Search results for: healthcare building
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5582

Search results for: healthcare building

1952 Report of a Realistic Simulation Training in Using Bougie Guide for Endotracheal Intubation

Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Dóris F. Rabelo

Abstract:

Some patients with COVID-19 disease and difficult airway characteristics undergo to endotracheal intubation (ETI) procedure. The tracheal introducer, known as the bougie guide, can aid ETI in patients with difficult airway pattern. Realistic simulation (RS) is a methodology utilized for healthcare professionals training. To improve skills in using the bougie guide of physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was carried out. Simulated scenario included the Nasco Lifeform realistic simulator for ETI and a bougie guide introducer. Training was a capacitation program organized by the Health Department of Bahia State. Objective: To report effects in participants´ self-confidence perception for using bougie guide after a RS based training. Methods: Descriptive study, secondary data extracted from questionnaires. Priority workplace and previous knowledge about bougie were reported on a preparticipation formulary. Participants also completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding to self-confidence in using bougie guide. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's exact test. Results: From May to June 2020 a total of 36 physicians participated of training, 25 (69%) from primary care setting, 32 (89%) with no previous knowledge about the bougie guide utilization. For those who had previous knowledge about bougie pre-training self-confidence median was 6,5, and 2 for participants who had not. In overall there was an increase in self-confidence median for bougie utilization. Median (variation) before and after training was 2.5 (1-7) vs. 8 (4-10) (p <0.0001). Among those who had no previous knowledge about bougie (n = 32) an increase in self-confidence greater than 3 points for bougie utilization was reported by 31 vs. 1 participants (p = 0.71). Conclusions: Most of participants had no previous knowledge about using the bougie guide. RS training contributed to self-confidence increase for using bougie for ETI procedure. RS methodology can contribute for training in using the bougie guide for ETI procedure during COVID-19 outbreak.

Keywords: bougie, confidence, COVID-19, endotracheal intubation, realistic simulation

Procedia PDF Downloads 144
1951 Nutrition and Physical Activity Intervention on Health Screening Outcomes for Singaporean Employees: A Worksite Based Randomised Controlled Trial

Authors: Elaine Wong

Abstract:

This research protocol aims to explore and justify the need for nutrition and physical activity intervention to improve health outcomes among SME (Small Medium Enterprise) employees. It was found that the worksite is an ideal and convenient setting for employees to take charge of their health thru active participation in health programmes since they spent a great deal of time at their workplace. This study will examine the impact of both general or/and targeted health interventions in both SME and non-SME companies utilizing the Workplace Health Promotion (WHP) grant over a 12 months period and assessed the improvement in chronic health disease outcomes in Singapore. Random sampling of both non-SME and SME companies will be conducted to undergo health intervention and statistical packages such as Statistical Package for Social Science (SPSS) 25 will be used to examine the impact of both general and targeted interventions on employees who participate and those who do not participate in the intervention and their effects on blood glucose (BG), blood lipid, blood pressure (BP), body mass index (BMI), and body fat percentage. Using focus groups and interviews, the data results will be transcribed to investigate enablers and barriers to workplace health intervention revealed by employees and WHP coordinators that could explain the variation in the health screening results across the organisations. Dietary habits and physical activity levels of the employees participating and not participating in the intervention will be collected before and after intervention to assess any changes in their lifestyle practices. It makes economic sense to study the impact of these interventions on health screening outcomes across various organizations that are existing grant recipients to justify the sustainability of these programmes by the local government. Healthcare policy makers and employers can then tailor appropriate and relevant programmes to manage these escalating chronic health disease conditions which is integral to the competitiveness and productivity of the nation’s workforce.

Keywords: chronic diseases, health screening, nutrition and fitness intervention , workplace health

Procedia PDF Downloads 148
1950 Short Teaching Sessions for Emergency Front of Neck Access

Authors: S. M. C. Kelly, A. Hargreaves, S. Hargreaves

Abstract:

