Search results for: psychosocial assessment and intervention
3556 A Robust Optimization Method for Service Quality Improvement in Health Care Systems under Budget Uncertainty
Authors: H. Ashrafi, S. Ebrahimi, H. Kamalzadeh
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With the development of business competition, it is important for healthcare providers to improve their service qualities. In order to improve service quality of a clinic, four important dimensions are defined: tangibles, responsiveness, empathy, and reliability. Moreover, there are several service stages in hospitals such as financial screening and examination. One of the most challenging limitations for improving service quality is budget which impressively affects the service quality. In this paper, we present an approach to address budget uncertainty and provide guidelines for service resource allocation. In this paper, a service quality improvement approach is proposed which can be adopted to multistage service processes to improve service quality, while controlling the costs. A multi-objective function based on the importance of each area and dimension is defined to link operational variables to service quality dimensions. The results demonstrate that our approach is not ultra-conservative and it shows the actual condition very well. Moreover, it is shown that different strategies can affect the number of employees in different stages.Keywords: allocation, budget uncertainty, healthcare resource, service quality assessment, robust optimization
Procedia PDF Downloads 1753555 Digital Maturity Framework: A Tool to Manage the Information Technologies and Develop Activities of Innovation in Companies
Authors: Paulina Solórzano Salgado, Luis Rodrigo Valencia Pérez, Alberto de Jesús Pastrana Palma
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In this research, it is presented a digital maturity framework, which contributes to the development of small and medium-sized enterprises (SMEs) in the commercial sector. This proposal is based on three important concepts: Marketing activities in the enterprise, information and communication technologies ICT, as well as Innovation. Prior to the development of this framework, was formulated a quantitative assessment tool through a literature review, and was validated with a method used by experts, and which determines the relationship of digital marketing and innovation activities in companies. The instrument was applied to 64 Mexican companies from the Made in Mexico database, which allowed both descriptive results and correlation results. These contributed to the development of the methodology, and confirming that the management of digital marketing has a positive relation with innovation activities of companies. Also, that analytics in digital marketing is a source for its development. In this paper, the management stages and activities are presented to be developed by companies in order to generate knowledge, which will allow them to reach its digital maturity.Keywords: digital marketing, digital maturity, innovation, SMEs
Procedia PDF Downloads 4543554 Syntactic Errors in Written Assessments of Non-Native English-Speaking Undergraduate Students and Pedagogical Implications in Correcting Grammatical Mistakes
Authors: Cheng Shuk Ling
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This paper examines the English syntactic errors and their patterns in the written assignments of a General Education course at City University of Hong Kong. Subjects are 60 local and non-local (exchange) undergraduate students who are all EFL learners and L2 users with diversified education and disciplinary background (i.e. their major of study), which are unrelated to English language studies. The objective of this paper brings to the foreground a broad discussion of EFL/L2 undergraduate learners’ average syntactic ability in terms of written assessment. This paper is an attempt in classifying the patterns and categories of syntactic errors committed by students who were brought up and educated in non-native English-speaking countries. Thus, pedagogical recommendations are offered for both EFL/L2 learners and educators in tertiary education settings in such ways as to calibrate how and in what manner English language as the medium of instruction can lead to more enduring effects in learners within non-native English-speaking countries.Keywords: syntactic errors, english as a foreign language, second language users, pedagogy
Procedia PDF Downloads 753553 Effect of Exercise Training on Body Composition and Metabolic Profile in Older Adults during Cancer Treatment
Authors: Adeline Fontvieille, Hugo Parent-Roberge, Marie-France Langlois, Tamas Fulop, Michel Pavic, Eleonor Riesco
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Introduction: Total lean body mass is reduced during cancer treatment. This loss is called cancer cachexia and is accompanied by a progressive loss of fat mass. In older adults, these body composition changes can have a larger impact on metabolic health, physical autonomy, and cancer survival. Although currently untreatable, exercise training could reduce these effects. Hence, the objective of this pilot study is to investigate if 12 weeks of exercise training during cancer treatment can mitigate the loss of muscle mass and fat mass in older adults. Methods: A total of 40 older adults (65-80 years) with an ongoing treatment for a curable cancer are currently recruited and randomised in two groups: 1) Combined training (EX, n=20) and 2) Control group (CON, n=20). All variables are measured before and after 12 weeks of intervention: Anthropometry (weight, height, body mass index), body composition (total fat mass, visceral adipose tissue, total and appendicular muscle mass; DXA), metabolic profile (HDL-C and LDL-C, triglycerides, glucose and insulin levels). Results: Preliminary analyses revealed no impact of exercise training on appendicular muscle mass (p=0,31) and fat mass (p=0,31). Furthermore, total body weight, waist circumference, HDL-cholesterol, LDL-cholesterol, glucose and insulin levels remained unchanged (all p ≥ 0.79) after 12 weeks of training. However, statistical analyses revealed that triglyceride levels slightly increased (p=0.03), irrespective of the group. Conclusion: Preliminary analyses did not reveal any impact of aerobic and resistance exercise training on body composition in oncogeriatric patients. Furthermore, exercise training seems not efficient to prevent the cancer treatment-related triglyceride levels increase.Keywords: muscle mass, fat mass, metabolic profile, combined training, aging, cancer
