Search results for: quality evaluation indicator

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Eirini Konstanta, Cedric Gouedard, Aggeliki Delimitsou, Stefania Patera, Samuel Murray

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Introduction: Quality reference DNA standards (QRS) for molecular testing by next-generation sequencing (NGS) are essential for accurate quantitation of copy number variations (CNV) for germline and variant allelic frequencies (VAF) for somatic analyses. Objectives: Presently, several molecular analytics for oncology patients are reliant upon quantitative metrics. Test validation and standardisation are also reliant upon the availability of surrogate control materials allowing for understanding test LOD (limit of detection), sensitivity, specificity. We have developed a dual calibration platform allowing for QRS pairs to be included in analysed DNA samples, allowing for accurate quantitation of CNV and VAF metrics within and between patient samples. Methods: QRS™ blocks up to 500nt were designed for common NGS panel targets incorporating ≥ 2 identification tags (IDTDNA.com). These were analysed upon spiking into gDNA, somatic, and ctDNA using a proprietary CalSuite™ platform adaptable to common LIMS. Results: We demonstrate QRS™ calibration reproducibility spiked to 5–25% at ± 2.5% in gDNA and ctDNA. Furthermore, we demonstrate CNV and VAF within and between samples (gDNA and ctDNA) with the same reproducibility (± 2.5%) in a clinical sample of lung cancer and HBOC (EGFR and BRCA1, respectively). CNV analytics was performed with similar accuracy using a single pair of QRS calibrators when using multiple single targeted sequencing controls. Conclusion: Dual paired QRS™ calibrators allow for accurate and reproducible quantitative analyses of CNV, VAF, intrinsic sample allele measurement, inter and intra-sample measure not only simplifying NGS analytics but allowing for monitoring clinically relevant biomarker VAF across patient ctDNA samples with improved accuracy.

Keywords: calibrator, CNV, gene copy number, VAF

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Authors: Martins Onyekwelu Onuorah, Jnr Dahiru Usman

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Introduction: In the realm of public health, the threat posed by Monkeypox continues to elicit concern, prompting rigorous studies to understand its dynamics and devise effective containment strategies. Particularly significant is its recurrence in variable populations, such as the observed outbreak in Nigeria in 2022. In light of this, our study undertakes a meticulous analysis, employing a data-driven approach to explore, validate, and propose optimized intervention strategies tailored to the distinct dynamics of Monkeypox within varying demographic structures. Utilizing a deterministic mathematical model, we delved into the intricate dynamics of Monkeypox, with a particular focus on a variable population context. Our qualitative analysis provided insights into the disease-free equilibrium, revealing its stability when R0 is less than one and discounting the possibility of backward bifurcation, as substantiated by the presence of a single stable endemic equilibrium. The model was rigorously validated using real-time data from the Nigerian 2022 recorded cases for Epi weeks 1 – 52. Transitioning from qualitative to quantitative, we augmented our deterministic model with optimal control, introducing three time-dependent interventions to scrutinize their efficacy and influence on the epidemic's trajectory. Numerical simulations unveiled a pronounced impact of the interventions, offering a data-supported blueprint for informed decision-making in containing the disease. A comprehensive cost-effectiveness analysis employing the Infection Averted Ratio (IAR), Average Cost-Effectiveness Ratio (ACER), and Incremental Cost-Effectiveness Ratio (ICER) facilitated a balanced evaluation of the interventions’ economic and health impacts. In essence, our study epitomizes a holistic approach to understanding and mitigating Monkeypox, intertwining rigorous mathematical modeling, empirical validation, and economic evaluation. The insights derived not only bolster our comprehension of Monkeypox's intricate dynamics but also unveil optimized, cost-effective interventions. This integration of methodologies and findings underscores a pivotal stride towards aligning public health imperatives with economic sustainability, marking a significant contribution to global efforts in combating infectious diseases.

Keywords: monkeypox, equilibrium states, stability, bifurcation, optimal control, cost-effectiveness

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Authors: Sahithi Yarlagadda

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The design of antenna is constrained by mathematical and geometrical parameters. Though there are diverse antenna structures with wide range of feeds yet, there are many geometries to be tried, which cannot be customized into predefined computational methods. The antenna design and optimization qualify to apply evolutionary algorithmic approach since the antenna parameters weights dependent on geometric characteristics directly. The evolutionary algorithm can be explained simply for a given quality function to be maximized. We can randomly create a set of candidate solutions, elements of the function's domain, and apply the quality function as an abstract fitness measure. Based on this fitness, some of the better candidates are chosen to seed the next generation by applying recombination and permutation to them. In conventional approach, the quality function is unaltered for any iteration. But the antenna parameters and geometries are wide to fit into single function. So, the weight coefficients are obtained for all possible antenna electrical parameters and geometries; the variation is learnt by mining the data obtained for an optimized algorithm. The weight and covariant coefficients of corresponding parameters are logged for learning and future use as datasets. This paper drafts an approach to obtain the requirements to study and methodize the evolutionary approach to automated antenna design for our past work on Vivaldi antenna as test candidate. The antenna parameters like gain, directivity, etc. are directly caged by geometries, materials, and dimensions. The design equations are to be noted here and valuated for all possible conditions to get maxima and minima for given frequency band. The boundary conditions are thus obtained prior to implementation, easing the optimization. The implementation mainly aimed to study the practical computational, processing, and design complexities that incur while simulations. HFSS is chosen for simulations and results. MATLAB is used to generate the computations, combinations, and data logging. MATLAB is also used to apply machine learning algorithms and plotting the data to design the algorithm. The number of combinations is to be tested manually, so HFSS API is used to call HFSS functions from MATLAB itself. MATLAB parallel processing tool box is used to run multiple simulations in parallel. The aim is to develop an add-in to antenna design software like HFSS, CSTor, a standalone application to optimize pre-identified common parameters of wide range of antennas available. In this paper, we have used MATLAB to calculate Vivaldi antenna parameters like slot line characteristic impedance, impedance of stripline, slot line width, flare aperture size, dielectric and K means, and Hamming window are applied to obtain the best test parameters. HFSS API is used to calculate the radiation, bandwidth, directivity, and efficiency, and data is logged for applying the Evolutionary genetic algorithm in MATLAB. The paper demonstrates the computational weights and Machine Learning approach for automated antenna optimizing for Vivaldi antenna.

