Search results for: Intensive Care Units
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1035

Search results for: Intensive Care Units

975 Ethnographic Exploration of Elderly Residents' Perceptions and Utilization of Health Care to Improve Their Quality of Life

Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

Abstract:

The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: Ethnographic study, health care needs, elderly Malay people, Malaysia, quality of life, residential home.

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974 Unit Selection Algorithm Using Bi-grams Model For Corpus-Based Speech Synthesis

Authors: Mohamed Ali KAMMOUN, Ahmed Ben HAMIDA

Abstract:

In this paper, we present a novel statistical approach to corpus-based speech synthesis. Classically, phonetic information is defined and considered as acoustic reference to be respected. In this way, many studies were elaborated for acoustical unit classification. This type of classification allows separating units according to their symbolic characteristics. Indeed, target cost and concatenation cost were classically defined for unit selection. In Corpus-Based Speech Synthesis System, when using large text corpora, cost functions were limited to a juxtaposition of symbolic criteria and the acoustic information of units is not exploited in the definition of the target cost. In this manuscript, we token in our consideration the unit phonetic information corresponding to acoustic information. This would be realized by defining a probabilistic linguistic Bi-grams model basically used for unit selection. The selected units would be extracted from the English TIMIT corpora.

Keywords: Unit selection, Corpus-based Speech Synthesis, Bigram model

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973 Validation of an Acuity Measurement Tool for Maternity Services

Authors: Cherryl Lowe

Abstract:

Background - The TrendCare Patient Dependency System is currently used by a large number of maternity Services across Australia, New Zealand and Singapore. In 2012, 2013 and 2014 validation studies were initiated in all three countries to validate the acuity tools used for women in labour, and postnatal mothers and babies. This paper will present the findings of the validation study. Aim - The aim of this study was to; identify if the care hours provided by the TrendCare acuity system was an accurate reflection of the care required by women and babies; obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of maternity care models in three countries. Method - A non-experimental action research methodology was used across maternity services in four District Health Boards in New Zealand, a large tertiary and a large secondary maternity service in Singapore and a large public maternity service in Australia. Standardised data collection forms and timing devices were used to collect midwife contact times, with women and babies included in the study. Rejection processes excluded samples when care was not completed/rationed, and contact timing forms were incomplete. The variances between actual timed midwife/mother/baby contact and the TrendCare acuity category times were identified and investigated. Results - Thirty two (88.9%) of the 36 TrendCare acuity category timings, fell within the variance tolerance levels when compared to the actual timings recorded for midwifery care. Four (11.1%) TrendCare categories provided less minutes of care than the actual timings and exceeded the variance tolerance level. These were all night shift category timings. Nine postnatal categories were not able to be compared as the sample size for these categories was statistically insignificant. 100% of labour ward TrendCare categories matched actual timings for midwifery care, all falling within the variance tolerance levels. The actual time provided by core midwifery staff to assist lead maternity carer (LMC) midwives in New Zealand labour wards showed a significant deviation to previous studies. The findings of the study demonstrated the need for additional time allocations in TrendCare to accommodate an increased level of assistance given to LMC midwives. Conclusion - The results demonstrated the importance of regularly validating the TrendCare category timings with actual timings of the care hours provided. It was evident from the findings that variances to models of care and length of stay in maternity units have increased midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the LMC midwife has increased substantially. Outcomes - As a consequence of this study, changes were made to the night duty TrendCare maternity categories, additional acuity indicators were developed and times for assisting LMC midwives in labour ward increased. The updated TrendCare version was delivered to maternity services in 2014.

Keywords: Maternity, acuity, midwifery research, midwifery workloads.

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972 Obstruction to Treatments Meeting International Standards for Lyme and Relapsing Fever Borreliosis Patients

Authors: J. Luché-Thayer, C. Perronne, C. Meseko

Abstract:

We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: Conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent.