Procedia PDF Downloads 3543552 An Assessment of Water and Sediment Quality of the Danube River: Polycyclic Aromatic Hydrocarbons and Trace Metals
Authors: A. Szabó Nagy, J. Szabó, I. Vass
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Water and sediment samples from the Danube River and Moson Danube Arm (Hungary) have been collected and analyzed for contamination by 18 polycyclic aromatic hydrocarbons (PAHs) and eight trace metal(loid)s (As, Cu, Pb, Ni, Cr, Cd, Hg and Zn) in the period of 2014-2015. Moreover, the trace metal(loid) concentrations were measured in the Rába and Marcal rivers (parts of the tributary system feeding the Danube). Total PAH contents in water were found to vary from 0.016 to 0.133 µg/L and concentrations in sediments varied in the range of 0.118 mg/kg and 0.283 mg/kg. Source analysis of PAHs using diagnostic concentration ratios indicated that PAHs found in sediments were of pyrolytic origins. The dissolved trace metal and arsenic concentrations were relatively low in the surface waters. However, higher concentrations were detected in the water samples of Rába (Zn, Cu, Ni, Pb) and Marcal (As, Cu, Ni, Pb) compared to the Danube and Moson Danube. The concentrations of trace metals in sediments were higher than those found in water samples.Keywords: surface water, sediment, PAH, trace metal
Procedia PDF Downloads 3013551 Health Literacy and Knowledge Related to Tuberculosis among Outpatients at a Referral Hospital in Lima, Peru
Authors: Rosalina Penaloza, Joanna Navarro, Pauline Jolly, Anna Junkins, Carlos Seas, Larissa Otero
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Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough is a possible symptom of TB and that formal health care needs to be sought. Despite its importance, health knowledge specific to TB is underexplored in Peru. This study aimed to assess health literacy and level of TB knowledge among outpatients attending a referral hospital in Lima, Peru. The goal was to ascertain knowledge gaps in key areas relating to TB, to identify and prioritize subgroups for intervention, and to provide insight for policy and community interventions considering health literacy. Methods: An observational cross-sectional study was conducted using a survey to measure sociodemographic factors, tuberculosis knowledge, and health literacy. Bivariate and Multivariate logistic regression was performed to study the associations between variables and to account for potential confounders. The study was conducted at Hospital Cayetano Heredia in Lima, Peru from June – August 2017. Results: 272 participants were included in the analysis. 57.7% knew someone who had had TB before, 9% had had TB in the past. Two weeks a cough was correctly identified as a symptom that could be TB by 69.1%. High TB knowledge was found among 149 (54.8%) participants. High health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR 0.9 (95%CI 0.5-1.5)). After controlling for sex, age, district, education, health insurance, frequency of hospital visits and previous TB diagnosis: High TB knowledge was associated with knowing someone with TB (aOR 2.7 (95%CI 1.6-4.7)) and being a public transport driver, (aOR 0.2 (95%CI 0.05-0.9)). Not being poor was the single factor associated with high health literacy (aOR 3.8 (95%CI 1.6-8.9)). Conclusions: TB knowledge was fair, though 30% did not know the most important symptom of TB. Tailoring educational strategies to risk groups may enhance passive case detection especially amongst transport workers in Lima, Peru.Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge
Procedia PDF Downloads 4853550 Urban Land Expansion Impact Assessment on Agriculture Land in Kabul City, Afghanistan
Authors: Ahmad Sharif Ahmadi, Yoshitaka Kajita
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Kabul city is experiencing urban land expansion in an unprecedented scale, especially since the last decade. With massive population expansion and fast economic development, urban land has increasingly expanded and encroached upon agriculture land during the urbanization history of the city. This paper evaluates the integrated urban land expansion impact on agriculture land in Kabul city since the formation of the basic structure of the city between 1962-1964. The paper studies the temporal and spatial characteristic of agriculture land and agriculture land loss in Kabul city using geographic information system (GIS) and remote sensing till 2008. Many temporal Landsat Thematic Mapper (TM) imageries were interpreted to detect the temporal and spatial characteristics of agriculture land loss. Different interval study periods, however, had vast difference in the agriculture land loss which is due to the urban land expansion trends in the city. the high number of Agriculture land adjacent to the city center and urban fringe have been converted into urban land during the study period in the city, as the agriculture land is highly correlated with the urban land.Keywords: agriculture land, agriculture land loss, Kabul city, urban land expansion, urbanization
Procedia PDF Downloads 4053549 Socio-Demographic Predictors of Divorce Adjustment in Pakistani Women
Authors: Rukhsana Kausar, Nida Zafar
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The present research investigated socio-demographic predictors of divorce adjustment in Pakistani women. The sample comprised of 80 divorced women from different areas of Lahore. Self developed Socio-Demographic predictor scale and Divorce Adjustment Scale by (Fisher, 2001) was used for assessment. Analyses showed that working divorced women living with joint family system are more adjusted as compared to non-working divorced women living with joint family system. Women having one child are more adjusted as compared to women having more than one child. Findings highlight importance of presence of father for healthy development of adolescents. Adjustment of divorcee women was positively associated with income, social support from the family, having favorable attitudes toward marital dissolution prior to divorce, and being the partner who initiated the divorce. In addition, older women showed some evidence of poorer adjustment than did younger women. Findings highlight importance of support for divorce adjustment.Keywords: socio-demographic, adjustment, women, divorce
Procedia PDF Downloads 4573548 Application of Failure Mode and Effects Analysis (FMEA) on the Virtual Process Hazard Analysis of Acetone Production Process
