Search results for: clinical performance assessment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 20445

Search results for: clinical performance assessment

20175 Predicting Resistance of Commonly Used Antimicrobials in Urinary Tract Infections: A Decision Tree Analysis

Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

Abstract:

Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

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20174 Clinical Profile of Oral Sensory Abilities in Developmental Dysarthria

Authors: Swapna N., Deepthy Ann Joy

Abstract:

One of the major causes of communication disorders in pediatric population is Motor speech disorders. These disorders which affect the motor aspects of speech articulators can have an adverse effect on the communication abilities of children in their developmental period. The motor aspects are dependent on the sensory abilities of children with motor speech disorders. Hence, oral sensorimotor evaluation is an important component in the assessment of children with motor speech disorders. To our knowledge, the importance of oral motor examination has been well established, yet the sensory assessment of the oral structures has received less focus. One of the most common motor speech disorders seen in children is developmental dysarthria. The present study aimed to assess the orosensory aspects in children with developmental dysarthria (CDD). The control group consisted of 240 children in the age range of four and eight years which was divided into four subgroups (4-4.11, 5-5.11, 6-6.11 and 7-7.11 years). The experimental group consisted of 15 children who were diagnosed with developmental dysarthria secondary to cerebral palsy who belonged in the age range of four and eight years. The oro-sensory aspects such as response to touch, temperature, taste, texture, and orofacial sensitivity were evaluated and profiled. For this purpose, the authors used the ‘Oral Sensorimotor Evaluation Protocol- Children’ which was developed by the authors. The oro-sensory section of the protocol was administered and the clinical profile of oro-sensory abilities of typically developing children and CDD was obtained for each of the sensory abilities. The oro-sensory abilities of speech articulators such as lips, tongue, palate, jaw, and cheeks were assessed in detail and scored. The results indicated that experimental group had poorer scores on oro-sensory aspects such as light static touch, kinetic touch, deep pressure, vibration and double simultaneous touch. However, it was also found that the experimental group performed similar to control group on few aspects like temperature, taste, texture and orofacial sensitivity. Apart from the oro-motor abilities which has received utmost interest, the variation in the oro-sensory abilities of experimental and control group is highlighted and discussed in the present study. This emphasizes the need for assessing the oro-sensory abilities in children with developmental dysarthria in addition to oro-motor abilities.

Keywords: cerebral palsy, developmental dysarthria, orosensory assessment, touch

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20173 Diagnostic Assessment for Mastery Learning of Engineering Students with a Bayesian Network Model

Authors: Zhidong Zhang, Yingchen Yang

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In this study, a diagnostic assessment model for Mastery Engineering Learning was established based on a group of undergraduate students who studied in an engineering course. A diagnostic assessment model can examine both students' learning process and report achievement results. One very unique characteristic is that the diagnostic assessment model can recognize the errors and anything blocking students in their learning processes. The feedback is provided to help students to know how to solve the learning problems with alternative strategies and help the instructor to find alternative pedagogical strategies in the instructional designs. Dynamics is a core course in which is a common course being shared by several engineering programs. This course is a very challenging for engineering students to solve the problems. Thus knowledge acquisition and problem-solving skills are crucial for student success. Therefore, developing an effective and valid assessment model for student learning are of great importance. Diagnostic assessment is such a model which can provide effective feedback for both students and instructor in the mastery of engineering learning.

Keywords: diagnostic assessment, mastery learning, engineering, bayesian network model, learning processes

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20172 Seismic Assessment of Old Existing RC Buildings In Madinah with Masonry Infilled Using Ambient Vibration Measurements

Authors: Tarek M. Alguhane, Ayman H. Khalil, Nour M. Fayed, Ayman M. Ismail

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Early, pre-code, reinforced concrete structures present undetermined resistance to earthquakes. This situation is particularly unacceptable in the case of essential structures, such as healthcare structures and pilgrims' houses. Among these, existing old RC building in Madinah is seismically evaluated with and without infill wall and their dynamic characteristics are compared with measured values in the field using ambient vibration measurements (AVM). After, updating the mathematical models for this building with the experimental results, three dimensional pushover analysis (Nonlinear static analysis) was carried out using SAP 2000 software incorporating inelastic material properties for concrete, infill and steel. The purpose of this analysis is to evaluate the expected performance of structural systems by estimating, strength and deformation demands in design, and comparing these demands to available capacities at the performance levels of interest. The results are summarized and discussed.

