Search results for: Hospital pharmacy standards

Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

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Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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Authors: M. O. Bayram, H. B. Gencdal, N. O. Fercan, B. Basbug

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Liquid limit, which is used as a measure of soil strength, can be detected by Casagrande and fall-cone testing methods. The two methods majorly diverge from each other in terms of operator dependency. The Casagrande method that is applied according to ASTM D4318-17 standards may give misleading results, especially if the calibration process is not performed well. In this study, to reveal the effect of calibration for drop height and amount of soil paste placement in the Casagrande cup, a series of tests were carried out by multipoint method as it is specified in the ASTM standards. The tests include the combination of 6 mm, 8 mm, 10 mm, and 12 mm drop heights and under-filled, half-filled, and full-filled Casagrande cups by kaolin samples. It was observed that during successive tests, the drop height of the cup deteriorated; hence the device was recalibrated before and after each test to provide the accuracy of the results. Besides, the tests by under-filled and full-filled samples for higher drop heights revealed lower liquid limit values than the lower drop heights revealed. For the half-filled samples, it was clearly seen that the liquid limit values did not change at all as the drop height increased, and this explains the function of standard specifications.

Keywords: Calibration, Casagrande cup method, drop height, kaolin, liquid limit, placing form.

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Authors: Chanisada Choosuk, Napisporn Memongkol Runchana Sinthavalai, Fareeda Lambensah

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The objective of this research is to explore the role of actors at the local level in managing the Pre-hospital Emergency Medical Service (EMS) system in Thailand. The research method was done through documentary research, individual interviews, and one forum conducted in each province. This paper uses the case of three provinces located in three regions in Thailand including; Ubon Ratchathani (North-eastern region), Lampang (Northern Region), and Songkhla (Southern Region). The result shows that, recently, the role of the local government in being the service provider for their local people is increasingly concerned. In identifying the key success factors towards the EMS system, it includes; (i) the local executives- vision and influence that the decisions made by them, for both PAO (Provincial Administration Organisation (PAO) and TAO (Tambon Administration Organisation), is vital to address the overall challenges in EMS development, (ii) the administrative system through reforming their working style create the flexibility in running the EMS task, (iii) the network-based management among different agencies at the local level leads to the better EMS practices, and (iv) the development in human resource is very vital in delivering the effective services.

Keywords: Local governments, Management, Emergency Medical Services (EMS), Thailand

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Authors: Ramón Cruzat, Sergio F. Ochoa, Ignacio Casas, Luis A. Guerrero, José Bravo

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Patients under health treatments that involve long  stays at a hospital or health center (e.g. cancer, organ transplants and  severe burns), tend to get bored or depressed because of the lack of  social interaction with family and friends. Such a situation also  affects the evolution and effectiveness of their treatments. In many  cases, the solution to this problem involves extra challenges, since  many patients need to rest quietly (or remain in bed) to their being  contagious. Considering the weak health condition in which usually  are these kinds, keeping them motivated and quiet represents an  important challenge for nurses and caregivers. This article presents a  mobile ubiquitous game called MagicRace, which allows hospitalized  kinds to interact socially with one another without putting to risk  their sensitive health conditions. The game does not require a  communication infrastructure at the hospital, but instead, it uses a  mobile ad hoc network composed of the handheld devices used by  the kids to play. The usability and performance of this application  was tested in two different sessions. The preliminary results show  that users experienced positive feelings from this experience.

 

Keywords: Ubiquitous game, children's emotional support, social isolation, mobile collaborative interactions.

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Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

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The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: Clique, clan, electronic health records, physician collaboration.

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Authors: Armin Samarghandi, Amirreza Jafari, Mohamad Ghiasi

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Since individuals spend the majority of their time indoors, this immediately affects their productivity and health. An essential factor in occupational health and public health is the influence of indoor environmental quality (IEQ) in buildings on occupant welfare and productivity. Since then, empirical data have been equivocal, indicating either that the studies are inaccurate or that the research has just scratched the surface of green buildings in offices, accommodation, and hospital settings and not taken the aforementioned holistically. This study compared three green-certified buildings — a residential green building, a green hospital, and a green school — with conventional structures in Tehran, Iran by means of a questionnaire spread among those utilizing these buildings, and assessing their productivity and health rate as opposed to the time they resided, worked in conventional buildings. The results demonstrated higher scores pertaining to productivity, physical and mental wellness as a consequence of better indoor environmental quality (IEQ), natural lighting, design, and sustainability of these building against non-green buildings. In addition, ancillary matters — environmental, financial, intellectual, emotional, social, spiritual dimensions of participants — were indirectly evaluated, and the same results are produced.

Keywords: Green building, Iran, productivity, physical and mental health, Tehran.

