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Objectives: To understand the facilitators and barriers to the implementation of renal tumour biopsy (RTB) in the diagnostic pathway for renal tumours in England. Patients and Methods: Participants consisted of patients who had a renal tumour diagnosed and/or treated at one of five tertiary centres in England, healthcare professionals involved in the direct care of patients diagnosed with renal tumours, and clinical service managers and commissioners. The study employed a mixed‐methods research methodology consisting of individual interviews and an on‐line survey that explored the types of facilitators and barriers individuals perceived and experienced and the frequency in which these were reported. A public dissemination event took place following the completion of data collection; to facilitate discussion of potential solutions to implementing RTB. Results: There were 50 participant interviews (23 patients, 22 clinicians, and five health service commissioners/operations managers). The patient on‐line survey received 52 responses, and the clinician survey received 22 responses. Patients most frequently reported influences in choosing whether to undergo RTB pertained to wanting to know the diagnosis of their kidney mass (40%), the advice or information provided by healthcare professionals (40%), and not wishing to delay treatment (23%). Clinicians most frequently reported barriers to recommending RTB related to their uncertainty of diagnostic accuracy (56%), availability of appointments or hospital beds (52%), concerns of risk of bleeding (44%), risk of seeding (41%), and delays in meeting national cancer pathway targets (41%). The dissemination event was attended by 18 participants (seven patients and 11 clinicians). Suggestions to improve implementation included reducing variation and promotion of standardisation of practice by a consensus statement, increasing the evidence base (clinicians) and improved communication by developing better patient aids such as videos and diagrams (patients and clinicians). Conclusion: Implementation of RTB may be dependent on the quality of information provided, its format and perceived reliability of the information. Increased utilisation of RTB may be improved by development of a consensus statement on the role of biopsy, with patients expressing a preference for alternative information aids such as patient videos. [ABSTRACT FROM AUTHOR]

Purpose: The increasing use of advanced medical technologies to detect adverse events, for instance, artificial intelligence‐assisted technologies, has shown promise in improving various aspects within health care but may also come with substantial expenses. Therefore, understanding the potential economic benefits can guide decision‐making processes regarding implementation. We aimed to estimate the potential cost savings associated with reducing length of stay and avoiding readmissions within the framework of an artificial intelligence‐assisted vital signs monitoring system. Methods: We used data from Danish national registries and coarsened exact matching to estimate the difference in length of stay and probability of readmission among adult in‐hospital patients exposed to and not exposed to serious adverse events. We used these estimates to calculate the maximum potential savings that could be achieved by early detection of adverse events to reduce length of stay and avoid readmissions. Results: Patients exposed to serious adverse events during admission had 2.4 (95% CI: 2.4–2.5) additional hospital bed days and had 14% (95% CI 11%–17%) higher odds of readmissions compared with patients not exposed to such events. A base case scenario yielded maximum potential savings if one patient avoided a serious adverse event of EUR 2040 due to reduced length of stay and EUR 43 due to avoidance of readmissions caused by serious adverse events. Conclusion: Reductions in serious adverse events are associated with decreased healthcare costs due to reduced length of stay and avoided readmissions. Artificial intelligence‐assisted vital signs monitoring systems are one potential approach to reduce serious adverse events, however, the ability of this technology to reduce adverse events remains unclear. Comprehensive prospective analyses of such systems including the intervention and implementation costs are necessary to understand their full economic impact. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Paediatric periorbital cellulitis, a common eye condition, typically requires inpatient admission for intravenous antibiotics due to concerns about orbital spread. This study aimed to assess the safety and effectiveness of ambulatory management for children with moderate periorbital cellulitis.Over a 24‐month period, we prospectively enrolled 84 children aged 1 to 16 years who presented with moderate periorbital cellulitis to the emergency department. Demographic and clinical data were collected. Following a guideline‐based decision tree, eligible children received intravenous antibiotics and were discharged with a peripheral cannula for follow‐up in ambulatory care and ophthalmology clinics. Descriptive statistics were used for data presentation.Among the 84 children, 62 (73.8%) were managed through the ambulatory care model. Within the category of moderate POC, those who were admitted to the hospital did not have higher CRP or White Cell counts and received IV antibiotics for the same length of time. The ambulatory care clinic provided a total of 132 daily doses of intravenous antibiotics. Two children treated on this pathway required inpatient admission due to clinical deterioration, one of whom required ophthalmic surgical intervention. There was no mortality or sight‐threatening complications in this study.Implementing a directed ambulatory care pathway for children with moderate periorbital cellulitis proved to be an effective and safe management strategy. This approach reduces the strain on hospital bed occupancy while promoting community‐based patient care. [ABSTRACT FROM AUTHOR]

Background: Increasing nosocomial infections during the COVID-19 pandemic have been reported. However, data describing peripheral venous catheter associated bloodstream infections (PVC-BSI) are limited. Aims: To describe the epidemiology and risk factors for PVC-BSI during the COVID-19 pandemic. Methods: We conducted retrospective cohort study of prospectively collected PVC-BSI data in a 2100 bed hospital network in Switzerland. Adult patients with a PVC inserted between January 1, 2020 and December 31, 2021 were included. Risk factors for PVC-BSI were identified through descriptive analysis of patient and catheter characteristics, and univariable marginal Cox models. Results: 206,804 PVCs and 37 PVC-BSI were analysed. Most PVC-BSI were attributed to catheters inserted in the Emergency department (76%) or surgical wards (22%). PVC-BSI increased in 2021 compared to 2020 (hazard ratio 2021 vs. 2020 = 2.73; 95% confidence interval 1.19–6.29), with a numerically higher rate of Staphylococcus aureus (1/10, 10%, vs. 5/27, 19%) and polymicrobial infection (0/10, 0% vs. 4/27, 15%). PVC insertions, patient characteristics, and catheter characteristics remained similar across the study period. PVC-BSI risk was associated with admission to the intensive care unit (ICU), and use of wide gauge catheter (< = 16G). Conclusion: Increased PVC-BSI during the COVID-19 pandemic was not explained by catheter or patient factors alone, and may result from system-wide changes. PVC-BSI events are primarily attributed to acute care settings, including the emergency department, surgical wards, and the ICU. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications and Impact Reporting Method Patient or Public Contribution To identify whether the introduction of low‐low hospital beds resulted in changes in the incidence, associated patient harms and event characteristics of bed‐related falls where implemented.This retrospective quality improvement study covered 36 months: 18 months pre‐intervention and 18 months post‐intervention.Our analysis incorporated patient fall data from a hospital in upstate New York. Pre‐/post‐intervention data covered 18 months on either side of introduction at the units of implementation. Data were sourced from contemporaneously recorded incident reports and the organisation's business intelligence records. Analysis addressed the incidence rate, frequency, patient harm classification and recurrence of bed‐related falls, as well as Morse Fall Scale risk classification, patient age, gender and other individualised risk factors. Lastly, we reviewed the presence of individualised interventions, staff assistance during the event, patient census and staffing ratios. Chi‐square goodness of fit tests were employed to compare the distribution, and Brunner‐Munzel tests the stochastic equality, of the pre‐ and post‐implementation categorical and continuous data.There were no significant differences in the incidence rate of bed‐related falls, patient harms or in the need for medical intervention following implementation of the low‐low hospital beds. Neither were there any significant differences in the proportion of events resulting in detectable harm or the need for medical intervention post‐implementation. The total number of bed‐involved falls substantively increased following implementation of the low‐low beds, as did the number of events resulting in detectable harms and medical intervention. Among these, substantive increases were noted among events resulting in minor temporary harm and patients referred for diagnostic imaging. The number of events involved patients experiencing recurrent falls of any kind increased significantly post‐implementation.We found that the introduction of low‐low hospital beds preceded no change in the incidence of bed‐related falls, associated patient harms or the need for post‐event medical intervention where implemented. While data limitations precluded definitive determination with respect to certain event characteristics, several post‐implementation changes, including substantive increases in the number of falls occurring during ingress and egress, may suggest a potential for relationship worthy of future study.Low‐low hospital beds are purported to help reduce the occurrence and severity of bed‐related falls, both serious problems in inpatient settings. This study describes null outcomes following an implementation of such beds, with implications for adoption in similar settings.We adhered to the relevant Enhancing the Quality and Transparency of Health Research guidelines, specifically following the Standards for Quality Improvement Reporting Excellence standards.No patient or public involvement in the design or conduct of the study. Nurses and medical staff were involved in intervention implementation, data collection and the conception, design and conduct of the study. [ABSTRACT FROM AUTHOR]

