Absence of Leave and Job Morality in the ICU

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.

Mobile Medical Operation Route Planning

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.

Evaluation of Sensitometric Properties of Radiographic Films at Different Processing Solutions

The aim of this study was to compare the sensitometric properties of commonly used radiographic films processed with chemical solutions in different workload hospitals. The effect of different processing conditions on induced densities on radiologic films was investigated. Two accessible double emulsions Fuji and Kodak films were exposed with 11-step wedge and processed with Champion and CPAC processing solutions. The mentioned films provided in both workloads centers, high and low. Our findings displays that the speed and contrast of Kodak filmscreen in both work load (high and low) is higher than Fuji filmscreen for both processing solutions. However there was significant differences in films contrast for both workloads when CPAC solution had been used (p=0.000 and 0.028). The results showed base plus fog density for Kodak film was lower than Fuji. Generally Champion processing solution caused more speed and contrast for investigated films in different conditions and there was significant differences in 95% confidence level between two used processing solutions (p=0.01). Low base plus fog density for Kodak films provide more visibility and accuracy and higher contrast results in using lower exposure factors to obtain better quality in resulting radiographs. In this study we found an economic advantages since Champion solution and Kodak film are used while it makes lower patient dose. Thus, in a radiologic facility any change in film processor/processing cycle or chemistry should be carefully investigated before radiological procedures of patients are acquired.

The Design of the HL7 RIM-based Sharing Components for Clinical Information Systems

The American Health Level Seven (HL7) Reference Information Model (RIM) consists of six back-bone classes that have different specialized attributes. Furthermore, for the purpose of enforcing the semantic expression, there are some specific mandatory vocabulary domains have been defined for representing the content values of some attributes. In the light of the fact that it is a duplicated effort on spending a lot of time and human cost to develop and modify Clinical Information Systems (CIS) for most hospitals due to the variety of workflows. This study attempts to design and develop sharing RIM-based components of the CIS for the different business processes. Therefore, the CIS contains data of a consistent format and type. The programmers can do transactions with the RIM-based clinical repository by the sharing RIM-based components. And when developing functions of the CIS, the sharing components also can be adopted in the system. These components not only satisfy physicians- needs in using a CIS but also reduce the time of developing new components of a system. All in all, this study provides a new viewpoint that integrating the data and functions with the business processes, it is an easy and flexible approach to build a new CIS.

Automated Detection of Alzheimer Disease Using Region Growing technique and Artificial Neural Network

Alzheimer is known as the loss of mental functions such as thinking, memory, and reasoning that is severe enough to interfere with a person's daily functioning. The appearance of Alzheimer Disease symptoms (AD) are resulted based on which part of the brain has a variety of infection or damage. In this case, the MRI is the best biomedical instrumentation can be ever used to discover the AD existence. Therefore, this paper proposed a fusion method to distinguish between the normal and (AD) MRIs. In this combined method around 27 MRIs collected from Jordanian Hospitals are analyzed based on the use of Low pass -morphological filters to get the extracted statistical outputs through intensity histogram to be employed by the descriptive box plot. Also, the artificial neural network (ANN) is applied to test the performance of this approach. Finally, the obtained result of t-test with confidence accuracy (95%) has compared with classification accuracy of ANN (100 %). The robust of the developed method can be considered effectively to diagnose and determine the type of AD image.

Virtual E-Medic: A Cloud Based Medical Aid

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.

Building an Inferential Model between Caregivers and Patients by using RFID

Nosocomial (i.e., hospital-acquired) infections (NI) is a major cause of morbidity and mortality in hospitals. NI rate is higher in intensive care units (ICU) than in the general ward due to patients with severe symptoms, poor immunity, and accepted many invasive therapies. Contact behaviors between health caregivers and patients is one of the infect factors. It is difficult to obtain complete contact records by traditional method of retrospective analysis of medical records. This paper establishes a contact history inferential model (CHIM) intended to extend the use of Proximity Sensing of rapid frequency identification (RFID) technology to transferring all proximity events between health caregivers and patients into clinical events (close-in events, contact events and invasive events).The results of the study indicated that the CHIM can infer proximity care activities into close-in events and contact events. The infection control team could redesign and build optimal workflow in the ICU according to the patient-specific contact history which provided by our automatic tracing system.