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971 Prone Positioning and Clinical Outcomes of Mechanically Ventilated Patients with Severe Acute Respiratory Distress Syndrome

Authors: Maha Salah Abdullah Ismail, Mahmoud M. Alsagheir, Mohammed Salah Abd Allah

Abstract:

Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Lung-protective ventilation is still the key of better outcome in ARDS. Prone position reduces the trans-pulmonary pressure gradient, recruiting collapsed regions of the lung without increasing airway pressure or hyperinflation. Prone ventilation showed improved oxygenation and improved outcomes in severe hypoxemic patients with ARDS. This study evaluates the effect of prone positioning on mechanically ventilated patients with ARDS. A quasi-experimental design was carried out at Critical Care Units, on 60 patients. Two tools were utilized to collect data; Socio demographic, medical and clinical outcomes data sheet. Results of the present study indicated that prone position improves oxygenation in patients with severe respiratory distress syndrome. The study recommended that use prone position in patients with severe ARDS, as early as possible and for long sessions. Also, replication of this study on larger probability sample at the different geographical location is highly recommended.

Keywords: Acute respiratory distress syndrome, Critical care, Mechanical ventilation and Prone position.

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970 Computer Based Medicine: I - The Future

Authors: Essam Abd-Elrazek

Abstract:

With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.

Keywords: Medical Informatics, telemedicine, e-health systems.

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969 Dynamic Performance Evaluation of Distributed Generation Units in the Micro Grid

Authors: Abdolreza Roozbeh, Reza Sedaghati, Ali Asghar Baziar, Mohammad Reza Tabatabaei

Abstract:

This paper presents dynamic models of distributed generators (DG) and investigates dynamic behavior of the DG units in the micro grid system. The DG units include photovoltaic and fuel cell sources. The voltage source inverter is adopted since the electronic interface which can be equipped with its controller to keep stability of the micro grid during small signal dynamics. This paper also introduces power management strategies and implements the DG load sharing concept to keep the micro grid operation in gridconnected and islanding modes of operation. The results demonstrate the operation and performance of the photovoltaic and fuel cell as distributed generators in a micro grid. The entire control system in the micro grid is developed by combining the benefits of the power control and the voltage control strategies. Simulation results are all reported, confirming the validity of the proposed control technique.

Keywords: Stability, Distributed Generation, Dynamic, Micro Grid.

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968 A Promising Approach to Supporting Knowledge-Intensive Business Processes: Business Case Management

Authors: Zeljko Panian

Abstract:

Through the course of this paper we define Business Case Management and its characteristics, and highlight its link to knowledge workers. Business Case Management combines knowledge and process effectively, supporting the ad hoc and unpredictable nature of cases, and coordinate a range of other technologies to appropriately support knowledge-intensive processes. We emphasize the growing importance of knowledge workers and the current poor support for knowledge work automation. We also discuss the challenges in supporting this kind of knowledge work and propose a novel approach to overcome these challenges.

Keywords: Knowledge management, knowledge workers, business process management, business case management, automation.

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967 Economic Load Dispatch with Daily Load Patterns and Generator Constraints by Particle Swarm Optimization

Authors: N. Phanthuna V. Phupha N. Rugthaicharoencheep, S. Lerdwanittip

Abstract:

This paper presents an optimization technique to economic load dispatch (ELD) problems with considering the daily load patterns and generator constraints using a particle swarm optimization (PSO). The objective is to minimize the fuel cost. The optimization problem is subject to system constraints consisting of power balance and generation output of each units. The application of a constriction factor into PSO is a useful strategy to ensure convergence of the particle swarm algorithm. The proposed method is able to determine, the output power generation for all of the power generation units, so that the total constraint cost function is minimized. The performance of the developed methodology is demonstrated by case studies in test system of fifteen-generation units. The results show that the proposed algorithm scan give the minimum total cost of generation while satisfying all the constraints and benefiting greatly from saving in power loss reduction

Keywords: Particle Swarm Optimization, Economic Load Dispatch, Generator Constraints.

