Search results for: hospital wastes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 434

Search results for: hospital wastes

164 Zero Truncated Strict Arcsine Model

Authors: Y. N. Phang, E. F. Loh

Abstract:

The zero truncated model is usually used in modeling count data without zero. It is the opposite of zero inflated model. Zero truncated Poisson and zero truncated negative binomial models are discussed and used by some researchers in analyzing the abundance of rare species and hospital stay. Zero truncated models are used as the base in developing hurdle models. In this study, we developed a new model, the zero truncated strict arcsine model, which can be used as an alternative model in modeling count data without zero and with extra variation. Two simulated and one real life data sets are used and fitted into this developed model. The results show that the model provides a good fit to the data. Maximum likelihood estimation method is used in estimating the parameters.

Keywords: Hurdle models, maximum likelihood estimation method, positive count data.

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163 Health Risk Assessment in Lead Battery Smelter Factory: A Bayesian Belief Network Method

Authors: Kevin Fong-Rey Liu, Ken Yeh, Cheng-Wu Chen, Han-Hsi Liang

Abstract:

This paper proposes the use of Bayesian belief networks (BBN) as a higher level of health risk assessment for a dumping site of lead battery smelter factory. On the basis of the epidemiological studies, the actual hospital attendance records and expert experiences, the BBN is capable of capturing the probabilistic relationships between the hazardous substances and their adverse health effects, and accordingly inferring the morbidity of the adverse health effects. The provision of the morbidity rates of the related diseases is more informative and can alleviate the drawbacks of conventional methods.

Keywords: Bayesian belief networks, lead battery smelter factory, health risk assessment.

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162 Evaluation the Distribution of Implant Supported Prostheses between 2005-2009 Years

Authors: Atay A, Suer BT

Abstract:

The aim of this retrospective study was to evaluate the parameters of dental implants such as patient gender, number of implant, failed implant before prosthetic restorations and failed implant after implantation and failed implant after prosthetic restorations. 135 male and 99 female patients, total 234 implant patients which have been treated with 450 implant between 2005- 2009 years in GATA Haydarpasa Training Hospital Dental Service. Twelve implants were failed before prosthetic restorations. Four implant were failed after fixed prosthetic restorations. Cumulative survival rate after prostheses were 97.56 % during 6 years period.

Keywords: Dental implants, implant supported prostheses, single implants, single crown

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161 Environmental Sanitation Dilemma in the Tamale Metropolis, Ghana

Authors: Paul N. Napari, Patrick B. Cobbinah

Abstract:

The 21st century has been characterized by rapid urbanization with its associated environmental sanitation challenges especially in developing countries. However, studies have focused largely on institutional capacity and the resources needed to manage environmental sanitation challenges, with few insights on the attitudes of city residents. This paper analyzes the environmental sanitation situation in a rapidly urbanizing Tamale metropolis, examines how city residents’ attitudes have contributed to poor environmental sanitation and further reviews approaches that have been employed to manage environmental sanitation. Using secondary and empirical data sources, the paper reveals that only 7.5 tons of 150 tons of total daily solid wastes generated is effectively managed. The findings suggest that the poor sanitation in the city is influenced by two factors; poor attitudes of city residents and weak institutions. While poor attitudes towards environmental sanitation has resulted in indiscriminate disposal of waste, weak institutions have resulted in lack of capacity and pragmatic interventions to manage the environmental sanitation challenges in the city. The paper recommends public education on environmental sanitation, public private partnership, increased stakeholder engagement and preparation and implementation of environmental sanitation plan as mechanisms to ensure effective environmental sanitation management in the Tamale metropolis.

Keywords: Environmental sanitation, developing countries, waste management, developing countries, Tamale, urbanization.

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160 The Care Management Network as an Effective Intervention in Mitigating the Risks of Hypertension

Authors: Feng-Chuan Pan, Fang-Yue Liu

Abstract:

Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Keywords: hypertension, joint care management network, cardiovascular diseases, metabolic syndrome.

