Search results for: hospital emergencies.

Authors: C. Ardil

Abstract:

In this paper, a new MCDMA approach, the permanent analytics process is proposed to assess the immovable valuation criteria and their significance in the placement of the healthcare facility. Five decision factors are considered for the value and selection of immovables. In the multiple factor selection problems, the priority vector of the criteria used to compare several immovables is first determined using the permanent analytics method, a mathematical model for the multiple criteria decisionmaking process. Then, to demonstrate the viability and efficacy of the suggested approach, twenty potential candidate locations were evaluated using the hospital site selection problem's decision criteria. The ranking accuracy of estimation was evaluated using composite programming, which took into account both the permanent analytics process and the weighted multiplicative model. 

Keywords: Hospital Facility Location Selection, Permanent Analytics Process, Multiple Criteria Decision Making (MCDM)

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Authors: Mahmoud A. El-Banna

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The need to increase the efficiency of health care systems is becoming an obligation, and one of area of improvement is the discharge process. The objective of this work is to minimize the patients discharge time (for insured patients) to be less than 50 minutes by using six sigma approach, this improvement will also: lead to an increase in customer satisfaction, increase the number of admissions and turnover on the rooms, increase hospital profitability.Three different departments were considered in this study: Female, Male, and Paediatrics. Six Sigma approach coupled with simulation has been applied to reduce the patients discharge time for pediatrics, female, and male departments at hospital. Upon applying these recommendations at hospital: 60%, 80%, and 22% of insured female, male, and pediatrics patients respectively will have discharge time less than the upper specification time i.e. 50 min.

Keywords: Discharge Time, Healthcare, Hospitals, Patients, Process Improvement, Six Sigma, Simulation

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Authors: Nareelux Suwannobol, Supap Chobkhayan

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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: Mudafara S Bengleil

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Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Keywords: Children, hospital, poisoning.

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Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

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The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: Hospital, light fidelity, Li-Fi, medical devices, security.

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Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

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The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: Caregiving, design basics, family integration, hospital ward, sustainability.

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Authors: Mourtou Efstratia, Abdel-Badeeh M. Salem, Pavlidis George

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Hierarchical high-level PNs (HHPNs) with time versions are a useful tool to model systems in a variety of application domains, ranging from logistics to complex workflows. This paper addresses an application domain which is receiving more and more attention: procedure that arranges the final inpatient charge in payment-s office and their management. We shall prove that Petri net based analysis is able to improve the delays during the procedure, in order that inpatient charges could be more reliable and on time.

Keywords: eHealth, Petri-Nets, Hospital Services, InpatientCharges, Workflow Modeling.

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Authors: Napisporn Memongkol, Runchana Sinthavalai, Nattapong Seneeratanaprayune Weerawat Ounsaneha, Chanisada Choosuk

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The objective of this research is to develop the performance indicators (PIs) in operational level for the Pre-hospital Emergency Medical Service (EMS) system employing in Thailand. This research started with ascertaining the current pre-hospital care system. The team analyzed the strategies of Narerthorn, a government unit under the ministry of public health, and the existing PIs of the pre-hospital care. Afterwards, the current National Strategic Plan of EMS development (2008-2012) of the Emergency Medical Institute of Thailand (EMIT) was considered using strategic analysis to developed Strategy Map (SM) and identified the Success Factors (SFs). The analysis results from strategy map and SFs were used to develop the Performance Indicators (PIs). To verify the set of PIs, the team has interviewed with the relevant practitioners for the possibilities to implement the PIs. To this paper, it was to ascertain that all the developed PIs support the objectives of the strategic plan. Nevertheless, the results showed that the operational level PIs suited only with the first dimension of National Strategic Plan (infrastructure and information technology development). Besides, the SF was the infrastructure development (to contribute the EMS system to people throughout with standard and efficiency both in normally and disaster conditions). Finally, twenty-nine indicators were developed from the analysis results of SM and SFs.

Keywords: Emergency Medical Service, Performance Indicator, Success Factor, Thailand

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Authors: Jiří Barta, Tomáš Ludík, Jiří Urbánek

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Topics Disaster and Emergency Management are highly debated among experts. Fast communication will help to deal with emergencies. Problem is with the network connection and data exchange. The paper suggests a solution, which allows possibilities and perspectives of new flexible communication platform to the protection of communication systems for crisis management. This platform is used for everyday communication and communication in crisis situations too.

