Abstract: 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.
Abstract: A total of twenty tensile biopsies were collected from
children undergoing tonsillectomy from teaching hospital ENT
department and Kurdistan private hospital in sulaimani city. All
biopsies were homogenized and cultured; the obtained bacterial
isolates were purified and identified by biochemical tests and VITEK
2 compact system. Among the twenty studied samples, only one
Pseudomonas putida with probability of 99% was isolated.
Antimicrobial susceptibility was carried out by disk diffusion
method, Pseudomonas putida showed resistance to all antibiotics
used except vancomycin. The isolate further subjected to PCR and
DNA sequence analysis of blaVIM gene using different set of primers
for different regions of VIM gene. The results were found to be PCR
positive for the blaVIM gene. To determine the sequence of blaVIM
gene, DNA sequencing performed. Sequence alignment of blaVIM
gene with previously recorded blaVIM gene in NCBI- database showed
that P. putida isolate have different blaVIM gene.
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.
Abstract: This paper presents a new strategy of identification
and classification of pathological voices using the hybrid method
based on wavelet transform and neural networks. After speech
acquisition from a patient, the speech signal is analysed in order to
extract the acoustic parameters such as the pitch, the formants, Jitter,
and shimmer. Obtained results will be compared to those normal and
standard values thanks to a programmable database. Sounds are
collected from normal people and patients, and then classified into
two different categories. Speech data base is consists of several
pathological and normal voices collected from the national hospital
“Rabta-Tunis". Speech processing algorithm is conducted in a
supervised mode for discrimination of normal and pathology voices
and then for classification between neural and vocal pathologies
(Parkinson, Alzheimer, laryngeal, dyslexia...). Several simulation
results will be presented in function of the disease and will be
compared with the clinical diagnosis in order to have an objective
evaluation of the developed tool.
Abstract: Recently research on human wayfinding has focused
mainly on mental representations rather than processes of
wayfinding. The objective of this paper is to demonstrate the
rationality behind applying multi-agent simulation paradigm to the
modeling of rescuer team wayfinding in order to develop
computational theory of perceptual wayfinding in crisis situations
using image schemata and affordances, which explains how people
find a specific destination in an unfamiliar building such as a
hospital. The hypothesis of this paper is that successful navigation is
possible if the agents are able to make the correct decision through
well-defined cues in critical cases, so the design of the building
signage is evaluated through the multi-agent-based simulation. In
addition, a special case of wayfinding in a building, finding one-s
way through three hospitals, is used to demonstrate the model.
Thereby, total rescue time for rescue operation during building fire is
computed. This paper discuses the computed rescue time for various
signage localization and provides experimental result for
optimization of building signage design. Therefore the most
appropriate signage design resulted in the shortest total rescue time in
various situations.
Abstract: In managing healthcare logistics, cost is not the only
factor to be considered. The level of items- criticality used in patient
care services plays an important role as well. A stock-out incident of
a high critical item could threaten a patient's life. In this paper, the
DMAIC (Define-Measure-Analyze-Improve-Control) methodology is
used to drive improvement projects based on customer driven critical
to quality characteristics at a Jordanian hospital. This paper shows
how the application of Six Sigma improves the performance of the
case hospital logistics system by reducing the number of stock-out
incidents.
Abstract: This paper has examined the energy consumption characteristics in six different buildings including apartments, offices, commercial buildings, hospitals, hotels and educational facilities. Then 5-hectare (50000m2) development site for respective building-s type has been assumed as case study to evaluate the introduction effect of Combined Heat and Power (CHP). All kinds of CHP systems with different distributed generation technologies including Gas Turbine (GT), Gas Engine (GE), Diesel Engine (DE), Solid Oxide Fuel Cell (SOFC) and Polymer Electrolyte Fuel Cell (PEFC), have been simulated by using HEATMAP, CHP system analysis software. And their primary energy utilization efficiency, energy saving ratio and CO2 reduction ratio have evaluated and compared respectively. The results can be summarized as follows: Various buildings have their special heat to power ratio characteristics. Matching the heat to power ratio demanded from an individual building with that supplied from a CHP system is very important. It is necessary to select a reasonable distributed generation technologies according to the load characteristics of various buildings. Distributed generation technologies with high energy generating efficiency and low heat to power ratio, like SOFC and PEFC is more reasonable selection for Building Combined Heat and Power (BCHP). CHP system is an attractive option for hotels, hospitals and apartments in Japan. The users can achieve high energy saving and environmental benefit by introducing a CHP systems. In others buildings, especially like commercial buildings and offices, the introduction of CHP system is unreasonable.
