Search results for: hospital facilities.

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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Authors: Osuagwu Justine Ugochukwu, Sazali Abd Wahab, Sunday Sunday Akpan

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Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought knowledge to leadership literature.

Keywords: Workers’ performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership.

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Authors: Alan Crowle, Philpp Thies

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s the floating offshore wind turbine industry continues to develop and grow, the capabilities of established port facilities need to be assessed as to their ability to support the expanding construction and installation requirements. This paper assesses current infrastructure requirements and projected changes to port facilities that may be required to support the floating offshore wind industry. Understanding the infrastructure needs of the floating offshore renewable industry will help to identify the port-related requirements. Floating offshore wind turbines can be installed further out to sea and in deeper waters than traditional fixed offshore wind arrays, meaning it can take advantage of stronger winds. Separate ports are required for substructure construction, fit-out of the turbines, moorings, subsea cables and maintenance. Large areas are required for the laydown of mooring equipment, inter array cables, turbine blades and nacelles. The capabilities of established port facilities to support floating wind farms are assessed by evaluation of size of substructures, height of wind turbine with regards to the cranes for fitting of blades, distance to offshore site and offshore installation vessel characteristics. The paper will discuss the advantages and disadvantages of using large land based cranes, inshore floating crane vessels or offshore crane vessels at the fit-out port for the installation of the turbine. Water depths requirements for import of materials and export of the completed structures will be considered. There are additional costs associated with any emerging technology. However, part of the popularity of Floating Offshore Wind Turbines stems from the cost savings against permanent structures like fixed wind turbines. Floating Offshore Wind Turbine developers can benefit from lighter, more cost effective equipment which can be assembled in port and towed to site rather than relying on large, expensive installation vessels to transport and erect fixed bottom turbines. The ability to assemble Floating Offshore Wind Turbines equipment on shore means minimising highly weather dependent operations like offshore heavy lifts and assembly, saving time and costs and reducing safety risks for offshore workers. Maintenance might take place in safer onshore conditions for barges and semi submersibles. Offshore renewables, such as floating wind, can take advantage of this wealth of experience, while oil and gas operators can deploy this experience at the same time as entering the renewables space. The floating offshore wind industry is in the early stages of development and port facilities are required for substructure fabrication, turbine manufacture, turbine construction and maintenance support. The paper discusses the potential floating wind substructures as this provides a snapshot of the requirements at the present time, and potential technological developments required for commercial development. Scaling effects of demonstration-scale projects will be addressed; however the primary focus will be on commercial-scale (30+ units) device floating wind energy farms.

Keywords: Floating offshore wind turbine, port logistics, installation, construction.

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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: Ayodele Adekunle Faiyetole, Olumide Olawale Jegede

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This paper presents the experimental design and needs justifications for a localized intelligent parking system (L-IPS), ideal for quasi-close communities with increasing vehicular volume that depends on limited or constant parking facilities. For a constant supply in parking facilities, the demand for an increasing vehicular volume could lead to poor time conservation or extended travel time, traffic congestion or impeded mobility, and safety issues. Increased negative environmental and economic externalities are other associated and consequent downsides of disparities in demand and supply. This L-IPS is designed using a microcontroller, ultrasonic sensors, LED indicators, such that the current status, in terms of parking spots availability, can be known from the main entrance to the community or a parking zone on a LCD screen. As an advanced traffic management system (ATMS), the L-IPS is designed to resolve aspects of infrastructure-to-driver (I2D) communication and parking detection issues. Thus, this L-IPS can act as a timesaver for users by helping them know the availability of parking spots. Providing on-time, informed routing, to a next preference or seamless moving to berth on the available spot on a proximate facility as the case may be. Its use could also increase safety and increase mobility, and fuel savings and costs, therefore, reducing negative environmental and economic externalities due to transportation systems.

Keywords: Intelligent parking systems, localized intelligent parking system, intelligent transport systems, advanced traffic management systems, infrastructure-to-drivers communication.