Authors: Princes Ann E. Prieto, Denise F. Alpuerto, John Rafael C. Unlayao, Neil Concibido, Monet Concepcion Maguyon-Detras
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Failure Mode and Effects Analysis (FMEA) has been used in the virtual Process Hazard Analysis (PHA) of the Acetone production process through the dehydrogenation of isopropyl alcohol, for which very limited process risk assessment has been published. In this study, the potential failure modes, effects, and possible causes of selected major equipment in the process were identified. During the virtual FMEA mock sessions, the risks in the process were evaluated and recommendations to reduce and/or mitigate the process risks were formulated. The risk was estimated using the calculated risk priority number (RPN) and was classified into four (4) levels according to their effects on acetone production. Results of this study were also used to rank the criticality of equipment in the process based on the calculated criticality rating (CR). Bow tie diagrams were also created for the critical hazard scenarios identified in the study.Keywords: chemical process safety, failure mode and effects analysis (FMEA), process hazard analysis (PHA), process safety management (PSM)
Procedia PDF Downloads 1263547 Soil Loss Assessment at Steep Slope: A Case Study at the Guthrie Corridor Expressway, Selangor, Malaysia
Authors: Rabiul Islam
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The study was in order to assess soil erosion at plot scale Universal Soil Loss Equation (USLE) erosion model and Geographic Information System (GIS) technique have been used for the study 8 plots in Guthrie Corridor Expressway, Selangor, Malaysia. The USLE model estimates an average soil loss soil integrating several factors such as rainfall erosivity factor(R ), Soil erodibility factor (K), slope length and steepness factor (LS), vegetation cover factor as well as conservation practice factor (C &P) and Results shows that the four plots have very low rates of soil loss, i.e. NLDNM, NDNM, PLDM, and NDM having an average soil loss of 0.059, 0.106, 0.386 and 0.372 ton/ha/ year, respectively. The NBNM, PLDNM and NLDM plots had a relatively higher rate of soil loss, with an average of 0.678, 0.757 and 0.493ton/ha/year. Whereas, the NBM is one of the highest rate of soil loss from 0.842 ton/ha/year to maximum 16.466 ton/ha/year. The NBM plot was located at bare the land; hence the magnitude of C factor(C=0.15) was the highest one.Keywords: USLE model, GIS, Guthrie Corridor Expressway (GCE), Malaysia
Procedia PDF Downloads 5213546 Building Teacher Capacity: Including All Students in Mathematics Experiences
Authors: Jay-R M. Mendoza
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In almost all mathematics classrooms, students demonstrated discrepancies in their knowledge, skills, and understanding. OECD reports predicted that this continued to aggravate as not all teachers were sufficiently trained to handle this concentration. In response, the paper explored the potential of reSolve’s professional learning module 3 (PLM3) as an affordable and accessible professional development (PD) resource. Participants’ hands-on experience and exposure to PLM3 were audio recorded. After it was transcribed and examined and their work samples were analysed, there were four issues emerged: (1) criticality of conducting preliminary data collections and increasing the validity of inferences about what students can and cannot do by addressing the probabilistic nature of their performance; (2) criticality of the conclusion: a > b and/or (a-b) ∈ Z⁺ among students’ algebraic reasoning; (3) enabling and extending prompts provided by reSolve were found useful; and (4) dynamic adaptation of reSolve PLM3 through developing transferable skills and collaboration among teachers. PLM3 provided valuable insights on assessment, teaching, and planning to include all students in mathematics experiences.Keywords: algebraic reasoning, building teacher capacity, including all students in mathematics experiences, professional development
Procedia PDF Downloads 1153545 Experimental Assessment of Polypropylene Plastic Aggregates(PPA) for Pavement Construction: Their Mechanical Properties via Marshall Test
Authors: Samiullah Bhatti, Safdar Abbas Zaidi, Syed Murtaza Ali Jafri
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This research paper presents the results of using plastic aggregate in flexible pavement. Plastic aggregates have been prepared with polypropylene (PP) recycled products and have been tested with Marshall apparatus. Grade 60/70 bitumen has been chosen for this research with a total content of 2.5 %, 3 % and 3.5 %. Plastic aggregates are mixed with natural aggregates with different proportions and it ranges from 10 % to 100 % with an increment of 10 %. Therefore, a total of 10 Marshall cakes were prepared with plastic aggregates in addition to a standard pavement sample. In total 33 samples have been tested for Marshall stability, flow and voids in mineral aggregates. The results show an increase in the value when it changes from 2.5 % bitumen to 3 % and after then it goes again toward declination. Thus, 3 % bitumen content has been found as the most optimum value for flexible pavements. Among all the samples, 20 % PP aggregates sample has been found satisfactory with respect to all the standards provided by ASTM. Therefore, it is suggested to use 20 plastic aggregates in flexible pavement construction. A comparison of bearing capacity and skid resistance is also observed.Keywords: marshall test, polypropylene plastic, plastic aggregates, flexible pavement alternative, recycling of plastic waste
Procedia PDF Downloads 1333544 Urban Regeneration of Historic Paths: A Case Study of Kom El Dekka Historic Path
Authors: Ahmed R. Ismail, Hatem A. El Tawil, Nevin G. Rezk
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Historic paths in today's cities are facing the pressure of the urban development due to the rapid urban growth. Every new development is tearing the old urban fabric and the socio-economic character of the historic paths. Furthermore, in some cases historic paths suffer from negligence and decay. Kom El Dekka historic path was one of those deteriorated paths in the city of Alexandria, Egypt, in spite of its high heritage and socio-economic value. Therefore, there was a need to develop urban regeneration strategies as a part of a wider sustainable development vision, to handle the situation and revitalize the path as a livable space in the heart of the city. This study aims to develop a comprehensive assessment methodology to evaluate the different values of the path and to create community-oriented and economic-based analysis methodology for its socio-economic values. These analysis and assessments provide strategies for any regeneration action plan for Kom El Dekka historic path.Keywords: community-oriented, economic-based, syntactical analysis, urban regeneration