AbstractFiltering face piece (FFP) masks according to EN 149 Respiratory protective devices – Filtering half masks to protect against particles – Requirements, testing, marking are essential components of personal protective equipment against biological agents from an occupational health and hospital hygiene perspective. Therefore, shortages due to increased demand or supply bottlenecks can lead to staff threats due to the risk of infection. To determine whether FFP masks could be made reusable in a hospital setting, a thermal reprocessing concept (steam at 105 °C with a holding phase of 10 min) was evaluated in a bed reprocessing chamber. The results indicate that it is logistically possible to establish a reprocessing concept. Of 267 reprocessed masks, 48 were rejected by inspection because of defect strapping, trapped hair, misfolding, and missing lot number or deformation, and 22 masks were rejected by bacteriological examination because of contamination > 10 CFU of total bacteria per 25 cm2 or the presence of Staphylococcus aureus. Two selected mask models maintained the expected mask performance equivalent to the FFP2 standard after reprocessing. Thermal reprocessing resulted in a virucidal effect. The results show that reprocessing of FFP masks in hospitals is possible. However, the success of reprocessing depends on the type of mask used. This study identified a suitable mask type for which the reported method is bactericidal and virucidal without impairing mask performance. The reported method required the use of a stationary hospital bed reprocessing chamber (sanitizing washer), so it cannot be used everywhere. Other methods and procedures should be tested to be independent of a bed reprocessing chamber and therefore may be more mobile and flexible. [ABSTRACT FROM AUTHOR]

Background: Hospital at home care services offer a potential solution to the problem of strain on hospital beds while simultaneously enhancing patient outcomes. Nevertheless, implementation of the hospital at home care model is associated with several challenges. One such barrier involves patient enrolment, particularly during the initial stage of service operation. Due to their frontline experience, healthcare professionals possess valuable insights that can help us understand and address this challenge. This study aimed to explore the experiences of hospital staff in the decision-making process concerning patient enrolment in hospital at home. Methods: In total, 22 semi-structured individual interviews were conducted with hospital staff members between January and May 2022 at the participants' workplace or in a public office depending on their preferences. Data were analysed using reflexive thematic analysis. Results: We identified four themes pertaining to the experiences of hospital staff with the decision-making process concerning patient enrolment in hospital at home: "beneficial for the patients; an important motivating factor", "patient eligibility; prioritizing safety", "contextual factors within hospital ward units; opportunities and limitations", and "collaboration with municipalities; crucial but challenging". Conclusions: Hospital staff described a complex and dynamic decision-making process when considering patient eligibility for enrolment to hospital at home services. The findings highlight both barriers and enablers pertaining to this process and emphasize the need to provide support to hospital staff as they navigate this complex situation. A key finding pertains to the critical importance of high-quality decision-making in ensuring positive outcomes and the overall effectiveness of hospital at home care services. Additionally, this study proposes a deeper exploration of the ethical considerations associated with balancing the goal of patient safety with that of equitable access to high-quality, person-centred care within the context of hospital at home. [ABSTRACT FROM AUTHOR]