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Authors: Bhavneet Sidhu, Hardeep Singh, Amit Chhabra

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The world of wireless telecommunications is rapidly evolving. Technologies under research and development promise to deliver more services to more users in less time. This paper presents the emerging technologies helping wireless systems grow from where we are today into our visions of the future. This paper will cover the applications and characteristics of emerging wireless technologies: Wireless Local Area Networks (WiFi-802.11n), Wireless Personal Area Networks (ZigBee) and Wireless Metropolitan Area Networks (WiMAX). The purpose of this paper is to explain the impending 802.11n standard and how it will enable WLANs to support emerging media-rich applications. The paper will also detail how 802.11n compares with existing WLAN standards and offer strategies for users considering higher-bandwidth alternatives. The emerging IEEE 802.15.4 (ZigBee) standard aims to provide low data rate wireless communications with high-precision ranging and localization, by employing UWB technologies for a low-power and low cost solution. WiMAX (Worldwide Interoperability for Microwave Access) is a standard for wireless data transmission covering a range similar to cellular phone towers. With high performance in both distance and throughput, WiMAX technology could be a boon to current Internet providers seeking to become the leader of next generation wireless Internet access. This paper also explores how these emerging technologies differ from one another.

Keywords: MIMO technology, WiFi, WiMAX, ZigBee.

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Authors: Banti Sidhiwala, T. C. S. M. Gupta

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Mineral oils of naphthenic and paraffinic type are in use as insulating liquids in the transformer applications to protect solid insulation from moisture and ensures effective heat transfer/cooling. The performance of these type of oils have been proven in the field over many decades and the condition monitoring and diagnosis of transformer performance have been successfully monitored through oil properties and dissolved gas analysis methods successfully. Different types of gases can represent various types of faults that may occur due to faulty components or unfavorable operating conditions. A large amount of database has been generated in the industry for dissolved gas analysis in mineral oil-based transformer oils, and various models have been developed to predict faults and analyze data. Additionally, oil specifications and standards have been updated to include stray gassing limits that cover low-temperature faults. This modification has become an effective preventative maintenance tool that can help greatly in understanding the reasons for breakdowns of electrical insulating materials and related components. Natural esters have seen a rise in popularity in recent years due to their "green" credentials. Some of its benefits include biodegradability, a higher fire point, improvement in load capability of transformer and improved solid insulation life than mineral oils. However, the stray gassing test shows that hydrogen and hydrocarbons like methane (CH4) and ethane (C2H6) show very high values which are much higher than the limits of mineral oil standards. Though the standards for these types of esters are yet to be evolved, the higher values of hydrocarbon gases that are available in the market is of concern which might be interpreted as a fault in transformer operation. The current paper focuses on developing a class of natural esters with low levels of stray gassing by American Society for Testing and Materials (ASTM) and International Electric Council (IEC) methods much lower values compared to the natural ester-based products reported in the literature. The experimental results of products are explained.

Keywords: Biodegradability, fire point, dissolved gas analysis, natural ester, stray gassing.

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Authors: Mustapha Achibane, Imane Allam

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Since the nineties, all Moroccan banking institutions have to respect an arsenal of prudential ratios. The respect of these prudential measures aims to ensure the financial system stability. In order to do so, regulatory authorities tried to reduce the financial and operational risks incurred by the banking entities. Meanwhile, regulatory authorities demanded a balance sheet management work from banks. They also asked them to establish a management control system to manage operational risk, as well as an effort in terms of incurred risk-based commitments. Therefore, the prudential approach has a macroeconomic nature and it is presented as a determinant of the operational, microeconomic approach. This operational approach takes the form of a strategy that each banking entity must develop to manage the different banking risks. This study seeks to analyze the problem of risk management between the prudential and the operational approaches. It was processed through a literature review followed by an analysis of the Moroccan banking sector’s performance. At first, we will reconcile the inductive logic and then, the analytical one. The first approach consists of analyzing the phenomenon from a normative and conceptual perspective, while the second one will consist of considering the Moroccan banking system and analyzing the behavior of Moroccan banking entities in terms of risk management and performance. The results identified a favorable growth in terms of performance, despite the huge provisioning effort made to meet the international standards and the harmonization of the regulations.

Keywords: Banking performance, financial intermediation, operational approach, prudential standards, risk management.

