Search results for: healthcare facilities

Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

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Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: Robotics and automation, engineering management, engineering in medicine and biology, medical services, public healthcare.

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Authors: Porntip Ruengtam

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This article is an extension of previous research presenting the relevant factors related to environmental perceptions, residential community, and the design of a healing environment, which have effects on the well-being and requirements of Thai elderly. Research methodology began with observations and interviews in three case studies in terms of the management processes and environment design of similar existing projects in Thailand. The interview results were taken to summarize with related theories and literature. A questionnaire survey was designed for data collection to confirm the factors of requirements in a residential community intended for the Thai elderly. A structural equation model (SEM) was formulated to explain the cause-effect factors for the requirements of a residential community for Thai elderly. The research revealed that the requirements of a residential community for Thai elderly were classified into three groups when utilizing a technique for exploratory factor analysis. The factors were comprised of (1) requirements for general facilities and activities, (2) requirements for facilities related to health and security, and (3) requirements for facilities related to physical exercise in the residential community. The results from the SEM showed the background of elderly people had a direct effect on their requirements for a residential community from various aspects. The results should lead to the formulation of policies for design and management of residential communities for the elderly in order to enhance quality of life as well as both the physical and mental health of the Thai elderly.

Keywords: Elderly, environmental design, residential community, structural equation modeling.

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Authors: A. Beduk, K. Eryesil, O. Esmen

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The aim of this study is to examine the relationship between organizational commitment which is defined as a strong belief in and acceptance of the organization’s goals and values, and burnout syndrome and organizational cynicism. Accordingly, a field research based on survey method was conducted on the employees of a health institution operating in the province of Konya. The findings of the research show that there is a positive statistically significant relationship between organizational cynicism and burnout while there is a negative statistically significant relationship between organizational commitment and burnout. Furthermore, it has been also realized that there is a negative and statistically significant relationship between organizational commitment and organizational cynicism.

Keywords: Burnout, organizational commitment, organizational cynicism, healthcare management.

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Authors: Y. Y. Su, K. T. Win, H. C. Chiu

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This study used Item Analysis, Exploratory Factor Analysis (EFA) and Reliability Analysis (Cronbach-s α value) to exam the Questions which selected by the Delphi method based on the issue of “Socio-technical system (STS)" and user-centered perspective. A structure questionnaire with seventy-four questions which could be categorized into nine dimensions (healthcare environment, organization behaviour, system quality, medical data quality, service quality, safety quality, user usage, user satisfaction, and organization net benefits) was provided to evaluate EMR of the Taiwanese healthcare environment.

Keywords: Instrument development, Reliability test, Validity test, Electronic Medical Record Evaluation.

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Authors: Amirali Shirazibeheshti, Tarik Radwan, Alireza Ettefaghian, Farbod Khanizadeh, George Wilson, Cristina Luca

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. This work evaluates the association between the average risk score and measures of socioeconomic status (index of multiple deprivation) and health (index of health and disability). The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, suggesting that females are more at risk from this kind of multiple medication. The risk may be monitored and controlled in a healthcare management system that is well-equipped with tools implementing appropriate techniques of artificial intelligence.

Keywords: Anticholinergic medication, socioeconomic status, deprivation, clustering, risk analysis.

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Authors: Taehan Lee

Abstract:

We consider a network design problem which has shortest routing restriction based on the values determined by the installed facilities on each arc. In conventional multicommodity network design problem, a commodity can be routed through any possible path when the capacity is available. But, we consider a problem in which the commodity between two nodes must be routed on a path which has shortest metric value and the link metric value is determined by the installed facilities on the link. By this routing restriction, the problem has a distinct characteristic. We present an integer programming formulation containing the primal-dual optimality conditions to the shortest path routing. We give some computational results for the model.

Keywords: Integer programming, multicommodity network design, routing, shortest path.

