Search results for: elderly care service model

Authors: Muhammad Shuaibu Birniwa

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Automobile Independent Workshop Service Technicians (popularly called roadside mechanics) are technical personals that repairs most of the automobile vehicles in Nigeria. Majority of these mechanics acquired their skills through apprenticeship training. Modern vehicle imported into the country posed greater challenges to the present automobile technicians particularly in the area of carrying out maintenance repairs of these latest automobile vehicles (autotronics vehicle) due to their inability to possessed autotronic skills competency. To source for solution to the above mentioned problems, therefore a research is carried out in North – Western region of Nigeria to produce a suitable maintenance training modules that can be used to train the technicians for them to upgrade/acquire the needed competencies for successful maintenance repair of the autotronic vehicles that were running everyday on the nation’s roads. A cluster sampling technique is used to obtain a sample from the population. The population of the study is all autotronic inclined lecturers, instructors and independent workshop service technicians that are within North – Western region of Nigeria. There are seven states (Jigawa, Kaduna, Kano, Katsina, Kebbi, Sokoto and Zamfara) in the study area, these serves as clusters in the population. Five (5) states were randomly selected to serve as the sample size. The five states are Jigawa, Kano, Katsina, Kebbi and Zamfara, the entire population of the five states which serves as clusters is (183), lecturers (44), instructors (49) and autotronic independent workshop service technicians (90), all of them were used in the study because of their manageable size. 183 copies of autotronic maintenance training module questionnaires (AMTMQ) with 174 and 149 question items respectively were administered and collected by the researcher with the help of an assistants, they are administered to 44 Polytechnic lecturers in the department of mechanical engineering, 49 instructors in skills acquisition centres/polytechnics and 90 master craftsmen of an independent workshops that are autotronic inclined. Data collected for answering research questions 1, 3, 4 and 5 were analysed using SPSS software version 22, Grand Mean and standard deviation were used to answer the research questions. Analysis of Variance (ANOVA) was used to test null hypotheses one (1) to three (3) and t-test statistical tool is used to analyzed hypotheses four (4) and five (5) all at 0.05 level of significance. The research conducted revealed that; all the objectives, contents/tasks, facilities, delivery systems and evaluation techniques contained in the questionnaire were required for the development of the autotronic maintenance training modules for independent workshop service technicians in the north – western zone of Nigeria. The skills upgrade training conducted by federal government in collaboration with SURE-P, NAC and SMEDEN was not successful because the educational status of the target population was not considered in drafting the needed training modules. The mode of training used does not also take cognizance of the theoretical aspect of the trainees, especially basic science which rendered the programme ineffective and insufficient for the tasks on ground.

Keywords: autotronics, roadside, mechanics, technicians, independent

Procedia PDF Downloads 58

Authors: Rezaei Hachesu Peyman, Oliyaee Azadeh, Salahzadeh Zahra, Alizadeh Somayyeh, Safaei Naser

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Coronary Artery Disease (CAD) is one major cause of disability in adults and one main cause of death in developed. In this study, data mining techniques including Decision Trees, Artificial neural networks (ANNs), and Support Vector Machine (SVM) analyze CAD data. Data of 4948 patients who had suffered from heart diseases were included in the analysis. CAD is the target variable, and 24 inputs or predictor variables are used for the classification. The performance of these techniques is compared in terms of sensitivity, specificity, and accuracy. The most significant factor influencing CAD is chest pain. Elderly males (age > 53) have a high probability to be diagnosed with CAD. SVM algorithm is the most useful way for evaluation and prediction of CAD patients as compared to non-CAD ones. Application of data mining techniques in analyzing coronary artery diseases is a good method for investigating the existing relationships between variables.

Keywords: classification, coronary artery disease, data-mining, knowledge discovery, extract

Procedia PDF Downloads 643

Authors: Nuseiba M. Altarawneh, Suhuai Luo, Brian Regan, Guijin Tang

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Liver segmentation from medical images poses more challenges than analogous segmentations of other organs. This contribution introduces a liver segmentation method from a series of computer tomography images. Overall, we present a novel method for segmenting liver by coupling density matching with shape priors. Density matching signifies a tracking method which operates via maximizing the Bhattacharyya similarity measure between the photometric distribution from an estimated image region and a model photometric distribution. Density matching controls the direction of the evolution process and slows down the evolving contour in regions with weak edges. The shape prior improves the robustness of density matching and discourages the evolving contour from exceeding liver’s boundaries at regions with weak boundaries. The model is implemented using a modified distance regularized level set (DRLS) model. The experimental results show that the method achieves a satisfactory result. By comparing with the original DRLS model, it is evident that the proposed model herein is more effective in addressing the over segmentation problem. Finally, we gauge our performance of our model against matrices comprising of accuracy, sensitivity and specificity.

