Search results for: emergency software

Authors: Jerome Dalphinis, Vishal Patel

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The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.

Keywords: advanced airway skills, checklist, procedural sedation, resuscitation

Procedia PDF Downloads 103

Authors: Abduladim Maitieg

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The oil manufacture is one of the main productive activities in Libya and has a massive infrastructure, including offshore drilling and exploration and wide oil export platform sites that located in coastal area. There is a threat to marine and coastal area of oil spills is greatest in those sites with a high spills comes from urban and industry, parallel to that, monitoring oil spills and risk emergency strategy is weakness, An approach for estimating a coastal resources vulnerability to oil spills is presented based on abundance, environmental and Scio-economic importance, distance to oil spill resources and oil risk likelihood. As many as 10 coastal resources were selected for oil spill assessment at the coast. This study aims to evaluate, determine and establish vulnerable coastal resource maps and estimating the rate of oil spill comes for different oil spill resources in Misratah marine environment. In the study area there are two type of oil spill resources, major oil resources come from offshore oil industries which are 96 km from the Coast and Loading/Uploading oil platform. However, the miner oil resources come from urban sewage pipes and fish ports. In order to analyse the collected database, the Geographic information system software has been used to identify oil spill location, to map oil tracks in front of study area, and developing seasonal vulnerable costal resources maps. This work shows that there is a differential distribution of the degree of vulnerability to oil spills along the coastline, with values ranging from high vulnerability and low vulnerability, and highlights the link between oil spill movement and coastal resources vulnerability. The results of assessment found most of costal freshwater spring sites are highly vulnerable to oil spill due to their location on the intertidal zone and their close to proximity to oil spills recourses such as Zreag coast. Furthermore, the Saltmarsh coastline is highly vulnerable to oil spill risk due to characterisation as it contains a nesting area of sea turtles and feeding places for migratory birds and the . Oil will reach the coast in winter season according to oil spill movement. Coastal tourist beaches in the north coast are considered as highly vulnerable to oil spill due to location and closeness to oil spill resources.

Keywords: coastal recourses vulnerability, oil spill trajectory, gnome software, Misratah coast- Libya, GIS

Procedia PDF Downloads 303

Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: D. M. Eric, D. Milosevic, F. D. Eric

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Concurrent engineering technologies are a modern concept in manufacturing engineering. One of the key goals in designing modern technological processes is further reduction of production costs, both in the prototype and the preparatory part, as well as during the serial production. Thanks to many segments of concurrent engineering, these goals can be accomplished much more easily. In this paper, we give an overview of the advantages of using modern software simulations in relation to the classical aspects of designing technological processes of metal deformation. Significant savings are achieved thanks to the electronic simulation and software detection of all possible irregularities in the functional-working regime of the technological process. In order for the expected results to be optimal, it is necessary that the input parameters are very objective and that they reliably represent the values ​of these parameters in real conditions. Since it is a metal deformation treatment here, the particularly important parameters are the coefficient of internal friction between the working material and the tools, as well as the parameters related to the flow curve of the processing material. The paper will give a presentation for the experimental determination of some of these parameters.

Keywords: production technologies, metal processing, software simulations, effects of application

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Authors: Sun-Mi Park, Ji-Hyun Jung, Min-Jung Kang

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Software (SW) education is scheduled to be included in the National curriculum in South Korea by 2018. However, Korean national kindergarten curriculum has been excepted from the revision of the entire Korean national school curriculum including software education. Even though the SW education has not been considered a part of current national kindergarten curriculum, there is a growing interest of adopting software education into the ECE practice. Teachers might be a key element in introducing and implementing new educational change such as SW education. In preparation for the adoption of SW education in ECE, it might be necessary to figure out ECE teachers’ perception and attitudes toward early childhood software education. For this study, 219 ECE teachers’ concern level in SW education was surveyed by using the Stages of Concern Questionnaire (SoCQ). As a result, the teachers' concern level in SW education is the highest at stage 0-Unconcerned and is high level in stage 1-informational, stage 2-personal, and stage 3-management concern. Thus, a non-user pattern was mostly indicated. However, compared to a typical non-user pattern, the personal and informative concern level is slightly high. The 'tailing up' phenomenon toward stage 6-refocusing was shown. Therefore, the pattern aspect close to critical non-user ever appeared to some extent. In addition, a significant difference in concern level was shown at all stages depending on the awareness of necessity. Teachers with SW training experience showed higher intensity only at stage 0. There was statistically significant difference in stage 0 and 6 depending on the future implementation decision. These results will be utilized as a resource in building ECE teachers’ support system according to his or her concern level of SW education.