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Authors: Muhammad Naseem Baig, Razia Sharif

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From past many decades human beings are suffering from plethora of natural disasters. Occurrence of disasters is a frequent process; it changes conceptual myths as more and more advancement are made. Although we are living in technological era but in developing countries like Pakistan disasters are shaped by socially constructed roles. The need is to understand the most vulnerable group of society i.e. females; their issues are complex in nature because of undermined gender status in the society. There is a need to identify maximum issues regarding females and to enhance the achievement of millennium development goals (MDGs). Gender issues are of great concern all around the globe including Pakistan. Here female visibility in society is low, and also during disasters, the failure to understand the reality that concentrates on double burden including productive and reproductive care. Women have to contribute a lot in society so we need to make them more disaster resilient. For this non-structural measures like awareness, trainings and education must be carried out. In rural and in urban settings in any disaster like earthquake or flood, elements like gender perspective, their age, physical health, demographic issues contribute towards vulnerability. In Pakistan the gender issues in disasters were of less concern before 2005 earthquake and 2010 floods. Significant achievements are made after 2010 floods when gender and child cell was created to provide all facilities to women and girls. The aim of the study is to highlight all necessary facilities in a disaster to build coping mechanism in females from basic rights till advance level including education.

Keywords: Disaster resilient, Gender cell, Millennium development.

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Authors: Guanglin Song

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Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city. The findings reveal that: 1) There exists overall maldistribution and over-concentration of healthcare resources in the study area, characterized by structural imbalance. 2) The low rate of primary care utilization in the study area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem. 3) Gradual optimization of the healthcare facility layout in the study area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance. This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. In addition, the study provides some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: Flow of public services, healthcare facilities, spatial planning, urban networks.

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Authors: A. A. Aiyeloja, A.T. Oladele, O. Tumulo

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Raphia wine is an important forest product with cultural significance besides its use as medicine and food in southern Nigeria. This work aims to evaluate the profitability of Raphia wine production and marketing in Sapele Local Government Area, Nigeria. Four communities (Sapele, Ogiede, Okuoke and Elume) were randomly selected for data collection via questionnaires among producers and marketers. A total of 50 producers and 34 marketers were randomly selected for interview. Data was analyzed using descriptive statistics, profit margin, multiple regression and rate of returns on investment (RORI). Annual average profit was highest in Okuoke (Producers – N90, 000.00, Marketers - N70, 000.00) and least in Sapele (Producers N50, 000.00, Marketers – N45, 000.00). Calculated RORI for marketers were Elume (40.0%), Okuoke (25.0%), Ogiede (33.3%) and Sapele (50.0%). Regression results showed that location has significant effects (0.000, ρ ≤ 0.05) on profit margins. Male (58.8%) and female (41.2%) invest in Raphia wine marketing, while males (100.0%) dominate production. Results showed that Raphia wine has potentials to generate household income, enhance food security and improve quality of life in rural, semi-urban and urban communities. Improved marketing channels, storage facilities and credit facilities via cooperative groups are recommended for producers and marketers by concerned agencies.

Keywords: Raphia wine, Profit margin, RORI, Livelihood, Nigeria.

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Authors: Saad Alkhaldi, Fadi Ghammas, Tariq Alghamdi, Stefano Alexandirs

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The operating conditions and corrosive nature of the process fluid in the Haradh and Hawiyah areas are subjecting facility piping to undesirable corrosion phenomena. Therefore, production headers inside remote headers have been internally cladded with high alloy material to mitigate the corrosion damage mechanism. Corrosion mitigation in the jump-over lines, constructed between the existing flowlines and the newly constructed facilities to provide operational flexibility, is proposed. This corrosion mitigation system includes the application of fusion bond epoxy (FBE) coating on the internal surface of the pipe and depositing corrosion-resistant alloy (CRA) weld layers at pipe and fittings ends to protect the carbon steel material. In addition, high alloy CRA weld material is used to deposit the girth weld between the 90-degree elbows and mating internally coated segments. A rigorous testing and qualification protocol was established prior to actual adoption at the Haradh and Hawiyah Field Gas Compression Program, currently being executed by Saudi Aramco. The proposed mitigation system, aimed at applying the cladding at the ends of the internally FBE coated pipes/elbows, will resolve field joint coating challenges, eliminate the use of approximately 1700 breakout flanges, and prevent the potential hydrocarbon leaks.

Keywords: Corrosion, FBE coated sour service, cost savings.