Keywords: machine learning, Vivaldi, evolutionary algorithm, genetic algorithm

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Authors: Desjardin, Michaels, Martinez, Ulmann

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Copper IUD is one of the most efficient and cost-effective contraception. However, pain at insertion hampers the use of this method. This is especially unfortunate in nulliparous women, often younger, who are excellent candidates for this contraception, including Emergency Contraception. Standard insertion procedure of a copper IUD usually involves measurement of uterine cavity with an hysterometer and the use of a tenaculum in order to facilitate device insertion. Both procedures lead to patient pain which often constitutes a limitation of the method. To overcome these issues, we have developed a modified insertor combined with a copper IUD. The singular design of the inserter includes a flexible inflatable membrane technology allowing an easy access to the uterine cavity even in case of abnormal uterine positions or narrow cervical canal. Moreover, this inserter makes possible a direct IUD insertion with no hysterometry and no need for tenaculum. To assess device effectiveness and patient-reported pain, a study was conducted at two clinics in Fance with 31 individuals who wanted to use a copper IUD as contraceptive method. IUD insertions have been performed by four healthcare providers. Operators completed questionnaire and evaluated effectiveness of the procedure (including IUD correct fundal placement and other usability questions) as their satisfaction. Patient also completed questionnaire and pain during procedure was measured on a 10-cm Visual Analogue Scale (VAS). Analysis of the questionnaires indicates that correct IUD placement took place in more than 93% of women, which is a standard efficacy rate. It also demonstrates that IUD insertion resulted in no, light or moderate pain predominantly in nulliparous women. No insertion resulted in severe pain (none above 6cm on a 10-cm VAS). This translated by a high level of satisfaction from both patients and practitioners. In addition, this modified inserter allowed a simplification of the insertion procedure: correct fundal placement was ensured with no need for hysterometry (100%) prior to insertion nor for cervical tenaculum to pull on the cervix (90%). Avoidance of both procedures contributed to the decrease in pain during insertion. Taken together, the results of the study demonstrate that this device constitutes a significant advance in the use of copper IUDs for any woman. It allows a simplification of the insertion procedure: there is no need for pre-insertion hysterometry and no need for traction on the cervix with tenaculum. Increased comfort during insertion should allow a wider use of the method for nulliparous women and for emergency contraception. In addition, pain is often underestimated by practitioners, but fear of pain is obviously one of the blocking factors as indicated by the analysis of the questionnaire. This evaluation brings interesting information on the use of this modified inserter for standard copper IUD and promising perspectives to set up a changement in the standard of IUD insertion procedure.

Keywords: contraceptio, IUD, innovation, pain

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Berrin Şentürk

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In this study, due to the recurrence of bovine tuberculosis, in the same areas, the risk factors for the disease were determined and evaluated at the local level. This study was carried out in 32 farms where the disease was detected in the district and center of Samsun province in 2014. Predetermined risk factors, such as farm, environmental and economic risks, were investigated with the survey method. It was predetermined that risks in the three groups are similar to the risk variables of the disease on the global scale. These risk factors that increase the susceptibility of the infection must be understood by the herd owners. The risk-based contagious disease management system approach should be applied for bovine tuberculosis by farmers, animal health professionals and public and private sector decision makers.

Keywords: bovine tuberculosis, disease management, control, outbreak, risk analysis

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Authors: Bernice V. Y. Wong, Kong Fah Tee

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Cross-laminated timber is increasingly being used in the construction of high-rise buildings due to its simple manufacturing system. In term of fire resistance, cross-laminated timber panels are promoted as having excellent fire resistance, comparable to that of non-combustible materials and to heavy timber construction, due to the ability of thick wood assemblies to char slowly at a predictable rate while maintaining most of their strength during the fire exposure. This paper presents an overview of fire performance of cross-laminated timber and evaluation of its resistance to elevated temperature in comparison to homogeneous timber panels. Charring rates for cross-laminated timber panels of those obtained experimentally were compared with those provided by Eurocode simplified calculation methods.