Keywords: seismic assessment, pushover analysis ambient vibration, modal update

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20171 Thermo-Ecological Assessment of a ‎Hybrid ‎‎Solar ‎Greenhouse Dryer for Grape Drying ‎

Authors: Ilham Ihoume, Rachid Tadili, Nora Arbaoui

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The use of solar energy in agricultural applications has gained significant at‎tention ‎‎in recent years as a sustainable and environmentally friendly alternative to ‎‎conventional energy sources. In particular, solar drying of crops has ‎been identified ‎‎as an effective method to preserve agricultural produce while ‎minimizing energy ‎‎consumption and reducing carbon emissions. In this context, the present study ‎‎aims to evaluate the thermo-economic and ecological ‎performance of a solar-electric hybrid greenhouse dryer designed for grape ‎drying. The proposed system ‎‎integrates solar collectors, an electric heater, ‎and a greenhouse structure to create a ‎‎controlled and energy-efficient environment for grape drying. The thermo-economic assessment involves the ‎analysis of the thermal performance, energy ‎‎consumption, and cost-effectiveness of the solar-electric hybrid greenhouse dryer. ‎‎On the other ‎hand, the ecological assessment focuses on the environmental impact ‎‎of the ‎system in terms of carbon emissions and sustainability. The findings of this ‎‎‎study are expected to contribute to the development of sustainable agricultural ‎‎practices and the promotion of renewable energy technologies in the ‎context of ‎‎food production. Moreover, the results may serve as a basis for the ‎design and ‎‎optimization of similar solar drying systems for other crops and ‎regions.‎

Keywords: solar energy, sustainability, agriculture, energy ‎‎analysis‎

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20170 Leadership Development for Nurses as Educators

Authors: Abeer Alhazmi

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Introduction: Clinical education is considered a significant part of the learning process for nurses and nursing students. However, recruiting high- caliber individuals to train them to be tomorrow’s educators/teachers has been a recurrent challenge. One of the troubling challenges in this field is the absent of proper training programmes to train educators to be future education professionals and leaders. Aim: To explore the impact of a stage 1 and stage 2 clinical instructor courses on developing leadership skills for nurses as educators.Theoretical Framework: Informed by a symbolic interactionist framework, this research explored the Impact of stage 1 and stage 2 clinical instructor courses on nurses' knowledge, attitudes, and leadership skills. Method: Using Glaserian grounded theory method the data were derived from 3 focus groups and 15 in-depth interviews with nurse educators/clinical instructors and nurses who attended stage 1 and stage 2 clinical instructor courses at King Abdu-Aziz University Hospital (KAUH). Findings: The findings of the research are represented in the core category exploring new identity as educator and its two constituent categories Accepting change, and constructing educator identity. The core and sub- categories were generated through a theoretical exploration of the development of educator’s identity throughout stage 1 and stage 2 clinical instructor courses. Conclusion: The social identity of the nurse educators was developed and changed during and after attending stage 1 and stage 2 clinical instructor courses. In light of an increased understanding of the development process of educators identity and role, the research presents implications and recommendations that may contribute to the development of nursing educators in general and in Saudi Arabia in specific.

Keywords: clinical instructor course, educators, identity work, clinical nursing

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20169 The Implications of the Lacanian Concept of 'Lalangue' for Lacanian Theory and Clinical Practice