Procedia PDF Downloads 4113543 Roadway Maintenance Management System
Authors: Chika Catherine Ayogu
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Rehabilitation plays an important and integral part in the life of roadway rehabilitation management system. It is a systematic method for inspection and rating the roadway condition in a given area. The system performs a cost effective analysis of various maintenance and rehabilitation strategies. Finally the system prioritize and recommend roadway rehabilitation and maintenance to maximize results within a given budget amount. During execution of maintenance activity, the system also tracks labour, materials, equipment and cost for activities performed. The system implements physical assessment field inspection and rating of each street segment which is then entered into a database. The information is analyzed using a software, and provide recommendations and project future conditions. The roadway management system provides a deterioration curve for each segment based on input then assigns the most cost-effective maintenance strategy based on conditions, surface type and functional classification, and available budget. This paper investigates the roadway management system and its capabilities to assist in applying the right treatment to the right roadway at the right time so that expected service life of the roadway is extended as long as possible with acceptable cost.Keywords: effectiveness, rehabilitation, roadway, software system
Procedia PDF Downloads 1423542 Estimation of Uncertainty of Thermal Conductivity Measurement with Single Laboratory Validation Approach
Authors: Saowaluck Ukrisdawithid
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The thermal conductivity of thermal insulation materials are measured by Heat Flow Meter (HFM) apparatus. The components of uncertainty are complex and difficult on routine measurement by modelling approach. In this study, uncertainty of thermal conductivity measurement was estimated by single laboratory validation approach. The within-laboratory reproducibility was 1.1%. The standard uncertainty of method and laboratory bias by using SRM1453 expanded polystyrene board was dominant at 1.4%. However, it was assessed that there was no significant bias. For sample measurement, the sources of uncertainty were repeatability, density of sample and thermal conductivity resolution of HFM. From this approach to sample measurements, the combined uncertainty was calculated. In summary, the thermal conductivity of sample, polystyrene foam, was reported as 0.03367 W/m·K ± 3.5% (k = 2) at mean temperature 23.5 °C. The single laboratory validation approach is simple key of routine testing laboratory for estimation uncertainty of thermal conductivity measurement by using HFM, according to ISO/IEC 17025-2017 requirements. These are meaningful for laboratory competent improvement, quality control on products, and conformity assessment.Keywords: single laboratory validation approach, within-laboratory reproducibility, method and laboratory bias, certified reference material
Procedia PDF Downloads 1423541 Hypotonia - A Concerning Issue in Neonatal Care
Authors: Eda Jazexhiu-Postoli, Gladiola Hoxha, Ada Simeoni, Sonila Biba
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Background Neonatal hypotonia represents a commonly encountered issue in the Neonatal Intensive Care Unit and newborn nursery. The differential diagnosis is broad, encompassing chromosome abnormalities, primary muscular dystrophies, neuropathies and inborn errors of metabolism. Aim of study Our study describes some of the main clinical features of hypotonia in newborns and presents clinical cases of neonatal hypotonia we treated in our Neonatal unit in the last 3 years. Case reports Four neonates born in our hospital presented with hypotonia after birth, one preterm newborn 35-36 weeks of gestational age and three other term newborns (38-39 weeks of gestational age). Prenatal data revealed a decrease in fetal movements in both cases. Intrapartum meconium-stained amniotic fluid was found in 75% of our hypotonic newborns. Clinical features included inability to establish effective respiratory movements and need for resuscitation in the delivery room, respiratory distress syndrome, feeding difficulties and need for oro-gastric tube feeding, dysmorphic features, hoarse voice and moderate to severe muscular hypotonia. The genetic workup revealed the diagnosis of Autosomal Recessive Congenital Myasthenic Syndrome 1-B, Sotos Syndrome, Spinal Muscular Atrophy Type 1 and Transient Hypotonia of the Newborn. Two out of four hypotonic neonates were transferred to the Pediatric Intensive Care Unit and died at the age of three to five months old. Conclusion Hypotonia is a concerning finding in neonatal care and it is suggested by decreased intrauterine fetal movements, failure to establish first breaths, respiratory distress and feeding difficulties in the neonate. Prognosis is determined by its etiology and time of diagnosis and intervention.Keywords: hypotonic neonate, respiratory distress, feeding difficulties, fetal movements
Procedia PDF Downloads 1073540 Application of a Model-Free Artificial Neural Networks Approach for Structural Health Monitoring of the Old Lidingö Bridge
Authors: Ana Neves, John Leander, Ignacio Gonzalez, Raid Karoumi
