Search results for: hospital wastes

Authors: Mehrdad Abkenari, Alireza Rezaei, Naghmeh Pournayeb

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There have recently been many studies and investments in developed and developing countries regarding the possibility of recycling construction waste, which are still ongoing. Since the term 'construction waste' covers a vast spectrum of materials in constructing buildings, roads and etc., many investigations are required to measure their technical performance in use as well as their time and place of use. Concrete is among the major and fundamental materials used in current construction industry. Along with the rise of population in developing countries, it is desperately required to meet the people's primary need in construction industry and on the other hand, dispose existing wastes for reducing the amount of environmental pollutants. Restrictions of natural resources and environmental pollution are the most important problems encountered by civil engineers. Reusing construction waste is an important and economic approach that not only assists the preservation of environment but also, provides us with primary raw materials. In line with consistent municipal development in disposal and reuse of construction waste, several approaches including, management of construction waste and materials, materials recycling and innovation and new inventions in materials have been predicted. This article has accordingly attempted to study the activities related to recycling of construction wastes and then, stated the economic, quantitative, qualitative and environmental results obtained.

Keywords: Civil engineering, environment, recycling, construction waste.

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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: Nurul Nadhirah Anuar, Muhammad Fauzi Abdul Ghani

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Scheduled waste management is very important in environmental and health aspects. In delivering services, highway industry has been indirectly involved in producing scheduled wastes. This paper aims to define the scheduled waste, to provide a conceptual framework of the scheduled waste management in highway industry, to highlight the effect of improper management of scheduled waste and to encourage future researchers to identify and share the present practice of scheduled waste management in their country. The understanding on effective management of scheduled waste will help the operators of highway industry, the academicians, future researchers, and encourage a friendly environment around the world. The study on scheduled waste management in highway industry is very crucial as highway transverse and run along kilometers crossing the various type of environment, residential and schools. Using Environmental Quality (Scheduled Waste) Regulations 2005 as a guide, this conceptual paper highlight several scheduled wastes produced by highway industry in Malaysia and provide a conceptual framework of scheduled waste management that focused on the highway industry. Understanding on scheduled waste management is vital in order to preserve the environment. Besides that, the waste substances are hazardous to human being. Many diseases have been associated with the improper management of schedule waste such as cancer, throat irritation and respiration problem.

Keywords: Asia Region, Environment, Highway Industry, Scheduled Waste.

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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: Marcus C. Garcia, Giselle C. Guimarães, Luciana H. Yamane, Renato R. Siman

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The environmental indicators and the classification of beach waste are essential tools to diagnose the current situation and to indicate ways to improve the quality of this environment. The purpose of this paper was to perform a quali-quantitative analysis of the beach waste on the Curva da Jurema Beach (Espírito Santo - Brazil). Three transects were used with equidistant positioning over the total length of the beach for the solid waste collection. Solid wastes were later classified according to their use and primary raw material from the low and high summer season. During the low season, average values of 7.10 items.m^-1, 18.22 g.m^-1 and 0.91 g.m^-2 were found for the whole beach, and transect 3 contributed the most waste, with the total sum of items equal to 999 (49%), a total mass of 5.62 kg and a total volume of 21.31 L. During the high summer season, average values of 8.22 items.m^-1, 54.40 g.m^-1 and 2.72 g.m^-2 were found, with transect 2 contributing the most to the total sum with 1,212 items (53%), a total mass of 10.76 kg and a total volume of 51.99 L. Of the total collected, plastic materials represented 51.4% of the total number of items, 35.9% of the total mass and 68% of the total volume. The implementation of reactive and proactive measures is necessary so that the management of the solid wastes on Curva da Jurema Beach is in accordance with principles of sustainability.

Keywords: Beach solid waste, environmental indicators, quali-quantitative analysis, waste management.

