Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) ...Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.展开更多
BACKGROUND Liver transplantation(LT)is a life-saving procedure for patients with end-stage liver disease and has become the standard and most effective treatment method for these patients.There are many indications fo...BACKGROUND Liver transplantation(LT)is a life-saving procedure for patients with end-stage liver disease and has become the standard and most effective treatment method for these patients.There are many indications for LT that vary between countries and settings.The outcome of LT depends on the available facilities and surgical expertise,as well as the types of liver graft donors available.AIM To assess the clinical characteristics of patients from Bahrain who underwent LT overseas,and analyze factors affecting their survival.METHODS In this retrospective cohort study,we reviewed the medical records and overseas committee registry information of all pediatric and adult patients who were sent overseas to undergo LT by the Pediatric and Medical Departments of Salmaniya Medical Complex and Bahrain Defence Force Hospital via the Overseas Treatment Office,Ministry of Health,Kingdom of Bahrain,between 1997 and 2023.Demographic data,LT indication,donor-recipient relationship,overseas LT center,graft type,post-LT medications,and LT complications,were collected.Outcomes measured included the overall and 5-year LT survival rate.Fisher’s exact,Pearsonχ2,and Mann-Whitney U tests were used to compare the pediatric and the adults’group in terms of clinical characteristics,donor-recipient relationship,medication,complications,and outcome.Survival analysis was estimated via the Kaplan-Meier’s method.Univariate and multivariate analyses were used to detect predictors of survival.RESULTS Of the 208 eligible patients,170(81.7%)were sent overseas to undergo LT while 38(18.3%)remained on the waiting list.Of the 170 patients,167(80.3%)underwent LT and were included in the study.The majority of the patients were Bahraini(91.0%),and most were males(57.5%).One-hundred-and-twenty(71.8%)were adults and 47(28.3%)were children.The median age at transplant was 50.0[interquartile range(IQR):14.9–58.4]years.The main indication for pediatric LT was biliary atresia(31.9%),while that of adult LT was hepatitis C-related cirrhosis(35.0%).Six(3.6%)patients required re-transplantation.Most patients received a living-related liver graft(82%).Pediatric patients received more living and related grafts than adults(P=0.038 and P=0.041,respectively),while adult patients received more cadaveric and unrelated grafts.Most patients required long-term immunosuppressive therapy after LT(94.7%),of which tacrolimus was the most prescribed(84.0%),followed by prednisolone(50.7%),which was prescribed more frequently for pediatric patients(P=0.001).Most patients developed complications(62.4%)with infectious episodes being the most common(38.9%),followed by biliary stricture(19.5%).Tonsilitis and sepsis(n=12,8.1%for each)were the most frequent infections.Pediatric patients experienced higher rates of infection,rejection,and early poor graft function than adult patients(P<0.001,P=0.003,and P=0.025,respectively).The median follow-up time was 6.5(IQR:2.6–10.6)years.The overall survival rate was 84.4%,the 5-year survival rate,86.2%,and the mortality rate,15.6%.Younger patients had significantly better odds of survival(P=0.019)and patients who survived had significantly longer follow-up periods(P<0.001).CONCLUSION Patients with end-stage liver disease in Bahrain shared characteristics with those from other countries.Since LT facilities are not available,an overseas LT has offered them great hope.展开更多
Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after ho...Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after hospitalization, or it can determine the level of assistance required after discharge from a skilled nursing facility (SNF). We believe that comprehensive rehabilitation can improve a patient’s overall functioning during their short term stay in SNFs. The purpose of this study is to determine if an individual’s level of independence improved after admission to a skilled nursing facility and procurement of rehabilitation services. Methods: This study retrospectively reviewed 4612 nursing home patients in California who underwent rehabilitative services at skilled nursing facilities to determine how the patients responded to their environments, therapy interventions, and any other additional supportive measures. The records of patients who were admitted for short-term rehabilitation were reviewed in a blinded fashion, looking specifically at Section GG of the Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative staff provide objective data and measure patients’ levels of assistance that were required. Each activity is scored from 1, being completely dependent, to 6, being entirely independent, with varying levels of assistance with scores in between. The admission scores versus the discharge scores can be compared to determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of improvement in ADL performance on Section GG between the admission and discharge scores was identified, implying significant improvement in functional independence upon discharge. The average percent improvement for Managed Care patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The results support the benefits of rehabilitation services in skilled nursing facilities, and the data suggests that admission scores can be used as a predictive tool for functional outcomes.展开更多
Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often r...Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient outcomes.展开更多
Patients’ satisfaction with waiting time and the facilities in eye clinics is an important indication of the patients’ assessment of the quality of service in the eye clinic. In this study, waiting time was defined ...Patients’ satisfaction with waiting time and the facilities in eye clinics is an important indication of the patients’ assessment of the quality of service in the eye clinic. In this study, waiting time was defined as time spent from arrival to time when the patient is seen by a doctor. Some factors that affect patients’ waiting time in health clinics include: healthcare setting, availability of adequate resources and personnel, efficient deployment of available resources and competence of healthcare workers, and punctuality of healthcare workers. The physical environment, comfort of patients, and level of infrastructure in the hospital also influence patients’ satisfaction. This observational, descriptive, cross-sectional study was conducted among patients that attended an eye care clinic, in a tertiary hospital, and 348 respondents were interviewed. Most of the respondents were aged 40 years and above (64.4%), females (63.5%), Igbos by tribe (94.8%), married (63.2%), Christians (96.6%), and had at least a secondary level of education (78.4%). Most perceived waiting time as being very long or long (60.1%), and only 48.8 were satisfied or very satisfied with the waiting time. Most also perceived the cleanliness of the eye clinic as being clean or very clean (85.0%), and 70.7% perceived the ventilation as being adequate or very adequate. The majority reported that a health talk was given (71.6%), and 62.7% were satisfied or very satisfied with the talk. More respondents (46.8%) perceived the waiting space as very inadequate or inadequate, as against 43.4% that perceived it as adequate or very adequate. More reported that prescribed drugs were completely unavailable or few available (48.0%), while 42.3% reported drugs as being reasonably or completely available. It is important that management of health facilities that offer eye care services, work towards improving patients’ perception and satisfaction with services provided in the eye clinics.展开更多
