Abstract: Operating rooms are important assets for hospitals as
they generate the largest revenue and, at the same time, produce the
largest cost for hospitals. The model presented in this paper helps
make capacity planning decisions on the combination of open
operating rooms (ORs) and estimated overtime to satisfy the
allocated OR time to each specialty. The model combines both
decisions on determining the amount of OR time to open and to
allocate to different surgical specialties. The decisions made are
based on OR costs, overutilization and underutilization costs, and
contribution margins from allocating OR time. The results show the
importance of having a good estimate of specialty usage of OR time
to determine the amount of needed capacity and highlighted the
tradeoff that the OR manager faces between opening more ORs
versus extending the working time of the ORs already in use.
Abstract: 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.
Abstract: The purpose of this article is to introduce an advanced
system for the support of processing of medical image information,
and the terminology related to this system, which can be an important
element to a faster transition to a fully digitalized hospital.
The core of the system is a set of DICOM compliant applications
running over a dedicated computer network. The whole integrated
system creates a collaborative platform supporting daily routines in
the radiology community, developing communication channels,
supporting the exchange of information and special consultations
among various medical institutions as well as supporting medical
training for practicing radiologists and medical students. It gives the
users outside of hospitals the tools to work in almost the same
conditions as in the radiology departments.
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.
Abstract: 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.
Abstract: In this paper we used data mining techniques to
identify outlier patients who are using large amount of drugs over a
long period of time. Any healthcare or health insurance system
should deal with the quantities of drugs utilized by chronic diseases
patients. In Kingdom of Bahrain, about 20% of health budget is spent
on medications. For the managers of healthcare systems, there is no
enough information about the ways of drug utilization by chronic
diseases patients, is there any misuse or is there outliers patients. In
this work, which has been done in cooperation with information
department in the Bahrain Defence Force hospital; we select the data
for Cardiac patients in the period starting from 1/1/2008 to
December 31/12/2008 to be the data for the model in this paper. We
used three techniques for finding the drug utilization for cardiac
patients. First we applied a clustering technique, followed by
measuring of clustering validity, and finally we applied a decision
tree as classification algorithm. The clustering results is divided into
three clusters according to the drug utilization, for 1603 patients, who
received 15,806 prescriptions during this period can be partitioned
into three groups, where 23 patients (2.59%) who received 1316
prescriptions (8.32%) are classified to be outliers. The classification
algorithm shows that the use of average drug utilization and the age,
and the gender of the patient can be considered to be the main
predictive factors in the induced model.
Abstract: In this work, the surgical theater of a local hospital in
KSA was analyzed using simulation. The focus was on attempting to
answer questions related to how many Operating Rooms (ORs) to
open and to analyze the performance of the surgical theater in
general and mainly the Post Anesthesia Care Unit (PACU) to assist
making decisions regarding PACU staffing. The surgical theater
consists of ten operating rooms and the PACU unit which has a
maximum capacity of fifteen beds. Different sequencing rules to
sequence the surgical cases were tested and the Longest Case First
(LCF) were superior to others. The results of the different
alternatives developed and tested can be used by the manager as a
tool to plan and manage the OR and PACU
Abstract: Information regarding early onset neonatal sepsis
(EONS) pathogens may vary between regions. Global perspectives
showed Group B Streptococcal (GBS) as the most common causative
pathogens, but the widespread use of intrapartum antibiotics has
changed the pathogens pattern towards gram negative
microorganisms, especially E. coli. Objective of this study is to
describe the pathogens isolated, to assess current treatment and risk
of EONS. Records of 899 neonates born in three General Hospitals
between 2009 until 2012 were retrospectively reviewed. Proven was
found in 22 (3%) neonates. The majority was isolated with gram
positive organisms, 17 (2.3%). All grams positive and most gram
negative organisms showed sensitivity to the tested antibiotics. Only
two rare gram negative organisms showed total resistant. Male was
possible risk of proven EONS. Although proven EONS remains
uncommon in Malaysia, nonetheless, the effect of intrapartum
antibiotics still required continuous surveillance.
Abstract: Pakistani doctors (MBBS) are emigrating towards developed countries for professional adjustments. This study aims to highlight causes and consequences of doctors- brain drain from Pakistan. Primary data was collected from Mayo Hospital, Lahore by interviewing doctors (n=100) through systematic random sampling technique. It found that various socio-economic and political conditions are working as push and pull factors for brain drain of doctors in Pakistan. Majority of doctors (83%) declared poor remunerations and professional infrastructure of health department as push factor of doctors- brain drain. 81% claimed that continuous instability in political situation and threats of terrorism are responsible for emigration of doctors. 84% respondents considered fewer opportunities of further studies responsible for their emigration. Brain drain of doctors is affecting health sector-s policies / programs, standard doctor-patient ratios and quality of health services badly.