Objective Data Sources Study Design Principal Findings Conclusions What is known on this topic What this study adds To quantify disruptions in hospitalization and ambulatory care throughout the coronavirus disease 2019 (COVID‐19) pandemic for 32 countries, and examine associations of health system characteristics and COVID‐19 response strategies on disruptions.We utilized aggregated inpatient hospitalization and surgical procedure data from the Organization for Economic Co‐operation and Development Health Database from 2010 to 2021. Covariate data were extracted from the Organization for Economic Co‐operation and Development Health Database, World Health Organization, and Oxford COVID‐19 Government Response Tracker.This is a descriptive study using time‐series analyses to quantify the annual effect of the COVID‐19 pandemic on non‐COVID‐19 hospitalizations for 20 diagnostic categories and 15 surgical procedures. We compared expected hospitalizations had the pandemic never occurred in 2020–2021, estimated using autoregressive integrated moving average modeling with data from 2010 to 2019, with observed hospitalizations. Observed‐to‐expected ratios and missed hospitalizations were computed as measures of COVID‐19 impact. Mixed linear models were employed to examine associations between hospitalization observed‐to‐expected ratios and covariates.The COVID‐19 pandemic was associated with 16,300,000 (95% uncertainty interval 14,700,000–17,900,000; 18.0% [16.5%–19.4%]) missed hospitalizations in 2020. Diseases of the respiratory (−2,030,000 [−2,300,000 to −1,780,000]), circulatory (−1,680,000 [−1,960,000 to −1,410,000]), and musculoskeletal (−1,480,000 [−1,720,000 to −1,260,000]) systems contributed most to the declines. In 2021, there were an additional 14,700,000 (95% uncertainty interval 13,100,000–16,400,000; 16.3% [14.9%–17.9%]) missed hospitalizations. Total healthcare workers per capita (β = 1.02 [95% CI 1.00, 1.04]) and insurance coverage (β = 1.05 [1.02, 1.09]) were associated with fewer missed hospitalizations. Stringency index (β = 0.98 [0.98, 0.99]) and excess all‐cause deaths (β = 0.98 [0.96, 0.99]) were associated with more missed hospitalizations.There was marked cross‐country variability in disruptions to hospitalizations and ambulatory care. Certain health system characteristics appeared to be more protective, such as insurance coverage, and number of inputs including healthcare workforce and beds. Substantial disruptions in health services associated with the coronavirus disease 2019 pandemic have placed a renewed interest in health system resilience. While there is a growing body of evidence documenting disruptions in services, there are limited comparative assessments across diverse countries with different health system designs, preparedness levels, and public health responses. Learning and adapting from health system‐specific gaps and challenges highlighted by the pandemic will be critical for improving resilience. All countries experienced disruptions to hospitalizations and surgical procedures with a combined total of 30 million missed hospitalizations and 4 million missed surgical procedures in 2020–2021, but there was marked cross‐country heterogeneity in disruptions. Countries with greater baseline healthcare workers, insurance coverage, and hospital beds had disproportionately lower disruptions in care. National health planning discussions may need to balance health system resiliency and efficiency to avert preventable morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare systems worldwide are facing numerous challenges, such as an aging population, reduced availability of hospital beds, staff reductions and closure of emergency departments (ED). These issues can exacerbate crowding and boarding problems in the ED, negatively impacting patient safety and the work environment. In Sweden a hybrid of prehospital and intrahospital emergency care has been established, referred to in this article as Medical Emergency Team (MET), to meet the increasing demand for emergency care. MET, consisting of physicians and nurses, moving emergency care from EDs to patients' home. Physicians and nurses may encounter challenges in their healthcare work, such as limited resources for example medical equipment, sampling and examination, in unfamiliar varying home environments. There is a lack of knowledge about how these challenges can influence patient care. Therefore, the aim of this study was to explore the healthcare work of the METs when addressing patients' emergency care needs in their homes, with a focus on the METs reasoning and actions. Methods: Using a qualitative multiple case study design, two METs in southwestern Sweden were explored. Data were collected from September 2023 – January 2024 and consist of field notes from participant observations, short interviews and written reflections. A qualitative manifest content analysis with an inductive approach was used as the analysis method. Result: The result of this study indicates that physicians and nurses face several challenges in their daily work, such as recurring interruptions, miscommunication and faltering teamwork. Some of these problems may arise because physicians and nurses are not accustomed to working together as a team in a different care context. These challenges can lead to stress, which ultimately can expose patients to unnecessary risks. Conclusion: When launching a new service like METs, which is a hybrid of prehospital and intrahospital emergency care, it is essential to plan and prepare thoroughly to effectively address the challenges and obstacles that may arise. One way to prepare is through team training. Team training can help reduce hierarchical structures by enabling physicians and nurses to feel that they can contribute, collaborate, and take responsibility, leading to a more dynamic and efficient work environment. [ABSTRACT FROM AUTHOR]

We aimed to identify variations in nitrous oxide (N2O) procurement between Australian states and territories per public hospital bed by undertaking a cross-sectional analysis of N2O procurement data for all Australian public hospitals from 1 January 2017 to 30 June 2022. Data were obtained from state and territory departments of health. All Australian public hospitals across six states and two territories were included. We obtained N2O procurement data from Department of Health representatives from all states and territories, accounting for all 697 Australian public hospitals and four public dental hospitals. The main outcome measured in this study was N2O procurement per public hospital bed by state or territory. Across the 5 years (1 January 2017 to 30 June 2022) an average of 242,054 (standard deviation (SD) 16,222) kg of N2O, equivalent to 64,144 (4299) tonnes of carbon dioxide emissions (CO2e), were procured per annum. CO2e emissions from N2O purchase varied more than threefold per public hospital bed between different states/territories (0.47–1.48 CO2e tonnes per hospital bed). There were significant variations in N2O procurement between Australian states and territories when adjusted for public hospital bed numbers. Further analysis of this variation to determine cause and to guide mitigation interventions is therefore warranted. [ABSTRACT FROM AUTHOR]

Manually adjusting hospital beds presents significant challenges for healthcare professionals, which affects their workflow and patient care outcomes. Manual bed modifications consume a significant amount of time, resulting in nurses being less available for other crucial duties. Patient needs can be delayed, and the quality of care delivered overall can be lowered. Manually adjusting the bed to ensure safety and comfort is a risky practice that could result in incorrect placement that can worsen pre-existing medical issues or cause discomfort and pressure sores. In addition, the demand for accurate and frequent bed changes during the day increases the strain on nurses, especially in situations with high patient turnover or complex care needs. The objective of this study is to create a hospital bed that responds to voice commands to improve patient care and monitoring. The bed's voice recognition technology allows patients to adjust their positions and improve comfort and accessibility, particularly for individuals with mobility issues. It includes sensors that continuously measure the patient's heart rate and temperature while they are in bed. These sensors provide real-time data, enabling prompt detection of any irregularities and facilitating immediate intervention in the patient's heartbeat and temperature. The combination of voice control and continuous health monitoring ensures a higher standard of patient care, improves patient autonomy, and reduces the workload on medical staff. The aim of this innovative bed is to create a healthcare environment that is more responsive and efficient, which ultimately leads to better patient outcomes and enhanced overall hospital efficiency. [ABSTRACT FROM AUTHOR]

Abstract Background Equitable geographical distribution of health resources, such as hospital beds, is fundamental in ensuring public accessibility to healthcare services. This study examines the distribution of hospital beds across Saudi Arabia's 20 health regions. Methods A secondary data analysis was conducted using the 2022 Saudi Ministry of Health Statistical Yearbook. The study focused on calculating the hospital beds-per-1,000-people ratio across Saudi Arabia's 20 health regions. The analysis involved comparing regional bed distributions using the Gini index and Lorenz curve to assess the distribution of hospital beds. Results The national average beds-per-1,000-people ratio was 2.43, serving a population of approximately 32.2 million. The calculated mean Gini index for bed distribution was 0.15, which indicates a relatively equitable distribution. Further analysis revealed some regional disparities, with health regions like Makkah and Jeddah displaying critically low bed-to-population ratios. In contrast, others like Al-Jouf and the Northern region reported higher ratios. The study also identified the need for an additional 17,062 beds to meet international standards of 2.9 beds per 1,000 people. Conclusions The findings revealed a national average beds-per-1,000-people ratio of 2.43, with some regional disparities. The study highlights the critical need for targeted healthcare planning and policy interventions to address the uneven distribution of hospital beds across Saudi Arabia. Trial registration Not applicable.

