Search results for: duty of care

Authors: B. Lonla Moffo, J. Mbihi, L. Nneme Nneme

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In this paper, a low cost duty-cycle modulation scheme is studied in depth and compared to the standard pulse width modulation technique. Using a mix of analytical reasoning and electronics simulation tools, it is shown that under the same operating conditions, most characteristics of the proposed duty-cycle modulation scheme are better than those provided by a standard pulse width modulation technique. The simulation results obtained when testing both modulation control policies on prototyping systems, indicate that the proposed duty-cycle modulation approach, appears to be a high quality control policy in a wide variety of application areas, including A/D and D/A conversion, signal transmission and switching control in power electronics.

Keywords: Duty-cycle Modulation, Operational amplifiers, Pulse width modulation, Power electronics, Signal processing.

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Authors: M. Sajjadnejad, H. Omidvar, M. Javanbakht, A. Mozafari

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Pure nickel coatings have been successfully electrodeposited on copper substrates by the pulse plating technique. The influence of current density, duty cycle and pulse frequency on the surface morphology, crystal orientation, and microhardness was determined. It was found that the crystallite size of the deposit increases with increasing current density and duty cycle. The crystal orientation progressively changed from a random texture at 1 A/dm2 to (200) texture at 10 A/dm2. Increasing pulse frequency resulted in increased texture coefficient and peak intensity of (111) reflection. An increase in duty cycle resulted in considerable increase in texture coefficient and peak intensity of (311) reflection. Coatings obtained at high current densities and duty cycle present a mixed morphology of small and large grains. Maximum microhardness of 193 Hv was achieved at 4 A/dm2, 10 Hz and duty cycle of 50%. Nickel coatings with (200) texture are ductile while (111) texture improves the microhardness of the coatings.

Keywords: Current density, Duty cycle, Microstructure, Nickel, Pulse frequency.

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Authors: Kaishuan Shen, Pan Changyu, Yuhsiang Lu, Zongshao Liu, Chishxsin Chuang, Minyuan Ma

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The culture of riding heavy motorcycles originates from advanced countries and mainly comes from Europe, North America, and Japan. Heavy duty motorcycle riders are different from people who view motorcycles as a convenient mean of transportation. They regard riding them as a kind of enjoyment and high-level taste. The activities of riding heavy duty motorcycles have formes a distinctive landscape in domestic land in Taiwan. Previous studies which explored motorcycle culture in Taiwan still focused on the objects of motorcycle engine displacement under 50 cc.. The study aims to study the heavy duty motorcycles of engine displacement over 550 cc. and explores where their attractiveness is. For finding the attractiveness of heavy duty motorcycle, the study chooses Miryoku Engineering (Preference-Based Design) approach. Two steps are adopted to proceed the research. First, through arranging the letters obtained from interviewing experts, EGM (The Evaluation Grid Method) was applied to find out the structure of attractiveness. The attractive styles are eye-dazzling, leisure, classic, and racing competitive styles. Secondarily, Quantification Theory Type I analysis was adopted as a tool for analyzing the importance of attractiveness. The relationship between style and attractive parts was also discussed. The results could contribute to the design and research development of heavy duty motorcycle industry in Taiwan.

Keywords: attractiveness, evaluation, heavy dutymotorcycle, miryoku engineering

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Authors: Liang Zhao, Jili Zhang, Kai Li

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A microcontroller-based fan coil unit (FCU) fuzzy controller is designed and implemented in this paper. The controller employs the concept of duty ratio on the electric valve control, which could make full use of the cooling and dehumidifying capacity of the FCU when the valve is off. The traditional control method and its limitations are analyzed. The hardware and software design processes are introduced in detail. The experimental results show that the proposed method is more energy efficient compared to the traditional controlling strategy. Furthermore, a more comfortable room condition could be achieved by the proposed method. The proposed low-cost FCU fuzzy controller deserves to be widely used in engineering applications.

Keywords: Fan coil unit, duty ratio, fuzzy controller, experiment.

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Authors: Wei Lei, Hui Chen, Lin Lu

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Microscopic emission and fuel consumption models have been widely recognized as an effective method to quantify real traffic emission and energy consumption when they are applied with microscopic traffic simulation models. This paper presents a framework for developing the Microscopic Emission (HC, CO, NOx, and CO2) and Fuel consumption (MEF) models for light-duty vehicles. The variable of composite acceleration is introduced into the MEF model with the purpose of capturing the effects of historical accelerations interacting with current speed on emission and fuel consumption. The MEF model is calibrated by multivariate least-squares method for two types of light-duty vehicle using on-board data collected in Beijing, China by a Portable Emission Measurement System (PEMS). The instantaneous validation results shows the MEF model performs better with lower Mean Absolute Percentage Error (MAPE) compared to other two models. Moreover, the aggregate validation results tells the MEF model produces reasonable estimations compared to actual measurements with prediction errors within 12%, 10%, 19%, and 9% for HC, CO, NOx emissions and fuel consumption, respectively.

