Counter Register Research Articles

Patient perception and satisfaction are prudent for assessment and improvement of hospital services: a cross sectional study among OPD patients at ESIC medical college and hospital, Faridabad, Haryana

Background: It is imperative for hospital managers to understand and estimate consumer perspective in order to identify and address the perceived gap (if any). The present study was conceived to assess quality of OPD services and patient satisfaction in a tertiary level hospital and to determine the remedial measures for improvement of health services as suggested by the patients. Methods: A hospital based, cross sectional, descriptive study was conducted, using exit interviews, among new OPD attendees at ESIC Medical College and Hospital, Faridabad from August-September, 2016. Data thus collected was analyzed using SPSS 17.0. Results: Out of 145 study subjects, 88.9% (129) subjects perceived the quality of services rendered at hospital as good and 11.1% (16) perceived the quality as poor. 80.68% (117) subjects were reportedly satisfied and only 19.31% (28) were dissatisfied with the hospital OPD services. No statistically significant association was observed between the overall perceived quality and socio-demographic variables of study subjects like age, sex, literacy status and occupation. Main reasons for dissatisfaction as reported by patients were poor availability of medicine(s) (46.15%), poor behavior of doctors (38.46%), long queue(s) at OPD (26.92%) and poor staff behavior (26.92%). Remedial measures suggested by patients were improvement in the availability of medicine (31%), doctor's behavior (17%) and increase in patient registration counters (17%), which were in line with the reasons for dissatisfaction. Conclusions: It is likely that the very act of involving respondents in evaluating their health services will make providers more sensitive and alert to patient needs.

WEB BASED MANAGEMENT SYSTEM FOR ENACTUS MALAYSIA NATIONAL CUP (E-EMNC)

Web Based Management System of Enactus Malaysia National Cup (E-EMNC) is event management system that specially designed for the uses of Enactus Malaysia National Cup. Without a proper event management system, Enactus Malaysia National Cup cannot be perfect enough due to several outburst issues such as miss update of payment, long queue at registration counter, misunderstand of information and others. Thus, this event management system was developed to overcome most of the problem that occurs before, during and after the events. Related objectives are stated to solve the problem. System Development Life Cycle Waterfall model is used as the methodology to develop this system. This system is developed by using PHP as server-side scripting and Bootstrap as front end framework. The prototype of the system was considered success because it could navigate student leader to complete submit the report by shown the flow of system. This system is expected to lighten the burden of event committees and educated team leader on filing document through internet.

Development and validation of a Hindi language health-related quality of life questionnaire for melasma in Indian patients.

Melasma, which is fairly common in Indians, causes significant emotional and psychological impact. A Hindi instrument would be useful to assess the impact of melasma on the quality of life in Indian patients. To create a semantic equivalent of the original MELASQOL questionnaire in Hindi and validate it. A Hindi adaptation of the original MELASQOL (Hi-MELASQOL) was prepared using previously established guidelines. After pre-testing, the Hi-MELASQOL questionnaire was administered to 100 women with melasma visiting the out-patient registration counter of Safdarjung Hospital, Delhi. These women were also administered a Hindi equivalent of the Health Related Quality of Life (HRQOL) questionnaire. Melasma area severity index (MASI) of all the participants was calculated. The mean MASI score was 20.0 ± 7.5 and Hi-MELASQOL score was 37.19 ± 18.15; both were highly, positively and significantly correlated. Reliability analysis showed satisfactory results. Physical health, emotional well-being and social life were the most adversely affected life domains. It was a single-center study and the number of patients studied could have been larger. Hi-MELASQOL is a reliable and validated tool to measure the quality of life in Indians with melasma.

Hiding the tobacco power wall reduces cigarette smoking risk in adolescents: using an experimental convenience store to assess tobacco regulatory options at retail point-of-sale

ObjectivesThis experiment tested whether changing the location or visibility of the tobacco power wall in a life sized replica of a convenience store had any effect on adolescents’ susceptibility to...