Authors: Dries Dulsster

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This research we want to discuss the implications of the concept of ‘lalangue’ and illustrate its importance for lacanian psychoanalysis and its clinical practice. We will look at this concept through an in depth reading of Lacan’s later seminars, his lectures at the North-American universities and his study on James Joyce. We will illustrate the importance of this concept with a case study from a clinical practice. We will argue that the introduction of ‘lalangue’ has several theoretical and clinical implications that will radically change Lacans teachings. We will illustrate the distinction between language and lalangue. Language serves communication, but this is not the case with lalangue. We will claim that there is jouissance in language and will approach this by introducing the concept of ‘lalangue’. We will ask ourselves what the effect will be of this distinction and how we can use this in clinical practice. The concept of ‘lalangue’ will introduce a new way of thinking about the unconscious. It will force us to no longer view the unconscious as Symbolic, but as Imaginary or Real. Another implication will be the approach on the symptom, no longer approaching it as a formation of the unconscious. It will be renamed as ‘sinthome’, as function of the real. Last of all it will force us to rethink the lacanian interpretation and how we direct the treatment. The implications on a clinical level will be how we think about the lacanian interpretation and the direction of the treatment. We will no longer focus on language and meaning, but focus on jouissance and the ways in which the subject deals with this. We will illustrate this importance with a clinical case study. To summarize, the concept of lalangue forces us to radically rethink lacanian psychoanalysis, with major implications on a theoretical and clinical level. It introduces new concepts such as the real unconscious and the sinthome. It will also make us rethink the way we work as lacanian psychoanalysts.

Keywords: Lacan's later teaching, language, Lalangue, the unconscious

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20168 Use of Telehealth for Facilitating the Diagnostic Assessment of Autism Spectrum Disorder: A Scoping Review

Authors: Manahil Alfuraydan, Jodie Croxall, Lisa Hurt, Mike Kerr, Sinead Brophy

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Autism Spectrum Disorder (ASD) is a developmental condition characterised by impairment in terms of social communication, social interaction, and a repetitive or restricted pattern of interest, behaviour, and activity. There is a significant delay between seeking help and a confirmed diagnosis of ASD. This may result in delay in receiving early intervention services, which are critical for positive outcomes. The long wait times also cause stress for the individuals and their families. Telehealth potentially offers a way of improving the diagnostic pathway for ASD. This review of the literature aims to examine which telehealth approaches have been used in the diagnosis and assessment of autism in children and adults, whether they are feasible and acceptable, and how they compare with face-to-face diagnosis and assessment methods. A comprehensive search of following databases- MEDLINE, CINAHL Plus with Full text, Business Sources Complete, Web of Science, Scopus, PsycINFO and trail and systematic review databases including Cochrane Library, Health Technology Assessment, Database of Abstracts and Reviews of Effectiveness and NHS Economic Evaluation was conducted, combining the terms of autism and telehealth from 2000 to 2018. A total of 10 studies were identified for inclusion in the review. This review of the literature found there to be two methods of using telehealth: (a) video conferencing to enable teams in different areas to consult with the families and to assess the child/adult in real time and (b) a video upload to a web portal that enables the clinical assessment of behaviours in the family home. The findings were positive, finding there to be high agreement in terms of the diagnosis between remote methods and face to face methods and with high levels of satisfaction among the families and clinicians. This field is in the very early stages, and so only studies with small sample size were identified, but the findings suggest that there is potential for telehealth methods to improve assessment and diagnosis of autism used in conjunction with existing methods, especially for those with clear autism traits and adults with autism. Larger randomised controlled trials of this technology are warranted.

Keywords: assessment, autism spectrum disorder, diagnosis, telehealth

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20167 Demystifying Mathematics: Handling Learning Disabilities in Mathematics Among Low Achievers in Kenyan Schools

Authors: Gladys Gakenia Njoroge

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Mathematics is a compulsory subject in both primary and secondary schools in Kenya. However, learners’ poor performance in the subject in Kenya national examinations year in year out remains a serious concern for teachers of Mathematics, parents, curriculum developers, and the general public. This is particularly worrying because of the importance attached to the subject in national development hence the need to find out what could be affecting learning of Mathematics in Kenyan schools. The research on which this paper is based sought to examine the factors that influence performance in Mathematics in Kenyan schools; identify the characteristics of Mathematics learning disabilities; determine how the learners with such learning disabilities can be assessed and identified and interventions for these difficulties implemented. A case study was undertaken on class six learners in a primary school in Nairobi County. The tools used for the research were: classroom observations and an Individualized Education Program (IEP) developed by the teachers with the help of the researcher. This paper therefore highlights the findings from the research, discusses the implications of the findings and suggests the way forward as far as teaching, learning and assessment of Mathematics in Kenyan schools is concerned. Perhaps with the application of the right interventions, poor performance in Mathematics in the national examinations in Kenya will be a thing of the past.