Keywords: Communication Platform, Crisis Management, Crisis Communication, Information Systems, Interoperability, Security Environment.

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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Authors: Wei-Wen Liu, Feng-Chuan Pan, Pei-Chi Wen, Sen-Ji Chen, Su-Hui Lin

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Nurses in an Armed Force Hospital (AFH) expose to stronger stress than those in a civil hospital, especially in an emergency department (ED). Ironically, stresses of these nurses received few if any attention in academic research in the past. This study collects 227 samples from the emergency departments of four armed force hospitals in central and southern Taiwan. The research indicates that the top five stressors are a massive casualty event, delayed physician support, overloads of routine work, overloads of assignments, and annoying paper work. Excessive work loading was found to be the primary source of stress. Nurses who were perceived to have greater stress levels were more inclined to deploy emotion-oriented approaches and more likely to seek job rotations. Professional stressors and problem-oriented approaches were positively correlated. Unlike other local studies, this study concludes that the excessive work-loading is more stressful in an AFH.

Keywords: Emergency nurse, Job stressor, Coping behavior, Armed force hospital.

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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: L. Korpinen, T. Kava, I. Salmi

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This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: Sleep, apnea patient, operating model, hospital.

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization.

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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: Health care provider, hospital, weight management, weight control.

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Authors: R. Miniati, F. Dori, E. Iadanza, M. Fregonara Medici

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management of medical devices in hospitals includes the planning of medical equipment acquisition and maintenance. The presence of critical and non-critical areas together with technological proliferation render the management of medical devices very complex. This study creates an easy and objective methodology for the analysis of medical equipment maintenance, that makes the management of medical devices more feasible. The study has been carried out at Florence Hospital Careggi and it aims to help the clinical engineering department to manage medical equipment by clarifying the hospital situation through a characterization of the different areas, technologies and fault typologies.

Keywords: Clinical Engineering, Maintenance, Medical DevicesManagement, Key Performance Indicators.

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: Sickle cell disease, quality of life, anxiety, depression, socio-demographic characteristics, Ghana.

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Authors: Samy A. Selim, Nashwa I. Hagag

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Abstract–The objectives of the current study are to determine the prevalence, etiological agents, drug susceptibility pattern and plasmid profile of Acinetobacter baumannii isolates from Hospital-Acquired Infections (HAI) at Community Hospital, Al Jouf Province, Saudi Arabia. A total of 1890 patients had developed infection during hospital admission and were included in the study. Among those who developed nosocomial infections, 15(9.4), 10(2.7) and 118 (12.7) had respiratory tract infection (RTI), blood stream infections (BSI) and urinary tract (UTI) respectively. A total of 268 bacterial isolates were isolated from nosocomial infection. S. aureus was reported in 23.5% for of the total isolates followed by Klebsiella pneumoniae (17.5%), E. coli (17.2%), P. aeruginosa (11.9%), coagulase negative staphylococcus (9%), A. baumannii (7.1%), Enterobacter spp. (3.4%), Citrobacter freundii (3%), Proteus mirabilis (2.6%), and Proteus vulgaris and Enterococcous faecalis (0.7%). Isolated organisms are multi-drug resistant, predominantly Gram-positive pathogens with a high incidence of methicillin-resistant S. aureus, extended spectrum beta lactamase and vancomycin resistant enterococci organisms. The RFLP (Fragment Length Polymorphisms) patterns of plasmid preparations from isolated A. baumannii isolates had altered RFLP patterns, possibly due to the presence of plasmid(s). Five A. baumannii isolates harbored plasmids all of which were not less than 2.71kbp in molecular weight. Hence, it showed that the gene coding for the isolates were located on the plasmid DNA while the remaining isolates which have no plasmid might showed gene coding for antibiotic resistance being located on chromosomal DNA. Nosocomial infections represent a current problem in Community Hospital, Al Jouf Province, Saudi Arabia. Problems associated with SSI include infection with multidrug resistant pathogens which are difficult to treat and are associated with increased mortality.

Keywords: Hospital-Acquired Infections, Acinetobacter baumannii, antibiotic resistance, plasmid profile, RFLP patterns, Al Jouf Province, Saudi Arabia

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Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: Skeletal scintigraphy, SPECT/CT, imaging.