Introduction: The Can’t intubate, Can’t ventilate emergency scenario is one which has been shown to be managed badly in the past. Reasons identified included gaps in knowledge of the procedure and the emergency equipment used. We aimed to show an increase in confidence amongst anesthetists and operating department practitioners in the technique following a short tea trolley style teaching intervention. Methods: We carried out the teaching on a one-to-one basis. Two Anaesthetists visited each operating theatre during normal working days. One carried out the teaching session and one took over the intra‐operative care of the patient, releasing the listed anaesthetist for a short teaching session. The teaching was delivered to mixture of students and healthcare professionals, both anaesthetists and anaesthetic practitioners. The equipment includes a trolley, an airway manikin, size 10 scalpel, bougie and size 6.0 tracheal tube. The educator discussed the equipment, performed a demonstration and observed the participants performing the procedure. We asked each person to fill out a pre and post teaching questionnaire, stating their confidence with the procedure. Results: The teaching was delivered to 63 participants in total, which included 21 consultant anaesthetists, 23 trainee doctors and 19 anaesthetic practitioners. The teaching sessions lasted on average 9 minutes (range 5– 15 minutes). All participants reported an increase in confidence in both the equipment and technique in front of neck access. Anaesthetic practitioners reported the greatest increase in confidence (53%), with trainee anaesthetists reporting 27% increase and consultant anaesthetists 22%. Overall, confidence in the performance of emergency front of neck access increased by 31% after the teaching session. Discussion: Short ‘Trolley style’ teaching improves confidence in the equipment and technique used for the emergency front of neck access. This is true for students and for consultant anaesthetists. This teaching style is quick with minimal running costs and is relevant for all anesthetic departments.

Keywords: airway teaching, can't intubate can't ventilate, cricothyroidotomy, front-of-neck

Procedia PDF Downloads 150
1949 Empowering Persons with Disabilities in Indonesia: Translating the Disability Law into Practice

Authors: Marthella Rivera Roidatua

Abstract:

Since the release of Convention on the Rights of Persons with Disabilities in 2006, disability became a mainstreamed global issue. Many developed countries have shown the continuous effort to improve their disability employment policy, for example, the US and the UK with their integrated support system through disability benefits. Relative little recent research on developing country is available. Surprisingly, Indonesia, just enacted the Law No.8/2016 on Disability that bravely highlighted on integrating disabled people into the workforce. It shows a positive progress shifting traditional perspective to what Tom Shakespeare’s concept of a social model of disability. But, the main question is how can this law support the disabled people to access and maintain paid work. Thus, besides the earlier literature reviews, interviews with leading sectors, Ministry of Social Affairs and Ministry of Manpower, was conducted to examine government’s attitude towards the disabled worker. Insights from two local social enterprises on disability were also engaged in building better perspective. The various source of data was triangulated then analysed with a thematic approach. Results were encouraging the Indonesian government to have a better collaboration with other impactful local organisations in promoting the disability employment. In the end, this paper also recommends the government to make a reasonable adjustment and practical guideline for companies in hiring disabled.

Keywords: disability, employment, policy, Indonesia, collaboration, guidelines

Procedia PDF Downloads 241
1948 Planning the Journey of Unifying Medical Record Numbers in Five Facilities and the Expected Challenges: Case Study in Saudi Arabia

Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

Abstract:

Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

Procedia PDF Downloads 196
1947 Peltier Air Conditioning System for Preventing Ambient Heating: An Alternative to Gas Air Conditioners

Authors: Siamak Eskandari, Neda Ebadi

Abstract:

After discovering and using Freon as refrigerant in refrigerators and air conditioners, researchers have been working hard to minimize massive environmental damage caused by this type of systems, including ozone depletion, heat production, and urban warming. However, there is a growing concern for global warming and climate change and its impacts on climates. Although gas air conditioners can provide comfort in short term, there are long-term consequences and effects, including global warming, polar ice melting, sea level rising, rising sea surface temperatures, reduction in seasonal precipitation, tropical storms, and drought. In this theoretical and practical study, Peltier electronic chip was used with no gas in the structure and operation. In fact, cooling and heating are based on bipolar electronics. With an innovative method, Peltier air conditioners provide cooling in warm seasons and heating in cold seasons in buildings. Such a system prevents ambient warming. The problem of air circulation between high buildings in large cities and draught will be considerably resolved through the use of the silent fan in the system. In addition, the system is designed and developed in accordance with international standards such as LEED and Energy Star.

Keywords: energy, Building cooling and heating, peltier, leed, energy star

Procedia PDF Downloads 195
1946 A Real-World Evidence Analysis of Associations between Costs, Quality of Life and Disease-Severity Indicators of Alzheimer’s Disease in Thailand

Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

Abstract:

Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

Procedia PDF Downloads 143
1945 Broadening Attentional Scope by Seeing Happy Faces

Authors: John McDowall, Crysta Derham

Abstract:

Broaden and build theory of emotion describes how experiencing positive emotions, such as happiness, broadens our ‘thought-action repertoire’ leading us to be more likely to go out and act on our positive emotions. This results in the building of new relationships, resources and skills, which we can draw on in times of need throughout life. In contrast, the experience of negative emotion is thought to narrow our ‘thought-action repertoire’, leading to specific actions to aid in survival. Three experiments aimed to explore the effect of briefly presented schematic faces (happy, sad, and neutral) on attentional scope using the flanker task. Based on the broaden and build theory it was hypothesised that there would be an increase in reaction time in trials primed with a happy face due to a broadening of attention, leading to increased flanker interference. A decrease in reaction time was predicted for trials primed with a sad face, due to a narrowing of attention leading to less flanker interference. Results lended partial support to the broaden and build hypothesis, with reaction times being slower following happy primes in incongruent flanker trials. Recent research is discussed in regards to potential mediators of the relationship between emotion and attention.