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Authors: M. A. N. Rasanjalee Perera

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The world is facing several problems due to increasing elderly population. In Sri Lanka, along with the complexity of the modern society and structural and functional changes of the family, “caring for elders” seems as an emerging social problem. This situation may intensify as the county is moving into a middle income society. Seeking higher education and related career opportunities, and urban living in modern housing are new trends, through which several problems are generated. Among many issues related with elders, “lack of accessible and appropriate facilities in their houses as well as public buildings” can be identified as a major problem. This study argues that welfare facilities provided for the elderly people, particularly in the home environment, in the country are not adequate. Modern housing features such as bathrooms, pantries, lobbies, and leisure areas etc. are questionable as to whether they match with elders’ physical and mental needs. Consequently, elders have to face domestic accidents and many other difficulties within their living environments. Records of hospitals in the country also proved this fact. Therefore, this study tries to identify how far modern houses are suited with elders’ needs. The study further questioned whether “aging” is a considerable matter when people are buying, planning and renovating houses. A randomly selected sample of 50 houses were observed and 50 persons were interviewed around the Maharagama urban area in Colombo district to obtain primary data, while relevant secondary data and information were used to have a depth analysis. The study clearly found that none of the houses included to the sample are considering elders’ needs in planning, renovating, or arranging the home. Instead, most of the families were giving priority to the rich and elegant appearance and modern facilities of the houses. Particularly, to the bathrooms, pantry, large setting areas, balcony, parking slots for two vehicles, ad parapet walls with roller-gates are the main concerns. A significant factor found here is that even though, many children of the aged are in middle age and reaching their older years at present, they do not plan their future living within a safe and comfortable home, despite that they are hoping to spent the latter part of their lives in the their current homes. This fact highlights that not only the other responsible parts of the society, but also those who are reaching their older ages are ignoring the problems of the aged. At the same time, it was found that more than 80% of old parents do not like to stay at their children’s homes as the living environments in such modern homes are not familiar or convenient for them. Due to this context, the aged in Sri Lanka may have to be alone in their own homes due to current trend of society of migrating to urban living in modern houses. At the same time, current urban families who live in modern houses may have to face adding accessible facilities in their home environment, as current modern housing facilities may not be appropriate them for a better life in their latter part of life.

Keywords: Aging population, elderly care, home environment, housing facilities.

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Authors: A. M. Omoare, E. O. Fakoya, B. G. Abiona, W. O. Oyediran

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This study assessed fish marketing as panacea towards sustainable agriculture in Ogun State, Nigeria. Multi-stage sampling technique was used in the selection of 150 fish marketers for this study. Descriptive statistics were used for the objectives while Product Pearson Moment Correlation was used to test the hypothesis. Result of the findings revealed that the mean age of the respondents was 38.60 years. Majority (93.33%) of the respondents had acceptable levels of formal education. Many (44.00%) of the respondents had spent 1-5 years in fish marketing. The average quantity of fish sold in a day was 94.10kg. However, efficient fish marketing were hindered by inadequate processing equipment, storage rooms and ice holding facilities (86.67%). There was a significant relationship between socio-economic characteristics and profit realized from fish marketing (p < 0.05). It was recommended that storage and warehousing facilities should be provided to the fish marketers in the study area.

Keywords: Fish marketers, panacea, retail markets, sustainable.

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Authors: Basavaraj Kabade, K. T. Nagaraja, Swathi Ramanathan, A. Veeraragavan, P. S. Reashma

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Deteriorating quality of the pedestrian environment and the increasing risk of pedestrian crashes are major concerns for most of the cities in India. The recent shift in the priority to motorized transport and the abating condition of existing pedestrian facilities can be considered as prime reasons for the increasing pedestrian related crashes in India. Bengaluru City – the IT capital hub of the nation is not much different from this. The increase in number of pedestrian crashes in Bengaluru reflects the same. To resolve this issue and to ensure safe, sustainable and pedestrian friendly sidewalks, Govt. of Karnataka, India has implemented newfangled pedestrian sidewalks popularized programme named Tender S.U.R.E. (Specifications for Urban Road Execution) projects. Tender SURE adopts unique urban street design guidelines where the pedestrians are given prime preference. The present study presents an assessment of the quality and performance of the pedestrian side walk and the walkability index of the newly built pedestrian friendly sidewalks. Various physical and environmental factors affecting pedestrian safety are identified and studied in detail. The pedestrian mobility is quantified through Pedestrian Level of Service (PLoS) and the pedestrian walking comfort is measured by calculating the Walkability Index (WI). It is observed that the new initiatives taken in reference to improving pedestrian safety have succeeded in Bengaluru by attaining a level of Service of ‘A’ and with a good WI score.