Keywords: demystifying mathematics, individualized education program, learning difficulties, assessment

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20166 The Role of Validity and Reliability in the Development of Online Testing

Authors: Ani Demetrashvili

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The purpose of this paper is to show how students trust online tests and determine validity and reliability in the development of online testing. The pandemic situation changed every field in the world, and it changed education as well. Educational institutions moved into the online space, which was the only decision they were able to make at that time. Online assessment through online proctoring was a totally new challenge for educational institutions, and they needed to deal with it successfully. Participants were chosen from the English language center. The validity of the questionnaire was identified according to the Likert scale and Cronbach’s alpha; later, data from the participants was analyzed as well. The article summarizes literature that is available about online assessment and is interesting for people who are interested in this kind of assessment. Based on the research findings, students favor in-person testing over online assessment due to their lack of experience and skills in the latter.

Keywords: online assessment, online proctoring

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20165 Psychical Impacts of Episiotomy: First Results

Authors: Clesse C., Lighezzolo-Alnot J., De Lavergne S.

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Considered as the most common surgical procedure worldwide, episiotomy can be defined as an incision around the vulva performed to enlarge it, in the aim of preventing the traumatic rupture of the perineum during childbirth. Rather mediatized, this practice raises many questions in the field of mental health, relayed by different users and health professionals. Today, is topicality is moderately hectic since many queries about the prophylactic exercise of episiotomy are subject to a relative consensus, particularly since WHO advocated in 1996 that only 10% of childbirths should involve an episiotomy. This indicator appeared after the publication of numerous results from randomized clinical trials. Unfortunately, these papers seem mostly centered about somatic impacts of episiotomy. From the side of psychological studies, they mostly integrate a major clinical methodological bias, especially considering that every primiparous woman is identical to the others face to the experience of parturition. In the aim to fill this lack of knowledge, we developed a longitudinal research starting in the 7th month of pregnancy and ending one year after delivery. We are studying in a comparative way different possible psychological consequences inherent to the use of episiotomy. To do this, we use a standardized methodology which combines semi-structured clinical interviews (IRMAG, IRMAN ...), free clinical interviews, a projective test (Rorschach) and five questionnaires (QIC, EPDS, CPQ WOMBLSQ4, SF36). Therefore, we can comprehend with shrewdness the question of psychic impacts of episiotomy in a qualitative and quantitative way by comparing it to other obstetric interventions. In this paper, we will present the first results obtained about a population of twenty-two primiparous women by focusing on body image, sexuality, quality of life, depressive affects, post-traumatic stress disorder and investment of the maternal role. Finally, we will consider the different implications and perspectives of this research which could improve the public health policies in the field of perinatal care.

Keywords: assessment, episiotomy, mental health, psychical impacts

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20164 Contribution of Automated Early Warning Score Usage to Patient Safety

Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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20163 An Assessment of Tai Chi Exercise on Cognitive Performance in Vietnamese Older Adults

Authors: Hung Manh Nguyen, Duong Dai Nguyen

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Objective: To evaluate the effects of Tai Chi exercise on cognitive performance of community-dwelling elderly in Vinh city, Vietnam. Design: A randomized controlled trial. Participants: One hundred and two subjected were recruited. Intervention: Subjects were divided randomly into two groups. Tai Chi group was assigned 6-months Tai Chi training. Control group was instructed to maintain their routine daily activities. Outcome measures: Trail Making Test (TMT) is primary outcome measure. Results: Participants in Tai Chi group reported significant improvement in TMT (part A) F(1, 71) = 78.37, p < .001, and in TMT (part B) F(1, 71)= 175.00, p < .001 in comparison with Control group. Conclusion: Tai Chi is beneficial to improve cognitive performance of the elderly.

Keywords: cognitive, elderly, Vietnam, Tai Chi

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20162 Creation of a Care Robot Impact Assessment

Authors: Eduard Fosch-Villaronga

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This paper pioneers Care Robot Impact Assessment (CRIA), a methodology used to identify, analyze, mitigate and eliminate the risks posed by the insertion of non-medical personal care robots (PCR) in medical care facilities. Its precedent instruments (Privacy and Surveillance Impact Assessment (PIA and SIA)) fall behind in coping with robots. Indeed, personal care robots change dramatically how care is delivered. The paper presents a specific risk-sector methodology, identifies which robots are under its scope and presents some of the challenges introduced by these robots.

