Search results for: pilot overhead
688 Reducing Falls in Memory Care through Implementation of the Stopping Elderly Accidents, Deaths, and Injuries Program
Authors: Cory B. Lord
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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.Keywords: dementia, elderly, falls, STEADI
Procedia PDF Downloads 135687 An Inherent Risk to Damage the Popliteus Tendon by Some Femoral Component Designs: A Pilot Study in Indian Knees
Authors: Rajendra Kanojia
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Femoral components with inbuilt rotation require thicker flexion resection of the lateral femoral condyle and could potential risk to damage the popliteus tendon especially in the smaller Asian knees. We prospectively evaluated 10 patients with bilateral varus osteoarthritis knee to size the cuts and their location in relation to the popliteus tendon. Two different types of implant were used on either side, one side requires resection in 3° external rotation (group A) and other side femoral component with inbuilt external roation (group B). We had popliteus tendon injury in 3 knees all from group B. Risk of damaging the popliteus tendon was found higher in group B.Keywords: popliteaus tendon injury, TKA, orthopaedic surgery, biomechanics and clinical applications
Procedia PDF Downloads 336686 Flow as a Positive Intervention for Post-Traumatic Stress Disorder
Authors: Sonal Khosla
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A research is proposed in the present paper to explore the role of flow in coping with traumatic experiences and attaining post-traumatic growth. A grounded theory research is proposed to be carried by analyzing memoirs of people who have been through trauma. A pilot study was carried out on two memoirs of women who were held captive for over ten years and were sexually assaulted repeatedly. The role of flow in their coping experiences was explored by analyzing the books. Some of the flow activities that were used by them were- drawing and daydreaming. Their narratives show the evidence for flow as having cathartic and healing effects on them. Applicability of the findings can take two forms: 1. Flow can be applied as a preventive technique to help the people who are going through trauma, 2. Flow can be adopted into a positive intervention to help people suffering from PTSD.Keywords: flow, positive intervention, PTSD, PTG
Procedia PDF Downloads 375685 Preliminary Efficacy of a Pilot Paediatric Day Hospital Program Project to Address Severe Mental Illness, Obesity, and Binge Eating
Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton
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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.Keywords: adolescent, binge eating, mental illness, obesity
Procedia PDF Downloads 360684 Construction Unit Rate Factor Modelling Using Neural Networks
Authors: Balimu Mwiya, Mundia Muya, Chabota Kaliba, Peter Mukalula
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Factors affecting construction unit cost vary depending on a country’s political, economic, social and technological inclinations. Factors affecting construction costs have been studied from various perspectives. Analysis of cost factors requires an appreciation of a country’s practices. Identified cost factors provide an indication of a country’s construction economic strata. The purpose of this paper is to identify the essential factors that affect unit cost estimation and their breakdown using artificial neural networks. Twenty-five (25) identified cost factors in road construction were subjected to a questionnaire survey and employing SPSS factor analysis the factors were reduced to eight. The 8 factors were analysed using the neural network (NN) to determine the proportionate breakdown of the cost factors in a given construction unit rate. NN predicted that political environment accounted 44% of the unit rate followed by contractor capacity at 22% and financial delays, project feasibility, overhead and profit each at 11%. Project location, material availability and corruption perception index had minimal impact on the unit cost from the training data provided. Quantified cost factors can be incorporated in unit cost estimation models (UCEM) to produce more accurate estimates. This can create improvements in the cost estimation of infrastructure projects and establish a benchmark standard to assist the process of alignment of work practises and training of new staff, permitting the on-going development of best practises in cost estimation to become more effective.Keywords: construction cost factors, neural networks, roadworks, Zambian construction industry
Procedia PDF Downloads 366683 Case Study Approach Using Scenario Analysis to Analyze Unabsorbed Head Office Overheads
Authors: K. C. Iyer, T. Gupta, Y. M. Bindal
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Head office overhead (HOOH) is an indirect cost and is recovered through individual project billings by the contractor. Delay in a project impacts the absorption of HOOH cost allocated to that particular project and thus diminishes the expected profit of the contractor. This unabsorbed HOOH cost is later claimed by contractors as damages. The subjective nature of the available formulae to compute unabsorbed HOOH is the difficulty that contractors and owners face and thus dispute it. The paper attempts to bring together the rationale of various HOOH formulae by gathering contractor’s HOOH cost data on all of its project, using case study approach and comparing variations in values of HOOH using scenario analysis. The case study approach uses project data collected from four construction projects of a contractor in India to calculate unabsorbed HOOH costs from various available formulae. Scenario analysis provides further variations in HOOH values after considering two independent situations mainly scope changes and new projects during the delay period. Interestingly, one of the findings in this study reveals that, in spite of HOOH getting absorbed by additional works available during the period of delay, a few formulae depict an increase in the value of unabsorbed HOOH, neglecting any absorption by the increase in scope. This indicates that these formulae are inappropriate for use in case of a change to the scope of work. Results of this study can help both parties in deciding on an appropriate formula more objectively, considering the events on a project causing the delay and contractor's position in respect of obtaining new projects.Keywords: absorbed and unabsorbed overheads, head office overheads, scenario analysis, scope variation
Procedia PDF Downloads 166682 Feasibility and Acceptability of an Emergency Department Digital Pain Self-Management Intervention: An Randomized Controlled Trial Pilot Study
Authors: Alexandria Carey, Angela Starkweather, Ann Horgas, Hwayoung Cho, Jason Beneciuk
