Abstract: Disasters are quite experienced in our days. They are
caused by floods, landslides, and building fires that is the main
objective of this study. To cope with these unexpected events,
precautions must be taken to protect human lives. The emphasis on
disposal work focuses on the resolution of the evacuation problem in
case of no-notice disaster. The problem of evacuation is listed as a
dynamic network flow problem. Particularly, we model the
evacuation problem as an earliest arrival flow problem with load
dependent transit time. This problem is classified as NP-Hard. Our
challenge here is to propose a metaheuristic solution for solving the
evacuation problem. We define our objective as the maximization of
evacuees during earliest periods of a time horizon T. The objective
provides the evacuation of persons as soon as possible. We
performed an experimental study on emergency evacuation from the
tunisian children’s hospital. This work prompts us to look for
evacuation plans corresponding to several situations where the
network dynamically changes.
Abstract: Second line antiretroviral therapy (ART) regimen is
used when patients fail their first line regimen. There are many
factors such as non-adherence, drug resistance as well as virological
and immunological failure that lead to second line highly active
antiretroviral therapy (HAART) regimen treatment failure. This study
was aimed at determining predictor factors to treatment failure with
second line HAART and analyzing median survival time.
An observational, retrospective study was conducted in Sungai
Buloh Hospital (HSB) to assess current status of HIV patients treated
with second line HAART regimen. Convenience sampling was used
and 104 patients were included based on the study’s inclusion and
exclusion criteria. Data was collected for six months i.e. from July
until December 2013. Data was then analysed using SPSS version 18.
Kaplan-Meier and Cox regression analyses were used to measure
median survival times and predictor factors for treatment failure.
The study population consisted mainly of male subjects, aged 30-
45 years, who were heterosexual, and had HIV infection for less than
6 years. The most common second line HAART regimen given was
lopinavir/ritonavir (LPV/r)-based combination. Kaplan-Meier
analysis showed that patients on LPV/r demonstrated longer median
survival times than patients on indinavir/ritonavir (IDV/r) based
combination (p
Abstract: Purpose: This E-survey was carried out to facilitate the implementation and Education of VMAT (Volumetric Modulated Arc Therapy) in Radiotherapy-RT departments and reasons for not using IMRT (Intensity Modulated Radiotherapy). VMAT Skills in demand were also identified. Method: E-Survey was distributed to NHS hospitals across UK by email. Thirty NHS and related centres in England, 21 in Scotland, 3 in Ireland and 1 in Wales were contacted. This Survey was intended for those working in RT and Medical Physics and who were responsible for Treatment Planning and training. Results: This E-survey have indicated pathways adopted by staff to acquire VMAT skills, strategies to efficiently implement VMAT in RT departments and for obtaining VMAT Education. Conclusion: Despite poor survey response this survey has managed to highlight requirements for education and implementation of VMAT that are also applicable to IMRT. Other RT centres in world can also find these results useful.
Abstract: The recent growth of internet applications on hospitality and tourism provokes on-line consumer comments and reviews. Many researchers and practitioners have named this enormous potential as “e-WOM (electronic word of mouth)”. Travel comments are important experiential information for the potential travellers. Many researches have been conducted to analyse the effects of e-WOM on hotel consumers. Broadly quantitative methods have been used for analysing online comments. But, a few studies have mentioned about the positive practical aspects of the comments for hotel marketers. The study aims to show different usage and effects of hotel consumers’ comments. As qualitative analysis method, grounded theory, content and discourse analysis, were used. The data based on the 10 resort hotel consumers’ on-line comments. Results show that consumers tend to write comments about service person, rooms, food services and pool in their online space. These indicators can be used by hotel marketers as a marketing information tool.
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.
Abstract: The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.
Abstract: Seismic retrofitting of important structures is essential in seismological active zones. The importance is doubled when it comes to some buildings like schools, hospitals, bridges etc. because they are required to continue their serviceability even after a major earthquake. Generally, seismic retrofitting codes have paid little attention to retrofitting of foundations due to its construction complexity. In this paper different methods for seismic retrofitting of tall buildings’ foundations will be discussed and evaluated. Foundations are considered in three different categories. First, foundations those are in danger of liquefaction of their underlying soil. Second, foundations located on slopes in seismological active regions. Third, foundations designed according to former design codes and may show structural defects under earthquake loads. After describing different methods used in different countries for retrofitting of the existing foundations in seismological active regions, comprehensive comparison between these methods with regard to the above mentioned categories is carried out. This paper gives some guidelines to choose the best method for seismic retrofitting of tall buildings’ foundations in retrofitting projects.
Abstract: Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.
