Search results for: patient centered decision making

Authors: Bindhiya Thomas, Rehana Hafeez

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Background: The Surgical Ambulatory Unit (SAU) also known as the Same Day Emergency Care (SDEC) is an established part of many hospitals providing same day emergency care service to surgical patients who would have otherwise required admission through the A&E. Prior to Covid, the SAU was functioning as a 12-hour service, but during the Covid crisis this service was transformed to a 24 hour functioning Surgical Ambulatory Assessment unit (SAAU). We studied the effects that this change brought about in-patient care in our hospital. Objective: The objective of the study was to assess the impact of a 24-hour Surgical Ambulatory Assessment unit on patient care during the time of Covid, in particular its role in freeing A&E capacity and delivering effective patient care. Methods: We collected two sets of data retrospectively. The first set was collected over a 6-week period when the SAU was functioning at the Princess Royal University Hospital. On March 23rd, 2020, the SAU was transformed into a 24-hour SAAU. Following this transformation, a second set of patient data was collected over a period of 6 weeks. A comparison was made between data collected from when the hospital had a 12-hour Surgical Ambulatory unit and later when it was transformed into a 24-hour facility. Its effects on the change in the number of patients breaching the four hour waiting period and the number of emergency surgical admissions. Results: The 24-hour Surgical Ambulatory Assessment unit brought significant reductions in the number of patients breaching the waiting period of 4 hours in A&E from 44% during the period of the 12-hour Surgical Ambulatory care facility to 0% from when the 24-hour Surgical Ambulatory Assessment Unit was established. A 28% reduction was also seen in the number of surgical patients' admissions from A&E. Conclusions: The 24-hour SAAU was found to have a profound positive impact on emergency care of surgical patients. Especially during the Covid crisis, it played a crucial role in providing not only effective and accessible patient care but also in reducing the A&E workload and admissions. It thus proved to be a strategic tool that helped to deal with the immense workload in emergency care during the Covid crisis and helped free much needed headspace at a time of uncertainty for the A&E to better configure their services. If sustained, the 24-hour SAAU could be relied on to augment the NHS emergency services in the future, especially in the event of another crisis.

Keywords: Princess Royal University Hospital, surgical ambulatory assessment unit, surgical ambulatory unit, same day emergency care

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Authors: Qudsiya Baig

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Empathy yields an unparalleled therapeutic value within patient physician interactions. Medical research is inundated with evidence to support that a physician’s ability to empathise with patients leads to a greater willingness to report symptoms, an improvement in diagnostic accuracy and safety, and a better adherence and satisfaction with treatment plans. Furthermore, the Institute of Medicine states that empathy leads to a more patient-centred care, which is one of the six main goals of a 21st century health system. However, there is a paradox between the theoretical significance of empathy and its presence, or lack thereof, in clinical practice. Recent studies have reported that empathy declines amongst students and physicians over time. The three most impactful contributors to this decline are: (1) disagreements over the definitions of empathy making it difficult to implement it into practice (2) poor consideration or regulation of empathy leading to burnout and thus, abandonment altogether, and (3) the lack of diversity in the curriculum and the influence of medical culture, which prioritises science over patient experience, limiting some physicians from using ‘too much’ empathy in the fear of losing clinical objectivity. These issues were investigated by conducting a fully inductive thematic narrative analysis of patient narratives in the UK to evaluate the behaviours and attitudes that patients associate with empathy. The principal enquiries underpinning this study included uncovering the factors that affected experience of empathy within provider-patient interactions and to analyse their effects on patient care. This research contributes uniquely to this discourse by examining the phenomenon of empathy directly from patients’ experiences, which were systematically extracted from a repository of online patient narratives of care titled ‘CareOpinion UK’. Narrative analysis was specifically chosen as the methodology to examine narratives from a phenomenological lens to focus on the particularity and context of each story. By enquiring beyond the superficial who-whatwhere, the study of narratives prescribed meaning to illness by highlighting the everyday reality of patients who face the exigent life circumstances created by suffering, disability, and the threat of life. The following six themes were found to be the most impactful in influencing the experience of empathy: dismissive behaviours, judgmental attitudes, undermining patients’ pain or concerns, holistic care and failures and successes of communication or language. For each theme there were overarching themes relating to either a failure to understand the patient’s perspective or a success in taking a person-centred approach. An in-depth analysis revealed that a lack of empathy was greatly associated with an emotive-cognitive imbalance, which disengaged physicians with their patients’ emotions. This study hereby concludes that competent providers require a combination of knowledge, skills, and more importantly empathic attitudes to help create a context for effective care. The crucial elements of that context involve (a) identifying empathy clues within interactions to engage with patients’ situations, (b) attributing a perspective to the patient through perspective-taking and (c) adapting behaviour and communication according to patient’s individual needs. Empathy underpins that context, as does an appreciation of narrative, and the two are interrelated.