Keywords: concerns-based adoption model (CBAM), early childhood education teachers, software education, Stages of Concern (SoC)

Procedia PDF Downloads 199

Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

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Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

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Authors: Farideh Azimi, Sam Vahedi Tafreshi

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This research tries to study the residential buildings in Ahvaz, the common materials used, and the impact of passive methods of energy storage (as one of the most effective ways to reduce energy consumption in residential complexes) in order to achieve patterns for construction of residential buildings in Ahvaz conditions to reduce energy consumption. In this research, after studying Ahvaz conditions, the components of an existing building were simulated in Energy Plus software, and the climatic data of Ahvaz station was introduced to software. Then to achieve the most optimal conditions of energy consumption in Ahvaz conditions, each of the residential building elements was optimized. The results of simulation showed that using inactive materials and design including double glass, outside wall insulation, inverted roof, etc. in the buildings can reduce energy consumption in the hot and dry climate of Ahvaz. Among the parameters investigated, the inverted roof was the most effective energy saving pattern. According to the results of simulation of the entire building with the most optimal parameters, energy consumption can be saved by a mean of 12.51% in buildings of Ahvaz, and the obtained pattern can also be used in similar climates.

Keywords: residential buildings, thermal comfort, energy storage, Energy Plus software, Ahvaz

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Authors: İrem Yetkin, Feray Maden, Seda Tosun, Yenal Akgün, Özgür Kilit, Koray Korkmaz, Gökhan Kiper, Mustafa Gündüzalp

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Forced migration, whether caused by conflicts or other factors, frequently places individuals in vulnerable situations, necessitating immediate access to shelter. To promptly address the immediate needs of affected individuals, temporary shelters are often established. These shelters are characterized by their adaptable and functional nature, encompassing lightweight and sustainable structural systems, rapid assembly capabilities, modularity, and transportability. The shelter design is contingent upon demand, resulting in distinct phases for different structural forms. A multi-phased shelter approach covers emergency response, temporary shelter, and permanent reconstruction. Emergency shelters play a critical role in providing immediate life-saving aid, while temporary and transitional shelters, which are also called “t-shelters,” offer longer-term living environments during the recovery and rebuilding phases. Among these, temporary shelters are more extensively covered in the literature due to their diverse inhabiting functions. The roles of emergency shelters and temporary shelters are inherently separate, addressing distinct aspects of sheltering processes. Given their prolonged usage, temporary shelters are built for greater durability compared to emergency shelters. Nonetheless, inadequacies in temporary shelters can lead to challenges in ensuring habitability. Issues like non-expandable structures unsuitable for accommodating large families, the use of short-term shelters that worsen conditions, non-waterproof materials providing insufficient protection against bad weather conditions, and complex installation systems contribute to these problems. Given the aforementioned problems, there arises a need to develop adaptive shelters featuring lightweight components for ease of transport, possess the ability for rapid assembly, and utilize durable materials to withstand adverse weather conditions. In this study, first, the state-of-the-art on temporary shelters is presented. Then, an adaptive temporary shelter composed of foldable plates is proposed, which can easily be assembled and transportable. The proposed shelter is deliberated upon its movement capacity, transportability, and flexibility. This study makes a valuable contribution to the literature since it not only offers a systematic analysis of temporary shelters utilizing kinetic systems but also presents a practical solution that meets the necessary design requirements.

Keywords: deployable structures, foldable plates, forced migration, temporary shelters

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Authors: Kamna Solanki, Yudhvir Singh, Sandeep Dalal

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Software testing is a time and cost intensive process. A scrutiny of the code and rigorous testing is required to identify and rectify the putative bugs. The process of bug identification and its consequent correction is continuous in nature and often some of the bugs are removed after the software has been launched in the market. This process of code validation of the altered software during the maintenance phase is termed as Regression testing. Regression testing ubiquitously considers resource constraints; therefore, the deduction of an appropriate set of test cases, from the ensemble of the entire gamut of test cases, is a critical issue for regression test planning. This paper presents a novel method for designing a suitable prioritization process to optimize fault detection rate and performance of regression test on predefined constraints. The proposed method for test case prioritization m-ACO alters the food source selection criteria of natural ants and is basically a modified version of Ant Colony Optimization (ACO). The proposed m-ACO approach has been coded in 'Perl' language and results are validated using three examples by computation of Average Percentage of Faults Detected (APFD) metric.