Keywords: timber structure, cross-laminated timber, charring rate, timber fire resistance

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Authors: Olga Blasco-Blasco, Vicente Liern

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The development of tourism since the mid-20th century has raised problems of overcrowding, indiscriminate construction in seaside areas and gentrification. Increasingly, the World Tourism Organisation and public institutions are promoting policies that encourage sustainability. From the perspective of sustainability, three types of tourism can be established: traditional tourism, sustainable tourism and sustainable impact tourism. Measuring sustainability is complex due to its multiple dimensions of different relative importance and diversity in nature. In order to try to answer this problem and to identify the benefits of applying policies that promote sustainable tourism, a decision-making analysis will be carried out through the application of a multicriteria analysis method. The proposal is applied to hotel reservations and to the evaluation and management of tourism sustainability in the Spanish Autonomous Communities.

Keywords: sustainable tourism, multicriteria analysis, flexible optimization, composite indicators

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Authors: Marzieh Moattari Mitra Abbasi, Masoud Mousavinasab, Poorahmad

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Background: Nurses in their daily practice need to communicate with patients and their families as well as health professional team members. Effective communication contributes to patients’ satisfaction which is a fundamental outcome of nursing practice. There are some evidences in support of patients' dissatisfaction with nurses’ performance in communication process. Therefore improving nurses’ communication skills is a necessity for nursing scholars and nursing administrators. Objective: The aim of the present study was to evaluate the effect of a 2-days workshop on nurses’ competencies and performances in communication in a central hospital located in the sought of Iran. Materials and Method: This is a randomized controlled trial which comprised of a convenient sample of 70 eligible nurses, working in a central hospital. They were randomly divided into 2 experimental and control groups. Nurses’ competencies was measured by an Objective Structured Clinical Examination (OSCE) and their performance was measured by asking eligible patients hospitalized in the nurses work setting during a one month period to evaluate nurses' communication skills before and 2 months after intervention. The experimental group participated in a 2 day workshop on communication skills. Content included in this workshop were: the importance of communication (verbal and non verbal), basic communication skills such as initiating the communication, active listening and questioning technique. Other subjects were patient teaching, problem solving, and decision making, cross cultural communication and breaking bad news. Appropriate teaching strategies such as brief didactic sessions, small group discussion and reflection were applied to enhance participants learning. The data was analyzed using SPSS 16. Result: A significant between group differences was found in nurses’ communication skills competencies and performances in the posttest. The mean scores of the experimental group was higher than that of the control group in the total score of OSCE as well as all stations of OSCE (p<0.003). Overall posttest mean scores of patient satisfaction with nurse's communication skills and all of its four dimensions significantly differed between the two groups of the study (p<0.001). Conclusion: This study shows that the education of nurses in communication skills, improves their competencies and performances. Measurement of Nurses’ communication skills as a central component of efficient nurse patient relationship by valid and reliable methods of evaluation is recommended. Also it is necessary to integrate teaching of communication skills in continuing nursing education programs. Trial Registration Number: IRCT201204042621N11

Keywords: communication skills, simulation, performance, competency, objective structure, clinical evaluation

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Authors: S. Anwar Sathik, K. Manoj Deepak, K. Venkatachalam

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Our study is a prospective study on the use of bio absorbable pins for the treatment of osteochondral fractures after patellar dislocation.22 patients who presented with osteochondral fractures were treated in our institution. They were followed for a minimum of 12 months by regular radiological evaluation. Of the 22 patients, 2 had fragments that detached from the fracture site which was treated arthroscopically. All the patients underwent open reduction and fixation of the pins using bio absorbable crews. They were immobilized in the cast for a minimum of 6 weeks after which mobilization was started according to our protocol. Fracture consolidation was found to occur in 20 of the 22 patients. Thus, Bio absorbable screws can be used as a reliable method of fixation of the osteochondral fragments.

Keywords: osteochondral fracture, bio absorbable pins, patella dislocation, physiotherapy

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Authors: Said Fares, Mary Fares

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It is well documented that introductory computer programming courses are difficult and that failure rates are high. The aim of this project was to reduce the high failure and withdrawal rates in learning to program. This paper presents a number of changes in module organization and instructional delivery system in teaching CS1. Daily out of class help sessions and tutoring services were applied, interactive lectures and laboratories, online resources, and timely feedback were introduced. Five years of data of 563 students in 21 sections was collected and analyzed. The primary results show that the failure and withdrawal rates were cut by more than half. Student surveys indicate a positive evaluation of the modified instructional approach, overall satisfaction with the course and consequently, higher success and retention rates.

Keywords: failure rate, interactive learning, student engagement, CS1

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Authors: Ghoname Abdullah, Hidekazu Nishimura

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Dust accumulation on the photovoltaic module's surface results in appreciable loss and negatively affects the generated power. Hence, in this paper, the design of a photovoltaic array cleaning system is presented. The cleaning system utilizes one drive motor, two guide rails, and four sweepers during the cleaning process. The cleaning system was experimentally implemented for one month to investigate its efficiency on PV array energy output. The energy capture over a month for PV array cleaned using the proposed cleaning system is compared with that of the energy capture using soiled PV array. The results show a 15% increase in energy generation from PV array with cleaning. From the results, investigating the optimal scheduling of the PV array cleaning could be an interesting research topic.

Keywords: cleaning system, dust accumulation, PV array, PV module, soiling

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Authors: P. Tanuska, A. Elias, P. Vazan, B. Zahradnikova

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This article describes the information system for measuring and evaluating the dose rate in the environment of nuclear power plants Mochovce and Bohunice in Slovakia. The article presents the results achieved in the implementation of the EU project–Research of monitoring and evaluation of non-standard conditions in the area of nuclear power plants. The objectives included improving the system of acquisition, measuring and evaluating data with mobile and autonomous units applying new knowledge from research. The article provides basic and specific features of the system and compared to the previous version of the system, also new functions.