Abstract: Sputum smear conversion after one month of antituberculosis
therapy in new smear positive pulmonary tuberculosis
patients (PTB+) is a vital indicator towards treatment success. The
objective of this study is to determine the rate of sputum smear
conversion in new PTB+ patients after one month under treatment of
National Institute of Diseases of the Chest and Hospital (NIDCH).
Analysis of sputum smear conversion was done by re-clinical
examination with sputum smear microscopic test after one month.
Socio-demographic and hematological parameters were evaluated to
perceive the correlation with the disease status. Among all enrolled
patients only 33.33% were available for follow up diagnosis and of
them only 42.86% patients turned to smear negative. Probably this
consequence is due to non-coherence to the proper disease
management. 66.67% and 78.78% patients reported low haemoglobin
and packed cell volume level respectively whereas 80% and 93.33%
patients accounted accelerated platelet count and erythrocyte
sedimentation rate correspondingly.
Abstract: Researchers of drug-drug interaction alert systems
have often suggested that there were high overridden rate for alerts and
also too false alerts. However, research about decreasing false alerts is
scant. Therefore, the aim of this article attempts to proactive
identification of false alert for drug-drug interaction and provide
solution to decrease false alerts. This research involved retrospective
analysis prescribing database and calculated false alert rate by using
MYSQL and JAVA. Results of this study showed 17% of false alerts
and the false alert rate in the hospitals (37%) was more than in the
clinics. To conclude, this study described the importance that
drug-drug interaction alert system should not only detect drug name
but also detect frequency or route, as well as in providing solution to
decrease false alerts.
Abstract: It is well known that Logistic Regression is the gold
standard method for predicting clinical outcome, especially
predicting risk of mortality. In this paper, the Decision Tree method
has been proposed to solve specific problems that commonly use
Logistic Regression as a solution. The Biochemistry and
Haematology Outcome Model (BHOM) dataset obtained from
Portsmouth NHS Hospital from 1 January to 31 December 2001 was
divided into four subsets. One subset of training data was used to
generate a model, and the model obtained was then applied to three
testing datasets. The performance of each model from both methods
was then compared using calibration (the χ2 test or chi-test) and
discrimination (area under ROC curve or c-index). The experiment
presented that both methods have reasonable results in the case of the
c-index. However, in some cases the calibration value (χ2) obtained
quite a high result. After conducting experiments and investigating
the advantages and disadvantages of each method, we can conclude
that Decision Trees can be seen as a worthy alternative to Logistic
Regression in the area of Data Mining.
Abstract: Fourty one strains of ESBL producing P.aeruginosa
which were previously isolated from burn patients in Kerman
University general hospital, Iran were subjected to PCR, RFLP and
sequencing in order to determine the type of extended spectrum β-
lactamases (ESBL), the restriction digestion pattern and possibility of
mutation among detected genes. DNA extraction was carried out by
phenol chloroform method. PCR for detection of bla genes was
performed using specific primer for each gene. Restriction Fragment
Length Polymorphism (RFLP) for ESBL genes was carried out using
EcoRI, NheI, PVUII, EcoRV, DdeI, and PstI restriction enzymes. The
PCR products were subjected to direct sequencing of both the strands
for identification of the ESBL genes.The blaCTX-M, blaVEB-1, blaPER-1,
blaGES-1, blaOXA-1, blaOXA-4 and blaOXA-10 genes were detected in the
(n=1) 2.43%, (n=41)100%, (n=28) 68.3%, (n=10) 24.4%, (n=29)
70.7%, (n=7)17.1% and (n=38) 92.7% of the ESBL producing isolates
respectively. The RFLP analysis showed that each ESBL gene has
identical pattern of digestion among the isolated strains. Sequencing
of the ESBL genes confirmed the genuinety of PCR products and
revealed no mutation in the restriction sites of the above genes. From
results of the present investigation it can be concluded that blaVEB-1
and blaCTX-M were the most and the least frequently isolated ESBL
genes among the P.aeruginosa strains isolated from burn patients. The
RFLP and sequencing analysis revealed that same clone of the bla
genes were indeed existed among the antibiotic resistant strains.
Abstract: Mathematical models can be used to describe the
transmission of disease. Dengue disease is the most significant
mosquito-borne viral disease of human. It now a leading cause of
childhood deaths and hospitalizations in many countries. Variations
in environmental conditions, especially seasonal climatic parameters,
effect to the transmission of dengue viruses the dengue viruses and
their principal mosquito vector, Aedes aegypti. A transmission model
for dengue disease is discussed in this paper. We assume that the
human and vector populations are constant. We showed that the local
stability is completely determined by the threshold parameter, 0 B . If
0 B is less than one, the disease free equilibrium state is stable. If
0 B is more than one, a unique endemic equilibrium state exists and
is stable. The numerical results are shown for the different values of
the transmission probability from vector to human populations.