Keywords: Pedestrian safety, pedestrian level of service, right of way, Tender SURE, walkability index, walkway facilities.

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Authors: Tero Huhtala, Minna Pikkarainen, Saila Saraniemi

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Information technology has long been used as an enabler of exchange for goods and services. Services are evolving from generic to personalized, and the reverse use of customer data has been discussed in both academia and industry for the past few years. This article presents the results of an empirical case study in the area of preventive health care services. The primary data were gathered in workshops, in which future personal data-based services were conceptualized by analyzing future scenarios from a business perspective. The aim of this study is to understand business model transformation in emerging personal data ecosystems. The work was done as a case study in the context of occupational healthcare. The results have implications to theory and practice, indicating that adopting personal data management principles requires transformation of the business model, which, if successfully managed, may provide access to more resources, potential to offer better value, and additional customer channels. These advantages correlate with the broadening of the business ecosystem. Expanding the scope of this study to include more actors would improve the validity of the research. The results draw from existing literature and are based on findings from a case study and the economic properties of the healthcare industry in Finland.

Keywords: Ecosystem, business model, personal data, preventive healthcare.

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Authors: Wan Hasrulnizzam Wan Mahmood, Mohd Nizam Ab Rahman, Husiah Mazli, Baba Md Deros

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This paper explores the plant maintenance management system that has been used by giant oil and gas company in Malaysia. The system also called as PMMS used to manage the upstream operations for more than 100 plants of the case study company. Moreover, from the observations, focus group discussion with PMMS personnel and application through simulation (SAP R/3), the paper reviews the step-by-step approach and the elements that required for the PMMS. The findings show that the PMMS integrates the overall business strategy in upstream operations that consist of asset management, work management and performance management. In addition, PMMS roles are to help operations personnel organize and plan their daily activities, to improve productivity and reduce equipment downtime and to help operations management analyze the facilities and create performance, and to provide and maintain the operational effectiveness of the facilities.

Keywords: Maintenance, Oil and Gas Industry, Upstream Operations

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Authors: S. Impey, D. Berry, S. Furtado, M. Galvin, L. Grogan, O. Hardiman, L. Hederman, M. Heverin, V. Wade, L. Douris, D. O'Sullivan, G. Stephens

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Healthcare is a knowledge-rich environment. This knowledge, while valuable, is not always accessible outside the borders of individual clinics. This research aims to address part of this problem (at a study site) by constructing a maximal data set (knowledge artefact) for motor neurone disease (MND). This data set is proposed as an initial knowledge base for a concurrent project to develop an MND patient data platform. It represents the domain knowledge at the study site for the duration of the research (12 months). A knowledge elicitation method was also developed from the lessons learned during this process - the WICKED method. WICKED is an anagram of the words: eliciting and confirming data, information, knowledge, wisdom. But it is also a reference to the concept of wicked problems, which are complex and challenging, as is eliciting expert knowledge. The method was evaluated at a second site, and benefits and limitations were noted. Benefits include that the method provided a systematic way to manage data, information, knowledge and wisdom (DIKW) from various sources, including healthcare specialists and existing data sets. Limitations surrounded the time required and how the data set produced only represents DIKW known during the research period. Future work is underway to address these limitations.

Keywords: Healthcare, knowledge acquisition, maximal data sets, action design science.