Vascular hemostasis after venous and arterial access in cardiovascular procedures remains a challenge. As sheath size gets larger for structural heart and vascular procedures, no dedicated closure devices exist that can overcome all the challenges of achieving vascular hemostasis, in particular on the venous side. Efficiently and reliably ensuring hemostasis at the access point is crucial for enhancing the safety of a procedure. Historically, hemostasis relied on manually compressing venous access sites. However, the shift towards larger sheaths and the more frequent use of continuous anticoagulation has strained this approach. Achieving hemostasis solely through compression in these scenarios demands heightened vigilance and prolonged application, resulting in increased patient discomfort and extended immobility. Consequently, manual compression may consume more time for healthcare providers and contribute to bed occupancy in hospitals. This review article summarizes the development of the SiteSeal® Vascular Closure Device, a novel leave-nothing-behind approach to achieve hemostasis. The introduction of this technology has provided clinicians with a safer and more effective way to achieve immediate hemostasis, facilitate early ambulation, and enable earlier discharges with fewer access site complications compared with traditional manual compression. [ABSTRACT FROM AUTHOR]

Background: In low and middle-income countries (LMICs), non-communicable diseases (NCDs) are on the rise and have become a significant cause of mortality. Unfortunately, accessing affordable healthcare services can prove to be challenging for individuals who are unable to bear the expenses out of their pockets. For NCDs, the treatment costs are already high, and being multimorbid further amplifies the economic burden on patients and their families. The present study seeks to bridge the gap in knowledge regarding the financial risks that come with NCD multimorbidity. It accomplishes this by examining the catastrophic out-of-pocket (OOP) expenditure levels and the factors that contribute to it at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A facility-based cross-sectional study was conducted at Tikur Anbesa Specialized Hospital between May 18 and July 22, 2020 and 392 multimorbid patients participated. The study participants were selected from the hospital's four NCD clinics using systematic random sampling. Patients' direct medical and non-medical out-of-pocket (OOP) expenditures were recorded, and the catastrophic OOP health expenditure for NCD care was estimated using various thresholds as cutoff points (5%, 10%, 15%, 20%, 25%, and 40% of both total household consumption expenditure and non-food expenditure). The collected data was entered into Epi Data version 3.1 and analyzed using STATA V 14. Descriptive statistics were utilized to present the study's findings, while logistic regression was used to examine the associations between variables. Results: A study was conducted on a sample of 392 patients who exhibited a range of socio-demographic and economic backgrounds. The annual out-of-pocket spending for the treatment of non-communicable disease multimorbidity was found to be $499.7 (95% CI: $440.9, $558.6) per patient. The majority of these expenses were allocated towards medical costs such as medication, diagnosis, and hospital beds. It was found that as the threshold for spending increased from 5 to 40% of total household consumption expenditure, the percentage of households facing catastrophic health expenditures (CHE) decreased from 77.55 to 10.46%. Similarly, the proportion of CHE as a percentage of non-food household expenditure decreased from 91.84 to 28.32% as the threshold increased from 5 to 40%. The study also revealed that patients who traveled to Addis Ababa for healthcare services (AOR = 7.45, 95% CI: 3.41–16.27), who were not enrolled in an insurance scheme (AOR = 4.97, 95% CI: 2.37, 10.4), who had more non-communicable diseases (AOR = 2.05, 95% CI: 1.40, 3.01), or who had more outpatient visits (AOR = 1.46, 95%CI: 1.31, 1.63) had a higher likelihood of incurring catastrophic out-of-pocket health expenditures at the 40% threshold. Conclusion and recommendation: This study has revealed that patients with multiple non-communicable diseases (NCDs) frequently face substantial out-of-pocket health expenditures (CHE) due to both medical and non-medical costs. Various factors, including absence from an insurance scheme, medical follow-ups necessitating travel to Addis Ababa, multiple NCDs and outpatient visits, and utilization of both public and private facilities, increase the likelihood of incurring CHE. To mitigate the incidence of CHE for individuals with NCD multimorbidity, an integrated NCD care service delivery approach, access to affordable medications and diagnostic services in public facilities, expanded insurance coverage, and fee waiver or service exemption systems should be explored. [ABSTRACT FROM AUTHOR]

Mobile bed to move patients in hospitals is a critical aspect in a healthcare system. Typical hospital beds often require significant manpower and impose physical stresses on caregivers. This paper explores potential solutions to improve hospital bed mobility, focusing on the integration of robotic technologies. Existing literatures on the subject are reviewed, including studies on hospital bed design structures, ergonomic considerations, and implementations of robotics. Different types of wheels suitable for robot movements are discussed, covering conventional wheels, omniwheels, mecanum wheels, swerve drives, and powered fifth wheels. Each wheel type is described and its advantages and disadvantages are highlighted. The comparison of these wheel types helps identify the most suitable option for modifying hospital beds while maintaining their maneuverability. Furthermore, the paper draws inspiration from many applications of mobile robots in other industries, such as automated guided vehicles (AGVs) and autonomous mobile robots (AMRs), to explore potential innovations for the healthcare. By leveraging robotic technologies, hospitals can enhance efficiency and alleviate the burden on healthcare workers. [ABSTRACT FROM AUTHOR]

As per the current scenario, hospitals and healthcare centers are becoming more crowded and require more healthcare professionals. As the demands for manpower increase, the number of workers also increases. As part of our project, we are considering the transfer of patients from bed to stretcher and vice versa, as well as across wards for clinical procedures such as medical imaging, treatment concerns, and shifting to the operating theater. Patients may be affected or disturbed by these procedures or actions, which can make things more complicated. The stretcher's height will vary depending on whether it is in a ward or an operating room, depending on its location. In this project, we have designed an automatic sensor-based height adjustment stretcher. The sensors in the stretcher will recognize the height of the bed near them and adjust themselves accordingly to the bed's height. In this project, we have reviewed existing techniques such as rail-based moving or hoverbased moving systems to improve patient transfer. We can use this automatic height-adjusting application not only in hospital beds but also in beds of CT and MRI machines and ambulances to hospitals, and vice versa. Furthermore, the height-adjusting stretcher, guided by automatic sensors, is designed to elevate the effectiveness of healthcare services by diminishing the need for manual labor in patient transfers. It promises a hassle-free and comforting encounter for both healthcare providers and their patients. [ABSTRACT FROM AUTHOR]

Background: Policymakers, who are constantly discussing growing health expenditures, should know whether the health system is efficient. We can provide them with such information through international health system efficiency evaluations. The main objectives of this study are: (a) to evaluate the efficiency of health systems in 28 developed countries by multiple-criteria decision analysis (MCDA) and data envelopment analysis (DEA) and (b) to identify reasonable benchmark countries for the Czech Republic, for which we collect information on the relative importance of health system inputs and outputs. Methods: We used MCDA and DEA to evaluate the efficiency of the health systems of 28 developed countries. The models included four health system inputs (health expenditure as a relative share of GDP, the number of physicians, nurses, and hospital beds) and three health system outputs (life expectancy at birth, healthy life expectancy, and infant mortality rate). The sample covers 27 OECD countries and Russia, which is also included in the OECD database. To determine the input and output weights, we used a questionnaire sent to health policy experts in the Czech Republic. Results: We obtained subjective information on the relative importance of the health system inputs and outputs from 27 Czech health policy experts. We evaluated health system efficiency using four MCDA and two DEA models. According to the MCDA models, Turkey, Poland, and Israel were found to have efficient health systems. The Czech Republic ranked 16th, 19th, 15th, and 17th. The benchmark countries for the Czech Republic's health system were Israel, Estonia, Luxembourg, Italy, the UK, Spain, Slovenia, and Canada. The DEA model with the constant returns to scale identified four technically efficient health systems: Turkey, the UK, Canada, and Sweden. The Czech Republic was found to be one of the worst-performing health systems. The DEA model with the variable returns to scale identified 15 technically efficient health systems. We found that efficiency results are quite robust. With two exceptions, the Spearman rank correlations between each pair of models were statistically significant at the 0.05 level. Conclusions: During the model formulation, we investigated the pitfalls of efficiency measurement in health care and used several practical solutions. We consider MCDA and DEA, above all, as exploratory methods, not methods providing definitive answers. [ABSTRACT FROM AUTHOR]