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Authors: Mojibul Sajjad, Mohammad G. Rasul, Md. Sharif Imam Ibne Amir

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The rate of natural gas dissociation from the Coal Matrix depends on depressurization of reservoir through removing of the cleat water from the coal seam. These waters are similar to brine and aged of very long years. For improving the connectivity through fracking /fracturing, high pressure liquids are pumped off inside the coal body. A significant quantity of accumulated water, a combined mixture of cleat water and fracking fluids (back flow water) is pumped out through gas well. In Queensland, Australia Coal Seam Gas (CSG) industry is in booming state and estimated of 30,000 wells would be active for CSG production forecasting life span of 30 years. Integrated water management along with water softening programs is practiced for subsequent treatment and later on discharge to nearby surface water catchment. Water treatment is an important part of the CSG industry. A case study on a CSG site and review on the test results are discussed for assessing the Standards & Practices for management of CSG by-product water and their subsequent disposal activities. This study was directed toward (i) water management and softening process in Spring Gully CSG field, (ii) Comparative analysis on experimental study and standards and (iii) Disposal of the treated water. This study also aimed for alternative usages and their impact on vegetation, living species as well as long term effects.

Keywords: Coal Seam Gas (CSG), Cleat Water, Hydro-Fracking, Desalination, Reverse Osmosis.

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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: Fardin Boustani

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The Kowsar dam supply water for different usages such as drinking, industrial, agricultural and aquaculture farms usages and located next to the city of Dehdashat in Kohgiluye and Boyerahmad province in southern Iran. There are some towns and villages on the Kowsar dam watersheds, which Dehdasht and Choram are the most important and populated cities in this area. The study was undertaken to assess the status of water quality in the urban areas of the Kowsar dam. A total of 28 water samples were collected from 6 stations on surface water and 1 station from groundwater on the watershed of the Kowsar dam. All the samples were analyzed for Cd concentration using standard procedures. The results were compared with other national and international standards. Among the analyzed samples, as the maximum value of cadmium (1.131 μg/L) was observed on the station 2 at the winter 2009, all the samples analyzed were within the maximum admissible limits by the United States Environmental Protection Agency, EU, WHO, New Zealand , Australian, Iranian, and the Indian standards. In general results of the present study have shown that Cd mean values of stations No. 4, 1 and 2 with 0.5135, 0.0.4733 and 0.4573 μg/L respectively are higher than the other stations . Although Cd level of all samples and stations have had normal values but this is an indication of pollution potential and hazards because of human activity and waste water of towns in the areas, which can effect on human health implications in future. This research, therefore, recommends the government and other responsible authorities to take suitable improving measures in the Kowsar dam watershed-s.

Keywords: Kowsar dam, Drinking water quality, Cadmium, Maximum admissible limit, World health organization,

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Authors: Masood Karamoozian, Zhang Hong

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The necessity and complexity of the decision-making process and the interference of the various factors to make decisions and consider all the relevant factors in a problem are very obvious nowadays. Hence, researchers show their interest in multi-criteria decision-making methods. In this research, the Analytical Hierarchy Process (AHP), Simple Additive Weighting (SAW), and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) methods of multi-criteria decision-making have been used to solve the problem of optimal construction systems. Systems being evaluated in this problem include; Light Steel Frames (LSF), a case study of designs by Zhang Hong studio in the Southeast University of Nanjing, Insulating Concrete Form (ICF), Ordinary Construction System (OCS), and Precast Concrete System (PRCS) as another case study designs in Zhang Hong studio in the Southeast University of Nanjing. Crowdsourcing was done by using a questionnaire at the sample level (200 people). Questionnaires were distributed among experts in university centers and conferences. According to the results of the research, the use of different methods of decision-making led to relatively the same results. In this way, with the use of all three multi-criteria decision-making methods mentioned above, the PRCS was in the first rank, and the LSF system ranked second. Also, the PRCS, in terms of performance standards and economics, was ranked first, and the LSF system was allocated the first rank in terms of environmental standards.

Keywords: Multi-criteria decision making, AHP, SAW, TOPSIS.

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Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: Disposal, Healthcare waste, management, Montserrado County, Monrovia.

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Authors: Nadezhda Kvatashidze

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The International Accounting Standards Board updated the conceptual framework for financial reporting. The main reason behind it is to resolve the tasks of the accounting, which are caused by the market development and business-transactions of a new economic content. Also, the investors call for higher transparency of information and responsibility for the results in order to make a more accurate risk assessment and forecast. All these make it necessary to further develop the conceptual framework for financial reporting so that the users get useful information. The market development and certain shortcomings of the conceptual framework revealed in practice require its reconsideration and finding new solutions. Some issues and concepts, such as disclosure and supply of information, its qualitative characteristics, assessment, and measurement uncertainty had to be supplemented and perfected. The criteria of recognition of certain elements (assets and liabilities) of reporting had to be updated, too and all this is set out in the updated edition of the conceptual framework for financial reporting, a comprehensive collection of concepts underlying preparation of the financial statement. The main objective of conceptual framework revision is to improve financial reporting and development of clear concepts package. This will support International Accounting Standards Board (IASB) to set common “Approach & Reflection” for similar transactions on the basis of mutually accepted concepts. As a result, companies will be able to develop coherent accounting policies for those transactions or events that are occurred from particular deals to which no standard is used or when standard allows choice of accounting policy.