Abstract: Hospitals, everywhere, are considered heavy energy consumers. Hospital Intensive Care Unit spaces pose a special challenge, where design guidelines requires the provision of external windows for daylighting and external view. Window protection strategies could be employed to reduce energy loads without detriment effect on comfort or health care. This paper addresses the effectiveness of using various window strategies on the annual cooling, heating and lighting energy use of a typical Hospital Intensive Unit space. Series of experiments were performed using the EnergyPlus simulation software for a typical Intensive Care Unit (ICU) space in Cairo, located in the Egyptian desert. This study concluded that the use of shading systems is more effective in conserving energy in comparison with glazing of different types, in the Cairo ICUs. The highest energy savings in the West and South orientations were accomplished by external perforated solar screens, followed by overhangs positioned at a protection angle of 45°.
Abstract: This paper proposes and analyzes an SIRS epidemic model incorporating the effects of the awareness programs driven by the media. Media and media driven awareness programs play a promising role in disseminating the information about outbreak of any disease across the globe. This motivates people to take precautionary measures and guides the infected individuals to get hospitalized. Timely hospitalization helps to reduce diagnostic delays and hence results in fast recovery of infected individuals. The aim of this study is to investigate the impact of the media on the spread and control of infectious diseases. This model is analyzed using stability theory of differential equations. The sensitivity of parameters has been discussed and it has been found that the awareness programs driven by the media have positive impact in reducing the infection prevalence of the infective population in the region under consideration.
Abstract: Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.
Abstract: The goal of the present paper is to model two classic lines of research in which employees starred, organizational justice and citizenship behavior (OCB), but that have never been studied together when targeting customers. The suggestion is made that a hotel’s fair treatment (in terms of distributive, procedural, and interactional justice) toward customers will be appreciated by the employees, who will reciprocate in kind by favoring the hotel with increased customer-oriented behaviors (COBs). Data were collected from 204 employees at eight upscale hotels in the Canary Islands (Spain). Unlike in the case of perceptions of distributive justice, results of structural equation modeling demonstrate that employees substantively react to interactional and procedural justice toward guests by engaging in customer-oriented behaviors (COBs). The findings offer new reasons why employees decide to engage in COBs, and they highlight potentially beneficial effects of fair treatment toward guests bring to hospitality through promoting COBs.
Abstract: Patients under health treatments that involve long
stays at a hospital or health center (e.g. cancer, organ transplants and
severe burns), tend to get bored or depressed because of the lack of
social interaction with family and friends. Such a situation also
affects the evolution and effectiveness of their treatments. In many
cases, the solution to this problem involves extra challenges, since
many patients need to rest quietly (or remain in bed) to their being
contagious. Considering the weak health condition in which usually
are these kinds, keeping them motivated and quiet represents an
important challenge for nurses and caregivers. This article presents a
mobile ubiquitous game called MagicRace, which allows hospitalized
kinds to interact socially with one another without putting to risk
their sensitive health conditions. The game does not require a
communication infrastructure at the hospital, but instead, it uses a
mobile ad hoc network composed of the handheld devices used by
the kids to play. The usability and performance of this application
was tested in two different sessions. The preliminary results show
that users experienced positive feelings from this experience.
Abstract: Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much.
Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA) on dynamic balance, pain and functional performance following rehabilitation.
Methods: Fifteen patients with CRTKA (group I), fifteen with PSTKA (group II), fifteen with UKA (group III) and fifteen indicated for arthroplasty but weren’t operated on yet (group IV) participated in the study. The mean age was 54.53±3.44, 55.13±3.48, 52.8±1.93 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99, 35.6±1.88 and 35.73±1.03 kg/m2 for group I, II, III and IV respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four and eight weeks pre- and post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-8th weeks) programs.
Results: The Mixed design MANOVA revealed that group III had significantly higher BBS scores, and lower pain scores and TUG and SC time than groups I and II four and eight weeks post-operatively. In addition, group I had significantly lower pain scores and SC time compared with group II eight weeks post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly eight weeks post-operatively compared with the three other assessments in group I, II and III with the opposite being true four weeks post-operatively.
Interpretation/Conclusion: CRTKA is preferable to PSTKA with UKA being generally superior to TKA, possibly due to the preserved human proprioceptors in the un-excised compartmental articular surface.
Abstract: Hospitals represent approximately 6% of total energy consumption in the utility buildings sector. Heating, Ventilation and Air Conditioning (HVAC) systems are the major part of electrical energy consumption at the hospitals. The air-conditioning system is responsible for around 70% of total electricity consumption. Electric motors and lighting systems in a hospital represent approximately 19% and 21% of the total energy consumption, respectively. In this paper, profiles of hospital energy end-use consumption and an overview of energy saving areas at the hospitals are presented.