An assessment of OPD registration counter services and channelization of patients in NSCB Medical College Hospital, Jabalpur (MP)

Background: Health is a fundamental human right. Outpatient department (OPD) registration counter is the first entry point of any patient, and it is an important point to reflect the services provided to the community in a hospital setting. Objectives: (1) To review the existing situation of patient load and OPD registration counter facility available, (2) the mode of channelization of patients from OPD registration counters to one nearest and one farthest OPD, and (3) the difficulty faced by patients and patient satisfaction. Materials and Methods: This was a cross-sectional study design based on direct observation and interview of patients done at OPD of NSCB Medical College, Jabalpur, Madhya Pradesh, India. A total of 640 patients were selected from simple random sampling technique, who were going to either medicine (nearest) or Pediatric (farthest) department. Time was noted at different points of channelization, and interview of the patient was taken with the help of a predesigned questionnaire. Data were analyzed using MS Office Excel 2007 software. Result: Of the 640 patients, only 605 (94.5%) of them took part till the end of the study. The average arrival rate was 80 patients/h. The average time taken between joining the queue and reaching up to the registration counter was 29 ± 2.9 min. The average total time taken to get the OPD services after joining the queue was 74.6 ± 4.1 min. Patients were dissatisfied with physical facility but satisfied with staffs. Conclusion: Patient satisfaction toward hospital staffs and doctors were good, but they were dissatisfied with physical facility and waiting time. There is an urgent need to focus on causes of dissatisfaction to increase patient compliance and success of treatment.

REDUCING WAITING TIME IN OUTPATIENT SERVICES OF LARGE UNIVERSITY TEACHING HOSPITAL - A SIX SIGMA APPROACH

This papar presents the results of a project of improving the quality of services provided in an outpatient department of an university hospital in India. The project was conducted on the basis of the six sigma methodology and aimed to reduce waiting times in outpatient cardiology office. Significant reduction in waiting time was achieved in the outpatient services of the Cardiology department by using the six sigma approach. In addition to the overall reduction in waiting time for cardiac medical consultation significant reduction in waiting time for getting the lab results was also achieved. As an off shoot of the study nine registration counters were started, registration forms were modified, usherers were appointed to guide patients, additional staff were appointed to handle the telephones in the Cardiology OPD and they were also taught basic telephone etiquette, dedicated biochemistry analyser was provided for the cardiology department and an alert system was put in place for patients waiting for more than one hour. Further data collection through VOC will help to monitor and control any variance.

An Engineering Design of 4-bit Special Purpose Microprogrammed Processor

This work is a complementary part for what we proposed in [1]. In this paper, an undergraduate design experience for special purpose 4-bit microprocessor using the skills learned from digital logic design and Microprocessors courses is presented. The experience started in [1] by designing the ALU using the hardware printed circuit board and we are following it by completing the design by the instruction set architecture and the microprogram code. Our microprocessor contains – in addition to the ALU- six registers: A 4-bit accumulator register, Flag register that holds only zero (Z) and carry (C) flags, Program counter register (PC), Memory address register (MAR), Instruction register (IR), and Buffer Register. All programs and data are stored in the 1k RAM.

A Mixed Signal (Analog-Digital) Integrator Design

Presented is a design of a mixed signal integrator, consisting of a traditional analog integrator (op-amp with capacitor in feedback) augmented with comparators, logic, counter registers, and a precharged capacitor that can be switched into, and out of, the input of the analog integrator. This device integrates with analog, but stores results in analog and digital. Whenever an analog integrator voltage equals or exceeds a threshold voltage, an amount of charge equivalent to the threshold voltage is cleared from the feedback capacitor of the analog integrator, and the counter register is incremented or decremented accordingly. With the threshold voltage representing one in a counting system, these actions convert the integrator contents to ±1. At any instant, the counter register holds the integer portion of the integral, and the analog integrator holds any fractional portion, permitting the integral to be internally stored as a real number. The mixed signal integrator accumulates integral beyond supply rails without op-amp saturation; has analog integrator bandwidth that extends into the limited gain low frequency region; avoids drift due to low pass filter effects and unbalanced input biases; and exhibits no sampled data or discrete system effects. Tests on a PCB prototype verified the design.