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Background/Significance: Over 3.4 million acute axial low back pain (aLBP) cases are treated annually in the United States (US) emergency departments (ED). ED patients with aLBP receive varying verbal and written discharge routine care (RC), leading to ineffective patient self-management. Ineffective self-management increase chronic low back pain (cLPB) transition risks, a chief cause of worldwide disability, with associated costs >$60 million annually. This research addresses this significant problem by evaluating an ED digital pain self-management intervention (EDPSI) focused on improving self-management through improved knowledge retainment, skills, and self-efficacy (confidence) (KSC) thus reducing aLBP to cLBP transition in ED patients discharged with aLBP. The research has significant potential to increase self-efficacy, one of the most potent mechanisms of behavior change and improve health outcomes. Focusing on accessibility and usability, the intervention may reduce discharge disparities in aLBP self-management, especially with low health literacy. Study Questions: This research will answer the following questions: 1) Will an EDPSI focused on improving KSC progress patient self-management behaviors and health status?; 2) Is the EDPSI sustainable to improve pain severity, interference, and pain recurrence?; 3) Will an EDPSI reduce aLBP to cLBP transition in patients discharged with aLBP? Aims: The pilot randomized-controlled trial (RCT) study’s objectives assess the effects of a 12-week digital self-management discharge tool in patients with aLBP. We aim to 1) Primarily assess the feasibility [recruitment, enrollment, and retention], and [intervention] acceptability, and sustainability of EDPSI on participant’s pain self-management; 2) Determine the effectiveness and sustainability of EDPSI on pain severity/interference among participants. 3) Explore patient preferences, health literacy, and changes among participants experiencing the transition to cLBP. We anticipate that EDPSI intervention will increase likelihood of achieving self-management milestones and significantly improve pain-related symptoms in aLBP. Methods: The study uses a two-group pilot RCT to enroll 30 individuals who have been seen in the ED with aLBP. Participants are randomized into RC (n=15) or RC + EDPSI (n=15) and receive follow-up surveys for 12-weeks post-intervention. EDPSI innovative content focuses on 1) highlighting discharge education; 2) provides self-management treatment options; 3) actor demonstration of ergonomics, range of motion movements, safety, and sleep; 4) complementary alternative medicine (CAM) options including acupuncture, yoga, and Pilates; 5) combination therapies including thermal application, spinal manipulation, and PT treatments. The intervention group receives Booster sessions via Zoom to assess and reinforce their knowledge retention of techniques and provide return demonstration reinforcing ergonomics, in weeks two and eight. Outcome Measures: All participants are followed for 12-weeks, assessing pain severity/ interference using the Brief Pain Inventory short-form (BPI-sf) survey, self-management (measuring KSC) using the short 13-item Patient Activation Measure (PAM), and self-efficacy using the Pain Self-Efficacy Questionnaire (PSEQ) weeks 1, 6, and 12. Feasibility is measured by recruitment, enrollment, and retention percentages. Acceptability and education satisfaction are measured using the Education-Preference and Satisfaction Questionnaire (EPSQ) post-intervention. Self-management sustainment is measured including PSEQ, PAM, and patient satisfaction and healthcare utilization (PSHU) requesting patient overall satisfaction, additional healthcare utilization, and pain management related to continued back pain or complications post-injury.Keywords: digital, pain self-management, education, tool
Procedia PDF Downloads 53681 Evaluation of Security and Performance of Master Node Protocol in the Bitcoin Peer-To-Peer Network
Authors: Muntadher Sallal, Gareth Owenson, Mo Adda, Safa Shubbar
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Bitcoin is a digital currency based on a peer-to-peer network to propagate and verify transactions. Bitcoin is gaining wider adoption than any previous crypto-currency. However, the mechanism of peers randomly choosing logical neighbors without any knowledge about underlying physical topology can cause a delay overhead in information propagation, which makes the system vulnerable to double-spend attacks. Aiming at alleviating the propagation delay problem, this paper introduces proximity-aware extensions to the current Bitcoin protocol, named Master Node Based Clustering (MNBC). The ultimate purpose of the proposed protocol, that are based on how clusters are formulated and how nodes can define their membership, is to improve the information propagation delay in the Bitcoin network. In MNBC protocol, physical internet connectivity increases, as well as the number of hops between nodes, decreases through assigning nodes to be responsible for maintaining clusters based on physical internet proximity. We show, through simulations, that the proposed protocol defines better clustering structures that optimize the performance of the transaction propagation over the Bitcoin protocol. The evaluation of partition attacks in the MNBC protocol, as well as the Bitcoin network, was done in this paper. Evaluation results prove that even though the Bitcoin network is more resistant against the partitioning attack than the MNBC protocol, more resources are needed to be spent to split the network in the MNBC protocol, especially with a higher number of nodes.Keywords: Bitcoin network, propagation delay, clustering, scalability
Procedia PDF Downloads 116680 Knowledge Management in the Tourism Industry in Project Management Paradigm
Authors: Olga A. Burukina
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Tourism is a complex socio-economic phenomenon, partly regulated by national tourism industries. The sustainable development of tourism in a region, country or in tourist destination depends on a number of factors (political, economic, social, cultural, legal and technological), the understanding and correct interpretation of which is invariably anthropocentric. It is logical that for the successful functioning of a tour operating company, it is necessary to ensure its sustainable development. Sustainable tourism is defined as tourism that fully considers its current and future economic, social and environmental impacts, taking into account the needs of the industry, the environment and the host communities. For the business enterprise, sustainable development is defined as adopting business strategies and activities that meet the needs of the enterprise and its stakeholders today while protecting, sustaining and enhancing the human and natural resources that will be needed in the future. In addition to a systemic approach to the analysis of tourist