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Authors: Sung-Hun Lee, Yun-Seong Lee, Jin-O Kim

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Reliability Centered Maintenance(RCM) is one of most widely used methods in the modern power system to schedule a maintenance cycle and determine the priority of inspection. In order to apply the RCM method to the Smart Grid, a precedence study for the new structure of rearranged system should be performed due to introduction of additional installation such as renewable and sustainable energy resources, energy storage devices and advanced metering infrastructure. This paper proposes a new method to evaluate the priority of maintenance and inspection of the power system facilities in the Smart Grid using the Risk Priority Number. In order to calculate that risk index, it is required that the reliability block diagram should be analyzed for the Smart Grid system. Finally, the feasible technical method is discussed to estimate the risk potential as part of the RCM procedure.

Keywords: Expert System, FMECA, Fuzzy Theory, Reliability Centered Maintenance, Risk Priority Number

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Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan

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We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.

Keywords: Daily activity recognition, healthcare, IoT sensors, transfer learning.

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Authors: C. A. Alves, A. I. Calvo, A. Castro, R. Fraile, M. Evtyugina, E. F. Bate-Epey

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In July 2012, an indoor/outdoor monitoring programme was undertaken in two university sports facilities: a fronton and a gymnasium. Comfort parameters (temperature, relative humidity, CO and CO2) and total volatile organic compounds (VOCs) were continuously monitored. Concentrations of NO2, carbonyl compounds and individual VOCs were obtained. Low volume samplers were used to collect particulate matter (PM10). The minimum ventilation rates stipulated for acceptable indoor air quality were observed in both sports facilities. It was found that cleaning activities may have a large influence on the VOC levels. Acrolein was one of the most abundant carbonyl compounds, showing concentrations above the recommended limit. Formaldehyde was detected at levels lower than those commonly reported for other indoor environments. The PM10 concentrations obtained during the occupancy periods ranged between 38 and 43μgm-3 in the fronton and from 154 to 198μgm-3 in the gymnasium.

Keywords: Air exchange rates, carbonyls, gymnasiums, indoor air quality, PM10, VOCs.

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Authors: Sarah Reker

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The Convention on the Rights of Persons with Disabilities (CRPD) provides the basis of this study. For all countries which have ratified the convention since its entry into force in 2007, the effective implementation of the requirements often leads to considerable challenges. Furthermore, missing indicators make it difficult to measure progress. Therefore, the aim of the research project is to contribute to analyze the consequences of the implementation process on the inclusion and exclusion conditions for people with disabilities in Germany. Disabled People’s Organisations and other associations consider the social space to be relevant for the successful implementation of the CRPD. Against this background, the research project wants to focus on the relationship between a barrier-free access to the social space and the “full and effective participation and inclusion” (Art. 3) of persons with disabilities. The theoretical basis of the study is the sociological theory of social space (“Sozialraumtheorie”).

Keywords: Decentralisation, qualitative research, residential facilities, social space.

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Authors: J. H. Ahn, J. W. Moon, K. H. Kim, H. K. Kim

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As the ecology of Lake Shihwa has been restored significantly nowadays, the urban development is in progress around Lake Shihwa areas. Each development project includes a plan on utilizing waterfront areas, but there exist a difference on waterfront design criteria between experts and users. Therefore, it is significant to analyze preferences in design elements of existing waterfront parks around Lake Shihwa (Ansan Waterfront Park, Shihwa Reed Wetland Park, and T-Light Park) based on users’ perspectives and to reflect the result on upcoming waterfront developments. This study derives design elements on waterfront parks from literature reviews. The survey questionnaires are created based on these classified elements and the surveys are conducted to experts and users with in-depth interviews. For all three parks, several park facilities appear to be not recognized by users. Therefore the circulation path should be introduced in guide maps and information activities and furthermore in disposition of park facilities.

Keywords: Design Elements, Lake Shihwa, Preference, Waterfront Park.

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Authors: A. A. AlRasheed, A. Atkins, R. Campion

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This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: Knowledge management, visualisation, patients, hospitals, healthcare workers, workflow, improvements.