ANALISIS KEPUASAN PASIEN TERHADAP MUTU PELAYANAN DI TPPRJ DI RUMAH SAKIT BHAKTI WIRA TAMTAMA SEMARANG PERIODE TAHUN 2011

Background. Place of registration of outpatients is often regarded as a place of registration, even though this is the place of first contact occurs between patients with officers as the beginning of a ministry. TPPRJ need to be placed on the officer who has a good competency, security services, as well as providing comfort and enjoyment. therefore, researchers wanted to find out patient satisfaction for the quality of service at the TPPRJ about competence officers, security services, as well as the comfort and enjoyment in the hospital. Method. Type of research used is descriptive, with a survey method and study population were patients who enroll in TPPRJ in 2011 with a sample of 98 patients. This research instrument using quisioner with interviews, primary data obtained from quisioner, processed and analyzed descriptively. Result. Results obtained from the research results on aspects of staff competence highest patient satisfaction in terms of officer performance is 92.85%, on the security aspects of patient care the highest satisfaction in terms of security of injury does not occur at the registration counter is equal to 97.95%,on the aspect of comfort and enjoyment of the highest patient satisfaction of service in terms of state of the waiting room in the registration that is equal to 89.79% Conclusion. Of patient opinion about what caused the dissatisfaction of patients in the tpprj then the suggestion that the authors give is more nimble workers in providing care for patients, the TPPRJ more concerned about the ease and speed of service procedures, as well as on the tpprj attention to patient safety while queuing at the counter registration Key words: patient satisfaction, quality of service, TPPRJ.

Disappearance of a deadly disease acute hepatomyoencephalopathy syndrome from Saharanpur

Sir, Apropos our earlier correspondence1, there has been a drastic reduction of the deadly disease affecting young children of Saharanpur district of western Uttar Pradesh (UP). The outbreaks of this unexplained acute brain disease in children was recurring every year, with very high (70-80%) fatality for over two decades. It was earlier known as “Saharanpur encephalitis” or “acute viral encephalitis of unknown origin”. However, it was later found not encephalitis, but a multi-system disease affecting liver, muscle and brain and re-named “acute hepatomyoencephalopathy (HME) syndrome” caused by phytotoxins2. Later, the source of toxicity was found to be to the consumption of beans of a ubiquitous herb Cassia occidentalis by unsupervised young children of poor families3,4. Cases occurred only in September through December every year coinciding with the poding season of this annual plant. After publication of these studies, a meeting of all stakes-holders that comprised paediatricians, general physicians, local health and district administrations, health agencies, and media representatives was conducted in 2007 at the district headquarter city of Saharanpur, the worst affected district. Later, the local unit of Indian Academy of Pediatrics, with support from the health agencies [mainly UNICEF and National Polio Surveillance Project (NPSP)], district administration, and media launched a massive educational campaign in and around Saharanpur district to educate people about the poisonous nature of the weed. Pamphlets in local language were printed and distributed; the ‘live weed’ was exhibited/displayed at the registration counters of all hospitals and nursing homes, frequently-visited government offices, and at other public places. The task of massive uprooting of the weed was taken by the forest and Public Works departments. Instructions were given to village ‘Pradhans’ to employ labourers for destroying the weed from the neighbourhoods. Regular meetings were organized with ‘Gram Panchayat’ members and villagers were educated regarding the toxic nature of the plant. Media played a significant role in creating awareness among rural population. The entire operation was supervised by the district magistrate of Saharanpur. This massive campaign, sustained over 2 years led to drastic reduction in the number of cases in the district. As evident from the Table, the total number of admissions in Saharanpur district hospital which has a special ‘encephalitis ward’ to admit these cases, fell from 100-200 cases admitted annually up to 2007 to 15-30 in 2008 and 2009 and to nil in 2010. Table Numbers of admitted cases and deaths in Saharanpur District Hospital, 2002-2010 There is an urgent need to carry out similar awareness/education campaigns in all other affected districts of western UP and Uttarakhand. The lessons learnt are that there is no substitute to systematic and professional investigation of any outbreak of unknown cause2–4. This experience deserves wider publicity and public understanding. Healthcare professionals both in private and public sectors should have inquisitive mind and motivation to solve local problems by team approach. Public-private partnership in health sector can help achieving some difficult, unattainable targets. And, media can also play a very important constructive role in raising awareness among general public.

