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: 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.
Abstract: Access to information holds the key to the empowerment of everybody despite where they are living. This research has been carried out in respect of the people living in developing countries, considering their plight and complex geographical, demographic, social-economic conditions surrounding the areas they live, which hinder access to information and of professionals providing services such as medical workers, which has led to high death rates and development stagnation. Research on Unified Communications and Integrated Collaborations (UCIC) system in the health sector of developing countries aims at creating a possible solution of bridging the digital canyon among the communities. The system is meant to deliver services in a seamless manner to assist health workers situated anywhere to be accessed easily and access information which will enhance service delivery. The proposed UCIC provides the most immersive telepresence experience for one-to-one or many-to-many meetings. Extending to locations anywhere in the world, the transformative platform delivers Ultra-low operating costs through the use of general purpose networks and using special lenses and track systems. The essence of this study is to create a security model for the deployment of the UCIC system in the health sector of developing countries. The model approach used for building the UCIC system security carefully considers the specific requirements for the health sector environment organization such as data centre, national, regional and district hospitals, and health centers IV, III, II and I and then builds the single best possible secure network to meet their needs. The security model demonstrates on how the components of the UCIC system will be protected physically and logically in the health sector environment. The UCIC system once adopted and implemented correctly will bring enhancement to the speed and quality of services offered by health workers. The capacities of UCIC will help health workers shorten decision cycles, accelerate service delivery and save lives by speeding access to information and by making it possible for all health workers and patients to collaborate ubiquitously.
Abstract: People with hepatitis C are likely to experience psychological distress related to adjustment issues following diagnosis. Objective: The study was conducted to determine the psycho-social stressors accompanying Hepatitis C virus (HCV) chronic infection. The study focused on immediate and later on reactions to being diagnosed as infected HCV patients. Effect of HCV on disruption of patients’ relationships in term of family relationship and friendship, employment and financial status was assessed. The magnitude and causes of the social stigma and its relation to awareness about illness, level of education were also assessed. Methods: During this study the subjective experiences of people having HCV was explored through a designed questionnaire targeted 540 cases; 359 males and 181 females from ten out of 21 National Treatment Reference Centers of National Hepatology and Tropical Medicine Research Institutes of Ministry of Health (MOH) hospitals. The study was conducted along a period of six months from September 2011 to March 2012. Results: The study revealed that the financial problems are the commonest problems faced by 75.5% of the cases. More than 70% of the cases suffered from immediate sadness versus 67.4% suffered from worry. Social stigma was reported by 13 % of HCV +patients, the majority of which were females. Conclusions: Exploring the psychosocial consequences of HCV infection can act as pressing motivators for behavior change needed for limiting HCV endemicity in Egypt.
Abstract: The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL), its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know how to cope with having a family member with hepatitis C and more importantly to know what should you say and what shouldn’t you say as a positive hopeful attitude is essential for combating HCV chronic infection.
Abstract: Large patients’ queues at pharmacies and hospitals are a problem that faces the supposedly smooth and healthy environment in United Arab Emirates. As this sometimes leads to dissatisfaction from visiting patients, we tried to solve this problem with additional beneficial functions by developing the Hospital-Pharmacy Management System. The primary purpose of this research is to develop a system that joins the databases of a hospital and a pharmacy together for a better integrated system that provides a better coherent working environment. Three methods are used to design the system. These methods are detailed literature review, an extensive feasibility study and surveys for doctors, hospital IT managers and End-users. Interviews and surveys with related stakeholders were done to depict system’s requirements; design and prototype. The prototype illustrates system’s features and its client and server architecture. The system has a mobile application for visiting patients to, mainly, keep track of their prescriptions and access to their personal information. The server side allows doctors to submit the prescriptions online to pharmacists who will process them. This system is expected to reduce the long waiting queues of patients and increase their satisfaction while also reducing doctors and pharmacists’ stress and facilitating their work. It will be deployed to users of Android devices only. This limitation will be resolved, as one of main future enhancements, once the system finds acceptance from hospitals and pharmacies in United Arab Emirates.
Abstract: Surgical team consists of variety types of medical specialists possessing different kind of knowledge, motivations, personalities or abilities. This together with poor knowledge transfer, lack of information and communication technologies (ICT) implementations in hospitals can cause protraction of patient care processes and even jeopardize patient safety. There is presented in the article the outcomes of studies on communication and workflow in surgical team in the background of different collaboration levels in healthcare system. As a result the five determinants of improving workflow and communication within surgical team were indicated as well as knowledge-based tools and supporting information technology were proposed.