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966 Problems of Measuring Effectiveness of Innovation Performance

Authors: Aziza S. Zhuparova

Abstract:

The innovation performance of nations has been repeatedly measured in the literature. We argue that while the literature offers many suggestions, their theoretical foundation is often weak and the underlying assumptions are rarely discussed. In this paper, we systematize various mechanisms by which spatial units influence nation and firms' innovation activities. On the basis of this, common innovation performance measures and analyses are discussed and evaluated. It is concluded that there is no general best way of measuring the innovation performance of spatial units. In fact, the most interesting insights can be obtained using a multitude of different approaches at the same time.

Keywords: Innovation performance, firms effectiveness of innovation, national innovativeness, innovation effectiveness, national innovation activity's measurement

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965 Structure of the Working Time of Nurses in Emergency Departments in Polish Hospitals

Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: Emergency nurses, nursing care, workload, work sampling.

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964 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

Abstract:

Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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963 Fetal and Infant Mortality in Botucatu City, São Paulo State, Brazil: Evaluation of Maternal - Infant Health Care

Authors: Noda L. M., Salvador I. C, C. M. L. G. Parada, Fonseca C. R. B.

Abstract:

In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Keywords: Fetal Mortality, Infant Mortality, Maternal-Child Health Services, Program Evaluation.

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962 A Profit-Based Maintenance Scheduling of Thermal Power Units in Electricity Market

Authors: Smajo Bisanovic, Mensur Hajro, Muris Dlakic

Abstract:

This paper presents one comprehensive modelling approach for maintenance scheduling problem of thermal power units in competitive market. This problem is formulated as a 0/1 mixedinteger linear programming model. Model incorporates long-term bilateral contracts with defined profiles of power and price, and weekly forecasted market prices for market auction. The effectiveness of the proposed model is demonstrated through case study with detailed discussion.

Keywords: Maintenance scheduling, bilateral contracts, market prices, profit.

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961 A Generic Middleware to Instantly Sync Intensive Writes of Heterogeneous Massive Data via Internet

Authors: Haitao Yang, Zhenjiang Ruan, Fei Xu, Lanting Xia

Abstract:

Industry data centers often need to sync data changes reliably and instantly from a large-scale of heterogeneous autonomous relational databases accessed via the not-so-reliable Internet, for which a practical generic sync middleware of low maintenance and operation costs is most wanted. To this demand, this paper presented a generic sync middleware system (GSMS), which has been developed, applied and optimized since 2006, holding the principles or advantages that it must be SyncML-compliant and transparent to data application layer logic without referring to implementation details of databases synced, does not rely on host computer operating systems deployed, and its construction is light weighted and hence of low cost. Regarding these hard commitments of developing GSMS, in this paper we stressed the significant optimization breakthrough of GSMS sync delay being well below a fraction of millisecond per record sync. A series of ultimate tests with GSMS sync performance were conducted for a persuasive example, in which the source relational database underwent a broad range of write loads (from one thousand to one million intensive writes within a few minutes). All these tests showed that the performance of GSMS is competent and smooth even under ultimate write loads.

Keywords: Heterogeneous massive data, instantly sync intensive writes, Internet generic middleware design, optimization.

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960 Optimal Allocation of DG Units for Power Loss Reduction and Voltage Profile Improvement of Distribution Networks using PSO Algorithm

Authors: K. Varesi

Abstract:

This paper proposes a Particle Swarm Optimization (PSO) based technique for the optimal allocation of Distributed Generation (DG) units in the power systems. In this paper our aim is to decide optimal number, type, size and location of DG units for voltage profile improvement and power loss reduction in distribution network. Two types of DGs are considered and the distribution load flow is used to calculate exact loss. Load flow algorithm is combined appropriately with PSO till access to acceptable results of this operation. The suggested method is programmed under MATLAB software. Test results indicate that PSO method can obtain better results than the simple heuristic search method on the 30-bus and 33- bus radial distribution systems. It can obtain maximum loss reduction for each of two types of optimally placed multi-DGs. Moreover, voltage profile improvement is achieved.

Keywords: Distributed Generation (DG), Optimal Allocation, Particle Swarm Optimization (PSO), Power Loss Minimization, Voltage Profile Improvement.