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Systematic monitoring and inspection are needed to assess the present state of a structure and predict its future condition. If an irregularity is noticed, repair actions may take place and the adequate intervention will most probably reduce the future costs with maintenance, minimize downtime and increase safety by avoiding the failure of the structure as a whole or of one of its structural parts. For this to be possible decisions must be made at the right time, which implies using systems that can detect abnormalities in their early stage. In this sense, Structural Health Monitoring (SHM) is seen as an effective tool for improving the safety and reliability of infrastructures. This paper explores the decision-making problem in SHM regarding the maintenance of civil engineering structures. The aim is to assess the present condition of a bridge based exclusively on measurements using the suggested method in this paper, such that action is taken coherently with the information made available by the monitoring system. Artificial Neural Networks are trained and their ability to predict structural behavior is evaluated in the light of a case study where acceleration measurements are acquired from a bridge located in Stockholm, Sweden. This relatively old bridge is presently still in operation despite experiencing obvious problems already reported in previous inspections. The prediction errors provide a measure of the accuracy of the algorithm and are subjected to further investigation, which comprises concepts like clustering analysis and statistical hypothesis testing. These enable to interpret the obtained prediction errors, draw conclusions about the state of the structure and thus support decision making regarding its maintenance.Keywords: artificial neural networks, clustering analysis, model-free damage detection, statistical hypothesis testing, structural health monitoring
Procedia PDF Downloads 1993539 Assessment of Ecosystem Readiness for Adoption of Circularity: A Multi-Case Study Analysis of Textile Supply Chain in Pakistan
Authors: Azhar Naila, Steuer Benjamin
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Over-exploitation of resources and the burden on natural systems have provoked worldwide concerns about the potential resource as well as supply risks in the future. It has been estimated that the consumption of materials and resources will double by 2060, substantially mounting the amount of waste and emissions produced by individuals, organizations, and businesses, which necessitates sustainable technological innovations to address the problem. Therefore, there is a need to design products and services purposefully for material resource efficiency. This directs us toward the conceptualization and implementation of the ‘Circular Economy (CE),’ which has gained considerable attention among policymakers, researchers, and businesses in the past decade. A large amount of literature focuses on the concept of CE. However, contextual empirical research on the need to embrace CE in an emerging economy like Pakistan is still scarce, where the traditional economic model of take-make-dispose is quite common. Textile exports account for approximately 61% of Pakistan's total exports, and the industry provides employment for about 40% of the country's total industrial workforce. The industry provides job opportunities to above 10 million farmers, with cotton as the main crop of Pakistan. Consumers, companies, as well as the government have explored very limited CE potential in the country. This gap has motivated us to carry out the present study. The study is based on a mixed method approach, for which key informant interviews have been conducted to get insight into the present situation of the ecosystem readiness for the adoption of CE in 20 textile manufacturing industries. The subject study has been conducted on the following areas i) the level of understanding of the CE concept among key stakeholders in the textile manufacturing industry ii) Companies are pushing boundaries to invest in circularity-based initiatives, exploring the depths of risk-taking iii) the current national policy framework support the adoption of CE. Qualitative assessment has been undertaken using MAXQDA to analyze the data received after the key informant interviews. The data has been transcribed and coded for further analysis. The results show that most of the key stakeholders have a clear understanding of the concept, whereas few consider it to be only relevant to the end-of-life treatment of waste generated from the industry. Non-governmental organizations have been observed to be key players in creating awareness among the manufacturing industries. Maximum companies have shown their consent to invest in initiatives related to the adoption of CE. Whereas a few consider themselves far behind the race due to a lack of financial resources and support from responsible institutions. Mostly, the industries have an ambitious vision for integrating CE into the company’s policy but seem not to be ready to take any significant steps to nurture a culture for experimentation. However, the government is not playing any vital role in the transition towards CE; rather, they have been busy with the state’s uncertain political situation. Presently, Pakistan does not have any policy framework that supports the transition towards CE. Acknowledging the present landscape a well-informed CE transition is immediately required.Keywords: circular economy, textile supply chain, textile manufacturing industries, resource efficiency, ecosystem readiness, multi-case study analysis
Procedia PDF Downloads 423538 Two-Way Reminder Systems to Support Activities of Daily Living for Adults with Cognitive Impairments: A Scoping Review
Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie
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Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems
Procedia PDF Downloads 683537 Health Effect of the Central European Diet in Postmenopausal Women with Increased Waist Circumference: A Preliminary Study
Authors: Joanna Bajerska, Agata Chmurzyńska, Agata Muzsik, Patrycja Krzyżanowska, Klaudia Łochocka, Jarosław Walkowiak
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The Mediterranean diet (MED) is regarded as beneficial in the therapy of central obesity-associated metabolic abnormalities. However, in the traditional diet of the Central European countries, food items with positive nutritional profiles (rye bread, oats, buckwheat, herrings, linseed and rapeseed oil, berries, apples, plums, root vegetables etc.) are also used. We hypothesized that the Central European Diet (CED) may be comparatively effective in reducing symptoms of central obesity as MED. We tested the health effects of the CED, which is an environmentally friendly regional diet and the traditional MED diet in a group of postmenopausal centrally obese women. A total 58 with a mean age of 60 y (50-70y), body mass index (in kg/m(2)) of 33.4 (22.6-47.3), and waist circumference of 105 cm (87.5-137 cm) were randomly assigned to receive either the diet based on food items commonly used in Central Europe (the CED group; n = 29) or the Mediterranean diet (the MED group; n = 29) for 15 weeks. Body mass and body composition were measured with a Bod Pod (Cosmed, Italy). A non-elastic flexible