Issue Of Overcrowding Research Articles

Usage of digital resources in Civil Technology: A case of teaching Tools and Equipment

The digital world is increasingly penetrating the education space, with digital technology gradually being used as a vehicle to deliver educational knowledge and skills in new and innovative ways. The need for technical teacher’s development in using digital resources as means to bridge the knowledge gap in teaching the topic Tools and Equipment is to be emphasized in these modern times. Most importantly, in Civil Technology issues of overcrowding, rare exposure to practical activities as well as lack of practical skilled-competent teachers are still pressing challenges. The purpose of this study was to investigate the extent to which digital resources are used in Civil Technology when teaching about Tools and Equipment. Non-probability sampling was used to select a total of 9 teachers and 145 learners to participate in this study. This study employed Roger’s ‘Diffusion of innovativeness’. Observation, semi-structured interviews and questionnaire instruments were used as data-collection methods. The study found that Civil Technology teachers prefer to use prescribed textbooks and previous exam question papers to teach the concepts in the topic Tools and Equipment whilst there are video clips and posters that can help to expand learners’ practical skill knowledge. Teachers did not see those digital technology resources as helpful in comparison to their own knowledge base when it comes to exposing learners to the wider context of Tools and Equipment. This study recommends that in order to bridge practical skill knowledge gap, teachers should integrate digital technology into their lessons as they are helpful in outlining concepts that might have been omitted by teachers during lessons.

Changes in the Use of Emergency Care for the Youth With Mental Health Problems Over Decades: A Repeated Cross Sectional Study

To understand whether changes exist in the types of youths mental health problems addressed in emergency in a context of increasing demand, we conducted a retrospective chart review in an emergency care outpatient unit. Data from children and adolescents admitted at four different time periods (years 1981, 1992, 2002, and 2017) were compared to determine trends in terms of patients' characteristics, nature of the mental health problems and final care decisions. Between 1981 and 2017 there was a 3.85 times increase in the annual number of patients presenting to the emergency consultations. The proportion of youths being referred for anxiety or depressive symptoms sharply increased over time, while no differences were found for the proportion of aggressive behaviors and suicidal attempts. Anxiety disorders became the most frequent discharge psychiatric disorder in youths admitted in the emergency unit, rising from 5% in 1981 to 34% in 2017. Significant changes were also observed in the source of referral to the emergency unit; in particular emergency consultations in 2017 were about twice as likely as in 1981 to be requested directly by the family. This data suggested that the increased use of emergency services observed over the last decades is associated with significant changes in the patient and his/her family's demands about mental health difficulties. Such findings are worth considering for mental health interventions that aim to address the emergency overcrowding issue.

An empirical review of Karachi's transportation predicaments: A paradox of public policy ranging from personal attitudes to public opinion in the megacity

Karachi as a megacity faces huge transportation challenges ranging from rampant urbanization and limited budgets to inefficient infrastructures. The issues of over-crowding, traffic congestion, poor quality of service, ill-fitness of the vehicles, women mobility and unbridled sexual harassment issues on busses are the emerging challenges in the transportation sector. The paper focuses on gauging the public opinions, attitude formation and travel behaviour choices of residents and documenting empirical evidence of public concern for improving the public transport predicaments in Karachi. The analysis, largely interpretive in nature, uses the results of a representative survey of residents of Karachi for the evidentiary aspects of the analysis. In principle, this research provides an empirical based mechanism through which public opinion and public policy could be reliably and usefully connected.

Monorail - an alternative solution for the urban transport in Romania

A well-developed system of public transportation can provide an answer to the problems that appear as a result of traffic overcrowding and congestion in large urban settlements. Taking into consideration the continuously worsening traffic conditions in more and more cities in Romania, it was relevant to search for answers in countries that have started addressing this urgent issue. It appears that the best answer to this situation is building a monorail network; this is the ideal solution since the overhead driveway makes it independent from all the other means of transport. In this article, monorail systems used around the world are also presented, as well as their advantages and disadvantages. Offering an overview of the possibility of integrating such a network in Bucharest, the authors suggest some possible routes, pinpointing the reasons taken into consideration before choosing them. Thus, building a monorail can be seen as a reliable, economic and ecological way to address the issue of overcrowding and congestion by offering shorter travelling times between various points of interest and by increasing traffic fluency in Bucharest.