In this study,information on energy usage in the United States(U.S.)aerospace manufacturing sector has been analyzed and then represented as energy intensities(kWh/m2)to establish benchmark data and to compare facilit...In this study,information on energy usage in the United States(U.S.)aerospace manufacturing sector has been analyzed and then represented as energy intensities(kWh/m2)to establish benchmark data and to compare facilities of varying sizes.First,public sources were identified and the data from these previously published sources were aggregated to determine the energy usage of aerospace manufacturing facilities within the U.S.From this dataset,a sample of 28 buildings were selected and the energy intensity for each building was estimated from the data.Next,as a part of this study the energy data for three additional aerospace manufacturing facilities in the U.S.were collected firsthand.That data was analyzed and the energy intensity(kWh/m2)for each facility was calculated and then compared with the energy intensities of the 28 buildings from the sample.Three different indicators of energy consumption in aerospace manufacturing facilities were used as comparators to assist facility managers with determining potential energy savings and help in the decision-making process.On average,aerospace manufacturing facilities in the United States spent 4 cents for each dollar of sale on energy.The energy intensity(kWh/m2)and the power intensity(W/m2)for each facility were calculated based on the actual facility energy bills.The power intensity for these facilities ranges from 34 to 134 W/m2.The energy intensity ranged from 232 to 949 kWh/m2.We found that the power intensity could be used to estimate energy consumption when the annual operating hours of the facility are considered.and to estimate the energy-related carbon dioxide emissions.展开更多
This research assessed the environmental impact of cement silos emission on the existing concrete batching facilities in M35-Mussafah, Abu Dhabi, United Arab Emirates. These assessments were conducted using an air qua...This research assessed the environmental impact of cement silos emission on the existing concrete batching facilities in M35-Mussafah, Abu Dhabi, United Arab Emirates. These assessments were conducted using an air quality dispersion model (AERMOD) to predict the ambient concentration of Portland Cement particulate matter less than 10 microns (PM<sub>10</sub>) emitted to the atmosphere during loading and unloading activities from 176 silos located in 25 concrete batching facilities. AERMOD was applied to simulate and describe the dispersion of PM<sub>10</sub> released from the cement silos into the air. Simulations were carried out for PM<sub>10</sub> emissions on controlled and uncontrolled cement silos scenarios. Results showed an incremental negative impact on air quality and public health from uncontrolled silos emissions and estimated that the uncontrolled PM<sub>10</sub> emission sources contribute to air pollution by 528958.32 kg/Year. The modeling comparison between the controlled and uncontrolled silos shows that the highest annual average concentration from controlled cement silos is 0.065 μg/m<sup>3</sup>, and the highest daily emission value is 0.6 μg/m<sup>3</sup>;both values are negligible and will not lead to significant air quality impact in the entire study domain. However, the uncontrolled cement silos’ highest annual average concentration value is 328.08 μg/m<sup>3</sup>. The highest daily emission average value was 1250.09 μg/m<sup>3</sup>;this might cause a significant air pollution quality impact and health effects on the public and workers. The short-term and long-term average PM<sub>10</sub> pollutant concentrations at these receptors predicted by the air dispersion model are discussed for both scenarios and compared with local and international air quality standards and guidelines.展开更多
With the successful holding of Beijing Winter Olympic Games in 2022,the planning and cultural services of Shijingshan District have been reviewed,but the systematic planning theory has not been fully applied.Through t...With the successful holding of Beijing Winter Olympic Games in 2022,the planning and cultural services of Shijingshan District have been reviewed,but the systematic planning theory has not been fully applied.Through the big data research method,the location advantages and disadvantages of Shijingshan District were analyzed,and the distribution of its cultural facilities was defined.Feasible optimization schemes were proposed according to its advantages and disadvantages as well as the experience and conditions of the Winter Olympics.展开更多
The international efforts to limit climate change are increasing, that during the COP26 convention, reaching Net Zero Greenhouse Gas emissions became part of the global goals for many countries and entities. One of th...The international efforts to limit climate change are increasing, that during the COP26 convention, reaching Net Zero Greenhouse Gas emissions became part of the global goals for many countries and entities. One of the sectors that holds the responsibility of addressing the impacts of climate change is the healthcare sector, and accordingly, it is also encouraged to take a leading role in maintaining its sustainability and be a role model for the other sectors. Additionally, the buildings sector, through the World Green Building council, has taken the initiative to launch the Net Zero Carbon Buildings Commitment for the sector. Based on these practices, the work presented aims to introduce and formulate an Approaching Net Zero assessment methodology to be integrated as part of the sustainability criteria and rating system for healthcare facilities in developing countries. The methodology planned is based on four different aspects which are: 1) Approaching Net Zero Energy, 2) Approaching Net Zero Wastewater, 3) Approaching Net Zero Solid Waste, and 4) Approaching Net Zero GHG emissions. The facility should have achieved a Green Building certification through any certification body, and then apply for the aspect on which it requires to be assessed. The assessment methodology follows a systematic approach, where a baseline year of normal operation is determined for existing facilities to act as a base of assessment, and normal design practices for new facilities Based on the assessment and proof of performance enhancement, the facility will either be awarded a basic certificate for achieving continuous savings, or additionally be awarded a best performance certificate compared to other facilities in the same category.展开更多