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Authors: Y. S. Liew, K. A. Puteh Ariffin, M. A. Mohd Nor

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One of the Best Management Practices (BMPs) promoted in Urban Stormwater Management Manual for Malaysia (MSMA) published by the Department of Irrigation and Drainage (DID) in 2001 is through the construction of wet ponds in new development projects for water quantity and quality control. Therefore, this paper aims to demonstrate a case study on evaluation of a constructed mini wet pond located at Sekolah Rendah Kebangsaan Seksyen 2, Puchong, Selangor, Malaysia in both stormwater quantity and quality aspect particularly to reduce the peak discharge by temporary storing and gradual release of stormwater runoff from an outlet structure or other release mechanism. The evaluation technique will be using InfoWorks Collection System (CS) as the numerical modeling approach for water quantity aspect. Statistical test by comparing the correlation coefficient (R²), mean error (ME), mean absolute error (MAE) and root mean square error (RMSE) were used to evaluate the model in simulating the peak discharge changes. Results demonstrated that there will be a reduction in peak flow at 11 % to 15% and time to peak flow is slower by 5 minutes through a wet pond. For water quality aspect, a survey on biological indicator of water quality carried out depicts that the pond is within the range of rather clean to clean water with the score of 5.3. This study indicates that a constructed wet pond with wetland facilities is able to help in managing water quantity and stormwater generated pollution at source, towards achieving ecologically sustainable development in urban areas.

Keywords: Wet pond, Retention Facilities, Best Management Practices (BMP), Urban Stormwater Management Manual for Malaysia (MSMA).

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Authors: A. Abdullah, N. Faghih Mirzaei, S. Hany Haron

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Neighbourhood environment walkability on reported physical activity (PA) levels of students of Universiti Sains Malaysia (USM) in Malaysia. Compared with previous generations, today’s young people spend less time playing outdoors and have lower participation rates in PA. Research suggests that negative perceptions of neighbourhood walkability may be a potential barrier to adolescents’ PA. The sample consisted of 200 USM students (to 24 years old) who live outside of the main campus and engage in PA in sport halls and sport fields of USM. The data were analysed using the t-test, binary logistic regression, and discriminant analysis techniques. The present study found that youth PA was affected by neighbourhood environment walkability factors, including neighbourhood infrastructures, neighbourhood safety (crime), and recreation facilities, as well as street characteristics and neighbourhood design variables such as facades of sidewalks, roadside trees, green spaces, and aesthetics. The finding also illustrated that active students were influenced by street connectivity, neighbourhood infrastructures, recreation facilities, facades of sidewalks, and aesthetics, whereas students in the less active group were affected by access to destinations, neighbourhood safety (crime), and roadside trees and green spaces for their PAs. These results report which factors of built environments have more effect on youth PA and they message to the public to create more awareness about the benefits of PA on youth health.

Keywords: Fear of crime, neighbourhood built environment, physical activities, street characteristics design.

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Authors: Shafiq ur Rehman, Jane-Lisa Coughlan

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Mobiles are considered to be the most frequently used electronic items in world after electricity. It is probably the only device that can be used by any gender with no age limits depending on its functionality. This paper present the interactive interface of Mobile and particularly aiming the use of advanced phones which are also called smart phones. With the changes in the trend where users are now moving from ordinary mobiles to the one with touch screens and facilities such as WiFi and internet browsing.

Keywords: interface design, functionality, intelligent system

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Authors: A. Vassila, D. Kalogeropoulos, R. Rawashdeh, N. Hall, N. Rahman, M. Fabian, S. Thulasidharan, H. Parwez

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Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. This is a retrospective analysis, which examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750 mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications.

Keywords: Scleritis, necrotizing scleritis, scleroderma, autoimmune disease.