Keywords: Bhattacharyya distance, distance regularized level set (DRLS) model, liver segmentation, level set method

Procedia PDF Downloads 301

Authors: Lassi Lehto, Jaakko Kahkonen, Juha Oksanen, Tapani Sarjakoski

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The use of raster-formatted data sets in geospatial analysis is increasing rapidly. At the same time, geographic data are being introduced into disciplines outside the traditional domain of geoinformatics, like climate change, intelligent transport, and immigration studies. These developments call for better methods to deliver raster geodata in an efficient and easy-to-use manner. Data cube technologies have traditionally been used in the geospatial domain for managing Earth Observation data sets that have strict requirements for effective handling of time series. The same approach and methodologies can also be applied in managing other types of geospatial data sets. A cloud service-based geodata cube, called GeoCubes Finland, has been developed to support online delivery and analysis of most important geospatial data sets with national coverage. The main target group of the service is the academic research institutes in the country. The most significant aspects of the GeoCubes data repository include the use of multiple resolution levels, cloud-optimized file structure, and a customized, flexible content access API. Input data sets are pre-processed while being ingested into the repository to bring them into a harmonized form in aspects like georeferencing, sampling resolutions, spatial subdivision, and value encoding. All the resolution levels are created using an appropriate generalization method, selected depending on the nature of the source data set. Multiple pre-processed resolutions enable new kinds of online analysis approaches to be introduced. Analysis processes based on interactive visual exploration can be effectively carried out, as the level of resolution most close to the visual scale can always be used. In the same way, statistical analysis can be carried out on resolution levels that best reflect the scale of the phenomenon being studied. Access times remain close to constant, independent of the scale applied in the application. The cloud service-based approach, applied in the GeoCubes Finland repository, enables analysis operations to be performed on the server platform, thus making high-performance computing facilities easily accessible. The developed GeoCubes API supports this kind of approach for online analysis. The use of cloud-optimized file structures in data storage enables the fast extraction of subareas. The access API allows for the use of vector-formatted administrative areas and user-defined polygons as definitions of subareas for data retrieval. Administrative areas of the country in four levels are available readily from the GeoCubes platform. In addition to direct delivery of raster data, the service also supports the so-called virtual file format, in which only a small text file is first downloaded. The text file contains links to the raster content on the service platform. The actual raster data is downloaded on demand, from the spatial area and resolution level required in each stage of the application. By the geodata cube approach, pre-harmonized geospatial data sets are made accessible to new categories of inexperienced users in an easy-to-use manner. At the same time, the multiresolution nature of the GeoCubes repository facilitates expert users to introduce new kinds of interactive online analysis operations.

Keywords: cloud service, geodata cube, multiresolution, raster geodata

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Authors: Saowapa Phaithayawat

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The purposes of this study are: 1) to study the impact of the 3-community-core model: House (H), Temple (T), and School (S) with the co-operation of official departments on community development to ASEAN economic community involvement, and 2) to study the procedures and extension of the model. The research which is a qualitative research based on formal and informal interviews. Local people in a community are observed. Group interview is also operated by executors and cooperators in the school in the community. In terms of social and cultural dimension, the 3-community-core model consisting of house, temple and school is the base of Thai cultures bringing about understanding, happiness and unity to the community. The result of this research is that the official departments in accompanied with this model developers cooperatively work together in the community to support such factors as budget, plan, activities. Moreover, the need of community, and the continual result to sustain the community are satisfied by the model implementation. In terms of the procedures of the model implementation, executors and co-operators can work, coordinate, think, and launch their public relation altogether. Concerning the model development, this enables the community to achieve its goal to prepare the community’s readiness for ASEAN Economic Community involvement.