Keywords: Conceptual framework, measurement basis, measurement uncertainty, neutrality, prudence, stewardship.

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Authors: Mohamed .S .Alazhari, Milad. M. Al Shebani

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Numerous concrete structures projects are currently running in Libya as part of a US$50 billion government funding. The quality of concrete used in 20 different construction projects were assessed based mainly on the concrete compressive strength achieved. The projects are scattered all over the country and are at various levels of completeness. For most of these projects, the concrete compressive strength was obtained from test results of a 150mm standard cube mold. Statistical analysis of collected concrete compressive strengths reveals that the data in general followed a normal distribution pattern. The study covers comparison and assessment of concrete quality aspects such as: quality control, strength range, data standard deviation, data scatter, and ratio of minimum strength to design strength. Site quality control for these projects ranged from very good to poor according to ACI214 criteria [1]. The ranges (Rg) of the strength (max. strength – min. strength) divided by average strength are from (34% to 160%). Data scatter is measured as the range (Rg) divided by standard deviation (
) and is found to be (1.82 to 11.04), indicating that the range is ±3σ. International construction companies working in Libya follow different assessment criteria for concrete compressive strength in lieu of national unified procedure. The study reveals that assessments of concrete quality conducted by these construction companies usually meet their adopted (internal) standards, but sometimes fail to meet internationally known standard requirements. The assessment of concrete presented in this paper is based on ACI, British standards and proposed Libyan concrete strength assessment criteria.

Keywords: Acceptance criteria, Concrete, Compressive strength, quality control

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Authors: S. Rawangwong, J. Chatthong, W. Boonchouytan

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The objective of the research was to study of foot anthropometry of children aged 7-12 years in the South of Thailand Thirty-three dimensions were measured on 305 male and 295 female subjects with 3 age ranges (7-12 years old). The instrumentation consists of four types of anthropometer, digital vernier caliper, digital height gauge and measuring tape. The mean values and standard deviations of average age, height, and weight of the male subjects were 9.52(±1.70) years, 137.80(±11.55) cm, and 37.57(±11.65) kg. Female average age, height, and weight subjects were 9.53(±1.70) years, 137.88(±11.55) cm, and 34.90(±11.57) kg respectively. The comparison of the 33 comparison measured anthropometric. Between male and female subjects were sexual differences in size on women in almost all areas of significance (p<0.05). The comparison of size and proportion elementary school students 11-12 years old men in Southern of Thailand with Thai boys aged 11-12 years of industrial standards at stage 4 year A.D. 2000-2001 Number nine ratio. Concluded that students male in Southern of Thailand has a size different from the proportions of research Industrial Standards. Ministry of Industry, Phase 4, when every year from A.D. 2000-2001 ratio was significantly (p<0.05).All of the feet studied were classified into 4 categories according to the ratios of diagonal foot breadth to the maximum foot length and heel breadth to the foot breadth. They were short but thick, small but long, small, and large. The numbers of the males feet classified in these categories were 86, 64, 40, and 115 persons or 28.20, 20.98, 13.11, and 37.70% respectively. For the female feet, the same values were 46, 59, 81, and 109 persons or 15.59, 20.00, 27.46, and 36.95% respectively.

Keywords: Ergonomics, foot anthropometry, male and female, primary school children

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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. 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: Merab Khokhobaia

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Within the framework of this research, the regulatory documents, which are in force in relation to this industry, were analyzed. The main attention is turned to their modernization and necessity of their compliance with European standards. It is a current issue to direct the efforts of state policy on support of business by implementing infrastructural projects, as well as by development of human resources, which may be possible by supporting the relevant higher and vocational studying-educational programs.

Keywords: Regional Development, Tourism Industry, Tourism Policy, Transition.

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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

Abstract:

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: Noha M. Rashad, W. Swelam, M. H. Abd ElAzeem

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A simple design of array antenna is presented in this paper, supporting millimeter wave applications which can be used in short range wireless communications such as 5G applications. This design enhances the use of V-band, according to IEEE standards, as the antenna works in the 70 GHz band with bandwidth more than 11 GHz and peak gain more than 13 dBi. The design is simulated using different numerical techniques achieving a very good agreement.

Keywords: 5G Technology, array antenna, microstrip, millimeter wave.

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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: Kaylash Chaudhary, Ansgar Fehnker

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There are many virtual payment systems available to conduct micropayments. It is essential that the protocols satisfy the highest standards of correctness. This paper examines the Netpay Protocol [3], provide its formalization as automata model, and prove two important correctness properties, namely absence of deadlock and validity of an ecoin during the execution of the protocol. This paper assumes a cooperative customer and will prove that the protocol is executing according to its description.

Keywords: Model, Verification, Micropayment.

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