Search results for: expert’s preference rating approach
14568 Stakeholder-Driven Development of a One Health Platform to Prevent Non-Alimentary Zoonoses
Authors: A. F. G. Van Woezik, L. M. A. Braakman-Jansen, O. A. Kulyk, J. E. W. C. Van Gemert-Pijnen
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Background: Zoonoses pose a serious threat to public health and economies worldwide, especially as antimicrobial resistance grows and newly emerging zoonoses can cause unpredictable outbreaks. In order to prevent and control emerging and re-emerging zoonoses, collaboration between veterinary, human health and public health domains is essential. In reality however, there is a lack of cooperation between these three disciplines and uncertainties exist about their tasks and responsibilities. The objective of this ongoing research project (ZonMw funded, 2014-2018) is to develop an online education and communication One Health platform, “eZoon”, for the general public and professionals working in veterinary, human health and public health domains to support the risk communication of non-alimentary zoonoses in the Netherlands. The main focus is on education and communication in times of outbreak as well as in daily non-outbreak situations. Methods: A participatory development approach was used in which stakeholders from veterinary, human health and public health domains participated. Key stakeholders were identified using business modeling techniques previously used for the design and implementation of antibiotic stewardship interventions and consisted of a literature scan, expert recommendations, and snowball sampling. We used a stakeholder salience approach to rank stakeholders according to their power, legitimacy, and urgency. Semi-structured interviews were conducted with stakeholders (N=20) from all three disciplines to identify current problems in risk communication and stakeholder values for the One Health platform. Interviews were transcribed verbatim and coded inductively by two researchers. Results: The following key values were identified (but were not limited to): (a) need for improved awareness of veterinary and human health of each other’s fields, (b) information exchange between veterinary and human health, in particularly at a regional level; (c) legal regulations need to match with daily practice; (d) professionals and general public need to be addressed separately using tailored language and information; (e) information needs to be of value to professionals (relevant, important, accurate, and have financial or other important consequences if ignored) in order to be picked up; and (f) need for accurate information from trustworthy, centrally organised sources to inform the general public. Conclusion: By applying a participatory development approach, we gained insights from multiple perspectives into the main problems of current risk communication strategies in the Netherlands and stakeholder values. Next, we will continue the iterative development of the One Health platform by presenting key values to stakeholders for validation and ranking, which will guide further development. We will develop a communication platform with a serious game in which professionals at the regional level will be trained in shared decision making in time-critical outbreak situations, a smart Question & Answer (Q&A) system for the general public tailored towards different user profiles, and social media to inform the general public adequately during outbreaks.Keywords: ehealth, one health, risk communication, stakeholder, zoonosis
Procedia PDF Downloads 28514567 Correlation of Unsuited and Suited 5ᵗʰ Female Hybrid III Anthropometric Test Device Model under Multi-Axial Simulated Orion Abort and Landing Conditions
Authors: Christian J. Kennett, Mark A. Baldwin
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As several companies are working towards returning American astronauts back to space on US-made spacecraft, NASA developed a human flight certification-by-test and analysis approach due to the cost-prohibitive nature of extensive testing. This process relies heavily on the quality of analytical models to accurately predict crew injury potential specific to each spacecraft and under dynamic environments not tested. As the prime contractor on the Orion spacecraft, Lockheed Martin was tasked with quantifying the correlation of analytical anthropometric test devices (ATDs), also known as crash test dummies, against test measurements under representative impact conditions. Multiple dynamic impact sled tests were conducted to characterize Hybrid III 5th ATD lumbar, head, and neck responses with and without a modified shuttle-era advanced crew escape suit (ACES) under simulated Orion landing and abort conditions. Each ATD was restrained via a 5-point harness in a mockup Orion seat fixed to a dynamic impact sled at the Wright Patterson Air Force Base (WPAFB) Biodynamics Laboratory in the horizontal impact accelerator (HIA). ATDs were subject to multiple impact magnitudes, half-sine pulse rise times, and XZ - ‘eyeballs out/down’ or Z-axis ‘eyeballs down’ orientations for landing or an X-axis ‘eyeballs in’ orientation for abort. Several helmet constraint devices were evaluated during suited testing. Unique finite element models (FEMs) were developed of the unsuited and suited sled test configurations using an analytical 5th ATD model developed by LSTC (Livermore, CA) and deformable representations of the seat, suit, helmet constraint countermeasures, and body restraints. Explicit FE analyses were conducted using the non-linear solver LS-DYNA. Head linear and rotational acceleration, head rotational velocity, upper neck force and moment, and lumbar force time histories were compared between test and analysis using the enhanced error assessment of response time histories (EEARTH) composite score index. The EEARTH rating paired with the correlation and analysis (CORA) corridor rating provided a composite ISO score that was used to asses model correlation accuracy. NASA occupant protection subject matter experts established an ISO score of 0.5 or greater as the minimum expectation for correlating analytical and experimental ATD responses. Unsuited 5th ATD head X, Z, and resultant linear accelerations, head