Background and Objective: Nowadays, the clinical utility of carbapenems is threatened by the emergence of resistant bacteria, favored by its increasing use. According to the WHO, Acinetobacter baumannii: nosocomial in...Background and Objective: Nowadays, the clinical utility of carbapenems is threatened by the emergence of resistant bacteria, favored by its increasing use. According to the WHO, Acinetobacter baumannii: nosocomial infection agent, tops the list of priority antibiotic-resistant pathogens, considered to be the riskiest for humans. This study sought to determine the prevalence of carbapenemase-producing Acinetobacter baumannii strains in four health facilities in the Center and Littoral regions of Cameroon and the associated risk factors. Materials and Method: An analytical cross-sectional study was conducted over a six-month period from January to June 2022. All suspicious A. baumanii isolates obtained from pathological samples at the bacteriology laboratory of the different health facilities were systematically collected and re-identified. Re-identification and antimicrobial susceptibility Testing (AST) were performed using the VITEK 2 System and the Kirby-Bauer method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Detection and phenotypic characterization of carbapenemases was performed according to adequate standard procedures. Results: A total of 168/226 clinical isolates of Acinetobacter baumannii were confirmed after re-identification, among which 52.69% derived from male patients, 55.09% from participants aged between 10 - 39 years old, and 46.71% from pus samples. A very high resistance rates to all families of antibiotics was noted, except to colistin (10.2%). 40.12% of these isolates produced carbapenemase, represented by 62.69% of class B and 37.31% of class A. Carbapenemase production was observed only at HMR1, Centre region and at Laquintinie hospital, Littoral region with 53.33% and 50% respectively, even if there is no significant difference (P = 0.81). In addition, frequent hospitalisation was significantly associated to the production of carbapenemase among A. baumanii (Adjusted-OR = 16.53, P-value 0.0001). Conclusion: This study highlighted the emergence of carbapenemase-producing Acinetobacter baumannii which is increasingly growing. Continuous drug-resistant monitoring and preventive measures could help to prevent and curb the dissemination of A. baumanii resistance genes, especially in health settings.展开更多
The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in ...The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in health care institutions (HCI in short) that have benefited from the primary health care support project (ASSP in short) after formative supervision. This is a descriptive study by periodic clinical audit between 2020 and 2022, carried out in 96 HCI in 3 provincial health divisions (DPS in short) of DR Congo. Each photographed partogram page was sent to the project’s central level for review by a team of experts (3 obstetric gynecologists and 3 midwives). The compliance rate for completing partograms in the 96 health facilities of the 3 DPS was 86.8%. The rate of traceability of labor continuity was 88.2%, and that of traceability of acts, incidents and treatments during labor was 87.1%. Finally, the compliance rate for filling out partograms in the immediate post-partum period was 81%. A clear improvement was noted between the January 2020 and March 2022 assessments.展开更多
In the case of major public emergencies, the ability of cities to resist shocks becomes very important and reflects urban resilience. This paper selected the supply guarantee facilities during the city-wide lockdown o...In the case of major public emergencies, the ability of cities to resist shocks becomes very important and reflects urban resilience. This paper selected the supply guarantee facilities during the city-wide lockdown of Shanghai during March-May 2022 due to COVID-19 pandemic as the research object. In this research, the per capita supply guarantee capacity and supply guarantee overlay intensity were analyzed based on the official list of facilities, and the actual role of the supply guarantee facilities was investigated through a public research questionnaire. The thermodynamic diagram map that was generated based on phone visits reflected the actual distribution of the population. Then the level of “supply guarantee resilience” was evaluated and graded for each district of Shanghai. It was concluded that the overall level of supply guarantee resilience was high in the central city, divergence in the near suburban districts, and generally low in the remote suburban districts. Based on this, the paper summarized the problems of supply guarantee revealed in Shanghai during the epidemic lockdown as well as proposed strategies to improve the resilience of similar scenarios in the future. With the help of big data and public research tools, this paper aimed to provide ways and methods to evaluate the resilience of cities under major public emergencies.展开更多
This research study quantifies the PM<sub>10</sub> emission rates (g/s) from cement silos in 25 concrete batching facilities for both controlled and uncontrolled scenarios by applying the USEPA AP-42 guide...This research study quantifies the PM<sub>10</sub> emission rates (g/s) from cement silos in 25 concrete batching facilities for both controlled and uncontrolled scenarios by applying the USEPA AP-42 guidelines step-by-step approach. The study focuses on evaluating the potential environmental impact of cement dust fugitive emissions from 176 cement silos located in 25 concrete batching facilities in the M35 Mussafah industrial area of Abu Dhabi, UAE. Emission factors are crucial for quantifying the PM<sub>10</sub> emission rates (g/s) that support developing source-specific emission estimates for areawide inventories to identify major sources of pollution that provide screening sources for compliance monitoring and air dispersion modeling. This requires data to be collected involves information on production, raw material usage, energy consumption, and process-related details, this was obtained using various methods, including field visits, surveys, and interviews with facility representatives to calculate emission rates accurately. Statistical analysis was conducted on cement consumption and emission rates for controlled and uncontrolled sources of the targeted facilities. The data shows that the average cement consumption among the facilities is approximately 88,160 (MT/yr), with a wide range of variation depending on the facility size and production rate. The emission rates from controlled sources have an average of 4.752E<sup>-04</sup> (g/s), while the rates from uncontrolled sources average 0.6716 (g/s). The analysis shows a significant statistical relationship (p < 0.05) and perfect positive correlation (r = 1) between cement consumption and emission rates, indicating that as cement consumption increases, emission rates tend to increase as well. Furthermore, comparing the emission rates from controlled and uncontrolled scenarios. The data showed a significant difference between the two scenarios, highlighting the effectiveness of control measures in reducing PM<sub>10</sub> emissions. The study’s findings provide insights into the impact of cement silo emissions on air quality and the importance of implementing control measures in concrete batching facilities. The comparative analysis contributes to understanding emission sources and supports the development of pollution control strategies in the Ready-Mix industry.展开更多
Teaching security management is important for institutions to effectively manage teaching resources.This article takes Xi’an Mingde Institute of Technology(referred to as Mingde Institute)as the research subject and ...Teaching security management is important for institutions to effectively manage teaching resources.This article takes Xi’an Mingde Institute of Technology(referred to as Mingde Institute)as the research subject and uses the literature review and field investigation to put forward relevant suggestions for the teaching facilities of Mingde Institute,in order to improve the teaching facilities of Mingde Institute.展开更多