Keywords: ethics, impact assessment, law, personal care robots

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20161 Synthesis, Antibacterial Activities, and Synergistic Effects of Novel Juglone and Naphthazarin Derivatives Against Clinical Methicillin-Resistant Staphylococcus aureus Strains

Authors: Zohra Benfodda, Valentin Duvauchelle, Chaimae Majdi, David Bénimélis, Catherine Dunyach-Remy, Patrick Meffre

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New antibiotics are necessary to treat microbial pathogens, especially ESKAPE pathogens that are becoming increasingly resistant to available treatment. Despite the medical need, the number of newly approved drugs continues to decline. The majority of antibiotics under clinical development are natural products or derivatives thereof. 43 juglone/naphthazarin derivatives were synthesized using Minisci-type direct C–H alkylation and evaluated for their antibacterial properties against various clinical and reference Gram-positive MSSA, clinical Gram-positive MRSA. Different compounds of the synthesized series showed promising activity against clinical and reference MSSA (MIC: 1–8 μg/ml) and good efficacy against clinical MRSA (MIC: 2–8 μg/ml) strains. The synergistic effects of active compounds were evaluated with reference antibiotics (vancomycin and cloxacillin), and it was found that the antibiotic combination with those active compounds efficiently enhanced the antimicrobial activity and consequently the MIC values of reference antibiotics were lowered up to 1/16th of the original MIC. These synthesized compounds did not present hemolytic activity on sheep red blood cells. In addition to the in silico prediction of ADME profile parameter which is promising and encouraging for further development.

Keywords: juglone, naphthazarin, antibacterial, clinical MRSA, synergistic studies, MIC determination

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20160 Assessment of the Two-Way Relationship between Capital Structure and Operation Performance of Listed Companies on Vietnam’s Stock

Authors: Uyen Tran Tu

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The decision on capital structure is one of the most important and sophisticated decisions in financial management in order to improve firm performance. This article would study the two-way impact between capital structure and firm performance. The study use EVIEWS 6.0 software to determine a two-way relationship between the capital structure and firm performance based on two-stage regression (2SLS - Two-Stage Least Squares). The findings are: capital structure has the opposite effect on the business efficiency and vice versa, factors that effect on business efficiency include Size and Opportunities. Factors effects on the capital structure are size; liquidity. These factors also affect the ratio of capital structure (total debt/ total asset) of companies. In particular, liquidity has the opposite effect; and the size of the business has the same impact. The results of the study are in line with the theory and empirical studies presented, and the results of the study are unchanged for all three years 2015-2017.

Keywords: capital structure, firm performance, factors, two-way relationship

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20159 Employee Assessment Systems in the Structures of Corporate Groups

Authors: D. Bąk-Grabowska, K. Grzesik, A. Iwanicka, A. Jagoda

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The process of human resources management in the structures of corporate groups demonstrates certain specificity, resulting from the division of decision-making and executive competencies, which occurs within these structures between a parent company and its subsidiaries. The subprocess of employee assessment is considered crucial, since it provides information for the implementation of personnel function. The empirical studies conducted in corporate groups, within which at least one company is located in Poland, confirmed the critical significance of employee assessment systems in the process of human resources management in corporate groups. Parent companies, most often, retain their decision-making authority within the framework of the discussed process and introduce uniform employee assessment and personnel controlling systems to subsidiary companies. However, the instruments for employee assessment applied in corporate groups do not present such specificity.

Keywords: corporate groups, employee periodical assessment system, holding, human resources management

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20158 Using Technology to Enhance the Student Assessment Experience

Authors: Asim Qayyum, David Smith

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The use of information tools is a common activity for students of any educational stage when they encounter online learning activities. Finding the relevant information for particular learning tasks is the topic of this paper as it investigates the use of information tools for a group of student participants. The paper describes and discusses the results with particular implications for use in higher education, and the findings suggest that improvement in assessment design and subsequent student learning may be achieved by structuring the purposefulness of information tools usage and online reading behaviors of university students.