Y rotational accelerations and velocities, neck X and Z forces, and lumbar Z forces all showed consistent ISO scores above 0.5 in the XZ impact orientation, regardless of peak g-level or rise time. Upper neck Y moments were near or above the 0.5 score for most of the XZ cases. Similar trends were found in the XZ and Z-axis suited tests despite the addition of several different countermeasures for restraining the helmet. For the X-axis ‘eyeballs in’ loading direction, only resultant head linear acceleration and lumbar Z-axis force produced ISO scores above 0.5 whether unsuited or suited. The analytical LSTC 5th ATD model showed good correlation across multiple head, neck, and lumbar responses in both the unsuited and suited configurations when loaded in the XZ ‘eyeballs out/down’ direction. Upper neck moments were consistently the most difficult to predict, regardless of impact direction or test configuration.Keywords: impact biomechanics, manned spaceflight, model correlation, multi-axial loading
Procedia PDF Downloads 11214566 Fish Is Back but Fishers Are Out: The Dilemma of the Education Methods Adapted for Co-management of the Fishery Resource
Authors: Namubiru Zula, Janice Desire Busingue
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Pro-active educational approaches have lately been adapted Globally in the Conservation of Natural Resources. This led to the introduction of the co-management system, which worked for some European Countries on the conservation of sharks and other Natural resources. However, this approach has drastically failed in the Fishery sector on Lake Victoria; and the punitive education approach has been re-instated. Literature is readily available about the punitive educational approaches and scanty with the pro-active one. This article analyses the pro-active approach adopted by the Department of Fisheries for the orientation of BMU leaders in a co-management system. The study is interpreted using the social constructivist lens for co-management of the fishery resource to ensure that fishers are also back to fishing sustainably. It highlights some of the education methods used, methodological challenges that included the power and skills gap of the facilitators and program designers, and some implications to practice.Keywords: beach management units, fishers, education methods, proactive approach, punitive approach
Procedia PDF Downloads 12214565 Development of Generally Applicable Intravenous to Oral Antibiotic Switch Therapy Criteria
Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon
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Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy
Procedia PDF Downloads 35414564 An Approach to Solving Some Inverse Problems for Parabolic Equations
Authors: Bolatbek Rysbaiuly, Aliya S. Azhibekova
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Problems concerning the interpretation of the well testing results belong to the class of inverse problems of subsurface hydromechanics. The distinctive feature of such problems is that additional information is depending on the capabilities of oilfield experiments. Another factor that should not be overlooked is the existence of errors in the test data. To determine reservoir properties, some inverse problems for parabolic equations were investigated. An approach to solving the inverse problems based on the method of regularization is proposed.Keywords: iterative approach, inverse problem, parabolic equation, reservoir properties
Procedia PDF Downloads 42614563 A Deep Learning Approach to Calculate Cardiothoracic Ratio From Chest Radiographs
Authors: Pranav Ajmera, Amit Kharat, Tanveer Gupte, Richa Pant, Viraj Kulkarni, Vinay Duddalwar, Purnachandra Lamghare
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The cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR, that is, a value greater than 0.55, is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR from chest X-rays (CXRs) aids in the early diagnosis of clinical conditions. We propose a deep learning-based model for automatic CTR calculation that can assist the radiologist with the diagnosis of cardiomegaly and optimize the radiology flow. The study population included 1012 posteroanterior (PA) CXRs from a single institution. The Attention U-Net deep learning (DL) architecture was used for the automatic calculation of CTR. A CTR of 0.55 was used as a cut-off to categorize the condition as cardiomegaly present or absent. An observer performance test was conducted to assess the radiologist's performance in diagnosing cardiomegaly with and without artificial intelligence (AI) assistance. The Attention U-Net model was highly specific in calculating the CTR. The model exhibited a sensitivity of 0.80 [95% CI: 0.75, 0.85], precision of 0.99 [95% CI: 0.98, 1], and a F1 score of 0.88 [95% CI: 0.85, 0.91]. During the analysis, we observed that 51 out of 1012 samples were misclassified by the model when compared to annotations made by the expert radiologist. We further observed that the sensitivity of the reviewing radiologist in identifying cardiomegaly increased from 40.50% to 88.4% when aided by the AI-generated CTR. Our segmentation-based AI model demonstrated high specificity and sensitivity for CTR calculation. The performance of the radiologist on the observer performance test improved significantly with AI assistance. A DL-based segmentation model for rapid quantification of CTR can therefore have significant potential to be used in clinical workflows.Keywords: cardiomegaly, deep learning, chest radiograph, artificial intelligence, cardiothoracic ratio
Procedia PDF Downloads 9614562 Metastasis of Breast Cancer to the Lungs: Implications of Molecular Biology and Treatment Options
Authors: Fakhrosadat Sajjadian
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The majority of deaths in cancer patients are caused by distant metastasis. Breast cancer shows a unique spread pattern, often affecting bone, liver, lung, and brain. Breast cancer can be categorized into various subtypes according to gene expression patterns, and these subtypes exhibit specific preferences for organs where metastasis occurs. Breast tumors with luminal characteristics have a preference for spreading to the bone, whereas basal-like breast cancer (BLBC) shows a tendency to metastasize to the lungs. Still, the mechanisms behind this particular pattern of metastasis in organs have yet to be fully understood. In this evaluation, we will outline the latest progress in molecular signaling pathways and treatment methods for breast cancer lung metastasis.Keywords: lung cancer, liver cancer, diagnosis, BLBC, metastasis