Keywords: Emission, Fuel consumption, Light-duty vehicle, Microscopic, Modeling.

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Authors: M. Tsirintani

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The article is proposing a base plan for the future Patient Care Information Systems in a changing health care environment where it is necessary to assure quality patient care services and reducing cost and where new technology trends give the opportunities to develop clinical applications and services patient focused according to new business objectives.

Keywords: Health care management, planning patient care information system.

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Authors: Sheroz Khan, Mustafa Zeki, Shihab Abdel Hameed, AHM Zahirul Alam, Aisha Hassan Abdalla, A. F. Salami, W. A. Lawal

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A novel circuit for generating a signal embedded with features about data from three sensors is presented. This suggested circuit is making use of a resistance-to-time converter employing a bridge amplifier, an integrator and a comparator. The second resistive sensor (Rz) is transformed into duty cycle. Another bridge with varying resistor, (Ry) in the feedback of an OP AMP is added in series to change the amplitude of the resulting signal in a proportional relationship while keeping the same frequency and duty cycle representing proportional changes in resistors Rx and Rz already mentioned. The resultant output signal carries three types of information embedded as variations of its frequency, duty cycle and amplitude.

Keywords: Integrator, Comparator, Bridge Circuit, Resistanceto-Time Converter, Conditioning Circuit.

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: Lean, Service improvement, SERVQUAL, Care home service.

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Authors: E. Fosch-Villaronga

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This paper pioneers Care Robot Impact Assessment (CRIA), a methodology used to identify, analyze, mitigate and eliminate the risks posed by the insertion of non-medical personal care robots (PCR) in medical care facilities. Its precedent instruments [Privacy and Surveillance Impact Assessment (PIA and SIA)] fall behind in coping with robots. Indeed, personal care robots change dramatically how care is delivered. The paper presents a specific risk-sector methodology, identifies which robots are under its scope and presents some of the challenges introduced by these robots.

Keywords: Ethics, Impact Assessment, Law, Personal Care Robots.

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Authors: Piyangkun Kukutapan, Siridech Boonsang

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The article proposes maximum power point tracking without mechanical sensor using Multilayer Perceptron Neural Network (MLPNN). The aim of article is to reduce the cost and complexity but still retain efficiency. The experimental is that duty cycle is generated maximum power, if it has suitable qualification. The measured data from DC generator, voltage (V), current (I), power (P), turnover rate of power (dP), and turnover rate of voltage (dV) are used as input for MLPNN model. The output of this model is duty cycle for driving the converter. The experiment implemented using Arduino Uno board. This diagram is compared to MPPT using MLPNN and P&O control (Perturbation and Observation control). The experimental results show that the proposed MLPNN based approach is more efficiency than P&O algorithm for this application.

Keywords: Maximum power point tracking, multilayer perceptron neural network, optimal duty cycle.

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Authors: Hsing-Yi Kao, Der-Ming Liou

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Transferring patient information between medical care sites is necessary to deliver better patient care and to reduce medical cost. So developing of electronic medical records is an important trend for the world.The Continuity of Care Document (CCD) is product of collaboration between CDA and CCR standards. In this study, we will develop a system to generate medical records with entry level based on CCD template module.

Keywords: Continuity Care Document, medical record, entrylevel

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Authors: M. Nirmala

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Power quality in terms of power factor, THD and precisely regulated output voltage are the major key factors for efficient operation of power electronic converters. This paper presents an easy and effective active wave shaping control scheme for the pulsed input current drawn by the uncontrolled diode bridge rectifier thereby achieving power factor nearer to unity and also satisfying the THD specifications. It also regulates the output DC-bus voltage. CCM boost power factor correction with constant frequency operation features smaller inductor current ripple resulting in low RMS currents on inductor and switch thus leading to low electromagnetic interference. The objective of this work is to develop an active PFC control circuit using CCM boost converter implementing variable duty cycle control. The proposed scheme eliminates inductor current sensing requirements yet offering good performance and satisfactory results for maintaining the power quality. Simulation results have been presented which covers load changes also.

Keywords: CCM Boost converter, Power factor Correction, Total harmonic distortion, Variable Duty Cycle.

