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2021 ◽  
Vol 5 (3) ◽  
pp. 474-482
Author(s):  
Anggara Cahya Putra ◽  
Kristoko Dwi Hartomo

Indonesian MSMEs were very seriously affected by the Covid-19 pandemic, which caused the Indonesian economy has experienced deceleration. The Indonesian government has taken several steps to keep economic activity running, such as direct cash assistance for micro-scale businesses but is having problems in obtaining real data so that assistance is not on target, the clustering method using Fuzzy C-Means (FCM) is used for grouping MSME data. FCM allows the data to be a member of all clusters in which each cluster has a membership degree value of 0-1. The data used is from the website of the Sleman Regency Cooperatives and SME Service. FCM classifies MSME data based on the attributes of revenue, assets and number of workers. This research resulted in grouping MSME data into 3 priority levels for MSMEs in obtaining assistance, namely high priority, medium priority, and low priority. The results of this study show that the number of MSMEs with high priority is 23,023 MSMEs, medium priority is 9,774 MSMEs and low priority is 3,159 MSMEs. The validation test of the FCM method uses the Partition Coefficient Index (PCI) which has a value of 0.826 which means that value good because it is close to 1.  


Author(s):  
Torgny Wessman ◽  
Johan Ärnlöv ◽  
Axel Carl Carlsson ◽  
Ulf Ekelund ◽  
Per Wändell ◽  
...  

AbstractThe detrimental effects of increased length of stay at the emergency department (ED-LOS) for patient outcome have been sparsely studied in the Swedish setting. Our aim was to further explore the association between ED-LOS and short-term mortality in patients admitted to the EDs of two large University hospitals in Sweden. All adult patients (> 18 years) visiting the ED at the Karolinska University Hospital, Sweden, from 1/1/2010 to 1/1/2015 (n = 639,385) were retrospectively included. Logistic regression analysis was used to determine association between ED-LOS and 7- and 30-day mortality rates. All patients were triaged according to the RETTS-A into different levels of medical urgency and subsequently separated into five quintiles of ED-LOS. Mortality rate was highest in highest triage priority level (7-day mortality 5.24%, and 30-day mortality 9.44%), and decreased by lower triage priority group. For patients with triage priority levels 2–4, prolonged ED-LOS was associated with increased mortality, especially for lowest priority level, OR for priority level 4 and highest quintile of ED-LOS 30-day mortality 1.49 (CI 95% 1.20–1.85). For patients with highest triage priority level the opposite was at hand, with decreasing mortality risk with increasing quintile of ED-LOS for 7-day mortality, and lower mortality for the two highest quintile of ED-LOS for 30-day mortality. In patients not admitted to in-hospital care higher ED-LOS was associated with higher mortality. Our data suggest that increased ED-LOS could be associated with slightly increased short-term mortality in patients with lower clinical urgency and dismissed from the ED.


2021 ◽  
Vol 4 (2) ◽  
pp. 15-25
Author(s):  
Fabiola M. Martinez-Licona ◽  
Sergio E. Perez-Ramos

