Search results for: Healthcare Service Delivery

Authors: Fabiola Xavier Leal, Lara Campanharo, Sueli Aparecida Rodrigues Lucas

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The phenomenon of judicialization in health policy brings with it a great deal of problematization, but in general, it means that some issues that were previously solved by traditional political bodies are being decided by the Judiciary bodies. It is, therefore, a controversial topic that has generated many reflections both in the academic and political fields, considering that not only a dispute of public funds is at stake, but also the debate on access to social rights provided for in the Brazilian Federal Constitution of 1988 and in the various public policies, such as healthcare. With regard to the phenomenon in the Mental Health Policy focusing on people who use drugs, the disputes that permeate this scenario are evident: moral, cultural, sanitary, economic, psychological aspects. There are also the individual and collective dimensions of suffering. And in this process, we all question: What is the role of the Brazilian State in this matter? In this context, another question that needs to be answered is the amount spent on this procedure in the state of Espírito Santo (ES), Brazil (in the last 04 years, around R$121,978,591.44 were paid only for compulsory hospitalization of individuals) in the field in question, which is the financing of the services of the Psychosocial Care Network (RAPS). Therefore, this article aims to problematize the phenomenon of judicialization in Mental Health Policy through the compulsory hospitalization of people who use drugs in Espírito Santo (ES). We proposed a study that sought to understand how this has been occurring and making an impact on the provision of RAPS services in the Espírito Santo scenario. Therefore, the general objective of this study is to analyze the expenses with compulsory hospitalizations for drug use carried out by the State Health Department (SESA) between 2014 and 2019, in which we will seek to identify its destination and the impact of these actions on public health policy. For the purposes of this article, we will present the preliminary data of this study, such as the amount spent by the state and the receiving institutions. For data collection, the following data sources were used: documents available publicly on the Transparency Portal (payments made per year, institutions that received, subjects hospitalized, period and the amount of the daily rates paid); as well as the processes generated by SESA through its own system - ONBASE. For qualitative analysis, content analysis was used; and for quantitative analysis, descriptive statistics was used. Thus, we seek to problematize the issue of judicialization for compulsory hospitalizations, considering the current situation in which this resource has been widely requested to legitimize the war on drugs. This scenario highlights the moral-legal discourse, pointing out strategies through the control of bodies and through faith as an alternative.

Keywords: compulsory hospitalization, drugs, judicialization, mental health

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Authors: Hossam Ali-Hassan, Michael Bliemel

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This poster reflects upon our experiences using INNOV8, IBM’s Business Process Management (BPM) simulation game, in online MBA and undergraduate MIS classes over a period of 2 years. The game is designed to gives both business and information technology players a better understanding of how effective BPM impacts an entire business ecosystem. The game includes three different scenarios: Smarter Traffic, which is used to evaluate existing traffic patterns and re-route traffic based on incoming metrics; Smarter Customer Service where players develop more efficient ways to respond to customers in a call centre environment; and Smarter Supply Chains where players balance supply and demand and reduce environmental impact in a traditional supply chain model. We use the game as an experiential learning tool, where students have to act as managers making real time changes to business processes to meet changing business demands and environments. The students learn how information technology (IT) and information systems (IS) can be used to intelligently solve different problems and how computer simulations can be used to test different scenarios or models based on business decisions without having to actually make the potentially costly and/or disruptive changes to business processes. Moreover, when students play the three different scenarios, they quickly see how practical process improvements can help meet profitability, customer satisfaction and environmental goals while addressing real problems faced by municipalities and businesses today. After spending approximately two hours in the game, students reflect on their experience from it to apply several BPM principles that were presented in their textbook through the use of a structured set of assignment questions. For each final scenario students submit a screenshot of their solution followed by one paragraph explaining what criteria you were trying to optimize, and why they picked their input variables. In this poster we outline the course and the module’s learning objectives where we used the game to place this into context. We illustrate key features of the INNOV8 Simulation Game, and describe how we used them to reinforce theoretical concepts. The poster will also illustrate examples from the simulation, assignment, and learning outcomes.

Keywords: experiential learning, business process management, BPM, INNOV8, simulation, game

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Authors: Amna Khaliq

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In this research paper, a comparison study has been undertaken between Canada and Denmark to analyze the education system between the countries in entrepreneurship. Denmark, a land of high wages and high taxes, and Canada, a land of immigrants and opportunities, have seen a positive relationship in entrepreneurs' growth. They are both considered one of the top ten countries to start a business and to have government support globally. However, education is entirely free to Danish students, including university degrees, compared to Canadians, which can further hurdle for Canadian millennials to grow in the business world—the business experience more growth with educated entrepreneurs with international backgrounds in new immigrants. Denmark has seen a gradual increase in female entrepreneurs over the decade but is still lower than OECD countries. Compassionate management and work-life balance are prioritized in Denmark, unlike in Canada. Danish are early adopters of technology and have excellent infrastructure to support the technology industry, whereas Canada is still a service-oriented and manufacturer-based country. 2018 has been the highest number of opening businesses for Canada and Denmark. Some companies offer high wages, hiring bonuses, flexible working hours, wellness, and mental health benefits during Pandemic to keep the companies running and keep their workers' morale high. Pandemic has taught consumers new patterns to shop online. It is essential now to use technology and automation to increase productivity in businesses. Only those companies will survive that are applying this strategy. The Pandemic has ultimately changed entrepreneurs' and employees' behavior in the business world. Along with Ph.D. professors, entrepreneurs should be allowed to teach at learning intuitions. Millennials turn out to be the most entrepreneurial generation in both countries. Entrepreneurship education will only be beneficial when students create businesses and learn from real-life experiences. Managing physical, mental, emotional, and psychological health while dealing with high pressure in entrepreneurship are soft skills learned through practical work.

