-site ophthalmology department run by a senior ophthalmologist with the ability to provide retinal photography, retinal surgery and photocoagulation therapy. Data was collected on 183 type 2 diabetics. 112 patients were male and 71 were female. The average age was 43 years. 4 patients were diet controlled, 140 patients were on oral hypoglycaemic agents (metformin and/or glibenclamide), and 39 patients were on a combination of insulin and oral hypoglycaemics. In the preceding 12 months, 5 patients had undergone eye screening (3%), 24 patients had undergone foot screening (13%), and 31 patients had lipid profile testing (17%). All patients had a documented blood pressure reading (100%). Our results show that screening is poorly performed in the basic indicators suggested by the IDF and the Lesotho Medical Council. On the basis of these results, a screening programme was developed using the mnemonic SaFE; secondary prevention, foot and eye care. This is simple, memorable and transferable between healthcare professionals. In the future, the expectation would be to expand upon this current programme to include renal screening, and to further develop screening pertaining to secondary prevention.

Keywords: Africa, complications, rural, screening

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Authors: H. Anzai, H. Nakayama, H. Kaminaga, Y. Morimoto, Y. Miyadera, S. Nakamura

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Various research resources such as papers and presentation slides are handled in the process of research activities. It is extremely important for smooth progress of the research to skillfully manage those research resources and utilize them for further investigations. However, number of the research resources increases more and more. Moreover, there are the differences in usage of each kind of research resource and their accumulation styles. So, it is actually difficult to satisfactorily manage and use the accumulated research resources. Therefore, a lack of tidiness of the resources causes the problems such as an oversight of the problem to be polish. Although there have existed research projects on support for management of research resources and for sharing of know-how, almost existing systems have not been effective enough since these systems have not sufficiently considered the polish process. This paper mainly describes a system that enables the strategic management of research resources together with polish process and their practical use.

Keywords: research resource, polish process, information sharing, knowledge management, information visualization

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Authors: Soungwan Kim

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This paper discusses an analysis of how the characteristics of resources at vocational rehabilitation facilities for the disabled affect the improvement of independency skills among people with severe disabilities. The analysis results indicate that more internal financial resources and more connections to local communities among network resources had greater effects on improving the independency of people with severe disabilities. Based on this result, this paper presents strategies for mobilizing resources to improve the independency of people with severe disabilities at vocational rehabilitation facilities.

Keywords: vocational rehabilitation facility for people with disabilities, types of resources, independency, network resources

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Authors: Iris Maria Velez Osorio

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There has been in the last decade a concern about the environment, particularly about clean and enough water for human consumption but, some enterprises had some trouble to understand the limited resources in the environment. This research tries to understand how some industries are better oriented to the preservation of the environment through investment for strategic management of scarce resources and try in the best way possible, the contaminants. It was made an industry classification since four different group of theories for Corporate Social Responsibility agree with variables of: investment in environmental care, water protection, and residues treatment finding different levels of commitment with CSR.

Keywords: corporate social responsibility, environment, strategic management, water

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Authors: Esha Saha, Pradip Kumar Ray

Abstract:

A hospital inventory comprises of a large number and great variety of items for the proper treatment and care of patients, such as pharmaceuticals, medical equipment, surgical items, etc. Improper management of these items, i.e. stockouts, may lead to delay in treatment or other fatal consequences, even death of the patient. So, generally the hospitals tend to overstock items to avoid the risk of stockout which leads to unnecessary investment of money, difficulty in storing, more expiration and wastage, etc. Thus, in such challenging environment, it is necessary for hospitals to follow an inventory policy considering the stochasticity of demand in a hospital. Statistical analysis captures the correlation of patient condition based on bed occupancy with the patient demand which changes stochastically. Due to the dependency on bed occupancy, the markov model is developed that helps to map the changes in demand of hospital inventory based on the changes in the patient condition represented by the movements of bed occupancy states (acute care state, rehabilitative state and long-care state) during the length-of-stay of patient in a hospital. An inventory policy is developed for a hospital based on the fulfillment of patient demand with the objective of minimizing the frequency and quantity of placement of orders of inventoried items. The analytical structure of the model based on probability calculation is provided to show the optimal inventory-related decisions. A case-study is illustrated in this paper for the development of hospital inventory model based on patient demand for multiple inpatient pharmaceutical items. A sensitivity analysis is conducted to investigate the impact of inventory-related parameters on the developed optimal inventory policy. Therefore, the developed model and solution approach may help the hospital managers and pharmacists in managing the hospital inventory in case of stochastic demand of inpatient pharmaceutical items.