Keywords: regression testing, software testing, test case prioritization, test suite optimization

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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Authors: Khaled Jaber

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The estimation of effort in software development is a complex task. The traditional Waterfall approach used to develop software systems requires a lot of time to estimate the effort needed to implement user requirements. Agile manifesto, however, is currently more used in the industry than the Waterfall to develop software systems. In Agile, the user requirement is referred to as a user story. Agile teams mostly use the Fibonacci sequence 1, 2, 3, 5, 8, 11, etc. in estimating the effort needed to implement the user story. This work shows through analysis that the Arithmetic sequence, e.g., 3, 6, 9, 12, etc., is more effective than the Fibonacci sequence in estimating the user stories. This paper mathematically and visually proves the effectiveness of the Arithmetic sequence over the FB sequence.

Keywords: agie, scrum, estimation, fibonacci sequence

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Authors: Joel Weymouth, Ramesh K. Karne, Alexander L. Wijesinha

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Bare Machine Internet is part of the Bare Machine Computing (BMC) paradigm. It is used in programming application ns to run directly on a device. It is software that runs directly against the hardware using CPU, Memory, and I/O. The software application runs without an Operating System and resident mass storage. An important part of the BMC paradigm is the Bare Machine Internet. It utilizes an Application Development model software that interfaces directly with the hardware on a network server and file server. Because it is “bare,” it is a powerful teaching and research tool that can readily display the internals of the network protocols, software, and hardware of the applications running on the Bare Server. It was also demonstrated that the bare server was accessible by laptop and by smartphone/android. The purpose was to show the further practicality of Bare Internet in Computer Engineering and Computer Science Education and Research. It was also to show that an undergraduate student could take advantage of a bare server with any device and any browser at any release version connected to the internet. This paper presents the Bare Web Server as an educational tool. We will discuss possible applications of this paradigm.

Keywords: bare machine computing, online research, network technology, visualizing network internals

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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Authors: Okan Cakir, Okan Tatli

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Acute motor and sensory axonal neuropathy (AMSAN) syndrome usually occurs following a postviral infection in two to four weeks and is a polyneuropathy characterized by axonal and sensorial degeneration as a rare variant of Gullian-Barre syndrome. In our case, we wanted to mention that a rare case of AMSAN Syndrome due to prior surgery. A 61-year-old male case admitted to emergency department with complaints of weakness in feet, numbness and incapability to walk. In his history, it was learned that endovascular aneurysm repair (EVAR) had applied for abdominal aort aneurysm two weeks ago before admission, his complaints had been for a couple of days increasingly and bilaterally, and there had been no infection disease history for four weeks. In physical examination, general status was good, vital signs were stable, and there was a mild paresis in dorsal flexion of feet in bilaterally lower extremities. No nuchal rigidity was determined. Other system examinations were normal. Urea:52 mg/dL (normal range: 15-44 mg/dL), creatinine: 1,05 mg/dL (normal range: 0,81-1,4 mg/dL), potassium: 3,68 mmol/L (normal range: 3,5-5,5 mmol/L), glycaemia: 142 mg/dL, calcium: 9,71 mg/dL (normal range: 8,5-10,5 mg/dL), erythrocyte sedimentation rate (ESR): 74 mm/h (normal range: 0-15 mm/h) were determined in biochemical tests. The case was consulted to neurology department and hospitalized. In performing electromyography, it was reported as a bilateral significant axonal degeneration with sensory-motor polyneuropathy. Normal ranges of glycaemia and protein levels were detected in lumbal punction. Viral markers and bucella, toxoplasma, and rubella markers were in normal range. Intravenous immunoglobulin (IVIG) was applied as a treatment, physical treatment programme was planned and the case discharged from neurology department. In our case, we mentioned that it should be considered polyneuropathy as an alternative diagnosis in cases admitting symptoms like weakness and numbness had a history of prior surgery.