The Effects of Human Activity in Yasuj Area on the Health of Stream City

The Yasuj city stream named the Beshar supply water for different usages such as aquaculture farms , drinking, agricultural and industrial usages. Fish processing plants ,Agricultural farms, waste water of industrial zones and hospitals waste water which they are generate by human activity produce a considerable volume of effluent and when they are released in to the stream they can effect on the water quality and down stream aquatic systems. This study was conducted to evaluate the effects of outflow effluent from different human activity and point and non point pollution sources on the water quality and health of the Beshar river next to Yasuj. Yasuj is the biggest and most important city in the Kohkiloye and Boyerahmad province . The Beshar River is one of the most important aquatic ecosystems in the upstream of the Karun watershed in south of Iran which is affected by point and non point pollutant sources . This study was done in order to evaluate the effects of human activities on the water quality and health of the Beshar river. This river is approximately 190 km in length and situated at the geographical positions of 51° 20' to 51° 48' E and 30° 18' to 30° 52' N it is one of the most important aquatic ecosystems of Kohkiloye and Boyerahmad province in south-west Iran. In this research project, five study stations were selected to examine water pollution in the Beshar River systems. Human activity is now one of the most important factors affecting on hydrology and water quality of the Beshar river. Humans use large amounts of resources to sustain various standards of living, although measures of sustainability are highly variable depending on how sustainability is defined. The Beshar river ecosystems are particularly sensitive and vulnerable to human activities. The water samples were analyzed, then some important water quality parameters such as pH, dissolve oxygen (DO), Biochemical Oxygen Demand (BOD5), Chemical Oxygen Demand (COD), Total Suspended Solids (TDS),Turbidity, Temperature, Nitrates (NO3) and Phosphates (PO4) were estimated at the two stations. The results show a downward trend in the water quality at the down stream of the city. The amounts of BOD5,COD,TSS,T,Turbidity, NO3 and PO4 in the down stream stations were considerably more than the station 1. By contrast the amounts of DO in the down stream stations were less than to the station 1. However when effluent discharge consequence of human activities are released into the Beshar river near the city, the quality of river are decreases and the environmental problems of the river during the next years are predicted to rise.

Detection of Legionella pneumophila in Cooling Water Systems of Hospitals and Nursing Homes of Kerman City, Iran by Semi- Nested PCR

Legionella pneumophila is involved in more than 95% cases of severe atypical pneumonia. Infection is mainly by inhalation the indoor aerosols through the water-coolant systems. Because some Legionella strains may be viable but not culturable, therefore, Taq polymerase, DNA amplification and semi-nested-PCR were carried out to detect Legionella-specific 16S-rDNA sequence. For this purpose, 1.5 litter of water samples from 77 water-coolant system were collected from four different hospitals, two nursing homes and one student hostel in Kerman city of Iran, each in a brand new plastic bottle during summer season of 2006 (from April to August). The samples were filtered in the sterile condition through the Millipore Membrane Filter. DNA was extracted from membrane and used for PCR to detect Legionella spp. The PCR product was then subjected to semi-nested PCR for detection of L. pneumophila. Out of 77 water samples that were tested by PCR, 30 (39%) were positive for most species of Legionella. However, L. pneumophila was detected from 14 (18.2%) water samples by semi-nested PCR. From the above results it can be concluded that water coolant systems of different hospitals and nursing homes in Kerman city of Iran are highly contaminated with L. pneumophila spp. and pose serious concern. So, we recommend avoiding such type of coolant system in the hospitals and nursing homes.

Total Quality Management: The Socio- Demographic and Operational-Financial Determinants for Users- Perception of the Services Quality

The aim of this paper is to know the sociodemographic and operational-financial determinants of the services quality perceived by users of the national health services. Through the use of an inquiry conducted by the Ministry of Health, comprehending 16.936 interviews in 2006, we intend to find out if there is any characteristic that determines the 2006 inquiry results. With the revision of the literature we also want to know if the operational-financial results have implications in hospitals users- perception on the quality of the received services. In order to achieve our main goals we will make use of the regression analysis to find out the possible dimensions that determine those results.

The Corporate Integration of Highly Skilled Professionals - A Social Capital Perspective

Not with standing the importance of foreign highly skilled professionals for host economies, there is a paucity of research studies investigating the role of the corporate social context during the integration process. This research aims to address this paucity by exploring the role of social capital in the integration of foreign health professionals. It does so by using a qualitative research approach. In this pilot study the hospital sector forms this study-s sample and interviews were conducted with HR managers, foreign health professionals and external HR consultants. It was found that most of the participating hospitals had not established specific HR practices and had only partly linked the development of organisational social capital with a successful integration process. This research contributes, for example, to the HR literature on the integration of self-initiated expatriates by analysing the role of HRM in generating organisational social capital needed for a successful integration process.

Improving Patients Discharge Process in Hospitals by using Six Sigma Approach

The need to increase the efficiency of health care systems is becoming an obligation, and one of area of improvement is the discharge process. The objective of this work is to minimize the patients discharge time (for insured patients) to be less than 50 minutes by using six sigma approach, this improvement will also: lead to an increase in customer satisfaction, increase the number of admissions and turnover on the rooms, increase hospital profitability.Three different departments were considered in this study: Female, Male, and Paediatrics. Six Sigma approach coupled with simulation has been applied to reduce the patients discharge time for pediatrics, female, and male departments at hospital. Upon applying these recommendations at hospital: 60%, 80%, and 22% of insured female, male, and pediatrics patients respectively will have discharge time less than the upper specification time i.e. 50 min.