Keywords: empathy, narratives, person-centred, perspective, perspective-taking

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Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons

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Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.

Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team

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Authors: K. S. Parlak, E. Turan

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The separation of marbles according to the pattern quality is a process made according to expert decision. The classification phase is the most critical part in terms of economic value. In this study, a self-learning system is proposed which performs the classification of marbles quickly and with high success. This system performs ten feature extraction by taking ten marble images from the camera. The marbles are classified by decision tree method using the obtained properties. The user forms the training set by training the system at the marble classification stage. The system evolves itself in every marble image that is classified. The aim of the proposed system is to minimize the error caused by the person performing the classification and achieve it quickly.

Keywords: decision tree, feature extraction, k-means clustering, marble classification

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Authors: Syed Qasim Gilani, Muhammad Umair, Muhammad Noman, Syed Bilawal Shah, Aqib Abbasi, Muhammad Waheed

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Cardiovascular Diseases(CVD's) are the major cause of death in the world. The main reason for these deaths is the unavailability of first aid for heart failure. In many cases, patients die before reaching the hospital. We in this paper are presenting innovative online health service for Cardiac Patients. The proposed online health system has two ends. Users through device developed by us can communicate with their doctor through a mobile application. This interface provides them with first aid.Also by using this service, they have an easy interface with their doctors for attaining medical advice. According to the proposed system, we developed a device called Cardiac Care. Cardiac Care is a portable device which a patient can use at their home for monitoring heart condition. When a patient checks his/her heart condition, Electrocardiogram (ECG), Blood Pressure(BP), Temperature are sent to the central database. The severity of patients condition is checked using Artificial Intelligence Algorithm at the database. If the patient is suffering from the minor problem, our algorithm will suggest a prescription for patients. But if patient's condition is severe, patients record is sent to doctor through the mobile Android application. Doctor after reviewing patients condition suggests next step. If a doctor identifies the patient condition as critical, then the message is sent to the central database for sending an ambulance for the patient. Ambulance starts moving towards patient for bringing him/her to hospital. We have implemented this model at prototype level. This model will be life-saving for millions of people around the globe. According to this proposed model patients will be in contact with their doctors all the time.

Keywords: cardiovascular disease, classification, electrocardiogram, blood pressure

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Authors: A. M. Bumbea, A. Musetescu, P. Ciurea, A. Bighea

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Objectives: The authors present a Parsonage Turner syndrome, a rare disease characterized by onset in apparently healthy person with shoulder and/or arm pain, sensory deficit, motor deficit. The causes are not established, could be determinate by vaccination, postoperative, immunologic disease, post traumatic etc. Methods: The authors present a woman case, 32 years old, (in 2006), no medical history, with arm pain and no other symptom. The onset was sudden with pain at very high level quantified as 10 to a 0 to 10 scale, with no response to classical analgesic and corticoids. The only drugs which can reduce the intensity of pain were oxycodone hydrochloride, 60 mg daily and pregabalinum150 mg daily. After two weeks the intensity of pain was reduced to 5. The patient started a rehabilitation program. After 6 weeks the patient associated sensory and motor deficit. We performed electromyography for upper limb that showed incomplete denervation with reduced neural transmission speed. The patient receives neurotrophic drugs and painkillers for a long period and physical and kinetic therapy. After 6 months the pain was reduced to level 2 and the patient maintained only 150 mg pregabalinum for another 6 months. Then, the evaluation showed no pain but general amiotrophy in upper limb. Results: At the evaluation in 2009, the patient developed a rheumatoid syndrome with tender and swelling joints, but no positive inflammation test, no antibodies or rheumatoid factor. After two years, in 2011 the patient develops an increase of antinuclear antibodies. This context certifies the diagnosis of lupus and the patient receives the specific therapy. Conclusions: This case is not a typical case of onset of lupus with PTS, but the onset of PTS could include the onset of an immune disease.