Abstract: This study investigates the relationship between the reliability of critical medical equipment (CME) and the effectiveness of CME maintenance management strategies in relation to patient outcomes in 84 public hospitals of a top 20 OECD country. The work has examined the effectiveness of CME maintenance management strategies used by the public hospital system of a large state run health organization. The conceptual framework was designed to examine the significance of the relationship between six variables: (1) types of maintenance management strategies, (2) maintenance services, (3) maintenance practice, (4) medical equipment reliability, (5) maintenance costs and (6) patient outcomes. The results provide interesting insights into the effectiveness of the maintenance strategies used. For example, there appears to be about a 1 in 10 000 probability of failure of anesthesia equipment, but these seem to be confined to specific maintenance situations. There are also some findings in relation to outsourcing of maintenance. For each of the variables listed, results are reported in relation to the various types of maintenance strategies and services. Decision-makers may use these results to evaluate more effective maintenance strategies for their CME and generate more effective patient outcomes.
Abstract: The purpose of this article is to propose a model designed to achieve Total Knowledge Transfer in the public health sector. The Total Knowledge Transfer Model integrated four essential organizational factors which have been under examined in totality in the literature. The research design was inductive in nature and used a case study for accomplishing the research objectives. The researcher investigated the factors that created a base to design a framework for total knowledge transfer in the public health sector. The results of this study are drawn from a fairly large sample in only two hospitals. A further research can be conducted to cover more responses from a wider health sector. The Total Knowledge Transfer Model is essential to improve the transfer and application of total common health knowledge.
Abstract: In this paper, we study statistical multiplexing of VBR
video in ATM networks. ATM promises to provide high speed realtime
multi-point to central video transmission for telemedicine
applications in rural hospitals and in emergency medical services.
Video coders are known to produce variable bit rate (VBR) signals
and the effects of aggregating these VBR signals need to be
determined in order to design a telemedicine network infrastructure
capable of carrying these signals. We first model the VBR video
signal and simulate it using a generic continuous-data autoregressive
(AR) scheme. We carry out the queueing analysis by the Fluid
Approximation Model (FAM) and the Markov Modulated Poisson
Process (MMPP). The study has shown a trade off: multiplexing
VBR signals reduces burstiness and improves resource utilization,
however, the buffer size needs to be increased with an associated
economic cost. We also show that the MMPP model and the Fluid
Approximation model fit best, respectively, the cell region and the
burst region. Therefore, a hybrid MMPP and FAM completely
characterizes the overall performance of the ATM statistical
multiplexer. The ramifications of this technology are clear: speed,
reliability (lower loss rate and jitter), and increased capacity in video
transmission for telemedicine. With migration to full IP-based
networks still a long way to achieving both high speed and high
quality of service, the proposed ATM architecture will remain of
significant use for telemedicine.
Abstract: Objective: The objective of this paper is to assess the
hospitals preparedness for emergency using WHO standards.
Method: This is a cross-sectional study, consisted of site visit,
questionnaire survey, 16 health facilities were included. The WHO
standard for emergency preparedness of health facilities was used to
evaluate and assess the hospitals preparedness of health facilities.
Result: 13 hospitals were responded. They scored below average
in all measure >75%), while above average score was in 7 out 9 nine
measure with a range of 8%-25%. Un acceptable below average was
noted in two measures only.
Discussion: The biggest challenge facing the hospitals in their
emergency intervention is the lack of pre-emergency and emergency
preparedness plans as well as the coordination of the hospitals
response mechanisms.
Conclusion: The studied hospitals presently are far from
international disasters preparedness protocols. That necessitates
improvements in emergency preparedness, as well as in physician
skills for injury management.
Abstract: The Application of e-health solutions has brought superb advancements in the health care industry. E-health solutions have already been embraced in the industrialized countries. In an effort to catch up with the growth, the developing countries have strived to revolutionize the healthcare industry by use of Information technology in different ways. Based on a technology assessment carried out in Kenya – one of the developing countries – and using multiple case studies in Nyanza Province, this work focuses on an investigation on how five rural hospitals are adapting to the technology shift. The issues examined include the ICT infrastructure and e-health technologies in place, the knowledge of participants in terms of benefits gained through the use of ICT and the challenges posing barriers to the use of ICT technologies in these hospitals. The results reveal that the ICT infrastructure in place is inadequate for e-health implementations as a result to various challenges that exist. Consequently, suggestions on how to tackle the various challenges have been addressed in this paper.
Abstract: Nowadays pharmaceutical care departments located in
hospitals are amongst the important pillars of the healthcare system.
The aim of this study was to evaluate quality of hospital drugstores
affiliated with Kermanshah University of Medical Sciences.
In this cross-sectional study a validated questionnaire was used.
The questionnaire was filled in by the one of the researchers in all
seventeen hospital drugstores located in the teaching and nonteaching
hospitals affiliated with Kermanshah University of Medical
Sciences. The results shows that in observed hospitals,24% of
pharmacy environments, 25% of pharmacy store and storage
conditions, 49% of storage procedure, 25% of ordering drugs and
supplies, 73% of receiving supplies (proper procedure are fallowed
for receiving supplies), 35% of receiving supplies (prompt action
taken if deterioration of drugs received is suspected), 23.35% of
drugs delivery to patients and finally 0% of stock cards are used for
proper inventory control have full compliance with standards.
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: 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: 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: 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.