Keywords: ASEAN Economic Community, the applying models and sufficiency development, house, temple, school

Procedia PDF Downloads 300

Authors: J. Sharon Mano Pappu, Sathyanarayana N. Gummadi

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Growth of Debaryomyces nepalensis on mixed substrates in batch culture follows diauxic pattern of completely utilizing glucose during the first exponential growth phase, followed by an intermediate lag phase and a second exponential growth phase consuming xylose. The present study deals with the development of cybernetic mathematical model for prediction of xylitol production and yield. Production of xylitol from xylose in batch fermentation is investigated in the presence of glucose as the co-substrate. Different ratios of glucose and xylose concentrations are assessed to study the impact of multi substrate on production of xylitol in batch reactors. The parameters in the model equations were estimated from experimental observations using integral method. The model equations were solved simultaneously by numerical technique using MATLAB. The developed cybernetic model of xylose fermentation in the presence of a co-substrate can provide answers about how the ratio of glucose to xylose influences the yield and rate of production of xylitol. This model is expected to accurately predict the growth of microorganism on mixed substrate, duration of intermediate lag phase, consumption of substrate, production of xylitol. The model developed based on cybernetic modelling framework can be helpful to simulate the dynamic competition between the metabolic pathways.

Keywords: co-substrate, cybernetic model, diauxic growth, xylose, xylitol

Procedia PDF Downloads 318

Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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Authors: Maha BenHamad, Ali Snoussi, Ammar Ben Brahim

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A steady-state analysis of triple-effect thermal vapor compressor desalination unit was performed. A mathematical model based on mass, salinity and energy balances is developed. The purpose of this paper is to develop a connection between process simulator and process optimizer in order to study the influence of several operating variables on the performance and the produced water cost of the unit. A MATLAB program is used to solve the model equations, and Aspen HYSYS is used to model the plant. The model validity is examined against a commercial plant and showed a good agreement between industrial data and simulations results. Results show that the pressures of the last effect and the compressed vapor have an important influence on the produced cost, and the increase of the difference temperature in the condenser decreases the specific heat area about 22%.

Keywords: steady-state, triple effect, thermal vapor compressor, Matlab, Aspen Hysys

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Authors: Yuanjin Liu

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Retirement withdrawal strategies are very important to minimize the probability of ruin in retirement. The ruin probability is modeled as a function of initial withdrawal age, gender, asset allocation, inflation rate, and initial withdrawal rate. The ruin probability is obtained based on the 2019 period life table for the Social Security, IRS Required Minimum Distribution (RMD) Worksheets, US historical bond and equity returns, and inflation rates using simulation. Several popular machine learning algorithms of the generalized additive model, random forest, support vector machine, extreme gradient boosting, and artificial neural network are built. The model validation and selection are based on the test errors using hyperparameter tuning and train-test split. The optimal model is recommended for retirees to monitor the ruin probability. The optimal withdrawal strategy can be obtained based on the optimal predictive model.

Keywords: ruin probability, retirement withdrawal strategies, predictive models, optimal model

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Authors: Waleerak Sittisom

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The objectives of this research were to analyze transportation route management, to identify potential cost reductions in logistic operation. In-depth interview techniques and small group discussions were utilized with 25 participants from various backgrounds in the areas of logistics. The findings of this research revealed that there were four areas that companies are able to effectively manage a logistic cost reduction: managing the space within the transportation vehicles, managing transportation personnel, managing transportation cost, and managing control of transportation. On the other hand, there were four areas that companies were unable to effectively manage a logistic cost reduction: the working process of transportation, the route planning of transportation, the service point management, and technology management. There are five areas that cost reduction is feasible: personnel management, process of working, map planning, service point planning, and technology implementation. To be able to reduce costs, the transportation companies should suggest that customers use a file system to save truck space. Also, the transportation companies need to adopt new technology to manage their information system so that packages can be reached easy, safe, and fast. Staff needs to be trained regularly to increase knowledge and skills. Teamwork is required to effectively reduce the costs.

Keywords: cost reduction, management, logistics, transportation

Procedia PDF Downloads 490

Authors: Camille A. Issa, Omar Masri

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In the study, the commercial finite element software Abaqus was used to develop a three-dimensional nonlinear finite element model capable of simulating the pull-out test of reinforcing bars from underwater concrete. The results of thirty-two pull-out tests that have different parameters were implemented in the software to study the effect of the concrete cover, the bar size, the use of stirrups, and the compressive strength of concrete. The interaction properties used in the model provided accurate results in comparison with the experimental bond-slip results, thus the model has successfully simulated the pull-out test. The results of the finite element model are used to better understand and visualize the distribution of stresses in each component of the model, and to study the effect of the various parameters used in this study including the role of the stirrups in preventing the stress from reaching to the sides of the specimens.