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Authors: Denise Levy, Gian M. A. A. Sordi

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This web based project focuses on continuing corporate education and improving workers' skills in Brazilian radioactive facilities throughout the country. The potential of Information and Communication Technologies (ICTs) shall contribute to improve the global communication in this very large country, where it is a strong challenge to ensure high quality professional information to as many people as possible. The main objective of this system is to provide Brazilian radioactive facilities a complete web-based repository - in Portuguese - for research, consultation and information, offering conditions for learning and improving professional and personal skills. UNIPRORAD is a web based system to offer unified programs and inter-related information about radiological protection programs. The content includes the best practices for radioactive facilities in order to meet both national standards and international recommendations published by different organizations over the past decades: International Commission on Radiological Protection (ICRP), International Atomic Energy Agency (IAEA) and National Nuclear Energy Commission (CNEN). The website counts on concepts, definitions and theory about optimization and ionizing radiation monitoring procedures. Moreover, the content presents further discussions related to some national and international recommendations, such as potential exposure, which is currently one of the most important research fields in radiological protection. Only two publications of ICRP develop expressively the issue and there is still a lack of knowledge of fail probabilities, for there are still uncertainties to find effective paths to quantify probabilistically the occurrence of potential exposures and the probabilities to reach a certain level of dose. To respond to this challenge, this project discusses and introduces potential exposures in a more quantitative way than national and international recommendations. Articulating ICRP and AIEA valid recommendations and official reports, in addition to scientific papers published in major international congresses, the website discusses and suggests a number of effective actions towards safety which can be incorporated into labor practice. The WEB platform was created according to corporate public needs, taking into account the development of a robust but flexible system, which can be easily adapted to future demands. ICTs provide a vast array of new communication capabilities and allow to spread information to as many people as possible at low costs and high quality communication. This initiative shall provide opportunities for employees to increase professional skills, stimulating development in this large country where it is an enormous challenge to ensure effective and updated information to geographically distant facilities, minimizing costs and optimizing results.

Keywords: Distance learning, information and communication technology, nuclear science, radioactive facilities.

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Authors: M. A. Amezcua-Allieri, E. Torres, J. A. Zermeño Eguía-Lis, M. Magdaleno, L. A. Melgarejo, E. Palmerín, A. Rosas, D. López, J. Aburto

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The use of biomass to produce renewable energy is one of the forms that can be used to reduce the impact of energy production. Like any other energy resource, there are limitations for biomass use, and it must compete not only with fossil fuels but also with other renewable energy sources such as solar or wind energy. Combustion is currently the most efficient and widely used waste-to-energy process, in the areas where direct use of biomass is possible, without the need to make large transfers of raw material. Many industrial facilities can use agricultural or forestry waste, straw, chips, bagasse, etc. in their thermal systems without making major transformations or adjustments in the feeding to the ovens, making this waste an attractive and cost-effective option in terms of availability, access, and costs. In spite of the facilities and benefits, the environmental reasons (emission of gases and particulate material) are decisive for its use for energy purpose. This paper describes a valorization of residues from forest industry to generate energy, using a case study.

Keywords: Bioenergy, forest waste, life-cycle assessment, waste-to-energy, electricity.

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Authors: Chia-Yu Hsu, Julaimin Goh, Pei-Chann Chang

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Home is important for Chinese people. Because the information regarding the house attributes and surrounding environments is incomplete in most real estate agency, most house buyers are difficult to consider the overall factors effectively and only can search candidates by sorting-based approach. This study aims to develop a decision support system for housing purchasing, in which surrounding facilities of each house are quantified. Then, all considered house factors and customer preferences are incorporated into Simple Multi-Attribute Ranking Technique (SMART) to support the housing evaluation. To evaluate the validity of proposed approach, an empirical study was conducted from a real estate agency. Based on the customer requirement and preferences, the proposed approach can identify better candidate house with consider the overall house attributes and surrounding facilities.