Keywords: lupus, arm pain, patient, swelling

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Authors: David Cook, Brynhildur Davidsdottir, Dadi. M. Kristofersson

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The approval of development projects with significant environmental impacts implies that the economic costs of the affected environmental resources must be less than the financial benefits, but such irreversible decisions are frequently made without ever attempting to estimate the monetary value of the losses. Due to this knowledge gap in the processes informing decision-making, development projects are commonly approved despite the potential for social welfare to be undermined. Heeding a repeated call by the OECD to commence economic accounting of environmental impacts as part of the cost-benefit analysis process for Icelandic energy projects, this paper sets out the results pertaining to the nation’s first two contingent valuation studies of geothermal areas likely to be developed in the near future. Interval regression using log-transformation was applied to estimate willingness to pay (WTP) for the preservation of the high-temperature Eldvörp and Hverahlíð fields. The estimated mean WTP was 8,333 and 7,122 ISK for Eldvörp and Hverahlíð respectively. Scaled up to the Icelandic population of national taxpayers, this equates to estimated total economic value of 2.10 and 1.77 billion ISK respectively. These results reinforce arguments in favour of accounting for the environmental impacts of Iceland’s future geothermal power projects as a mandatory component of the exploratory and production license application process. Further research is necessary to understand the economic impacts to specific ecosystem services associated with geothermal environments, particularly connected to changes in recreational amenity. In so doing, it would be possible to gain greater comprehension of the various components of total economic value, evolving understanding of why one geothermal area – in this case, Eldvörp – has a higher preservation value than another.

Keywords: decision-making, contingent valuation, geothermal energy, preservation

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Authors: Peri Harish Kumar, Rafique Umer Harvitkar

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Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

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Authors: Gizelle K. Vianna, Gustavo S. Oliveira, Gabriel V. Cunha

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The use of decision support systems in agriculture may help monitoring large fields of crops by automatically detecting the symptoms of foliage diseases. In our work, we designed and implemented a decision support system for small tomatoes producers. This work investigates ways to recognize the late blight disease from the analysis of digital images of tomatoes, using a pair of multilayer perceptron neural networks. The networks outputs are used to generate repainted tomato images in which the injuries on the plant are highlighted, and to calculate the damage level of each plant. Those levels are then used to construct a situation map of a farm where a cellular automata simulates the outbreak evolution over the fields. The simulator can test different pesticides actions, helping in the decision on when to start the spraying and in the analysis of losses and gains of each choice of action.

Keywords: artificial neural networks, cellular automata, decision support system, pattern recognition

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Authors: Bassem M. Darwish, Robert H. Ablove

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Introduction: Total knee arthroscopy (TKA) is a commonly performed procedure in patients with end-stage osteoarthritis and inaccuracy of component alignment in TKA has been shown to have many adverse post-operative outcomes such as accelerated implant wear, reduced functional outcomes, and shorter overall implant survival. Robotic surgical systems have been introduced to try and improve joint alignment and functional outcomes in knee arthroscopy, one recent iteration is the ROSA knee system, released to the market in 2019. The objective of this scoping review is to map the available evidence, identify the current types of evidence, and identify knowledge gaps to guide future studies on patient outcomes following ROSA-assisted total knee arthroplasties. Methods: An electronic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Search terms included ROSA, knee arthroscopy, osteoarthritis, robotic, and malalignment. Types of study participants included patients with osteoarthritis, ages 18 and older, male or female, who received manual TKA (mTKA) or ROSA-assisted TKA (rTKA), and human patients or cadavers. Published, peer-reviewed controlled trials, observational studies, and case series were included. Case reports were not included in article review. Resulting articles were first screened based on title and abstract. Articles meeting inclusion criteria based on title and abstract review then underwent full-text review by the same reviewer. Results: This scoping review identified 11 total studies, 3 prospective observational studies, and 8 retrospective observational studies - a total of 970 rTKA patients and 1745 mTKA patients. There were no case series or randomized controlled trials comparing rTKA and mTKA. Patient-centered outcomes showed promise for rTKA, where it frequently showed significantly favorable functional outcomes, measured via KOOS-JR, VAS, KSS, OKS, FJS, and PROMIS scores, at various times postoperatively. However, there was much discrepancy about which score yielded significance at which postoperative follow-up. Complication rates, reoperation rates, and LOS were very similar between mTKA and rTKA groups. Studies also showed rTKA had more accurate joint alignment within the 0 ± 3o corridor and had significantly higher rates of achieving postoperative joint angles similar to the preoperative plan. Finally, there was major agreement that rTKA cases take significantly longer time at the start, however, there is a rapid learning curve. Once past the learning curve, rTKA cases are performed in a similar time to mTKA and reduced physician stress and strain. Conclusion: The ROSA knee system represents a promising option for the management of osteoarthritis via total knee arthroscopy. The studies reviewed in this paper favor the patient-centered function outcomes, joint alignments, and physician health implications of the ROSA knee system to conventional total knee arthroscopy. Further study is warranted, however, to better understand recovery periods, longer-term functional outcomes, operative fatigue, and reduction in radiation exposure.