Keywords: information system, dose rate, mobile devices, nuclear power plant

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Authors: Fahad A. Alotaibi

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An increase in salt dissolution rate with continuous water flow is expected to lead to the progressive collapse of the soil structure. Evaluation of the relationship between soil salt dissolution and the variation of sabkha soil permeability in terms of type, rate, and quantity in order to assure construction safety in these environments. The current study investigates the relationship of soil permeability with the rate of dissolution of calcium (Ca2+), sulfate (SO4-2), chloride (CL−1), magnesium (Mg2+), sodium (Na+), and potassium (K+1) ions. Results revealed an increase in sabkha soil permeability with the rate of ions dissolution. This makes the efficiency of using a waterproofing stabilization agent in the reduction of sabkha salts dissolution the main criterion is selecting suitable stabilizing method.

Keywords: sabkha, permeability, salts, dissolution

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Authors: Ahmad Ali Shahid, Mukhtar Ahmed

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The demand for long staple fiber having better strength and length is increasing with the introduction of modern spinning and weaving industry in Pakistan. Work on gene discovery from developing cotton fibers has helped to identify dozens of genes that take part in cotton fiber development and several genes have been characterized for their role in fiber development. Sucrose synthase (SuS) is a key enzyme in the metabolism of sucrose in a plant cell, in cotton fiber it catalyzes a reversible reaction, but preferentially converts sucrose and UDP into fructose and UDP-glucose. UDP-glucose (UDPG) is a nucleotide sugar act as a donor for glucose residue in many glycosylation reactions and is essential for the cytosolic formation of sucrose and involved in the synthesis of cell wall cellulose. The study was focused on successful Agrobacterium-mediated stable transformation of SuS gene in pCAMBIA 1301 into cotton under a CaMV35S promoter. Integration and expression of the gene were confirmed by PCR, GUS assay, and real-time PCR. Young leaves of SuS overexpressing lines showed increased total soluble sugars and plant biomass as compared to non-transgenic control plants. Cellulose contents from fiber were significantly increased. SEM analysis revealed that fibers from transgenic cotton were highly spiral and fiber twist number increased per unit length when compared with control. Morphological data from field plants showed that transgenic plants performed better in field conditions. Incorporation of genes related to cotton fiber length and quality can provide new avenues for fiber improvement. The utilization of this technology would provide an efficient import substitution and sustained production of long-staple fiber in Pakistan to fulfill the industrial requirements.

Keywords: agrobacterium-mediated transformation, cotton fiber, sucrose synthase gene, staple length

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Authors: M. Chen, S-Q. Zhang, X. Wang, D. Tate

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This paper presents a numerical solution, namely limit and shakedown analysis, to predict the safety state of smart structures made of heterogeneous materials under unknown cyclic loadings, for instance, the flexure hinge in the micro-positioning stage driven by piezoelectric actuator. In combination of homogenization theory and finite-element method (FEM), the safety evaluation problem is converted to a large-scale nonlinear optimization programming for an acceptable bounded loading as the design reference. Furthermore, a general numerical scheme integrated with the FEM and interior-point-algorithm based optimization tool is developed, which makes the practical application possible.

Keywords: limit state, shakedown analysis, homogenization, heterogeneous structure

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Authors: Hardeep

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The aim of this research work to improve the solubility and bioavailability of Simvastatin using a self nanoemulsifying drug delivery system (SNEDDS). Self emulsifying property of various oils including essential oils was evaluated with suitable surfactants and co-surfactants. Validation of a method for accuracy, repeatability, Interday and intraday precision, ruggedness, and robustness were within acceptable limits. The liquid SNEDDS was prepared and optimized using a ternary phase diagram, thermodynamic, centrifugation and cloud point studies. The globule size of optimized formulations was less than 200 nm which could be an acceptable nanoemulsion size range. The mean droplet size, drug loading, PDI and zeta potential were found to be 141.0 nm, 92.22%, 0.23 and -10.13 mV and 153.5nm, 93.89 % ,0.41 and -11.7 mV and 164.26 nm, 95.26% , 0.41 and -10.66mV respectively.

Keywords: simvastatin, self nanoemulsifying drug delivery system, solubility, bioavailability

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Authors: Kevin R. Wilson, Roger Mantie

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Community arts-based learning and participatory education are pedagogical techniques that serve to be advantageous for students, curriculum development, and local communities. Using an interpretive approach to examine the significance of this arts-informed research in relation to the eight ‘design imperatives’ proposed as the new model for measuring quality in scholarship for Arizona State University as ‘A New American University’, the purpose of this study was to investigate personal, social, and cultural benefits resulting from student engagement in interdisciplinary community-based projects. Students from a graduate level music education class at the ASU Tempe campus (n=7) teamed with students from an undergraduate level community development class at the ASU Downtown Phoenix campus (n=14) to plan, facilitate, and evaluate seven community-based projects in several locations around the Phoenix-metro area. Data was collected using photo evidence, student reports, and evaluative measures designed by the students. The effectiveness of each project was measured in terms of their ability to meet the eight design imperatives to: 1) leverage place; 2) transform society; 3) value entrepreneurship; 4) conduct use-inspired research; 5) enable student success; 6) fuse intellectual disciplines; 7) be socially embedded; and 8) engage globally. Results indicated that this community arts-based project sufficiently captured the essence of each of these eight imperatives. Implications for how the nature of this interdisciplinary initiative allowed for the eight imperatives to manifest are provided, and project success is expounded upon in relation to utility of each imperative. Discussion is also given for how this type of service learning project formatted within the ‘New American University’ model for measuring quality in academia can be a beneficial pedagogical tool in higher education.

