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Respiratory diseases or lung diseases are becoming one of the leading causes of death in Malaysia and survivability among the elderly when they are hospitalized to these diseases are doubtful. The study aims to compare the efficiency of survival models which are semi-parametric and parametric models in the analysis of length of hospital stay for respiratory diseases in elderly (65 years old and above) patients until recovery and demographics factors associated with length of stay in the hospital. The study was carried out using data for hospital admission and discharge from all goverments hospitals in Malaysia. Cases among the elderly classified under respiratory diseases J00 to J99 from the year 2012 to 2020. Patients' data such as age, gender, ethnicity, marital status and class of respiratory diseases were also selected as potential prognostic factors for semiparametric and parametric models. The survival results for all models showed that patients with the increase in age, Chinese ethnicity, unmarried and admitted with other diseases of respiratory will have a shorter period of stay hence will increase the risk of do not recover during the period of stay in the hospital. It is found that lognormal model is a better fit model than the other semi-parametric by having the lowest AIC and BIC for the respiratory diseases in elderly patient's data. Parametric models may be used to be more accurate and precise results as an alternative to Cox Proportional Hazard Model. [ABSTRACT FROM AUTHOR]

The nutrition value of breast milk has been shown to provide a positive benefit for preterm infants such as improving immunity, reducing morbidity, and may affect preterm infants' length of hospital stay. However, lack of evidence in Indonesia that supported a correlation between early oral feeding and preterm infants' length of hospital stay. Therefore, this study was intended to investigate the correlation between early oral feeding using breast milk with preterm infants' length of hospital stay and investigate the moderator variables. An observational method was used as the study design. Data were retrieved from medical records from one hospital belonging to Central Java Province that is located in Purwokerto Town, Banyumas Regency, Central Java Province, Indonesia using a self-designed data collection sheet. The sample involved a convenience sample of 96 preterm infants who were treated in level 2 and 3 neonatal cares. Univariate analysis, Kolmogorov-Smirnov test, Spearman's Rank were used as the statistical analysis. The early oral feeding had a weak positive correlation with preterm infants' length of hospital stay after was controlled by infants' gestation and birth weight (r=.371, p=<0. 01, df=92). Infants gestational age and birth weight had a negative correlation with preterm infants' length of hospital stay (r=-.562, r=-.634, p=<0. 01). Healthcare professionals can support a shorter length of stay for premature infants by giving oral breast milk as early as possible for preterm infants who have shown readiness to feed. Further, healthcare professional should reduce the risk for preterm birth delivery since the young gestational age and low birth weight impacts on longer length of hospital stay. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to apply Lean and Six Sigma techniques in Indian hospital to investigate the barriers in length of stay (LOS) period of Intestinal obstruction patients. The Six Sigma's DMAIC (Define-Measure-Analyse-Improve-Control) procedure is being applied along with standard Lean tools. The detailed data of patients are observed over a period of eight months. The mean LOS is computed to be 11.55 days with standard deviation of 3.34 days. The value stream mapping is used to find various non-value added activities and Fishbone diagram is utilized to determine root causes of the process. Patient's feedback and GEMBA observations are used to validate the possible causes for the problem. It is observed that nearly 70% of total LOS is non-value added time and can be minimized to reduce the LOS. The waiting time for surgery, time for admission, time for discharge, lack of motivation from doctors, etc. are identified as root causes for the process. It is concluded that Lean and Six Sigma methodologies have great potential to produce clinically significant improvement for surgical patients. [ABSTRACT FROM AUTHOR]

Two similar patients undergoing the same procedure might follow different pathways inside a hospital. Some of this variation is expected, but too much variation is associated with increased adverse events. Currently, there are no standard methods to establish when variability for any given clinical process becomes excessive. In this study we use process mining techniques to describe clinical processes and calculate and visualise clinical variability. We selected a sample of patients undergoing elective coronary bypass surgery from the MIMIC dataset, represented their clinical processes in the form of traces, and calculated variability metrics for each process execution and for the complete set of processes. We then analysed the subset of processes with the highest and lowest relative variability and compared their clinical outcomes. We established that processes with the greatest variability were associated with longer length of stay (LOS) with a doseresponse relationship: the higher the variability, the longer the LOS. This study provides an effective way to estimate and visualise clinical variability and to understand its impact on patient relevant outcomes. [ABSTRACT FROM AUTHOR]