Keywords: emotion, attention, broaden and build, flanker task

Procedia PDF Downloads 478
1944 Method and Apparatus for Optimized Job Scheduling in the High-Performance Computing Cloud Environment

Authors: Subodh Kumar, Amit Varde

Abstract:

Typical on-premises high-performance computing (HPC) environments consist of a fixed number and a fixed set of computing hardware. During the design of the HPC environment, the hardware components, including but not limited to CPU, Memory, GPU, and networking, are carefully chosen from select vendors for optimal performance. High capital cost for building the environment is a prime factor influencing the design environment. A class of software called “Job Schedulers” are critical to maximizing these resources and running multiple workloads to extract the maximum value for the high capital cost. In principle, schedulers work by preventing workloads and users from monopolizing the finite hardware resources by queuing jobs in a workload. A cloud-based HPC environment does not have the limitations of fixed (type of and quantity of) hardware resources. In theory, users and workloads could spin up any number and type of hardware resource. This paper discusses the limitations of using traditional scheduling algorithms for cloud-based HPC workloads. It proposes a new set of features, called “HPC optimizers,” for maximizing the benefits of the elasticity and scalability of the cloud with the goal of cost-performance optimization of the workload.

Keywords: high performance computing, HPC, cloud computing, optimization, schedulers

Procedia PDF Downloads 93
1943 A Review of Energy in the Democratic Republic of Congo

Authors: Kanzumba Kusakana

Abstract:

The Democratic Republic of Congo (DRC) is currently experiencing a general energy crisis due to lack of proper investment and management in the energy sector. 93, 6% of the country is highly dependent on wood fuels as main source of energy having severe impacts such as deforestation and general degradation of the environment. On the other hand, the major share of the electricity produced mainly from ill-conditioned hydro and thermal power stations is principally used to supply the industrial sector as well as very few urban areas. Nevertheless, DRC possesses huge potential in renewable resources such as hydropower, biomass, methane gas, solar geothermal and moderate wind potential that can be used for energy generation. Recently the country has initiated projects to build decentralized micro hydropower station to supply remotes and isolated areas; to rehabilitate its existent main hydropower plants and transmission lines as well as to extend its current generation capacity by building new hydropower stations able to respond to a major part of the African continent energy needs. This paper presents a comprehensive review of current energy resources as well as of the electricity situation in DRC. Recent energy projects, the energy policy as well as the energy challenges in the DRC are also presented.

Keywords: energy, biomass, hydro power, renewable energy, energy policy, Democratic Republic of Congo

Procedia PDF Downloads 337
1942 Prevalence of Dengue in Sickle Cell Disease in Pre-school Children

Authors: Nikhil A. Gavhane, Sachin Shah, Ishant S. Mahajan, Pawan D. Bahekar

Abstract:

Introduction: Millions of people are affected with dengue fever every year, which drives up healthcare expenses in many low-income countries. Organ failure and other serious symptoms may result. Another worldwide public health problem is sickle cell anaemia, which is most prevalent in Africa, the Caribbean, and Europe. Dengue epidemics have reportedly occurred in locations with a high frequency of sickle cell disease, compounding the health problems in these areas. Aims and Objectives: This study examines dengue infection in sickle cell disease-afflicted pre-schoolers. Method:This Retrospective cohort study examined paediatric patients. Young people with sickle cell disease (SCD), dengue infection, and a control group without SCD or dengue were studied. Data on demographics, SCD consequences, medical treatments, and laboratory findings were gathered to analyse the influence of SCD on dengue severity and clinical outcomes, classified as severe or non-severe by the 2009 WHO classification. Using fever or admission symptoms, the research estimated acute illness duration. Result: Table 1 compares haemoglobin genotype-based dengue episode features in SS, SC, and controls. Table 2 shows that severe dengue cases are older, have longer admission delays, and have particular symptoms. Table 3's multivariate analysis indicates SS genotype's high connection with severe dengue, multiorgan failure, and acute pulmonary problems. Table 4 relates severe dengue to greater white blood cell counts, anaemia, liver enzymes, and reduced lactate dehydrogenase. Conclusion: This study is valuable but confined to hospitalised dengue patients with sickle cell illness. Small cohorts limit comparisons. Further study is needed since findings contradict predictions.