Keywords: entrepreneurship education, millennials, pandemic, Denmark, Canada

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Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: adverse drug reactions, drug safety, monitoring, pharmacovigilance

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Authors: Atiya Khan

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Recent research on the condition of school education in India has reaffirmed the importance of quality teacher professional development, especially in light of the rapid changes in teaching methods, learning theories, curriculum, and major shifts in information and technology that education systems are experiencing around the world. However, the quality of programs of teacher professional development in India is often uneven, in some cases non-existing. The educational authorities in India have long recognized this and have developed a range of programs to assist in-service teacher education. But, these programs have been mostly inadequate at improving the quality of teachers in India. Policy literature and reports indicate that the unevenness of these programs and more generally the lack of quality teacher professional development in India are due to factors such as a large number of teachers, budgetary constraints, top-down decision making, teacher overload, lack of infrastructure, and little or no follow-up. The disparity between the government stated goals for quality teacher professional development in India and its inability to meet the learning needs of teachers suggests that new interventions are needed. The realization that globalization has brought about an increase in the social, cultural, political and economic interconnectedness between countries has also given rise to transnational opportunities for education systems, such as India’s, aiming to build their capacity to support teacher professional development. Moreover, new developments in communication technologies seem to present a plausible means of achieving high-quality professional development for teachers through the creation of social learning spaces, such as transnational learning networks. This case study investigates the potential of one such transnational learning network to support the quality of teacher professional development in India, namely the Australia-Asia BRIDGE School Partnerships Project. It explores the participation of some fifteen teachers and their principals from BRIDGE participating schools in Delhi region of India; focusing on their professional development expectations from the BRIDGE program and account for their experiences in the program, in order to determine the program’s potential for the professional development of teachers in this study.

Keywords: case study, Australia-Asia BRIDGE Project, teacher professional development, transnational learning networks

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Authors: T. Al-Alawi, N. Shorbaji, E. Rashaidi, M.Alidrisi

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Purpose/Objective(s): The main purpose of this study is to analyze the planning of SBRT treatments for localized prostate cancer with 6FFF and 10FFF energies to see if there is a dosimetric difference between the two energies and how we can increase the plan efficiency and reduce its complexity. Also, to introduce a planning method in our department to treat prostate cancer by utilizing high energy photons without increasing patient toxicity and fulfilled all dosimetric constraints for OAR (an organ at risk). Then toevaluate the target 95% coverage PTV95, V5%, V2%, V1%, low dose volume for OAR (V1Gy, V2Gy, V5Gy), monitor unit (beam-on time), and estimate the values of homogeneity index HI, conformity index CI a Gradient index GI for each treatment plan.Materials/Methods: Two treatment plans were generated for15 patients with localized prostate cancer retrospectively using the CT planning image acquired for radiotherapy purposes. Each plan contains two/three complete arcs with two/three different collimator angle sets. The maximum dose rate available is 1400MU/min for the energy 6FFF and 2400MU/min for 10FFF. So in case, we need to avoid changing the gantry speed during the rotation, we tend to use the third arc in the plan with 6FFF to accommodate the high dose per fraction. The clinical target volume (CTV) consists of the entire prostate for organ-confined disease. The planning target volume (PTV) involves a margin of 5 mm. A 3-mm margin is favored posteriorly. Organs at risk identified and contoured include the rectum, bladder, penile bulb, femoral heads, and small bowel. The prescription dose is to deliver 35Gyin five fractions to the PTV and apply constraints for organ at risk (OAR) derived from those reported in references. Results: In terms of CI=0.99, HI=0.7, and GI= 4.1, it was observed that they are all thesame for both energies 6FFF and 10FFF with no differences, but the total delivered MUs are much less for the 10FFF plans (2907 for 6FFF vs.2468 for 10FFF) and the total delivery time is 124Sc for 6FFF vs. 61Sc for 10FFF beams. There were no dosimetric differences between 6FFF and 10FFF in terms of PTV coverage and mean doses; the mean doses for the bladder, rectum, femoral heads, penile bulb, and small bowel were collected, and they were in favor of the 10FFF. Also, we got lower V1Gy, V2Gy, and V5Gy doses for all OAR with 10FFF plans. Integral dosesID in (Gy. L) were recorded for all OAR, and they were lower with the 10FFF plans. Conclusion: High energy 10FFF has lower treatment time and lower delivered MUs; also, 10FFF showed lower integral and meant doses to organs at risk. In this study, we suggest usinga 10FFF beam for SBRTprostate treatment, which has the advantage of lowering the treatment time and that lead to lessplan complexity with respect to 6FFF beams.

Keywords: FFF beam, SBRT prostate, VMAT, prostate cancer

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Authors: Nabil Abu-Heakal, Ismail Abo-Ghanema, Basma Hamed Merghani

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The aim of this investigation is to study the effect of seasonal variations in Egypt on hematological parameters, reproductive and metabolic hormones of Egyptian buffalo-cows. This study lasted one year extending from December 2009 to November 2010 and was conducted on sixty buffalo-cows. Group of 5 buffalo-cows at estrus phase were selected monthly. Then, after blood sampling through tail vein puncture in the 2nd day after natural service, they were divided in two samples: one with anticoagulant for hematological analysis and the other without anticoagulant for serum separation. Results of this investigation revealed that the highest atmospheric temperature was in hot summer 32.61±1.12°C versus 26.18±1.67°C in spring and 19.92±0.70°C in winter season, while the highest relative humidity % was in winter season 43.50±1.60% versus 32.50±2.29% in summer season. The rise in temperature-humidity index from 63.73±1.29 in winter to 78.53±1.58 in summer indicates severe heat stress which is associated with significant reduction in total red blood cell count (3.20±0.15×106), hemoglobin concentration (8.83±0.43 g/dl), packed cell volume (30.73±0.12%), lymphocytes % (40.66±2.33 %), serum progesterone hormone concentration (0.56±0.03 ng/mll), estradiol17-B concentration (16.8±0.64 ng/ml), triiodothyronin (T3) concentration (2.33±0.33 ng/ml) and thyroxin hormone (T4) concentration (21.66±1.66 ng/ml), while hot summer resulted in significant increase in mean cell volume (96.55±2.25 fl), mean cell hemoglobin (30.81±1.33 pg), total white blood cell count (10.63±0.97×103), neutrophils % (49.66±2.33%), serum prolactin hormone (PRL) concentration (23.45±1.72 ng/ml) and cortisol hormone concentration (4.47±0.33 ng/ml) compared to winter season. There was no significant seasonal variation in mean cell hemoglobin concentration (MCHC). It was concluded that in Egypt there was a seasonal variation in atmospheric temperature, relative humidity, temperature humidity index (THI) and the rise in THI above the upper critical level (72 units), which, for lactating buffalo-cows in Egypt is the major constraint on buffalo-cows' hematological parameters and hormonal secretion that affects animal reproduction. Hence, we should improve climatic conditions inside the dairy farm to eliminate or reduce summer infertility.