Facility agriculture is an essential carrier for promoting stable production and supply.In2020,the planting area of facility agriculture in Beijing(290098000 m2)accounted for 29.06%of the total planting area of crops(...Facility agriculture is an essential carrier for promoting stable production and supply.In2020,the planting area of facility agriculture in Beijing(290098000 m2)accounted for 29.06%of the total planting area of crops(998078000 m2),and the output value accounted for 46.56%.In2022,Beijing Agricultural Technology Extension Station organized relevant departments to summarize and evaluate the agricultural facilities in Beijing through consultation materials,interviews,questionnaires,and field trips,combining survey data and statistical data to draw the following conclusions.Facilities play a major supporting role in stabilizing production and ensuring supply.The number of traditional greenhouses is extensive and covers a large area,so special planning and classification upgrades are urgently needed.Facilities are rich in scientific and technological resources,but the mode of production is out of date.It is of great significance to improve the comprehensive production capacity of facility agriculture and promote the healthy and stable development of facility industry in Beijing to increase the utilization rate of facility agriculture land,strengthen the support of facility science and technology,and cultivate the socialized service organization of facility.展开更多
Objective:This systematized review aimed to synthesize the results of empirical studies focused on the types and factors of adverse events(AEs)that contribute to them in long-term care(LTC)settings.Methods:The search ...Objective:This systematized review aimed to synthesize the results of empirical studies focused on the types and factors of adverse events(AEs)that contribute to them in long-term care(LTC)settings.Methods:The search was conducted in Pro Quest,Scopus,and Pub Med in January 2021 and resulted in 1057 records.The content analysis method was used in the data analysis.Results:In all,35 studies were identified as relevant for the review.The analysis revealed 133 different types of AEs and 60 factors that contributed to them.Conclusions:In LTC,various AEs occur,most of which are preventable,while many factors that influence their occurrence could be significantly modifiable.Through an effective analysis of AEs in LTC,it is possible to minimize their occurrence and,at the same time,minimize their negative impact on all par ties concerned.展开更多
This paper studied the spatial accessibility of emergency facilities to road accident victims in Federal Capital City to determine the sufficiency of existing emergency health care facilities and rescue facilities in ...This paper studied the spatial accessibility of emergency facilities to road accident victims in Federal Capital City to determine the sufficiency of existing emergency health care facilities and rescue facilities in servicing accident victims. This is useful for developing means of saving the lives of accident victims in the Federal Fapital City (FCC). The data used comprised of Nigerian Sat II 2013 multispectral imagery (5 m multispectral and 2.5 m Panchromatic) of FCC obtained from the National Space Research and Development Agency (NARSDA), coordinates of seventy (70) accident black spots, five (5) zebra points and sixteen (16) emergency health care facilities obtained from Federal Road Safety Commission (FRSC). ArcGIS 10.0 software was used to display, visualize, identify and extract features from the imagery, and create maps from different layers of the spatial data, choose colors and symbols, create buffer zones, analyze spatial relationships, and design map layouts. Purposeful sampling method was adopted to administer 99 questionnaires to accident victims in the hospitals within the FCC. The spatial data were used to determine the time of rescue, type of rescue and coverage time of rescue operation. The statistical data were used to assess the spatio-temporal distribution of accidents and determine the level of response by the rescue teams. The results show that accident victims have adequate access to health facilities but inadequate access to zebra points, and passers-by have more effective accident response than the government action agencies. Specific points for the creation of additional zebra points were identified through buffering, and the creation of sustainable Good Samaritan programs and training for community persons in first aid were suggested. Meanwhile, further research to determine the impact of time of rescue, type of rescue and category of hospital on the accident victims was suggested.展开更多
The present work adopted Reliability Centered Maintenance (RCM) methodology to evaluate marginal oilfield Early Production Facility (EPF) system to properly understand its functional failures and to develop an efficie...The present work adopted Reliability Centered Maintenance (RCM) methodology to evaluate marginal oilfield Early Production Facility (EPF) system to properly understand its functional failures and to develop an efficient maintenance strategy for the system. The outcome of the RCM conducted for a typical EPF within the Niger Delta zone of Nigeria provides an indication of equipment whose failure can significantly affect operations at the production facility. These include the steam generation unit and the wellhead choke assembly, using a risk-based failure Criticality Analysis. Failure Mode and Effect Analysis (FMEA) was conducted for the identified critical equipment on a component basis. Each component of the equipment was analyzed to identify the failure modes, causes and the effect of the failure. The outcome of the FMEA analysis aided the development of a robust maintenance management strategy, which is based on an optimized mix of corrective, preventive and condition-based monitoring maintenance for the marginal oilfield EPF.展开更多
The overuse of injection exists more than 20 years since economic reform in China.It is a persistent problem and seems becoming a new challenge in the new health reform period.This study was designed to assess the eff...The overuse of injection exists more than 20 years since economic reform in China.It is a persistent problem and seems becoming a new challenge in the new health reform period.This study was designed to assess the effect of national essential medicines policy(NEMP) on injection use at primary health facilities in China by investigating their prescription information.Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011.The injection use was measured as the indicator as the percentage of prescriptions with one or more injections.The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82%(2 =11.158,P=0.001) in the all survey areas during the NEMP reform.The difference in level of the injection use in 2011 was significant among the eastern,central and western regions(2 =223.584,P=0.000);level of the injection use in western region was the lowest(27.73%),while that in the central region was the highest(43.10%).The level of the injection use in 2011 among different provinces was also of great difference(26.00%-58.25%,range:32.25%).The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries(13.4%-24.1%).It was concluded that NEMP has improved injection use in China,but the injection abuse situation remains serious,indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs,especially the injection use.展开更多
Comfort is one of the important indicators evaluation of voice. In order to understand the urban neighborhood public space environment of comfort,this paper is to explore characteristics of consumer society on the pub...Comfort is one of the important indicators evaluation of voice. In order to understand the urban neighborhood public space environment of comfort,this paper is to explore characteristics of consumer society on the public space environment evaluation of the effect,and using the questionnaire survey method,to evaluate the Harbin city neighborhood area public space as the typical case analysis. Based on one of the main sound source in neighborhood public space,environment,business facilities environment as the breakthrough point,it is to consider neighborhood public space environment evaluation and social characteristics.展开更多
文摘Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.