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159 Isolation and Screening of Fungal Strains for β-Galactosidase Production

Authors: Parmjit S. Panesar, Rupinder Kaur, Ram S. Singh

Abstract:

Enzymes are the biocatalysts which catalyze the biochemical processes and thus have a wide variety of applications in the industrial sector. β-Galactosidase (E.C. 3.2.1.23) also known as lactase, is one of the prime enzymes, which has significant potential in the dairy and food processing industries. It has the capability to catalyze both the hydrolytic reaction for the production of lactose hydrolyzed milk and transgalactosylation reaction for the synthesis of prebiotics such as lactulose and galactooligosaccharides. These prebiotics have various nutritional and technological benefits. Although, the enzyme is naturally present in almonds, peaches, apricots and other variety of fruits and animals, the extraction of enzyme from these sources increases the cost of enzyme. Therefore, focus has been shifted towards the production of low cost enzyme from the microorganisms such as bacteria, yeast and fungi. As compared to yeast and bacteria, fungal β-galactosidase is generally preferred as being extracellular and thermostable in nature. Keeping the above in view, the present study was carried out for the isolation of the β-galactosidase producing fungal strain from the food as well as the agricultural wastes. A total of more than 100 fungal cultures were examined for their potential in enzyme production. All the fungal strains were screened using X-gal and IPTG as inducers in the modified Czapek Dox Agar medium. Among the various isolated fungal strains, the strain exhibiting the highest enzyme activity was chosen for further phenotypic and genotypic characterization. The strain was identified as Rhizomucor pusillus on the basis of 5.8s RNA gene sequencing data.

Keywords: β-galactosidase, enzyme, fungus, isolation.

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158 Water Quality Determination of River Systems in Antalya Basin by Biomonitoring

Authors: Hasan Kalyoncu, Füsun Kılçık, Hatice Gülboy Akyıldırım, Aynur Özen, Mehmet Acar, Nur Yoluk

Abstract:

For evaluation of water quality of the river systems in Antalya Basin, macrozoobenthos samples were taken from 22 determined stations by a hand net and identified at family level. Water quality of Antalya Basin was determined according to Biological Monitoring Working Party (BMWP) system, by using macrozoobenthic invertebrates and physicochemical parameters. As a result of the evaluation, while Aksu Stream was determined as the most polluted stream in Antalya Basin, Isparta Stream was determined as the most polluted tributary of Aksu Stream. Pollution level of the Isparta Stream was determined as quality class V and it is the extremely polluted part of stream. Pollution loads at the sources of the streams were determined in low levels in general. Due to some parts of the streams have passed through deep canyons and take their sources from nonresidential and non-arable regions, majority of the streams that take place in Antalya Basin are at high quality level. Waste water, which comes from agricultural and residential regions, affects the lower basins of the streams. Because of the waste water, lower parts of the stream basins exposed to the pollution under anthropogenic effects. However, in Aksu Stream, which differs by being exposed to domestic and industrial wastes of Isparta City, extreme pollution was determined, particularly in the Isparta Stream part.

Keywords: Antalya Basin, biomonitoring, BMWP, water quality.

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157 GSM Based Smart Patient Monitoring System

Authors: Ayman M. Mansour

Abstract:

In this paper, we propose an intelligent system that is used for monitoring the health conditions of patients. Monitoring the health condition of patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The ability of making medical decisions, the quality of medical is expected to be improved.

Keywords: GSM, SMS, Patient, Monitoring system, Fuzzy Logic, Multi-agent system.

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156 Designing Ontology-Based Knowledge Integration for Preprocessing of Medical Data in Enhancing a Machine Learning System for Coding Assignment of a Multi-Label Medical Text

Authors: Phanu Waraporn

Abstract:

This paper discusses the designing of knowledge integration of clinical information extracted from distributed medical ontologies in order to ameliorate a machine learning-based multilabel coding assignment system. The proposed approach is implemented using a decision tree technique of the machine learning on the university hospital data for patients with Coronary Heart Disease (CHD). The preliminary results obtained show a satisfactory finding that the use of medical ontologies improves the overall system performance.