Keywords: arthroplasty, knee, robotics, malalignment

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Authors: Mukta Avachat-Shirke

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The process of manifestation in art has been studied deeply by various Indian and Western philosophers through times. In the art of painting, ‘Practice’ is always considered as techniques or making and ‘Theory’ is related to intelligence or the ‘conceptual.' The question about the significance of ‘Practice’ in artistic research has been a topic of debate. The aim of this qualitative study is to find the relevance of practice and theory while creating artworks. This study analyzes the thoughts and philosophy of Abhinavgupta, Hegel, and Croce to find a new perspective for looking at practice and theory within artistic research. With the method of grounded theory, the study attempts to establish the importance of both in artistic research. It discusses the issues like stages of creating art, role of tacit knowledge and importance of the decision-making the ability of the artist. This comparative analysis of these three philosophers along with the present systems can be used as a point of reference for further developments in the pedagogy of art research and artists, to understand the psychology and to follow the process of creativity effectively.

Keywords: artistic research, Indian philosophy, practice, Western Philosophy

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Authors: Müjde Erol Genevois, Hatice Kocaman

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Growing concerns about the increasing consumption of fossil energy and the improved recognition of environmental protection require sustainable road transportation technology. Electric vehicles (EVs) can contribute to improve environmental sustainability and to solve the energy problem with the right infrastructure. The problem of where to locate electric vehicle charging station can be grouped as decision-making problems because of including many criteria and alternatives that have to be considered simultaneously. The purpose of this paper is to present an integrated AHP and TOPSIS model to rank the optimal sites of EVs charging station in Istanbul, Turkey. Ten different candidate points and three decision criteria are identified. The performances of each candidate points with respect to criteria are obtained according to AHP calculations. These performances are used as an input for TOPSIS method to rank the candidate points. It is obtained accurate and robust results by integrating AHP and TOPSIS methods.

Keywords: electric vehicle charging station (EVCS), AHP, TOPSIS, location selection

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Authors: Bi̇rsen Tutunis, Zuhal Aydin

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Guided digital learning has attracted many researchers as it leads to autonomous learning.The developments in Guided digital learning have led to changes in teaching and learning in English Language Teaching classes (Jeong-Bae, 2014). This study reports on tasks designed under the principles of learner autonomy in an online learning platform ‘’Webquest’’ with the purpose of teaching English to Turkish tertiary level students at a foundation university in Istanbul. Guided digital learning blog project contents were organized according to work-cycles phases (planning and negotiation phase, decision-making phase, project phase and evaluation phase) which are compatible with the principles of autonomous learning (Legenhausen,2003). The aim of the study was to implement the class blog project to find out its impact on students’ behaviours and beliefs towards autonomous learning. The mixed method research approach was taken. 24 tertiary level students participated in the study on voluntary basis. Data analysis was performed with Statistical Package for the Social Sciences. According to the results, students' attitudes towards digital learning did not differ before and after the training application. The learning styles of the students and their knowledge on digital learning scores differed. It has been observed that the students' learning styles and their digital learning scores increased after the training application. Autonomous beliefs, autonomous behaviors, group cohesion and group norms differed before and after the training application. Students' motivation level, strategies for learning English, perceptions of responsibility and out-of-class activity scores differed before and after the training application. It was seen that work-cycles in online classes create student centered learning that fosters autonomy. This paper will display the work cycles in detail and the researchers will give examples of in and beyond class activities and blog projects.

Keywords: guided digital learning, work cycles, english language teaching, autonomous learning

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Authors: Ayat-Allah Bouramdane