文摘BACKGROUND Liver transplantation(LT)is a life-saving procedure for patients with end-stage liver disease and has become the standard and most effective treatment method for these patients.There are many indications for LT that vary between countries and settings.The outcome of LT depends on the available facilities and surgical expertise,as well as the types of liver graft donors available.AIM To assess the clinical characteristics of patients from Bahrain who underwent LT overseas,and analyze factors affecting their survival.METHODS In this retrospective cohort study,we reviewed the medical records and overseas committee registry information of all pediatric and adult patients who were sent overseas to undergo LT by the Pediatric and Medical Departments of Salmaniya Medical Complex and Bahrain Defence Force Hospital via the Overseas Treatment Office,Ministry of Health,Kingdom of Bahrain,between 1997 and 2023.Demographic data,LT indication,donor-recipient relationship,overseas LT center,graft type,post-LT medications,and LT complications,were collected.Outcomes measured included the overall and 5-year LT survival rate.Fisher’s exact,Pearsonχ2,and Mann-Whitney U tests were used to compare the pediatric and the adults’group in terms of clinical characteristics,donor-recipient relationship,medication,complications,and outcome.Survival analysis was estimated via the Kaplan-Meier’s method.Univariate and multivariate analyses were used to detect predictors of survival.RESULTS Of the 208 eligible patients,170(81.7%)were sent overseas to undergo LT while 38(18.3%)remained on the waiting list.Of the 170 patients,167(80.3%)underwent LT and were included in the study.The majority of the patients were Bahraini(91.0%),and most were males(57.5%).One-hundred-and-twenty(71.8%)were adults and 47(28.3%)were children.The median age at transplant was 50.0[interquartile range(IQR):14.9–58.4]years.The main indication for pediatric LT was biliary atresia(31.9%),while that of adult LT was hepatitis C-related cirrhosis(35.0%).Six(3.6%)patients required re-transplantation.Most patients received a living-related liver graft(82%).Pediatric patients received more living and related grafts than adults(P=0.038 and P=0.041,respectively),while adult patients received more cadaveric and unrelated grafts.Most patients required long-term immunosuppressive therapy after LT(94.7%),of which tacrolimus was the most prescribed(84.0%),followed by prednisolone(50.7%),which was prescribed more frequently for pediatric patients(P=0.001).Most patients developed complications(62.4%)with infectious episodes being the most common(38.9%),followed by biliary stricture(19.5%).Tonsilitis and sepsis(n=12,8.1%for each)were the most frequent infections.Pediatric patients experienced higher rates of infection,rejection,and early poor graft function than adult patients(P<0.001,P=0.003,and P=0.025,respectively).The median follow-up time was 6.5(IQR:2.6–10.6)years.The overall survival rate was 84.4%,the 5-year survival rate,86.2%,and the mortality rate,15.6%.Younger patients had significantly better odds of survival(P=0.019)and patients who survived had significantly longer follow-up periods(P<0.001).CONCLUSION Patients with end-stage liver disease in Bahrain shared characteristics with those from other countries.Since LT facilities are not available,an overseas LT has offered them great hope.
文摘Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after hospitalization, or it can determine the level of assistance required after discharge from a skilled nursing facility (SNF). We believe that comprehensive rehabilitation can improve a patient’s overall functioning during their short term stay in SNFs. The purpose of this study is to determine if an individual’s level of independence improved after admission to a skilled nursing facility and procurement of rehabilitation services. Methods: This study retrospectively reviewed 4612 nursing home patients in California who underwent rehabilitative services at skilled nursing facilities to determine how the patients responded to their environments, therapy interventions, and any other additional supportive measures. The records of patients who were admitted for short-term rehabilitation were reviewed in a blinded fashion, looking specifically at Section GG of the Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative staff provide objective data and measure patients’ levels of assistance that were required. Each activity is scored from 1, being completely dependent, to 6, being entirely independent, with varying levels of assistance with scores in between. The admission scores versus the discharge scores can be compared to determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of improvement in ADL performance on Section GG between the admission and discharge scores was identified, implying significant improvement in functional independence upon discharge. The average percent improvement for Managed Care patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The results support the benefits of rehabilitation services in skilled nursing facilities, and the data suggests that admission scores can be used as a predictive tool for functional outcomes.
文摘Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient outcomes.