There is a large burden of diabetes in Western Sydney, and this descriptor is also valid for the inpatient population. Optimizing diabetes care in hospital is important to prevent inpatient morbidity. A surveillance system was developed to address this need and a diabetes dashboard was developed around a data model built around the patient journey that integrated key data feeds from the pathology, medication, and patient administration systems. This facilitated the rapid identification and triaging of individuals with diabetes. We evaluated this dashboard using high level clinical and financial indicators. This implementation resulted in an improved time to patient review, and a reduction in 28-day readmission rates but the inpatient length of hospital stay was unchanged. (116 words). [ABSTRACT FROM AUTHOR]

Recurrent AKI has been found common among hospitalized patients after discharge, and early prediction may allow timely intervention and optimized postdischarge treatment [1]. There are significant gaps in the literature regarding the risk prediction on the post-AKI population, and most current works only included a limited number of pre-selected variables [2]. In this study, we built and compared machine learning models using both knowledge-based and data-driven features in predicting the risk of recurrent AKI within 1-year of discharge. Our results showed that the additional use of data-driven features statistically improved the model performances, with best AUC=0.766 by using logistic regression. [ABSTRACT FROM AUTHOR]

While the proliferation of data-driven machine learning approaches has resulted in new opportunities for precision healthcare, there are a number of challenges associated with fully utilizing medical data, for example partly due to the heterogeneity of data modalities in electronic health records. Moreover, medical data often sits in data silos due to various regulatory, privacy, ethical, and legal considerations, which complicates efforts to fully utilize machine learning. Motivated by these challenges, we focus on clinical care--length of stay prediction and propose a Multimodal Federated Learning approach. The latter is designed to leverage both privacy-preserving federated learning and multimodal data to facilitate length of stay prediction. By applying this approach to a real-world medical dataset, we demonstrate the predictive power of our approach as well as how it can address the earlier discussed challenges. The findings also suggest the potential of the proposed multimodal federated learning approach for other similar healthcare settings. [ABSTRACT FROM AUTHOR]

While the outbreak of Covid-19 pandemic is a severe global health problem, health authorities are focusing on managing patients' treatment and healthcare facilities. The aim of this study is to investigate the relationship between personal characteristics, symptoms, and underlying diseases nominated as predictors, and the hospitalized duration of treatment for the patients contracted to Covid-19 as a dependent variable. To this purpose, patients have been divided into three categories of recovered, transferred, and death followed by developing separate regression models with the above-mentioned variables. Data have been collected for 1015 patients who were positively contracted to Covid-19 and received clinical treatment or intensive care. The results revealed that age causes significant effects on the hospitalized duration of treatment among the aforementioned contributing factors, so the health service managers can estimate the patient hospitalized duration based on the age even if the symptoms and underlying diseases may cause significant effects on the infection rate. [ABSTRACT FROM AUTHOR]

Telehealth is an alternative care delivery model to in-person care. It uses electronic information and telecommunication technologies to provide remote clinical care to patients, especially those living in rural areas that lack sufficient access to health care services. Like other areas of care affected by the COVID-19 pandemic, the prevalence of telehealth has increased in prenatal care. This study reports on telehealth use in prenatal care at a large academic medical center in Middle Tennessee, USA. We examine the electronic health records of over 2500 women to characterize 1) the volume of prenatal visits participating in telehealth, 2) disparities in obstetric patients using telehealth, and 3) the impact of telehealth use on obstetric outcomes, including duration of intrapartum hospital stays, preterm birth, Cesarean rate, and newborn birthweight. Our results show that telehealth mainly was used in the second and third trimesters, especially for consulting services. In addition, we found that certain demographics correlated with lower telehealth utilization, including patients who were under 26 years old, were Black and/or Hispanic, were on a state-sponsored health insurance program, and those who lived in urban areas. Furthermore, no significant differences were found on preterm birth and Cesarean between the patients who used telehealth in their prenatal care and those who did not. [ABSTRACT FROM AUTHOR]

Electronic Health Records offer an opportunity to improve patient care (in terms of quality and/or safety) by making available patient health information stored in a single Clinical Data Repository. We aimed to estimate the frequency of hypoglycemic recurrences in hospitalized adult patients in non-critical areas. We designed a cross sectional study with hospitalizations between 2017 and 2018, which included patients with at least one hypoglycemia health record (defined as a value <70 mg/dL, either by capillary glycemic monitoring or serum measurement). Recurrence was defined as those who presented a second event, with at least 2 hours of difference. We included 1884 patients, and 573 presented recurrences, yielding a global prevalence of 30.41% (95%CI 28.34-32.54). Due to the high frequency, it is important to identify vulnerable populations, to implement preventive measures to assist clinicians for decision-making tasks, as a clinical decision support system. [ABSTRACT FROM AUTHOR]