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Authors: Kaan Yamanturk, Cihan Dogruoz

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Seismic isolators have been utilized around the world to protect the structures, nonstructural components and contents from the damaging effects of earthquakes. In Structural Engineering, seismic isolation is used for protecting buildings and its vibration-sensitive contents from earthquakes. Seismic isolation is a passive control system that lowers effective earthquake forces by utilizing flexible bearings. One of the most significant isolation systems is seismic isolators. In this paper, double pendulum type Teflon coated seismic isolators utilized in a city hospital project by Guris Construction and Engineering Co. Inc, located in Kutahya, Turkey, have been investigated. Totally, 498 seismic isolators were applied in the project. These isolators are double friction pendulum type seismic isolation devices. The review of current practices is also examined in this study. The focus of this study is related to the application of passive seismic isolation systems for buildings as practiced in Kutahya City Hospital Project. Based on the study, the acceleration at the top floor will be 0.18 g and it will decrease 0.01 g in every floor. Therefore, seismic isolators are very important for buildings located in earthquake zones.

Keywords: Maximum considered earthquake, moment resisting frame, seismic isolator, seismic design.

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Authors: Petr Vcelak, Jana Kleckova

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Our Medicine-oriented research is based on a medical data set of real patients. It is a security problem to share patient private data with peoples other than clinician or hospital staff. We have to remove person identification information from medical data. The medical data without private data are available after a de-identification process for any research purposes. In this paper, we introduce an universal automatic rule-based de-identification application to do all this stuff on an heterogeneous medical data. A patient private identification is replaced by an unique identification number, even in burnedin annotation in pixel data. The identical identification is used for all patient medical data, so it keeps relationships in a data. Hospital can take an advantage of a research feedback based on results.

Keywords: DASTA, De-identification, DICOM, Health Level Seven, Medical data, OCR, Personal data

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Authors: Madiajagan Muthaiyan, Neha Goel, Deepti Sunder Prakash

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This paper discusses about an intelligent system to be installed in ambulances providing professional support to the paramedics on board. A video conferencing device over mobile 4G services enables specialists virtually attending the patient being transferred to the hospital. The data centre holds detailed databases on the patients past medical history and hospitals with the specialists. It also hosts various software modules that compute the shortest traffic –less path to the closest hospital with the required facilities, on inputting the symptoms of the patient, on a real time basis.

Keywords: 4G mobile services, cloud computing, data centre, intelligent system, optimization, real time traffic reporting, SaaS, video conferencing.

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Authors: Komwit Surachat, Supasit Kajkamhaeng, Kasikrit Damkliang, Watanyoo Tiprat, Taninnuch Wacharanimit

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An accident is an unexpected and unplanned situation that happens and affects human in a negative outcome. The accident can cause an injury to a human biological organism. Thus, the provision of initial care for an illness or injury is very important move to prepare the patients/victims before sending to the doctor. In this paper, a First Aid Application is developed to give some directions for preliminary taking care of patient/victim via Android mobile device. Also, the navigation function using Google Maps API is implemented in this paper for searching a suitable path to the nearest hospital. Therefore, in the emergency case, this function can be activated and navigate patients/victims to the hospital with the shortest path.

Keywords: First Aid Application, Android, Google Maps API, Navigation System.

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Authors: Snezhana P. Kostova, Krassi V. Rumchev, Todor Vlaev, Silviya B. Popova

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Air pollution is still considered as one of the major environmental and health issues. There is enough research evidence to show a strong relationship between exposure to air contaminants and respiratory illnesses among children and adults. In this paper we used the Copula approach to study a potential relationship between selected air pollutants (PM10 and NO2) and hospital admissions for respiratory diseases. Kendall-s tau and Spearman-s rho rank correlation coefficients are calculated and used in Copula method. This paper demonstrates that copulas can be used to provide additional information as a measure of an association when compared to the standard correlation coefficients. The results find a significant correlation between the selected air pollutants and hospital admissions for most of the selected respiratory illnesses.

Keywords: Air pollution, Copula, Respiratory Health.