Keywords: AMSAN Syndrome, emergency department, prior surgery, weakness

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Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospital Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre- EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors that are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality, and the data were analyzed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system that can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analyzed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospital staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: emergency medical teams, communication, information and communication technologies, disaster

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Authors: Phatthara Surachon, Tosaphol Ratniyomchai, Thanatchai Kulworawanichpong

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This paper presents an aerodynamic brake study of reducing braking distance for high-speed trains (HST) using aerodynamic brakes as inspiration from the applications on the commercial aircraft wings. In case of emergency, both braking distance and stopping time are longer than the usual situation. Therefore, the passenger safety and the HST driving control management are definitely obtained by reducing the time and distance of train braking during emergency situation. Due to the limited study and implementation of the aerodynamic brake in HST, the possibility in use and the effectiveness of the aerodynamic brake to the train dynamic movement during braking are analyzed and considered. Regarding the aircraft’s flaps that applied in the HST, the areas of the aerodynamic brake acted as an additional drag force during train braking are able to vary depending on the operating angle and the required dynamic braking force. The HST with a varying speed of 200 km/h to 350 km/h is taken as a case study of this paper. The results show that the stopping time and the brake distance are effectively reduced by the aerodynamic brakes. The mechanical brake and its maintenance are effectively getting this benefit by extending its lifetime for longer use.

Keywords: high-speed train, aerodynamic brake, brake distance, drag force

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Authors: Asad Abbas, Muhammad Fezan Afzal, Muhammad Latif Anjum, Muhammad Azmat

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The Internet of Things (IoT) is used to link up real objects that use the internet to interact. IoT applications allow handling and operating the equipment in accordance with environmental needs, such as transportation and healthcare. IoT devices are linked together via a number of agents that act as a middleman for communications. The operation of a heat sensor differs indoors and outside because agent applications work with environmental variables. In this article, we suggest using Software Product Line (SPL) to model IoT agents and applications' features on an XML-based basis. The contextual diversity within the same domain of application can be handled, and the reusability of features is increased by XML-based feature modelling. For the purpose of managing contextual variability, we have embraced XML for modelling IoT applications, agents, and internet-connected devices.

Keywords: IoT agents, IoT applications, software product line, feature model, XML

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Authors: Hao-Hsi Tseng, Hsin-Yun Lee, Yu-Cheng Kuo

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In order to understand whether there is a better than the learning function of learning methods and improve the CAD Courses for enterprise’s design human resource development, this research is applied in learning practical learning computer graphics software. In this study, Revit building information model for learning content, design of two different modes of learning curriculum to learning, learning functions, respectively, and project learning. Via a post-test, questionnaires and student interviews, etc., to study the effectiveness of a comparative analysis of two different modes of learning. Students participate in a period of three weeks after a total of nine-hour course, and finally written and hands-on test. In addition, fill in the questionnaire response by the student learning, a total of fifteen questionnaire title, problem type into the base operating software, application software and software-based concept features three directions. In addition to the questionnaire, and participants were invited to two different learning methods to conduct interviews to learn more about learning students the idea of two different modes. The study found that the ad hoc short-term courses in learning, better learning outcomes. On the other hand, functional style for the whole course students are more satisfied, and the ad hoc style student is difficult to accept the ad hoc style of learning.

Keywords: development, education, human resource, learning

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Authors: Luke McDonagh

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Over the past three decades, free and open source software (FOSS) programmers have developed new, innovative and legally binding licences that have in turn enabled the creation of innumerable pieces of everyday software, including Linux, Mozilla Firefox and Open Office. That FOSS has been highly successful in competing with 'closed source software' (e.g. Microsoft Office) is now undeniable, but in noting this success, it is important to examine in detail why this system of FOSS has been so successful. One key reason is the existence of networks or communities of programmers, who are bound together by a key shared social norm of 'reciprocity'. At the same time, these FOSS networks are not unitary – they are highly diverse and there are large divergences of opinion between members regarding which licences are generally preferable: some members favour the flexible ‘free’ or 'no copyleft' licences, such as BSD and MIT, while other members favour the ‘strong open’ or 'strong copyleft' licences such as GPL. This paper argues that without both the existence of the shared norm of reciprocity and the diversity of licences, it is unlikely that the innovative legal framework provided by FOSS would have succeeded to the extent that it has.