destinations, each tourism project can and should be considered as a system characterized by a very high degree of variability, since each particular case of its implementation differs from the previous and subsequent ones, sometimes in a cardinal way. At the same time, it is important to understand that this variability is predominantly of anthropogenic nature (except for force majeure situations that are considered separately and afterwards). Knowledge management is the process of creating, sharing, using and managing the knowledge and information of an organization. It refers to a multidisciplinary approach to achieve organisational objectives by making the best use of knowledge. Knowledge management is seen as a key systems component that allows obtaining, storing, transferring, and maintaining information and knowledge in particular, in a long-term perspective. The study aims, firstly, to identify (1) the dynamic changes in the Italian travel industry in the last 5 years before the COVID19 pandemic, which can be considered the scope of force majeure circumstances, (2) the impact of the pandemic on the industry and (3) efforts required to restore it, and secondly, how project management tools can help to improve knowledge management in tour operating companies to maintain their sustainability, diminish potential risks and restore their pre-pandemic performance level as soon as possible. The pilot research is based upon a systems approach and has employed a pilot survey, semi-structured interviews, prior research analysis (aka literature review), comparative analysis, cross-case analysis, and modelling. The results obtained are very encouraging: PM tools can improve knowledge management in tour operating companies and secure the more sustainable development of the Italian tourism industry based on proper knowledge management and risk management.Keywords: knowledge management, project management, sustainable development, tourism industr
Procedia PDF Downloads 158679 Efficient Fuzzy Classified Cryptographic Model for Intelligent Encryption Technique towards E-Banking XML Transactions
Authors: Maher Aburrous, Adel Khelifi, Manar Abu Talib
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Transactions performed by financial institutions on daily basis require XML encryption on large scale. Encrypting large volume of message fully will result both performance and resource issues. In this paper a novel approach is presented for securing financial XML transactions using classification data mining (DM) algorithms. Our strategy defines the complete process of classifying XML transactions by using set of classification algorithms, classified XML documents processed at later stage using element-wise encryption. Classification algorithms were used to identify the XML transaction rules and factors in order to classify the message content fetching important elements within. We have implemented four classification algorithms to fetch the importance level value within each XML document. Classified content is processed using element-wise encryption for selected parts with "High", "Medium" or “Low” importance level values. Element-wise encryption is performed using AES symmetric encryption algorithm and proposed modified algorithm for AES to overcome the problem of computational overhead, in which substitute byte, shift row will remain as in the original AES while mix column operation is replaced by 128 permutation operation followed by add round key operation. An implementation has been conducted using data set fetched from e-banking service to present system functionality and efficiency. Results from our implementation showed a clear improvement in processing time encrypting XML documents.Keywords: XML transaction, encryption, Advanced Encryption Standard (AES), XML classification, e-banking security, fuzzy classification, cryptography, intelligent encryption
Procedia PDF Downloads 412678 Error Detection and Correction for Onboard Satellite Computers Using Hamming Code
Authors: Rafsan Al Mamun, Md. Motaharul Islam, Rabana Tajrin, Nabiha Noor, Shafinaz Qader
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In an attempt to enrich the lives of billions of people by providing proper information, security and a way of communicating with others, the need for efficient and improved satellites is constantly growing. Thus, there is an increasing demand for better error detection and correction (EDAC) schemes, which are capable of protecting the data onboard the satellites. The paper is aimed towards detecting and correcting such errors using a special algorithm called the Hamming Code, which uses the concept of parity and parity bits to prevent single-bit errors onboard a satellite in Low Earth Orbit. This paper focuses on the study of Low Earth Orbit satellites and the process of generating the Hamming Code matrix to be used for EDAC using computer programs. The most effective version of Hamming Code generated was the Hamming (16, 11, 4) version using MATLAB, and the paper compares this particular scheme with other EDAC mechanisms, including other versions of Hamming Codes and Cyclic Redundancy Check (CRC), and the limitations of this scheme. This particular version of the Hamming Code guarantees single-bit error corrections as well as double-bit error detections. Furthermore, this version of Hamming Code has proved to be fast with a checking time of 5.669 nanoseconds, that has a relatively higher code rate and lower bit overhead compared to the other versions and can detect a greater percentage of errors per length of code than other EDAC schemes with similar capabilities. In conclusion, with the proper implementation of the system, it is quite possible to ensure a relatively uncorrupted satellite storage system.Keywords: bit-flips, Hamming code, low earth orbit, parity bits, satellite, single error upset
Procedia PDF Downloads 130677 The Effects of a Hippotherapy Simulator in Children with Cerebral Palsy: A Pilot Study
Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci
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Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.Keywords: balance, cerebral palsy, hippotherapy, rehabilitation
Procedia PDF Downloads 144676 Load Balancing Technique for Energy - Efficiency in Cloud Computing
Authors: Rani Danavath, V. B. Narsimha