Программная конвейеризация циклов на платформе ARM

This article describes improvements we made in the implementation of swing modulo scheduling (SMS), a well-known software pipelining technique, in the GNU Compiler Collection (GCC) for ARM platform. Prior GCC implementation required a loop being pipelined to conform to the do-loop pattern, which needs a special hardware instruction. However, such hardware instruction is absent on ARM. First we implemented a “fake” do-loop instruction in the ARM backend, which helped us to verify whether GCC SMS implementation is profitable on ARM. Then we designed and implemented support for loops which loop counter varies as an arithmetic progression. In do-loops the loop counter must be used only in control part of the loop, and we allow reading loop counter register by other loop instructions. For such loops we improved the algorithm for creating prologue and epilogue as well as implemented much more complex algorithm of verification conditions for entering performance-optimized version of the loop. Also we made necessary changes in data dependency graph to generate correct code. When dependency graph is built we create additional anti-dependencies between instructions which use flag register. The resulting performance improvement is 3-4% for selected test applications on ARM platform. For x86-64 platform, performance results are mostly neutral, with exception of 2-3% improvement on matrix multiplication tests.

DRAM as source of randomness

Proposed is a true random number generator (TRNG) based on collision between DRAM accesses and refresh operations. The generator repeatedly executes a short code and reads a part of time counter register after each execution without an explicit post-processing. The simplicity allows the generation of true random numbers with a reasonable efficiency on commodity desktop computers without special devices and opens the possibility for simple TRNG on devices that use DRAM. Although very simple, the quality of the bit sequence is surprisingly good, as demonstrated by test results using NIST test suite.

A new adaptive delay method for wideband wireless Kahn's RF power amplifiers

This paper presents an adaptive delay control method used in wideband Kahn's envelope elimination and restoration (EER) RF power amplifiers (PAs). Besides control circuits, envelope and phase signals are also implemented by baseband digital signal processing (DSP) technique. It avoids using not only nonlinear limiter and envelope detector, but also difficult RF delay module or complicated feedback loop, each of which is necessary in conventional EER PA's structure. With the help of applying phase detector, counter, and latch register, the delay varies adaptively with circuit parameters, and then the new PA maintains performance at all times. With the application of this method we can realize a PA applicable to IEEE 802.11b standard with 11 MHz signal bandwidth, of which adjacent channel power ratio (ACPR) is better than -40 dBc at the first side lobe

Method for direct multiway branching in microprogram control

A new technique is proposed for simultaneously executing multiway branching with PLAs. The basic structure consists of three units: the microcode ROM, the microsequencer PLA and a register counter. The main idea is to store only branching information in PLA, exploiting the associative addressing properties of the latter. Benefits in speed and memory space are obtained.