Keywords: open source, copyright, licensing, copyleft

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Authors: Hakan Bozdoğan

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A wide variety of traditional methodologies has been enhanced for characterising smooth habitats in order to find out different environmental objectives. The habitats were characterised based on size and shape by using Geo-Gebra Software. In this study, an innovative approach to researching habitat characterisation in the lacewing species, GeoGebra software is utilised. This approach is demonstrated using the example of ‘surface area’ as an analytical concept, wherein the goal was to increase clearness for researchers, and to improve the quality of researching in survey area. In conclusion, habitat characterisation using the mathematical programme provides a unique potential to collect more comprehensible and analytical information about in shapeless areas beyond the range of direct observations methods. This research contributes a new perspective for assessing the structure of habitat, providing a novel mathematical tool for the research and management of such habitats and environments. Further surveys should be undertaken at additional sites within the Amanos Mountains for a comprehensive assessment of lacewings habitat characterisation in an analytical plane. This paper is supported by Ahi Evran University Scientific Research Projects Coordination Unit, Projects No:TBY.E2.17.001 and TBY.A4.16.001.

Keywords: uneven habitat shape, habitat assessment, lacewings, Geo-Gebra Software

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Authors: Alessandra Chiara Maraschin, Estelle Trengove

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In South Africa, only 23% of engineering students attain their degrees in the minimum time of 4 years. This begs the question: Why is the 4-year throughput rate so low? Improving the throughput rate is crucial in assisting students to the shortest possible path to completion. The Electrical Engineering programme has a fixed curriculum and students must pass all courses in order to graduate. In South Africa, as is the case in several other countries, many students rely on external funding such as bursaries from companies in industry. If students fail a course, they often lose their bursaries, and most might not be able to fund their 'repeating year' fees. It is thus important to improve the throughput rate, since for many students, graduating from university is a way out of poverty for an entire family. In Electrical Engineering, it has been found that the Software Development I course (an introduction to C++ programming) is a significant hurdle course for students and has been found to have a low pass rate. It has been well-documented that students struggle with this type of course as it introduces a number of new threshold concepts that can be challenging to grasp in a short time frame. In an attempt to mitigate this situation, a part-time night-school for Software Development I was introduced in 2015 as an intervention measure. The course includes all the course material from the Software Development I module and allows students who failed the course in first semester a second chance by repeating the course through taking the night-school course. The purpose of this study is to determine whether the introduction of this intervention course could be considered a success. The success of the intervention is assessed in two ways. The study will first look at whether the night-school course contributed to improving the pass rate of the Software Development I course. Secondly, the study will examine whether the intervention contributed to improving the overall throughput from the 2nd year to the 3rd year of study at a South African University. Second year academic results for a sample of 1216 students have been collected from 2010-2017. Preliminary results show that the lowest pass rate for Software Development I was found to be in 2017 with a pass rate of 34.9%. Since the intervention course's inception, the pass rate for Software Development I has increased each year from 2015-2017 by 13.75%, 25.53% and 25.81% respectively. To conclude, the preliminary results show that the intervention course is a success in improving the pass rate of Software Development I.

Keywords: academic performance, electrical engineering, engineering education, intervention course, low pass rate, software development course, throughput

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Authors: Charles Amoo, Joshua New, Bill Eckman

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Buildings in the United States account for a significant proportion of energy consumption and greenhouse gas (GHG) emissions, and this trend is expected to continue as well as rise in the near future. Low-income households, in particular, bear a disproportionate burden of high building energy consumption and spending due to high energy costs. Energy efficiency improvements need to reach an average of 4% per year in this decade in order to meet global net zero emissions target by 2050, but less than 1 % of U.S. buildings are improved each year. The government has recognized the importance of technology in addressing this issue, and energy efficiency programs have been developed to tackle the problem. The Weatherization Assistance Program (WAP), the largest residential whole-house energy efficiency program in the U.S., is specifically designed to reduce energy costs for low-income households. Under the WAP, energy auditors must follow specific audit procedures and use Department of Energy (DOE) approved energy audit tools or software. This article proposes an expanded framework of factors that should be considered in energy audit software that is approved for use in energy efficiency programs, particularly for low-income households. The framework includes more than 50 factors organized under 14 assessment criteria and can be used to qualitatively and quantitatively score different energy audit software to determine their suitability for specific energy efficiency programs. While the tool can be useful for developers to build new tools and improve existing software, as well as for energy efficiency program administrators to approve or certify tools for use, there are limitations to the model, such as the lack of flexibility that allows continuous scoring to accommodate variability and subjectivity. These limitations can be addressed by using aggregate scores of each criterion as weights that could be combined with value function and direct rating scores in a multicriteria decision analysis for a more flexible scoring.