Keywords: buffalo, climate change, Egypt, physiological parameters

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Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.

Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid

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Authors: James G. Matthew, Seonmin Huh, Frank X. Bennett

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English for Specific Purposes, ESP, aims to equip learners with necessary English language skills. Many ESP programs address language skills for job performance, including reading job related documents and oral proficiency. Within ESP is English for occupational purposes, EOP, which centers around developing communicative competence for the globalized workplace. Many ESP and EOP courses lack the content needed to assist students to progress at work, resulting in the need to create lexical compilation for different professions. It is important to teach communicative competence and soft skills for real job-related problem situations and address the complexities of the real world to help students to be successful in their professions. ESP and EOP research is therefore trying to balance both profession-specific educational contents as well as international multi-disciplinary language skills for the globalized workforce. The current study will build upon the existing discussion by developing pedagogy to assist students in their career through developing a strong practical command of relevant English vocabulary. Our research question focuses on the pedagogy two professors incorporated in their English for employment courses. The current study is a qualitative case study on the modes of teaching delivery for EOP in South Korea. Two foreign professors teaching at two different universities in South Korea volunteered for the study to explore their teaching practices. Both professors’ curriculums included the components of employment-related concept vocabulary, business presentations, CV/resume and cover letter preparation, and job interview preparation. All the pre-made recorded video lectures, live online class sessions with students, teachers’ lesson plans, teachers’ class materials, students’ assignments, and midterm and finals video conferences were collected for data analysis. The study then focused on unpacking representative patterns in their teaching methods. The professors used their strengths as native speakers to extend the class discussion from narrow and restricted conversations to giving students broader opportunities to practice authentic English conversation. The methods of teaching utilized three main steps to extend the conversation. Firstly, students were taught concept vocabulary. Secondly, the vocabulary was then combined in speaking activities where students had to solve scenarios, and the students were required to expand on the given forms of words and language expressions. Lastly, the students had conversations in English, using the language learnt. The conversations observed in both classes were those of authentic, expanded English communication and this way of expanding concept vocabulary lessons into extended conversation is one representative pedagogical approach that both professors took. Extended English conversation, therefore, is crucial for EOP education.

Keywords: concept vocabulary, english as a foreign language, english for employment, extended conversation

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Authors: Yanjie Zhu, André Jesus, Irwanda Laory

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Structural Health Monitoring (SHM), involving data acquisition, data interpretation and decision-making system aim to continuously monitor the structural performance of civil infrastructures under various in-service circumstances. The main value and purpose of SHM is identifying damages through data interpretation system. Research on SHM has been expanded in the last decades and a large volume of data is recorded every day owing to the dramatic development in sensor techniques and certain progress in signal processing techniques. However, efficient and reliable data interpretation for damage detection under environmental variations is still a big challenge. Structural damages might be masked because variations in measured data can be the result of environmental variations. This research reports a novel method based on single-channel Blind Signal Separation (BSS), which extracts environmental effects from measured data directly without any prior knowledge of the structure loading and environmental conditions. Despite the successful application in audio processing and bio-medical research fields, BSS has never been used to detect damage under varying environmental conditions. This proposed method optimizes and combines Ensemble Empirical Mode Decomposition (EEMD), Principal Component Analysis (PCA) and Independent Component Analysis (ICA) together to separate structural responses due to different loading conditions respectively from a single channel input signal. The ICA is applying on dimension-reduced output of EEMD. Numerical simulation of a truss bridge, inspired from New Joban Line Arakawa Railway Bridge, is used to validate this method. All results demonstrate that the single-channel BSS-based method can recover temperature effects from mixed structural response recorded by a single sensor with a convincing accuracy. This will be the foundation of further research on direct damage detection under varying environment.

Keywords: damage detection, ensemble empirical mode decomposition (EEMD), environmental variations, independent component analysis (ICA), principal component analysis (PCA), structural health monitoring (SHM)

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Authors: Avrokomi Zavitsanou, Spiros Papadopoulos, Theofanis Alexandridis

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This paper presents the research project ‘Colour & Travel’, which is co-funded by the European Union and national resources through the Operational Programme “Competitiveness, Entrepreneurship and Innovation” 2014-2020, under the Single RTDI State Aid Action "RESEARCH - CREATE - INNOVATE". The research project proposes the design of an innovative, playful framework for exploring a variety of travel destinations and creating personalised travel narratives, aiming to entertain, educate, and promote culture and tourism. Gamification of the cultural and touristic environment can enhance its experiential, multi-sensory aspects and broaden the perception of the traveler. The latter's involvement in creating and shaping his personal travel narrations and the possibility of sharing it with others can offer him an alternative, more binding way of getting acquainted with a place. In particular, the paper presents the design of an infrastructure: (a) for the development of interactive travel guides for mobile devices, where sites with specific points of interest will be recommended, with which the user can interact in playful ways and then create his personal travel narratives, (b) for the development of innovative games within virtual reality environment, where the interaction will be offered while the user is moving within the virtual environment; and (c) for an online application where the content will be offered through the browser and the modern 3D imaging technologies (WebGL). The technological products that will be developed within the proposed project can strengthen important sectors of economic and social life, such as trade, tourism, exploitation and promotion of the cultural environment, creative industries, etc. The final applications delivered at the end of the project will guarantee an improved level of service for visitors and will be a useful tool for content creators with increased adaptability, expansibility, and applicability in many regions of Greece and abroad. This paper aims to present the research project by referencing the state of the art and the methodological scheme, ending with a brief reflection on the expected outcome in terms of results.