Procedia PDF Downloads 4814561 Geographical Information System and Multi-Criteria Based Approach to Locate Suitable Sites for Industries to Minimize Agriculture Land Use Changes in Bangladesh
Authors: Nazia Muhsin, Tofael Ahamed, Ryozo Noguchi, Tomohiro Takigawa
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One of the most challenging issues to achieve sustainable development on food security is land use changes. The crisis of lands for agricultural production mainly arises from the unplanned transformation of agricultural lands to infrastructure development i.e. urbanization and industrialization. Land use without sustainability assessment could have impact on the food security and environmental protections. Bangladesh, as the densely populated country with limited arable lands is now facing challenges to meet sustainable food security. Agricultural lands are using for economic growth by establishing industries. The industries are spreading from urban areas to the suburban areas and using the agricultural lands. To minimize the agricultural land losses for unplanned industrialization, compact economic zones should be find out in a scientific approach. Therefore, the purpose of the study was to find out suitable sites for industrial growth by land suitability analysis (LSA) by using Geographical Information System (GIS) and multi-criteria analysis (MCA). The goal of the study was to emphases both agricultural lands and industries for sustainable development in land use. The study also attempted to analysis the agricultural land use changes in a suburban area by statistical data of agricultural lands and primary data of the existing industries of the study place. The criteria were selected as proximity to major roads, and proximity to local roads, distant to rivers, waterbodies, settlements, flood-flow zones, agricultural lands for the LSA. The spatial dataset for the criteria were collected from the respective departments of Bangladesh. In addition, the elevation spatial dataset were used from the SRTM (Shuttle Radar Topography Mission) data source. The criteria were further analyzed with factors and constraints in ArcGIS®. Expert’s opinion were applied for weighting the criteria according to the analytical hierarchy process (AHP), a multi-criteria technique. The decision rule was set by using ‘weighted overlay’ tool to aggregate the factors and constraints with the weights of the criteria. The LSA found only 5% of land was most suitable for industrial sites and few compact lands for industrial zones. The developed LSA are expected to help policy makers of land use and urban developers to ensure the sustainability of land uses and agricultural production.Keywords: AHP (analytical hierarchy process), GIS (geographic information system), LSA (land suitability analysis), MCA (multi-criteria analysis)
Procedia PDF Downloads 26214560 Oath Taking-An Approach to Combating Criminality: Challenges and Implication to the Victim Centered Approach in Human Trafficking
Authors: Faith G. Ehiemua, Chandra E. Ulinfun
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This work presents two approaches that use competing models to combat criminality in human trafficking. It argues that oath-taking is an approach used to combat and repress crime by natives of African descent. Therefore, certain value choices reflected explicitly or implicitly in its habitual functioning are features of crime control, a model of the criminal process used to repress and prevent crime. By pitting the approaches against each other, the work examines the utility of the purpose of each approach with the aim of assessing moral worthiness. The approaches adopted are descriptive, normative, and theoretical. The findings reveal that oath-taking is effective in human trafficking mainly because Africans believe that the African traditional system is efficient. However, the utilitarian ethical theory applied to the use of oath-taking in human trafficking shows oath-taking as protecting the interest of human traffickers against the general good of society.Keywords: human rights, human trafficking, oath taking, utilitarianism, victim-centered approach
Procedia PDF Downloads 21414559 Evaluation of Regional Anaesthesia Practice in Plastic Surgery: A Retrospective Cross-Sectional Study
Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam
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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia
Procedia PDF Downloads 8314558 Development and Psychometric Properties of the Dutch Contextual Assessment of Social Skills: A Blinded Observational Outcome Measure of Social Skills for Adolescents with Autism Spectrum Disorder
Authors: Sakinah Idris, Femke Ten Hoeve, Kirstin Greaves-Lord
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Background: Social skills interventions are considered to be efficacious if social skills are improved as a result of an intervention. Nevertheless, the objective assessment of social skills is hindered by a lack of sensitive and validated measures. To measure the change in social skills after an intervention, questionnaires reported by parents, clinicians and/or teachers are commonly used. Observations are the most ecologically valid method of assessing improvements in social skills after an intervention. For this purpose, The Program for the Educational and Enrichment of Relational Skills (PEERS) was developed for adolescents, in order to teach them the age-appropriate skills needed to participate in society. It is an evidence-based intervention for adolescents with ASD that taught ecologically valid social skills techniques. Objectives: The current study aims to describe the development and psychometric evaluation of the Dutch Contextual Assessment of Social Skills (CASS), an observational outcome measure of social skills for adolescents with Autism Spectrum