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Cloud computing is emerging as a new paradigm of large scale distributed computing. Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources (e.g., three service models, and four deployment networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. This cloud model is composed of five essential characteristics models. Load balancing is one of the main challenges in cloud computing, which is required to distribute the dynamic workload across multiple nodes, to ensure that no single node is overloaded. It helps in optimal utilization of resources, enhancing the performance of the system. The goal of the load balancing is to minimize the resource consumption and carbon emission rate, that is the direct need of cloud computing. This determined the need of new metrics energy consumption and carbon emission for energy-efficiency load balancing techniques in cloud computing. Existing load balancing techniques mainly focuses on reducing overhead, services, response time and improving performance etc. In this paper we introduced a Technique for energy-efficiency, but none of the techniques have considered the energy consumption and carbon emission. Therefore, our proposed work will go towards energy – efficiency. So this energy-efficiency load balancing technique can be used to improve the performance of cloud computing by balancing the workload across all the nodes in the cloud with the minimum resource utilization, in turn, reducing energy consumption, and carbon emission to an extent, which will help to achieve green computing.Keywords: cloud computing, distributed computing, energy efficiency, green computing, load balancing, energy consumption, carbon emission
Procedia PDF Downloads 450675 UVA or UVC Activation of H₂O₂ and S₂O₈²⁻ for Estrogen Degradation towards an Application in Rural Wastewater Treatment Plant
Authors: Anaelle Gabet, Helene Metivier, Christine De Brauer, Gilles Mailhot, Marcello Brigante
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The presence of micropollutants in surface waters has been widely reported around the world, particularly downstream from wastewater treatment plants (WWTPs). Rural WWTPs constitute more than 90 % of the total WWTPs in France. Like conventional ones, they are not able to fully remove micropollutants. Estrogens are excreted by human beings every day and several studies have highlighted their endocrine disruption properties on river wildlife. They are mainly estrone (E1), 17β-estradiol (E2) and 17α-ethinylestradiol (EE2). Rural WWTPs require cheap and robust tertiary processes. UVC activation of H₂O₂ for HO· generation, a very reactive molecule, has demonstrated its effectiveness. However, UVC rays are dangerous to manipulate and energy-consuming. This is why the ability of UVA rays was investigated in this study. Moreover, the use of S₂O₈²⁻ for SO₄·- generation as an alternative to HO· has emerged in the last few years. Such processes have been widely studied on a lab scale. However, pilot-scale works constitute fewer studies. This study was carried out on a 20-L pilot composed of a 1.12-L UV reactor equipped with a polychromatic UVA lamp or a monochromatic (254 nm) UVC lamp fed in recirculation. Degradation rates of a mixture of spiked E1, E2 and EE2 (5 µM each) were followed by HPLC-UV. Results are expressed in UV dose (mJ.cm-2) received by the compounds of interest to compare UVC and UVA. In every system, estrogen degradation rates followed pseudo-first-order rates. First, experiments were carried out in tap water. All estrogens underwent photolysis under UVC rays, although E1 photolysis is higher. However, only very weak photolysis was observed under UVA rays. Preliminary studies on both oxidants have shown that S₂O₈²⁻ photolysis constants are higher than H₂O₂ under both UVA and UVC rays. Therefore, estrogen degradation rates are about ten times higher in the presence of 1 mM of S₂O₈²⁻ than with one mM of H₂O₂ under both radiations. In the same conditions, the mixture of interest required about 40 times higher UV dose when using UVA rays compared to UVC. However, the UVA/S₂O₈²⁻ system only requires four times more UV dose than the conventional UVC/H₂O₂ system. Further studies were carried out in WWTP effluent with the UVC lamp. When comparing these results to the tap water ones, estrogen degradation rates were more inhibited in the S₂O₈²⁻ system than with H₂O₂. It seems that SO₄·- undergo higher quenching by a real effluent than HO·. Preliminary experiments have shown that natural organic matter is mainly responsible for the radical quenching and that HO and SO₄ both had similar second-order reaction rate constants with dissolved organic matter. However, E1, E2 and EE2 second-order reaction rate constants are about ten times lower with SO₄ than with HO. In conclusion, the UVA/S₂O₈²⁻ system showed encouraging results for the use of UVA rays but further studies in WWTP effluent have to be carried out to confirm this interest. The efficiency of other pollutants in the real matrix also needs to be investigated.Keywords: AOPs, decontamination, estrogens, radicals, wastewater
Procedia PDF Downloads 191674 Formative Assessment of Creative Thinking Skills Embedded in Learning Through Play
Authors: Yigal Rosen, Garrett Jaeger, Michelle Newstadt, Ilia Rushkin, Sara Bakken
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All children are capable of advancing their creative thinking skills and engaging in creative play. Creative play puts children in charge of exploring ideas, relationships, spaces and problems. Supported by The LEGO Foundation, the creative thinking formative assessment is designed to provide valid, reliable and informative measurement to support the development of creative skills while children are engaged in Learning through Play. In this paper we provide an overview of the assessment framework underpinned the assessment of creative thinking and report the results from the 2022 pilot study demonstrating promising evidence on the ability to measure creative skills in a conceptually and ecologically valid way to inform the development of creative skills.Keywords: creativity, creative thinking, assessment, learning through play, creative play, learning progressions
Procedia PDF Downloads 135673 A Cross-Cultural Validation of the Simple Measure of Impact of Lupus Erythematosus in Youngsters (Smiley) among Filipino Pediatric Lupus Patients
Authors: Jemely M. Punzalan, Christine B. Bernal, Beatrice B. Canonigo, Maria Rosario F. Cabansag, Dennis S. Flores, Paul Joseph T. Galutira, Remedios D. Chan