The terms correction and manipulation in the surgical management of scoliosis define a harmonization of several measures performed individually or simultaneously to realign a deformed spine into its normal state on sagittal or coronal views. Scoliosis surgical procedures are modified due to the fact that they are complex procedures with frequent complications and unsatisfactory surgical outcomes. This technique combines rod and screws corrective manipulations applied to each vertebral segment according to the pathobiomechanic state of the deformity to simplify the manipulation process and achieve a good surgical outcome. A preliminary experimental study was done on modifications to the screw application technique, rod application for vertebral segment maneuver techniques during manipulation, and connecting rod use. Surgical outcomes were compared between the rod and screw corrective manipulation (RSCM) and conventional techniques in patients who underwent corrective surgery for scoliosis. Twelve scoliosis patients who underwent the RSCM technique had better complication rates, operative time, estimated blood loss, length of hospital stay, and sagittal alignment correction outcome compared with the 15 scoliosis patients who underwent surgery via the conventional technique. The RSCM technique was not complex, and it was easy to apply and provided better corrective outcomes. Hence, this is a promising treatment of choice for the surgical management of scoliosis patients. [ABSTRACT FROM AUTHOR]

In the healthcare system, Coronary Artery Bypass Grafting (CABG) surgery is performed to treat coronary artery disease. Complications of CABG postoperative disease, which is called postoperative morbidity, affect the length of stay of the patient in the hospital. Therefore, predict the risk of patients experiencing postoperative morbidity is required to optimize the use of resources in the hospital. This study proposed about predicting the postoperative morbidity from patients who underwent CABG based on risk factors by using Bayes Factor and Naïve Bayes Classification. The Bayes Factor method is applied to determine the risk factors that affect the prolonged hospital stay of patients postoperatively. Then the Naïve Bayes Classification is applied to predict postoperative morbidity, which leads the patient to be treated for more than 4 days. Data were obtained from medical history of patients at the FundaCardio Foundation in Venezuela during the period 2010–2014. Based on the results of the Bayes factor calculation, risk factors that influenced the length of stay diagnosis in the hospital include elderly, blood transfusion of more than 2 units of PRCB (Packet of Red Cell Blood), New York Heart Association (NYHA) heart failure classification, extubation process, duration of surgery and length of stay at the ICU. By using the Naïve Bayes Classification, it was found that these risk factors lead the patient to be hospitalized for more than 4 days. The results of this classification can be a consideration for patients in determining the cost of the coverage and the premium of an insurance product. [ABSTRACT FROM AUTHOR]

It is important to effectively manage the allocation of limited resources such as beds in order to provide access to care in a timely manner. Bed capacity management is essential in delivering high-quality health care. The aim of this paper is to optimize the number of beds in the hospital, reduce length of stay, reduce discharge delays, and evaluate alternative solutions to bed management. This research mainly focuses on developing a discrete event simulation to help and support in decision making on scheduling staff and optimizing resources. Scenarios were tested to find out the effect of length of stay, queue length and waiting times of patients. Data required to build the model such as patients' length of stay, available resources, and processing times were collected from a public hospital. The results were found to be that the bottlenecks in the system is resulting from the over occupancy in wards (especially surgical wards) that is affecting the patient flow and overcrowding in the Emergency Department. OptQuest was used to optimize the number of beds in order to have bed utilization no less than 70% and no more than 85% which will give the optimal solution. In addition, four what-if scenarios were constructed and tested as solutions to be recommended to improve the system. [ABSTRACT FROM AUTHOR]

Health information exchange (HIE) is presumed to reduce medical expenditure and enhance operational efficiency by facilitating information sharing across healthcare providers, but mixed results have been found. We explore the role of physician agency in determining the value of HIE and focus on two important medical expenditures of a hospitalization episode (test expenditure and medication expenditure) and length of stay. Employing a natural experiment and the discharge data of a hospital, we find negative direct effects of availability of HIE on test expenditure and length of stay. We also find its negative externality on medication expenditure, such that more patients having access to HIE in a department would increase the medication expenditure of patients in the same department. We posit that the negative externality is caused by income loss but could be mitigated through efficiency improvements. Our analyses confirm our theoretical hypotheses. Implications for theory and practice are discussed. [ABSTRACT FROM AUTHOR]