Keywords: Medical Ontology, Knowledge Integration, Machine Learning, Medical Coding, Text Assignment.

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155 Methodology for Obtaining Static Alignment Model

Authors: Lely A. Luengas, Pedro R. Vizcaya, Giovanni Sánchez

Abstract:

In this paper, a methodology is presented to obtain the Static Alignment Model for any transtibial amputee person. The proposed methodology starts from experimental data collected on the Hospital Militar Central, Bogotá, Colombia. The effects of transtibial prosthesis malalignment on amputees were measured in terms of joint angles, center of pressure (COP) and weight distribution. Some statistical tools are used to obtain the model parameters. Mathematical predictive models of prosthetic alignment were created. The proposed models are validated in amputees and finding promising results for the prosthesis Static Alignment. Static alignment process is unique to each subject; nevertheless the proposed methodology can be used in each transtibial amputee.

Keywords: Information theory, prediction model, prosthetic alignment, transtibial prosthesis.

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154 Methodology for Bioenergy Potential and Assessment for Energy Deployment in Rural Vhembe District Areas

Authors: Clement M. Matasane, Mohamed T. Kahn

Abstract:

Biomass resources such as animal waste, agricultural and acro-industrial residues, forestry and woodland waste, and industrial and municipal solid wastes provide alternative means to utilize its untapped potential for biomass/biofuel renewable energy systems. In addition, crop residues (i.e., grain, starch, and energy crops) are commonly available in the district and play an essential role in community farming activities. The remote sensing technology (mappings) and geographic information systems tool will be used to determine the biomass potential in the Vhembe District Municipality. The detailed assessment, estimation, and modeling in quantifying their distribution, abundance, and quality yield an effective and efficient use of their potential. This paper aims to examine the potential and prospects of deploying bioenergy systems in small or micro-systems in the district for community use and applications. This deployment of the biofuels/biomass systems will help communities for sustainable energy supply from their traditional energy use into innovative and suitable methods that improve their livelihood. The study demonstrates the potential applications of Geographical Information Systems (GIS) in spatial mapping analysis, evaluation, modeling, and decision support for easy access to renewable energy systems.

Keywords: Agricultural crops, waste materials, biomass potentials, bioenergy potentials, GIS mappings, environmental data, renewable energy deployment, sustainable energy supply.

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153 Evidence Based Practice for Oral Care in Children

Authors: T. Turan, Ç. Erdoğan

Abstract:

As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.

Keywords: Children, evidence based practice, nursing, oral care.

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152 Treatment of Biowaste (Generated in Biodiesel Process) - A New Strategy for Green Environment and Horticulture Crop

Authors: Shivani Chaturvedi, Santosh Satya, S. K. Tiwari

Abstract:

Recent research on seeds of bio-diesel plants like Jatropha curcas, constituting 40-50% bio-crude oil indicates its potential as one of the most promising alternatives to conventional sources of energy. Also, limited studies on utilization of de-oiled cake have revealed that Jatropha bio-waste has good potential to be used as organic fertilizers produced via aerobic and anaerobic treatment. However, their commercial exploitation has not yet been possible. The present study aims at developing appropriate bio-processes and formulations utilizing Jatropha seed cake as organic fertilizer, for improving the growth of Polianthes tuberose L. (Tuberose). Pot experiments were carried out by growing tuberose plants on soil treated with composted formulations of Jatropha de-oiled cake, Farm Yard Manure (FYM) and inorganic fertilizers were also blended in soil. The treatment was carried out through soil amendment as well as foliar spray. The growth and morphological parameters were monitored for entire crop cycle. The growth Length and number of leaves, spike length, rachis length, number of bulb per plant and earliness of sprouting of bulb and yield enhancement were comparable to that achieved under inorganic fertilizer. Furthermore, performance of inorganic fertilizer also showed an improvement when blended with composted bio-waste. These findings would open new avenues for Jatropha based bio-wastes to be composted and used as organic fertilizers for commercial floriculture.