Keywords: community arts-based learning, participatory education, pedagogy, service learning

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Authors: G. Barański, P. Kacejko, M. Wendeker

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The impact of the ignition advance control algorithms of the ASz-62IR-16X aircraft piston engine on a combustion process has been presented in this paper. This aircraft engine is a nine-cylinder 1000 hp engine with a special electronic control ignition system. This engine has two spark plugs per cylinder with an ignition advance angle dependent on load and the rotational speed of the crankshaft. Accordingly, in most cases, these angles are not optimal for power generated. The scope of this paper is focused on developing algorithms to control the ignition advance angle in an electronic ignition control system of an engine. For this type of engine, i.e. radial engine, an ignition advance angle should be controlled independently for each cylinder because of the design of such an engine and its crankshaft system. The ignition advance angle is controlled in an open-loop way, which means that the control signal (i.e. ignition advance angle) is determined according to the previously developed maps, i.e. recorded tables of the correlation between the ignition advance angle and engine speed and load. Load can be measured by engine crankshaft speed or intake manifold pressure. Due to a limited memory of a controller, the impact of other independent variables (such as cylinder head temperature or knock) on the ignition advance angle is given as a series of one-dimensional arrays known as corrective characteristics. The value of the ignition advance angle specified combines the value calculated from the primary characteristics and several correction factors calculated from correction characteristics. Individual cylinder control can proceed in line with certain indicators determined from pressure registered in a combustion chamber. Control is assumed to be based on the following indicators: maximum pressure, maximum pressure angle, indicated mean effective pressure. Additionally, a knocking combustion indicator was defined. Individual control can be applied to a single set of spark plugs only, which results from two fundamental ideas behind designing a control system. Independent operation of two ignition control systems – if two control systems operate simultaneously. It is assumed that the entire individual control should be performed for a front spark plug only and a rear spark plug shall be controlled with a fixed (or specific) offset relative to the front one or from a reference map. The developed algorithms will be verified by simulation and engine test sand experiments. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: algorithm, combustion process, radial engine, spark plug

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Authors: Emmanuel Bernard, Rebecca L. Cordell, Akeem A. Abayomi, Rose Alani, Paul S. Monks

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This study investigates the prevalence and extent of BTEX (Benzene, Toluene, Ethylbenzene, and Xylene) contamination in Leicester, United Kingdom, and Lagos, Nigeria, through field measurements at roadside (RS) and urban background (UB) sites. Using thermal desorption gas chromatography mass spectrometry (TD-GC-MS), BTEX concentrations were quantified. In Leicester, the average RS concentration was 24.9 ± 8.9 μg/m³, and the UB concentration was 12.7 ± 5.7 μg/m³. In Lagos, the RS concentration was significantly higher at 106 ± 39.3 μg/m³, and the UB concentration was 20.1 ± 8.9 μg/m³. The RS concentration in Lagos was approximately 4.3 times higher than in Leicester, while the UB concentration was about 1.6 times higher. These disparities are attributed to differences in road infrastructure, traffic regulation compliance, fuel and oil quality, and local activities. In Leicester, the highest UB concentration (20.5 ± 1.7 μg/m³) was at Knighton Village, near the heavily polluted RS Wigston roundabout. In Lagos, the highest concentration (172.1 ± 12.2 μg/m³) was at Ojuelegba, a major transportation hub. Correlation analysis revealed strong positive relationships between the concentrations of BTEX compounds in both cities, suggesting common sources such as vehicular emissions and industrial activities. The ratios of toluene to benzene (T:B) and m/p xylene to ethylbenzene (m/p X:E) were analysed to infer source contributions and the photochemical age of air masses. The T:B ratio in Leicester ranged from 0.44 to 0.71, while in Lagos, it ranged from 1.36 to 2.17. The m/p X:E ratio in Leicester ranged from 2.11 to 2.19, like other UK cities, while in Lagos, it ranged from 1.65 to 2.32, indicating relatively fresh emissions. This study highlights significant differences in BTEX concentrations between Leicester and Lagos, emphasizing the need for tailored pollution control strategies to address the specific sources and conditions in different urban environments.