Keywords: gamification, culture, tourism, AR, VR, applications

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Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

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Authors: D. Szinay, O. Perski, A. Jones, T. Chadborn, J. Brown, F. Naughton

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Background: The uptake of health and wellbeing smartphone apps is largely influenced by popularity indicators (e.g., rankings), rather than evidence-based content. Rapid disengagement is common. This study aims to explore how and why potential users 1) select and 2) engage with such apps, and 3) how increased engagement could be promoted. Methods: Semi-structured interviews and a think-aloud approach were used to allow participants to verbalise their thoughts whilst searching for a health or wellbeing app online, followed by a guided search in the UK National Health Service (NHS) 'Apps Library' and Public Health England’s (PHE) 'One You' website. Recruitment took place between June and August 2019. Adults interested in using an app for behaviour change were recruited through social media. Data were analysed using the framework approach. The analysis is both inductive and deductive, with the coding framework being informed by the Theoretical Domains Framework. The results are further mapped onto the COM-B (Capability, Opportunity, Motivation - Behaviour) model. The study protocol is registered on the Open Science Framework (https://osf.io/jrkd3/). Results: The following targets were identified as playing a key role in increasing the uptake of and engagement with health and wellbeing apps: 1) psychological capability (e.g., reduced cognitive load); 2) physical opportunity (e.g., low financial cost); 3) social opportunity (e.g., embedded social media); 4) automatic motivation (e.g., positive feedback). Participants believed that the promotion of evidence-based apps on NHS-related websites could be enhanced through active promotion on social media, adverts on the internet, and in general practitioner practices. Future Implications: These results can inform the development of interventions aiming to promote the uptake of and engagement with evidence-based health and wellbeing apps, a priority within the UK NHS Long Term Plan ('digital first'). The targets identified across the COM-B domains could help organisations that provide platforms for such apps to increase impact through better selection of apps.

Keywords: behaviour change, COM-B model, digital health, mhealth

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Authors: Henry Lau, Dilupa Nakandala, Li Zhao

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In today’s business, it is well-recognized that risk is an important factor that needs to be taken into consideration before a decision is made. Studies indicate that both the number of risks faced by organizations and their potential consequences are growing. Supply chain risk management has become one of the major concerns for practitioners and researchers. Supply chain leaders and scholars are now focusing on the importance of managing supply chain risk. In order to meet the challenge of managing and mitigating supply chain risk (SCR), we must first identify the different dimensions of SCR and assess its relevant probability and severity. SCR has been classified in many different ways, and there are no consistently accepted dimensions of SCRs and several different classifications are reported in the literature. Basically, supply chain risks can be classified into two dimensions namely disruption risk and operational risk. Disruption risks are those caused by events such as bankruptcy, natural disasters and terrorist attack. Operational risks are related to supply and demand coordination and uncertainty, such as uncertain demand and uncertain supply. Disruption risks are rare but severe and hard to manage, while operational risk can be reduced through effective SCM activities. Other SCRs include supply risk, process risk, demand risk and technology risk. In fact, the disorganized classification of SCR has created confusion for SCR scholars. Moreover, practitioners need to identify and assess SCR. As such, it is important to have an overarching framework tying all these SCR dimensions together for two reasons. First, it helps researchers use these terms for communication of ideas based on the same concept. Second, a shared understanding of the SCR dimensions will support the researchers to focus on the more important research objective: operationalization of SCR, which is very important for assessing SCR. In general, fresh food supply chain is subject to certain level of risks, such as supply risk (low quality, delivery failure, hot weather etc.) and demand risk (season food imbalance, new competitors). Effective strategies to mitigate fresh food supply chain risk are required to enhance operations. Before implementing effective mitigation strategies, we need to identify the risk sources and evaluate the risk level. However, assessing the supply chain risk is not an easy matter, and existing research mainly use qualitative method, such as risk assessment matrix. To address the relevant issues, this paper aims to analyze the risk factor of the fresh food supply chain using an approach comprising both fuzzy logic and hierarchical holographic modeling techniques. This novel approach is able to take advantage the benefits of both of these well-known techniques and at the same time offset their drawbacks in certain aspects. In order to develop this integrated approach, substantial research work is needed to effectively combine these two techniques in a seamless way, To validate the proposed integrated approach, a case study in a fresh food supply chain company was conducted to verify the feasibility of its functionality in a real environment.

Keywords: fresh food supply chain, fuzzy logic, hierarchical holographic modelling, operationalization, supply chain risk

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Authors: Sahar Tabarroki, Ahad Nazari

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The design process is one of the most key project processes in the construction industry. Although architects have the responsibility to produce complete, accurate, and coordinated documents, architectural design is accompanied by many errors. A design error occurs when the constraints and requirements of the design are not satisfied. Errors are potentially costly and time-consuming to correct if not caught early during the design phase, and they become expensive in either construction documents or in the construction phase. The aim of this research is to identify the risk factors of architectural design errors, so identification of risks is necessary. First, a literature review in the design process was conducted and then a questionnaire was designed to identify the risks and risk factors. The questions in the form of the questionnaire were based on the “similar service description of study and supervision of architectural works” published by “Vice Presidency of Strategic Planning & Supervision of I.R. Iran” as the base of architects’ tasks. Second, the top 10 risks of architectural activities were identified. To determine the positions of possible causes of risks with respect to architectural activities, these activities were located in a design process modeled by the IDEF0 technique. The research was carried out by choosing a case study, checking the design drawings, interviewing its architect and client, and providing a checklist in order to identify the concrete examples of architectural design errors. The results revealed that activities such as “defining the current and future requirements of the project”, “studies and space planning,” and “time and cost estimation of suggested solution” has a higher error risk than others. Moreover, the most important causes include “unclear goals of a client”, “time force by a client”, and “lack of knowledge of architects about the requirements of end-users”. For error detecting in the case study, lack of criteria, standards and design criteria, and lack of coordination among them, was a barrier, anyway, “lack of coordination between architectural design and electrical and mechanical facility”, “violation of the standard dimensions and sizes in space designing”, “design omissions” were identified as the most important design errors.