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Authors: Khaireyah Kh. Al-Hamad, V. Nassehi, A. R. Khan

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Air pollution is a major environmental health problem, affecting developed and developing countries around the world. Increasing amounts of potentially harmful gases and particulate matter are being emitted into the atmosphere on a global scale, resulting in damage to human health and the environment. Petroleum-related air pollutants can have a wide variety of adverse environmental impacts. In the crude oil production sectors, there is a strong need for a thorough knowledge of gaseous emissions resulting from the flaring of associated gas of known composition on daily basis through combustion activities under several operating conditions. This can help in the control of gaseous emission from flares and thus in the protection of their immediate and distant surrounding against environmental degradation. The impacts of methane and non-methane hydrocarbons emissions from flaring activities at oil production facilities at Kuwait Oilfields have been assessed through a screening study using records of flaring operations taken at the gas and oil production sites, and by analyzing available meteorological and air quality data measured at stations located near anthropogenic sources. In the present study the Industrial Source Complex (ISCST3) Dispersion Model is used to calculate the ground level concentrations of methane and nonmethane hydrocarbons emitted due to flaring in all over Kuwait Oilfields. The simulation of real hourly air quality in and around oil production facilities in the State of Kuwait for the year 2006, inserting the respective source emission data into the ISCST3 software indicates that the levels of non-methane hydrocarbons from the flaring activities exceed the allowable ambient air standard set by Kuwait EPA. So, there is a strong need to address this acute problem to minimize the impact of methane and non-methane hydrocarbons released from flaring activities over the urban area of Kuwait.

Keywords: Kuwait Oilfields, ISCST3 model, flaring, Airpollution, Methane and Non-methane.

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Authors: Mahdiyeh Zafaranchi, Ethan S. Cantor, William T. Riddell, Jess W. Everett

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The New Jersey Department of Military and Veteran’s Affairs (NJ DMAVA) operates over 50 facilities throughout the state of New Jersey, US. NJ DMAVA is under a mandate to move toward decarbonization, which will eventually include eliminating the use of natural gas and other fossil fuels for heating. At the same time, the organization requires increased resiliency regarding electric grid disruption. These competing goals necessitate adopting the use of on-site renewables such as photovoltaic and geothermal power, as well as implementing power control strategies through microgrids. Planning for these changes requires a detailed understanding of current and future electricity use on yearly, monthly, and shorter time scales, as well as a breakdown of consumption by heating, ventilation, and air conditioning (HVAC) equipment. This paper discusses case studies of two buildings that were simulated using the QUick Energy Simulation Tool (eQUEST). Both buildings use electricity from the grid and photovoltaics. One building also uses natural gas. While electricity use data are available in hourly intervals and natural gas data are available in monthly intervals, the simulations were developed using monthly and yearly totals. This approach was chosen to reflect the information available for most NJ DMAVA facilities. Once completed, simulation results are compared to metrics recommended by several organizations to validate energy use simulations. In addition to yearly and monthly totals, the simulated peak demands are compared to actual monthly peak demand values. The simulations resulted in monthly peak demand values that were within 30% of the measured values. These benchmarks will help to assess future energy planning efforts for NJ DMAVA.

Keywords: Building Energy Modeling, eQUEST, peak demand, smart meters.

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Authors: Ali Pirdavani, Tom Brijs, Tom Bellemans, Geert Wets, Koen Vanhoof

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Signalized intersections on high-volume arterials are often congested during peak hours, causing a decrease in through movement efficiency on the arterial. Much of the vehicle delay incurred at conventional intersections is caused by high left-turn demand. Unconventional intersection designs attempt to reduce intersection delay and travel time by rerouting left-turns away from the main intersection and replacing it with right-turn followed by Uturn. The proposed new type of U-turn intersection is geometrically designed with a raised island which provides a protected U-turn movement. In this study several scenarios based on different distances between U-turn and main intersection, traffic volume of major/minor approaches and percentage of left-turn volumes were simulated by use of AIMSUN, a type of traffic microsimulation software. Subsequently some models are proposed in order to compute travel time of each movement. Eventually by correlating these equations to some in-field collected data of some implemented U-turn facilities, the reliability of the proposed models are approved. With these models it would be possible to calculate travel time of each movement under any kind of geometric and traffic condition. By comparing travel time of a conventional signalized intersection with U-turn intersection travel time, it would be possible to decide on converting signalized intersections into this new kind of U-turn facility or not. However comparison of travel time is not part of the scope of this research. In this paper only travel time of this innovative U-turn facility would be predicted. According to some before and after study about the traffic performance of some executed U-turn facilities, it is found that commonly, this new type of U-turn facility produces lower travel time. Thus, evaluation of using this type of unconventional intersection should be seriously considered.