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Solar Photovoltaic (PV) and Concentrated Solar Power (CSP) do not burn fossil fuels and, therefore, could meet the world's needs for low-carbon power generation as they do not release greenhouse gases into the atmosphere as they generate electricity. The power output of the solar PV module and CSP collector is proportional to the temperature and the amount of solar radiation received by their surface. Hence, the determination of the most convenient locations of PV and CSP systems is crucial to maximizing their output power. This study aims to provide a hands-on and plausible approach to the multi-criteria evaluation of site suitability of PV and CSP plants using a combination of Geographic Referenced Information (GRI) and Analytic Hierarchy Process (AHP). Applying the GRI-based AHP approach is meant to specify the criteria and sub-criteria, to identify the unsuitable areas, the low-, moderate-, high- and very high suitable areas for each layer of GRI, to perform the pairwise comparison matrix at each level of the hierarchy structure based on experts' knowledge, and calculate the weights using AHP to create the final map of solar PV and CSP plants suitability in Morocco with a particular focus on the Dakhla city. The results recognize that solar irradiation is the main decision factor for the integration of these technologies on energy policy goals of Morocco but explicitly account for other factors that cannot only limit the potential of certain locations but can even exclude the Dakhla city classified as unsuitable area. We discuss the sensitivity of the PV and CSP site suitability to different aspects, such as the methodology, the climate conditions, and the technology used in each source, and provide the final recommendations to the Moroccan energy strategy by analyzing if actual Morocco's PV and CSP installations are located within areas deemed suitable and by discussing several cases to provide mutual benefits across the Food-Energy-Water nexus. The adapted methodology and conducted suitability map could be used by researchers or engineers to provide helpful information for decision-makers in terms of sites selection, design, and planning of future solar plants, especially in areas suffering from energy shortages, such as the Dakhla city, which is now one of Africa's most promising investment hubs and it is especially attractive to investors looking to root their operations in Africa and import to European markets.

Keywords: analytic hierarchy process, concentrated solar power, dakhla, geographic referenced information, Morocco, multi-criteria decision-making, photovoltaic, site suitability

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Authors: Devieta Romadhon Saendardy

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Introduction: The case of aneurysmal subarachnoid hemorrhage (SAH) associated with intraventricular hemorrhage (IVH) in many way. In general, the anterior communicating artery and posterior circulation aneurysms cause Intraventricular Hemorrhage. The development of intraventricular hemorrhage (IVH) in aneurysmal subarachnoid hemorrhage (aSAH) is linked with higher mortality and poor neurological recovery. Case: This case report presents a 51-year-old female patient who developed IVH following SAH. The patient's Glasgow Coma Scale score was 14, the patient has a severe headache, and there were right extremity hemipharese neurological deficits. A non-contrast head CT scan revealed a massive intraventricular haemorrhage. In an hour, the patient got her headache and pharese worse. Discussion: Intraventricular hemorrhage is a serious complication of subarachnoid hemorrhage, necessitating prompt recognition and management. This case highlights the importance of a time management, medical management and surgical intervention to optimize outcomes in patients with intraventricular hemorrhage caused by subarachnoid hemorrhage. Placement of a shunt system improves clinical outcome in intraventricular hemorrhage.

Keywords: Intraventricular hemorrhage, subarachnoid hemorrhage, shunt, time

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Authors: Luís Marques, João Rocha, Andreia Fernandes, Maria Moura, Cláudia Caseiro, Filipa Figueiredo, João Nunes

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The implementation of circularity strategies other than recycling, such as reducing the amount of raw material, as well as reusing or sharing existing products, remains marginal. The European Commission announced that the transition towards a more circular economy could lead to the net creation of about 700,000 jobs in Europe by 2030, through additional labour demand from recycling plants, repair services and other circular activities. Efforts to create new circular business models in accordance with completely circular processes, as opposed to linear ones, have increased considerably in recent years. In order to create a societal Circular Economy transition model, it is necessary to include innovative solutions, where startups play a key role. Early-stage startups based on new business models according to circular processes often face difficulties in creating enough impact. The StartUp Zero Program designs a model and approach to increase the flow of startups in the Circular Economy field, focusing on a systemic decision analysis and multi-generational approach, considering Multi-Criteria Decision Analysis to support a decision-making tool, which is also supported by the use of a combination of an Analytical Hierarchy Process and Multi-Attribute Value Theory methods. We define principles, criteria and indicators for evaluating startup prerogatives, quantifying the evaluation process in a unique result. Additionally, this entrepreneurship program spanning 16 months involved more than 2400 young people, from ages 14 to 23, in more than 200 interaction activities.