Keywords: Organic fertilizer, Jaropha cake, Tuberose (Polianthes tuberosa L.).

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151 Non-Burn Treatment of Health Care Risk Waste

Authors: Jefrey Pilusa, Tumisang Seodigeng

Abstract:

This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: Autoclave, disposal, fuel, incineration, medical waste.

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150 Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score

Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

Abstract:

Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, Burns, FLAMES, scoring systems, outcome.

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149 Production of Biocomposites Using Chars Obtained by Co-Pyrolysis of Olive Pomace with Plastic Wastes

Authors: Esra Yel, Tabriz Aslanov, Merve Sogancioglu, Suheyla Kocaman, Gulnare Ahmetli

Abstract:

The disposal of waste plastics has become a major worldwide environmental problem. Pyrolysis of waste plastics is one of the routes to waste minimization and recycling that has been gaining interest. In pyrolysis, the pyrolysed material is separated into gas, liquid (both are fuel) and solid (char) products. All fractions have utilities and economical value depending upon their characteristics. The first objective of this study is to determine the co-pyrolysis product fractions of waste HDPE- (high density polyethylene) and LDPE (low density polyethylene)-olive pomace (OP) and to determine the qualities of the solid product char. Chars obtained at 700 °C pyrolysis were used in biocomposite preparation as additive. As the second objective, the effects of char on biocomposite quality were investigated. Pyrolysis runs were performed at temperature 700 °C with heating rates of 5 °C/min. Biocomposites were prepared by mixing of chars with bisphenol-F type epoxy resin in various wt%. Biocomposite properties were determined by measuring electrical conductivity, surface hardness, Young’s modulus and tensile strength of the composites. The best electrical conductivity results were obtained with HDPE-OP char. For HDPE-OP char and LDPE-OP char, compared to neat epoxy, the tensile strength values of the composites increased by 102% and 78%, respectively, at 10% char dose. The hardness measurements showed similar results to the tensile tests, since there is a correlation between the hardness and the tensile strength.

Keywords: Pyrolysis, olive pomace, char, biocomposite, PE plastics.

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148 A Concept of Rational Water Management at Local Utilities – The Use of RO for Water Supply and Wastewater Treatment/Reuse

Authors: N. Matveev, A. Pervov

Abstract:

Local utilities often face problems of local industrial wastes, storm water disposal due to existing strict regulations. For many local industries, the problem of wastewater treatment and discharge into surface reservoirs can’t be solved through the use of conventional biological treatment techniques. Current discharge standards require very strict removal of a number of impurities such as ammonia, nitrates, phosphate, etc. To reach this level of removal, expensive reagents and sorbents are used. The modern concept of rational water resources management requires the development of new efficient techniques that provide wastewater treatment and reuse. As RO membranes simultaneously reject all dissolved impurities such as BOD, TDS, ammonia, phosphates etc., they become very attractive for the direct treatment of wastewater without biological stage. To treat wastewater, specially designed membrane "open channel" modules are used that do not possess "dead areas" that cause fouling or require pretreatment. A solution to RO concentrate disposal problem is presented that consists of reducing of initial wastewater volume by 100 times. Concentrate is withdrawn from membrane unit as sludge moisture. The efficient use of membrane RO techniques is connected with a salt balance in water system. Thus, to provide high ecological efficiency of developed techniques, all components of water supply and wastewater discharge systems should be accounted for.

Keywords: Reverse osmosis, stormwater treatment, openchannel module, wastewater reuse.