In the United States alone, approximately 6.2 million children have asthma. Managing the care of pediatric patients presenting in the emergency department with asthma requires clinicians to access multiple locations within the electronic health record. This wealth of information makes it vital to develop methods for sifting through the clutter to information that is relevant to the specific task to be completed. Unfortunately, current information displays have not been developed to maximize provider efficiency when integrating information across a number of disparate locations. Using proven data display theories, we aimed to create a consolidated acute pediatric asthma display to aid in the patient's care with the goal of improving the efficiency and consistency by which they are treated - ultimately reducing the length of stay, complications, and morbidity in these patients. [ABSTRACT FROM AUTHOR]

Several definitions of chronic diseases exist. The objective is to reuse a nationwide medical-administrative database (PMSI) to estimate the lifespan of diagnostic codes, hence the chronicity of the corresponding diseases. We analyzed 162 million inpatient stays from 2008 to 2014, and estimate the lifespan of every ICD-10 code for every patient, identified by a unique imprint. We calculated 200 indicators for different time and survival values, and selected the ones that maximized the area under the ROC curve (AUC) drawn by comparison against 4 chronic disease classifications: CCI, ALD, result from the analysis of ICD-10 labels, and a handmade list. The best indicator was the time to reach a survival of 4.5%. It enables to get the following AUC: 78.9% compared with CCI, 90.3% compared with ALD, 75.1% compared with labels analysis, and 91.5% compared with the handmade list. This indicator enables to classify 23,349 ICD-10 codes from “most chronic” to “most acute”. The 100 most chronic codes are listed. [ABSTRACT FROM AUTHOR]

The amount of medical expenses incurred in health insurance is usually determined by the maximum frequency limit and the cost for each component. If this year's total outpatients for the diagnosis of typhoid fever is 500 patients and 239 patients are hospitalized with total incurred up to Rp 1.396.388.877, how the total incurred if next year there is an increase risk incidence of hospitalization? This problem is interesting to discuss as to predict the risk of occurrence in hospitalization based on outpatient claims data. Limitation problem in this study is limited to six diagnosis of coronary disease that are atrial disease' typhoid fever' dengue hemorrhagic fever' chronic renal failure' other specified diabetes mellitus' and diarrhea and gastroenteritis of infectious origin presumed as the highest cost of disease occurrence and frequency of hospitalization often occurred based on secondary data obtained from a third party administrator firm PT XX. To predict, we will be used the binary logistic regression analysis and to see the pattern of the spread or the characteristics of the prediction' we will be used multiple correspondence analysis (MCA). Binary logistic regression show an increase in the incidence of hospitalization for typhoid fever and dengue hemorrhagic fever are influenced by the frequency of outpatient and age. MCA showed an increased risk of hospitalization tend to occur in RS Awal Bros Bekasi, RS Eka Hospital BSD, RS Bina Sehat, RS Hermina Arcamani, RS Graha Permata Ibu, RSIA Tumbuh kembang, and RS H Daijad. [ABSTRACT FROM AUTHOR]

This is a quantitative cross-sectional study using the characteristics of innovation diffusion theory to evaluate nurse' acceptance and adoption of digital nursing technology (DNT). Data were collected through questionnaires based on innovation diffusion theory in the wards of a regional hospital in Taiwan from March 21 to May 31, 2022. Results indicated that the higher the innovative characteristics of DNT, the higher the DNT acceptance. Difficulties with network connections contributed to negative experiences and led to recommendations for future system improvement. [ABSTRACT FROM AUTHOR]

Overcrowding in emergency departments (EDs) is a common yet nagging problem. It is not only costly for hospitals but also compromises care quality and patient experience. Hence, finding effective ways to improve ED efficiency is of great importance. Using a large dataset from New York State, we investigate the role of telemedicine in enhancing ED efficiency. We show that on average, ED telemedicine adoption significantly reduces patients' length of stay by 15.7% and waiting time by 9.7%. Such an effect is not a byproduct of other widely adopted health IT applications. Interestingly, the effect of telemedicine is larger for less severe patients or when the ED is at a higher occupancy level. Also, we show that the efficiency improvement does not come at the expense of care quality or patient cost, and its effectiveness is persistent over time. Therefore, our research points to telemedicine as a potential cost-efficient solution to alleviate ED overcrowding. [ABSTRACT FROM AUTHOR]