Keywords: bed occupancy, hospital inventory, markov model, patient condition, pharmaceutical items

Procedia PDF Downloads 298

Authors: Burak Köken, Hatice D. Arslan, Bilgehan Y. Çakmak

Abstract:

Analyzing the relation networks between the hospital buildings which have complex structure and distinctive spatial relationships is quite difficult. The hospital buildings which require specialty in spatial relationship solutions during design and self-innovation through the developing technology should survive and keep giving service even after the disasters such as earthquakes. In this study, a hospital building where the load-bearing system was strengthened because of the insufficient earthquake performance and the construction of an additional building was required to meet the increasing need for space was discussed and a comparative spatial evaluation of the hospital building was made with regard to its status before the change and after the change. For this reason, spatial organizations of the building before change and after the change were analyzed by means of Space Syntax method and the effects of the change on space organization parameters were searched by applying an analytical procedure. Using Depthmap UCL software, connectivity, visual mean depth, beta and visual integration analyses were conducted. Based on the data obtained after the analyses, it was seen that the relationships between spaces of the building increased after the change and the building has become more explicit and understandable for the occupants. Furthermore, it was determined according to findings of the analysis that the increase in depth causes difficulty in perceiving the spaces and the changes considering this problem generally ease spatial use.

Keywords: architecture, hospital building, space syntax, strengthening

Procedia PDF Downloads 493

Authors: Ibeku Bernadine Ezenwanyi

Abstract:

Hospital-Acquired Infections (HAI), also called ‘Nosocomial Infection’ is an infection you get while in the hospital for another reason. They are an important cause of morbidity and mortality. This study examined the epidemiology, clinical outcomes of some instruments used on patients especially catheter that was passed on them during their stay in the hospital. It was discovered that they had catheter–associated urinary tract infection (CAUTI). An observational study was carried out from January to March, 2022, on 180 patients (80 males and 100 females) admitted in the surgical wards, medical wards, dialysis unit and intensive care unit (ICU) of the hospital. The patient’s urine samples were collected for urine culture and the isolation was carried out using plate count agar medium and macconkey agar. Among the 80 males, 45 had Urinary Tract Infections (UTI) mostly proteus infection and among the 100 females, 70 also had (UTI) and the most common was caused by Escherichia coli. Other strain of microorganisms such as Klebsiella, Staphylococcus aureus and Pseudomonas aeruginosa. It is important to follow up patients that these devices were used on with antibiotics to make sure that these infections are not developed because the rate of these infections (UTI) are high especially in females.

Keywords: catheter, urinary tract infection, nosocomial infection, microorganisms

Procedia PDF Downloads 87

Authors: M. Bouzid, A. Djadi, C. Aribi, A. Irekti, B. Bezzazi, F. Halouene

Abstract:

The nature of materials structuring our health institutions promote the development of germs. The sustainability of nosocomial infections remains significant (12% and 15%). One of the major factors is the portland cement which is brittle and porous. As part of a national plan to fight nosocomial infections, led by the University Hospital of Blida, we opted for a composite coating, application by multilayer model, composed of epoxy-polyester resin as a binder and calcium carbonate as mineral fillers. The application of composite materials reinforce the wall coating of hospital units and eliminates the hospital infectious areas. The resistance to impact, chemicals, raising temperature and to a biologically active environment gives satisfactory results.

Keywords: nosocomial infection, microbial load, composite materials, portland cement

Procedia PDF Downloads 363

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

Abstract:

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

Procedia PDF Downloads 548

Authors: Abu Hashan Md Mashud, M. Sharif Uddin, Aminur Rahman Khan

Abstract:

In this paper, we formulate a new problem as a linear programming and Integer Programming problem and maximize profit within the limited budget and limited resources based on the construction of a tea garden problem. It describes a new idea about how to optimize profit and focuses on the practical aspects of modeling and the challenges of providing a solution to a complex real life problem. Finally, a comparative study is carried out among Graphical method, Simplex method and Branch and bound method.

Keywords: integer programming, tea garden, graphical method, simplex method, branch and bound method

Procedia PDF Downloads 583