Keywords: BTEX contamination, urban air quality, thermal desorption GC-MS, roadside emissions, urban background sites, vehicular emissions, pollution control strategies

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Authors: Abdul-Ganiyu Fuseini, Bernice Redley, Helen Rawson, Lenore Lay, Debra Kerr

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Aim: The study aimed to develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospital admissions. Design: A three-phased mixed-method sequential exploratory design was used. Methods: Concept elicitation and generation of items for the scale was informed by older adults’ perspectives about dignity during acute hospitalization and a literature review. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. A cross-sectional survey design was conducted involving 270 hospitalized older adults for evaluation of construct and convergent validity, internal consistency reliability, and test–retest reliability of the scale. Analysis was performed using Statistical Package for the Social Sciences, version 25. Reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: We established the 15-item Hospitalized Older Adults’ Dignity Scale that has a 5-factor structure: Shared Decision-Making (3 items); Healthcare Professional-Patient Communication (3 items); Patient Autonomy (4 items); Patient Privacy (2 items); and Respectful Care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability, and good test-retest reliability were demonstrated. Conclusion: We established the Hospitalized Older Adults Dignity Scale as a valid and reliable scale to measure dignity for older adults during acute hospital admissions. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may provide information that informs the development of strategies to improve dignity-related care in the future. Impact: The development and validation of the Hospitalized Older Adults Dignity Scale will provide healthcare professionals with a feasible and reliable scale for measuring older adults’ dignity during acute hospitalization. Routine use of the scale may enable the capturing and incorporation of older patients’ perspectives about their healthcare experience and provide information that informs the development of strategies to improve dignity-related care in the future.

Keywords: dignity, older adults, hospitalisation, scale, patients, dignified care, acute care

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Authors: Markus Feufel, Friederike Kendel, Caren Hilger, Selamawit Woldai

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Since the corona pandemic, the use of video consultation has increased remarkably. For vulnerable groups such as oncological patients, the advantages seem obvious. But how does video consultation potentially change the doctor-patient relationship compared to face-to-face consultation? Which barriers may hinder the effective use of this consultation format in practice? We are presenting first results from a mixed-methods field study, funded by Federal Ministry of Health, which will provide the basis for a hands-on guide for both physicians and patients on how to improve the quality of video consultations. We use a quasi-experimental design to analyze qualitative and quantitative differences between face-to-face and video consultations based on video recordings of N = 64 actual counseling sessions (n = 32 for each consultation format). Data will be recorded from n = 32 gynecological and n = 32 urological cancer patients at two clinics. After the consultation, all patients will be asked to fill out a questionnaire about their consultation experience. For quantitative analyses, the counseling sessions will be systematically compared in terms of verbal and nonverbal communication patterns. Relative frequencies of eye contact and the information exchanged will be compared using 𝝌2 -tests. The validated questionnaire MAPPIN'Obsdyad will be used to assess the expression of shared decision-making parameters. In addition, semi-structured interviews will be conducted with n = 10 physicians and n = 10 patients experienced with video consultation, for which a qualitative content analysis will be conducted. We will elaborate the comprehensive methodological approach we used to compare video vs. face-to-face consultations and present first evidence on how video consultations change the doctor-patient interaction. We will also outline possible barriers of video consultations and best practices on how they may be overcome. Based on the results, we will present and discuss recommendations outlining best practices for how to prepare and conduct high-quality video consultations from the perspective of both physicians and patients.

Keywords: video consultation, patient-doctor-relationship, digital applications, technical barriers

Procedia PDF Downloads 129

Authors: Mequanint Birhan

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Modern urban environments present a dynamically growing field where, notwithstanding shared goals, several mutually conflicting interests frequently collide. However, it has a big impact on the city's socioeconomic standing, waiting lines and queues are common occurrences. This results in extremely long lines for both vehicles and people on incongruous routes, service coagulation, customer murmuring, unhappiness, complaints, and looking for other options sometimes illegally. The root cause of this is corruption, which leads to traffic jams, stopping, and packing vehicles beyond their safe carrying capacity, and violating the human rights and freedoms of passengers. This study focused on the optimizing time of passengers had to wait in public vehicle stations. This applied research employed both data gathering sources and mixed approaches, then 166 samples of key informants of transport station were taken by using the Slovin sampling formula. The length of time vehicles, including the drivers and auxiliary drivers ‘Weyala', had to wait was also studied. To maximize the service level at vehicle stations, a queuing model was subsequently devised ‘Menaharya’. Time, cost, and quality encompass performance, scope, and suitability for the intended purposes. The minimal response time for passengers and vehicles queuing to reach their final destination at the stations of the Tepi, Mizan, and Bonga towns was determined. A new bus station system was modeled and simulated by Arena simulation software in the chosen study area. 84% improvement on cost reduced by 56.25%, time 4hr to 1.5hr, quality, safety and designed load performance calculations employed. Stakeholders are asked to put the model into practice and monitor the results obtained.

Keywords: Arena 14 automatic rockwell, queue, transport services, vehicle stations

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Authors: Atom Mkhitaryan, Astghik Avetisyan

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We analyze the developments of doctoral education in Armenia since 1990 and the management process. Education and training of highly qualified personnel are increasingly seen as a fundamental platform that ensures the development of the state. Reforming the national institute for doctoral studies (aspirantura) is aimed at improving the quality of human resources in science, optimizing research topics in accordance with the priority areas of development of science and technology, increasing publication and innovative activities, bringing national science and research closer to the world level and achieving international recognition. We present a number of defended dissertations in Armenia during the last 30 years, the dynamics and the main trends of the development of the academic degree awarding system. We discuss the possible impact of reforming the system of training and certification of highly qualified personnel on the organization of third–level doctoral education (doctoral schools) and specialized / dissertation councils in Armenia. The results of the SWOT analysis of doctoral education and academic degree awarding processes in Armenia are shown. The article presents the main activities and projects aimed at using the advantages and strong points of the National Academy network in order to improve the quality of doctoral education and training. The paper explores the mechanisms of organizational, methodological and infrastructural support for research and innovation activities of doctoral students and young scientists. There are also suggested approaches to the organization of strong networking between research institutes and foreign universities for training and certification of highly qualified personnel. The authors define the role of ISEC in the management of doctoral studies and the establishment of a competitive third-level education for the sphere of research and development in Armenia.