Keywords: dengue, chills, headache, severe myalgia, vomiting, nausea, prostration

Procedia PDF Downloads 72
1941 The Secret Ingredient of Student Involvement: Applied Science Case Studies to Enhance Sustainability

Authors: Elizelle Juanee Cilliers

Abstract:

Recent planning thinking has laid the foundations for a general sense of best practice that aims to enhance the quality of life, suggesting an open and participatory process. It is accepted that integration of top-down and bottom-up approaches may lead to efficient action in environments and sustainable planning and development, although it is also accepted that such an integrated approach has various challenges of implementation. A flexible framework in which the strengths of both the top-down and bottom-up approaches were explored in this research, based on the EU Interreg VALUE Added project and five case studies where student education and student involvement played a crucial role within the participation process of the redesign of the urban environment. It was found that international student workshops were an effective tool to integrate bottom-up and top-down structures, as it acted as catalyst for communication, interaction, creative design, quick transformation from planning to implementation, building social cohesion, finding mutual ground between stakeholders and thus enhancing overall quality of life and quality of environments. It offered a good alternative to traditional participation modes and created a platform for an integrative planning approach. The role and importance of education and integration within the urban environment were emphasized.

Keywords: top-down, bottom-up, flexible, student involvement

Procedia PDF Downloads 210
1940 Evaluation of the Urban Regeneration Project: Land Use Transformation and SNS Big Data Analysis

Authors: Ju-Young Kim, Tae-Heon Moon, Jung-Hun Cho

Abstract:

Urban regeneration projects have been actively promoted in Korea. In particular, Jeonju Hanok Village is evaluated as one of representative cases in terms of utilizing local cultural heritage sits in the urban regeneration project. However, recently, there has been a growing concern in this area, due to the ‘gentrification’, caused by the excessive commercialization and surging tourists. This trend was changing land and building use and resulted in the loss of identity of the region. In this regard, this study analyzed the land use transformation between 2010 and 2016 to identify the commercialization trend in Jeonju Hanok Village. In addition, it conducted SNS big data analysis on Jeonju Hanok Village from February 14th, 2016 to March 31st, 2016 to identify visitors’ awareness of the village. The study results demonstrate that rapid commercialization was underway, unlikely the initial intention, so that planners and officials in city government should reconsider the project direction and rebuild deliberate management strategies. This study is meaningful in that it analyzed the land use transformation and SNS big data to identify the current situation in urban regeneration area. Furthermore, it is expected that the study results will contribute to the vitalization of regeneration area.

Keywords: land use, SNS, text mining, urban regeneration

Procedia PDF Downloads 293
1939 Sustainable Development: Evaluation of an Urban Neighborhood

Authors: Harith Mohammed Benbouali

Abstract:

The concept of sustainable development is becoming increasingly important in our society. The efforts of specialized agencies, cleverly portrayed in the media, allow a widespread environmental awareness. Far from the old environmental movement in the backward-looking nostalgia, the environment is combined with today's progress. Many areas now include these concerns in their efforts, this in order to try to reduce the negative impact of human activities on the environment. The quantitative dimension of development has given way to the quality aspect. However, this feature is not common, and the initial target was abandoned in favor of economic considerations. Specialists in the field of building and construction have constantly sought to further integrate the environmental dimension, creating a seal of high environmental quality buildings. The pursuit of well-being of neighborhood residents and the quality of buildings are also a hot topic in planning. Quality of life is considered so on, since financial concerns dominate to the detriment of the environment and the welfare of the occupants. This work concerns the development of an analytical method based on multiple indicators of objectives across the district. The quantification of indicators related to objectives allows the construction professional, the developer or the community, to quantify and compare different alternatives for development of a neighborhood. This quantification is based on the use of simulation tools and a multi-criteria aggregation.