Cancer Patients in the Emergency Department: A "Nightmare" that Might Become a Virtuous Clinical Pathway.

Emergency departments (EDs) often face overcrowding issues while simultaneously confronting with the increasing clinical needs of patients, such as cancer patients, with both acute and chronic illnesses. In order to guarantee a prompt and specialized treatment of ED-attending cancer patients and reduce inappropriate inpatient admissions, a dedicated ED cancer pathway (EDCP) consisting of ED-bound Medical Oncology (MO) resident doctor and direct admission for candidate patients exclusively to the MO division was established at the Tor Vergata University Hospital in April 2015. Consecutive cancer patients attending the ED in two reference three-month periods were enrolled: pre-EDCP period, from 1st October 2014 to 31st December 2014, and post-EDCP period, from 1st October 2014 to 31st December 2015. Inpatient admission rate, mortality rate and both ED and inpatient length of stay were compared between the two analyzed periods, pre- and post-EDCP. In the pre- and post-EDCP periods 127 and 123 cancer patients, respectively, were included. Most of the analyzed indicators were improved by EDCP implementation: Inpatient admission rate from 70% to 41% (p<0.0001), ED mortality rate from 10-4% (p=0.04), mean ED length of stay, from 58 to 42 h (p=0.03), mean inpatient length of stay, from 15.5 to 6.5 days (p<0.0001), in the pre- and post-EDCp period, respectively. EDCP implementation led to a significant improvement of health care delivery to cancer patients attending the Emergency Department.

Should freestanding emergency departments be considered in Australia?

The concept of freestanding EDs is a popular operational model of emergency care in the USA. This model has been described as an emergency physician-created innovative solution in resolving ongoing overcrowding issues in EDs. A decentralised community-based emergency care model may be a solution to meet the increasing demand for emergency and unscheduled acute care in Australia. It may also help to reduce the number of acute hospital admissions through EDs. The aim of freestanding EDs should be to manage and discharge a cohort of patients, mainly in Australasian Triage Scale 3 and 4 categories, currently seen in hospital-based EDs. This article briefly examines the potential merits and issues if this concept is considered in Australia. It also provides an early proposed model for such EDs.

Telescope-based cavity for negative ion beam neutralization in future fusion reactors.

In future fusion reactors, heating system efficiency is of the utmost importance. Photo-neutralization substantially increases the neutral beam injector (NBI) efficiency with respect to the foreseen system in the International Thermonuclear Experimental Reactor (ITER) based on a gaseous target. In this paper, we propose a telescope-based configuration to be used in the NBI photo-neutralizer cavity of the demonstration power plant (DEMO) project. This configuration greatly reduces the total length of the cavity, which likely solves overcrowding issues in a fusion reactor environment. Brought to a tabletop experiment, this cavity configuration is tested: a 4mm beam width is obtained within a ≃1.5 m length cavity. The equivalent cavity g factor is measured to be 0.038(3), thus confirming the cavity stability.

Social identity and the prison health worker: Implications for practitioner satisfaction and turnover intentions.

Delivering health care within the prison walls poses distinct and arduous challenges to the practitioner. Correctional health workers regularly face issues of overcrowding, increased prevalence of infectious disease, advancing age, deteriorating conditions, and patients with an inclination for violence. Still, regardless of the sizeable workforce, costs, and impact on community well-being, correctional health is often overlooked in health services delivery research. The aim of this study was to better understand the unique nature of delivering services in the prison context through the lens of social identity theory and further explore practitioner satisfaction and retention. A survey design was used in this study, sampling clinicians in a state department of corrections in the United States. Using the data from 317 respondents, the study explored the relationship between professional identification and perceived organizational support as they impact job satisfaction and turnover intention and while controlling for burnout. Using nested ordinary least squares regression and nested logistic regression, the results showed that professional identification and perceived organizational support were positively associated with job satisfaction. Perceived organizational support was negatively and significantly related to turnover intentions. This article adds originality and value to the literature by using social identity theory to address the occupational perceptions of a large, yet often underrepresented and underexplored, subsector of the health workforce. The results highlight several areas where health care managers, whether from correctional or noncorrectional environments, could implement policy and procedure changes to further engage and retain the clinical workforce. To engage and retain the health worker population, managers must consider identification-reinforcing interventions that align with the self-concept and visibly display gestures of organizational support.