Keywords: doctoral studies, academic degree, PhD, certification, highly qualified personnel, dissertation, research and development, innovation, networking, management of doctoral school

Procedia PDF Downloads 51

Authors: Eugene Allevato

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Developing a responsible personal worldview is central to sustainable development, but achieving quality education to promote transformative learning for sustainability is thus far, poorly understood. Most programs involving education for sustainable development rely on changing behavior, rather than attitudes. The emphasis is on the scientific and utilitarian aspect of sustainability with negligible importance on the intrinsic value of nature. Campus sustainability projects include building sustainable gardens and implementing energy-efficient upgrades, instead of focusing on educating for sustainable development through exploration of students’ values and beliefs. Even though green technology adoption maybe the right thing to do, most schools are not targeting the root cause of the environmental crisis; they are just providing palliative measures. This study explores the under-examined factors that lead to pro-environmental behavior by investigating the environmental perceptions of both college business students and personnel of green organizations. A mixed research approach of qualitative, based on structured interviews, and quantitative instruments was developed including 30 college-level students’ interviews and 40 green organization staff members involved in sustainable activities. The interviews were tape-recorded and transcribed for analysis. Categorization of the responses to the open‐ended questions was conducted with the purpose of identifying the main types of factors influencing attitudes and correlating with behaviors. Overall the findings of this study indicated a lack of appreciation for nature, and inability to understand interconnectedness and apply critical thinking. The results of the survey conducted on undergraduate students indicated that the responses of business and liberal arts students by independent t-test were significantly different, with a p‐value of 0.03. While liberal arts students showed an understanding of human interdependence with nature and its delicate balance, business students seemed to believe that humans were meant to rule over the rest of nature. This result was quite intriguing from the perspective that business students will be defining markets, influencing society, controlling and managing businesses that supposedly, in the face of climate change, shall implement sustainable activities. These alarming results led to the focus on green businesses in order to better understand their motivation to engage in sustainable activities. Additionally, a probit model revealed that childhood exposure to nature has a significantly positive impact in pro-environmental attitudes to most of the New Ecological Paradigm scales. Based on these findings, this paper discusses educators including Socrates, John Dewey and Paulo Freire in the implementation of eco-pedagogy and transformative learning following a curriculum with emphasis on critical and systems thinking, which are deemed to be key ingredients in quality education for sustainable development.

Keywords: eco-pedagogy, environmental behavior, quality education for sustainable development, transformative learning

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Authors: Nadhiya N. Subramony, Jenifer Vaughan, Lesley E. Scott

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In South Africa, the World Health Organisation estimated 454000 new cases of Mycobacterium tuberculosis (M.tb) infection (MTB) in 2015. Disseminated tuberculosis arises from the haematogenous spread and seeding of the bacilli in extrapulmonary sites. The gold standard for the detection of MTB in bone marrow is TB culture which has an average turnaround time of 6 weeks. Histological examinations of trephine biopsies to diagnose MTB also have a time delay owing mainly to the 5-7 day processing period prior to microscopic examination. Adding to the diagnostic delay is the non-specific nature of granulomatous inflammation which is the hallmark of MTB involvement of the bone marrow. A Ziehl-Neelson stain (which highlights acid-fast bacilli) is therefore mandatory to confirm the diagnosis but can take up to 3 days for processing and evaluation. Owing to this delay in diagnosis, many patients are lost to follow up or remain untreated whilst results are awaited, thus encouraging the spread of undiagnosed TB. The Xpert® MTB/RIF (Cepheid, Sunnyvale, CA) is the molecular test used in the South African national TB program as the initial diagnostic test for pulmonary TB. This study investigates the optimisation and performance of the Xpert® MTB/RIF on bone marrow aspirate specimens (BMA), a first since the introduction of the assay in the diagnosis of extrapulmonary TB. BMA received for immunophenotypic analysis as part of the investigation into disseminated MTB or in the evaluation of cytopenias in immunocompromised patients were used. Processing BMA on the Xpert® MTB/RIF was optimised to ensure bone marrow in EDTA and heparin did not inhibit the PCR reaction. Inactivated M.tb was spiked into the clinical bone marrow specimen and distilled water (as a control). A volume of 500mcl and an incubation time of 15 minutes with sample reagent were investigated as the processing protocol. A total of 135 BMA specimens had sufficient residual volume for Xpert® MTB/RIF testing however 22 specimens (16.3%) were not included in the final statistical analysis as an adequate trephine biopsy and/or TB culture was not available. Xpert® MTB/RIF testing was not affected by BMA material in the presence of heparin or EDTA, but the overall detection of MTB in BMA was low compared to histology and culture. Sensitivity of the Xpert® MTB/RIF compared to both histology and culture was 8.7% (95% confidence interval (CI): 1.07-28.04%) and sensitivity compared to histology only was 11.1% (95% CI: 1.38-34.7%). Specificity of the Xpert® MTB/RIF was 98.9% (95% CI: 93.9-99.7%). Although the Xpert® MTB/RIF generates a faster result than histology and TB culture and is less expensive than culture and drug susceptibility testing, the low sensitivity of the Xpert® MTB/RIF precludes its use for the diagnosis of MTB in bone marrow aspirate specimens and warrants alternative/additional testing to optimise the assay.