Cerebellum and cerebrum model with periodic processing, neurotubules conduction hypothesis

This paper compares the brain model described in a preceding paper with the nervous system. The operation of association leads us to suppose not observed functions equivalent to some parts of the model The following hypothesis are advanced. The neurotubular networks inside the dendrites are considered as analysis fibers and working rules are supposed for neurotubules joints, synapses and neurons. The cerebellum processes as a dynamic controller. Annular circuits going by the cerebellar nuclei and the inferior olive feed back the preceding information and reserve cells. The periodic processing is correlated with focal potentials. In the brain, the future events are simulated in a neuronal network. The forecast action is executed if the look ahead wave excites pleasure autonomic centers. Relation between this model and the behaviour is developed. One arbor of the large pyramidal cell analyses the sensory input, the other the look ahead wave. The thalamus is a frequency counter register. The perithalamic reticular nucleus is a selection center. The striatum is a temporary storage. The set cortex entorhinal, hippocampus, septum is used to distinguish already lived situations and to load again conscious status. Some mental illnesses are compared with misfunctions.

Synthesis of Binary Ring Counters of Given Periods

A number of papers have been written from time to time about logical counters of a certain type which have quite simple logic and have been variously referred to as Binary Ring Counters, Shift Register Counters, Johnson Counters, etc. To my knowledge, most of these papers confine themselves to certain special cases and usually leave the subject with some speculation as to the possibility of generating periods of any desired length by the use of these special types. The point of view of this paper is to consider all possible counters of this general type to see how one would obtain a particular period. Special emphasis is placed on determining the least number of bits, n , required to produce a given period, K . The rules for counting are as follows. If an n -bit counter is in state ( a n -1 , a n -2 ···, a 2 , a 1 , a 0 ) at a given time, T , then at T + 1 its state is ( b n -1 , b n -2 , ···, b 1 , b 0 ) where b 0 = a n -1 , b i = a i -1 + c i a n -1 for i = 1, 2, ···, n - 1. The a 's, b 's, and c 's are all 0's or 1's, the c 's being constants, and the indicated operations are carried out using modulo 2 arithmetic. This is equivalent to considering the state of the counter as an ( n - 1)th degree polynomial in X , multiplying said polynomial by X and reducing it modulo m ( X ), where m ( X ) is a polynomial of degree n which is relatively prime to X . At time T the state of the counter corresponds to: A ( X ) = a n -1 X n -1 + a n -2 X n -2 + ··· + a 1 X + a 0 . The polynomial which corresponds to the state of the counter at time T + 1 is obtained by forming X · A ( X ) and reducing, if necessary, modulo m ( X ) = X n + c n -1 X n -1 + c n -2 X n -2 + ··· + c 1 X + 1. Since a n -1 · m ( X ) = 0 mod m ( X ), X · A ( X ) = X · A ( X )+ a n -1 m ( X ) mod m ( X ), so X · A ( X ) = ( a n -2 + c n -1 · a n -1 ) X n -1 + ( a n -3 + c n -2 a n -1 ) X n -2 + ··· + ( a 0 + c 1 a n -1 ) X + a n -1 = b n -1 X n -1 + b n -2 X n -2 + ··· + b 1 X + b 0 . It is well known that more than one possible period may be obtained depending upon the initial state of the counter. Several examples are given by Young [4]. However, starting with X itself will always yield the longest possible period for any given m ( X ) and, furthermore, any other periods possible will always be divisors of the major period (Theorem I below). Since these minor periods can always be obtained with moduli of lower degree they are of no real interest here, and throughout the remainder of this paper the expression “period of the counter” will be assumed to refer to the major period. The set of all polynomials whose coefficients are the integers modulo 2 is the polynomial domain GF (2, X ), which has among other things unique factorization into primes (irreducibles). If m ( X ) is in GF (2, X ), then GF (2, X ) modulo m ( X ) is a commutative ring. Thus it is closed under multiplication, but it may have proper divisors of zero. However, any element which is relatively prime to m ( X ) in GF (2, X ) has an inverse in GF (2, X )/ m ( X ) [1].

Analysis of Shift Register Counters

Analysis of Shift Register Counters