Keywords: circular economy, entrepreneurship, startups;, multi-criteria decision analysis

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Authors: Mishak Rahul, Naveen Kumar, Bharath Kumar

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Conceived as a high-end engine to revolutionise sustainable agri-food production, the intelligent crop circle (ICC) aims to incorporate the Internet of Things (IoT), blockchain technology and artificial intelligence (AI) to bolster resource efficiency and prevent waste, increase the volume of production and bring about sustainable solutions with long-term ecosystem conservation as the guiding principle. The operating principle of the ICC relies on bringing together multidisciplinary bottom-up collaborations between producers, researchers and consumers. Key elements of the framework include IoT-based smart sensors for sensing soil moisture, temperature, humidity, nutrient and air quality, which provide short-interval and timely data; blockchain technology for data storage on a private chain, which maintains data integrity, traceability and transparency; and AI-based predictive analysis, which actively predicts resource utilisation, plant growth and environment. This data and AI insights are built into the ICC platform, which uses the resulting DSS (Decision Support System) outlined as help in decision making, delivered through an easy-touse mobile app or web-based interface. Farmers are assumed to use such a decision-making aid behind the power of the logic informed by the data pool. Building on existing data available in the farm management systems, the ICC platform is easily interoperable with other IoT devices. ICC facilitates connections and information sharing in real-time between users, including farmers, researchers and industrial partners, enabling them to cooperate in farming innovation and knowledge exchange. Moreover, ICC supports sustainable practice in agriculture by integrating gamification techniques to stimulate farm adopters, deploying VR technologies to model and visualise 3D farm environments and farm conditions, framing the field scenarios using VR headsets and Real-Time 3D engines, and leveraging edge technologies to facilitate secure and fast communication and collaboration between users involved. And through allowing blockchain-based marketplaces, ICC offers traceability from farm to fork – that is: from producer to consumer. It empowers informed decision-making through tailor-made recommendations generated by means of AI-driven analysis and technology democratisation, enabling small-scale and resource-limited farmers to get their voice heard. It connects with traditional knowledge, brings together multi-stakeholder interactions as well as establishes a participatory ecosystem to incentivise continuous growth and development towards more sustainable agro-ecological food systems. This integrated approach leverages the power of emerging technologies to provide sustainable solutions for a resilient food system, ensuring sustainable agriculture worldwide.

Keywords: blockchain, internet of things, artificial intelligence, decision support system, virtual reality, gamification, traceability, sustainable agriculture

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Authors: Onur Özdemir, M.Erhan ORHAN

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Knowledge Development (KD) is just one of the important phases of Knowledge Management (KM). KD is the phase in which intelligence is used to see the big picture. In order to understand whether information is important or not, we have to use the intelligence cycle that includes four main steps: aiming, collecting data, processing and utilizing. KD also needs these steps. To make a precise decision, the decision maker has to be aware of his subordinates’ ideas. If the decision maker ignores the ideas of his subordinates or participants of the organization, it is not possible for him to get the target. KD is a way of using wisdom to accumulate the puzzle. If the decision maker does not bring together the puzzle pieces, he cannot get the big picture, and this shows its effects on the battlefield. In order to understand the battlefield, the decision maker has to use the intelligence cycle. To convert information to knowledge, KD is the main means for the intelligence cycle. On the other hand, the “Z Generation” born after the millennium are really the game changers. They have different attitudes from their elders. Their understanding of life is different - the definition of freedom and independence have different meanings to them than others. Decision makers have to consider these factors and rethink their decisions accordingly. This article tries to explain the relation between KD and Generation Z. KD is the main method of target managing. But if leaders neglect their people, the world will be seeing much more movements like the Arab Spring and other insurgencies.

Keywords: knowledge development, knowledge management, generation Z, intelligence cycle

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Authors: C. Soh, S. Muktar, C. M. Malata, J. R. Benson

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Introduction Reasons for requesting CPM include prevention of recurrence, peace of mind and moving on after breast cancer. Some women seek CPM as a delayed procedure but factors influencing this are poorly understood. Methods A retrospective analysis examined patients undergoing CPM as either an immediate or delayed procedure with or without breast reconstruction (BR) between January 2009 and December 2019. A cross-sectional survey based on validated questionnaires (5 point Likert scale) explored patients’ decision-making process in terms of timing of CPM and any BR. Results A total of 123 patients with unilateral breast cancer underwent CPM with 39 (32.5%) delayed procedures with or without BR. The response rate amongst patients receiving questionnaires (n=33) was 22/33 (66%). Within this delayed CPM cohort were three reconstructive scenarios 1) unilateral immediate BR with CPM (n=12); 2) delayed CPM with concomitant bilateral BR (n=22); 3) delayed bilateral BR after delayed CPM (n=3). Two patients had delayed CPM without BR. The most common reason for delayed CPM was to complete all cancer treatments (including radiotherapy) before surgery on the unaffected breast (score 2.91). The second reason was unavailability of genetic test results at the time of therapeutic mastectomy (score 2.64) whilst the third most cited reason was a subsequent change in family cancer history. Conclusion Factors for delayed CPM are patient-driven with few women spontaneously changing their mind having initially decided against immediate CPM for reasons also including surgical duration. CPM should be offered as a potentially delayed option with informed discussion of risks and benefits.