Keywords: bone marrow aspirate , extrapulmonary TB, low sensitivity, Xpert® MTB/RIF

Procedia PDF Downloads 156

Authors: Cumhur Cansever, Selcuk Er

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There is an increasing cooperation and interaction between the military logistic systems and civil organizations operating in today's market. While the scope and functions of civilian logistics have different characteristics, military logistics tries to import some applications that are conducted by private sectors successfully. Also, at this point, the determination of the optimal point of integration and interaction between civilian and military logistics has emerged as a key issue. In this study, the mutual effects between military and civilian logistics and their most common integration areas, (Supply Chain Management (SCM), Integrated Logistics Support (ILS) and Outsourcing) will be examined with risk analysis and determination of basic skills evaluation methods for determining the optimum point in the integration.

Keywords: core competency, integrated logistics support, outsourcing, supply chain management

Procedia PDF Downloads 516

Authors: Rakan Hassan M. Alzahrani, Ziyad Alzahrani, Bader Bashrahil, Abdulrahman Elyasi, Abdullah a Ghaddaf, Rayan Alzahrani, Mohammed Alkathlan, Nawaf Alghamdi, Dakheelallah Almutairi

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Background: Corticosteroid irrigations, which regularly involve the off-label use of budesonide mixed with normal saline in high volume Sino-nasal irrigations, have been more commonly used in the management of post-operative chronic rhinosinusitis (CRS). Objective: This article attempted to measure the efficacy of post-operative budesonide nasal irrigation compared to normal saline-alone nasal irrigation in the management of chronic rhinosinusitis (CRS) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The databases PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched by two independent authors. Only RCTs comparing budesonide irrigation to normal saline alone irrigation for CRS with or without polyposis after functional endoscopic sinus surgery (FESS) were eligible. A random effect analysis model of the reported CRS-related quality of life (QOL) measures and the objective endoscopic assessment scales of the disease was done. Results: Only 6 RCTs met the eligibility criteria, with a total number of participants of 356. Compared to normal saline irrigation, budesonide nasal irrigation showed statically significant improvements in both the CRS-related quality of life (QOL) and the endoscopic findings (MD= -4.22 confidence interval [CI]: -5.63, -2.82 [P < 0.00001]), (SMD= -0.50 confidence interval [CI]: -0.93, -0.06 [P < 0.03]) respectively. Conclusion: Both intervention arms showed improvements in CRS-related QOL and endoscopic findings in post-FESS chronic rhinosinusitis with or without polyposis. However, budesonide irrigation seems to have a slight edge over conventional normal saline irrigation with no reported serious side effects, including hypothalamic-pituitary-adrenal (HPA) axis suppression.

Keywords: Budesonide, chronic rhinosinusitis, corticosteroids, nasal irrigation, normal saline

Procedia PDF Downloads 64

Authors: Aušra Černauskienė

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The heritage of modern architecture is closely related to the materiality and technology used to implement the buildings. Concrete is one of the most ubiquitous post-war building materials with enormous aesthetic and structural potential that architects have creatively used for everyday buildings and exceptional architectural objects that have survived. Concrete's material, structural, and architectural development over the post-war years has produced a remarkably rich and diverse typology of buildings, for implementation of which unique handicraft skills and industrialized novelties were used. Nonetheless, in the opinion of the public, concrete architecture is often treated as ugly and obsolete, and in Lithuania, it also has negative associations with the scarcity of the Soviet era. Moreover, aesthetic non-appreciation is not the only challenge that concrete architecture meets. It also no longer meets the needs of contemporary requirements: buildings are of poor energy class, have little potential for transformation, and have an obsolete surrounding environment. Thus, as a young heritage, concrete architecture is not yet sufficiently appreciated by society and heritage specialists, as it takes a short time to rethink what they mean from a historical perspective. However, concrete architecture is considered ambiguous but has its character and specificity that needs to be carefully studied in terms of cultural heritage to avoid the risk of poor renovation or even demolition, which has increasingly risen in recent decades in Lithuania. For example, several valuable pieces of post-war concrete architecture, such as the Banga restaurant and the Summer Stage in Palanga, were demolished without understanding their cultural value. Many unique concrete structures and raw concrete surfaces were painted or plastered, paying little attention to the appearance of authentic material. Furthermore, it raises a discussion on how to preserve buildings of different typologies: for example, innovative public buildings in their aesthetic, spatial solutions, and mass housing areas built using precast concrete panels. It is evident that the most traditional preservation strategy, conservation, is not the only option for preserving post-war concrete architecture, and more options should be considered. The first step in choosing the right strategy in each case is an appropriate assessment of the cultural significance. For this reason, an evaluation matrix for post-war concrete architecture is proposed. In one direction, an analysis of different typological groups of buildings is suggested, with the designation of ownership rights; in the other direction – the analysis of traditional value aspects such as aesthetic, technological, and relevant for modern architecture such as social, economic, and sustainability factors. By examining these parameters together, three relevant scenarios for preserving post-war concrete architecture were distinguished: conservation, renovation, and reuse, and they are revealed using examples of concrete architecture in Lithuania.

Keywords: modern heritage, value aspects, typology, conservation, upgrade, reuse

Procedia PDF Downloads 121