measuring tape was used to measure waist circumference. Additionally, blood pressure, plasma lipid and glucose levels were assessed with the use of a biochemical analyzer. A total of 50 subjects [86% (CED 83%; MED 90%)] completed the intervention. A high dietary compliance for both described diets was achieved. The mean (±SEM) weight and waist circumference changes were -7.4 ± 0.7 kg; -8.3 ± 0.7 cm and -8.1 ± 0.5 kg; -7.1 ± 0.6 cm for the CED and MED groups, respectively. Moreover, there were no differences between the effectiveness of the diets used in terms of the influence on fat mass, blood pressure, and biochemical parameters. The preliminary data suggest that both described diets may be successfully used for improving central obesity-associated metabolic abnormalities. The project was financed by the National Science Centre awarded based on the number of decision DEC-013/09/B/NZ9/02365Keywords: central european diet, central obesity, Mediterranean diet, metabolic abnormalities
Procedia PDF Downloads 4253536 Finite Element Modeling of Aortic Intramural Haematoma Shows Size Matters
Authors: Aihong Zhao, Priya Sastry, Mark L Field, Mohamad Bashir, Arvind Singh, David Richens
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Objectives: Intramural haematoma (IMH) is one of the pathologies, along with acute aortic dissection, that present as Acute Aortic Syndrome (AAS). Evidence suggests that unlike aortic dissection, some intramural haematomas may regress with medical management. However, intramural haematomas have been traditionally managed like acute aortic dissections. Given that some of these pathologies may regress with conservative management, it would be useful to be able to identify which of these may not need high risk emergency intervention. A computational aortic model was used in this study to try and identify intramural haematomas with risk of progression to aortic dissection. Methods: We created a computational model of the aorta with luminal blood flow. Reports in the literature have identified 11 mm as the radial clot thickness that is associated with heightened risk of progression of intramural haematoma. Accordingly, haematomas of varying sizes were implanted in the modeled aortic wall to test this hypothesis. The model was exposed to physiological blood flows and the stresses and strains in each layer of the aortic wall were recorded. Results: Size and shape of clot were seen to affect the magnitude of aortic stresses. The greatest stresses and strains were recorded in the intima of the model. When the haematoma exceeded 10 mm in all dimensions, the stress on the intima reached breaking point. Conclusion: Intramural clot size appears to be a contributory factor affecting aortic wall stress. Our computer simulation corroborates clinical evidence in the literature proposing that IMH diameter greater than 11 mm may be predictive of progression. This preliminary report suggests finite element modelling of the aortic wall may be a useful process by which to examine putative variables important in predicting progression or regression of intramural haematoma.Keywords: intramural haematoma, acute aortic syndrome, finite element analysis,
Procedia PDF Downloads 4263535 Revisiting the Donning and Doffing Procedure: Ensuring a Coordinated Practice
Authors: Deanna Ruano-Meas, Laura Shenkman
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Variances are seen in the way healthcare personnel (HCP) don and doff PPE risking contamination to self and others. By standardizing practice, variances in technique decrease, and so does the risk of contamination. To implement this change, the Model for Improvement will be used. A system change will be developed that will outline the role of the organizational leader’s support of HCP in the proper donning and doffing of PPE. Interventions will include environmental surveys to assess the safety and work situation ensuring a permissible environment, plan audits to confirm consistency, and the assessment of PPE wear for standardization. The change will also include an educational plan that will involve instruction of the current guidelines recommended by the Centers for Disease Control and Prevention (CDC) to all pertinent HCP, and the incorporation of PPE education in yearly educational training. The goal is a standardized practice and a reduced risk of contamination through education and organizational support. Personal protective equipment has had recent attention with the coming of the SARS-CoV-2. The realization that proper technique is important to decreasing contamination of pathogens has led to the revising of current processes.Keywords: donning and doffing, HAI, infection control, PPE
Procedia PDF Downloads 1893534 Sildenafil Citrate (Viagra) Suppositories Are Promising Approach for Treatment of Unexplained Infertility
Authors: Shahinaz El-Shourbagy El-Shourbagy, Ahmed M. E Ossman Ossman, Ashraf El-Mohamady El-Mohamady
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Objective: To investigate if there is a role of sildenafil citrate (Viagra) in the treatment of infertile couples for idiopathic cause. Design: An observational study. Setting: Infertility outpatient clinic of Tanta University Hospital Egypt. Patient(s): 50 unexplained infertility women {endometrial thickness (EM) and the mean resistance index (RI)} compared to 50 fertile control group attended for check-up in the same period and receiving no treatment. Intervention(s): unexplained infertility women were given 25 mg of sildenafil citrate suppositories four times per day for seven days starting from the 5th day of the menstrual cycle for three cycles. Main Outcome Measures: EM and RI of endometrial spiral artery were assessed by transvaginal color-pulsed Doppler ultrasound in unexplained infertility women before and after sildenafil citrate treatment and compared with control. The conception rate and pregnancy outcome were recorded in the two groups. Result(s): Women with unexplained infertility had significantly thinner endometrium and a higher spiral artery resistance index, meaning lower peri-implantation blood flow than the fertile controls. Sildenafil citrate treated women showed a statistically significant increase in endometrial thickness (p < 0.001) and a significant decrease in the mean spiral artery resistance index (p < 0.001) giving a better conception rate. Conclusion: Sildenafil citrate suppositories treatment enhance the endometrial blood flow through decreasing spiral artery resistance index 'RI' and consequently improve endometrial growth and receptivity in cases of unexplained infertility thus giving a better conception rate.Keywords: Unexplained infertility, endometrial blood flow, endome¬trial receptivity, color-pulsed Doppler ultrasound; RI (resis¬tance index, Sildenafil citrate (Viagra)