BACKGROUND: Emergency department crowding is one of the biggest issues facing healthcare systems worldwide. Increased presentations by the elderly have been identified as a potential contributing factor. Patient-perceived access to care has been suggested as one explanation for increased elderly presentations. A group of conditions collectively called Potentially Preventable Hospitalisations (PPHs) are a commonly used measure of patient-perceived access to primary care services. AIM: To investigate the hypothesis that patient-perceived access to care, as measured by PPHs, is a factor leading to increased emergency department presentations and subsequent hospitalisations of elderly patients. METHOD: Six years of inpatient data, from one Australian hospital, were coded to identify PPHs. The data were further divided to identify (i) admissions by those aged ≥75 years and (ii) admissions by patients aged ≥75 years with a length of stay ≤ 2 days (short-stay). Descriptive statistics were used to compare changes in rates of admissions for PPHs versus non-PPHs. RESULTS: PPHs accounted for 7.4% of all admissions and increased by 21% over 6 years, whereas non-PPHs increased by only 1.7%. Twenty-five percent of PPHs were by patients aged ≥ 75 years. PPHs related to chronic disease increased at the greatest rate (16%) for this patient demographic. Short-stay admissions for PPHs accounted for 51% of all PPHs in patients aged > 75 years, and increased by 70% over six years. Congestive cardiac failure (CCF) was the most common associated condition, accounting for 21% of all short-stay PPHs in the elderly. CONCLUSION: Our analysis suggests that patient-perceived access to care, as measured by PPHs, is a driver of increased emergency department presentations and subsequent hospital admissions of patients aged ≤ 75 years. Short-stay admissions for chronic conditions are the biggest contributor. Understanding elderly patients' perceptions of access to chronic care management outside of the hospital setting may provide insights into how best to improve access to required services, and thereby reduce the need for expensive, short-term, acute care management of chronic conditions. [ABSTRACT FROM AUTHOR]

During the daily treatment of patients large quantities of data are recorded in electronic health records (EHRs). Compared to data in paper records, these EHR data are easily available for reuse in research and quality improvement. However, the opportunities for reuse depend on the quality of the data. In this study we analyze the completeness with which main treatment activities are recorded on emergency department (ED) whiteboards and whether completeness varies with the severity of the patient's condition. Data from 381,231 ED visits show that after the whiteboard had been in successful use for several years the clinicians recorded four of the five main treatment activities with a completeness of less than 50%. Completeness tended to increase with three indicators of the severity of the patient's condition: triage level, length of stay and patient age. We conclude that the low completeness of the activity data probably prevents most types of reuse. [ABSTRACT FROM AUTHOR]

Obstetric care refers to the care provided to patients during ante-, intra and postpartum periods. Predicting length of stay (LOS) for these patients during their hospitalizations can assist healthcare organizations in allocating hospital resources more effectively and efficiently, ultimately improving maternal care quality and reducing costs to patients. In this paper, we investigate the extent to which LOS can be forecast from a patient's medical history. We introduce a machine learning framework to incorporate a patient's prior conditions (e.g., diagnostic codes) as features in a predictive model for LOS. We evaluate the framework with three years of historical billing data from the electronic medical records of 9188 obstetric patients in a large academic medical center. The results indicate that our framework achieved an average accuracy of 49.3%, which is higher than the baseline accuracy 37.7% (that relies solely on a patient's age). The most predictive features were found to have statistically significant discriminative ability. These features included billing codes for normal delivery (indicative of shorter stay) and antepartum hypertension (indicative of longer stay). [ABSTRACT FROM AUTHOR]