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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: Nanh Lovanh, John Loughrin, Kimberly Cook, Phil Silva, Byung-Taek Oh

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In the era of sustainability, utilization of livestock wastes as soil amendment to provide micronutrients for crops is very economical and sustainable. It is well understood that livestock wastes are comparable, if not better, nutrient sources for crops as chemical fertilizers. However, the large concentrated volumes of animal manure produced from livestock operations and the limited amount of available nearby agricultural land areas necessitated the need for volume reduction of these animal wastes. Composting of these animal manures is a viable option for biomass and pathogenic reduction in the environment. Nevertheless, composting also increases the potential loss of available nutrients for crop production as well as unwanted emission of anthropogenic air pollutants due to the loss of ammonia and other compounds via volatilization. In this study, we examine the emission of ammonia and nitrous oxide from swine manure windrows to evaluate the benefit of biomass reduction in conjunction with the potential loss of available nutrients. The feedstock for the windrows was obtained from swine farm in Kentucky where swine manure was mixed with wood shaving as absorbent material. Static flux chambers along with photoacoustic gas analyzer were used to monitor ammonia and nitrous oxide concentrations during the composting process. The results show that ammonia and nitrous oxide fluxes were quite high during the initial composting process and after the turning of each compost pile. Over the period of roughly three months of composting, the biochemical oxygen demand (BOD) decreased by about 90%. Although composting of animal waste is quite beneficial for biomass reduction, composting may not be economically feasible from an agronomical point of view due to time, nutrient loss (N loss), and potential environmental pollution (ammonia and greenhouse gas emissions). Therefore, additional studies are needed to assess and validate the economics and environmental impact of animal (swine) manure composting (e.g., crop yield or impact on climate change).

Keywords: Windrow, swine manure, ammonia, nitrous oxide, fluxes, management.

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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: Asok Adak, Debabrata Mazumder, Pratip Bandyopadhyay

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Anaerobic Digestion has become a promising technology for biological transformation of organic fraction of the municipal solid wastes (MSW). In order to represent the kinetic behavior of such biological process and thereby to design a reactor system, development of a mathematical model is essential. Addressing this issue, a simplistic mathematical model has been developed for anaerobic digestion of MSW in a continuous flow reactor unit under homogeneous steady state condition. Upon simulated hydrolysis, the kinetics of biomass growth and substrate utilization rate are assumed to follow first order reaction kinetics. Simulation of this model has been conducted by studying sensitivity of various process variables. The model was simulated using typical kinetic data of anaerobic digestion MSW and typical MSW characteristics of Kolkata. The hydraulic retention time (HRT) and solid retention time (SRT) time were mainly estimated by varying different model parameters like efficiency of reactor, influent substrate concentration and biomass concentration. Consequently, design table and charts have also been prepared for ready use in the actual plant operation.

Keywords: Anaerobic digestion, municipal solid waste (MSW), process design model, simulation study, hydraulic retention time(HRT), solid retention time (SRT).

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Authors: Masaumi Nakahara, Sou Watanabe, Hiromichi Ogi, Atsuhiro Shibata, Kazunori Nomura

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In the Japan Atomic Energy Agency, three types of experimental research, advanced reactor fuel reprocessing, radioactive waste disposal, and nuclear fuel cycle technology, have been carried out at the Chemical Processing Facility. The facility has generated high level radioactive liquid and solid wastes in hot cells. The high level radioactive solid waste is divided into three main categories, a flammable waste, a non-flammable waste, and a solid reagent waste. A plastic product is categorized into the flammable waste and molten with a heating mantle. The non-flammable waste is cut with a band saw machine for reducing the volume. Among the solid reagent waste, a used adsorbent after the experiments is heated, and an extractant is decomposed for its stabilization. All high level radioactive solid wastes in the hot cells are packed in a high level radioactive solid waste can. The high level radioactive solid waste can is transported to the 2nd High Active Solid Waste Storage in the Tokai Reprocessing Plant in the Japan Atomic Energy Agency.

Keywords: High level radioactive solid waste, advanced reactor fuel reprocessing, radioactive waste disposal, nuclear fuel cycle technology.