文摘Patients’ satisfaction with waiting time and the facilities in eye clinics is an important indication of the patients’ assessment of the quality of service in the eye clinic. In this study, waiting time was defined as time spent from arrival to time when the patient is seen by a doctor. Some factors that affect patients’ waiting time in health clinics include: healthcare setting, availability of adequate resources and personnel, efficient deployment of available resources and competence of healthcare workers, and punctuality of healthcare workers. The physical environment, comfort of patients, and level of infrastructure in the hospital also influence patients’ satisfaction. This observational, descriptive, cross-sectional study was conducted among patients that attended an eye care clinic, in a tertiary hospital, and 348 respondents were interviewed. Most of the respondents were aged 40 years and above (64.4%), females (63.5%), Igbos by tribe (94.8%), married (63.2%), Christians (96.6%), and had at least a secondary level of education (78.4%). Most perceived waiting time as being very long or long (60.1%), and only 48.8 were satisfied or very satisfied with the waiting time. Most also perceived the cleanliness of the eye clinic as being clean or very clean (85.0%), and 70.7% perceived the ventilation as being adequate or very adequate. The majority reported that a health talk was given (71.6%), and 62.7% were satisfied or very satisfied with the talk. More respondents (46.8%) perceived the waiting space as very inadequate or inadequate, as against 43.4% that perceived it as adequate or very adequate. More reported that prescribed drugs were completely unavailable or few available (48.0%), while 42.3% reported drugs as being reasonably or completely available. It is important that management of health facilities that offer eye care services, work towards improving patients’ perception and satisfaction with services provided in the eye clinics.
文摘In this study,information on energy usage in the United States(U.S.)aerospace manufacturing sector has been analyzed and then represented as energy intensities(kWh/m2)to establish benchmark data and to compare facilities of varying sizes.First,public sources were identified and the data from these previously published sources were aggregated to determine the energy usage of aerospace manufacturing facilities within the U.S.From this dataset,a sample of 28 buildings were selected and the energy intensity for each building was estimated from the data.Next,as a part of this study the energy data for three additional aerospace manufacturing facilities in the U.S.were collected firsthand.That data was analyzed and the energy intensity(kWh/m2)for each facility was calculated and then compared with the energy intensities of the 28 buildings from the sample.Three different indicators of energy consumption in aerospace manufacturing facilities were used as comparators to assist facility managers with determining potential energy savings and help in the decision-making process.On average,aerospace manufacturing facilities in the United States spent 4 cents for each dollar of sale on energy.The energy intensity(kWh/m2)and the power intensity(W/m2)for each facility were calculated based on the actual facility energy bills.The power intensity for these facilities ranges from 34 to 134 W/m2.The energy intensity ranged from 232 to 949 kWh/m2.We found that the power intensity could be used to estimate energy consumption when the annual operating hours of the facility are considered.and to estimate the energy-related carbon dioxide emissions.
文摘This research assessed the environmental impact of cement silos emission on the existing concrete batching facilities in M35-Mussafah, Abu Dhabi, United Arab Emirates. These assessments were conducted using an air quality dispersion model (AERMOD) to predict the ambient concentration of Portland Cement particulate matter less than 10 microns (PM<sub>10</sub>) emitted to the atmosphere during loading and unloading activities from 176 silos located in 25 concrete batching facilities. AERMOD was applied to simulate and describe the dispersion of PM<sub>10</sub> released from the cement silos into the air. Simulations were carried out for PM<sub>10</sub> emissions on controlled and uncontrolled cement silos scenarios. Results showed an incremental negative impact on air quality and public health from uncontrolled silos emissions and estimated that the uncontrolled PM<sub>10</sub> emission sources contribute to air pollution by 528958.32 kg/Year. The modeling comparison between the controlled and uncontrolled silos shows that the highest annual average concentration from controlled cement silos is 0.065 μg/m<sup>3</sup>, and the highest daily emission value is 0.6 μg/m<sup>3</sup>;both values are negligible and will not lead to significant air quality impact in the entire study domain. However, the uncontrolled cement silos’ highest annual average concentration value is 328.08 μg/m<sup>3</sup>. The highest daily emission average value was 1250.09 μg/m<sup>3</sup>;this might cause a significant air pollution quality impact and health effects on the public and workers. The short-term and long-term average PM<sub>10</sub> pollutant concentrations at these receptors predicted by the air dispersion model are discussed for both scenarios and compared with local and international air quality standards and guidelines.
基金Sponsored by the General Project of Beijing Higher Education Association in 2022(MS2022414)Innovation and Entrepreneurship Training Planning Project for University Students in 2023。
文摘With the successful holding of Beijing Winter Olympic Games in 2022,the planning and cultural services of Shijingshan District have been reviewed,but the systematic planning theory has not been fully applied.Through the big data research method,the location advantages and disadvantages of Shijingshan District were analyzed,and the distribution of its cultural facilities was defined.Feasible optimization schemes were proposed according to its advantages and disadvantages as well as the experience and conditions of the Winter Olympics.
文摘The international efforts to limit climate change are increasing, that during the COP26 convention, reaching Net Zero Greenhouse Gas emissions became part of the global goals for many countries and entities. One of the sectors that holds the responsibility of addressing the impacts of climate change is the healthcare sector, and accordingly, it is also encouraged to take a leading role in maintaining its sustainability and be a role model for the other sectors. Additionally, the buildings sector, through the World Green Building council, has taken the initiative to launch the Net Zero Carbon Buildings Commitment for the sector. Based on these practices, the work presented aims to introduce and formulate an Approaching Net Zero assessment methodology to be integrated as part of the sustainability criteria and rating system for healthcare facilities in developing countries. The methodology planned is based on four different aspects which are: 1) Approaching Net Zero Energy, 2) Approaching Net Zero Wastewater, 3) Approaching Net Zero Solid Waste, and 4) Approaching Net Zero GHG emissions. The facility should have achieved a Green Building certification through any certification body, and then apply for the aspect on which it requires to be assessed. The assessment methodology follows a systematic approach, where a baseline year of normal operation is determined for existing facilities to act as a base of assessment, and normal design practices for new facilities Based on the assessment and proof of performance enhancement, the facility will either be awarded a basic certificate for achieving continuous savings, or additionally be awarded a best performance certificate compared to other facilities in the same category.