Amsterdam Residents and Their Attitude Towards Tourists and Tourism

In Amsterdam, the phenomenon of overcrowding is increasing, and tourism is one of the causes. Both the public debate and the municipal authorities are pointing to an increasing need for more expertise and knowledge regarding ways of achieving a healthy balance for various stakeholders. This article focuses on the stakeholder role of city residents and discusses their attitudes to tourists and tourism-related developments in their own neighbourhood and in the rest of the city. The term “attitude” can be divided into three components: feeling, behaviour and thinking. The results of this study are based on both quantitative and qualitative fieldwork (surveys and semi-structured interviews) and on desk research. It can be concluded that, for the most part, residents have a positive attitude to tourists and tourism. Differences in attitude are mostly determined by the city district where respondents live and by personal feelings and thinking. Follow-up research in the coming years will examine the complexity of the issue of overcrowding in more depth.

Kidney Stone Protocols to Reduce Emergency Department Overcrowding

Background: As emergency department (ED) overcrowding affects timely patient care, strategies such as standardize protocols are required.Objective: The purpose of this study was to 1) investigate impact of utilizing various Computed Tomography (CT) scans modalities namely CT without contrast (WO), with contrast (W), and with and without contrast (WWO) in diagnosing kidney stones on ED operational metrics (i.e., CT order to report time, room to discharge, and ED length of stay), and 2) develop, implement, and test kidney stone protocols.Methods: The study included both retrospective, cross-sectional and pre/post analyses of patients presenting to the ED of a large, academic medical center with suspicion of kidney stone who received CT scans from December 2010 to December 2011. ANOVA, t-test, Chi-Square test, and linear regression were used for statistical analyses.Results: During pre implementation, statistically significant difference of at least 41.7 minutes were observed between CT WO and CT WWO for all operational metrics After implementation of the kidney stone protocol (i.e., switching to CT WO contrast) the order compliance rate improved from 35.9% to 72.8%, with similar savings for CT order to report times.Conclusions: With 37% additional patients evaluated using CT WO and ¾ to 1 hour savings in CT order to report time, the estimated net capacity gain is 32 to 43 routine ED patients for a 50,000 volume ED. Thus, standardization of protocol using the developed framework for other common diseases (e.g., abdominal pain) may add ED capacity and revenue while reducing ED overcrowding issues.

Perceived psycho-social and school factors contributing to malpractices in internal examinations among secondary school students in Kakamega-Central Sub-county: Implications for counseling

Examination malpracticeis rated as one of the greatest problems that undermine the foundation of educational practicein Kenya today. The magnitude of the problem and the dangers posed bythe phenomenon have been identified by stakeholders as national malady that requires drastic solution. Thus, this study attempted to investigate the view of students about the psycho-social and school causes of and roles of guidance and counselling in addressing the malpractices in internal examination in Kakamega Central Sub-county. A total of three hundred and fifty nine students were randomly sampled from twelve schools selected at random for the study. Data were collected using researcher developed questionnaires. Four research questions were raised and answered using frequency counts, simple percentage and means scores. However, results indicated that poor study habits, laziness, lack of self confidence, family pressure to excel and host of others were considered by students as the major psycho-social causes ofexamination malpractice. Inadequate preparation for examination,poor teaching, overcrowded exam rooms and poor invigilation were considered by respondents as the causes of examination malpractice. On the roles of the school guidance and counselling units most of the respondents indicated that the G&C unit exists and talks to them about self esteem, peer pressue management, self confidence and that exam cheating is wrong. However, most of them did not agree that G&C can assist students involved in exam cheating to change. The psycho-social factors are the predisposing factors to exam malpractices while the school factors are the environmental causes. Most schools have active guidance and counselling units. However, these units do not seem to be effective in addressing the problems of malpractices in internal examinations in secondary schools. Based on these findings, it was recommended that students and teachers should be given enlightenment campaign that will highlight the consequences of examination malpractice. Also, government should sensitize all citizens to basic ethical values of selfworth, dignity of labour, integrity and personal responsibility. Professional guidance counselors should be employed and posted to secondary schools to help students in self understanding and self management as well as the development of effective study habits in relation to how they can utilize their assets and manage their abilities for optimal development. Further, all schools should be adequately equipped and staffed to address issues of overcrowding and poor invigilation. Key words: Examination malpractice, secondary schools students, counselling.