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959 The Presence of Enterobacters (E.Coli and Salmonella spp.) in Industrial Growing Poultry in Albania

Authors: Boci J., Çabeli P., Shtylla T., Kumbe I.

Abstract:

The development of the poultry industry in Albania is mainly based on the existence of intensive modern farms with huge capacities, which often are mixed with other forms. Colibacillosis is commonly displayed regardless of the type of breeding, delivering high mortality in poultry industry. The mechanisms with which pathogen enterobacters are able to cause the infection in poultry are not yet clear. The routine diagnose in the field, followed by isolation of E. coli and species of Salmonella genres in reference laboratories cannot lead in classification or full recognition of circulative strains in a territory, if it is not performed a differentiation among the present microorganisms in intensive farms and those in rural areas. In this study were isolated 1.496 strains of E. coli and 378 Salmonella spp. This study, presents distribution of poultry pathogenosity of E.coli and Salmonella spp., based on the usage of innovative diagnostic methods.

Keywords: poultry, E.coli, Salmonella spp., Enterobacter

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958 Identification of Industrial Health Using ANN

Authors: Deepak Goswami, Padma Lochan Hazarika, Kandarpa Kumar Sarma

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The customary practice of identifying industrial sickness is a set traditional techniques which rely upon a range of manual monitoring and compilation of financial records. It makes the process tedious, time consuming and often are susceptible to manipulation. Therefore, certain readily available tools are required which can deal with such uncertain situations arising out of industrial sickness. It is more significant for a country like India where the fruits of development are rarely equally distributed. In this paper, we propose an approach based on Artificial Neural Network (ANN) to deal with industrial sickness with specific focus on a few such units taken from a less developed north-east (NE) Indian state like Assam. The proposed system provides decision regarding industrial sickness using eight different parameters which are directly related to the stages of sickness of such units. The mechanism primarily uses certain signals and symptoms of industrial health to decide upon the state of a unit. Specifically, we formulate an ANN based block with data obtained from a few selected units of Assam so that required decisions related to industrial health could be taken. The system thus formulated could become an important part of planning and development. It can also contribute towards computerization of decision support systems related to industrial health and help in better management.

Keywords: Industrial, Health, Classification, ANN, MLP, MSE.

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957 A Novel QoS Optimization Architecture for 4G Networks

Authors: Aaqif Afzaal Abbasi, Javaid Iqbal, Akhtar Nawaz Malik

Abstract:

4G Communication Networks provide heterogeneous wireless technologies to mobile subscribers through IP based networks and users can avail high speed access while roaming across multiple wireless channels; possible by an organized way to manage the Quality of Service (QoS) functionalities in these networks. This paper proposes the idea of developing a novel QoS optimization architecture that will judge the user requirements and knowing peak times of services utilization can save the bandwidth/cost factors. The proposed architecture can be customized according to the network usage priorities so as to considerably improve a network-s QoS performance.

Keywords: QoS, Network Coverage Boundary, ServicesArchives Units (SAU), Cumulative Services Archives Units (CSAU).

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956 Qualitative Data Analysis for Health Care Services

Authors: Taner Ersoz, Filiz Ersoz

Abstract:

This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.

Keywords: Multiple correspondence analysis, optimal scaling, multivariate categorical data, health care services, health satisfaction survey, statistical visualizing, Turkey.

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955 Outcomes of Teenage Mothers at Dankhunthot Hospital, Nakhon Ratchasima

Authors: Nareelux Suwannobol, Supap Chobkhayan

Abstract:

The aim of this study was to investigate the pregnancy outcomes of teenage mothers at DanKhunThot hospital, Nakhon Ratchasima, Thailand. A retrospective descriptive study was conducted in 573 of teenage pregnant from charts reviewed from 1st October 2010-31st March, 2012. Data were analyzed by frequency distribution, mean and Standard Deviation. The results shown several problems and negatives outcomes of pregnancy in teenager such as not attended prenatal care, Low birth weight infants, death fetus in utero and other complications. The results of this study can be utilized in the development of prenatal, perinatal and post natal care services, especially in DanKhunthot Hospital contexts. Moreover, the results were present to the District Health Care committees in order to enhance health care service system for teenage pregnancy of DanKhunthot District in further.