Keywords: pull-out test, bond strength, underwater concrete, nonlinear finite element analysis, abaqus

Procedia PDF Downloads 427

Authors: Arnold Missiame

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In Ghana, rural dwellers who depend primarily on agriculture for their livelihood constitute about 60% of the country’s population. This shows the critical role and potentials of the agricultural sector in helping to achieve Ghana’s vision 2030. With the current threat of climate change and advancements in technology, agricultural extension is not just about technology transfer and improvements in productivity, but it is also about improving the managerial and technical skills of farmers. In Ghana, the government of Ghana as well as other players in the sector like; non-governmental organizations, NGOs, local and international funding agencies, for decades now, have made capacity-building-investments in smallholder farmers by way of extension services delivery. This study sought to compare the technical efficiency of farmers who have access to agricultural extension and farmers who do not in Ghana. The study employed the stochastic meta-frontier model to analyze household survey data comprising 300 smallholder cassava farmers from the Fanteakwa district of Ghana. The farmers were selected through a two-stage sampling technique where 5 communities were purposively selected in the first stage and then 60 smallholder cassava farmers were randomly selected from each of the 5 communities. Semi-structured questionnaires were used to collect data on farmers’ socioeconomic and farm-level characteristics. The results showed that farmers who have access to agricultural extensions services have higher technical efficiencies (TE) and produce much closer to their meta-production frontiers (higher technology gap ratios (TGR) than farmers who do not have access to such extension services. Furthermore, experience in cassava cultivation and formal education significantly improves the technical efficiencies of farmers. The study recommends that the mode and scope of agricultural extension service delivery in the country should be enhanced to ensure that smallholder farmers have easy access to extension agents.

Keywords: agricultural extension, Ghana, smallholder farmers, stochastic meta-frontier model, technical efficiency

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Authors: G. Çetinkaya, M. Yıldız, P. Çetinkaya

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Tourism is one of the world’s largest industries and its total contribution to the global economy in 2014 was US$7.6 trillion, which equates to 9.8% of total economy GDP in 2014. Mountains are important regions for tourism industry and its second most popular tourist destinations after coastal regions. Hiking and trekking are most popular activity in mountains region and it is estimated that more than 50 million people visit mountains each year. So that hiking was come out to individual activity and it’s to be a massive event. Nowadays hiking is commercialized and mostly it’s become organized by travel agency and tour operators. Travel agency which is offering hiking activities to know the demands of the individuals involved in these activities and is required to submit to it for services. The aim of this study to determined hiking participant expectation from hiking by travel agency perspective. 34 travel agency officials participated in the study. Data were collected by questionnaire developed by the researchers. Results show that according to travel agency officials “visual quality” is the most important expectation factor for hikers. And other expectation factors are “safety”, “accessibility”, “unspoiled local service”, “walking grade”, “expert guidance service”, “popularity of trail”, “uncrowded trail”, “substructure facilities”, “relevant cost”, “guidebook” and “suitable climatic conditions”.