文摘Background and Objective: Nowadays, the clinical utility of carbapenems is threatened by the emergence of resistant bacteria, favored by its increasing use. According to the WHO, Acinetobacter baumannii: nosocomial infection agent, tops the list of priority antibiotic-resistant pathogens, considered to be the riskiest for humans. This study sought to determine the prevalence of carbapenemase-producing Acinetobacter baumannii strains in four health facilities in the Center and Littoral regions of Cameroon and the associated risk factors. Materials and Method: An analytical cross-sectional study was conducted over a six-month period from January to June 2022. All suspicious A. baumanii isolates obtained from pathological samples at the bacteriology laboratory of the different health facilities were systematically collected and re-identified. Re-identification and antimicrobial susceptibility Testing (AST) were performed using the VITEK 2 System and the Kirby-Bauer method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Detection and phenotypic characterization of carbapenemases was performed according to adequate standard procedures. Results: A total of 168/226 clinical isolates of Acinetobacter baumannii were confirmed after re-identification, among which 52.69% derived from male patients, 55.09% from participants aged between 10 - 39 years old, and 46.71% from pus samples. A very high resistance rates to all families of antibiotics was noted, except to colistin (10.2%). 40.12% of these isolates produced carbapenemase, represented by 62.69% of class B and 37.31% of class A. Carbapenemase production was observed only at HMR1, Centre region and at Laquintinie hospital, Littoral region with 53.33% and 50% respectively, even if there is no significant difference (P = 0.81). In addition, frequent hospitalisation was significantly associated to the production of carbapenemase among A. baumanii (Adjusted-OR = 16.53, P-value 0.0001). Conclusion: This study highlighted the emergence of carbapenemase-producing Acinetobacter baumannii which is increasingly growing. Continuous drug-resistant monitoring and preventive measures could help to prevent and curb the dissemination of A. baumanii resistance genes, especially in health settings.
文摘The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in health care institutions (HCI in short) that have benefited from the primary health care support project (ASSP in short) after formative supervision. This is a descriptive study by periodic clinical audit between 2020 and 2022, carried out in 96 HCI in 3 provincial health divisions (DPS in short) of DR Congo. Each photographed partogram page was sent to the project’s central level for review by a team of experts (3 obstetric gynecologists and 3 midwives). The compliance rate for completing partograms in the 96 health facilities of the 3 DPS was 86.8%. The rate of traceability of labor continuity was 88.2%, and that of traceability of acts, incidents and treatments during labor was 87.1%. Finally, the compliance rate for filling out partograms in the immediate post-partum period was 81%. A clear improvement was noted between the January 2020 and March 2022 assessments.
文摘In the case of major public emergencies, the ability of cities to resist shocks becomes very important and reflects urban resilience. This paper selected the supply guarantee facilities during the city-wide lockdown of Shanghai during March-May 2022 due to COVID-19 pandemic as the research object. In this research, the per capita supply guarantee capacity and supply guarantee overlay intensity were analyzed based on the official list of facilities, and the actual role of the supply guarantee facilities was investigated through a public research questionnaire. The thermodynamic diagram map that was generated based on phone visits reflected the actual distribution of the population. Then the level of “supply guarantee resilience” was evaluated and graded for each district of Shanghai. It was concluded that the overall level of supply guarantee resilience was high in the central city, divergence in the near suburban districts, and generally low in the remote suburban districts. Based on this, the paper summarized the problems of supply guarantee revealed in Shanghai during the epidemic lockdown as well as proposed strategies to improve the resilience of similar scenarios in the future. With the help of big data and public research tools, this paper aimed to provide ways and methods to evaluate the resilience of cities under major public emergencies.
文摘This research study quantifies the PM<sub>10</sub> emission rates (g/s) from cement silos in 25 concrete batching facilities for both controlled and uncontrolled scenarios by applying the USEPA AP-42 guidelines step-by-step approach. The study focuses on evaluating the potential environmental impact of cement dust fugitive emissions from 176 cement silos located in 25 concrete batching facilities in the M35 Mussafah industrial area of Abu Dhabi, UAE. Emission factors are crucial for quantifying the PM<sub>10</sub> emission rates (g/s) that support developing source-specific emission estimates for areawide inventories to identify major sources of pollution that provide screening sources for compliance monitoring and air dispersion modeling. This requires data to be collected involves information on production, raw material usage, energy consumption, and process-related details, this was obtained using various methods, including field visits, surveys, and interviews with facility representatives to calculate emission rates accurately. Statistical analysis was conducted on cement consumption and emission rates for controlled and uncontrolled sources of the targeted facilities. The data shows that the average cement consumption among the facilities is approximately 88,160 (MT/yr), with a wide range of variation depending on the facility size and production rate. The emission rates from controlled sources have an average of 4.752E<sup>-04</sup> (g/s), while the rates from uncontrolled sources average 0.6716 (g/s). The analysis shows a significant statistical relationship (p < 0.05) and perfect positive correlation (r = 1) between cement consumption and emission rates, indicating that as cement consumption increases, emission rates tend to increase as well. Furthermore, comparing the emission rates from controlled and uncontrolled scenarios. The data showed a significant difference between the two scenarios, highlighting the effectiveness of control measures in reducing PM<sub>10</sub> emissions. The study’s findings provide insights into the impact of cement silo emissions on air quality and the importance of implementing control measures in concrete batching facilities. The comparative analysis contributes to understanding emission sources and supports the development of pollution control strategies in the Ready-Mix industry.
基金This work was funded by Research on Teaching Guarantee of Mingde College Based on Undergraduate Qualified Teaching Evaluation(Fund number:JG2023YB05[Z])。
文摘Teaching security management is important for institutions to effectively manage teaching resources.This article takes Xi’an Mingde Institute of Technology(referred to as Mingde Institute)as the research subject and uses the literature review and field investigation to put forward relevant suggestions for the teaching facilities of Mingde Institute,in order to improve the teaching facilities of Mingde Institute.