Abstract: A collaboration among the Hospital S. Giovanni Battista
of Turin, the Politecnico of Turin, and the MUST company is
described. The content of the collaboration has been and is the use of
ICT-s, e-learning, and blended learning for the internal professional
education, training, and keeping up to date of the personnel of the
hospital. A platform for the delivery of the teaching materials has
been built, including an evaluation and self-evaluation tool. The first
on line courses have been developed and delivered and many more
are in preparation. The first results of the monitoring of the efficacy
of the online education have been positive.
Abstract: 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.
Abstract: This paper presents the development of a Bayesian
belief network classifier for prediction of graft status and survival
period in renal transplantation using the patient profile information
prior to the transplantation. The objective was to explore feasibility
of developing a decision making tool for identifying the most suitable
recipient among the candidate pool members. The dataset was
compiled from the University of Toledo Medical Center Hospital
patients as reported to the United Network Organ Sharing, and had
1228 patient records for the period covering 1987 through 2009. The
Bayes net classifiers were developed using the Weka machine
learning software workbench. Two separate classifiers were induced
from the data set, one to predict the status of the graft as either failed
or living, and a second classifier to predict the graft survival period.
The classifier for graft status prediction performed very well with a
prediction accuracy of 97.8% and true positive values of 0.967 and
0.988 for the living and failed classes, respectively. The second
classifier to predict the graft survival period yielded a prediction
accuracy of 68.2% and a true positive rate of 0.85 for the class
representing those instances with kidneys failing during the first year
following transplantation. Simulation results indicated that it is
feasible to develop a successful Bayesian belief network classifier for
prediction of graft status, but not the graft survival period, using the
information in UNOS database.
Abstract: This paper presents an approach for early breast
cancer diagnostic by employing combination of artificial neural
networks (ANN) and multiwaveletpacket based subband image
decomposition. The microcalcifications correspond to high-frequency
components of the image spectrum, detection of microcalcifications
is achieved by decomposing the mammograms into different
frequency subbands,, reconstructing the mammograms from the
subbands containing only high frequencies. For this approach we
employed different types of multiwaveletpacket. We used the result
as an input of neural network for classification. The proposed
methodology is tested using the Nijmegen and the Mammographic
Image Analysis Society (MIAS) mammographic databases and
images collected from local hospitals. Results are presented as the
receiver operating characteristic (ROC) performance and are
quantified by the area under the ROC curve.
Abstract: 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.
Abstract: In this paper, we propose a novel algorithm for
delineating the endocardial wall from a human heart ultrasound scan.
We assume that the gray levels in the ultrasound images are
independent and identically distributed random variables with
different Rician Inverse Gaussian (RiIG) distributions. Both synthetic
and real clinical data will be used for testing the algorithm. Algorithm
performance will be evaluated using the expert radiologist evaluation
of a soft copy of an ultrasound scan during the scanning process and
secondly, doctor’s conclusion after going through a printed copy of
the same scan. Successful implementation of this algorithm should
make it possible to differentiate normal from abnormal soft tissue and
help disease identification, what stage the disease is in and how best
to treat the patient. We hope that an automated system that uses this
algorithm will be useful in public hospitals especially in Third World
countries where problems such as shortage of skilled radiologists and
shortage of ultrasound machines are common. These public hospitals
are usually the first and last stop for most patients in these countries.
Abstract: User satisfaction is one of the most used success
indicators in the research of information system (IS). Literature
shows user expectations have great influence on user satisfaction.
Both expectation and satisfaction of users are important for Hospital
Information Systems (HIS). Education, IS experience, age, attitude
towards change, business title, sex and working unit of the hospital,
are examined as the potential determinant of the medical users’
expectations. Data about medical user expectations are collected by
the “Expectation Questionnaire” developed for this study.
Expectation data are used for calculating the Expectation Meeting
Ratio (EMR) with the evaluation framework also developed for this
study. The internal consistencies of the answers to the questionnaire
are measured by Cronbach´s Alpha coefficient. The multivariate
analysis of medical user’s EMRs of HIS is performed by forward
stepwise binary logistic regression analysis. Education and business
title is appeared to be the determinants of expectations from HIS.
Abstract: Understanding patient factors related to physical activity behavior is important in the management of Type 2 Diabetes. This study applied the Theory of Planned Behavior model to understand physical activity behavior among sampled Type 2 diabetics in Kenya. The study was conducted within the diabetic clinic at Kisii Level 5 Hospital and adopted sequential mixed methods design beginning with qualitative phase and ending with quantitative phase. Qualitative data was analyzed using grounded theory analysis method. Structural equation modeling using maximum likelihood was used to analyze quantitative data. The common fit indices revealed that the theory of planned behavior fitted the data acceptably well among the Type 2 diabetes and within physical activity behavior {¤ç2 = 213, df = 84, n=230, p = .061, ¤ç2/df = 2.53; TLI = .97; CFI =.96; RMSEA (90CI) = .073(.029, .08)}. This theory proved to be useful in understanding physical activity behavior among Type 2 diabetics.