Disorder (ASD). Methods: 64 adolescents (M = 14.68, SD = 1.41, 71% boys) with ASD performed the CASS before and after a social skills intervention (i.e. PEERS or the active control condition). Each adolescent completed a 3-minute conversation with a confederate. The conversation was prompt as a natural introduction between two-unfamiliar, similar ages, opposite-sex peers who meet for the first time. The adolescent and the confederate completed a brief questionnaire about the conversation (Conversation Rating Scale). Results: Results indicated sufficient psychometric properties. The Dutch CASS has a high level of internal consistency (Cronbach's α coefficients = 0.84). Data supported the convergent validity (i.e., significant correlated with the Social Skills Improvement System (SSiS). The Dutch CASS did not significantly correlate with the autistic mannerism subscale from Social Responsiveness Scale (SRS), thus proved the divergent validity. Based on scorings made by raters who were kept blind to the time points, reliable change index was computed to assess the change in social skills. With regard to the content validity, only the learning objectives of the first two meetings of PEERS about conversational skills relatively matched with rating domains of the CASS. Due to this underrepresentation, we found an existing observational measure (TOPICC) that covers some of the other learning objectives of PEERS. TOPICC covers 22% of the learning objectives of PEERS about conversational skills, meanwhile, CASS is 45%. Unfortunately, 33% of the learning objectives of PEERS was not covered by CASS or TOPICC. Conclusion: Recommendations are made to improve the psychometric properties and content validity of the Dutch CASS.Keywords: autism spectrum disorder, observational, PEERS, social skills
Procedia PDF Downloads 15414557 Building and Development of the Stock Market Institutional Infrastructure in Russia
Authors: Irina Bondarenko, Olga Vandina
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The theory of evolutionary economics is the basis for preparation and application of methods forming the stock market infrastructure development concept. The authors believe that the basis for the process of formation and development of the stock market model infrastructure in Russia is the theory of large systems. This theory considers the financial market infrastructure as a whole on the basis of macroeconomic approach with the further definition of its aims and objectives. Evaluation of the prospects for interaction of securities market institutions will enable identifying the problems associated with the development of this system. The interaction of elements of the stock market infrastructure allows to reduce the costs and time of transactions, thereby freeing up resources of market participants for more efficient operation. Thus, methodology of the transaction analysis allows to determine the financial infrastructure as a set of specialized institutions that form a modern quasi-stable system. The financial infrastructure, based on international standards, should include trading systems, regulatory and supervisory bodies, rating agencies, settlement, clearing and depository organizations. Distribution of financial assets, reducing the magnitude of transaction costs, increased transparency of the market are promising tasks in the solution for questions of services level and quality increase provided by institutions of the securities market financial infrastructure. In order to improve the efficiency of the regulatory system, it is necessary to provide "standards" for all market participants. The development of a clear regulation for the barrier to the stock market entry and exit, provision of conditions for the development and implementation of new laws regulating the activities of participants in the securities market, as well as formulation of proposals aimed at minimizing risks and costs, will enable the achievement of positive results. The latter will be manifested in increasing the level of market participant security and, accordingly, the attractiveness of this market for investors and issuers.Keywords: institutional infrastructure, financial assets, regulatory system, stock market, transparency of the market
Procedia PDF Downloads 13314556 Internal Migration and Poverty Dynamic Analysis Using a Bayesian Approach: The Tunisian Case
Authors: Amal Jmaii, Damien Rousseliere, Besma Belhadj
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We explore the relationship between internal migration and poverty in Tunisia. We present a methodology combining potential outcomes approach with multiple imputation to highlight the effect of internal migration on poverty states. We find that probability of being poor decreases when leaving the poorest regions (the west areas) to the richer regions (greater Tunis and the east regions).Keywords: internal migration, potential outcomes approach, poverty dynamics, Tunisia
Procedia PDF Downloads 30814555 Manufacturing Facility Location Selection: A Numercal Taxonomy Approach
Authors: Seifoddini Hamid, Mardikoraeem Mahsa, Ghorayshi Roya
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Manufacturing facility location selection is an important strategic decision for many industrial corporations. In this paper, a new approach to the manufacturing location selection problem is proposed. In this approach, cluster analysis is employed to identify suitable manufacturing locations based on economic, social, environmental, and political factors. These factors are quantified using the existing real world data.Keywords: manufacturing facility, manufacturing sites, real world data
Procedia PDF Downloads 56114554 Psycholinguistic Analysis on Stuttering Treatment through Systemic Functional Grammar in Tom Hooper’s The King’s Speech
Authors: Nurvita Wijayanti