Backgrounds and Objective: The Intensive Care Unit (ICU) receives patients whose situation demands high complexity tasks. Their recovery depends on medical care, their response to medications and clinical procedures, and the optimal functioning of the medical devices devoted to them. Adverse events in ICU due to failures in the facilities, particularly medical devices, have an important impact not only on the patients but also on the operators and all those involved in their care. The origins of the technological failures seem to be more oriented to the interaction between the equipment and the operator: once the medical equipment is functioning, we must guarantee its correct execution to meet both the clinical service's objectives and the expectations of those involved in care, including the patients themselves. We present an approach to quality management based on failure analysis as the source of risk for medical devices' functioning and operation in the ICU. We decided to address it through a systematic approach by using the Failure Mode and Effects Analysis (FMEA) method and the Ishikawa diagrams' support to obtain the causes graphically. Material and Methods: We used the risk analysis framework as a basis of the methodology. By obtaining the causes and sub causes of technological failures in the ICU for adult patients, we applied the FMEA method and the Ishikawa diagrams to analyze the relationship between cause and failure. The ICU devices came from the Official Mexican Standard and WHO information related to the ICU operation and facilities. The data from the causes of failure came from specialized consultation and discussion forums on medical devices where these topics were addressed; we searched for over five years in Spanish forums. We proposed a calculation of the Risk Priority Number based on the information subtracted from the forums. Then, we defined an indicator showing the priority level that can be used to address the issue. Results: In general, the results showed that most of the medical equipment failure causes have medium and high-risk priority levels and, in some cases, the cause presented as the most prevalent didn't match with the reported in official documents such as technical or operation manuals. The most frequent causes found are related to electrical system issues and operation skills. We presented three study cases: defibrillator, vital sign monitor, and volumetric ventilator, to show the risk level designation. The conclusions inferred from these cases are oriented to training strategies and the development of support material in Spanish. Conclusion: The development of risk management methodologies that aim to monitor and solve potential hazard situations in critical areas is valuable to the health technology management program. The FMEA method showed to be a strong basis for the risk assessment processes, and its application to the ICU medical technology allowed the creation of the evidence supporting the decision-making process concerning strategic solutions to guarantee patient safety


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18599-e18599
Author(s):  
Raisa Epistola ◽  
Michael Olufemi Shodiya ◽  
Jordan Epistola ◽  
Dong Chang ◽  
James Jen-Chi Yeh

e18599 Background: Admissions of cancer patients to intensive care units (ICU) are increasing with improved mortality. While ICU care can be lifesaving, its higher cost does not always result in reduced mortality. Moreover, timely goals of care (GOC) discussions correlate with less ICU use in those with certain cancers. We investigate if hospital mortality and disposition outcomes for cancer patients correlate to triage by ICU providers. Methods: This subgroup analysis of a prospective cohort of 808 patients admitted to the ICU from 1 July 2015- 15 June 2016 at an academic safety net hospital included 106 patients diagnosed with cancer. Medical records were reviewed by ICU physicians, who assigned priority ranks using Society of Critical Care Medicine guidelines: 1: critically ill, needing treatment/monitoring not provided outside of ICU, 2: not critically ill, but requiring close monitoring/potentially immediate intervention, 3: critically ill patients with reduced likelihood of recovery, 4: not appropriate for ICU, equivalent outcomes achieved with non-ICU care. We did a chart review for factors like prior therapy and documentation of GOC discussions. Statistical tests were conducted to examine if priority levels correlate with disposition, mortality, and length of stay (LOS). Results: χ2-tests revealed priority rank correlated with disposition after hospitalization (p<.05) with group 3 having the highest proportion of deaths and lowest proportion of discharges home. It revealed that mortality rate differed by group (p<.05) with logistic regression showing that priority 3 predicted increased mortality (p<.05). ANCOVA indicated ICU LOS differed by priority group (p<.05), with priority 3 averaging the longest LOS. While priority 3 had the most in-hospital GOC discussions, relatively few were documented pre-hospitalization. Conclusions: Overall, our patients were accurately triaged, with worse mortality and discharge outcomes among priority 3 and a dearth of pre-hospitalization GOC documentation for all groups. Our data show the importance of triaging patients and having early, frequent GOC discussions to minimize ICU admission given increasing demand and costs. GOC discussions are associated with less aggressive medical care near death and better patient quality of life. Thus, holding these talks with our sickest patients prior to potential ICU admission is an area to improve cost-effective high quality care.[Table: see text]


Author(s):  
V. Padmavathi ◽  
R. Saminathan ◽  
S. Selvamuthukumaran

The demand for a providing QoS adaptive routing over IoT networks is always a challenge among current research community. This research work KHAI proposes a framework for QoS-adaptive routing approach, which incorporates Krill Herd optimization model over IoT network. Variable QoS user preference and handling differential service types over a scalable IoT network shows that challenge for designing an adaptive QoS is a must. Research survey suggest that major works have been carried out on bandwidth appreciable services and route management approaches. Hence QoS adaptive user defined services, which adapt to variable service priority levels based on user demand and network resource utilization is proposed in this research work. The performance analysis of proposed approach shows an improved throughput of 97.51 Mbps and minimal packet loss of 37.29% over a session in comparison to traditional computational approaches. Considering large scale of interconnected IoT devices, proposed approach delivers near optimal solution of throughput and adaptive utilization of network resources.