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Background: Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders predominates in women of childbearing age. Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) is the only health specific quality of life tool for pediatric SLE, which has been translated to different languages except in Filipino. Objective: The primary objective of this study was to develop a Filipino translation of the SMILEY and to examine the validity and reliability of this translation. Methodology: The SMILEY was translated into Filipino by a bilingual individual and back-translated by another bilingual individual blinded from the original English version. The translation was evaluated for content validity by a panel of experts and subjected to pilot testing. The pilot-tested translation was used in the validity and reliability testing proper. The SMILEY, together with the previously validated PEDSQL 4.0 Generic Core Scale was administered to lupus pediatric patients and their parent at two separate occasions: a baseline and a re-test seven to fourteen days apart. Tests for convergent validity, internal consistency, and test-retest reliability were performed. Results: A total of fifty children and their parent were recruited. The mean age was 15.38±2.62 years (range 8-18 years), mean education at high school level. The mean duration of SLE was 28 months (range 1-81 months). Subjects found the questionnaires to be relevant, easy to understand and answer. The validity of the SMILEY was demonstrated in terms of content validity, convergent validity, internal consistency, and test-retest reliability. Age, socioeconomic status and educational attainment did not show a significant effect on the scores. The difference between scores of child and parent report was showed to be significant with SMILEY total (p=0.0214), effect on social life (p=0.0000), and PEDSQL physical function (p=0.0460). Child reports showed higher scores for the following domains compared to their parent. Conclusion: SMILEY is a brief, easy to understand, valid and reliable tool for assessing pediatric SLE specific HRQOL. It will be useful in providing better care, understanding and may offer critical information regarding the effect of SLE in the quality of life of our pediatric lupus patients. It will help physician understands the needs of their patient not only on treatment of the specific disease but as well as the impact of the treatment on their daily lives.Keywords: systemic lupus erythematosus, pediatrics, quality of life, Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY)
Procedia PDF Downloads 446672 Verification of Low-Dose Diagnostic X-Ray as a Tool for Relating Vital Internal Organ Structures to External Body Armour Coverage
Authors: Natalie A. Sterk, Bernard van Vuuren, Petrie Marais, Bongani Mthombeni
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Injuries to the internal structures of the thorax and abdomen remain a leading cause of death among soldiers. Body armour is a standard issue piece of military equipment designed to protect the vital organs against ballistic and stab threats. When configured for maximum protection, the excessive weight and size of the armour may limit soldier mobility and increase physical fatigue and discomfort. Providing soldiers with more armour than necessary may, therefore, hinder their ability to react rapidly in life-threatening situations. The capability to determine the optimal trade-off between the amount of essential anatomical coverage and hindrance on soldier performance may significantly enhance the design of armour systems. The current study aimed to develop and pilot a methodology for relating internal anatomical structures with actual armour plate coverage in real-time using low-dose diagnostic X-ray scanning. Several pilot scanning sessions were held at Lodox Systems (Pty) Ltd head-office in South Africa. Testing involved using the Lodox eXero-dr to scan dummy trunk rigs at various degrees and heights of measurement; as well as human participants, wearing correctly fitted body armour while positioned in supine, prone shooting, seated and kneeling shooting postures. The verification of sizing and metrics obtained from the Lodox eXero-dr were then confirmed through a verification board with known dimensions. Results indicated that the low-dose diagnostic X-ray has the capability to clearly identify the vital internal structures of the aortic arch, heart, and lungs in relation to the position of the external armour plates. Further testing is still required in order to fully and accurately identify the inferior liver boundary, inferior vena cava, and spleen. The scans produced in the supine, prone, and seated postures provided superior image quality over the kneeling posture. The X-ray-source and-detector distance from the object must be standardised to control for possible magnification changes and for comparison purposes. To account for this, specific scanning heights and angles were identified to allow for parallel scanning of relevant areas. The low-dose diagnostic X-ray provides a non-invasive, safe, and rapid technique for relating vital internal structures with external structures. This capability can be used for the re-evaluation of anatomical coverage required for essential protection while optimising armour design and fit for soldier performance.Keywords: body armour, low-dose diagnostic X-ray, scanning, vital organ coverage
Procedia PDF Downloads 124671 The Effect of CPU Location in Total Immersion of Microelectronics
Authors: A. Almaneea, N. Kapur, J. L. Summers, H. M. Thompson
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Meeting the growth in demand for digital services such as social media, telecommunications, and business and cloud services requires large scale data centres, which has led to an increase in their end use energy demand. Generally, over 30% of data centre power is consumed by the necessary cooling overhead. Thus energy can be reduced by improving the cooling efficiency. Air and liquid can both be used as cooling media for the data centre. Traditional data centre cooling systems use air, however liquid is recognised as a promising method that can handle the more densely packed data centres. Liquid cooling can be classified into three methods; rack heat exchanger, on-chip heat exchanger and full immersion of the microelectronics. This study quantifies the improvements of heat transfer specifically for the case of immersed microelectronics by varying the CPU and heat sink location. Immersion of the server is achieved by filling the gap between the microelectronics and a water jacket with a dielectric liquid which convects the heat from the CPU to the water jacket on the opposite side. Heat transfer is governed by two physical mechanisms, which is natural convection for the fixed enclosure filled with dielectric liquid and forced convection for the water that is pumped through the water jacket. The model in this study is validated with published numerical and experimental work and shows good agreement with previous work. The results show that the heat transfer performance and Nusselt number (Nu) is improved by 89% by placing the CPU and heat sink on the bottom of the microelectronics enclosure.Keywords: CPU location, data centre cooling, heat sink in enclosures, immersed microelectronics, turbulent natural convection in enclosures
Procedia PDF Downloads 274670 Hybrid Approach for Face Recognition Combining Gabor Wavelet and Linear Discriminant Analysis
Authors: A: Annis Fathima, V. Vaidehi, S. Ajitha