Aim: To acquire a fuller understanding of the influences on decision-making in an acute care hospital for seriously ill patients. Background: Fromthe moment of a diagnosis of serious, potentially life-limiting illness, patients and their families are faced withmultiple, complex and significant decisions that will influence the entire illness trajectory, including their end-of-life care (EOLC). Compounding personal factors is the complexity of dying today with acute ward areas in tertiary hospitals use of technological interventions to prolong life, at all costs being the norm. If hospice care is initiated, in these areas, it is often at too late a stage to relieve distressing symptoms and to offer the person the best possible path of care for a dignified death. Design and methods: A retrospective cohort research design was used for this study. Results: Thirty nine (39) medical records that met the inclusion criteria were audited. While medical records are limited in terms of the quality of the information contained in them in terms of social, behavioural and other qualitative information, the audit obtained detailed clinical information on patient characteristics, clinical care, and family and clinician involvement in the care of these patients. Communication between health professionals and patient and or family were limited. Poor documentation in the medical record did not support shared decision-making with decisions to amend the care pathway to palliative not undertaken in most instances despite no improvement in response to care or deterioration in the patient's condition. Conclusion: Communication between health care professions, patients and their family's needs to be addressed. The management of patients who are seriously ill in acute ward areas should be altered to reflect the patient's condition. Nurses, using a person-centred approach, have a role in advocating for the patient and the family in times of stress. Discussions concerning end-oflife of seriously ill patients need to be open, transparent and communicated as these discussions are critical to ensuring the patient's wishes are realised. [ABSTRACT FROM AUTHOR]

Hospital discharge and mortality has increasingly become important outcomes in medical research for investigating risk factors of hospital length of stay (LOS). Competing risk setting is a most popular method to analyze multiple events and several ad-hoc methods are more popular when focusing on risk factors for certain event of interest. Thus, the basis for this article was to investigate multiple events of hospital length of stay: discharge and mortality, through two well-known competing risk models: cause specific hazard and sub-distribution, for the dengue patients in Sri Lanka for the years 2007-2008. Moreover, this study concludes that the effect of age, ethnicity, sex, dengue classification, district and platelet count are important to the event of discharge and age, dengue classification, district and platelet count are significant to the event of mortality/death. Also, finally it reveals that both cause specific and subdistribution hazard exhibited similar results under the competing risk setting. [ABSTRACT FROM AUTHOR]

Operating room scheduling is one of the most complex tasks in hospitals due to the integration of many actors with conflicting objectives such as surgeons, patients, nurses, and operating room management. At the same time, operating rooms are one of the most important areas in a hospital for generating a big portion of hospital costs and revenues. With having increased demand for operating rooms, health care providers are facing a pressure of how to decrease hospital costs and improve the quality of care delivered to patients. One of the ways of decreasing the costs and improving the quality of care is having an effective operating room scheduling that will optimize the utilization of operating rooms and minimize the patients' length of stay. When patients stay longer in hospitals, the hospital costs increase as they require hospital resources for a longer period of time, and the quality of care is improved when patients are given the care at the right time. Thus, in this study, a model is developed which allocates a hospital's limited resources to multiple operating rooms in order to produce schedules that improve service quality and minimize the patients' stay and associated costs. [ABSTRACT FROM AUTHOR]

Copyright of Conference Proceedings for the Biannual Congress of Psychologists of Bosnia & Herzegovina / Kongres Psihologa Bosne i Hercegovine s Medunarodnim Ucešcem is the property of Association of Psychologists in the Federation of Bosnia & Herzegovina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The hospitalization process is inevitably a source of stress for an individual due to the unfamiliar setting and to the fear of pain and unknown medical test. When the patients are children it is even more crucial to offer a more secure and friendly hospital environment in order to eliminate as much as possible the stress factor. The design of healthcare facilities for children is a field of architecture that deeply affects the young mind and body of a child. During a hospital visit or stay the children's desires need to be fulfilled in order to promote healing, dismiss their negative feelings and restore balance. A space's quality is defined by its effectiveness, its efficiency and the satisfaction that can offer to its users. Basic parameters of architectural design such as the use of lighting and materials (both interior and exterior), the stability of an exterior design, the connection of a building to its surrounding and nature, orientation and wayfinding, scale and etc can create a child friendly environment that will eliminate stress and promote healing. This dissertation is about the design of children's healthcare facilities and the way that architectural elements can create a more secure and less traumatic experience to hospitalized children. The purpose of this research is to specify the current trends of architecture in this field estimate the quality of children's hospitals and children's wards in the public general hospitals of Greece and propose a new design that focuses on a health promoting environment on the case study of an adolescent's psychiatry unit. [ABSTRACT FROM AUTHOR]