Procedia PDF Downloads 2083533 Development of a Multi-Factorial Instrument for Accident Analysis Based on Systemic Methods
Authors: C. V. Pietreanu, S. E. Zaharia, C. Dinu
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The present research is built on three major pillars, commencing by making some considerations on accident investigation methods and pointing out both defining aspects and differences between linear and non-linear analysis. The traditional linear focus on accident analysis describes accidents as a sequence of events, while the latest systemic models outline interdependencies between different factors and define the processes evolution related to a specific (normal) situation. Linear and non-linear accident analysis methods have specific limitations, so the second point of interest is mirrored by the aim to discover the drawbacks of systemic models which becomes a starting point for developing new directions to identify risks or data closer to the cause of incidents/accidents. Since communication represents a critical issue in the interaction of human factor and has been proved to be the answer of the problems made by possible breakdowns in different communication procedures, from this focus point, on the third pylon a new error-modeling instrument suitable for risk assessment/accident analysis will be elaborated.Keywords: accident analysis, multi-factorial error modeling, risk, systemic methods
Procedia PDF Downloads 2043532 Pupil with Special Educational Needs Camouflaging and Teacher Training of University Teaching Staff: Practical Reflection
Authors: Ana Mercedes Vernia Carrasco
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The objective of this work is to reflect through the theoretical framework on the access to the university for the formation of a degree in a teacher of primary education. The University Access Tests in Spain evaluate a series of skills and competencies in writing, which leave aside the sample of another set of skills and tools that this type of test cannot evaluate. In the last years, a very much diversified student body has arrived in the classrooms of the Universities. Nowadays, talking about special education means attending to the changes that are being experienced in this area. At present, the educational model focuses on the reinforcement by the educational institutions so that they form the students according to their personal characteristics and that it is not the students that must adapt to the system. A bibliographic review plus some years of experience in training for the future teacher allows us to make an initial assessment about the lack of rigor in the tests of access to the university. In conclusion, we can say that, although we are not a specialist in the type of Special Educational Needs that can manifest the students, therefore, we understand that teacher today needs training and support to develop their teaching with the best quality possible. These teacher and student needs also imply more institutional support.Keywords: training, special needs, didactics, music
Procedia PDF Downloads 933531 Factors Associated with Oral Cavity Colonization by Candida albicans
Authors: Nwafia Ifeyinwa Nkeiruka, Nwafia Walter Chukwuma
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Since the early 1980’s fungi have emerged as major causes of human diseases, especially among immunocompromised. The most commonly isolated yeast is Candida albicans and constitutes the 4th most common nosocomial BSI in humans. It is progressive and cumulative and become more complex over time.It can even lead to leaky gut syndrome that causes food and environmental allergies. It is worthy of note that all the available data on oral Candida risk factors in humans were documented essentially using data from studies conducted in other areas, hence there is need for comparative and complementary information from the South eastern part of Nigeria. Method: 200 subjects of all age groups of both sexes were randomly examined,by swabbing their palatine mucosa and dorsal tongue with sterile cotton wool,then cultured into Sabouraud dextrose agar plates supplemented with antibiotics and incubated aerobically at 37 degree for 48 hrs. Identification of Candida albicans was done by germ tubes tests, chlamydospores production on cornmeal agar supplemented with 1% Tween 80.Sugar and nitrogen assimilation test using API 20C Auxanogram and potassium nitrate agar. Results: Out of 30 samples that were positive for candida, 15 (50%) were candida albicans. Using the anova test (P < 0.05) this variation is significant (P = 0016). followed by C. dublinensis 3 (13%), C. tropicalis 3 (10%), C. pseudotropicalis 3 (10%), C, glabrata 2 (7%), C. parapsilosis 2 (7%) and lastly C. krusei 1 (3%).However, 53% of the patients were female while 47% were male. Among the HIV positive isolates.67% were HIV isolates not on drugs while 33% positives isolates were on drugs and the percentages of candida species in these patients were as follows C. albicans were 45% followed by C. glabrata and C.tropicalis which were 17% each, C.parapsilosis, C.dubliensis and C.pseudotropicalis were all 8% each. Conclusion: Oral Candidiasis is a marker of systemic diseases and in some cases, it may be the first clinical presentation. There is need for more intensive clinical and laboratory monitoring and possible early intervention to prevent the reoccurrence and resistance to treatment.Keywords: oral cavity, Candida species, oral Candidiasis, risk factors
Procedia PDF Downloads 3553530 Statistical Analysis of the Factors that Influence the Properties of Blueberries from Cultivar Bluecrop
Authors: Raquel P. F. Guiné, Susana R. Matos, Daniela V. T. A. Costa, Fernando J. Gonçalves