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Face recognition system finds many applications in surveillance and human computer interaction systems. As the applications using face recognition systems are of much importance and demand more accuracy, more robustness in the face recognition system is expected with less computation time. In this paper, a hybrid approach for face recognition combining Gabor Wavelet and Linear Discriminant Analysis (HGWLDA) is proposed. The normalized input grayscale image is approximated and reduced in dimension to lower the processing overhead for Gabor filters. This image is convolved with bank of Gabor filters with varying scales and orientations. LDA, a subspace analysis techniques are used to reduce the intra-class space and maximize the inter-class space. The techniques used are 2-dimensional Linear Discriminant Analysis (2D-LDA), 2-dimensional bidirectional LDA ((2D)2LDA), Weighted 2-dimensional bidirectional Linear Discriminant Analysis (Wt (2D)2 LDA). LDA reduces the feature dimension by extracting the features with greater variance. k-Nearest Neighbour (k-NN) classifier is used to classify and recognize the test image by comparing its feature with each of the training set features. The HGWLDA approach is robust against illumination conditions as the Gabor features are illumination invariant. This approach also aims at a better recognition rate using less number of features for varying expressions. The performance of the proposed HGWLDA approaches is evaluated using AT&T database, MIT-India face database and faces94 database. It is found that the proposed HGWLDA approach provides better results than the existing Gabor approach.Keywords: face recognition, Gabor wavelet, LDA, k-NN classifier
Procedia PDF Downloads 467669 Comparative Study of Computer Assisted Instruction and Conventional Method in Attaining and Retaining Mathematical Concepts
Authors: Nirupma Bhatti
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This empirical study was aimed to compare the effectiveness of Computer Assisted Instruction (CAI) and Conventional Method (CM) in attaining and retaining mathematical concepts. Instructional and measuring tools were developed for five units of Matrix Algebra, two of Calculus and five of Numerical Analysis. Reliability and validity of these tools were also examined in pilot study. Ninety undergraduates participated in this study. Pre-test – post-test equivalent – groups research design was used. SPSS v.16 was used for data analysis. Findings supported CAI as better mode of instruction for attainment and retention of basic mathematical concepts. Administrators should motivate faculty members to develop Computer Assisted Instructional Material (CAIM) in mathematics for higher education.Keywords: attainment, CAI, CAIM, conventional method, retention
Procedia PDF Downloads 188668 Efficient Implementation of Finite Volume Multi-Resolution Weno Scheme on Adaptive Cartesian Grids
Authors: Yuchen Yang, Zhenming Wang, Jun Zhu, Ning Zhao
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An easy-to-implement and robust finite volume multi-resolution Weighted Essentially Non-Oscillatory (WENO) scheme is proposed on adaptive cartesian grids in this paper. Such a multi-resolution WENO scheme is combined with the ghost cell immersed boundary method (IBM) and wall-function technique to solve Navier-Stokes equations. Unlike the k-exact finite volume WENO schemes which involve large amounts of extra storage, repeatedly solving the matrix generated in a least-square method or the process of calculating optimal linear weights on adaptive cartesian grids, the present methodology only adds very small overhead and can be easily implemented in existing edge-based computational fluid dynamics (CFD) codes with minor modifications. Also, the linear weights of this adaptive finite volume multi-resolution WENO scheme can be any positive numbers on condition that their sum is one. It is a way of bypassing the calculation of the optimal linear weights and such a multi-resolution WENO scheme avoids dealing with the negative linear weights on adaptive cartesian grids. Some benchmark viscous problems are numerical solved to show the efficiency and good performance of this adaptive multi-resolution WENO scheme. Compared with a second-order edge-based method, the presented method can be implemented into an adaptive cartesian grid with slight modification for big Reynolds number problems.Keywords: adaptive mesh refinement method, finite volume multi-resolution WENO scheme, immersed boundary method, wall-function technique.
Procedia PDF Downloads 150667 Selecting the Best Sub-Region Indexing the Images in the Case of Weak Segmentation Based on Local Color Histograms
Authors: Mawloud Mosbah, Bachir Boucheham
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Color Histogram is considered as the oldest method used by CBIR systems for indexing images. In turn, the global histograms do not include the spatial information; this is why the other techniques coming later have attempted to encounter this limitation by involving the segmentation task as a preprocessing step. The weak segmentation is employed by the local histograms while other methods as CCV (Color Coherent Vector) are based on strong segmentation. The indexation based on local histograms consists of splitting the image into N overlapping blocks or sub-regions, and then the histogram of each block is computed. The dissimilarity between two images is reduced, as consequence, to compute the distance between the N local histograms of the both images resulting then in N*N values; generally, the lowest value is taken into account to rank images, that means that the lowest value is that which helps to designate which sub-region utilized to index images of the collection being asked. In this paper, we make under light the local histogram indexation method in the hope to compare the results obtained against those given by the global histogram. We address also another noteworthy issue when Relying on local histograms namely which value, among N*N values, to trust on when comparing images, in other words, which sub-region among the N*N sub-regions on which we base to index images. Based on the results achieved here, it seems that relying on the local histograms, which needs to pose an extra overhead on the system by involving another preprocessing step naming segmentation, does not necessary mean that it produces better results. In addition to that, we have proposed here some ideas to select the local histogram on which we rely on to encode the image rather than relying on the local histogram having lowest distance with the query histograms.Keywords: CBIR, color global histogram, color local histogram, weak segmentation, Euclidean distance
Procedia PDF Downloads 360666 ‘Green Gait’ – The Growing Relevance of Podiatric Medicine amid Climate Change
Authors: Angela Evans, Gabriel Gijon-Nogueron, Alfonso Martinez-Nova