Background: A methodology for determining the appropriate balance between medical access and combating poverty remains undetermined. To address the boundary conditions for exceedingly good medical access, this study examined whether the impact of deprivation on cancer stage distribution could be eliminated in Japan, which has the highest hospital bed density in the world. Methods: A nationwide medical claims‐based database was used to evaluate the influence of municipality‐level hospital bed density and the postal code‐level areal deprivation index on cancer stage at diagnosis. Given the limited number of similar studies in Japan, we focused on colorectal cancer (CRC), for which disparities have been reported in a prefecture‐level study. Multilevel multivariate logistic regression models were used, with odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for baseline and socioeconomic factors. Results: Regardless of the early/advanced‐stage definitions, CRC consistently tended to be detected at more advanced stages in more deprived areas. In the analysis of stages 0–I/II–IV, the OR (95% CI) was 1.09 (1.05, 1.14) (p < 0.001). In the analyses of stages 0–I/II–IV and 0–II/III–IV, gradients were observed, and later detections were observed for more deprived segments. Hospital bed density was not significantly associated with the stage distribution. Conclusion: The results indicate that inequalities in CRC detection due to deprivation persist even in the country with the highest hospital bed density worldwide, suggesting that poverty measures remain indispensable regardless of hospital bed access. Further investigation of various regions and cancers is required to develop a practical framework. [ABSTRACT FROM AUTHOR]

The move from psychiatric hospitals to community-based care is the goal of policies in many countries. Latvia has attempted to reach this goal by establishing two outpatient centers in Riga. Since 2005, when the first outpatient centers opened, the ability of day clinics to reduce the total length of stay for hospital inpatients has been observed, although using the outpatient centers did not affect the number of patients treated. The opendoor inpatient wards of the centers also attracted a new patient group. However, due to the COVID-19 pandemic, the number and length of stay of both outpatients and inpatients at psychiatric hospitals decreased. Therefore, other factors that can affect the move from psychiatric hospital inpatient care to outpatient centers should be further investigated. [ABSTRACT FROM AUTHOR]

Background: Fatigue in surgical technologists is of paramount importance and is known as a priority because it can be regarded as a threat to the nurse's health and patient's safety. The fatigue level of healthcare workers can be affected by some factors, while the role of part of these factors is less known. This study aimed to determine the predictive role of resilience and the hospital ethical climate in the fatigue of surgical technologists working in operating rooms (ORs). Methods: This is a cross-sectional study conducted on 217 surgical technologists working in ORs of hospitals affiliated with Shiraz University of Medical Sciences. Data were collected using Connor-Davidson's Resilience scale, Olson's Hospital Ethical Climate Survey, and the Multidimensional Fatigue Inventory, and then analyzed using Pearson's correlation coefficient and multiple regression analysis. Results: 87.1% and 12.9% of surgical technologists reported low and high fatigue, respectively. All fatigue subscales had significant and negative relationships with resilience (p < 0.05). Moreover, the relationship between fatigue and ethical climate was significant (p = 0.02). The multiple linear regression model showed the predictive role of resilience in fatigue (β=-0.29, P < 0.001). According to the model, 10% of the change of fatigue was related to resilience and ethical climate. Conclusion: The present study demonstrated the relationship between resilience and ethical climate with fatigue. Moreover, resilience was a predictor of the surgical technologists' fatigue, so that their fatigue decreased with increasing resilience. However, future studies are recommended to determine other factors influencing fatigue in surgical technologists. [ABSTRACT FROM AUTHOR]

Hospital effluents are important sources for the release of pharmaceuticals into the environment. Metronidazole (MTZ) is one of the most popular antimicrobial agent, widely used in veterinary and human medicine. This study aims to determine the concentrations of MTZ in the effluent of hospitals and to evaluate ecotoxicological risk for aquatic organisms. Grab samples were taken from the effluents of 15 large hospitals in Isfahan City (Iran) and MTZ concentrations were analyzed using HPLC-UV. Average daily MTZ prescriptions for patients in each hospital was also determined. MTZ was detected in effluents of all 15 hospitals in the range of 0.3 to 9.5 µg/L (mean = 4.8 ± 6.4 µg/L). A significant correlation was observed between MTZ concentration in hospital effluent and MTZ prescription as well as the hospital beds. Ecological risk assessment showed MTZ contamination of hospital effluent from 7 of 15 hospitals had median risk (risk quotient of 0.1 to 1) for green algae (Chlorella sp.) while the effluent of all hospitals had minimal risk (risk quotient <0.1) for gram-negative bacteria (Vibrio fischeri) and aquatic crustaceans (Daphnia magna). It is necessary to develop efficient treatment methods for the removal of MTZ from the hospital effluents before discharging them into the municipal wastewater systems. [ABSTRACT FROM AUTHOR]

Information regarding the status of surgical antimicrobial prophylaxis (SAP) in Japanese hospitals is lacking. This study aimed to explore the status of SAP prescriptions for surgeries and adherence to Japanese SAP guidelines. From February to July 2020, a 1-day multicentre point prevalent survey was conducted at 27 hospitals in Aichi Prefecture, Japan. Patients prescribed SAP were included in this study. The appropriateness of the SAP was evaluated based on the guidelines for selection of antimicrobials and their duration. Surgery was defined as appropriate when all the items were appropriate. A total of 728 patients (7.1 %; 728/10,199) received antimicrobials for SAP. Among them, 557 patients (76.5 %, 557/728) underwent the surgeries described in the guidelines. The overall appropriateness of all surgeries was 33.9 % (189/557). The appropriate selection of antimicrobial before/during and after surgery and their durations were 67.5 % (376/557), 67.5 % (376/557), and 43.3 % (241/557), respectively. The overall appropriateness ranged from 0 % (0/37, oral and maxillofacial surgery) to 58.7 % (88/150, orthopaedic surgery) and 27.7 % (36/130, community hospitals with 400–599 beds) to 47.2 % (17/36, specific hospitals). Cefazolin was the most prevalent antimicrobial prescribed before/during (55.5 %, 299/539), and after (45.1 %, 249/552) surgery. In total, 101 oral antimicrobials were prescribed postoperatively. SAP adherence by specific surgical fields and hospitals was shown in this study. Intensive intervention and repeated surveillance are necessary to improve SAP prescriptions in Japanese hospitals. [ABSTRACT FROM AUTHOR]