Keywords: Innovative U-turn facility, Microsimulation, Traveltime, Unconventional intersection design.

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Authors: D. Bheenick, M. Young, M. Elmussareh, A. Ali

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Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. To conduct the study, retrospective data of patients presenting acutely to the urology department were collected between January 13 to March 22, 2020 (pre-lockdown period) and March 23 to May 31, 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Included in the study were 1092 patients. The results show that an overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. The results of the study concluded that the admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Keywords: COVID-19, lockdown, admissions, urology

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Authors: Do Thi Ha, Khanitta Nuntaboot

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Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. There exists little up to date information concerning actual competency among Vietnamese nurses. Purposes: The purpose of this study is to identify the actual nursing competency among nurses in clinical settings in Vietnam. Methods: A qualitative study, ethnographic method, comprised of the participant-observation, in-depth interview, and focus group discussion with multidisciplinary groups of nurses employing in Cho Ray hospital, Vietnam, managers/administrators, nurse teachers, medical doctors, other health care providers, patients and family members which derived from purposeful sampling technique. Content analysis was used for data analysis. Results: Five essential themes of nursing competencies among nurses were identified include (1) knowledge, (2) skills, (3) attitude and value-based nursing practice, (4) legal and ethical competencies, and (5) transcultural competencies. Basic and advanced knowledge were identified as further two dimensions of knowledge. There were five sub themes identified as further dimensions of skills include technical skills, communication skills, organizing and management skills, teamwork and interrelationship, and critical thinking skills. Conclusions: The findings from this study provide valuable information and understanding of the actual competency among nurses in clinical settings in Vietnam. It is expected that this understanding would assist in developing a guide to nursing education and training, nursing practice and relevant policy regulation used for promoting nursing competency among nurses.

Keywords: Nursing competency, qualitative design, ethnographic method, Vietnam.

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Authors: B. O. Diyaolu

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The stadium transcends a field of play to cultural heritage of a club especially when there is security of life and property and a conducive environment with exciting media facilities, CCTV and adequate field of play. Football fans love watching their clubs’ matches especially when nothing discourages their presence in the stadium. This study investigated the influence of security on fans’ attendance during Nigeria Professional Football League matches. Descriptive survey research design was used and the population consists of all Nigeria Professional Football League fans. Simple random sampling technique was used to pick a state from the six geo-political zones. 600 respondents comprising male and female fans were sampled from the ten selected vendors’ stands in each selected state. A structured questionnaire on Security and Fan attendance scale (SFAS) was used. The instrument consists of two sections. Section A seeks information on demographic data of the respondents, while section B was used to elicit information on security and fans’ attendance. The modified instrument which consists of 20 items has a reliability coefficient of 0.73. The hypothesis was tested at 0.05 significance level. The completed questionnaire was collated, coded and analyzed using descriptive statistics of frequency counts and percentage and inferential statistics of chi-square (X²). Findings of this study revealed that adequate security significantly influences fan attendance during Nigeria Professional Football League matches. There is no sport that can develop if the facilities in use are inadequate. Improving the condition of the stadium in Nigeria is paramount to the development of the Nigeria Professional Football League. All stakeholders in the organization of the League must put into consideration the need to improve the standard of the stadium as it will help to increase the attendance of fans during matches. Only the standard ones should be used during matches.

Keywords: Adequate Security, fans attendance, football fans, football stadium, Nigeria Professional Football League.

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Authors: B. Muhammadani

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Health workforce is a fundamental component of health system and plays a significant role in delivering effective health care services. However, there is a crucial shortage of skilled personnel which make them prone to work in stressful conditions. In spite of excessively high workload and burnout among the staff, little attention is given to their job satisfaction level which has serious implications on the productivity and effective performance of staff to achieve organizational goals. Therefore, this study aims to explore the job satisfaction of midwives working in the labor ward of the Lady Dufferin Hospital, Karachi. A cross-sectional survey was conducted. The short version of Minnesota Job Satisfaction Questionnaire was administered on a convenient sample group of 22 midwives to gather information on their job satisfaction. The results demonstrated that midwives were overall satisfied with their job. The level of job satisfaction was however found different in various positions within midwifery cadre. The head of midwives was highly satisfied as compared to midwifery staff who works under the supervision of head. The level of satisfaction of team leaders fall between the head and staff of midwifery. Similar trends were observed for both intrinsic and extrinsic job satisfaction. Such evidences on these issues are essential and useful as it helps explore the attitudes of individuals towards work which has direct implications on access to quality care services. Strategic interventions are required at organizational level to provide motivators and satisfiers to health workers for their work related satisfaction and enhanced motivation.