2021 ◽  
Author(s):  
Mhd Amen Summakieh ◽  
Chee Keong Tan ◽  
Yin Hoe Ng ◽  
Ayman A. El-Saleh

Abstract Heterogeneous networks (HetNets) are a promising communication paradigm to satisfy the diverse requirements of Long Term Evolution-Advanced (LTE-A). Associating users with different base station tiers using the conventional technique based on the highest received SINR is not viable in HetNets due to its rigid association, which only aims at throughput maximization. Many e orts have been made to tackle the optimization problem of user association with a single objective such as throughput, fairness or energy efficiency. In this paper, we propose a novel multi-objective user association technique using particle swarm optimization (PSO) with the aim of jointly maximizing the throughput and the network balance index (NBI). By incorporating weight factors into the proposed scheme, the system operator has the flexibility to configure the priority levels of throughput and NBI. Numerical results demonstrate that our proposed multi-objective user association technique achieves better performance in terms of fitness values compared to the single-objective user association schemes.


2021 ◽  
Vol 9 (1) ◽  
pp. e040
Author(s):  
Luis Ernesto Arriola Guillén

The requirement of vaccines for the prevention of Covid-19 has become one of the health priorities of different countries worldwide (1, 2). However, most societies still do not have the necessary number of vaccines to cover their entire target population (3, 4). This is especially true in countries that delayed negotiations with the supply companies, and which will, unfortunately, have to wait a long time for the arrival of sufficient quantities to protect their populations. On theother hand, the global vaccination process has established priority levels among its citizens, specifically starting with the so-called first line of action that is health professionals attending Covid-19 patients, due to the great risk to which they are exposed. Additionally, the health organizations of the different countries have proposed to continue the vaccination process according to different criteria, one being the risk levels of the professions. This criterion is aimed at prioritizing professionals most exposed to contagion, but according to their daily practice, what professionals are really the most exposed to contagion?


2021 ◽  
Vol 7 (1) ◽  
pp. 31
Author(s):  
Musthofa Galih Pradana ◽  
Azriel Christian Nurcahyo ◽  
Fandli Supandi

Kebijakan Promosi dari Universitas untuk mendapatkan mahasiswa baru merupakan hal yang vital bagi kelancaran proses penerimaan Mahasiswa Baru. Pihak lembaga perlu mengkaji dan melakukan analisis yang baik sebelum melakukan promosi. Di era sekarang, banyak media yang dapat dijadikan sebagai media promosi. Dengan berkembangnya cara penyebaran informasi serta banyaknya media pihak yang berkepentingan sudah seharusnya jeli mana yang mendapat prioritas lebih dari semua banyak lini media tempat promosi. Ketika tingkat prioritas sudah ditentukan maka upaya promosi akan menjadi lebih mudah dan lebih tepat sasaran. Akan tetapi penentuan tingkat prioritas tidak dapat dilakukan secara asal dan sembarangan. Perlu dilakukan pengkajian yang lebih dalam bukan hanya sekedar intuisi belaka. Penelitian ini membahas tentang pengaruh promosi dengan minat calon mahasiswa memilih AMIKOM sebagai universitas pilihan dengan acuan tiga variable yaitu sosial media, website, dan referensi alumni. Pengolahan data menggunakan software SPSS dan SPSS AMOS untuk mencari validitas, reliabilitas dan uji hipotesis. Hasil yang didapatkan adalah semua variable signifikan, dengan urutan dari nilai tertinggi ke terendah adalah Sosial Media, Referensi Alumni, dan Website. Kata Kunci—Promosi, Validitas, Reliabilitas, HipotesisPromotion policy from the University to get new students is vital for the smooth process of admission of New Students. The institution needs to review and conduct a good analysis before conducting a promotion. In this era, many media can be used as promotional media. With the development of ways of disseminating information and the many media interested parties it should be observant which gets priority over all the many lines of media wherepromotion. When the priority level has been determined, the promotion effort will be easier and more targeted. However, the determination of priority levels cannot be done arbitrarily and carelessly. Deeper studies need to be done not just mere intuition. This study discusses the effect of promotion with the interest of prospective students choosing AMIKOM as the university of choice with three variables reference, namely social media, website, and alumni reference. Data processing using SPSS and SPSS AMOS software to find validity, reliability, and hypothesis testing. The results obtained are all significant variables, with the order from highest to lowest values are Social Media, Alumni Reference, and Website.Keywords— Promotion, Validity, Reliability, Hypothesis