Hospitals are considered the backbone of healthcare systems, and their significance is particularly pronounced during emergencies. However, the rapid overpopulation and recent pandemics have caused tremendous shortages of hospital beds, raising major threats to public health. This developmental research study aims to help improve the management of hospital beds through the design, development, testing, and evaluation of an Internet of Things (IoT)-based monitoring system implemented using Agile Scrum methodology. Based on the results of the hypothesis testing, the authors found that the optical sensors installed in 4 hospital rooms, with varying distance readings, are consistently accurate (F (3, 388) = 1.000, p=0.393), hence the authors accepted the proposed null hypothesis. Moreover, the beneficiaries, composed of the public, hospital staff, nurses, and a doctor evaluated the system to be overall very good, very efficient, very suitable, reliable, very usable, and very satisfactory. The outcome of this research aims to contribute to the United Nations' Sustainable Development Goals (UN-SDG) on good health and well-being (SDG 3). [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva 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 emergence of the global COVID-19 pandemic in 2020 quickly generated claims that the crisis had demonstrated the superiority of extensive welfare states and a failure of market economies. We conduct cross-sectional statistical analyses to test this claim with regard to first response and reported COVID-19 related deaths per 31 December 2020 (N = 164–200), using government spending as a central variable. The analyses confirm some of what is known from other studies: COVID-19 deaths associate positively and robustly with ageing and more obese populations. However, we find no statistically significant associations between various measures of government size and the number of COVID-19 deaths, alone or when controlled against demographic, political and economic factors. If anything, the general effectiveness of government services and the availability of hospital beds seem more important than the simple size of government or level of health care expenditures. [ABSTRACT FROM AUTHOR]

Because a hospital is an interconnected, interdependent network of care units, allocating resources—beds, nurses, and improvement initiatives—to one unit to reduce its congestion may have spillover effects on other units. If such congestion spillover is substantial, ignoring it may lead to unintended consequences and missed opportunities. We use data collected over five years from a hospital with 16 inpatient units to empirically examine whether and how much congestion propagates through the network of inpatient units. Our estimation result suggests that the magnitude of the congestion spillover is indeed substantial in our study hospital. For example, increasing one inpatient unit's utilization by 10 percentage points today can increase its neighboring inpatient unit's utilization by up to 4.33 percentage points tomorrow. Using counterfactual analyses, we estimate the effect of adding a bed to each unit. We find that due to congestion spillover, adding one bed to the bottleneck unit can free up 4.14 beds in the hospital, which translates to 383.53 more hospital visits per year or a 3% increase in hospital throughput. This effect is about three times bigger in magnitude compared with what one can achieve by naively choosing which unit to add a bed to. Hospitals and other manufacturing and service systems with complex interdependence across resources can use our empirical framework to examine the spillover effect of resources on performance metrics and leverage such understanding to effectively improve their operations. This paper was accepted by Vishal Gaur, operations management. Funding: This work was supported by the Creative-Pioneering Researchers Program through Seoul National University. Supplemental Material: The data files and online appendices are available at https://doi.org/10.1287/mnsc.2023.4887. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Administrative Sciences / Yonetim Bilimleri Dergisi is the property of Canakkale Onsekiz Mart Universitesi, Terzioglu Kampusu 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.)

A challenging SIR epidemiological dynamic model with harmonic rate of incidence and nonlinear rate of recovery is developed to examine the effects of available beds in hospitals and intervention decrease upon the propagation of viral disease. The incorporation of the harmonic mean as an incidence rate is the novelty of the present manuscript. The assumed incidence rate is less sensitive to the larger values of the variables and proves more advantageous for highly skewed data compared to the bi-linear and monod types of incidence rates. For model's stability, precise mathematical conclusions have been produced. The model has two states of equilibrium: an infection-free equilibrium (E 0) , whenever the threshold number assumes values less than one, and a disease-present state (E 1) , whenever R 0 > 1. We employ the principle of LaSalle invariance and Lyapunov's direct technique to demonstrate that the basic threshold quantity R 0 < 1 indicates the global asymptotic stability of E 0. Also whenever 1 < R 0 then the equilibrium point E 1 is stable, under specific parametric conditions. The optimal control strategies for the described model are chosen with the aid of maximum principle of Pontryagin. To support the analytical conclusions, some numerical results are presented. The study's findings show that the model can accurately reflect the complex dynamics of numerous epidemic diseases, resulting in a considerable decrease in infection transmission. [ABSTRACT FROM AUTHOR]

The increasing number of Corona Virus Disease (COVID-19) cases in Bandung, Indonesia, in July 2021 resulted in a higher hospital bed occupancy rate. The conversion of two student dormitory buildings into isolation shelters is expected to accommodate COVID-19 patients who do not have rooms in the hospital. This requires specific planning and innovation, particularly for materials. This study has two objectives: first, to evaluate how long coronaviruses can remain active on different material surfaces. The data collection strategy was carried out through Systematic Review. The second research objective was to design a COVID-19 isolation room that uses materials that facilitate the healing process. Field surveys and traditional literature reviews were conducted for this purpose. This study found that the virus did not survive long on the surfaces of cotton and cardboard. Thus, the room design uses these materials and is considered a biophilic design. This study is expected to provide insights for academics and researchers in interior design and architecture regarding the knowledge of furniture materials that prevent viruses from surviving longer. In addition, it is expected to inspire interior designers to design rooms that can help the healing process using a biophilic approach. [ABSTRACT FROM AUTHOR]

Background: The Standard Inpatient Class Policy (KRIS) in Indonesia aims to provide equitable healthcare services, ensuring the same standards in inpatient wards across all hospitals in Indonesia. This policy has been issued since 2021 and is mandatory for all hospitals to implement by December 2024. The implementation of the KRIS policy impacts hospitals, necessitating analysis and mitigation of risks arising from its implementation. This study aims to provide an overview of the analysis and mitigation of risks in the standard inpatient class implemented by Hospital X. Method: Qualitative research using Focus Group Discussions (FGDs) in November 2023 involving 7 key informants, including Hospital Directors and Department Heads, regarding the mitigation of risks in the standard inpatient class using risk analysis matrices. Results: There are two criteria for the standard inpatient class that pose a very high level of risk, namely the building components lacking high porosity and the density of ward spaces and bed spacing. Conclusion: Hospital X implements risk mitigation by taking actions to reduce the impact of risks through room improvement based on related room reports, risk reduction mitigation by planning inpatient building renovations, and risk acceptance mitigation by allowing ward areas to be 9.8 square meters per bed. [ABSTRACT FROM AUTHOR]