Keywords: Health workforce, job satisfaction, motivation, workload, burnout, midwives, health system.

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Authors: Guclu Insel, Efe Gumuslu, Gulten Yuksek, Nilay Sayi Ucar, Emine Ubay Cokgor, Tugba Olmez Hanci, Didem Okutman Tas, Fatos Germirli Babuna, Derya Firat Ertem, Okmen Yildirim, Ozge Erturan, Betul Kirci

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In order to eliminate water scarcity problems, effective precautions must be taken. Growing competition for water is increasingly forcing facilities to tackle their own water scarcity problems. At this point, application of wastewater reclamation and reuse results in considerable economic advantageous. In this study, an enamel coating facility, which is one of the high water consumed facilities, is evaluated in terms of its wastewater reuse potential. Wastewater reclamation and reuse can be defined as one of the best available techniques for this sector. Hence, process and pollution profiles together with detailed characterization of segregated wastewater sources are appraised in a way to find out the recoverable effluent streams arising from enamel coating operations. Daily, 170 m³ of process water is required and 160 m³ of wastewater is generated. The segregated streams generated by two enamel coating processes are characterized in terms of conventional parameters. Relatively clean segregated wastewater streams (reusable wastewaters) are separately collected and experimental treatability studies are conducted on it. The results reflected that the reusable wastewater fraction has an approximate amount of 110 m³/day that accounts for 68% of the total wastewaters. The need for treatment applicable on reusable wastewaters is determined by considering water quality requirements of various operations and characterization of reusable wastewater streams. Ultra-filtration (UF), Nano-filtration (NF) and Reverse Osmosis (RO) membranes are subsequently applied on reusable effluent fraction. Adequate organic matter removal is not obtained with the mentioned treatment sequence.

Keywords: enamel coating, membrane, reuse, wastewater

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Authors: Nareelux Suwannobol, JintanaTapin, Khuanchanok Narachan

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The objective of this study was to determine the accuracy to estimation fetal weight by Johnson-s method and compares it with actual birth weight. The sample group was 126 infants delivered in Dan KhunThot hospital from January March 2012. Fetal weight was estimated by measuring fundal height according to Johnson-s method. The information was collected by studying historical delivery records and then analyzed by using the statistics of frequency, percentage, mean, and standard deviation. Finally, the difference was analyzed by a paired t-test.The results showed had an average birth weight was 3093.57 ± 391.03 g (mean ± SD) and 3,455 ± 454.55 g average estimated fetal weight by Johnson-s method higher than average actual birth weight was 384.09 grams. When classifying the infants according to birth weight found that low birth weight (<2500 g) and the appropriate birth weight (2500-3999g) actual birth weight less than estimate fetal weight . But the high birth weight (> 4000 g) actual birth weight was more than estimated fetal weight. The difference was found between actual birth weight and estimation fetal weight of the minimum weight in high birth weight ( > 4000 g) , the appropriate birth weight (2500-3999g) and low birth weight (<2500 g) respectively. The rate of estimates fetal weight within 10% of actual birth weight was 35.7%. Actual birth weight were compared with the found that the difference is statistically significant (p <.000). Employing Johnson-s method to estimate fetal weight can estimate initial fetal weight before passing to special examinations, which may require excessive high cost. A variety of methods should be employed to estimate fetal weight more precisely, which will help plan care for mother-s and infant-s safety.

Keywords: Johnson's method, Fetal weight estimate, Delivery Room, Student nurse.

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: Clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula.