Keywords: architectural design, design error, risk management, risk factor

Procedia PDF Downloads 114

Authors: Tammeen Siraj, Wenxing Zhou, Terry Huang, Mohammad Al-Amin

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The high resolution inline inspection (ILI) tool is used extensively in the pipeline industry to identify, locate, and measure metal-loss corrosion anomalies on buried oil and gas steel pipelines. Corrosion anomalies may occur singly (i.e. individual anomalies) or as clusters (i.e. a colony of corrosion anomalies). Although the ILI technology has advanced immensely, there are measurement errors associated with the sizes of corrosion anomalies reported by ILI tools due limitations of the tools and associated sizing algorithms, and detection threshold of the tools (i.e. the minimum detectable feature dimension). Quantifying the measurement error in the ILI data is crucial for corrosion management and developing maintenance strategies that satisfy the safety and economic constraints. Studies on the measurement error associated with the length of the corrosion anomalies (in the longitudinal direction of the pipeline) has been scarcely reported in the literature and will be investigated in the present study. Limitations in the ILI tool and clustering process can sometimes cause clustering error, which is defined as the error introduced during the clustering process by including or excluding a single or group of anomalies in or from a cluster. Clustering error has been found to be one of the biggest contributory factors for relatively high uncertainties associated with ILI reported anomaly length. As such, this study focuses on developing a consistent and comprehensive framework to quantify the measurement errors in the ILI-reported anomaly length by comparing the ILI data and corresponding field measurements for individual and clustered corrosion anomalies. The analysis carried out in this study is based on the ILI and field measurement data for a set of anomalies collected from two segments of a buried natural gas pipeline currently in service in Alberta, Canada. Data analyses showed that the measurement error associated with the ILI-reported length of the anomalies without clustering error, denoted as Type I anomalies is markedly less than that for anomalies with clustering error, denoted as Type II anomalies. A methodology employing data mining techniques is further proposed to classify the Type I and Type II anomalies based on the ILI-reported corrosion anomaly information.

Keywords: clustered corrosion anomaly, corrosion anomaly assessment, corrosion anomaly length, individual corrosion anomaly, metal-loss corrosion, oil and gas steel pipeline

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Authors: Jeffrey A. Humenik

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Environmental, Limited Liability Corporation (EMR) provided civil construction services to the U.S. Army Corps of Engineers, Kansas City District, for the placement of a protective riprap blanket on the west bank of the Smoky Hill River, construction of 2 shore abutments and the construction of a 140 foot long sill wall spanning the Smoky Hill River in Salina, Kansas. The purpose of the project was to protect the riverbank from erosion and hold back water to a specified elevation, creating a pool to ensure adequate water intake for the municipal water supply. Geotextile matting and riprap were installed for streambank erosion protection. An inflatable bladder (AquaDam®) was designed to the specific river dimension and installed to divert the river and allow for dewatering during the construction of the sill walls and cofferdam. AquaDam® consists of water filled polyethylene tubes to create aqua barriers and divert water flow or prevent flooding. A challenge of the project was the fact that 100% of the sill wall was constructed within an active river channel. The threat of flooding of the work area, damage to the aqua dam by debris, and potential difficulty of water removal presented a unique set of challenges to the construction team. Upon completion of the West Sill Wall, floating debris punctured the AquaDam®. The manufacturing and delivery of a new AquaDam® would delay project completion by at least 6 weeks. To keep the project ahead of schedule, the decision was made to construct an earthen cofferdam reinforced with rip rap for the construction of the East Abutment and East Sill Wall section. During construction of the west sill wall section, a deep scour hole was encountered in the wall alignment that prevented EMR from using the natural rock formation as a concrete form for the lower section of the sill wall. A formwork system was constructed, that allowed the west sill wall section to be placed in two horizontal lifts of concrete poured on separate occasions. The first sectional lift was poured to fill in the scour hole and act as a footing for the second sectional lift. Concrete wall forms were set on the first lift and anchored to the surrounding riverbed in a manner that the second lift was poured in a similar fashion as a basement wall. EMR’s timely decision to keep the project moving toward completion in the face of changing conditions enabled project completion two (2) months ahead of schedule. The use of inflatable bladders is an effective and cost-efficient technology to divert river flow during construction. However, a secondary plan should be part of project design in the event debris transported by river punctures or damages the bladders.

Keywords: abutment, AquaDam®, riverbed, scour

Procedia PDF Downloads 134

Authors: Charles Amoatey, Ebenezer Kumah

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Purpose: The purpose of this paper is to assess the effects of implementation of Distributor Management Solution (DMS) on supply chain performance in the Fast Moving Consumer Goods (FMCG) industry in Ghana. Methodology: A purposive sampling approach was used in selecting the respondents for the study. Data was collected from senior management and field supervisors from sales, distribution and customer service units of the case study firm and its channel members. This study made use of systematic literature review and results of survey data analysis to assess how information system has been used to improve supply chain performance. Findings: Results from the study showed that the critical effect factors from implementation of a DMS include (1) Obtain prompt and reliable feedback from the market; (2) Building the capacity and skills levels of employees as well as 3rd Party Agents; (3) Motivated top management to invest in MIS; and (4) Performance improvement in sales route management. The most critical challenges to an effective and sustainable MIS implementation are lack of enough trained IT employees and high barriers to cultural change especially with distributors. The paper recommends consistent investment in IS infrastructure and development of IT skills. Research limitations/implications: This study contributes to the literature by exploring the effects of distribution management solution implementation and supply chain performance in a developing country context. Considering the fact that this study is based on data from only one case study firm and its channel members, generalization of the results should be treated with caution. Practical implications: The findings have confirmed the benefits of implementing a Management Information System. The result should encourage channel members to allocate adequate resources for building MIS capacity to enhance their supply chain performance. Originality/Value: In this paper, the relationship between DMS/MIS implementation and improvement in supply chain performance, in the Ghanaian context, has been established.