Keywords: Breast Cancer, CPM, Prophylactic, Rationale

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Authors: Ayodele James Akinola

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This study examines how social and linguistic variables influenced communication between neurologists and patients in selected university teaching hospitals (UTHs) in southwestern Nigeria. Jacob Mey’s Pragmatic Acts, complemented by Emanuel and Emanuel’s model of doctor-patient relationship, served as the theoretical framework. Data comprising 22 audio-recorded neurologist-patient interactions were collected from two UTHs in the southwestern region of Nigeria. Data revealed that educational attainment of patients has insignificant influence on the interaction where the linguistic prowess of the patient has been impaired for consultative communication. However, the status influenced the degree of attention paid to patients by neurologists and determines the amount of time 'trying to help patients to communicate'. Patients with lower educational status and who could not communicate in English spent more time narrating their ailment to neurologists. Patients with higher educational status and could communicate in English saves consultation time as they express themselves briefly unlike those who were of little or no education in the clinics. Through this, diagnoses and therapeutic processes took eight to 12 minutes. 20 minutes was the longest duration recorded. Neurologist-patient interaction in the observed hospitals is shaped by neurologists’ experience, patients’ social variables and language.

Keywords: medical pragmatics, neurologist-patient interaction, nigeria, socio-linguistic influence

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Authors: Muhammad Zia Ullah Baig, Atiq Uz Zama

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The motivation of the project is to facilitate the governance body, as well as the common man in his/her daily life consuming product rates, to easily monitor the expense, to control the budget with the help of single SMS (message), e-mail facility, and to manage governance body by task management system. The system will also be capable of finding irregularities being done by the concerned department in mitigating the complaints generated by the customer and also provide a solution to overcome problems. We are building a system that easily controls the price control system of any country, we will feeling proud to give this system free of cost to Indian Government also. The system is able to easily manage and control the price control department of government all over the country. Price control department run in different cities under City District Government, so the system easily run in different cities with different SMS Code and decentralize Database ensure the non-functional requirement of system (scalability, reliability, availability, security, safety). The customer request for the government official price list with respect to his/her city SMS code (price list of all city available on website or application), the server will forward the price list through a SMS, if the product is not available according to the price list the customer generate a complaint through an SMS or using website/smartphone application, complaint is registered in complaint database and forward to inspection department when the complaint is entertained, the inspection department will forward a message about the complaint to customer. Inspection department physically checks the seller who does not follow the price list, but the major issue of the system is corruption, may be inspection officer will take a bribe and resolve the complaint (complaint is fake) in that case the customer will not use the system. The major issue of the system is to distinguish the fake and real complain and fight for corruption in the department. To counter the corruption, our strategy is to rank the complain if the same type of complaint is generated the complaint is in high rank and the higher authority will also notify about that complain, now the higher authority of department have reviewed the complaint and its history, the officer who resolve that complaint in past and the action against the complaint, these data will help in decision-making process, if the complaint was resolved because the officer takes bribe, the higher authority will take action against that officer. When the price of any good is decided the market/former representative is also there, with the mutual understanding of both party the price is decided, the system facilitate the decision-making process. The system shows the price history of any goods, inflation rate, available supply, demand, and the gap between supply and demand, these data will help to allot for the decision-making process.

Keywords: price control, goods, government, inspection, department, customer, employees

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Authors: Mayuri Roy Choudhury

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In recent times the concept of agrivoltaics has gained popularity due to the dual use of land and the added value provided by photovoltaics in terms of renewable energy and crop production on farms. However, the transition towards agrivoltaics has been slow, and our research tries to investigate the obstacles leading towards the slow progress of agrivoltaics. We applied data science decision tree algorithms to quantify qualitative perceptions of farmers in the United States for agrivoltaics. To date, there has not been much research that mentions farmers' perceptions, as most of the research focuses on the benefits of agrivoltaics. Our study adds value by putting forward the voices of farmers, which play a crucial towards the transition to agrivoltaics in the future. Our results show a mixture of responses in favor of agrivoltaics. Furthermore, it also portrays significant concerns of farmers, which is useful for decision-makers when it comes to formulating policies for agrivoltaics.