Keywords: buildings, energy efficiency, energy audit, software

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Authors: Alisher Agzamov, Hanan Al Harbi

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BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists. We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 220 +/- 80 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 150 +/- 55 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for patients with AML (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 20 % compared with the prerobot era, and there was an ICU cost savings of KD2.5 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, rp - 7 in icu management, cost and icu occupancy

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Authors: J. Fernandez, R. Fernandez de Canete, J. Perea-Paizal, J. C. Ramos-Diaz

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The high prevalence of cardiovascular diseases has provoked a raising interest in the development of mathematical models in order to evaluate the cardiovascular function both under physiological and pathological conditions. In this paper, a physical model of the cardiovascular system with intrinsic regulation is presented and implemented by using the object-oriented Modelica simulation software tools.  For this task, a multi-compartmental system previously validated with physiological data has been built, based on the interconnection of cardiovascular elements such as resistances, capacitances and pumping among others, by following an electrohydraulic analogy. The results obtained under both physiological and pathological scenarios provide an easy interpretative key to analyze the hemodynamic behavior of the patient. The described approach represents a valuable tool in the teaching of physiology for graduate medical and nursing students among others.

Keywords: cardiovascular system, MODELICA simulation software, physical modelling, teaching tool

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Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

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Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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Authors: Musa Auwal Mamman, S. G. Isa

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This study was carried out in order to investigate the effectiveness of GeoGebra software in teaching and learning of linear and quadratic equations amongst senior secondary school students in Fagge Local Government Area, Kano State–Nigeria. Five research items were raised in objectives, research questions and hypotheses respectively. A random sampling method was used in selecting 398 students from a population of 2098 of SS2 students. The experimental group was taught using the GeoGebra software while the control group was taught using the conventional teaching method. The instrument used for the study was the mathematics performance test (MPT) which was administered at the beginning and at the end of the study. The results of the study revealed that students taught with GeoGebra software (experimental group) performed better than students taught with traditional teaching method. The t- test was used to analyze the data obtained from the study.

Keywords: GeoGebra Software, mathematics performance, random sampling, mathematics teaching

Procedia PDF Downloads 238

Authors: Fernando Miguel Campos, Fernando Jesus Aguiar Campos, Pedro Filipe Campos

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A large amount of software products offer a wide range and number of features. This is called featurities or creeping featurism and tends to rise with each release of the product. Feautiris often adds unnecessary complexity to software, leading to longer learning curves and overall confusing the users and degrading their experience. We take a look to a new design approach tendency that has been coming up, the so-called “What You Get Is What You Need” concept that argues that products should be very focused, simple and with minimalistic interfaces in order to help users conduct their tasks in distraction-free ambiances. This is not as simple to implement as it might sound and the developers need to cut down features. Our contribution illustrates and evaluates this design method through a novel distraction-free diagramming tool named Delineato Pro for Mac OS X in which the user is confronted with an empty canvas when launching the software and where tools only show up when really needed.

Keywords: diagramming, HCI, usability, user interface

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Authors: Pauline Calleja, Brooke Alexander

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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.

Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education

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Authors: Prat Yotyawilai, Taratip Suwannasart

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Business Process Model and Notation (BPMN) is more important in the business process and creating functional models, and is a standard for OMG, which becomes popular in various organizations and in education. Researches related to software testing based on models are prominent. Although most researches use the UML model in software testing, not many researches use the BPMN Model in creating test cases. Therefore, this research proposes a design of a tool for generating test cases from the BPMN. The model is analyzed and the details of the various components are extracted before creating a flow graph. Both details of components and the flow graph are used in generating test cases.

Keywords: software testing, test case, BPMN, flow graph

Procedia PDF Downloads 544