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Authors: Essa Alenazi, Zulfikar Adamu

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The Kingdom of Saudi Arabia (KSA) is not an exception in relying on the growth of its construction industry to support rapid population growth. However, its need for infrastructure development is constrained by low productivity levels and cost overruns caused by factors such as delays to project completion. Delays in delivering a construction project are a global issue and while theories such as Optimism Bias have been used to explain such delays, in KSA, client-related causes of delays are also significant. The objective of this paper is to develop a framework-based approach to explore how the country’s construction industry can manage and reduce delays in construction projects through building information modelling (BIM) in order to mitigate the cost consequences of such delays.  It comprehensively and systematically reviewed the global literature on the subject and identified gaps, critical delay factors and the specific benefits that BIM can deliver for the delay management.  A case study comprising of nine hospital projects that have experienced delay and cost overruns was also carried out. Five critical delay factors related to the clients were identified as candidates that can be mitigated through BIM’s benefits. These factors are: Ineffective planning and scheduling of the project; changes during construction by the client; delay in progress payment; slowness in decision making by the client; and poor communication between clients and other stakeholders. In addition, data from the case study projects strongly suggest that optimism bias is present in many of the hospital projects. Further validation via key stakeholder interviews and documentations are planned.

Keywords: BIM, client perspective, delay management, optimism bias, public sector projects.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

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Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3^rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: Age incidence, breast carcinoma, fine needle aspiration, Hail Region.

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Authors: W. C. Lucas, S. Titus, M. E. M. Young

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Gymnastics is the umbrella term that represents seven different and unique disciplines of gymnastics. Men and women of all ages and abilities practice this sport, and participation in gymnastics can develop both gross and fine motor skills, strength, flexibility, coordination and balance. There are various social factors, such as a family’s socioeconomic status or accessibility to sports facilities that may play a role in affecting levels of participation. The aim of this study is to investigate the social factors that have an influence on gymnastics participation in the Western Cape. To this end, a qualitative approach is adopted to collect data. This study also adopts the ecological systems theory as the theoretical framework, and is used to analyze and interpret current social factors that directly or indirectly influence participation in gymnastics. The study’s objectives were to ascertain which social factors hinder participation, and which social factors promote participation, thus, coaches, parents and gymnasts participated in focus group discussions. Key informant interviews took place with experts in the field of gymnastics in the Western Cape. A thematic analysis was conducted on transcriptions from the focus group discussions and key informant interviews. Social factors investigated in this study occurred in the chronosystem, macrosystem, exosystem, mesosystem, and microsystem, and had both a direct and indirect influence on the gymnast’s continued participation. These systems are defined as the environment of the individual, in which they grow and develop. The research findings of this paper are used to draw conclusions and make specific recommendations for practice and further research. The information gathered in this study can assist all stakeholders within the field of gymnastics, such as parents, judges, coaches, gymnasts, and the supporting community which surround the participating gymnast.

Keywords: Developing child, ecological systems theory, facilities, federation, gymnastics, influence, participation, social factors, socioeconomic status, sport.

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Authors: Sharan Badiger, Prema T. Akkasaligar, P. Amith Kumar

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Upper gastrointestinal endoscopy is a commonly performed diagnostic and therapeutic procedure and has many adverse effects like cardiopulmonary complications, complications related to sedation, infectious complications, bleeding and perforation. So this study was undertaken to evaluate important variables like patient’s age, gender and stage of the procedure in relation to the cardiopulmonary changes during diagnostic upper gastrointestinal endoscopy by monitoring oxygen saturation, blood pressure, heart rate and electrocardiogram. This is a prospective longitudinal hospital based study involving a total of 140 consecutive patients, at Sri. B. M. Patil Medical College, Hospital and Research Centre. Cardiopulmonary changes during upper gastrointestinal endoscopy are more common in the age groups of 51-60 years, with equal frequency in both male and female. Oxygen saturation levels decreased by about 4% in both sexes during introduction of endoscopy. Mild to moderate hypoxia was found in 32% of the study group. Severe hypoxia was found in 5% of the patients, mostly in those patients who are above 50 years of age. Tachycardia was noted in 88% of the study group patients. Blood pressure increased to hypertension levels in 22 patients (15.7%) which returned to normal within few minutes after the procedure. S-T depression was noticed in 4% of patients and T wave inversion in 8% of patients during upper gastrointestinal endoscopy. All these changes disappeared after 10 minutes after the endoscopy. Cardiopulmonary changes are common during upper gastrointestinal endoscopy. Maximum changes in oxygen saturation, heart rate and blood pressure occurred immediately after the introduction of endoscope. The cardiopulmonary changes did not manifest into any identifiable clinical symptoms. The rate of recovery was faster in younger age groups and women.