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Authors: Federico Cabitza, Marco P. Locatelli, Marcello Sarini, Carla Simone

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The paper shows how the CASMAS modeling language, and its associated pervasive computing architecture, can be used to facilitate continuity of care by providing members of patientcentered communities of care with a support to cooperation and knowledge sharing through the usage of electronic documents and digital devices. We consider a scenario of clearly fragmented care to show how proper mechanisms can be defined to facilitate a better integration of practices and information across heterogeneous care networks. The scenario is declined in terms of architectural components and cooperation-oriented mechanisms that make the support reactive to the evolution of the context where these communities operate.

Keywords: Pervasive Computing, Communities of Care, HeterogeneousCare Networks, Multi-Agent System.

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Authors: Cherryl Lowe

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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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Authors: Dina Maratovna Aikenova

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Child care policy must be a priority area of public authorities in any country. This study investigates child care policy in Kazakhstan in accordance with the current position of children and laws. The results show that Kazakhstan policy in this sphere needs more systematic model including state economic and social measures, parental involvement and role of non-government organizations.

Keywords: Children, Kazakhstan, policy, vulnerability.

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Authors: Marisa Catarina da Conceição Dinis

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The commercial companies’ management has suffered an important material and legal transformation in the last years, mainly related to the changes in the Portuguese legal framework and because of the fact they were recently object of great expansion. In fact, next to the smaller family businesses, whose management is regularly assumed by partners, companies with social investment highly scattered, whose owners are completely out from administration, are now arising. In those particular cases, the business transactions are much more complex and require from the companies’ managers a highly technical knowledge and some specific professionals’ skills and abilities. This kind of administration carries a high-level risk that can both result in great success or in great losses. Knowing that the administration performance can result in important losses to the companies, the Portuguese legislator has created a legal structure to impute them some responsibilities and sanctions. The main goal of this study is to analyze the Portuguese law and some jurisprudence about companies’ management rules and about the conflicts between the directors and the company. In order to achieve these purposes we have to consider, on the one hand, the legal duties directly connected to the directors’ functions and on the other hand the disrespect for those same rules. The Portuguese law in this matter, influenced by the common law, determines that the directors’ attitude should be guided by loyalty and honesty. Consequently, we must reflect in which cases the administrators should respond to losses that they might cause to companies as a result of their duties’ disrespect. In this way is necessary to study the business judgment rule wich is a rule that refers to a liability exclusion rule. We intend, in the same way, to evaluate if the civil liability that results from the directors’ duties disrespect can extend itself to those who have elected them ignoring or even knowing that they don´t have the necessary skills or appropriate knowledge to the position they hold. To charge directors’, without ruining entrepreneurship, charging, in the same way, those who select them reinforces the need for more responsible and cautious attitudes which will lead consequently to more confidence in the markets.

Keywords: Duty of loyalty, duty of care, business judgment rule, civil liability of directors.

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Authors: A. Kulprasutidilok

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In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.

Keywords: Community-based participatory research, elderly health care, Thailand.

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Authors: Elham Rastegari, Amirmasood Rahmani, Saeed Setayeshi

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The hospital and the health-care center of a community, as a place for people-s life-care and health-care settings, must provide more and better services for patients or residents. After Establishing Electronic Medical Record (EMR) system -which is a necessity- in the hospital, providing pervasive services is a further step. Our objective in this paper is to use pervasive computing in a case study of healthcare, based on EMR database that coordinates application services over network to form a service environment for medical and health-care. Our method also categorizes the hospital spaces into 3 spaces: Public spaces, Private spaces and Isolated spaces. Although, there are many projects about using pervasive computing in healthcare, but all of them concentrate on the disease recognition, designing smart cloths, or provide services only for patient. The proposed method is implemented in a hospital. The obtained results show that it is suitable for our purpose.

Keywords: Pervasive computing, RFID, Health-care.

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Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

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The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20^th week of pregnancy up to 12^th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12^th and 24^th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: Cellphone, health technology, prenatal care, prevention.

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Authors: Bhaveshkumar P. Patel, J. M. Prajapati

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Excavators are high power machines used in the mining, agricultural and construction industry whose principal functions are digging (material removing), ground leveling and material transport operations. During the digging task there are certain unknown forces exerted by the bucket on the soil and the digging operation is repetitive in nature. Automation of the digging task can be performed by an automatically controlled excavator system, which is not only control the forces but also follow the planned digging trajectories. To develop such a controller for automated excavation, it is required to develop a dynamic model to describe the behavior of the control system during digging operation and motion of excavator with time. The presented work described a dynamic model needed for controller design and which is derived by applying Lagrange-Euler approach. The developed dynamic model is intended for further development of an automated excavation control system for light duty construction work and can be applied for heavy duty or all types of backhoe excavators.