Keywords: expectation, hikers, travel agency, mountain tourism

Procedia PDF Downloads 266

Authors: Bassma A. Abdel Haleem, Ehab K. Emam, George E. Yacoub, Ashraf M. Salem

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Background: Obesity is an increasingly common problem in childhood. Childhood obesity is considered the main risk factor for the development of metabolic syndrome (MetS) (diabetes type 2, dyslipidemia, and hypertension). Recent studies estimated that among children with obesity 30-60% will develop MetS. Visceral fat thickness is a valuable predictor of the development of MetS. Computed tomography and dual-energy X-ray absorptiometry are the main techniques to assess visceral fat. However, they carry the risk of radiation exposure and are expensive procedures. Consequently, they are seldom used in the assessment of visceral fat in children. Some studies explored the potential of ultrasound as a substitute to assess visceral fat in the elderly and found promising results. Given the vulnerability of children to radiation exposure, we sought to evaluate ultrasound as a safer and more cost-efficient alternative for measuring visceral fat in obese children. Additionally, we assessed the correlation between visceral fat and obesity indicators such as insulin resistance. Methods: A cross-sectional study was conducted on 46 children with obesity (aged 6–16 years). Their visceral fat was evaluated by ultrasound. Subcutaneous fat thickness (SFT), i.e., the measurement from the skin-fat interface to the linea alba, and visceral fat thickness (VFT), i.e., the thickness from the linea alba to the aorta, were measured and correlated with anthropometric measures, fasting lipid profile, homeostatic model assessment for insulin resistance (HOMA-IR) and liver enzymes (ALT). Results: VFT assessed via ultrasound was found to strongly correlate with the BMI, HOMA-IR with AUC for VFT as a predictor of insulin resistance of 0.858 and cut off point of >2.98. VFT also correlates positively with serum triglycerides and serum ALT. VFT correlates negatively with HDL. Conclusions: Ultrasound, a safe and cost-efficient technique, could be a useful tool for measuring the abdominal fat thickness in children with obesity. Ultrasound-measured VFT could be an appropriate prognostic factor for insulin resistance, hypertriglyceridemia, and elevated liver enzymes in obese children.

Keywords: metabolic syndrome, pediatric obesity, sonography, visceral fat

Procedia PDF Downloads 111

Authors: Aleema Rahman

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Introduction: This study aims to estimate the prevalence of long-term otitis media with effusion (OME) and hearing loss in a prospective longitudinal cohort studyand to study the relationship between the condition and educational and psychosocial outcomes. Methods: Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) will be undertaken. ALSPAC is a longitudinal birth cohort study carried out in the UK, which has collected detailed measures of hearing on ~7000 children from the age of seven. A descriptive analysis of the data will be undertaken to estimate the prevalence of OME and hearing loss (defined as having average hearing levels > 20dB and type B tympanogram) at 7, 9, 11, and 15 years as well as that of long-term OME and hearing loss. Logistic and linear regression analyses will be conducted to examine associations between long-term OME and hearing loss and educational outcomes (grades obtained from standardised national attainment tests) and psychosocial outcomes such as anxiety, social fears, and depression at ages 10-11 and 15-16 years. Results: Results will be presented in terms of the prevalence of OME and hearing loss in the population at each age. The prevalence of long-term OME and hearing loss, defined as having OME and hearing loss at two or more time points, will also be reported. Furthermore, any associations between long-term OME and hearing loss and the educational and psychosocial outcomes will be presented. Analyses will take into account demographic factors such as sex and social deprivation and relevant confounders, including socioeconomic status, ethnicity, and IQ. Discussion: Findings from this study will provide new epidemiological information on the prevalence of long-term OME and hearing loss. The research will provide new knowledge on the impact of OME for the small group of children who do not grow out of condition by age 7 but continue to have hearing loss and need clinical care through later childhood. The study could have clinical implications and may influence service delivery for this group of children.

Keywords: educational attainment, hearing loss, otitis media with effusion, psychosocial development

Procedia PDF Downloads 124

Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

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Background: Our study assesses the impact of the COVID-19 pandemic on early pregnancy assessment clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ± 4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID-19 compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID-19, but ectopic pregnancy operative management remained unchanged.

Keywords: early pregnancy, ultrasound, COVID-19, obstetrics

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Authors: Hady Atef, Zinab Helmy, Heba Abdeen, Mostafa Fadel

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Background and purpose: After the success of the first trials of this experiment which were done on rabbits, a new study were conducted on dogs to ensure the past results; in a step forward to use low-level LASER therapy in the treatment of congenital septal defects in infants. The aim of this study was to investigate the effect of low-level LASER irradiation on congenital septal defects in dogs. Subjects and Methodology: six male dogs who have congenital septal defects in their hearts -with age ranged 6-10 months- enrolled in this study for one and half months. They were assigned into two groups: Group (A): The study group consisted of 3 canine hearts who received routine animal care associated with LASER irradiation. Group (B): The control group consisted of 3 canine hearts who received only routine animal care. Sizes of the septal defects were measured for both groups at the beginning and after the end of the study. Results: There was a significant decrease in the size of the diameter of the congenital septal defect with the study group (percentage of improvement was 42.19%) when compared with control group. Conclusion: It was concluded that low-level LASER therapy can be considered as a promising therapy for congenital heart defects in animals and to be examined on children with similar congenital lesions after then.