基金supported by the Rural Revitalization Science and Technology Project of Beijing(No.20221230-01)Beijing Agriculture Innovation Consortium(No.BAIC 2022-1)。
文摘Facility agriculture is an essential carrier for promoting stable production and supply.In2020,the planting area of facility agriculture in Beijing(290098000 m2)accounted for 29.06%of the total planting area of crops(998078000 m2),and the output value accounted for 46.56%.In2022,Beijing Agricultural Technology Extension Station organized relevant departments to summarize and evaluate the agricultural facilities in Beijing through consultation materials,interviews,questionnaires,and field trips,combining survey data and statistical data to draw the following conclusions.Facilities play a major supporting role in stabilizing production and ensuring supply.The number of traditional greenhouses is extensive and covers a large area,so special planning and classification upgrades are urgently needed.Facilities are rich in scientific and technological resources,but the mode of production is out of date.It is of great significance to improve the comprehensive production capacity of facility agriculture and promote the healthy and stable development of facility industry in Beijing to increase the utilization rate of facility agriculture land,strengthen the support of facility science and technology,and cultivate the socialized service organization of facility.
文摘Objective:This systematized review aimed to synthesize the results of empirical studies focused on the types and factors of adverse events(AEs)that contribute to them in long-term care(LTC)settings.Methods:The search was conducted in Pro Quest,Scopus,and Pub Med in January 2021 and resulted in 1057 records.The content analysis method was used in the data analysis.Results:In all,35 studies were identified as relevant for the review.The analysis revealed 133 different types of AEs and 60 factors that contributed to them.Conclusions:In LTC,various AEs occur,most of which are preventable,while many factors that influence their occurrence could be significantly modifiable.Through an effective analysis of AEs in LTC,it is possible to minimize their occurrence and,at the same time,minimize their negative impact on all par ties concerned.
文摘This paper studied the spatial accessibility of emergency facilities to road accident victims in Federal Capital City to determine the sufficiency of existing emergency health care facilities and rescue facilities in servicing accident victims. This is useful for developing means of saving the lives of accident victims in the Federal Fapital City (FCC). The data used comprised of Nigerian Sat II 2013 multispectral imagery (5 m multispectral and 2.5 m Panchromatic) of FCC obtained from the National Space Research and Development Agency (NARSDA), coordinates of seventy (70) accident black spots, five (5) zebra points and sixteen (16) emergency health care facilities obtained from Federal Road Safety Commission (FRSC). ArcGIS 10.0 software was used to display, visualize, identify and extract features from the imagery, and create maps from different layers of the spatial data, choose colors and symbols, create buffer zones, analyze spatial relationships, and design map layouts. Purposeful sampling method was adopted to administer 99 questionnaires to accident victims in the hospitals within the FCC. The spatial data were used to determine the time of rescue, type of rescue and coverage time of rescue operation. The statistical data were used to assess the spatio-temporal distribution of accidents and determine the level of response by the rescue teams. The results show that accident victims have adequate access to health facilities but inadequate access to zebra points, and passers-by have more effective accident response than the government action agencies. Specific points for the creation of additional zebra points were identified through buffering, and the creation of sustainable Good Samaritan programs and training for community persons in first aid were suggested. Meanwhile, further research to determine the impact of time of rescue, type of rescue and category of hospital on the accident victims was suggested.
文摘The present work adopted Reliability Centered Maintenance (RCM) methodology to evaluate marginal oilfield Early Production Facility (EPF) system to properly understand its functional failures and to develop an efficient maintenance strategy for the system. The outcome of the RCM conducted for a typical EPF within the Niger Delta zone of Nigeria provides an indication of equipment whose failure can significantly affect operations at the production facility. These include the steam generation unit and the wellhead choke assembly, using a risk-based failure Criticality Analysis. Failure Mode and Effect Analysis (FMEA) was conducted for the identified critical equipment on a component basis. Each component of the equipment was analyzed to identify the failure modes, causes and the effect of the failure. The outcome of the FMEA analysis aided the development of a robust maintenance management strategy, which is based on an optimized mix of corrective, preventive and condition-based monitoring maintenance for the marginal oilfield EPF.
基金supported by the National Natural Science Foundation of China (No. 71173082)
文摘The overuse of injection exists more than 20 years since economic reform in China.It is a persistent problem and seems becoming a new challenge in the new health reform period.This study was designed to assess the effect of national essential medicines policy(NEMP) on injection use at primary health facilities in China by investigating their prescription information.Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011.The injection use was measured as the indicator as the percentage of prescriptions with one or more injections.The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82%(2 =11.158,P=0.001) in the all survey areas during the NEMP reform.The difference in level of the injection use in 2011 was significant among the eastern,central and western regions(2 =223.584,P=0.000);level of the injection use in western region was the lowest(27.73%),while that in the central region was the highest(43.10%).The level of the injection use in 2011 among different provinces was also of great difference(26.00%-58.25%,range:32.25%).The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries(13.4%-24.1%).It was concluded that NEMP has improved injection use in China,but the injection abuse situation remains serious,indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs,especially the injection use.
基金Sponsored by the National Science & Technology Pillar Program during the 12th Five-year Plan Period (Grant No.2013BAJ12B01)
文摘Comfort is one of the important indicators evaluation of voice. In order to understand the urban neighborhood public space environment of comfort,this paper is to explore characteristics of consumer society on the public space environment evaluation of the effect,and using the questionnaire survey method,to evaluate the Harbin city neighborhood area public space as the typical case analysis. Based on one of the main sound source in neighborhood public space,environment,business facilities environment as the breakthrough point,it is to consider neighborhood public space environment evaluation and social characteristics.