Keywords: distributor management solution, fast-moving consumer goods, supply chain management, information systems, Ghana

Procedia PDF Downloads 550

Authors: Chinwe Okpoko, Vivian Atasie

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One of the leading causes of death amongst women of child-bearing age in southeast Nigeria is pregnancy. Women in the reproductive age group die at a higher rate than men of the same age bracket. Furthermore, most maternal deaths occur among poor women who live in rural communities, and who generally fall within the low socio-economic group in society. Failure of policy makers and the media to create the strategic awareness and communication that conform with the sensibilities of this group account, in part, for the persistence of this malaise. Family planning (FP) is an essential component of safe motherhood, which is designed to ensure that women receive high-quality care to achieve an optimum level of health of mother and infant. The aim is to control the number of children a woman can give birth to and prevent maternal and child mortality and morbidity. This is what sustainable development goal (SDG) health target of World Health Organization (WHO) also strives to achieve. FP programmes reduce exposure to the risks of child-bearing. Indeed, most maternal deaths in the developing world can be prevented by fully investing simultaneously in FP and maternal and new-born care. Given the intrinsic value of communication in health care delivery, it is vital to adopt the most efficacious means of awareness creation and communication amongst rural women in FP. In a country where over 50% of her population resides in rural areas with attendant low-level profile standard of living, the need to communicate health information like FP through indigenous channels becomes pertinent. Interpersonal communication amongst family, friends, religious groups and other associations, is an efficacious means of communicating social issues in rural Africa. Communication in informal settings identifies with the values and social context of the recipients. This study therefore sought to determine the place of interpersonal communication on the knowledge of rural women on FP and how it influences uptake of FP. Descriptive survey design was used in the study, with interviewer administered questionnaire constituting the instrument for data collection. The questionnaire was administered on 385 women from rural communities in southeast Nigeria. The results show that majority (58.5%) of the respondents agreed that interpersonal communication helps women understand how to plan their family size. Many rural women (82%) prefer the short term natural method to the more effective modern contraceptive methods (38.1%). Husbands’ approval of FP, as indicated in the Mean response of 2.56, is a major factor that accounts for the adoption of FP messages among rural women. Socio-demographic data also reveal that educational attainment and/or exposure influenced women’s acceptance or otherwise of FP messages. The study, therefore, recommends amongst others, the targeting of husbands in subsequent FP communication interventions, since they play major role on contraceptive usage.

Keywords: family planning, interpersonal communication, interpersonal interaction, traditional communication

Procedia PDF Downloads 108

Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ülle Ernits

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Background data. This is a study in the field of health humanities. The 1930s were years of rapid cultural and economic development in Europe and in Estonia. The urban way of life the glamorous lifestyle gained popularity, although the society of Estonia in the 1930s had traditionally been agrarian. People's free time increased, which needed to be filled with activities either at home or outside the home. Therefore, the number of popular magazines aimed at housewives increased. More than 200 magazines and bulletins were published in the Republic of Estonia before the Second World War (in 1934, the population of Estonia was 1,126,000). In the 1930s, the Republic of Estonia faced several challenges in healthcare. Infectious diseases, alcoholism, prostitution and child mortality had to be dealt with. Healers without medical education operated in the villages. For the average person, medical care was quite expensive, and despite efforts, by 1940, only 20% of the population was covered by health insurance. Advice published in popular family magazines provided help in solving, understanding and preventing health problems. Aim. The aim of the study is to analyze the health counseling through magazines during the Republic of Estonia (1930-1940) in historical and cultural context. Method. In total, 420 magazine issues were processed. An extensive textual analysis, as well as an analysis of photographs and illustrations from the aspect of health advice was carried out to achieve the research objective. Results. Health counseling was written by well-known doctors of the time, leaders of the abstinence movement and others. There was advice in various areas: prevention of infectious and non-infectious diseases and their treatment with simple methods, first aid, combating sexually transmitted diseases, women's and children's health, mental health, folk medicine techniques, abstinence, healthy eating, skin care, hygiene, introducing pharmacy products. Advice was offered in both written and visual form. Photos and illustrations helped to empower the health advice. Folk heritage and health knowledge of the time were relied upon, and a scientific point of view was popularized. Aspirations towards a European lifestyle were reflected in articles and illustrations. Contribution. The article has an ethnological attitude, and its impact comes down to understanding the history of health care in its socio-cultural context. The health counseling topics of the 1930s are also applicable in today's health education and research. Health counseling builds on the legacy of the past, and it helps to understand that the past is in the future and the main principles of health counseling arise from our history and background.

Keywords: estonian republic, health counseling, lifestyle, magazines, media

Procedia PDF Downloads 46

Authors: Kadri-Ann Kertsmik, Martin Talvik, Kimmo Lylykangas, Simo Ilomets, Targo Kalamees

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This study compares the building carbon footprint (CF) values for a case study of a private house located in a cold climate, using the Level(s) methodology. It provides a framework for measuring the environmental performance of buildings throughout their life cycle, taking into account various factors. The study presents the results of the three scenarios, comparing their carbon emissions and highlighting the benefits of circular material usage. The construction process was thoroughly documented, and all materials and components (including minuscule mechanical fasteners, each meter of cable, a kilogram of mortar, and the component of HVAC systems, among other things) delivered to the construction site were noted. Transportation distances of each delivery, the fuel consumption of construction machines, and electricity consumption for temporary heating and electrical tools were also monitored. Using the detailed data on material and energy resources, the CF was calculated for two scenarios: one where circular material usage was applied and another where virgin materials were used instead of reused ones. The results were compared with the CF calculated based on the building permit design model using the Level(s) methodology. To study the range of possible results in the early stage of CF assessment, the same building permit design was given to several experts. Results showed that embodied carbon values for a built scenario were significantly lower than the values predicted by the building permit stage as a result of more precise material quantities, as the calculation methodology is designed to overestimate the CF. Moreover, designers made an effort to reduce the building's CF by reusing certain materials such as ceramic tiles, lightweight concrete blocks, and timber during the construction process. However, in a cold climate context where operational energy (B6) continues to dominate, the total building CF value changes between the three scenarios were less significant. The calculation for the building permit project was performed by several experts, and CF results were in the same range. It alludes that, for the first estimation of preliminary building CF, using average values proves to be an appropriate method for the Estonian national carbon footprint estimation phase during building permit application. The study also identified several opportunities for reducing the carbon footprint of the building, such as reusing materials from other construction sites, preferring local material producers, and reducing wastage on site. The findings suggest that using circular materials can significantly reduce the carbon footprint of buildings. Overall, the study highlights the importance of using a comprehensive approach to measure the environmental performance of buildings, taking into account both the project and the actually built house. It also emphasises the need for ongoing monitoring for designing the building and construction site waste. The study also gives some examples of how to enable future circularity of building components and materials, e.g., building in layers, using wood as untreated, etc.