Keywords: information tools, assessment, online learning, student assessment experience

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20157 A Script for Presentation to the Management of a Teaching Hospital on DXplain Clinical Decision Support System

Authors: Jacob Nortey

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Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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20156 Establishment of a Classifier Model for Early Prediction of Acute Delirium in Adult Intensive Care Unit Using Machine Learning

Authors: Pei Yi Lin

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Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.

Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model

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20155 Holistic Simulation-Based Impact Analysis Framework for Sustainable Manufacturing

Authors: Mijoh A. Gbededo, Kapila Liyanage, Sabuj Mallik

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The emerging approaches to sustainable manufacturing are considered to be solution-oriented with the aim of addressing the environmental, economic and social issues holistically. However, the analysis of the interdependencies amongst the three sustainability dimensions has not been fully captured in the literature. In a recent review of approaches to sustainable manufacturing, two categories of techniques are identified: 1) Sustainable Product Development (SPD), and 2) Sustainability Performance Assessment (SPA) techniques. The challenges of the approaches are not only related to the arguments and misconceptions of the relationships between the techniques and sustainable development but also to the inability to capture and integrate the three sustainability dimensions. This requires a clear definition of some of the approaches and a road-map to the development of a holistic approach that supports sustainability decision-making. In this context, eco-innovation, social impact assessment, and life cycle sustainability analysis play an important role. This paper deployed an integrative approach that enabled amalgamation of sustainable manufacturing approaches and the theories of reciprocity and motivation into a holistic simulation-based impact analysis framework. The findings in this research have the potential to guide sustainability analysts to capture the aspects of the three sustainability dimensions into an analytical model. Additionally, the research findings presented can aid the construction of a holistic simulation model of a sustainable manufacturing and support effective decision-making.

Keywords: life cycle sustainability analysis, sustainable manufacturing, sustainability performance assessment, sustainable product development

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20154 Integrating Deterministic and Probabilistic Safety Assessment to Decrease Risk & Energy Consumption in a Typical PWR

Authors: Ebrahim Ghanbari, Mohammad Reza Nematollahi

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Integrating deterministic and probabilistic safety assessment (IDPSA) is one of the most commonly used issues in the field of safety analysis of power plant accident. It has also been recognized today that the role of human error in creating these accidents is not less than systemic errors, so the human interference and system errors in fault and event sequences are necessary. The integration of these analytical topics will be reflected in the frequency of core damage and also the study of the use of water resources in an accident such as the loss of all electrical power of the plant. In this regard, the SBO accident was simulated for the pressurized water reactor in the deterministic analysis issue, and by analyzing the operator's behavior in controlling the accident, the results of the combination of deterministic and probabilistic assessment were identified. The results showed that the best performance of the plant operator would reduce the risk of an accident by 10%, as well as a decrease of 6.82 liters/second of the water sources of the plant.

Keywords: IDPSA, human error, SBO, risk

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20153 Internal Audit Innovation Affects to the Firm Performance Effectiveness

Authors: Prateep Wajeetongratana

Abstract:

The objective of this research is to examine the effects of internal audit innovation on firm performance effectiveness influences of financial report reliability, organizational process improvement, and risk management effectiveness. This paper drew upon the survey data collected from 400 employees survey conducted at Nonthaburi province, Thailand. The statistics utilized in this paper included percentage, mean, standard deviation, and regression analysis. The findings revealed that the majority of samples were between 31-40 years old, married, held an undergraduate degree, and had an average income between 10,000-15,000 baht. And also the results show that auditing integration has only influence on financial report reliability. Moreover, corporate risk evaluation has effect on firm performance by risk management effectiveness and control self-assessment has effect influence on firm performance by organizational process improvement and risk management effectiveness as well.