Non-clinical work counts: facilitating patient outflow in an emergency department

We conducted an observational study in an emergency department (ED) to acquire an in-depth understanding of the activities and processes involved in the ED patient outflow and the challenges encountered in the outflow coordination with heterogeneous and autonomous stakeholders within and across organisations. We identified that inefficient patient outflow not only led to overcrowding in the ED because patients could not be admitted to the ED, but it also affected the operation of other inpatient units and that of external organisations. Moreover, the overcrowding issue was found to be contingent on how efficiently the multiple, concurrent, and intertwined patient outflow work was coordinated. The patient outflow coordination work was primarily non-clinical, and invisible in the current information system. Therefore, we propose to make the non-clinical coordination outflow work visible and be supported in the information system as efficient outflow is crucial to the efficiency of the overall patient flow.

Importance of Male Fertility Control in Family Planning

The world population, currently estimated to be almost seven billion, is expected to double in less than four decades. The projected population growth will cause severe competition for existing resources, not to mention the issue of overcrowding of the planet and additional greenhouse gases that will have an adverse effect on the ecological health of the planet. A recent survey conducted by the United Nations Population Control Division shows that the majority of today's young men in many countries are willing to participate in family planning by taking full control of their fertility, an important global health issue. However, the contraceptive needs of tens of millions of men/couples go unmet every single day and results in millions of unwanted pregnancies. Ever since the approval of the birth control pill by the Food and Drug Administration (FDA) in 1960, scientists have been hoping for a male equivalent. It has, however, been a difficult road, in part because of the complicated science of the male reproductive system. It is easier to control a monthly event of ovulation in women than to regulate the production of millions of fertile spermatozoa every day in men. Thus, the contraceptive options for men have not changed in decades and are still limited to the use of condoms, a timely withdrawal/pulling out (coitus interruptus) or vasectomy, a minor surgical procedure in which the vas deferens is occluded to prevent the release of spermatozoa during ejaculation. The first two approaches have a relatively higher failure rate, whereas the last approach is largely irreversible and not suitable for younger men. In this article, we will discuss various approaches currently available for men to take control of their fertility. Our intention is to discuss the details of three similar approaches that will provide safe, affordable and reversible contraception for men and are close to being approved for use by millions of men around the globe. The availability of safe, reversible and reliable male contraceptives will allow men and women to take full control of their fertility in family planning.

Assessing Issues of Overcrowding in Emergency Room of a Tertiary Care Hospital

Assessing Issues of Overcrowding in Emergency Room of a Tertiary Care Hospital

Situación penitenciaria en América Latina y el Caribe ¿Qué hacer?

This article presents an overview of the situation of prison conditions in Latin America and the Caribbean and suggests guidelines for action. The author points to two crucial factors that must be taken into account: on the one hand, the physical space available in prisons and the issue of overcrowding and, on the other hand, the number, selection and education of prison staff. Both factors are analyzed empirically and the human rights violations that come about due to the current functioning of the region’s prison systems are evaluated. The author suggests following the United Nations Rights and Obligations Model, and taking successful reforms as a guide, he rejects the privatization of prisons as a viable alternative, and argues in favor of the implementation of integrated criminal justice and prison system reform programs, which must be accompanied by democratic and inclusive social policies in order to reduce income inequality.

The situation in Latin American penitentiaries: what to do?

This article presents an overview of the situation of prison conditions in Latin America and the Caribbean and suggests guidelines for action. The author points to two crucial factors that must be taken into account: on the one hand, the physical space available in prisons and the issue of overcrowding and, on the other hand, the number, selection and education of prison staff. Both factors are analyzed empirically and the human rights violations that come about due to the current functioning of the region’s prison systems are evaluated. The author suggests following the United Nations Rights and Obligations Model, and taking successful reforms as a guide, he rejects the privatization of prisons as a viable alternative, and argues in favor of the implementation of integrated criminal justice and prison system reform programs, which must be accompanied by democratic and inclusive social policies in order to reduce income inequality.

Situación penitenciaria en América Latina y el Caribe ¿Qué hacer?