Keywords: Backhoe excavator, controller, digging, excavation, trajectory.

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Authors: Samsudin A. Rahim, Latiffah Pawanteh, Ali Salman

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This paper explores the changing trend in citizenship norms among young citizens from various ethnic groups in Malaysia and the extent to which it influences the participation of young citizens in political and civil issues. Embedded in democratic constitutions are the rights and freedoms that accompany citizenship, and these rights and freedoms include participation. Participation in democracies should go beyond voting; it should include taking part in the governance process. The political process is not at risk even though politics does not work as it did in the past. A national sample of 1697 respondents between the ages of 21 and 40 years were interviewed in January 2011. The findings show that respondents embrace an engaged-citizenship norm more than they do the traditional duty-citizen norm. Among the ethnic groups, the Chinese show lower means in both citizenship norms compared with other ethnic groups, namely, the Malays and the Indians. The duty-citizen norm correlates higher with political participation than with civic participation. On the other hand, the engaged-citizen norm correlates higher with civic participation than with political participation.

Keywords: citizenship norms, political participation, civic participation, youths, globalization

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Authors: K. Arunachalam, P. Mannar Jawahar

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This paper deals with design of walking beam pendel axle suspension system. This axles and suspension systems are mainly required for transportation of heavy duty and Over Dimension Consignment (ODC) cargo, which is exceeding legal limit in terms of length, width and height. Presently, in Indian transportation industry, ODC movement growth rate has increased in transportation of bridge sections (pre-cast beams), transformers, heavy machineries, boilers, gas turbines, windmill blades etc. However, current Indian standard road transport vehicles are facing lot of service and maintenance issues due to non availability of suitable axle and suspension to carry the ODC cargoes. This in turn will lead to increased number of road accidents, bridge collapse and delayed deliveries, which finally result in higher operating cost. Understanding these requirements, this work was carried out. These axles and suspensions are designed for optimum self – weight with maximum payload carrying capacity with better road stability.

Keywords: Heavy duty trailer, Off–highway trucks, Over dimension cargo, Walking beam pendel axle suspension.

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

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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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Authors: Vahid Aryanpur , Ehsan Shafiei

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This paper presents an environmental and technoeconomic evaluation of light duty vehicles in Iran. A comprehensive well-to-wheel (WTW) analysis is applied to compare different automotive fuel chains, conventional internal combustion engines and innovative vehicle powertrains. The study examines the competitiveness of 15 various pathways in terms of energy efficiencies, GHG emissions, and levelized cost of different energy carriers. The results indicate that electric vehicles including battery electric vehicles (BEV), fuel cell vehicles (FCV) and plug-in hybrid electric vehicles (PHEV) increase the WTW energy efficiency by 54%, 51% and 46%, respectively, compared to common internal combustion engines powered by gasoline. On the other hand, greenhouse gas (GHG) emissions per kilometer of FCV and BEV would be 48% lower than that of gasoline engines. It is concluded that BEV has the lowest total cost of energy consumption and external cost of emission, followed by internal combustion engines (ICE) fueled by CNG. Conventional internal combustion engines fueled by gasoline, on the other hand, would have the highest costs.

Keywords: Well-to-Wheel analysis, Energy Efficiency, GHG emissions, Levelized cost of energy, Alternative fuel vehicles.

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Authors: Rizwan Ullah, Abdar Ali, Zahid Ullah

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This paper illustrates the study of three isolated zero voltage switched (ZVS) PWM full bridge (FB) converters to charge the high voltage battery in the charger of electric vehicle (EV). EV battery chargers have several challenges such as high efficiency, high reliability, low cost, isolation, and high power density. The cost of magnetic and filter components in the battery charger is reduced when switching frequency is increased. The increase in the switching frequency increases switching losses. ZVS is used to reduce switching losses and to operate the converter in the battery charger at high frequency. The performance of each of the three converters is evaluated on the basis of ZVS range, dead times of the switches, conduction losses of switches, circulating current stress, circulating energy, duty cycle loss, and efficiency. The limitations and merits of each PWM FB converter are reviewed. The converter with broader ZVS range, high efficiency and low switch stresses is selected for battery charger applications in EV.

Keywords: Electric vehicle, PWM FB converter, zero voltage switching, circulating energy, duty cycle loss, battery charger.

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

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

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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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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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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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