To assess the safety and efficacy of superior hypogastric nerve block (SHNB) in managing periprocedural pain associated with uterine fibroid embolisation (UFE) and in facilitating same-day discharge. Prospectively enrolled case–control study with retrospective analysis comprising 119 eligible patients who underwent UFE for symptomatic fibroids was undertaken at a UK teaching hospital between January 2016 and September 2022. SHNB was administered to 62 participants in addition to systemic analgesia; 57 participants received systemic analgesia alone. SHNB was performed mid-UFE using 20 ml of 0.25% levobupivacaine. Pain scores were assessed using an 11-point (0–10) verbal numerical rating scale (NRS). The study received research and ethics committee approval. Statistical analysis was performed using the chi-square and independent t -test or Mann–Whitney U -test. A p -value of <0.05 defined significance. Participants who received SHNB experienced significantly less pain during the first 6 h post-procedure (averaged median pain score 2.6 versus 3.8, p =0.031). SHNB reduced the proportion of participants requiring post-procedural anti-emetics (45% versus 63%, p <0.05). For participants entered on the day-case pathway (SHNB = 34, no-SHNB = 16), those who received SHNB had a higher rate of successful same-day discharge (62% versus 31%, p =0.044). This SHNB group required significantly less opioids for periprocedural pain relief (median oral morphine equivalents; 44 mg versus 80 mg, p =0.020). No SHNB-related adverse events occurred. SHNB is safe and effective in reducing perioperative pain, opioid requirements, and anti-emetic use in patients undergoing UFE for symptomatic fibroids. SHNB, as an adjunct to analgesic optimisation, facilitates same-day discharge, which is often limited by severe post-embolisation pain. • Superior hypogastric nerve block (SHNB) is a safe and effective regional anaesthesia. • SHNB reduces pain and opioid requirements post uterine fibroid embolisation (UFE). • The addition of SHNB to an optimised analgesic regime may facilitate day-case UFE. • SHNB can potentially make UFE more cost-effective saving inpatient hospital beds. [ABSTRACT FROM AUTHOR]

COVID19 pandemic has put the global health emergency response to the test. Providing health and socio-economic justice across communities/regions helps in resilient response. In this study, a Geographic Information Systems-based framework is proposed and demonstrated in the context of public health-related hazards and pandemic response, such as in the face of COVID19. Indicators relevant to health system (HS) and socio-economic conditions (SC) are utilized to compute a response readiness index (RRI). The frequency histograms and the Analysis of Variance approaches are applied to analyze the distribution of response readiness. We further integrate spatial distributional models to explore the geographically-varying patterns of response readiness pinpointing the priority intervention areas in the context of cross-regional health and socio-economic justice. The framework's application is demonstrated using Pakistan's most developed and populous province, namely Punjab (districts scale, n = 36), as a case study. The results show that ~ 45% indicators achieve below-average scores (value < 0.61) including four from HS and five from SC. The findings ascertain maximum districts lack health facilities, hospital beds, and health insurance from HS and more than 50% lack communication means and literacy-rates, which are essential in times of emergencies. Our cross-regional assessment shows a north–south spatial heterogeneity with southern Punjab being the most vulnerable to COVID-like situations. Dera Ghazi Khan and Muzaffargarh are identified as the statistically significant hotspots of response incompetency (95% confidence), which is critical. This study has policy implications in the context of decision-making, resource allocation, and strategy formulation on health emergency response (i.e., COVID19) to improve community health resilience. [ABSTRACT FROM AUTHOR]

Travel-time computation with large transportation networks is often computationally intensive for two main reasons: 1) large computer memory is required to handle large networks; and 2) calculating shortest-distance paths over large networks is computing intensive. Therefore, previous research tends to limit their spatial extent to reduce computational intensity or resolve computational intensity with advanced cyberinfrastructure. In this context, this article describes a new Spatial Partitioning Algorithm for Scalable Travel-time Computation (SPASTC) that is designed based on spatial domain decomposition with computer memory limit explicitly considered. SPASTC preserves spatial relationships required for travel-time computation and respects a user-specified memory limit, which allows efficient and large-scale travel-time computation within the given memory limit. We demonstrate SPASTC by computing spatial accessibility to hospital beds across the conterminous United States. Our case study shows that SPASTC achieves significant efficiency and scalability making the travel-time computation tens of times faster. [ABSTRACT FROM AUTHOR]

Copyright of Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores 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 development of robots featuring holonomic drivetrains, more exactly swerves, is a comprehensive area of study with numerous potential applications across diverse industries and fields such as metallurgical or car production, where heavy weight mobile transporters are required. Unfortunately, the narrow use of this new technology produced in limited batches and its poor documentation led to its avoidance in some fields, such as hospitality or mining. These drivetrains can precisely navigate through difficult terrains and environments, making them an optimal fit for search and rescue operations, where the need for quick and efficient mobility in remote, hard-to-reach areas is paramount. Moreover, sensors, LIDARs and cameras can be mounted on these robots to collect parameters providing information about hazardous environments without putting human lives at unnecessary risk. Due to their high modularity, such chassis can be mounted on patients' beds in hospitals, where there is not enough space for complex maneuvers. Thus, mobility is enhanced in crowded situations where patients must be moved from one room to another, or during an emergency when an efficient evacuation is crucial. To effectively assess the capabilities of the drivetrain, we designed a scaled-down prototype. We collected data on mobility, off-road capability, modularity, and maintenance requirements for our prototype and three conventional chassis. Upon analyzing the test results, we found that the prototype consistently demonstrated high performance, being 15% more efficient when averaged over all the experiments considered. The findings of this study confirm the effectiveness of this new generation equipment and can support its incorporation in various fields, especially healthcare. [ABSTRACT FROM AUTHOR]

Emergency department overcrowding is a complex problem that persists globally. Data of visits constitute an opportunity to understand its dynamics. However, the gap between the collected information and the real-life clinical processes, and the lack of a whole-system perspective, still constitute a relevant limitation. An analytical pipeline was developed to analyse one-year of production data following the patients that came from the ED (n = 49,938) at Uppsala University Hospital (Uppsala, Sweden) by involving clinical experts in all the steps of the analysis. The key internal issues to the ED were the high volume of generic or non-specific diagnoses from non-urgent visits, and the delayed decision regarding hospital admission caused by several imaging assessments and lack of hospital beds. Furthermore, the external pressure of high frequent re-visits of geriatric, psychiatric, and patients with unspecified diagnoses dramatically contributed to the overcrowding. Our work demonstrates that through analysis of production data of the ED patient flow and participation of clinical experts in the pipeline, it was possible to identify systemic issues and directions for solutions. A critical factor was to take a whole systems perspective, as it opened the scope to the boundary effects of inflow and outflow in the whole healthcare system. [ABSTRACT FROM AUTHOR]