The laparoscopic surgery has gained presence in the operating room in cases where it is feasible to spare patient trauma and minimize the hospital stay. One unique challenge in laparoscopic/endoscopic surgery is operating and removing tissue volume through keyhole - trocar. The removal of tissues by fragmentation is generally termed morcellation. We proposed a new method for soft tissue morcellation using laparoscopy. A unique ultrasonic laparoscopic surgical device, termed Laparosound{trade mark, serif}, utilizing laparoscopic high amplitude ultrasonic waveguides, operating in edge mode, has been developed that uses the principle of ultrasonic cavitation phenomenon for excision and morcellation of a variety of tissue types. The local ultrasonic acoustic intensity at the distal waveguide tip is sufficiently high that the liquefaction of moist tissue occurs. The mechanism of tissue morcellation is deemed to be cavitation based, therefore is dependant on water content in tissue, and thus its effectiveness depends on tissue type. This results in ultrasound being efficient in moist tissue and sparing dry, collagen rich blood vessels and thus minimizes bleeding. The applications of such device in particular, commonly encountered, could lay in general and ob/gyn laparoscopic surgery, whereas other applications could emerge. The design of power ultrasonic instruments for mass clinical applications poses however unique challenges, such as ability to design and build ultrasonic resonators that last in conditions of ultrasonic fatigue. These highly non-linear devices, whose behavior is hard to predict, have become the challenge of the author of the present paper. The object of work is to design and build an operating device capable of ultrasonic soft tissue morcellation in laparoscopic surgery. This includes heavy computational ultrasonics verified by testing and manufacturing feasibility using titanium biomedical alloys. The prototype Laparosound{trade mark, serif} device has been built and tested. Some of the challenges in design and development of Laparosound{trade mark, serif} ultrasonic laparoscopic morcellator have been presented. [ABSTRACT FROM AUTHOR]

Copyright of Proceedings of the International Scientific Conference of Daugavpils University / Daugavpils Universitates Starptautiskas Zinatniskas Konferences Materiali is the property of Daugavpils University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study established a predictive model for the early detection of micro-progression of pressure injuries (PIs) from the perspective of nurses. An easy and programing-free artificial intelligence modeling tool with professional evaluation capability and it performed independently by nurses was used for this purpose. In the preliminary evaluation, the model achieved an accuracy of 89%. It can bring positive benefits to clinical care. Only the overfitting issue and image subtraction method remain to be addressed. [ABSTRACT FROM AUTHOR]

Racial disparities in medical care use may be manifest on a number of indicators, but relatively little research has been done on the actual length of hospital stay (LOS). The aim of this paper is to examine racial disparities in access to and use of a cardiac care unit (CCU). The analyses use the National Health and Nutrition Examination Survey I: Epidemiologic Follow-up Study of adults 25 years of age and older at baseline followed prospectively for 20 years (N=4,227). The results show that Black adults are less likely to be admitted to cardiac care units than their White counterparts (p<.05), but that this difference is due to socioeconomic disadvantage. However, among those admitted to CCUs, length of stay for Black adults is significantly shorter than for White adults. By contrast, hospital length of stay outside of the CCU is longer for Black than White adults. Overall, the findings demonstrate that accumulation of disadvantage for Black adults is not confined to discretionary medical but exists in CCUs also. [ABSTRACT FROM AUTHOR]

Efficiency wage theory is applied to investigate the relation between hospitals' relative wage practices for registered nurses and hospitals' average lengths of stay. Hospitals' relative wage practices for registered nurses are hypothesized to positively influence hospitals' average lengths of stay. Support for the hypothesis is found using an unbalanced panel data sample of 394 California hospitals analyzed through a least squares dummy variables analysis technique. The research concludes with a discussion of the results, their limitations, and suggestions for future research. [ABSTRACT FROM AUTHOR]

Physiotherapists are part of the multidisciplinary team within the intensive care units (ICU) in Kosovo and they play important role in the treatment of patients with critical illness. The aim of a physiotherapy approach in these cases is to decrease patient dependency on the ventilator and to improve quality of life. Many patients develop conditions like sarcopenia and cachexia, thus involving symptoms such as weight loss, muscle weakness and loss of balance. Within the ICU the physiotherapist will treat the problems that are presented and also is responsible to reduce long-term consequences that may appear from a period of immobility. The prolonged bed rest together with the physiological effects of inactivity and immobility, including pressure ulcers and muscle weakness, present the major burden towards which the physiotherapeutic approach is oriented. This way, early mobilization has its benefits in the improvement of respiratory function and hospital length of stay. Then after, postural drainage techniques are presented amongst the most used methods for airway clearance in the ICU patients, including those on mechanical ventilation. Notwithstanding, the regular repetitions following a strict time-controlled plan while always following by a specific breathing exercise is required in order to succeed the process. [ABSTRACT FROM AUTHOR]