Keywords: Teenage mothers, Pregnancy outcome, Neonatal outcomes, Maternal outcomes.

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954 Health Post A Sustainable Prototype for the Third World

Authors: Chizzoniti Domenico, Beggiora Klizia, Cattani Letizia, Moscatelli Monica

Abstract:

This paper concerns the study of sustainable construction materials applied on the "Health Post", a prototype for the primary health care situated in alienated areas of the world. It's suitable for social and climatic Sub-Saharan context; however, it could be moved in other countries of the world with similar urgent needs. The idea is to create a Health Post with local construction materials that have a low environmental impact and promote the local workforce allowing reuse of traditional building techniques lowering production costs and transport. The aim of Primary Health Care Centre is to be a flexible and expandable structure identifying a modular form that can be repeated several times to expand its existing functions. In this way it could be not only a health care centre but also a socio-cultural facility.

Keywords: Low costs building, sustainable construction materials, green construction system, prototype, health care, emergency.

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953 Life Cycle Assessment of Precast Concrete Units

Authors: Ya Hong Dong, Conrad T.C. Wong, S. Thomas Ng, James M.W. Wong

Abstract:

Precast concrete has been widely adopted in public housing construction of Hong Kong since the mid-1980s. While pre-casting is considered an environmental friendly solution, there is lack of study to investigate the life cycle performance of precast concrete units. This study aims to bridge the knowledge gap by providing a comprehensive life cycle assessment (LCA) study for two precast elements namely façade and bathroom. The results show that raw material is the most significant contributor of environmental impact accounting for about 90% to the total impact. Furthermore, human health is more affected by the production of precast concrete than the ecosystems.

Keywords: Environment, green, LCA, LCIA, precast.

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952 Gas Condensing Unit with Inner Heat Exchanger

Authors: Dagnija Blumberga, Toms Prodanuks, Ivars Veidenbergs, Andra Blumberga

Abstract:

Gas condensing units with inner tubes heat exchangers represent third generation technology and differ from second generation heat and mass transfer units, which are fulfilled by passive filling material layer. The first one improves heat and mass transfer by increasing cooled contact surface of gas and condensate drops and film formed in inner tubes heat exchanger. This paper presents a selection of significant factors which influence the heat and mass transfer. Experimental planning is based on the research and analysis of main three independent variables; velocity of water and gas as well as density of spraying. Empirical mathematical models show that the coefficient of heat transfer is used as dependent parameter which depends on two independent variables; water and gas velocity. Empirical model is proved by the use of experimental data of two independent gas condensing units in Lithuania and Russia. Experimental data are processed by the use of heat transfer criteria-Kirpichov number. Results allow drawing the graphical nomogram for the calculation of heat and mass transfer conditions in the innovative and energy efficient gas cooling unit.

Keywords: Gas condensing unit, filling, inner heat exchanger, package, spraying, tunes.

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951 A Survey on Data-Centric and Data-Aware Techniques for Large Scale Infrastructures

Authors: Silvina Caíno-Lores, Jesús Carretero

Abstract:

Large scale computing infrastructures have been widely developed with the core objective of providing a suitable platform for high-performance and high-throughput computing. These systems are designed to support resource-intensive and complex applications, which can be found in many scientific and industrial areas. Currently, large scale data-intensive applications are hindered by the high latencies that result from the access to vastly distributed data. Recent works have suggested that improving data locality is key to move towards exascale infrastructures efficiently, as solutions to this problem aim to reduce the bandwidth consumed in data transfers, and the overheads that arise from them. There are several techniques that attempt to move computations closer to the data. In this survey we analyse the different mechanisms that have been proposed to provide data locality for large scale high-performance and high-throughput systems. This survey intends to assist scientific computing community in understanding the various technical aspects and strategies that have been reported in recent literature regarding data locality. As a result, we present an overview of locality-oriented techniques, which are grouped in four main categories: application development, task scheduling, in-memory computing and storage platforms. Finally, the authors include a discussion on future research lines and synergies among the former techniques.