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The movie titled The King’s Speech is based on a true story telling an English king suffers from stuttering and how he gets the treatment from the therapist, so that he can reduce the high frequency on stuttering. The treatment uses the unique approach implying the linguistic principles. This study shows how the language works significantly in order to treat the stuttering sufferer using psychological approach. Therefore, the linguistic study is done to analyze the treatment activity. Halliday’s Systemic Functional Grammar is used as the main approach in this study along with qualitative descriptive method. The study finds that the therapist though using the orthodox approach applies the psycholinguistic method to overcome the king’s stuttering.Keywords: psycholinguistics, stuttering, systemic functional grammar, treatment
Procedia PDF Downloads 25014553 Preoperative Anxiety Evaluation: Comparing the Visual Facial Anxiety Scale/Yumul Faces Anxiety Scale, Numerical Verbal Rating Scale, Categorization Scale, and the State-Trait Anxiety Inventory
Authors: Roya Yumul, Chse, Ofelia Loani Elvir Lazo, David Chernobylsky, Omar Durra
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Background: Preoperative anxiety has been shown to be caused by the fear associated with surgical and anesthetic complications; however, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting given the duration and concentration required to complete the 40-item extensive questionnaire. Our primary aim in the study is to investigate the correlation of the Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparison analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusions: Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul FACES Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul FACES Anxiety Scale are merited.Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale
Procedia PDF Downloads 13914552 Implementation of the Collaborative Learning Approach in Learning of Second Language English
Authors: Ashwini Mahesh Jagatap
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This paper presents the language learning strategy with respect to speaking skill with collaborative learning approach. Collaborative learning has been proven to be efficient learning methodology for all kinds of students. Students are working in groups of two or more, reciprocally searching for understanding, Solutions, or meanings, or creating a product. The presentation highlights the different stages which can be implemented during actual implementation of the methodology in the class room teaching learning process.Keywords: collaborative classroom, collaborative learning approach, language skills, traditional teaching
Procedia PDF Downloads 57114551 Entrepreneurial Ecosystems and Innovation Systems: An Appraisal of Literature
Authors: Jose Carlos Rodriguez, Mario Gomez
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In the last years, the concept of entrepreneurial ecosystems has gained popularity. It reveals the importance of a supportive community and adequate economic environment for entrepreneurial activity, and thus the possibility of developing a different perspective on the innovation system. On the other hand, the (regional/technology) innovation system approach lacks in its analyses the presence of an entrepreneur as a key actor that develops innovations. In this regard, this paper examines the foundations of both theoretical approaches (the entrepreneurial ecosystems and the regional/technology systems of innovation) and their contributions to understand entrepreneurial activity at different levels of analyses, namely national, regional or local. The paper makes a literature review on both perspectives of innovation stressing the role played by entrepreneurs in these theoretical approaches. It concludes remarking that the regional/technology innovation systems approach and the entrepreneurial ecosystem approach have established themselves in their own right, but the regional/technology innovation system approach is a predecessor of the entrepreneurial ecosystem approach.Keywords: entrepreneurial ecosystems, innovation systems, entrepreneurial activity, comparative analysis
Procedia PDF Downloads 18014550 Language Activation Theory: Unlocking Bilingual Language Processing
Authors: Leorisyl D. Siarot
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It is conventional to see and hear Filipinos, in general, speak two or more languages. This phenomenon brings us to a closer look on how our minds process the input and produce an output with a specific chosen language. This study aimed to generate a theoretical model which explained the interaction of the first and the second languages in the human mind. After a careful analysis of the gathered data, a theoretical prototype called Language Activation Model was generated. For every string, there are three specialized banks: lexico-semantics, morphono-syntax, and pragmatics. These banks are interrelated to other banks of other language strings. As the bilingual learns more languages, a new string is replicated and is filled up with the information of the new language learned. The principles of the first and second languages' interaction are drawn; these are expressed in laws, namely: law of dominance, law of availability, law of usuality and law of preference. Furthermore, difficulties encountered in the learning of second languages were also determined.Keywords: bilingualism, psycholinguistics, second language learning, languages
Procedia PDF Downloads 51014549 Working From Home: On the Relationship Between Place Attachment to Work Place, Extraversion and Segmentation Preference to Burnout
Authors: Diamant Irene, Shklarnik Batya