Keywords: decision support system, real estate, decision analysis, housing evaluation, SMART

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Authors: Jagmohan Mago, Parvinder S. Sandhu, Neeru Chawla

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In this paper, a Bayesian Network (BN) based system is presented for providing clinical decision support to healthcare practitioners in rural or remote areas of India for young infants or children up to the age of 5 years. The government is unable to appoint child specialists in rural areas because of inadequate number of available pediatricians. It leads to a high Infant Mortality Rate (IMR). In such a scenario, Intelligent Pediatric System provides a realistic solution. The prototype of an intelligent system has been developed that involves a knowledge component called an Intelligent Pediatric Assistant (IPA); and User Agents (UA) along with their Graphical User Interfaces (GUI). The GUI of UA provides the interface to the healthcare practitioner for submitting sign-symptoms and displaying the expert opinion as suggested by IPA. Depending upon the observations, the IPA decides the diagnosis and the treatment plan. The UA and IPA form client-server architecture for knowledge sharing.

Keywords: Network, Based Intelligent, Pediatric System

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Authors: A.L.Deghal.Cheridi, A.Chaker, A.Loubar

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loss of feedwater accident is one of the frequently sever accidents in steam boiler facilities. It threatens the system structural integrity and generates serious hazards and economic loses. The safety analysis of the thermal installations, based extensively on the numeric simulation. The simulation analysis using realistic computer codes like Relap5/Mod3.2 will help understand steam boiler thermal-hydraulic behavior during normal and abnormal conditions. In this study, we are interested on the evaluation of the radiant steam boiler assessment and response to loss-of-feedwater accident. Pressure, temperature and flow rate profiles are presented in various steam boiler system components. The obtained results demonstrate the importance and capability of the Relap5/Mod3.2 code in the thermal-hydraulic analysis of the steam boiler facilities.

Keywords: Radiant steam boiler, Relap5/Mod3.2 code system, Steady-state simulation, Transient simulation, Loss of feedwateraccident

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Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: Average run length, Bernoulli CUSUM chart, beta binomial posterior predictive distribution, clinical indicator, health care organization, highest posterior density interval.

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Authors: Esra E. Aleisa

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A local municipality has decided to build a sewage pit to receive residential sewage waste arriving by tank trucks. Daily accumulated waste are to be pumped to a nearby waste water treatment facility to be re-consumed for agricultural and construction projects. A discrete-event simulation model using Arena Software was constructed to assist in defining the capacity of the system in cubic meters, number of tank trucks to use the system, number of unload docks required, number of standby areas needed and manpower required for data collection at entrance checkpoint and truck tank load toxicity testing. The results of the model are statistically validated. Simulation turned out to be an excellent tool in the facility planning effort for the pit project, as it insured smooth flow lines of tank trucks load discharge and best utilization of facilities on site.

Keywords: Discrete-event simulation, Facilities Planning, Layout, Pit, Sewage management.

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Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: Assessments, evaluation, monitoring, pharmacovigilance.

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Authors: A. A. Alshabanat, R. B. Albacker, A. A. Basalama, A. A. Bin Salamah, A. S. Alfrayh

Abstract:

The study was conducted to investigate the profile of hepatitis in Kingdom of Saudi Arabia, and to determine which age group hepatitis viruses most commonly infect. The epidemiology of viral hepatitis in Saudi Arabia has undergone major changes, concurrent with major socioeconomic developments over the last two to three decades. This disease represents a major public health problem in Saudi Arabia resulting in the need for considerable healthcare resources. A retrospective cross sectional analysis of the reported cases of viral hepatitis was conducted based on the reports of The Ministry of Health in Saudi Arabia about Hepatitis A, B and C infections in all regions from the period of January 2006 to December 2010. The study demonstrated that incidence of viral Hepatitis is decreasing, except for Hepatitis B that showed minimal increase. Of hepatitis A, B, and C, Hepatitis B virus (HBV) was the most predominant type, accounting for (53%) of the cases, followed by Hepatitis C virus (HCV) (30%) and HAV (17%). HAV infection predominates in children (5–14 years) with 60% of viral hepatitis cases, HBV in young adults (15–44 years) with 69% of viral hepatitis cases, and HCV in older adults (>45 years) with 59% of viral hepatitis cases. Despite significant changes in the prevalence of viral hepatitis A, B and C, it remains a major public health problem in Saudi Arabia; however, it showed a significant decline in the last two decades that could be attributed to the vaccination programs and the improved health facilities. Further researches are needed to identify the risk factors making a specific age group or a specific region in Saudi Arabia targeted for a specific type of hepatitis viruses.