Keywords: laser, congenital septal defects, dogs, infants

Procedia PDF Downloads 265

Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

Procedia PDF Downloads 144

Authors: Z. Mowafy Emam Mowafy, Ahmed R. Sayed, M. El Sayed Mohmmed Hassan

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Purpose: to evaluate the effect of low intensity laser on severe tinnitus in idiopathic sudden hearing loss patients. Methods of evaluation (Visual analogue scale and tinnitus handicap inventory scale):- Thirty patients who had unilateral tinnitus with sensorineural hearing loss were participated in the study. Subjects aged from 40 to 50 were randomly divided into two equal groups: group (A): composed of 15 patients who received the routine medical care (Systemic steroids) in addition to the low-intensity laser therapy (LILT) while group (B): composed of 15 patients who received only the routine medical care. Continuous 632.8nm He-Ne laser was used with 5mW power for 15 min\day, 3 days per week for 3 months. Results and conclusion: Results showed that application of the LILT had a valuable effect on severe tinnitus in idiopathic sudden hearing loss patients as evidenced by the highly decreased visual analogue scale and tinnitus handicap inventory scale.

Keywords: idiopathic sudden hearing loss, low intensity laser, tinnitus, tinnitus handicap inventory scale and visual analogue scale

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Authors: Ashwini V. Chavan, Sukhanand S. Bhosale

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Challenges of weak soil subgrade are often resolved either by stabilization or reinforcing it. However, it is also practiced to reinforce the granular fill to improve the load-settlement behavior of over weak soil strata. The inclusion of reinforcement in the engineered granular fill provided a new impetus for the development of enhanced Soil-Structure Interaction (SSI) models, also known as mechanical foundation models or lumped parameter models. Several researchers have been working in this direction to understand the mechanism of granular fill-reinforcement interaction and the response of weak soil under the application of load. These models have been developed by extending available SSI models such as the Winkler Model, Pasternak Model, Hetenyi Model, Kerr Model etc., and are helpful to visualize the load-settlement behavior of a physical system through 1-D and 2-D analysis considering beam and plate resting on the foundation respectively. Based on the literature survey, these models are categorized as ‘Reinforced Pasternak Model,’ ‘Double Beam Model,’ ‘Reinforced Timoshenko Beam Model,’ and ‘Reinforced Kerr Model.’ The present work reviews the past 30+ years of research in the field of SSI models for reinforced foundation systems, presenting the conceptual development of these models systematically and discussing their limitations. Special efforts are taken to tabulate the parameters and their significance in the load-settlement analysis, which may be helpful in future studies for the comparison and enhancement of results and findings of physical models.

Keywords: geosynthetics, mathematical modeling, reinforced foundation, soil-structure interaction, ground improvement, soft soil

Procedia PDF Downloads 112

Authors: Raeed Alanazi

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Introduction: Nursing students have a crucial role to play in the inhibition of infectious diseases and, therefore, must be trained in infection control and prevention modules prior to entering clinical settings. Simulations have been found to have a positive impact on infection control skills and the use of standard precautions. Aim: The purpose of this study was to use the four sources of self-efficacy in explaining the level of clinical self-efficacy and adherence to infection control practices in Saudi nursing students during simulation practice. Method: A cross-sectional design with convenience sampling was used. This study was conducted in all Saudi nursing schools, with a total number of 197 students participated in this study. Three scales were used simulation self- efficacy Scale (SSES), the four sources of self-efficacy scale (SSES), and Compliance with Standard Precautions Scale (CSPS). Multiple linear regression was used to test the use of the four sources of self-efficacy (SSES) in explaining level of clinical self-efficacy and adherence to infection control in nursing students. Results: The vicarious experience subscale (p =.044) was statistically significant. The regression model indicated that for every one unit increase in vicarious experience (observation and reflection in simulation), the participants’ adherence to infection control increased by .13 units (β =.22, t = 2.03, p =.044). In addition, the regression model indicated that for every one unit increase in education level, the participants’ adherence to infection control increased by 1.82 units (beta=.34= 3.64, p <.001). Also, the mastery experience subscale (p <.001) and vicarious experience subscale (p = .020) were shared significant associations with clinical self-efficacy. Conclusion: The findings of this research support the idea that simulation-based learning can be a valuable teaching-learning method to help nursing students develop clinical competence, which is essential in providing quality and safe nursing care.