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Background The health sector, whose mission is protecting health, also contributes to the climate crisis, the greatest health threat of the 21st century. The carbon footprint from healthcare exceeds 5% of emissions globally, surpassing 7% in the USA and Australia. Global recognition has led to the Paris Agreement, the United Nations Sustainable Development Goals, and the World Health Organization's Climate Change Action Plan. It is agreed that the majority of health impacts stem from energy and resource consumption, as well as the production of greenhouse gases in the environment and deforestation. Many professional medical associations and healthcare providers advocate for their members to take the lead in environmental sustainability. Objectives To avail and expand ‘Green Podiatry’ via the three pillars of: Exercise ; Evidence ; Everyday changes; to highlight the benefits of physical activity and exercise for both human health and planet health. Walking and running are beneficial for health, provide low carbon transport, and have evidence-based health benefits. Podiatrists are key healthcare professionals in the physical activity space and can influence and guide their patients to increase physical activity and avert the many non-communicable diseases that are decimating public health, eg diabetes, arthritis, depression, cancer, obesity. Methods Publications, conference presentations, and pilot projects pertinent to ‘Green Podiatry’ have been activated since 2021, and a survey of podiatrist’s knowledge and awareness has been undertaken.The survey assessed attitudes towards environmental sustainability in work environment. The questions addressed commuting habits, hours of physical exercise per week, and attitudes in the clinic, such as prescribing unnecessary treatments or emphasizing sports as primary treatment. Results Teaching and Learning modules have been developed for podiatric medicine students and graduates globally. These will be availed. A pilot foot orthoses recycling project has been undertaken and will be reported, in addition to established footwear recycling. The preliminary survey found almost 90% of respondents had no knowledge of green podiatry or footwear recycling. Only 30% prescribe sports/exercise as the primary treatment for patients, and 45% do not to prescribe unnecessary treatments. Conclusions Podiatrists are in a good position to lead in the crucial area of healthcare and climate change implications. Sufficient education of podiatrists is essential for the profession to beneficially promote health and physical activity, which is beneficial for the health of all peoples and all communities.Keywords: climate change, gait, green, healthcare, sustainability
Procedia PDF Downloads 92665 Single Carrier Frequency Domain Equalization Design to Cope with Narrow Band Jammer
Authors: So-Young Ju, Sung-Mi Jo, Eui-Rim Jeong
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In this paper, based on the conventional single carrier frequency domain equalization (SC-FDE) structure, we propose a new SC-FDE structure to cope with narrowband jammer. In the conventional SC-FDE structure, channel estimation is performed in the time domain. When a narrowband jammer exists, time-domain channel estimation is very difficult due to high power jamming interference, which degrades receiver performance. To relieve from this problem, a new SC-FDE frame is proposed to enable channel estimation under narrow band jamming environments. In this paper, we proposed a modified SC-FDE structure that can perform channel estimation in the frequency domain and verified the performance via computer simulation.Keywords: channel estimation, jammer, pilot, SC-FDE
Procedia PDF Downloads 475664 MyAds: A Social Adaptive System for Online Advertisment from Hypotheses to Implementation
Authors: Dana A. Al Qudah, Alexandra I. Critea, Rizik M. H. Al Sayyed, Amer Obeidah
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Online advertisement is one of the major incomes for many companies; it has a role in the overall business flow and affects the consumer behavior directly. Unfortunately most users tend to block their ads or ignore them. MyAds is a social adaptive hypermedia system for online advertising and its main goal is to explore how to make online ads more acceptable. In order to achieve such a goal, various technologies and techniques are used. This paper presents a theoretical framework as well as the system architecture for MyAds that was designed based on a set of hypotheses and an exploratory study. The system then was implemented and a pilot experiment was conducted to validate it. The main outcomes suggest that the system has provided personalized ads for users. The main implications suggest that the system can be used for further testing and validating.Keywords: adaptive hypermedia, e-advertisement, social, hypotheses, exploratory study, framework
Procedia PDF Downloads 413663 Effectiveness of Raga Desi Todi on Depression, Anxiety and Stress Among Adults
Authors: Sushila Pareek, Divya Shekhawat
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Music has been shown as a therapeutic agent in depression, anxiety, and stress. A pilot study was carried out to see the therapeutic effects of Indian classical instrumental Raga Todi on depression, anxiety, and stress. 50 individuals diagnosed with depression, anxiety, and stress with DSM-V were taken for the study. Subjects were randomly divided into two groups: the experimental group and the control group. The experimental group received the instrumental raga Todi whereas the other control group didn't receive any intervention. DASS-21 was used on the baseline and after the intervention to measure depression, anxiety, and stress. The result indicates that anxiety, stress, and depression level was reduced after listening to the raga desi Todi. It was concluded that raga desi Todi is an effective intervention for reducing depression, anxiety, and stress.Keywords: raga, anxiety, stress, depression, DASS-21, mental health
Procedia PDF Downloads 147662 Developing Sustainable Tourism Practices in Communities Adjacent to Mines: An Exploratory Study in South Africa
Authors: Felicite Ann Fairer-Wessels
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There has always been a disparity between mining and tourism mainly due to the socio-economic and environmental impacts of mines on both the adjacent resident communities and the areas taken up by the mining operation. Although heritage mining tourism has been actively and successfully pursued and developed in the UK, largely Wales, and Scandinavian countries, the debate whether active mining and tourism can have a mutually beneficial relationship remains imminent. This pilot study explores the relationship between the ‘to be developed’ future Nokeng Mine and its adjacent community, the rural community of Moloto, will be investigated in terms of whether sustainable tourism and livelihood activities can potentially be developed with the support of the mine. Concepts such as social entrepreneur, corporate social responsibility, sustainable development and triple bottom line are discussed. Within the South African context as a mineral rich developing country, the government has a statutory obligation to empower disenfranchised communities through