Keywords: corporate risk evaluation, firm performance effectiveness, internal audit innovation, marketing management

Procedia PDF Downloads 377
20152 Adenoid Cystic Carcinoma of the Lacrimal Gland (About a Case)

Authors: H. Hadjeris, R. B. Ghoul, Lekhlaf, M. Nebbal

Abstract:

Introduction: Adenoid cystic carcinomas of the lacrimal gland or orbital cylindroma constitute the second cause of epithelial tumors of this gland. It is a malignant tumor usually developed at the expense of the salivary glands; its orbital location is exceptional. It is a rare clinical entity, formidable by its malignancy and local aggressiveness; the recurrence rate is high. Materials and methods: Clinical case: 63 years old woman who presents with irreducible no pulsatile painful left exophthalmos with inflammatory chemosis and a decrease in visual acuity with a moderate intracranial hypertension syndrome that has been evolving for 03 months. Antecedent; a biopsy of the tumor was made; the histological examination was in favor of an adenoid cystic carcinoma of the lacrimal gland. Lesion assessment: computed tomography and brain MRI: show an intra and extra-conical mass; with sinus (ethmoido-frontal) and cerebral (left frontal) extension strongly enhanced after injection of contrast product surrounded by edema around the lesion, associated with left frontal bone lysis extension assessment: unremarkable treatment: Patient operated by left frontotemporal approach, a total exenteration was performed with macroscopically complete excision of the frontal lesion and wide frontal craniectomy with craniofacial reconstruction, followed by complementary radiotherapy. Results: The patient was seen again after 3 months in consultation; she does not present any signs in favor of a recurrence. Conclusion: Adenoid cystic carcinomas of the lacrimal gland are rare malignant tumors; they are very infiltrating and invasive. The prognosis is strongly linked to the treatment time.

Keywords: adenoid cystic, lacrimal gland, orbital location, fronto-temporal approac

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20151 Assessment of Online Web-Based Learning for Enhancing Student Grades in Chemistry

Authors: Ian Marc Gealon Cabugsa, Eleanor Pastrano Corcino, Gina Lapaza Montalan

Abstract:

This study focused on the effect of Online Web-Learning (OWL) in the performance of the freshmen Civil Engineering Students of Ateneo de Davao University in their Chem 12 subject. The grades of the students that were required to use OWL were compared to students without OWL. The result of the study suggests promising result for the use of OWL in increasing the performance rate of students taking up Chem 12. Furthermore, there was a positive correlation between the final grade and OWL grade of the students that had OWL. While the majority of the students find OWL to be helpful in supporting their chemistry knowledge needs, most of them still prefer to learn using the traditional face-to-face instruction.

Keywords: chemistry education, enhanced performance, engineering chemistry, online web-based learning

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20150 Impact of Contemporary Performance Measurement System and Organization Justice on Academic Staff Work Performance

Authors: Amizawati Mohd Amir, Ruhanita Maelah, Zaidi Mohd Noor

Abstract:

As part of the Malaysia Higher Institutions' Strategic Plan in promoting high-quality research and education, the Ministry of Higher Education has introduced various instrument to assess the universities performance. The aims are that university will produce more commercially-oriented research and continue to contribute in producing professional workforce for domestic and foreign needs. Yet the spirit of the success lies in the commitment of university particularly the academic staff to translate the vision into reality. For that reason, the element of fairness and justice in assessing individual academic staff performance is crucial to promote directly linked between university and individual work goals. Focusing on public research universities (RUs) in Malaysia, this study observes at the issue through the practice of university contemporary performance measurement system. Accordingly management control theory has conceptualized that contemporary performance measurement consisting of three dimension namely strategic, comprehensive and dynamic building upon equity theory, the relationships between contemporary performance measurement system and organizational justice and in turn the effect on academic staff work performance are tested based on online survey data administered on 365 academic staff from public RUs, which were analyzed using statistics analysis SPSS and Equation Structure Modeling. The findings validated the presence of strategic, comprehensive and dynamic in the contemporary performance measurement system. The empirical evidence also indicated that contemporary performance measure and procedural justice are significantly associated with work performance but not for distributive justice. Furthermore, procedural justice does mediate the relationship between contemporary performance measurement and academic staff work performance. Evidently, this study provides evidence on the importance of perceptions of justice towards influencing academic staff work performance. This finding may be a fruitful input in the setting up academic staff performance assessment policy.