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147 Evaluation of Performance Requirements for Seismic Design of Piping System

Authors: Bu Seog Ju, Woo Young Jung

Abstract:

The cost of damage to the non-structural systems in critical facilities like nuclear power plants and hospitals can exceed 80% of the total cost of damage during an earthquake. The failure of nonstructural components, especially, piping systems led to leakage of water and subsequent shut-down of hospitals immediately after the event. Consequently, the evaluation of performance of these types of structural configurations has become necessary to mitigate the risk and to achieve reliable designs. This paper focuses on a methodology to evaluate the static and dynamic characteristics of complex actual piping system based on NFPA-13 and SMACNA guidelines. The result of this study revealed that current piping system subjected to design lateral force and design spectrum based on UBC-97 was failed in both cases and mode shapes between piping system and building structure were very different

Keywords: Nonstructural component, piping, hospital, seismic, bracing.

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146 The Digital Microscopy in Organ Transplantation: Ergonomics of the Tele-Pathological Evaluation of Renal, Liver and Pancreatic Grafts

Authors: C. S. Mammas, A. Lazaris, A. S. Mamma-Graham, G. Kostopanagiotou, C. Lemonidou, J. Mantas, E. Patsouris

Abstract:

Introduction: The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the remote evaluation of the grafts. It has been estimated that even in well-organized transplant systems an average of 8% to 14% of the grafts (G) that arrive at the recipient hospitals may be considered as diseased, injured, damaged or improper for transplantation. Digital microscopy adds information on a microscopic level about the grafts in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G, will arrive at the recipient hospital for implantation. Aim: Ergonomics of Digital Microscopy (DM) based on virtual slides, on Telemedicine Systems (TS) for Tele-Pathological (TPE) evaluation of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of Renal Graft (RG), Liver Graft (LG) and Pancreatic Graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying Virtual Slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included: a. Development of an OTE-TS similar Experimental Telemedicine System (Exp.-TS), b. Simulation of the integration of TS with the VS based microscopic TPE of RG, LG and PG applying DM. Simulation of the DM based TPE was performed by 2 specialists on a total of 238 human Renal Graft (RG), 172 Liver Graft (LG) and 108 Pancreatic Graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to diagnose accurately the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet and Mobile-Phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and aware ness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval; seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: Organ Transplantation, Tele-Pathology, Digital Microscopy, Virtual Slides.

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145 Determination of Geometric Dimensions of a Double Sided Linear Switched Reluctance Motor

Authors: Dursun M., Koc F., Ozbay H.

Abstract:

In this study, a double-sided linear switched reluctance motor (LSRM) drive was investigated as an alternative actuator for vertical linear transportation applications such as a linear elevator door, hospital and subway doors which move linearly and where accurate position control and rapid response is requested. A prototype sliding elevator door that is focused on a home elevator with LSRMs is designed. The motor has 6/4 poles, 3 phases, 8A, 24V, 250 W and 250 N pull forces. Air gap between rotor and translator poles of the designed motor and phase coil-s ideal inductance profile are obtained in compliance with the geometric dimensions. Operation and switching sections as motor and generator has been determined from the inductance profile.

Keywords: Linear switched reluctance motor, sliding door, elevator door, linear motor design.

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144 Role-Specific Target-Systems in Professional Bureaucracies: A Qualitative Analysis in the OR

Authors: Kirsten Hoeper, Maike Kriependorf

Abstract:

This paper firstly discusses the initial situation and problems. Afterward, it defines professional bureaucracies and shows their impact for the OR-work. The OR-center and its actors are shown. Finally, the paper provides the empiric design for detecting the target systems of the different work groups within the OR, the quality criteria in qualitative research and empirical results. It is shown that different groups have different targets in their daily work and that helps for a better understanding. More precisely, by detecting the target systems of these experts, we can ‘bridge’ the different points of view to create a common basis for the work in the OR. One of the aims was to find bridges to overcome separating factors. This paper describes the situation in Germany focusing the Hannover Medical School. It can be assumed that the results can be transferred to other countries using the DRG-System (Diagnosis Related Groups).