Keywords: sustainable development, environment, district, indicators, multi-criteria analysis, evaluation

Procedia PDF Downloads 312
1938 Applications Using Geographic Information System for Planning and Development of Energy Efficient and Sustainable Living for Smart-Cities

Authors: Javed Mohammed

Abstract:

As urbanization process has been and will be happening in an unprecedented scale worldwide, strong requirements from academic research and practical fields for smart management and intelligent planning of cities are pressing to handle increasing demands of infrastructure and potential risks of inhabitants agglomeration in disaster management. Geo-spatial data and Geographic Information System (GIS) are essential components for building smart cities in a basic way that maps the physical world into virtual environment as a referencing framework. On higher level, GIS has been becoming very important in smart cities on different sectors. In the digital city era, digital maps and geospatial databases have long been integrated in workflows in land management, urban planning and transportation in government. People have anticipated GIS to be more powerful not only as an archival and data management tool but also as spatial models for supporting decision-making in intelligent cities. The purpose of this project is to offer observations and analysis based on a detailed discussion of Geographic Information Systems( GIS) driven Framework towards the development of Smart and Sustainable Cities through high penetration of Renewable Energy Technologies.

Keywords: digital maps, geo-spatial, geographic information system, smart cities, renewable energy, urban planning

Procedia PDF Downloads 526
1937 Pathogenic Candida Biofilms Producers Involved in Healthcare Associated Infections

Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir

Abstract:

The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.

Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin

Procedia PDF Downloads 323
1936 Effective Public Health Communication: Vaccine Health Messaging with Aboriginal and Torres Strait Islander Peoples

Authors: Maria Karidakis, Barbara Kelly

Abstract:

The challenges precipitated by the advent of COVID-19 have brought to the fore the task governments and key stakeholders are faced with; ensuring public health communication is readily accessible to vulnerable populations. COVID-19 has presented challenges for the provision and reception of timely, accessible, and accurate health information pertaining to vaccine health messaging to Aboriginal and Torres Strait Islander peoples. The aim of this qualitative study was to explore strategies used by Aboriginal-led organisations to improve communication about COVID-19 and vaccination for their communities and to explore how these mediation and outreach strategies were received by community members. We interviewed 6 Aboriginal-led organisations and 15 community members from several states across Australian, and these interviews were analysed thematically. The findings suggest that effective public health communication is enhanced when aFirst nations-led response defines the governance that happens in First Nations communities. Pro-active and self-determining Aboriginal leadership and decision-making helps drive the response to counter a growing trend towards vaccine hesitancy. Other strategies include establishing partnerships with government departments and relevant non-governmental organisations to ensure services are implemented and culturally appropriate. The outcomes of this research will afford policymakers, stakeholders in healthcare, and cultural mediators the capacity to identify strengths and potential problems associated with pandemic health information and to subsequently implement creative and culturally specific solutions that go beyond the provision of written documentation via translation or interpreting. It will also enable governing bodies to adjust multilingual polices and to adopt mediation strategies that will improve information delivery and intercultural services on a national and international level.

Keywords: intercultural communication, qualitative, public health communication, COVID-19, pandemic, mediated communication, first nations people

Procedia PDF Downloads 160
1935 The Impact of Digital Transformation on the Construction Industry in Kuwait

Authors: M. Aladwani, Y. Alarfaj

Abstract:

The construction industry is currently experiencing a shift towards digitisation. This transformation is driven by adopting technologies like Building Information Modelling (BIM), drones, and augmented reality (AR). These advancements are revolutionizing the process of designing, constructing, and operating projects. BIM, for instance, is a new way of communicating and exploiting technology such as software and machinery. It enables the creation of a replica or virtual model of buildings or infrastructure projects. It facilitates simulating construction procedures, identifying issues beforehand, and optimizing designs accordingly. Drones are another tool in this revolution, as they can be utilized for site surveys, inspections, and even deliveries. Moreover, AR technology provides real-time information to workers involved in the project. Implementing these technologies in the construction industry has brought about improvements in efficiency, safety measures, and sustainable practices. BIM helps minimize rework and waste materials, while drones contribute to safety by reducing workers' exposure to areas. Additionally, AR plays a role in worker safety by delivering instructions and guidance during operations. Although the digital transformation within the construction industry is still in its early stages, it holds the potential to reshape project delivery methods entirely. By embracing these technologies, construction companies can boost their profitability while simultaneously reducing their environmental impact and ensuring safer practices.

Keywords: BIM, digital construction, construction technologies, digital transformation

Procedia PDF Downloads 86
1934 Potential of Visualization and Information Modeling on Productivity Improvement and Cost Saving: A Case Study of a Multi-Residential Construction Project

Authors: Sara Rankohi, Lloyd Waugh

Abstract:

Construction sites are information saturated. Digitalization is hitting construction sites to meet the incredible demand of knowledge sharing and information documentations. From flying drones, 3D Lasers scanners, pocket mobile applications, to augmented reality glasses and smart helmet, visualization technologies help real-time information imposed straight onto construction professional’s field of vision. Although these technologies are very applicable and can have the direct impact on project cost and productivity, experience shows that only a minority of construction professionals quickly adapt themselves to benefit from them in practice. The majority of construction managers still tend to apply traditional construction management methods. This paper investigates a) current applications of visualization technologies in construction projects management, b) the direct effect of these technologies on productivity improvement and cost saving of a multi-residential building project via a case study on Mac Taggart Senior Care project located in Edmonton, Alberta. The research shows the imaged based technologies have a direct impact on improving project productivity and cost savings.