Keywords: simulation-based learning, clinical self-efficacy, infection control, nursing students

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Authors: Karla E. Sanchez-Cazares, Kim H. Parker, Jennifer H. Tweedy

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The purpose of this work is to develop a simple compartmental model of cerebral fluid balance including blood and cerebrospinal-fluid (CSF). At the first level the cerebral arteries and veins are modelled as bifurcating trees with constant scaling factors between generations which are connected through a homogeneous microcirculation. The arteries and veins are assumed to be non-rigid and the cross-sectional area, resistance and mean pressure in each generation are determined as a function of blood volume flow rate. From the mean pressure and further assumptions about the variation of wall permeability, the transmural fluid flux can be calculated. The results suggest the next level of modelling where the cerebral vasculature is divided into three compartments; the large arteries, the small arteries, the capillaries and the veins with effective compliances and permeabilities derived from the detailed vascular model. These vascular compartments are then linked to other compartments describing the different CSF spaces, the cerebral ventricles and the subarachnoid space. This compartmental model is used to calculate the distribution of fluid in the cranium. Known volumes and flows for normal conditions are used to determine reasonable parameters for the model, which can then be used to help understand pathological behaviour and suggest clinical interventions.

Keywords: cerebrovascular, compartmental model, CSF model, vascular network

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Authors: Ilana Lavy, Rami Rashkovits

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In this study, we describe Information Systems students' learning model which was applied by students in order to cope with professional knowledge gaps in the context of their final project. The students needed to implement a software system according to specifications and design they have made beforehand. They had to select certain technologies and use them. Most of them decided to use programming environments that were learned during their academic studies. The students had to cope with various levels of knowledge gaps. For that matter they used learning strategies that were organized by us as a learning model which includes two phases each suitable for different learning tasks. We analyze the learning model, describing advantages and shortcomings as perceived by the students, and provide excerpts to support our findings.

Keywords: knowledge gaps, independent learner skills, self-regulated learning, final project

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Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.

Keywords: healthcare, fires, smoke, management, strategies

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Authors: Tomas Premoli, Sareh Rowlands

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In this study, we investigate the impact of various convolutional neural network (CNN) architectures on the accuracy of diagnosing Alzheimer’s disease (AD) using patient MRI scans. Alzheimer’s disease is a debilitating neurodegenerative disorder that affects millions worldwide. Early, accurate, and non-invasive diagnostic methods are required for providing optimal care and symptom management. Deep learning techniques, particularly CNNs, have shown great promise in enhancing this diagnostic process. We aim to contribute to the ongoing research in this field by comparing the effectiveness of different CNN architectures and providing insights for future studies. Our methodology involved preprocessing MRI data, implementing multiple CNN architectures, and evaluating the performance of each model. We employed intensity normalization, linear registration, and skull stripping for our preprocessing. The selected architectures included VGG, ResNet, and DenseNet models, all implemented using the Keras library. We employed transfer learning and trained models from scratch to compare their effectiveness. Our findings demonstrated significant differences in performance among the tested architectures, with DenseNet201 achieving the highest accuracy of 86.4%. Transfer learning proved to be helpful in improving model performance. We also identified potential areas for future research, such as experimenting with other architectures, optimizing hyperparameters, and employing fine-tuning strategies. By providing a comprehensive analysis of the selected CNN architectures, we offer a solid foundation for future research in Alzheimer’s disease diagnosis using deep learning techniques. Our study highlights the potential of CNNs as a valuable diagnostic tool and emphasizes the importance of ongoing research to develop more accurate and effective models.

Keywords: Alzheimer’s disease, convolutional neural networks, deep learning, medical imaging, MRI

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Authors: Dawei Shen, Ming Xu, Pengfei Liu