Keywords: Hospital, OR, professional bureaucracies, target systems.

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143 Family Carers' Experiences in Striving for Medical Care and Finding Their Solutions for Family Members with Mental Illnesses

Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

Abstract:

Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: Family carers, coercive treatment, independent living, mental health crisis, persons with mental illness.

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142 Spatio-temporal Variations in Heavy Metal Concentrations in Sediment of Qua Iboe River Estuary, Nigeria

Authors: Justina I. R. Udotong, Ime R. Udotong, Offiong U. Eka

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The concentrations of heavy metals in sediments of Qua Iboe River Estuary (QIRE) were monitored at four different sampling locations in wet and dry seasons. A preliminary survey to determine the four sampling stations along the river continuum showed that the area spanned between <0.1‰ salinity at the control station and 21.5‰ at the fourth station along the river continuum. A preliminary survey to determine the four sampling locations along the river estuary showed variations in salinity and other physicochemical parameters. The estuary was found to be polluted with heavy metals from point and nonpoint sources at varying degrees. Mean values of 7.80 mg/kg, 4.97 mg/kg and 2.80 mg/kg of nickel were obtained for sediment samples from Douglas creek, Qua Iboe and Atlantic sampling locations, respectively in the dry season. The wet season nickel concentrations were however lower. The entire study area was grossly contaminated by iron. At Douglas creek, the concentration of iron in sediment was 9274 ± 9.54mg/kg while copper, nickel, lead and vanadium were <0.5mg/kg each as compared to iron. Bioaccumulation was therefore suspected within the study area as values of 31.00 ± 0.79, 36.00 ± 0.10 and 55.00 ± 0.05 mg/kg of zinc were recorded in sediment at Douglas creek, Atlantic and the control sampling locations. The results from this study showed that the source of these heavy metals were from point sources like the corrosion of metal steel pipes from old bridges as well as oily sludge wastes from the Qua Iboe Terminal / tank farm located within the vicinity of the study area.

Keywords: Heavy metal, Qua Iboe River Estuary, seasonal variations, sediment.

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141 Telehealth Ecosystem: Challenge and Opportunity

Authors: R. Poonsuph

Abstract:

Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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140 Using Discrete Event Simulation Approach to Reduce Waiting Times in Computed Tomography Radiology Department

Authors: Mwafak Shakoor

Abstract:

The purpose of this study was to reduce patient waiting times, improve system throughput and improve resources utilization in radiology department. A discrete event simulation model was developed using Arena simulation software to investigate different alternatives to improve the overall system delivery based on adding resource scenarios due to the linkage between patient waiting times and resource availability. The study revealed that there is no addition investment need to procure additional scanner but hospital management deploy managerial tactics to enhance machine utilization and reduce the long waiting time in the department.

Keywords: Arena, Computed Tomography (CT), Discrete event simulation, Healthcare modeling, Radiology department, Waiting time.

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139 Using Knowledge Management and Visualisation Concepts to Improve Patients and Hospitals Staff Workflow

Authors: A. A. AlRasheed, A. Atkins, R. Campion

Abstract:

This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: Knowledge management, visualisation, patients, hospitals, healthcare workers, workflow, improvements.

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138 Hospitals Disaster Preparedness during Arab Spring in Yemen

Authors: Saleem Ahmed Aladhrai, Pier Luigi Ingrassia, Nahid K. El- Bakri

Abstract:

Objective: The objective of this paper is to assess the hospitals preparedness for emergency using WHO standards. Method: This is a cross-sectional study, consisted of site visit, questionnaire survey, 16 health facilities were included. The WHO standard for emergency preparedness of health facilities was used to evaluate and assess the hospitals preparedness of health facilities. Result: 13 hospitals were responded. They scored below average in all measure >75%), while above average score was in 7 out 9 nine measure with a range of 8%-25%. Un acceptable below average was noted in two measures only. Discussion: The biggest challenge facing the hospitals in their emergency intervention is the lack of pre-emergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. Conclusion: The studied hospitals presently are far from international disasters preparedness protocols. That necessitates improvements in emergency preparedness, as well as in physician skills for injury management.