Keywords: image-based technologies, project management, cost, productivity improvement

Procedia PDF Downloads 361
1933 Performance of On-site Earthquake Early Warning Systems for Different Sensor Locations

Authors: Ting-Yu Hsu, Shyu-Yu Wu, Shieh-Kung Huang, Hung-Wei Chiang, Kung-Chun Lu, Pei-Yang Lin, Kuo-Liang Wen

Abstract:

Regional earthquake early warning (EEW) systems are not suitable for Taiwan, as most destructive seismic hazards arise due to in-land earthquakes. These likely cause the lead-time provided by regional EEW systems before a destructive earthquake wave arrives to become null. On the other hand, an on-site EEW system can provide more lead-time at a region closer to an epicenter, since only seismic information of the target site is required. Instead of leveraging the information of several stations, the on-site system extracts some P-wave features from the first few seconds of vertical ground acceleration of a single station and performs a prediction of the oncoming earthquake intensity at the same station according to these features. Since seismometers could be triggered by non-earthquake events such as a passing of a truck or other human activities, to reduce the likelihood of false alarms, a seismometer was installed at three different locations on the same site and the performance of the EEW system for these three sensor locations were discussed. The results show that the location on the ground of the first floor of a school building maybe a good choice, since the false alarms could be reduced and the cost for installation and maintenance is the lowest.

Keywords: earthquake early warning, on-site, seismometer location, support vector machine

Procedia PDF Downloads 244
1932 A Systematic Review of the Predictors, Mediators and Moderators of the Uncanny Valley Effect in Human-Embodied Conversational Agent Interaction

Authors: Stefanache Stefania, Ioana R. Podina

Abstract:

Background: Embodied Conversational Agents (ECAs) are revolutionizing education and healthcare by offering cost-effective, adaptable, and portable solutions. Research on the Uncanny Valley effect (UVE) involves various embodied agents, including ECAs. Achieving the optimal level of anthropomorphism, no consensus on how to overcome the uncanniness problem. Objectives: This systematic review aims to identify the user characteristics, agent features, and context factors that influence the UVE. Additionally, this review provides recommendations for creating effective ECAs and conducting proper experimental studies. Methods: We conducted a systematic review following the PRISMA 2020 guidelines. We included quantitative, peer-reviewed studies that examined human-ECA interaction. We identified 17,122 relevant records from ACM Digital Library, IEE Explore, Scopus, ProQuest, and Web of Science. The quality of the predictors, mediators, and moderators adheres to the guidelines set by prior systematic reviews. Results: Based on the included studies, it can be concluded that females and younger people perceive the ECA as more attractive. However, inconsistent findings exist in the literature. ECAs characterized by extraversion, emotional stability, and agreeableness are considered more attractive. Facial expressions also play a role in the UVE, with some studies indicating that ECAs with more facial expressions are considered more attractive, although this effect is not consistent across all studies. Few studies have explored contextual factors, but they are nonetheless crucial. The interaction scenario and exposure time are important circumstances in human-ECA interaction. Conclusions: The findings highlight a growing interest in ECAs, which have seen significant developments in recent years. Given this evolving landscape, investigating the risk of the UVE can be a promising line of research.

Keywords: human-computer interaction, uncanny valley effect, embodied conversational agent, systematic review

Procedia PDF Downloads 81
1931 Identity Conflict between Social and Business Entrepreneurs: The Challenge of Constructing a Novel Social Identity

Authors: Rui G. Serôdio, Carina Martins, Alexandra Serra, José A. Lima, Luísa Catita, Paula Lopes

Abstract:

Building on social identity approach, we tested the impact of social categorization and comparison in the psychosocial process by which social entrepreneurs define their group identity. Specifically, we address how both differentiation and assimilation processes are set of in the context of constructing a novel, distinctive and socially salient – social entrepreneurs. As part of a larger research line, a quasi-experimental study with Social and Business Entrepreneurs, as well as “Lay People” provided evidence consistent with our predictions: (1) Social Entrepreneurs, in contrast with Lay People and Business Entrepreneurs, value more strongly social identity than personal identity, and the later is the only group that values Personal Differentiation; (2) unlike Entrepreneurs, Social Entrepreneurs display an ingroup bias across group evaluations; (3) Lay People, display a self-serving bias, although, overall, they allocate a more positive image to the target groups; (4) combining own vs. others evaluations across all groups, Social Entrepreneurs receive the more positive value. From the standpoint of social identity and self-categorization theories and their approach to group process, we discuss the processes of intergroup comparison and differentiation as core processes in the construction of a positive social identity. We illustrate it within the context of social entrepreneurship, a political and social “wave” that flows across Europe at this time.