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The joints between simply supported bridge decks and abutments need to be regularly repaired, which would greatly increase the cost during the service life of the bridge. Simply supported girder bridges suffered the most severe damage during earthquakes. Another type of bridge, the integral bridge, of which the superstructure and abutment are rigidly connected, was also used in some European countries. Because no bearings or joints exit in the integral bridge, this type of bridge could significantly reduce maintenance requirements and costs. However, conventional integral bridge usually result in high earth pressure on the abutment and surface settlement in the backfill. To solve these problems, a new type of integral bridge, geosynthetic-reinforced soil (GRS) integral bridge, was come up in recent years. This newly invented bridge has not been used in engineering practices. There was a lack of research on the seismic behavior of the conventional and new type of integral abutments. In addition, no common design code could be found for the calculation of seismic pressure of soil behind the abutment. This paper developed a dynamic constitutive model, which can consider the soil behaviors under cyclic loading. Numerical analyses of the seismic response of a full height integral bridge and GRS integral bridge were carried out using the two-dimensional numerical code, FLAC. A parametric study was also performed to investigate the soil-structure interaction. The results are presented below. The seismic responses of GRS integral bridge together with conventional simply supported bridge, GRS conventional bridge and conventional integral bridge were investigated. The results show that the GRS integral bridge holds the highest seismic stability, followed by conventional integral bridge, GRS simply supported bridge and conventional simply supported bridge. Compared with the integral bridge with 1 m thick abutments, the GRS integral bridge with 0.4 m thick abutments is subjected to a smaller bending moment, and the natural frequency and horizontal displacement remains almost the same. Geosynthetic-reinforcement will be more effective when the abutment becomes thinner or the abutment is higher.

Keywords: geosynthetic-reinforced soil integral bridge, nonlinear hysteretic model, numerical analysis, seismic response

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Authors: Hyun-Woo Cho

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Detection of incipient abnormal events in production processes is important to improve safety and reliability of manufacturing operations and reduce losses caused by failures. The construction of calibration models for predicting faulty conditions is quite essential in making decisions on when to perform preventive maintenance. This paper presents a multivariate calibration monitoring approach based on the statistical analysis of process measurement data. The calibration model is used to predict faulty conditions from historical reference data. This approach utilizes variable selection techniques, and the predictive performance of several prediction methods are evaluated using real data. The results shows that the calibration model based on supervised probabilistic model yielded best performance in this work. By adopting a proper variable selection scheme in calibration models, the prediction performance can be improved by excluding non-informative variables from their model building steps.

Keywords: calibration model, monitoring, quality improvement, feature selection

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Authors: Awais Ali, Hesham Ali

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The absence of teeth through either premature loss or developmental absence is a common condition with potentially severe impact on affected individuals. Management of these cases presents a clinical challenge which may be difficult to resolve given the effects of tooth loss or hypodontia over the course of a patient’s lifetime. Treatment of such cases is often best provided by a multi-disciplinary team, where the patient’s expectations and care delivery can be optimally managed. Orthodontic treatment is often used to prepare the dentition in advance of restorative replacement of missing teeth. Conversely, the placement of implants may precede the delivery of orthodontic treatment and indeed may function as an adjunctive orthodontic procedure. We discuss the use of both approaches here and illustrate their clinical implementation with two case reports. The first case demonstrates the use of fixed appliances to prepare the mouth for an opposing implant-retained complete denture. A second case demonstrates the use of implant-retained crowns to provide orthodontic anchorage in a partially dentate patient. We propose that complex cases such as these should always be planned and treated by a multi-disciplinary team in order to optimise the delivery of care, patient experience, and treatment outcome. The presented cases add to the body of evidence in this area.

Keywords: orthodontics, dental implantology, hypodontia, multi-disciplinary

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Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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Authors: Mahdi Saadat, Abbas Taheri

Abstract:

Understanding the cracking response of crystalline rocks at mineralogical scale is of great importance during the design procedure of mining structures. A grain-based distinct element model (GBM) is employed to numerically study the cracking response of Barre granite at micro- and macro-scales. The GBM framework is augmented with a proposed distinct element-based cohesive model to reproduce the micro-cracking response of the inter- and intra-grain contacts. The cohesive GBM framework is implemented in PFC2D distinct element codes. The microstructural properties of Barre granite are imported in PFC2D to generate synthetic specimens. The microproperties of the model is calibrated against the laboratory uniaxial compressive and Brazilian split tensile tests. The calibrated model is then used to simulate the fracturing behaviour of pre-cracked Barre granite with different flaw configurations. The numerical results of the proposed model demonstrate a good agreement with the experimental counterparts. The GBM framework proposed thus appears promising for further investigation of the influence of grain microstructure and mineralogical properties on the cracking behaviour of crystalline rocks.

Keywords: discrete element modelling, cohesive grain-based model, crystalline rock, fracturing behavior

Procedia PDF Downloads 118