The patient admission scheduling problem (PASP) has been studied for many years as one of the most important scheduling problems in the health sector. The primary goal of PASP is to assign patients to appropriate hospital beds while considering some hard and soft constraints. PASP is an NP-hard problem, which implies that the optimization approach is one of the best approaches that can be used to solve it. The arithmetic optimization algorithm (AOA) is a new optimization algorithm that can effectively solve both continuous and discrete optimization problems. However, it may suffer from poor exploration and premature convergence to sub-optimal solutions due to some problems with its exploration operators. In this paper, we propose a new method for the PASP using an improved AOA algorithm called the island-based AOA (iAOA). The new algorithm is based on a structured population model called the island model. This model distributes the population of candidate solutions among islands that periodically exchange some of the candidate solutions among each other based on a migration protocol. In iAOA, some modifications were applied to AOA's parameters to make it capable of handling discrete space. We evaluated iAOA using a public benchmark for the PASP and compared our results with those of other baseline algorithms (DFPA, SA, HS, GD-NLGD, HTS, TS, I-BBO, and MBBO). The simulation results revealed that iAOA achieved the minimum average execution time on 5 out of 6 instances of the public benchmark. It also showed that iAOA achieved the second minimum average violation of the objective function over 10 independent runs. Finally, the statistical examination of the experimental results using Friedman and Wilcoxon tests confirms the significance of the results of iAOA compared with the other baseline algorithms. [ABSTRACT FROM AUTHOR]

Low levels of media literacy in Bulgaria have provided fertile soil for anti-vaxxers and spawned disinformation campaigns as a major means of influencing the public opinion. Bulgaria has gained a reputation as the poorest and most corrupt country in the European Union (EU) and the fastest-shrinking nation in the world. The COVID-19 pandemic exacerbated some of the well-known, long-standing problems in the healthcare system in Bulgaria – rising morbidity, an insufficient number of hospital beds, a low rate of COVID-19 vaccination, and, above all, a high mortality rate. [ABSTRACT FROM AUTHOR]

The relationship between two variables is an essential factor in statistics, and the accuracy of the results depends on the data collected. However, the data collected for statistical analysis can be unclear and difficult to interpret. One way to predict how one variable will change about another is by using the correlation coefficient (CC), but this method is not commonly used in interval-valued Pythagorean fuzzy hypersoft set (IVPFHSS). The IVPFHSS is a more advanced and generalized form of the Pythagorean fuzzy hypersoft set (PFHSS), which allows for more precise and accurate analysis. In this research, we introduce the correlation coefficient (CC) and weighted correlation coefficient (WCC) for IVPFHSS and their essential properties. To demonstrate the applicability of these measures, we use the COVID-19 pandemic as an example and establish a prioritization technique for order preference by similarity to the ideal solution (TOPSIS) model. The technique is used to study the problem of optimizing the allocation of hospital beds during the pandemic. This study provides insights into the importance of utilizing correlation measures for decision-making in uncertain and complex situations like the COVID-19 pandemic. It is a robust multi-attribute decision-making (MADM) methodology with significant importance. Subsequently, it is planned to increase a dynamic bed allocation algorithm based on biogeography to accomplish the superlative decision-making system. Moreover, numerical investigations deliberate the best decision structures and deliver sensitivity analyses. The efficiency of our encouraged algorithm is more consistent than prevalent models, and it can effectively control and determine the optimal configurations for the study. [ABSTRACT FROM AUTHOR]

The ceiling of therapeutic security in Aotearoa New Zealand is medium security. The aim of this study is to identify and characterise a putative cohort of high-secure patients at a medium-secure regional forensic mental health service. A retrospective review of all admissions to a specific service was conducted over 3.75 years. The Dangerousness Understanding, Recovery and Urgency Manual, Triage Security Scale (DUNDRUM-1) was used to identify patients with high-secure care needs. A multiple logistic regression analysis was used to identify the local needs of this cohort. We found a significant incidence (an admission every 55 days) and prevalence (11%) of mixed-gendered and culturally diverse patients with high-secure care needs. The cohort had a high prevalence of psychosis and violent offences, and relatively short length of stay. There is also an indication that the cohort was subject to more restrictive practice. A solution is proposed to meet the needs of this cohort. [ABSTRACT FROM AUTHOR]

E-health is being adapted in modern hospitals as a significant addition to the existing healthcare services. To this end, modern hospitals urgently require a mobile, high-capacity, secure, and cost-effective communication infrastructure. In this paper, we explore potential applications of a hybrid broadband power line communication (PLC) and Wi-Fi in an indoor hospital scenario. It utilizes the existing power line cables and Wi-Fi plug-and-play devices for indoor broadband communication. Broadband power line (BPL) adaptors with Wi-Fi outputs are used to build an access network in hospitals, particularly in areas where the wireless router signal is poor. The Tenda PH10 AV1,000 AC Wi-Fi power line adapter is a set of BPL adapters that offer operational bandwidth of up to 1,000 Mbps. These adapters are based on the HomePlug AV2 protocol and can provide a data rate up to 200 Mbps on the physical layer. An experiment using the PLC Wi-Fi kit is carried out to show that a Wi-Fi and PLC hybrid network is the best candidate to provide wide range of practical applications in a hospital including, but not limited to, telemedicine, electronic medical records, early-stage disease diagnosis, health management, real-time monitoring, and remote surgeries. [ABSTRACT FROM AUTHOR]

To evaluate the clinical and economic consequences of penile prosthesis (PP) implantation in an outpatient setting compared to its implantation in an inpatient setting in the Spanish National Health System (NHS). A cost-consequence model was developed to estimate the total cost per patient (€, 2021) of PP implantation in the outpatient or inpatient setting and the total cost in a hypothetical future scenario in which the annual percentage of patients implanted in an outpatient setting could reach 50% (n = 349) to 70% (n = 488). Consequences included health resource consumption, total time gained/per patient and bed occupation. PP implantation in the outpatient vs inpatient setting resulted in cost savings of €962/per patient and 1 hospital bed day per procedure. Increasing the percentage of patients implanted in outpatient setting to 50% and 70% could generate annual savings of €279,657 and €413,785, respectively, compared to the current scenario (8.3% PP implantation in the outpatient setting). If the patients currently undergoing surgery in the inpatient setting underwent surgery in the outpatient setting, 328 additional patients/per year could be admitted. PP implantation in the outpatient setting has been shown to have similar outcomes and to yield cost savings compared to inpatient surgery within the Spanish NHS. [ABSTRACT FROM AUTHOR]

With the aggravation of the shortage of staffing hospital beds, elective surgeries have to be postponed or even cancelled, which directly affects hospital income and patient health. Therefore, we propose a fuzzy scheduling model based on a patient transfer strategy in the hierarchical diagnosis and treatment system to ensure timely surgery. We propose a risk estimation method based on health failure mode and effect analysis to reduce the transfer risk and represent the surgery duration and the length of stay as fuzzy numbers to deal with the uncertainty. Given that solving the fuzzy model is challenging, we propose an equivalent formulation to transform the fuzzy model into a two-stage mixed integer linear programming (TMIP) model, which can reduce the loss of decision-making information. Finally, the column and constraint generation algorithm is used to solve the TMIP model that is suited for the structure of the main problem and subproblem. The experiment shows that the patient transfer strategy can effectively relieve the hospital bed shortage, and its potential can be further released if the transfer risk can be properly assessed. The proposed method for solving the fuzzy model can reduce the information loss comparing traditional methods. [ABSTRACT FROM AUTHOR]