Keywords: group processes, social entrepreneurship, social identity, business entrepreneurs

Procedia PDF Downloads 695
1930 Pre-Service Teachers’ Reasoning and Sense Making of Variables

Authors: Olteanu Constanta, Olteanu Lucian

Abstract:

Researchers note that algebraic reasoning and sense making is essential for building conceptual knowledge in school mathematics. Consequently, pre-service teachers’ own reasoning and sense making are useful in fostering and developing students’ algebraic reasoning and sense making. This article explores the forms of reasoning and sense making that pre-service mathematics teachers exhibit and use in the process of analysing problem-posing tasks with a focus on first-degree equations. Our research question concerns the characteristics of the problem-posing tasks used for reasoning and sense making of first-degree equations as well as the characteristics of pre-service teachers’ reasoning and sense making in problem-posing tasks. The analyses are grounded in a post-structuralist philosophical perspective and variation theory. Sixty-six pre-service primary teachers participated in the study. The results show that the characteristics of reasoning in problem-posing tasks and of pre-service teachers are selecting, exploring, reconfiguring, encoding, abstracting and connecting. The characteristics of sense making in problem-posing tasks and of pre-service teachers are recognition, relationships, profiling, comparing, laddering and verifying. Beside this, the connection between reasoning and sense making is rich in line of flight in problem-posing tasks, while the connection is rich in line of rupture for pre-service teachers.

Keywords: first-degree equations, problem posing, reasoning, rhizomatic assemblage, sense-making, variation theory

Procedia PDF Downloads 114
1929 Data Protection and Regulation Compliance on Handling Physical Child Abuse Scenarios- A Scoping Review

Authors: Ana Mafalda Silva, Rebeca Fontes, Ana Paula Vaz, Carla Carreira, Ana Corte-Real

Abstract:

Decades of research on the topic of interpersonal violence against minors highlight five main conclusions: 1) it causes harmful effects on children's development and health; 2) it is prevalent; 3) it violates children's rights; 4) it can be prevented and 5) parents are the main aggressors. The child abuse scenario is identified through clinical observation, administrative data and self-reports. The most used instruments are self-reports; however, there are no valid and reliable self-report instruments for minors, which consist of a retrospective interpretation of the situation by the victim already in her adult phase and/or by her parents. Clinical observation and collection of information, namely from the orofacial region, are essential in the early identification of these situations. The management of medical data, such as personal data, must comply with the General Data Protection Regulation (GDPR), in Europe, and with the General Law of Data Protection (LGPD), in Brazil. This review aims to answer the question: In a situation of medical assistance to minors, in the suspicion of interpersonal violence, due to mistreatment, is it necessary for the guardians to provide consent in the registration and sharing of personal data, namely medical ones. A scoping review was carried out based on a search by the Web of Science and Pubmed search engines. Four papers and two documents from the grey literature were selected. As found, the process of identifying and signaling child abuse by the health professional, and the necessary early intervention in defense of the minor as a victim of abuse, comply with the guidelines expressed in the GDPR and LGPD. This way, the notification in maltreatment scenarios by health professionals should be a priority and there shouldn’t be the fear or anxiety of legal repercussions that stands in the way of collecting and treating the data necessary for the signaling procedure that safeguards and promotes the welfare of children living with abuse.

Keywords: child abuse, disease notifications, ethics, healthcare assistance

Procedia PDF Downloads 95
1928 A Comparative Analysis about the Effects of a Courtyard in Indoor Thermal Environment of a Room with and without Transitional Space Adjacent to Courtyard of a House in Old Dhaka, Bangladesh

Authors: Fatema Tasmia, Brishti Majumder, Atiqur Rahman

Abstract:

Attaining appropriate comfort conditions in a place where the climate is hot and humid can be perplexing. Especially, when it is resided at a congested place like old Dhaka Bangladesh, the provision of giving cross ventilation and building with proper orientation is quite difficult. Courtyards are the part of buildings which are used as space for outdoor household activities, social gathering and it is also proved to have indoor thermal comfort as an effect of courtyard. This paper aims to investigate the effect of courtyard in indoor thermal environment of a room adjacent to the courtyard and a room next to transitional space after a courtyard through field measurements of a case study house. The field measurement was conducted in a two-storey house. Among different aspects of thermal environment, the study of this paper is based on the analysis of temperature in both situations. Ventilation or air movement was considered to have no impact because of the rooms’ layout and location. Other aspects and their variables were considered as constant (especially material) for accuracy and avoidance of confusion. This study focuses on the outcome that can ultimately contribute to the configuration of courtyards and in its relation to indoor space while achieving thermal comfort.