Keywords: Arab Spring, Yemen, Hospital Preparedness, Disaster.

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137 LCA and Multi-Criteria Analysis of Fly Ash Concrete Pavements

Authors: M. Ondova, A. Estokova

Abstract:

Rapid industrialization results in increased use of natural resources bring along serious ecological and environmental imbalance due to the dumping of industrial wastes. Principles of sustainable construction have to be accepted with regard to the consumption of natural resources and the production of harmful emissions. Cement is a great importance raw material in the building industry and today is its large amount used in the construction of concrete pavements. Concerning raw materials cost and producing CO2 emission the replacing of cement in concrete mixtures with more sustainable materials is necessary. To reduce this environmental impact people all over the world are looking for a solution. Over a period of last ten years, the image of fly ash has completely been changed from a polluting waste to resource material and it can solve the major problems of cement use. Fly ash concretes are proposed as a potential approach for achieving substantial reductions in cement. It is known that it improves the workability of concrete, extends the life cycle of concrete roads, and reduces energy use and greenhouse gas as well as amount of coal combustion products that must be disposed in landfills.

Life cycle assessment also proved that a concrete pavement with fly ash cement replacement is considerably more environmentally friendly compared to standard concrete roads. In addition, fly ash is cheap raw material, and the costs saving are guaranteed. The strength properties, resistance to a frost or de-icing salts, which are important characteristics in the construction of concrete pavements, have reached the required standards as well. In terms of human health it can´t be stated that a concrete cover with fly ash could be dangerous compared with a cover without fly ash. Final Multi-criteria analysis also pointed that a concrete with fly ash is a clearly proper solution.

Keywords: Life cycle assessment, fly ash, waste, concrete pavements

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136 Comparative Study of Filter Characteristics as Statistical Vocal Correlates of Clinical Psychiatric State in Human

Authors: Thaweesak Yingthawornsuk, Chusak Thanawattano

Abstract:

Acoustical properties of speech have been shown to be related to mental states of speaker with symptoms: depression and remission. This paper describes way to address the issue of distinguishing depressed patients from remitted subjects based on measureable acoustics change of their spoken sound. The vocal-tract related frequency characteristics of speech samples from female remitted and depressed patients were analyzed via speech processing techniques and consequently, evaluated statistically by cross-validation with Support Vector Machine. Our results comparatively show the classifier's performance with effectively correct separation of 93% determined from testing with the subjectbased feature model and 88% from the frame-based model based on the same speech samples collected from hospital visiting interview sessions between patients and psychiatrists.

Keywords: Depression, SVM, Vocal Extract, Vocal Tract

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135 A Study on Websites of Public and Private Hospitals in Konya

Authors: H. Nur Gorkemli, Mehmet Fidan

Abstract:

After the first acquaintance with internet in April 1993, number of internet users increased rapidly in Turkey. Almost half of the population between 16-74 age group use internet in the country. Hospitals are one of the areas where the internet is intensively being used like many other businesses. As a part of public relations application, websites are important tools for hospitals to reach a wide range of target audience within and outside the organization. With their websites, hospitals have opportunities to give information about their organization, strengthen their image, compete with their rivals, interact with shareholders, reflect their transparency and meet with new audiences. This study examines web sites of totally 34 hospitals which are located in Konya. Institutions are categorized as public and private hospitals and then three main research categories are determined: content, visual and technical. Main and sub categories are examined by using content analysis method. Results are interpreted in scope of public and private institutions and as a whole.

Keywords: Health Communication, Hospital, Internet, Webpages, Websites

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