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Because blueberries are worldwide recognized as a good source of beneficial components, their consumption has increased in the past decades, and so have the scientific works about their properties. Hence this work was undertaken to evaluate the effect of some production and conservation factors on the properties of blueberries from cultivar Bluecrop. The physical and chemical analyses were done according to established methodologies and then all data was treated using software SPSS for assessment of the possible differences among the factors investigated and/or the correlations between the variables at study. The results showed that location of production influenced some of the berries properties (caliber, sugars, antioxidant activity, color and texture) and that the age of the bushes was correlated with moisture, sugars and acidity, as well as lightness. On the other hand, altitude of the farm only was correlated to sugar content. With regards to conservation, it influenced only anthocyanins content and DPPH antioxidant activity. Finally, the type of extract and the order of extraction had a pronounced influence on all the phnolic properties evaluated.Keywords: Antioxidant activity, blueberry, conservation, geographical origin, phenolic compounds, statistical analysis
Procedia PDF Downloads 4673529 Optimizing Exposure Parameters in Digital Mammography: A Study in Morocco
Authors: Talbi Mohammed, Oustous Aziz, Ben Messaoud Mounir, Sebihi Rajaa, Khalis Mohammed
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Background: Breast cancer is the leading cause of death for women around the world. Screening mammography is the reference examination, due to its sensitivity for detecting small lesions and micro-calcifications. Therefore, it is essential to ensure quality mammographic examinations with the most optimal dose. These conditions depend on the choice of exposure parameters. Clinically, practices must be evaluated in order to determine the most appropriate exposure parameters. Material and Methods: We performed our measurements on a mobile mammography unit (PLANMED Sofie-classic.) in Morocco. A solid dosimeter (AGMS Radcal) and a MTM 100 phantom allow to quantify the delivered dose and the image quality. For image quality assessment, scores are defined by the rate of visible inserts (MTM 100 phantom), obtained and compared for each acquisition. Results: The results show that the parameters of the mammography unit on which we have made our measurements can be improved in order to offer a better compromise between image quality and breast dose. The last one can be reduced up from 13.27% to 22.16%, while preserving comparable image quality.Keywords: Mammography, Breast Dose, Image Quality, Phantom
Procedia PDF Downloads 1643528 An Affordability Evaluation of Computer-Based Social-Emotional Skills Interventions for School-Aged Children with Autism Spectrum Disorder
Authors: Ezra N. S. Lockhart
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The number of children diagnosed with autism spectrum disorder (ASD) has increased approximately 173% during the last decade making ASD the fastest growing developmental disability in the United States. This rise in prevalence rates indeed has an effect on schools. ASD is overwhelmingly the most reported primary special education eligibility category for students accessing special education, at a national average of 61.3%. ASD is regarded as an urgent public health concern at an estimated annual per capita cost of $3.2 million. Furthermore, considering that ASD is a lifelong disorder estimated lifetime per capita cost reach $35 billion. The resources available to special education programs are insufficient to meet the educational needs of the 6.4 million students receiving special educational services. This is especially true given that there has been and continues to be a chronic shortage of fully certified special education teachers for decades. Reports indicate that 81.1% of students with special needs spend 40% or more in general education classrooms. Regardless of whether support is implemented in the special education or general education classroom the resource demand is obvious. Schools are actively seeking to implement low-cost alternatives and budget saving measures in response to this demand. In public school settings, programs such as Applied Behavior Analysis are challenging to implement and fund at $40,000 per student per year. As an alternative, computer-based interventions are inexpensive, less time-consuming to implement, and require minimal teacher or paraprofessional training to administer. Affordability, pricing schemes, availability, and compatibility of computer-based interventions that support social and emotional skill development in individuals with ASD are discussed.Keywords: affordability, autism spectrum disorder, computer-based intervention, emotional skills, social skills
Procedia PDF Downloads 1553527 The Uses of Photodynamic Therapy versus Anti-vascular Endothelial Growth Factor in the Management of Acute Central Serous Chorioretinopathy: Systematic Review and Meta-Analysis
Authors: Hadeel Seraj, Mohammed Khoshhal, Mustafa Alhamoud, Hassan Alhashim, Anas Alsaif, Amro Abukhashabah
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Central serous chorioretinopathy (CSCR) is an idiopathic retinal disease characterized by localized serous detachment of the neurosensory retina at the macula. To date, there is no high-quality evidence of recent updates on treating acute CSCR, focusing on photodynamic therapy (PDT) and anti-vascular endothelial growth factor (anti-VEGF). Hence, this review aims to systematically review the latest treatment strategies for acute CSCR. Methodology: The following electronic databases were used for a comprehensive and systematic literature review: MEDLINE, EMBASE, and Cochrane. In addition, we analyzed studies comparing PDT with placebo, anti-VEGF with placebo, or PDT with anti-VEGF in treating acute CSC eyes with no previous intervention. Results: Seven studies were included, with a total of 292 eyes. The overall positive results were significantly higher among patients who received PDT compared to control groups (OR = 7.96, 95% CI, 3.02 to 20.95, p < 0.001). The proportions of positive results were 81.0% and 97.1% among patients who received anti-VEGF and PDT, respectively, with no statistically significant differences between the groups. In addition, there were no significant differences between anti-VEGF and control groups. In contrast, PDT was significantly associated with lower recurrence odds than the control groups (OR = 0.12, 95% CI, 0.04 to 0.39, p = 0.042). Conclusion: According to our findings, PDT showed higher positive results than Anti-VEGF in acute CSCR. In addition, PDT was significantly associated with a lower recurrence rate than the control group. However, the analysis needs to be confirmed and updated by large-scale, well-designed RCTs.Keywords: central serous chorioretinopathy, Acute CSCR, photodynamic therapy, anti-vascular endothelial growth factor
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