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In on to its widespread effects on health and economic issues, Covid-19 shook the work and employment world. Among the prominent changes during the pandemic is the work-from-home trend, complete or partial, as part of social distancing. In fact, these changes accelerated an existing tendency of work flexibility already underway before the pandemic. Technology and means of advanced communications led to a re-assessment of “place of work” as a physical space in which work takes place. Today workers can remotely carry out meetings, manage projects, work in groups, and different research studies point to the fact that this type of work has no adverse effect on productivity. However, from the worker’s perspective, despite numerous advantages associated with work from home, such as convenience, flexibility, and autonomy, various drawbacks have been identified such as loneliness, reduction of commitment, home-work boundary erosion, all risk factors relating to the quality of life and burnout. Thus, a real need has arisen in exploring differences in work-from-home experiences and understanding the relationship between psychological characteristics and the prevalence of burnout. This understanding may be of significant value to organizations considering a future hybrid work model combining in-office and remote working. Based on Hobfoll’s Theory of Conservation of Resources, we hypothesized that burnout would mainly be found among workers whose physical remoteness from the workplace threatens or hinders their ability to retain significant individual resources. In the present study, we compared fully remote and partially remote workers (hybrid work), and we examined psychological characteristics and their connection to the formation of burnout. Based on the conceptualization of Place Attachment as the cognitive-emotional bond of an individual to a meaningful place and the need to maintain closeness to it, we assumed that individuals characterized with Place Attachment to the workplace would suffer more from burnout when working from home. We also assumed that extrovert individuals, characterized by the need of social interaction at the workplace and individuals with segmentationpreference – a need for separation between different life domains, would suffer more from burnout, especially among fully remote workers relative to partially remote workers. 194 workers, of which 111 worked from home in full and 83 worked partially from home, aged 19-53, from different sectors, were tested using an online questionnaire through social media. The results of the study supported our assumptions. The repercussions of these findings are discussed, relating to future occupational experience, with an emphasis on suitable occupational adjustment according to the psychological characteristics and needs of workers.Keywords: working from home, burnout, place attachment, extraversion, segmentation preference, Covid-19
Procedia PDF Downloads 19014548 Improving the Uptake of Community-Based Multidrug-Resistant Tuberculosis Treatment Model in Nigeria
Authors: A. Abubakar, A. Parsa, S. Walker
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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach
Procedia PDF Downloads 12114547 Examination of the Impact of Projects Based on Reggio Emilia Approach on the Creative Thinking Skills of Preschool Children: A Qualitative Study
Authors: Arzu Akar Gençer, Mübeccel Gönen
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The objective of the study is to investigate the impact of the projects based on Reggio Emilia Approach, on the creative thinking skills of preschool children. The study is carried out with eighteen 6 years old children in a class of a preschool, and entailed the development of projects based on Reggio Emilia approach with the children, for a period of 3 months. The study employs qualitative model. The children were analyzed with reference to the creative thinking aspects (rationality, originality, flexibility, and applicability) of the projects applied. As the projects based on Reggio Emilia approach arose out of the interests and curiosity of the children, and had their roots in the existing class culture, it is possible to conclude that they have an impact on the creativity of the children with reference to the aspects of creative thinking.Keywords: Reggio Emilia approach, project, creativity, preschool children
Procedia PDF Downloads 58014546 Translation And Cultural Adaptation Of The Rivermead Behavioural Memory Test–3rd Edition Into the Arabic Language
Authors: Mai Alharthy, Agnes Shiel, Hynes Sinead
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Objectives: The objectives of the study are to translate and culturally adapt the RBMT-3 to be appropriate for use within an Arabic-speaking population and to achieve maximum equivalency between the translated and original versions and to evaluate the psychometric properties of the Arabic version of the RBMT-3. Participants' numbers are 16 (10 females and 6 males). All participants are bilingual speakers of Arabic and English, above 18 years old and with no current nor past memory impairment. Methods: The study was conducted in two stages: Translation and cultural adaptation stage: Forward and backward translations were completed by professional translators. Five out of the 14 RBMT-3 subtests required cultural adaptations. Half of the faces in the face recognition subtests were replaced with Arabic faces by a professional photographer. Pictures that are irrelevant to the Arabic culture in the picture recognition subtests were replaced. Names, story and orientations subtests were also adapted to suit the Arabic culture. An expert committee was formed to compare the translated and original versions and to advise on further changes required for test materials. Validation of the Arabic RBMT-3- pilot: 16 Participants were tested on version 1 of the English version and the two versions of the Arabic RBMT-3 ( counterbalanced ). The assessment period was 6 weeks long, with two weeks gap between tests. All assessments took place in a quiet room in the National University of Ireland Galway. Two qualified occupational therapists completed the assessments. Results: Wilcox signed-rank test was used to compare between subtest scores. Significant differences were found in the story, orientation and names subtests between the English and Arabic versions. No significant differences were found in subtests from both Arabic versions except for the story subtest. Conclusion: The story and orientation subtests should be revised by the expert committee members to make further adaptations. The rest of the Arabic RBMT-3 subtests are equivalent to the subtests of the English version. The psychometric properties of the Arabic RBMT-3 will be investigated in a larger Arabic-speaking sample in Saudi Arabia. The outcome of this research is to provide clinicians and researchers with a reliable tool to assess memory problems in Arabic speaking population.Keywords: memory impairment, neuropsychological assessment, cultural adaptation, cognitive assessment