Keywords: Blood Pressure, Cardio-Pulmonary, Heart Rate, Oxygen Saturation, Upper Gastrointestinal Endoscopy.

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Authors: Pranee Suecharoen, Jaturat Kanpittaya

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Background: The incidence of adverse reactions to iodinated contrast media has risen. The dearth of reports on reactions to the administration of iso- and low-osmolar contrast media should be addressed. We, therefore, studied the profile of adverse reactions to iodinated contrast media; viz., (a) the body systems affected (b) causality, (c) severity, and (d) preventability. Objective: To study adverse reactions (causes and severity) to iodinated contrast media at Srinagarind Hospital. Method: Between March and July, 2015, 1,101 patients from the Department of Radiology were observed and interviewed for the occurrence of adverse reactions. The patients were classified per Naranjo’s algorithm and through use of an adverse reactions questionnaire. Results: A total of 105 cases (9.5%) reported adverse reactions (57% male; 43% female); among whom 2% were iso-osmolar vs. 98% low-osmolar. Diagnoses included hepatoma and cholangiocarcinoma (24.8%), colorectal cancer (9.5%), breast cancer (5.7%), cervical cancer (3.8%), lung cancer (2.9%), bone cancer (1.9%), and others (51.5%). Underlying diseases included hypertension and diabetes mellitus type 2. Mild, moderate, and severe adverse reactions accounted for 92, 5 and 3%, respectively. The respective groups of escalating symptoms included (a) mild urticaria, itching, rash, nausea, vomiting, dizziness, and headache; (b) moderate hypertension, hypotension, dyspnea, tachycardia and bronchospasm; and (c) severe laryngeal edema, profound hypotension, and convulsions. All reactions could be anticipated per Naranjo’s algorithm. Conclusion: Mild to moderate adverse reactions to low-osmolar contrast media were most common and these occurred immediately after administration. For patient safety and better outcomes, improving the identification of patients likely to have an adverse reaction is essential.

Keywords: Adverse reactions, contrast media, computed tomography, iodinated contrast agents.

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Authors: M. S. R. Waas, S. G. U. S. Chandrarathne, U. A. Kumara

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The purpose of this quantitative study is to identify the impact of the destination attributes of Negombo on the coastal tourists’ visitor experience. As an island nation, Sri Lanka is identified and well renowned for its gold sandy beaches and natural scenic beauty. Among many tourist attractions, Negombo is identified as a developed beach centric tourist destination in the country. Yet, it is identified that there are low positive reviews on the internet for Negombo compared to other beach centric tourist attractions in Sri Lanka. Therefore, this study would help the policymakers and tourism service providers to identify the impact of destination attributes on international visitor satisfaction and to understand the visitors comprehensively so as to develop Negombo as a stable tourist destination while offering a memorable and satisfying experience for its visitors. In support, a self-administered questionnaire survey study was performed with 150 respondents (international tourists) in Negombo. The questions were designed based on the selected dimensions of destination attributes such as tourism service quality, infrastructure and superstructure developments, tourist information facilities and destination aesthetics and developments. The results showed that the overall satisfaction level of the international tourists who visit Sri Lanka is significantly affected by the destination attributes of Negombo. Yet, the dimensions of destination aesthetics and developments and tourist information facilities indicated a low level of mean satisfaction, paving the critique that Negombo as a beach centric tourist attraction is not serving well with its natural beauty and its destination management. Further, it is advocated that the policymakers and tourism service providers have a significant role in leading the way to attract more potential visitors to enhance their destination satisfaction and to encourage them to revisit Sri Lanka while recommending it to others. The survey was done during the off-peak season of the industry and it is suggested that the survey would have been conducted throughout a complete year.

Keywords: Destination attributes, coastal tourism, tourism development, tourist satisfaction.

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