Author(s):  
Zainul Ikhwan Ahmad Khusairi

Introduction: Emergency departments (ED) typically practice a triage system to classify patients into priority levels. A triage system is commonly used in crowded emergency rooms to determine which patient should be seen and treated immediately.Objective: The objective of this study was to evaluate the effectiveness of triaging pathway guidelines for critical cases seen in the Emergency Department during the COVID-19 outbreak.Case Presentation: Emergency Department, Taiping Hospital is practicing a triaging system which consists of two divisions; cases with respiratory symptoms (SARI) and cases without symptoms of respiratory impairment (non-SARI). A patient with snake bite was presented at the Emergency Department, Taiping Hospital with symptoms of numbness at the site of the bite and a complaint of difficulty to open the eyes, while tachycardia was noted. However, no shortness of breath or difficulty in breathing was reported. COVID-19 rapid screening was done and the patient was treated under Red Zone (non-SARI). Luckily, the patient survived and was stable with no reaction observed after treated with Neuro Polyvalent Antivenom 50ml in 500ml normal saline over one hour.Conclusion: The available patient triaging pathway strategy guideline was effectively practiced by paramedics when managing critical cases at the Emergency Department during COVID-19 outbreak. Other emergency departments are advised to practice effective and appropriate triaging pathway strategy guidelines to save patients’ lives.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S15


2021 ◽  
Author(s):  
Basim Alsaywid ◽  
Miltiadis D. Lytras ◽  
Maha Abuzenada ◽  
Hara Lytra ◽  
Abdulrahman Housawi ◽  
...  

Abstract Background: Under the urgent circumstances of COVID-19 pandemic, higher education institutions of an international scale have resorted to online education methods, exclusive or not. Among those, medical institutions are under double pressure, fighting the pandemic’s effects and, at the same time providing efficient clinical training to their residents.Methods: This is an observational cross-sectional study design. The survey’s sample included 300 medical students and residents of multiple training levels and specialties, coming from more than 15 different cities of Saudi Arabia. Filling the questionnaire required specific inclusion criteria and all obtained data were secured by Saudi Commission of Health specialty. Main objective was to evaluate the quality of e-learning methods, provided by medical universities.Results: The study found that the frequency of digital education use increased by approximately 61% during the coronavirus crisis, while almost 9 out of 10 residents have used some e-learning platform. It was reported that before the pandemic, participants’ online training was deemed to be rather ineffective, given the rate of 3.65 out of 10. However, despite the increase in e-learning use after COVID-19, many obstacles arose during adaptation process, according to our survey: lectures and training sessions were not conducted as per curriculum (56.33%); both students and instructors’ academic behavior and attitude changed (48.33%); engagement, satisfaction and motivation in class was rated low (5.93, 6.33 & 6.54 out of 10 accordingly), compared to the desired ones. Still, participants accredited e-learning as a potential mandatory tool (77.67%) and pinpointed the qualifications that in their opinion will maximize educational impact. Conclusions: The study concluded that innovative restructuring of online education should be based on defined critical success factors (technical support, content enhancement, pedagogy etc.) and if possible, set priority levels, so that a more permanent e-learning practice is achievable.


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