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Authors: Dimas T. Anantyo, Zsa-Zsa A. Laksmi, Adhie N. Radityo, Arsita E. Rini, Gatot I. Sarosa

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A six-point-two-magnitude earthquake rocked Mamuju District, West Sulawesi Province, Indonesia, on 15 January 2021, causing significant health issues for the affected community, particularly among vulnerable populations such as neonates and children. The aim of this study is to examine and describe the diseases diagnosed in the pediatric population in Mamuju 14 days after the earthquake. This study uses a prospective observational study of the pediatric population presenting at West Sulawesi Regional Hospital, Mamuju Regional Public Hospital, and Bhayangkara Hospital for the period of 14 days after the earthquake. Demographic and clinical information was recorded. 153 children were admitted to the health center. Children younger than six years old were the highest proportion (78%). Out of 153 children, 82 of them were male (54%). The most frequently diagnosed disease during the first and second weeks after the earthquake was respiratory problems, followed by gastrointestinal problems that showed an increase in incidence in the second week. This study found that age has a correlation with common disease in children after an earthquake. Respiratory and gastrointestinal problems were found to be the most common diseases among the pediatric population in Mamuju after the earthquake.

Keywords: Health outcomes, pediatric population, earthquake, Mamuju.

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Authors: Surasak Siripornadulsil, Nutt Poomai, Wilailak Siripornadulsil

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Due to a high ethanol demand, the approach for  effective ethanol production is important and has been developed  rapidly worldwide. Several agricultural wastes are highly  abundant in celluloses and the effective cellulase enzymes do exist  widely among microorganisms. Accordingly, the cellulose  degradation using microbial cellulase to produce a low-cost substrate  for ethanol production has attracted more attention. In this  study, the cellulase producing bacterial strain has been isolated  from rich straw and identified by 16S rDNA sequence analysis as Acinetobacter sp. KKU44. This strain is able to grow and exhibit the cellulase activity. The optimal temperature for its growth and  cellulase production is 37°C. The optimal temperature of bacterial  cellulase activity is 60°C. The cellulase enzyme from  Acinetobacter sp. KKU44 is heat-tolerant enzyme. The bacterial culture of 36h. showed highest cellulase activity at 120U/mL when  grown in LB medium containing 2% (w/v). The capability of  Acinetobacter sp. KKU44 to grow in cellulosic agricultural wastes as a sole carbon source and exhibiting the high cellulase activity at high temperature suggested that this strain could be potentially developed further as a cellulose degrading strain for a production of low-cost substrate used in ethanol production. 

 

Keywords: Acinetobacter sp. KKU44, bagasse, cellulase enzyme, rice husk.

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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: S. R. Shamili, C. Natarajan, J. Karthikeyan

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Rapid growth of world population and widespread urbanization has remarkably increased the development of the construction industry which caused a huge demand for sand and gravels. Environmental problems occur when the rate of extraction of sand, gravels, and other materials exceeds the rate of generation of natural resources; therefore, an alternative source is essential to replace the materials used in concrete. Now-a-days, electronic products have become an integral part of daily life which provides more comfort, security, and ease of exchange of information. These electronic waste (E-Waste) materials have serious human health concerns and require extreme care in its disposal to avoid any adverse impacts. Disposal or dumping of these E-Wastes also causes major issues because it is highly complex to handle and often contains highly toxic chemicals such as lead, cadmium, mercury, beryllium, brominates flame retardants (BFRs), polyvinyl chloride (PVC), and phosphorus compounds. Hence, E-Waste can be incorporated in concrete to make a sustainable environment. This paper deals with the composition, preparation, properties, classification of E-Waste. All these processes avoid dumping to landfills whilst conserving natural aggregate resources, and providing a better environmental option. This paper also provides a detailed literature review on the behaviour of concrete with incorporation of E-Wastes. Many research shows the strong possibility of using E-Waste as a substitute of aggregates eventually it reduces the use of natural aggregates in concrete.

Keywords: Disposal, electronic waste, landfill, toxic chemicals.