Keywords: Co-scheduling, data-centric, data-intensive, data locality, in-memory storage, large scale.

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950 Antibiotic Prescribing in the Acute Care in Iraq

Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

Abstract:

Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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949 Federalism and Foreign Affairs: The International Relations of Mexican Sub-State Governments

Authors: Jorge A. Schiavon

Abstract:

This article analyzes the international relations of sub-State governments (IRSSG) in Mexico. It aims to answer five questions: 1) What explains the recent and dramatic increase in their international activities? 2) What is the impact of federalism on the foreign affairs of the federal units? 3) What are the levels or degrees of IRSSG and how have they changed over the last years? 4) How do Mexican federal units institutionalize their international activities? 5) What are the perceptions and capacities of the federal units in their internationalization process? The first section argues that the growth in the IRSSG is generated by growing interdependence and globalization in the international system, and democratization, decentralization and structural reform in the national arena. The second section sustains that the renewed Mexican federalism has generated the incentives for SSG to participate more intensively in international affairs. The third section defends that there is a wide variation in their degree of international participation, which is measured in three moments in time (2004 2009 and 2014), and explains how this activity has changed in the last decade. The fourth section studies the institutionalization of the IRSSG in Mexico through the analysis of Inter-Institutional Agreements (IIA). Finally, the last section concentrates in explaining the perceptions and capacities of Mexican sub-State governments to conduct international relations.

Keywords: Federalism, foreign policy, international relations of sub-state governments, paradiplomacy, Mexico.

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948 Allocation of Mobile Units in an Urban Emergency Service System

Authors: Dimitra Alexiou

Abstract:

In an urban area the location allocation of emergency services mobile units, such as ambulances, police patrol cars must be designed so as to achieve a prompt response to demand locations. In this paper the partition of a given urban network into distinct sub-networks is performed such that the vertices in each component are close and simultaneously the sums of the corresponding population in the sub-networks are almost uniform. The objective here is to position appropriately in each sub-network a mobile emergency unit in order to reduce the response time to the demands. A mathematical model in framework of graph theory is developed. In order to clarify the corresponding method a relevant numerical example is presented on a small network.

Keywords: Distances, Emergency Service, Graph Partition, location.

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947 A Study on Performance-Based Design Analysis for Vertical Extension of Apartment Units

Authors: Minsun Kim, Ki-Sun Choi, Hyun-Jee Lee, Young-Chan You

Abstract:

There is no reinforcement example for the renovation of the vertical and horizontal extension to existing building structures which is a shear wall type in apartment units in Korea. Among these existing structures, the structures which are shear wall type are rare overseas, while Korea has many shear wall apartment units. Recently, in Korea, a few researchers are trying to confirm the possibility of the vertical extension in existing building with shear walls. This study evaluates the possibility of the renovation by applying performance-based seismic design to existing buildings with shear walls in the analysis phase of the structure. In addition, force-based seismic design, used by general structural engineers in Korea, is carried out to compare the amount of reinforcement of walls, which is a main component of wall structure. As a result, we suggest that performance-based design obtains more economical advantages than force-based seismic design.

Keywords: Vertical extension, performance-based design, renovation, shear wall structure, structural analysis.

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946 Interface Terminologies: A Case Study on the International Classification of Primary Care

Authors: Laurent Letrilliart, Anne-Katty Bacis, François Mennerat, Cyrille Colin

Abstract:

The International Classification of Primary Care (ICPC), which belongs to the WHO Family of International Classifications (WHO-FIC), has a low granularity, which is convenient for describing general medical practice. However, its lack of specificity makes it useful to be used along with an interface terminology. An international survey has been performed, using a questionnaire sent by email to experts from 25 countries, in order to describe the terminologies interfacing with ICPC. Eleven interface terminologies have been identified, developed in Argentina, Australia, Belgium (2), Canada, Denmark, France, Germany, Norway, South Africa, and The Netherlands. Globally, these systems have been poorly assessed until now.

Keywords: Terminology, controlled vocabulary, thesaurus, classification, International Classification of Primary Care.

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