Keywords: courtyard, old Dhaka, temperature, thermal comfort, transitional space

Procedia PDF Downloads 224
1927 Development of an Energy Independant DC Building Demonstrator for Insulated Island Site

Authors: Olivia Bory Devisme, Denis Genon-Catalot, Frederic Alicalapa, Pierre-Olivier Lucas De Peslouan, Jean-Pierre Chabriat

Abstract:

In the context of climate change, it is essential that island territories gain energy autonomy. Currently mostly dependent on fossil fuels, the island of Reunion lo- cated in the Indian Ocean nevertheless has a high potential for solar energy. As the market for photovoltaic panels has been growing in recent years, the issues of energy losses linked to the multiple conversions from direct current to alternating current are emerging. In order to quantify these advantages and disadvantages by a comparative study, this document present the measurements carried out on a direct current test bench, particularly for lighting, ventilation, air condi- tioning and office equipment for the tertiary sector. All equipment is supplied with DC power from energy produced by photovoltaic panels. A weather sta- tion, environmental indoor sensors, and drivers are also used to control energy. Self-consumption is encouraged in order to manage different priorities between user consumption and energy storage in a lithium iron phosphate battery. The measurements are compared to a conventional electrical architecture (DC-AC- DC) for energy consumption, equipment overheating, cost, and life cycle analysis.

Keywords: DC microgrids, solar energy, smart buildings, storage

Procedia PDF Downloads 162
1926 An Artificial Intelligence Framework to Forecast Air Quality

Authors: Richard Ren

Abstract:

Air pollution is a serious danger to international well-being and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.Air pollution is a serious danger to international wellbeing and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.Air pollution is a serious danger to international wellbeing and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.

Keywords: air quality prediction, air pollution, artificial intelligence, machine learning algorithms

Procedia PDF Downloads 127
1925 Effects of Self-Management Programs on Blood Pressure Control, Self-Efficacy, Medication Adherence, and Body Mass Index among Older Adult Patients with Hypertension: Meta-Analysis of Randomized Controlled Trials

Authors: Van Truong Pham

Abstract:

Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.

Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index

Procedia PDF Downloads 128
1924 Spatial Data Science for Data Driven Urban Planning: The Youth Economic Discomfort Index for Rome

Authors: Iacopo Testi, Diego Pajarito, Nicoletta Roberto, Carmen Greco

Abstract:

Today, a consistent segment of the world’s population lives in urban areas, and this proportion will vastly increase in the next decades. Therefore, understanding the key trends in urbanization, likely to unfold over the coming years, is crucial to the implementation of sustainable urban strategies. In parallel, the daily amount of digital data produced will be expanding at an exponential rate during the following years. The analysis of various types of data sets and its derived applications have incredible potential across different crucial sectors such as healthcare, housing, transportation, energy, and education. Nevertheless, in city development, architects and urban planners appear to rely mostly on traditional and analogical techniques of data collection. This paper investigates the prospective of the data science field, appearing to be a formidable resource to assist city managers in identifying strategies to enhance the social, economic, and environmental sustainability of our urban areas. The collection of different new layers of information would definitely enhance planners' capabilities to comprehend more in-depth urban phenomena such as gentrification, land use definition, mobility, or critical infrastructural issues. Specifically, the research results correlate economic, commercial, demographic, and housing data with the purpose of defining the youth economic discomfort index. The statistical composite index provides insights regarding the economic disadvantage of citizens aged between 18 years and 29 years, and results clearly display that central urban zones and more disadvantaged than peripheral ones. The experimental set up selected the city of Rome as the testing ground of the whole investigation. The methodology aims at applying statistical and spatial analysis to construct a composite index supporting informed data-driven decisions for urban planning.

Keywords: data science, spatial analysis, composite index, Rome, urban planning, youth economic discomfort index

Procedia PDF Downloads 135
1923 Clinical Advice Services: Using Lean Chassis to Optimize Nurse-Driven Telephonic Triage of After-Hour Calls from Patients

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

Abstract:

It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

Procedia PDF Downloads 174