Procedia PDF Downloads 25514545 Electret: A Solution of Partial Discharge in High Voltage Applications
Authors: Farhina Haque, Chanyeop Park
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The high efficiency, high field, and high power density provided by wide bandgap (WBG) semiconductors and advanced power electronic converter (PEC) topologies enabled the dynamic control of power in medium to high voltage systems. Although WBG semiconductors outperform the conventional Silicon based devices in terms of voltage rating, switching speed, and efficiency, the increased voltage handling properties, high dv/dt, and compact device packaging increase local electric fields, which are the main causes of partial discharge (PD) in the advanced medium and high voltage applications. PD, which occurs actively in voids, triple points, and airgaps, is an inevitable dielectric challenge that causes insulation and device aging. The aging process accelerates over time and eventually leads to the complete failure of the applications. Hence, it is critical to mitigating PD. Sharp edges, airgaps, triple points, and bubbles are common defects that exist in any medium to high voltage device. The defects are created during the manufacturing processes of the devices and are prone to high-electric-field-induced PD due to the low permittivity and low breakdown strength of the gaseous medium filling the defects. A contemporary approach of mitigating PD by neutralizing electric fields in high power density applications is introduced in this study. To neutralize the locally enhanced electric fields that occur around the triple points, airgaps, sharp edges, and bubbles, electrets are developed and incorporated into high voltage applications. Electrets are electric fields emitting dielectric materials that are embedded with electrical charges on the surface and in bulk. In this study, electrets are fabricated by electrically charging polyvinylidene difluoride (PVDF) films based on the widely used triode corona discharge method. To investigate the PD mitigation performance of the fabricated electret films, a series of PD experiments are conducted on both the charged and uncharged PVDF films under square voltage stimuli that represent PWM waveform. In addition to the use of single layer electrets, multiple layers of electrets are also experimented with to mitigate PD caused by higher system voltages. The electret-based approach shows great promise in mitigating PD by neutralizing the local electric field. The results of the PD measurements suggest that the development of an ultimate solution to the decades-long dielectric challenge would be possible with further developments in the fabrication process of electrets.Keywords: electrets, high power density, partial discharge, triode corona discharge
Procedia PDF Downloads 20114544 Positioning Analysis of Atlantic Canadian Provinces as Travel Destinations by Americans
Authors: Dongkoo Yun, Melissa James-MacEachern
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This study analyzes Americans’ views of four Atlantic Canadian provinces as travel destinations regarding specific destination attributes for a pleasure trip, awareness (heard) of the destinations, past visit to the destinations during the prior two years, and intention to visit in the next two years. Results indicate that American travellers perceived the four Atlantic Canadian provinces as separate and distinct when rating best-fit destination attributes to each destination. The results suggest that travel destinations, specifically the four selected destinations, must be prepared to differentiate their destination’s image and the range of experiences and services to appeal and attract more American travellers.Keywords: American perceptions, Atlantic Canadian provinces, competitiveness, positioning analysis
Procedia PDF Downloads 27514543 A Bundled Approach to Explaining Technological Change: The Case of E-Estonia
Authors: Andrew Adjah Sai, Portia Opoku Boadi
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Explaining change is an abstract endeavor. Many management scholars have adopted metaphors to explain change. In this paper, we deal with the drivers of technological change. We use a historical and theoretical approach to review and elaborate on the concepts and context about a specific case. We discuss the limitations of each approach proffered and the implications as a consequence on technological change. We present plurality and multiplicity of perspectives using a socio-technical approach to explain technological change contextually on an organizational level. We show by using our model how technology absorption and diffusion can be accelerated through artefactual institutions to enable social change. The multiplicity of perspectives and plurality of our arguments creates a fine explanation of the e-Estonia case as an example.Keywords: artefactual institutions, e-Estonia, social change, technological trajectories
Procedia PDF Downloads 44614542 The Effect of Family Controlling Ownership on Financing Policy
Authors: Vera Diyanty, Akhmad Syahroza
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This research aims to describe an empirical evidence of the influence of family control on the company’s financing policy. Additionally, this research also shows the effect of leadership from family member and the effectiveness of the board of commissioners on companies’ financing policy. The result of this study found that family control through direct and indirect ownership mechanism have a positive impact on the choice of bank loan compare to public debt. Nevertheless, this research also shows that companies’ founders who become CEO and the effectiveness of board of commissioners do not prove to increase the alignment effect nor decrease the negative impact of entrenchment effect on the bank loan preference.Keywords: family controlling, family CEO, board effectiveness, financing policy
Procedia PDF Downloads 45514541 The Transcutaneous Auricular Vagus Nerve Stimulation in Treatment of Depression and Anxiety Disorders in Recovery Patient with Feeding and Eating Disorders
Authors: Y. Melis, E. Apicella, E. Dozio, L. Mendolicchio