Keywords: carbon footprint, circular economy, sustainable construction, level(s) methodology

Procedia PDF Downloads 67

Authors: Anchal Rana

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Indian Himalayas with their diverse climatic conditions are home to many rare and endangered medicinal flora. One such species is Polygonatum verticillatum Linn., popularly known as King Solomon’s Seal or Solomon’s Seal. Its mention as an incredible medicinal herb comes from 5000 years ago in Indian Materia Medica as a component of Ashtavarga, a poly-herbal formulation comprising of eight herbs illustrated as world’s first ever revitalizing and rejuvenating nutraceutical food, which is now commercialised in the name ‘Chaywanprash’. It is an erect tall (60 to 120 cm) perennial herb with sessile, linear leaves and white pendulous flowers. The species grows well in an altitude range of 1600 to 3600 m amsl, and propagates mostly through rhizomes. The rhizomes are potential source for significant phytochemicals like flavonoids, phenolics, lectins, terpenoids, allantoin, diosgenin, β-Sitosterol and quinine. The presence of such phytochemicals makes the species an asset for antioxidant, cardiotonic, demulcent, diuretic, energizer, emollient, aphrodisiac, appetizer, glactagogue, etc. properties. Having profound concentrations of macro and micronutrients, species has fine prospects of being used as a diet supplement. However, due to unscientific and gregarious uprooting, it has been assigned a status of ‘vulnerable’ and ‘endangered’ in the Conservation Assessment and Management Plan (CAMP) process conducted by Foundation for Revitalisation of Local Health Traditions (FRLHT) during 2010, according to IUCN Red-List Criteria. Further, destructive harvesting, land use disturbances, heavy livestock grazing, climatic changes and habitat fragmentation have substantially contributed towards anomaly of the species. It, therefore, became imperative to conserve the diversity of the species and make judicious use in future research and commercial programme and schemes. A Gene Bank was therefore established at High Altitude Herbal Garden of the Forest Research Institute, Dehradun, India situated at Chakarata (30042’52.99’’N, 77051’36.77’’E, 2205 m amsl) consisting 149 accessions collected from thirty-one geographical locations spread over three Himalayan States of Jammu and Kashmir, Himachal Pradesh, and Uttarakhand. The present investigations purport towards sampling and collection of divergent germplasm followed by planting and cultivation techniques. The ultimate aim is thereby focussed on analysing genetic diversity of the species and capturing promising genotypes for carrying out further genetic improvement programme so to contribute towards sustainable development and healthcare.

Keywords: Polygonatum verticillatum Linn., phytochemicals, genetic diversity, conservation, gene bank

Procedia PDF Downloads 144

Authors: Amanda Maria Rodrigues Barroso, Ary Paixao Borges Santana Junior, Caio Araujo Damasceno

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In Piauí, the Brazilian state, solar energy has become one of the renewable sources targeted by internal and external investments, with the intention of leveraging the development of society. However, for a residential or business consumer to be able to deploy this source, there is usually a need for a high initial investment due to its high cost. The countless high taxes on equipment and services are one of the factors that contribute to this cost and ultimately fall on the consumer. Through analysis, a way of reducing taxes is sought in order to encourage consumer adhesion to the use of photovoltaic solar energy. Thus, the objective is to implement the Piauí Solar Program in the state of Piauí in order to stimulate the deployment of photovoltaic solar energy, through benefits granted to users, providing state development by boosting the diversification of the state's energy matrix. The research method adopted was based on the analysis of data provided by the Teresina City Hall, by the Brazilian Institute of Geography and Statistics and by a private company in the capital of Piauí. The account was taken of the total amount paid in Property and Urban Territorial Property Tax (IPTU), in electricity and in the service of installing photovoltaic panels in a residence with 6 people. Through Piauí Solar, a discount of 80% would be applied to the taxes present in the budgets regarding the implementation of these photovoltaic plates in homes and businesses, as well as in the IPTU. In addition, another factor also taken into account is the energy savings generated after the implementation of these boards. In the studied residence, the annual payment of IPTU went from R $ 99.83 reais to R $ 19.96, the reduction of taxes present in the budget for the implantation of solar panels, caused the value to increase from R $ 42,744.22 to R $ 37,241.98. The annual savings in electricity bills were estimated at around R $ 6,000. Therefore, there is a reduction of approximately 24% in the total invested. The trend of the Piauí Solar program, then, is to bring benefits to the state, providing an improvement in the living conditions of the population, through the savings generated by this program. In addition, an increase in the diversification of the Piauí energy matrix can be seen with the advancement of the use of this renewable energy.