social and labour plans and policies. All South African mines must preside over a Social and Labour Plan according to the Mineral and Petroleum Resources Development Act, No 28 of 2002. The ‘social’ component refers to the ‘social upliftment’ of communities within or adjacent to any mine; whereas the ‘labour’ component refers to the mine workers sourced from the specific community. A qualitative methodology is followed using the case study as research instrument for the Nokeng Mine and Moloto community with interviews and focus group discussions. The target population comprised of the Moloto Tribal Council members (8 in-depth interviews), the Moloto community members (17: focus groups); and the Nokeng Mine representatives (4 in-depth interviews). In this pilot study two disparate ‘worlds’ are potentially linked: on the one hand, the mine as social entrepreneur that is searching for feasible and sustainable ideas; and on the other hand, the community adjacent to the mine, with potentially sustainable tourism entrepreneurs that can tap into the resources of the mine should their ideas be feasible to build their businesses. Being an exploratory study the findings are limited but indicate that the possible success of tourism and sustainable livelihood activities lies in the fact that both the Mine and Community are keen to work together – the mine in terms of obtaining labour and profit; and the community in terms of improved and sustainable social and economic conditions; with both parties realizing the importance to mitigate negative environmental impacts. In conclusion, a relationship of trust is imperative between a mine and a community before a long term liaison is possible. However whether tourism is a viable solution for the community to engage in is debatable. The community could initially rather pursue the sustainable livelihoods approach and focus on life-supporting activities such as building, gardening, etc. that once established could feed into possible sustainable tourism activities.Keywords: community development, mining tourism, sustainability, South Africa
Procedia PDF Downloads 304661 Me and My Selfie: Identity Building Through Self Representation in Social Media
Authors: Revytia Tanera
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This research is a pilot study to examine the rise of selfie trend in dealing with individual self representation and identity building in social media. The symbolic interactionism theory is used as the concept of the desired self image, and Cooley’s looking glass-self concept is used to analyze the mechanical reflection of ourselves; how do people perform their “digital self” in social media. In-depth interviews were conducted in the study with a non-random sample who owns a smartphone with a front camera feature and are active in social media. This research is trying to find out whether the selfie trend brings any influence on identity building on each individual. Through analysis of interview results, it can be concluded that people take selfie photos in order to express themselves and to boost their confidence. This study suggests a follow up and more in depth analysis on identity and self representation from various age groups.Keywords: self representation, selfie, social media, symbolic interaction, looking glass-self
Procedia PDF Downloads 299660 The Effect of Post-Acute Stroke Inpatient Rehabilitation under per Diem Payment: A Pilot Study
Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan
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Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.Keywords: rehabilitation, post-acute stroke, per diem payment, NHI
Procedia PDF Downloads 313659 A Demonstration of How to Employ and Interpret Binary IRT Models Using the New IRT Procedure in SAS 9.4
Authors: Ryan A. Black, Stacey A. McCaffrey
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Over the past few decades, great strides have been made towards improving the science in the measurement of psychological constructs. Item Response Theory (IRT) has been the foundation upon which statistical models have been derived to increase both precision and accuracy in psychological measurement. These models are now being used widely to develop and refine tests intended to measure an individual's level of academic achievement, aptitude, and intelligence. Recently, the field of clinical psychology has adopted IRT models to measure psychopathological phenomena such as depression, anxiety, and addiction. Because advances in IRT measurement models are being made so rapidly across various fields, it has become quite challenging for psychologists and other behavioral scientists to keep abreast of the most recent developments, much less learn how to employ and decide which models are the most appropriate to use in their line of work. In the same vein, IRT measurement models vary greatly in complexity in several interrelated ways including but not limited to the number of item-specific parameters estimated in a given model, the function which links the expected response and the predictor, response option formats, as well as dimensionality. As a result, inferior methods (a.k.a. Classical Test Theory methods) continue to be employed in efforts to measure psychological constructs, despite evidence showing that IRT methods yield more precise and accurate measurement. To increase the use of IRT methods, this study endeavors to provide a comprehensive overview of binary IRT models; that is, measurement models employed on test data consisting of binary response options (e.g., correct/incorrect, true/false, agree/disagree). Specifically, this study will cover the most basic binary IRT model, known as the 1-parameter logistic (1-PL) model dating back to over 50 years ago, up until the most recent complex, 4-parameter logistic (4-PL) model. Binary IRT models will be defined mathematically and the interpretation of each parameter will be provided. Next, all four binary IRT models will be employed on two sets of data: 1. Simulated data of N=500,000 subjects who responded to four dichotomous items and 2. A pilot analysis of real-world data collected from a sample of approximately 770 subjects who responded to four self-report dichotomous items pertaining to emotional consequences to alcohol use. Real-world data were based on responses collected on items administered to subjects as part of a scale-development study (NIDA Grant No. R44 DA023322). IRT analyses conducted on both the simulated data and analyses of real-world pilot will provide a clear demonstration of how to construct, evaluate, and compare binary IRT measurement models. All analyses will be performed using the new IRT procedure in SAS 9.4. SAS code to generate simulated data and analyses will be available upon request to allow for replication of results.Keywords: instrument development, item response theory, latent trait theory, psychometrics
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