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Introduction: Feeding and Eating Disorders (FED) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. In FED, there is a spectrum of symptoms which with TaVNS (Transcutaneous Auricular Vagus Nerve Stimulation) therapy, is possible to have a therapeutic efficacy. Materials and Methods: Sample subjects are composed of 15 female subjects aged > 18 ± 51. Admitted to a psychiatry community having been diagnosed according to DSM-5: anorexia nervosa (AN) (N= 9), bulimia nervosa (BN) (N= 5), binge eating disorder (BED) (N= 1). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS-17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p > 0.05) in HAM-D (t0 = 18.28 ± 5.31; t4 = 9.14 ± 7.15), in BAI (t0 = 24.7 ± 10.99; t4 = 13.8 ± 7.0). The reported values show how during (T0-T4) the treatment there is a decay of the degree in the depressive state, in the state of anxiety, and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of HRV did not show a clear change among subjects, thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in FED. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger population, this study reports how the application of neuro-stimulation in FED may become a further approach therapeutic. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study.Keywords: feeding and eating disorders, neurostimulation, anxiety disorders, depression
Procedia PDF Downloads 14414540 Non-Destructive Visual-Statistical Approach to Detect Leaks in Water Mains
Authors: Alaa Al Hawari, Mohammad Khader, Tarek Zayed, Osama Moselhi
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In this paper, an effective non-destructive, non-invasive approach for leak detection was proposed. The process relies on analyzing thermal images collected by an IR viewer device that captures thermo-grams. In this study a statistical analysis of the collected thermal images of the ground surface along the expected leak location followed by a visual inspection of the thermo-grams was performed in order to locate the leak. In order to verify the applicability of the proposed approach the predicted leak location from the developed approach was compared with the real leak location. The results showed that the expected leak location was successfully identified with an accuracy of more than 95%.Keywords: thermography, leakage, water pipelines, thermograms
Procedia PDF Downloads 35314539 Narratives of Self-Renewal: Looking for A Middle Earth In-Between Psychoanalysis and the Search for Consciousness
Authors: Marilena Fatigante
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Contemporary psychoanalysis is increasingly acknowledging the existential demands of clients in psychotherapy. A significant aspect of the personal crises that patients face today is often rooted in the difficulty to find meaning in their own existence, even after working through or resolving traumatic memories and experiences. Tracing back to the correspondence between Freud and Romain Rolland (1927), psychoanalysis could not ignore that investigation of the psyche also encompasses the encounter with deep, psycho-sensory experiences, which involve a sense of "being one with the external world as a whole", the well-known “oceanic feeling”, as Rolland posed it. Despite the recognition of Non-ordinary States of Consciousness (NSC) as catalysts for transformation in clinical practice, highlighted by neuroscience and results from psychedelic-assisted therapies, there is few research on how psychoanalytic knowledge can integrate with other treatment traditions. These traditions, commonly rooted in non -Western, unconventional, and non-formal psychological knowledge, emphasize the individual’s innate tendency toward existential integrity and transcendence of self-boundaries. Inspired by an autobiographical account, this paper examines narratives of 12 individuals, who engaged in psychoanalytic therapy and also underwent treatment involving a non-formal helping relationship with an expert guide in consciousness, which included experience of this nature. The guide relies on 35 yrs of experience in Psychological, multidisciplinary studies in Human Sciences and Art, and demonstrates knowledge of many wisdom traditions, ranging from Eastern to Western philosophy, including Psychoanalysis and its development in cultural perspective (e.g, Ethnopsychiatry). Analyses focused primarily on two dimensions that research has identified as central in assessing the degree of treatment “success” in the patients’ narrative accounts of their therapies: agency and coherence, defined respectively as the increase, expressed in language, of the client’s perceived ability to manage his/her own challenges and the capacity, inherent in “narrative” itself as a resource for meaning making (Bruner, 1990), to provide the subject with a sense of unity, endowing his /her life experience with temporal and logical sequentiality. The present study reports that, in all narratives from the participants, agency and coherence are described differently than in “common” psychotherapy narratives. Although the participants consistently identified themselves as responsible agentic subject, the sense of agency derived from the non-conventional guidance pathway is never reduced to a personal, individual accomplishment. Rather, the more a new, fuller sense of “Life” (more than “Self”) develops out of the guidance pathway they engage with the expert guide, the more they “surrender” their own sense of autonomy and self-containment. Something, which Safran (2016) identified as well talking about the sense of surrender and “grace” in psychoanalytic sessions. Secondly, narratives of individuals engaging with the expert guide describe coherence not as repairing or enforcing continuity but as enhancing their ability to navigate dramatic discontinuities, falls, abrupt leaps and passages marked by feelings of loss and bereavement. The paper ultimately explores whether valid criteria can be established to analyze experiences of non-conventional paths of self-evolution. These paths are not opposed or alternative to conventional ones, and should not be simplistically dismissed as exotic or magical.Keywords: oceanic feeling, non conventional guidance, consciousness, narratives, treatment outcomes
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