Abstract: Severe symptoms, such as dissociation, depersonalization, self-mutilation, suicidal ideations and gestures, are the main reasons for a person to be diagnosed with Borderline Personality Disorder (BPD) and admitted to an inpatient Psychiatric Hospital. However, these symptoms are also indicators of a severe traumatic history as indicated by the extensive research on the topic. Unfortunately patients with such clinical presentation often are treated repeatedly only for their symptomatic behavior, while the main cause for their suffering, the trauma itself, is usually left unaddressed therapeutically. All of the highly structured, replicable, and manualized treatments lack the recognition of the uniqueness of the person and fail to respect his/her rights to experience and react in an idiosyncratic manner. Thus the communicative and adaptive meaning of such symptomatic behavior is missed. Only its pathological side is recognized and subjected to correction and stigmatization, and the message that the person is damaged goods that needs fixing is conveyed once again. However, this time the message would be even more convincing for the victim, because it is sent by mental health providers, who have the credibility to make such a judgment. The result is a revolving door of very expensive hospitalizations for only a temporary and patchy fix. In this way the patients, once victims of abuse and hardship are left invalidated and thus their re-victimization is perpetuated in their search for understanding and help. Keywordsborderline personality disorder (BPD), complex PTSD, integrative treatment of trauma, re-victimization of trauma victims.
Abstract: The objective of this study was to determine the accuracy to estimation fetal weight by Johnson-s method and compares it with actual birth weight. The sample group was 126 infants delivered in Dan KhunThot hospital from January March 2012. Fetal weight was estimated by measuring fundal height according to Johnson-s method. The information was collected by studying historical delivery records and then analyzed by using the statistics of frequency, percentage, mean, and standard deviation. Finally, the difference was analyzed by a paired t-test.The results showed had an average birth weight was 3093.57 ± 391.03 g (mean ± SD) and 3,455 ± 454.55 g average estimated fetal weight by Johnson-s method higher than average actual birth weight was 384.09 grams. When classifying the infants according to birth weight found that low birth weight ( 4000 g) actual birth weight was more than estimated fetal weight. The difference was found between actual birth weight and estimation fetal weight of the minimum weight in high birth weight ( > 4000 g) , the appropriate birth weight (2500-3999g) and low birth weight (
Abstract: Leave of absence is important in maintaining a good
status of human resource quality. Allowing the employees temporarily
free from the routine assignments can vitalize the workers- morality
and productivity. This is particularly critical to secure a satisfactory
service quality for healthcare professionals of which were typically
featured with labor intensive and complicated works to perform. As
one of the veteran hospitals that were found and operated by the
Veteran Department of Taiwan, the nursing staff of the case hospital
was squeezed to an extreme minimum level under the pressure of a
tight budgeting. Leave of absence on schedule became extremely
difficult, especially for the intensive care units (ICU), in which
required close monitoring over the cared patients, and that had more
easily driven the ICU nurses nervous. Even worse, the deferred leaves
were more than 10 days at any time in the ICU because of a fluctuating
occupancy. As a result, these had brought a bad setback to this
particular nursing team, and consequently defeated the job
performance and service quality. To solve this problem and
accordingly to strengthen their morality, a project team was organized
across different departments specific for this. Sufficient information
regarding jobs and positions requirements, labor resources, and actual
working hours in detail were collected and analyzed in the team
meetings. Several alternatives were finalized. These included job
rotating, job combination, leave on impromptu and cross-departmental
redeployment. Consequently, the deferred leave days sharply reduced
70% to a level of 3 or less days. This improvement had not only
provided good shelter for the ICU nurses that improved their job
performance and patient safety but also encouraged the nurses active
participating of a project and learned the skills of solving problems
with colleagues.
Abstract: Medical services are usually provided in hospitals; however, in developing country, some rural residences have fewer opportunities to access in healthcare services due to the limitation of transportation communication. Therefore, in Thailand, there are charitable organizations operating to provide medical treatments to these people by shifting the medical services to operation sites; this is commonly known as mobile medical service. Operation routing is important for the organization to reduce its transportation cost in order to focus more on other important activities; for instance, the development of medical apparatus. VRP is applied to solve the problem of high transportation cost of the studied organization with the searching techniques of saving algorithm to find the minimum total distance of operation route and satisfy available time constraints of voluntary medical staffs.
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.