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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: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. EMS Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients that seconds are vital in saving their lives. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service, location-based services, emergency medical services information system

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Authors: M. L. Dinis, M. C. Vila, A. Fiúza, A. Futuro, C. Nunes

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The present paper describes the study of paste tailings prepared in laboratory using gold tailings, produced in a Finnish gold mine with the incorporation of coal ash. Natural leaching tests were conducted with the original materials (tailings, fly and bottom ashes) and also with paste mixtures that were prepared with different percentages of tailings and ashes. After leaching, the solid wastes were physically and chemically characterized and the results were compared to those selected as blank – the unleached samples. The tailings and the coal ash, as well as the prepared mixtures, were characterized, in addition to the textural parameters, by the following measurements: grain size distribution, chemical composition and pH. Mixtures were also tested in order to characterize their mechanical behavior by measuring the flexural strength, the compressive strength and the consistency. The original tailing samples presented an alkaline pH because during their processing they were previously submitted to pressure oxidation with destruction of the sulfides. Therefore, it was not possible to ascertain the effect of the coal ashes in the acid mine drainage. However, it was possible to verify that the paste reactivity was affected mostly by the bottom ash and that the tailings blended with bottom ash present lower mechanical strength than when blended with a combination of fly and bottom ash. Surface paste disposal offer an attractive alternative to traditional methods in addition to the environmental benefits of incorporating large-volume wastes (e.g. bottom ash). However, a comprehensive characterization of the paste mixtures is crucial to optimize paste design in order to enhance engineer and environmental properties.

Keywords: Coal ash, gold tailings, paste, surface disposal.

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Authors: Mehtap Dursun, E. Ertugrul Karsak, Melis Almula Karadayi

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The management of the health-care wastes is one of the most important problems in Istanbul, a city with more than 12 million inhabitants, as it is in most of the developing countries. Negligence in appropriate treatment and final disposal of the healthcare wastes can lead to adverse impacts to public health and to the environment. This paper employs a fuzzy multi-criteria group decision making approach, which is based on the principles of fusion of fuzzy information, 2-tuple linguistic representation model, and technique for order preference by similarity to ideal solution (TOPSIS), to evaluate health-care waste (HCW) treatment alternatives for Istanbul. The evaluation criteria are determined employing nominal group technique (NGT), which is a method of systematically developing a consensus of group opinion. The employed method is apt to manage information assessed using multigranularity linguistic information in a decision making problem with multiple information sources. The decision making framework employs ordered weighted averaging (OWA) operator that encompasses several operators as the aggregation operator since it can implement different aggregation rules by changing the order weights. The aggregation process is based on the unification of information by means of fuzzy sets on a basic linguistic term set (BLTS). Then, the unified information is transformed into linguistic 2-tuples in a way to rectify the problem of loss information of other fuzzy linguistic approaches.

Keywords: Group decision making, health care waste management, multi-criteria decision making, OWA, TOPSIS, 2-tuple linguistic representation

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

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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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Authors: Melek Kalkan, Hatice Odacı, Hatice Epli Koç

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The aim of this study is to compare the innovativeness, risk taking, and focusing on opportunity of the nurse managers and nurses. The data are collected from nurse managers and nurses in Ondokuz Mayıs University, Faculty of Medicine Hospital and Karadeniz Technical University, Faculty of Medicine Hospital. The study sample consisted of 151 participants, 76 nurse managers (50.3%) and 75 nurses (49.7%). All participants have been assessed by Participant Information Form and Corporate Entrepreneurship Scale. In data analysis, independent t-test has applied. The results show that there are significant differences between nurse managers and nurses on innovativeness (t = 2.42, p < 0.05), risk taking (t = 3.62, p < 0.01), and focusing on opportunity (t = 2.16, p < 0.05). Consequently, it can be said that nurse managers have more innovativeness than nurses and tend to take more risks and focus more on opportunities. 

Keywords: Focusing on opportunity attitudes, innovativeness, risk taking, nurse.

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