Work Engagement of Malaysian Nurses: Exploring the Impact of Hope and Resilience

The purpose of this study was to investigate the relationship between hope and resilience with work engagement. A total of 422 staff nurses working in three public hospitals in Peninsular Malaysia participated in this study. Statistical results using regression analysis revealed that hope and resilience were positively related to work engagement. Possible reasons for these findings, as well as their implications and future research directions are discussed.

Determination of a Fair Price for Blood Transportation by Applying the Vehicle Routing Problem: A Case for National Blood Center, Thailand

The National Blood Center, Thai Red Cross Society is responsible for providing blood to hospitals all over the country. When any hospital needs blood, it will have to send the vehicle to pick up at the NBC. There are a lot of vehicles to pick up blood at the NBC every day. Each vehicle is usually empty for inbound trip and a little loaded for outbound. The NBC realized such waste or loss and there have been the third party offered to distribute blood and charge for fee. This paper proposes to apply the vehicle routing problem (VRP) for estimating the fair price. The idea is tested with the real data during seven-day period of 6 – 12 July 2010 to estimate the fair price for transporting blood in Bangkok Metropolitan Region.

Analysis of Plasmids and Restriction Fragment Length Polymorphisms of Acinetobacter baumannii Isolated from Hospitals- AL Jouf Region- KSA

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.

Job Stressors and Coping Mechanisms among Emergency Department Nurses in the Armed Force Hospitals of Taiwan

Nurses in an Armed Force Hospital (AFH) expose to stronger stress than those in a civil hospital, especially in an emergency department (ED). Ironically, stresses of these nurses received few if any attention in academic research in the past. This study collects 227 samples from the emergency departments of four armed force hospitals in central and southern Taiwan. The research indicates that the top five stressors are a massive casualty event, delayed physician support, overloads of routine work, overloads of assignments, and annoying paper work. Excessive work loading was found to be the primary source of stress. Nurses who were perceived to have greater stress levels were more inclined to deploy emotion-oriented approaches and more likely to seek job rotations. Professional stressors and problem-oriented approaches were positively correlated. Unlike other local studies, this study concludes that the excessive work-loading is more stressful in an AFH.

Standard Deviation of Mean and Variance of Rows and Columns of Images for CBIR

This paper describes a novel and effective approach to content-based image retrieval (CBIR) that represents each image in the database by a vector of feature values called “Standard deviation of mean vectors of color distribution of rows and columns of images for CBIR". In many areas of commerce, government, academia, and hospitals, large collections of digital images are being created. This paper describes the approach that uses contents as feature vector for retrieval of similar images. There are several classes of features that are used to specify queries: colour, texture, shape, spatial layout. Colour features are often easily obtained directly from the pixel intensities. In this paper feature extraction is done for the texture descriptor that is 'variance' and 'Variance of Variances'. First standard deviation of each row and column mean is calculated for R, G, and B planes. These six values are obtained for one image which acts as a feature vector. Secondly we calculate variance of the row and column of R, G and B planes of an image. Then six standard deviations of these variance sequences are calculated to form a feature vector of dimension six. We applied our approach to a database of 300 BMP images. We have determined the capability of automatic indexing by analyzing image content: color and texture as features and by applying a similarity measure Euclidean distance.

Effect of Cold, Warm or Contrast Therapy on Controlling Knee Osteoarthritis Associated Problems

Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering  sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.

Acute Coronary Syndrome Prediction Using Data Mining Techniques- An Application

In this paper we use data mining techniques to investigate factors that contribute significantly to enhancing the risk of acute coronary syndrome. We assume that the dependent variable is diagnosis – with dichotomous values showing presence or  absence of disease. We have applied binary regression to the factors affecting the dependent variable. The data set has been taken from two different cardiac hospitals of Karachi, Pakistan. We have total sixteen variables out of which one is assumed dependent and other 15 are independent variables. For better performance of the regression model in predicting acute coronary syndrome, data reduction techniques like principle component analysis is applied. Based on results of data reduction, we have considered only 14 out of sixteen factors.

ISTER (Immune System - Tumor Efficiency Rate): An Important Key for Planning in Radiotherapic Facilities

The use of the oncologic index ISTER allows for a more effective planning of the radiotherapic facilities in the hospitals. Any change in the radiotherapy treatment, due to unexpected stops, may be adapted by recalculating the doses to the new treatment duration while keeping the optimal prognosis. The results obtained in a simulation model on millions of patients allow the definition of optimal success probability algorithms.