Keywords: development, economy, energy, taxes

Procedia PDF Downloads 115

Authors: Marie Alexandre, Jean Bernatchez

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This paper focuses on the complexity of the face-to-face-to-distance learning transition process. Our research action aims to support the process of transition from classroom to distance learning for teachers in higher education with regard to pedagogical practices that can meet the various needs of students using digital learning environments. In Quebec and elsewhere in the world, the advent of digital education is helping to transform teaching, which is significantly changing the role of teachers. While distance education implies a dissociation of teaching and learning to a variable degree in space and time, distance education (DE) is becoming more and increasingly becoming a preferred option for maintaining the delivery of certain programs and providing access to programs and to provide access to quality activities throughout Quebec. Given the impact of teaching practices on educational success, this paper reports on the results of three research objectives: 1) To document teachers' knowledge of teaching in distance education through the design, experimentation and production of a repertoire of the determinants of pedagogical practices in response to students' needs. 2) Explain, according to a gendered logic, the adequacy between the pedagogical practices implemented in distance learning and the response to the profiles and needs expressed by students using digital learning environments; 3) Produce a model of a support approach during the process of transition from classroom to distance learning at the college level. A mixed methodology, i.e., a quantitative component (questionnaire survey) and a qualitative component (explanatory interviews and living lab) was used in cycles that were part of an ongoing validation process. The intervention includes the establishment of a professional collaboration group, webinars training webinars for the participating teachers on the didactic issue of knowledge-teaching in FAD, the didactic use of technologies, and the differentiated socialization models of educational success in college education. All of the tools developed will be used by partners in the target environment as well as by all teacher educators, students in initial teacher training, practicing teachers, and the general public. The results show that access to training leading to qualifications and commitment to educational success reflects the existing links between the people in the educational community. The relational stakes of being present in distance education take on multiple configurations and different dimensions of learning testify to needs and realities that are sometimes distinct depending on the life cycle. This project will be of interest to partners in the targeted field as well as to all teacher trainers, students in initial teacher training, practicing college teachers, and to university professors. The entire educational community will benefit from digital resources in education. The scientific knowledge resulting from this action research will benefit researchers in the fields of pedagogy, didactics, teacher training and pedagogy in higher education in a digital context.

Keywords: action research, didactics, digital learning environment, distance learning, higher education, pedagogy technological, pedagogical content knowledge

Procedia PDF Downloads 66

Authors: Glenda Wrenn, Juliet Muzere, Meldra Hall, Allyson Belton, Kisha Holden, Chanita Hughes-Halbert, Martha Kent, Bekh Bradley

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Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.

Keywords: culture, help-seeking, integrated care, PTSD

Procedia PDF Downloads 219

Authors: Ayhan Cinici, Mustafa Ozden, Umit Duruk, Gulden Akdag

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The purpose of this study was to investigate how feedbacks left from two different sources (mentors and peers) during microteaching sessions effecting preservice teachers’ teaching skills and views on science teaching. Sampling process is twofold in the study. As part of qualitative research, among other counterparts, case study method was chosen and respectively, constructed six working groups in which there were six preservice teachers, totally from thirty six preservice teachers enrolled in the third grade of Elementary Education Department by random assignment. Subsequently, one preservice teacher from all groups was appointed as the moderator of those groups (totally six moderators). Rest of them taking part remained as audience in all groups. At the beginning of the instructional process, all participants were asked to watch some videos by which someone already recorded. After watching these videos, they were also given a chance to discuss their ideas and impressions regarding microteaching in the classroom atmosphere. Both academic staff as mentors and participants as preservice teachers took role in the process of determining which teaching skills would be taken into consideration as part of microteaching sessions. Each group were gathered at regular intervals throughout twelve weeks together with their mentor who guided them and performed their microteaching. Data was collected using reflective diaries by which researchers constructed for both preservice teachers playing role as teacher of the group and preservice teachers playing role as audience during these microteaching sessions. Semi structured interviews were also carried out with only preservice teachers playing role as teachers of the groups. Findings from these reflective diaries and semi structured interviews were analysed by descriptive statistics and content analysis method. With regard to these findings, explanatory themes and subthemes were categorized and supported by direct citations. The results reveal that preservice teachers playing role as the teachers of the each group consider “content knowledge” as the most important aspect among other teaching skills. Furthermore, preservice teachers also point out that the more they get feedback on any teaching skill, the more they get motivated to develop it.

Keywords: teacher education, microteaching, mentor, peer feedback

Procedia PDF Downloads 369

Authors: Tarmi A'Vard

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This paper discusses the transformative learning experience for students participating in the Inside-Out Prison Exchange Program (Inside-out) and explores the value this pedagogical approach may have in youth justice centers. Inside-Out is a semester-long university course which is unique as it takes 15 university students, with their textbook and theory-based knowledge, behind the walls to study alongside 15 incarcerated students, who have the lived experience of the criminal justice system. Inside-out is currently offered in three Victorian prisons, expanding to five in 2020. The Inside-out pedagogy which is based on transformative dialogic learning is reliant upon the participants sharing knowledge and experiences to develop an understanding and appreciation of the diversity and uniqueness of one another. Inside-out offers the class an opportunity to create its own guidelines for dialogue, which can lead to the student’s sense of equality, which is fundamental in the success of this program. Dialogue allows active participation by all parties in reconciling differences, collaborating ideas, critiquing and developing hypotheses and public policies, and encouraging self-reflection and exploration. The structure of the program incorporates the implementation of circular seating (where the students alternate between inside and outside), activities, individual reflective tasks, group work, and theory analysis. In this circle everyone is equal, this includes the educator, who serves as a facilitator more so than the traditional teacher role. A significant function of the circle is to develop a group consciousness, allowing the whole class to see itself as a collective, and no one person holds a superior role. This also encourages participants to be responsible and accountable for their behavior and contributions. Research indicates completing academic courses, like Inside-Out, contributes positively to reducing recidivism. Inside-Out’s benefits and success in many adult correctional institutions have been outlined in evaluation reports and scholarly articles. The key findings incorporate the learning experiences for the students in both an academic capability and professional practice and development. Furthermore, stereotypes and pre-determined ideas are challenged, and there is a promotion of critical thinking and evidence of self-discovery and growth. There is empirical data supporting positive outcomes of education in youth justice centers in reducing recidivism and increasing the likelihood of returning to education upon release. Hence, this research could provide the opportunity to increase young people’s engagement in education which is a known protective factor for assisting young people to move away from criminal behavior. In 2016, Tarmi completed the Inside-Out educator training in Philadelphia, Pennsylvania, and has developed an interest in exploring the pedagogy of Inside-Out, specifically targeting young offenders in a Youth Justice Centre.

Keywords: dialogic transformative learning, inside-out prison exchange program, prison education, youth justice

Procedia PDF Downloads 109

Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira

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Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Keywords: absenteeism, health/safety integration, work accommodation management, total worker health

Procedia PDF Downloads 143

Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

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Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

Procedia PDF Downloads 62

Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

Abstract:

Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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