Keywords: Epidemiology, Hepatitis, Saudi Arabia.

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Authors: M. Abdou, M. K. Khalil

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The heat pipe is a thermal device which allows efficient transport of thermal energy. The experimental work of this research was split into two phases; phase 1 is the development of the facilities, material and test rig preparation. Phase 2 is the actual experiments and measurements of the thermal control mockup inside the modified vacuum chamber (MVC). Due to limited funds, the development on the thermal control subsystem was delayed and the experimental facilities such as suitable thermal vacuum chamber with space standard specifications were not available from the beginning of the research and had to be procured over a period of time. In all, these delays extended the project by one and a half year. Thermal control subsystem needs a special facility and equipment to be tested. The available vacuum chamber is not suitable for the thermal tests. Consequently, the modification of the chamber was a must. A vacuum chamber has been modified to be used as a Thermal Vaccum Chamber (TVC). A MVC is a vacuum chamber modified by using a stainless mirror box with perfect reflectability and the infrared lamp connected with the voltage regulator to vary the lamp intensity as it will be illustrated through the paper.

Keywords: Heat pipe, thermal control, thermal vacuum chamber, satellite.

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Authors: Edjere Oghenekohwiroro, Asibor Irabor Godwin, Uwem Bassey

Abstract:

This paper determines the presence and levels of phthalates in sachet and borehole water source in some parts of Delta State, Nigeria. Sachet and borehole water samples were collected from seven different water packaging facilities and level of phthalates determined using GC-MS instrumentation. Phthalates concentration in borehole samples varied from 0.00-0.01 (DMP), 0.06-0.20 (DEP), 0.10-0.98 (DBP), 0.21-0.36 (BEHP), 0.01-0.03 (DnOP) µg/L and (BBP) was not detectable; while sachet water varied from 0.03-0.95 (DMP), 0.16-12.45 (DEP), 0.57-3.38 (DBP), 0.00-0.03 (BBP), 0.08-0.31 (BEHP) and 0-0.03 (DnOP) µg/L. Phthalates concentration in the sachet water was higher than that of the corresponding boreholes sources and also showed significant difference (p < 0.05) between the two. Sources of these phthalate esters were the interaction between water molecules and plastic storage facilities. Although concentration of all phthalate esters analyzed were lower than the threshold limit value(TLV), over time storage of water samples in this medium can lead to substantial increase with negative effects on individuals consuming them.

Keywords: Phthalate esters, borehole, sachet water, sample extraction, gas chromatography, GC-MS.

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Authors: Micheli Anna Paola, Intrisano Carmelo, Calce Anna Maria

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This research focused on the capability of health tourism to improve the economic and financial performance of healthcare companies. It is assumed that health tourism companies have better profitability and financial efficiency because they can also count on cross-border demand differently from no health tourism companies. A three-level gap analysis was conducted: the first concerns health tourism companies located in Italy and in the other EU28 states; in the second Italian and EU28, no health tourism companies were compared; the third level is about the Italian system with a comparison between health tourism and no health tourism companies. Findings highlighted that Italian healthcare companies have better profitability performance if compared to European ones, but they present weaknesses in the financial position given the illiquidity and excessive leverage. Furthermore, studying the Italian system, we found that health tourism companies are more profitable than no health tourism companies.

Keywords: Financial performance, gap analysis, health tourism, profitability performance, value creation.

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