This article presents an overview of the situation of prison conditions in Latin America and the Caribbean and suggests guidelines for action. The author points to two crucial factors that must be taken into account: on the one hand, the physical space available in prisons and the issue of overcrowding and, on the other hand, the number, selection and education of prison staff. Both factors are analyzed empirically and the human rights violations that come about due to the current functioning of the region’s prison systems are evaluated. The author suggests following the United Nations Rights and Obligations Model, and taking successful reforms as a guide, he rejects the privatization of prisons as a viable alternative, and argues in favor of the implementation of integrated criminal justice and prison system reform programs, which must be accompanied by democratic and inclusive social policies in order to reduce income inequality.

Pharmacist Improves Timely Administration of Medications to Boarded Patients in the Emergency Department

Our purpose was to assess the variations in timely administration of medications based on differences in nursing staff (ED nurses who are responsible for emergency and boarded patients vs inpatient nurses who are responsible for only boarded patients) and to determine whether a pharmacist's interventions can improve the timely administration of medications to boarded patients in the emergency department. This was a prospective observational study. Patients were included in the study if they were aged 18 years or older, were physically located in the emergency department but had already been admitted to the medical center, and had medication orders. The pharmacist documented the medication orders and the allotted time for administration. Once the upper limit of the allotted time frame for administration had passed, the pharmacist determined whether the medications were given and interventions were then carried out for those medications that were not administered. Successful interventions were documented when the medication was given within 1 hour from the time of intervention. Seventy-nine patients were included in the study, resulting in 266 medication administration opportunities (emergency department, 146; inpatient, 120). Inpatient nurses administered medications in a timely manner at a significantly greater rate than ED nurses (83.3% vs 63.7%, P < .0001). The greatest difference was observed during the evening hours (95.2% vs 53.8% of medications administered for inpatient vs ED nurses, P = .002). The most common reason for medications not being administered by ED nurses was insufficient time (51.4%), and for inpatient nurses, it was that the medication order was not verified (77.8%). The pharmacist's interventions were successful with both the ED and inpatient nurses (95.5% and 94.1%, respectively). This study illustrates that assigning nurses with varying workloads as a means to manage overcrowding is likely to result in boarded patients in the emergency department not receiving their medications. ED pharmacists' interventions may fill the gap, ensuring compliance with the administration of medication orders prescribed for boarded patients and ensuring more timely administration. A multidisciplinary team approach is needed to manage current overcrowding issues.

ED Patient Flow: Utilizing the Six Sigma Approach to Reduce Emergency Department Overcrowding

Study Objectives: Six Sigma, a performance improvement process with origins in the manufacturing sector, is a methodology that can be applied to ED patient flow and overcrowding issues. While staff input is a key tool in the process, the methodology is essentially data-driven, measuring and analyzing systems to identify, implement and maintain process improvements. In our ED, admitted patients with assigned beds waited approximately 145 minutes to go from the ED to the Patient Care Unit. This prolonged wait caused patient and ED staff dissatisfaction and operational inefficiency. We applied the Six Sigma methodology to the issue of ED patient flow. The goal was to identify correctable causes of delays, implement solutions, and reduce patient turn around time (TAT) from 145 minutes to 75 minutes (48.2% improvement).

Emergency department overcrowding: the Emergency Department Cardiac Analogy Model (EDCAM)

Increasing patient numbers, changing demographics and altered patient expectations have all contributed to the current problem with 'overcrowding' in emergency departments (EDs). The problem has reached crisis level in a number of countries, with significant implications for patient safety, quality of care, staff 'burnout' and patient and staff satisfaction. There is no single, clear definition of the cause of overcrowding, nor a simple means of addressing the problem. For some hospitals, the option of ambulance diversion has become a necessity, as overcrowded waiting rooms and 'bed-block' force emergency staff to turn patients away. But what are the options when ambulance diversion is not possible? Christchurch Hospital, New Zealand is a tertiary level facility with an emergency department that sees on average 65,000 patients per year. There are no other EDs to whom patients can be diverted, and so despite admission rates from the ED of up to 48%, other options need to be examined. In order to develop a series of unified responses, which acknowledge the multifactorial nature of the problem, the Emergency Department Cardiac Analogy model of ED flow, was developed. This model highlights the need to intervene at each of three key points, in order to address the issue of overcrowding and its associated problems.