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Authors: Hind Bouami, Patrick Millot

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Handling life-critical systems complexity requires to be equipped with appropriate technology and the right human agents’ functions such as knowledge, experience, and competence in problem’s prevention and solving. Human agents are involved in the management and control of human-machine system’s performance. Documenting human agent’s situation awareness is crucial to support human-machine designers’ decision-making. Knowledge about risks, critical parameters and factors that can impact and threaten automation system’s performance should be collected using preventive and retrospective approaches. This paper aims to document operators’ situation awareness through the analysis of automated organizations’ feedback. The analysis of automated hospital pharmacies feedback helps identify and control critical parameters influencing human machine interaction in order to enhance system’s performance and security. Our human machine system evaluation approach has been deployed in Macon hospital center’s pharmacy which is equipped with automated drug dispensing systems since 2015. Automation’s specifications are related to technical aspects, human-machine interaction, and human aspects. The evaluation of drug delivery automation performance in Macon hospital center has shown that the performance of the automated activity depends on the performance of the automated solution chosen, and also on the control of systemic factors. In fact, 80.95% of automation specification related to the chosen Sinteco’s automated solution is met. The performance of the chosen automated solution is involved in 28.38% of automation specifications performance in Macon hospital center. The remaining systemic parameters involved in automation specifications performance need to be controlled. 

Keywords: Life-critical systems, situation awareness, human-machine interaction, decision-making.

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Authors: C. Blatier, M. El Methni, F. Carpentier, S. Abdellaoui, C. Kock, M. Maillard

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International literature emphasizes on the concern regarding the phenomenon of aggression in hospital. This paper focuses on the reality of aggressive interactions reigning within an emergency triage involving three chaps of protagonists: the professionals, the patients and their carers. The data collection was made from a grid of observation, in which the various variables exposed in the literature were integrated. They observations took place around the clock, for three weeks, at the rate of one week a month. In this research 331 aggressive interactions have been listed and analyzed by means of the software SPSS. This research is one of the very few continuous observation surveys in the literature. It shows the various human factors at play in the emergence of aggressive interaction. The data may be used both for taking steps in primary prevention, thanks to the analysis of interaction modes, and in secondary prevention by integrating the useful results in situational prevention.

Keywords: Aggressive interaction, emergency unit, observational study.

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Authors: Sreejith Jayachandran, Mojtaba Ghodsi, Morteza Mohammadzaheri

Abstract:

The modern busy world is running behind new embedded technologies based on computers and software meanwhile some people are unable to monitor their health condition and regular medical check-ups. Some of them postpone medical check-ups due to a lack of time and convenience while others skip these regular evaluations and medical examinations due to huge medical bills and hospital expenses. In this research, we present a device in the telemonitoring system capable of monitoring, checking, and evaluating the health status of the human body remotely through the internet for the needs of all kinds of people. The remote health monitoring device is a microcontroller-based embedded unit. The various types of sensors in this device are connected to the human body, and with the help of an Arduino UNO board, the required analogue data are collected from the sensors. The microcontroller on the Arduino board processes the analogue data collected in this way into digital data and transfers that information to the cloud and stores it there; the processed digital data are then instantly displayed through the LCD attached to the machine. By accessing the cloud storage with a username and password, the concerned person’s health care teams/doctors, and other health staff can collect these data for the assessment and follow-up of that patient. Besides that, the family members/guardians can use and evaluate these data for awareness of the patient's current health status. Moreover, the system is connected to a GPS module. In emergencies, the concerned team can be positioning the patient or the person with this device. The setup continuously evaluates and transfers the data to the cloud and also the user can prefix a normal value range for the evaluation. For example, the blood pressure normal value is universally prefixed between 80/120 mmHg. Similarly, the Remote Health Monitoring System (RHMS) is also allowed to fix the range of values referred to as normal coefficients. This IoT-based miniature system 11×10×10 cm3 with a low weight of 500 gr only consumes 10 mW. This smart monitoring system is manufactured for 100 GBP (British Pound Sterling), and can facilitate the communication between patients and health systems, but also it can be employed for numerous other uses including communication sectors in the aerospace and transportation systems.

Keywords: Embedded Technology, Telemonitoring system, Microcontroller, Arduino UNO, Cloud storage, GPS, RHMS, Remote Health Monitoring System, Alert system.

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md Saad

Abstract:

Background: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self-administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: Glyceryl trinitrate, knowledge, adherence.

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Authors: Kay-Anne Haykal, Issack Biyong

Abstract:

The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: Post-Traumatic Stress Disorder, diagnosis, co-morbidities, mental health disorders.

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