Keywords: comprehensive, dynamic, distributive justice, contemporary performance measurement system, strategic, procedure justice, work performance

Procedia PDF Downloads 408
20149 A Robust System for Foot Arch Type Classification from Static Foot Pressure Distribution Data Using Linear Discriminant Analysis

Authors: R. Periyasamy, Deepak Joshi, Sneh Anand

Abstract:

Foot posture assessment is important to evaluate foot type, causing gait and postural defects in all age groups. Although different methods are used for classification of foot arch type in clinical/research examination, there is no clear approach for selecting the most appropriate measurement system. Therefore, the aim of this study was to develop a system for evaluation of foot type as clinical decision-making aids for diagnosis of flat and normal arch based on the Arch Index (AI) and foot pressure distribution parameter - Power Ratio (PR) data. The accuracy of the system was evaluated for 27 subjects with age ranging from 24 to 65 years. Foot area measurements (hind foot, mid foot, and forefoot) were acquired simultaneously from foot pressure intensity image using portable PedoPowerGraph system and analysis of the image in frequency domain to obtain foot pressure distribution parameter - PR data. From our results, we obtain 100% classification accuracy of normal and flat foot by using the linear discriminant analysis method. We observe there is no misclassification of foot types because of incorporating foot pressure distribution data instead of only arch index (AI). We found that the mid-foot pressure distribution ratio data and arch index (AI) value are well correlated to foot arch type based on visual analysis. Therefore, this paper suggests that the proposed system is accurate and easy to determine foot arch type from arch index (AI), as well as incorporating mid-foot pressure distribution ratio data instead of physical area of contact. Hence, such computational tool based system can help the clinicians for assessment of foot structure and cross-check their diagnosis of flat foot from mid-foot pressure distribution.

Keywords: arch index, computational tool, static foot pressure intensity image, foot pressure distribution, linear discriminant analysis

Procedia PDF Downloads 499
20148 Issues in Organizational Assessment: The Case of Frustration Tolerance Measurement in Mexico

Authors: David Ruiz, Carlos Nava, Roberto Carbajal

Abstract:

The psychological profile has become one of the most important sources of information when it comes to individual selection and the hiring process in any organization. Psychological instruments are used to collect data about variables that are considered critically important for performance in work. However, because of conceptual chaos in organizational psychology, most of the information provided by psychological testing is not directly useful for Mexican human resources professionals to take hiring decisions. The aims of this paper are 1) to underline the lack of conceptual precision in theoretical testing foundations in Mexico and 2) presenting a reliability and validity analysis of a frustration tolerance instrument created as an alternative to a heuristically conduct individual assessment in organizations. First, a description of assessment conditions in Mexico is made. Second, an instrument and a theoretical framework is presented as an alternative to the assessment practices in the country. A total of 65 Psychology Iztacala Superior Studies Faculty students were assessed. Cronbach´s alpha coefficient was calculated and an exploratory factor analysis was carried out to prove the scale unidimensionality. Reliability analysis revealed good internal consistency of the scale (Cronbach’s α = 0.825). Factor analysis produced 4 factors for the scale. However, factor loadings and explained variation give proof to the scale unidimensionality. It is concluded that the instrument has good psychometric properties that will allow human resources professionals to collect useful data. Different possibilities to conduct psychological assessment are suggested for future development.

Keywords: psychological assessment, frustration tolerance, human resources, organizational psychology

Procedia PDF Downloads 309
20147 Analysis of Business Intelligence Tools in Healthcare

Authors: Avishkar Gawade, Omkar Bansode, Ketan Bhambure, Bhargav Deore

Abstract:

In recent year wide range of business intelligence technology have been applied to different area in order to support decision making process BI enables extraction of knowledge from data store. BI tools usually used in public health field for financial and administrative purposes.BI uses a dashboard in presentation stage to deliver information to information to end users.In this paper,we intend to analyze some open source BI tools on the market and their applicability in the clinical sphere taking into consideration the general characteristics of the clinical environment.A pervasive BI platform was developed using a real case in order to prove the tool viability.Analysis of various BI Tools in done with the help of several parameters such as data security,data integration,data quality reporting and anlaytics,performance,scalability and cost effectivesness.

Keywords: CDSS, EHR, business intelliegence, tools

Procedia PDF Downloads 137
20146 Applying Resilience Engineering to improve Safety Management in a Construction Site: Design and Validation of a Questionnaire

Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

Abstract:

Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan

Procedia PDF Downloads 137