Abstract: The objectives of this research are to know the management form of Samut Songkram lodging entrepreneurs with sufficient economy framework, to know the threat that affect this business and drawing the fit model for this province in order to sustain their business with Samut Songkram style. What will happen if they do not use this philosophy? Will they have a cash short fall? The data and information are collected by informal discussion with 8 managers and 400 questionnaires. We will use a mix of methods both qualitative research and quantitative research for our study. Bent Flyvbjerg’s phronesis is utilized for this analysis. Our research will prove that sufficient economy can help small and medium business firms solve their problems. We think that the results of our research will be a financial model to solve many problems of the entrepreneurs and this way will use to practice in other areas of our country.
Abstract: A failure of the non-structural component can cause significant damages in critical facilities such as nuclear power plants and hospitals. Historically, it was reported that the damage from the leakage of sprinkler systems, resulted in the shutdown of hospitals for several weeks by the 1971 San Fernando and 1994 North Ridge earthquakes. In most cases, water leakages were observed at the cross joints, sprinkler heads, and T-joint connections in piping systems during and after the seismic events. Hence, the primary objective of this study was to understand the seismic performance of T-joint connections and to develop an analytical Finite Element (FE) model for the T-joint systems of 2-inch fire protection piping system in hospitals subjected to seismic ground motions. In order to evaluate the FE models of the piping systems using OpenSees, two types of materials were used: 1) Steel02 materials and 2) Pinching4 materials. Results of the current study revealed that the nonlinear moment-rotation FE models for the threaded T-joint reconciled well with the experimental results in both FE material models. However, the system-level fragility determined from multiple nonlinear time history analyses at the threaded T-joint was slightly different. The system-level fragility at the T-joint, determined by Pinching4 material was more conservative than that of using Steel02 material in the piping system.
Abstract: Upper gastrointestinal endoscopy is a commonly performed diagnostic and therapeutic procedure and has many adverse effects like cardiopulmonary complications, complications related to sedation, infectious complications, bleeding and perforation. So this study was undertaken to evaluate important variables like patient’s age, gender and stage of the procedure in relation to the cardiopulmonary changes during diagnostic upper gastrointestinal endoscopy by monitoring oxygen saturation, blood pressure, heart rate and electrocardiogram. This is a prospective longitudinal hospital based study involving a total of 140 consecutive patients, at Sri. B. M. Patil Medical College, Hospital and Research Centre. Cardiopulmonary changes during upper gastrointestinal endoscopy are more common in the age groups of 51-60 years, with equal frequency in both male and female. Oxygen saturation levels decreased by about 4% in both sexes during introduction of endoscopy. Mild to moderate hypoxia was found in 32% of the study group. Severe hypoxia was found in 5% of the patients, mostly in those patients who are above 50 years of age. Tachycardia was noted in 88% of the study group patients. Blood pressure increased to hypertension levels in 22 patients (15.7%) which returned to normal within few minutes after the procedure. S-T depression was noticed in 4% of patients and T wave inversion in 8% of patients during upper gastrointestinal endoscopy. All these changes disappeared after 10 minutes after the endoscopy. Cardiopulmonary changes are common during upper gastrointestinal endoscopy. Maximum changes in oxygen saturation, heart rate and blood pressure occurred immediately after the introduction of endoscope. The cardiopulmonary changes did not manifest into any identifiable clinical symptoms. The rate of recovery was faster in younger age groups and women.
Abstract: Lean technique is very important in the service and industrial fields. It is defined as an effective tool to eliminate the wastes. In lean the wastes are defined as anything which does not add value to the end product. There are wastes that can be avoided, but some are unavoidable for many reasons.
The present study aims to apply the principles of lean in two different sectors, healthcare and industry. Two case studies have been selected to apply the experimental work. The first case was Al-Jalaa Hospital, while the second case study was the Technical Company of Aluminum Sections in Benghazi, LIBYA. In both case studies the Value Stream Map (VSM) of the current state has been constructed. The proposed plans have been implemented by merging or eliminating procedures or processes.
The results obtained from both case studies showed improvement in Capacity, Idle time and Utilized time.
Abstract: Bone hydatidosis is an infection in worldwide distribution. Although there is no evidence in literature on Bone Hydatid disease in Libya, we tried to present the first Epidemiological study of this disease in Eastern Libya through retrospective study from 1995 to 2013. Our data were collected from 3 hospitals in Eastern Libya particularly the sheep-raising areas with total number of musculoskeletal infection cases of two thousand one hundred ninety four (2,194). There were five (5) five cases of bone infection, four (4) of it have been diagnosed after more than three (3) months. Our study is comparable to other international study but this type of bone infection need further studies for effective control strategies for all dogs to avoid serious complications that might happened from the delay in diagnosing this type of disease.