Keywords: agrivoltaics, decision-tree algorithms, farmers perception, transition

Procedia PDF Downloads 184

Authors: Xudong Guan, Ainong Li, Gaohuan Liu, Chong Huang, Wei Zhao

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Due to the low spatial resolution of MODIS data, the accuracy of small-area plaque extraction with a high degree of landscape fragmentation is greatly limited. To this end, the study combines Landsat data with higher spatial resolution and MODIS data with higher temporal resolution for decision-level fusion. Considering the importance of the land heterogeneity factor in the fusion process, it is superimposed with the weighting factor, which is to linearly weight the Landsat classification result and the MOIDS classification result. Three levels were used to complete the process of data fusion, that is the pixel of MODIS data, the pixel of Landsat data, and objects level that connect between these two levels. The multilevel decision fusion scheme was tested in two sites of the lower Mekong basin. We put forth a comparison test, and it was proved that the classification accuracy was improved compared with the single data source classification results in terms of the overall accuracy. The method was also compared with the two-level combination results and a weighted sum decision rule-based approach. The decision fusion scheme is extensible to other multi-resolution data decision fusion applications.

Keywords: image classification, decision fusion, multi-temporal, remote sensing

Procedia PDF Downloads 115

Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

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To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

Procedia PDF Downloads 84

Authors: Hokuma Isgandarova, Khalil Aryanfar

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The patient's rights include all care items that the patient has the right to receive. Considering the growing importance of this important issue and its effect on improving treatment results and customer satisfaction, the present study was conducted with the aim of investigating the level of respect for patient rights in the physiotherapy clinic of the Faculty of Medicine University of Medical Sciences in 2023. In this study, the patients or companions who were referred to the clinic answered questions about the performance status of the clinic with respect to various aspects of the patient's rights. The aspects that were studied: choosing the service provider, having authority, respect, safety, prevention and access were found to have inappropriate performance scores. However, communication and interaction, continuity of service, quality of basic facilities and facilities, timely and immediate attention and trust had appropriate performance. Also, the results of the data analysis showed that there is no significant relationship between the total performance score and any of the demographic variables.

Keywords: compliance, patients' rights, physiotherapy clinic, performance level

Procedia PDF Downloads 49

Authors: Shilpa Sondkar, Maithili Patil, Atharva Potnis

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The current health care landscape desires efficiency and patient satisfaction for optimal performance. Medical appointment booking apps have increased the overall efficiency of clinics, hospitals, and e-health marketplaces while simplifying processes. These apps allow patients to connect with doctors online. Not only are mobile doctor appointment apps a reliable and efficient solution, but they are also the future of clinical progression and a distinct new stage in the patient-doctor relationship. Compared to the usual queuing method, the web-based appointment system could significantly increase patients' satisfaction with registration and reduce total waiting time effectively.

Keywords: appointment, patient, scheduling, design and development, Figma

Procedia PDF Downloads 78

Authors: C. Mazziotti Gomez de Teran, D. Fiore, B. Cola, A. Fardelli

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The present paper summarizes the analysis of the request for consultation of information and data on industrial emissions made publicly available on the web site of the Ministry of Environment, Land and Sea on integrated pollution prevention and control from large industrial installations, the so called “AIA Portal”. However, since also local Competent Authorities have been organizing their own web sites on IPPC permits releasing procedures for public consultation purposes, as a result, a huge amount of information on national industrial plants is already available on internet, although it is usually proposed as textual documentation or images. Thus, it is not possible to access all the relevant information through interoperability systems and also to retrieval relevant information for decision making purposes as well as rising of awareness on environmental issue. Moreover, since in Italy the number of institutional and private subjects involved in the management of the public information on industrial emissions is substantial, the access to the information is provided on internet web sites according to different criteria; thus, at present it is not structurally homogeneous and comparable. To overcome the mentioned difficulties in the case of the Coordinating Committee for the implementation of the Agreement for the industrial area in Taranto and Statte, operating before the IPPC permit granting procedures of the relevant installation located in the area, a big effort was devoted to elaborate and to validate data and information on characterization of soil, ground water aquifer and coastal sea at disposal of different subjects to derive a global perspective for decision making purposes. Thus, the present paper also focuses on main outcomes matured during such experience.

Keywords: public information, emissions into atmosphere, IPPC permits, territorial information systems

Procedia PDF Downloads 274

Authors: Antonella Falanga, Armando Cartenì

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Today, an unprecedented amount of data coming from several sources, including mobile devices, sensors, tracking systems, and online platforms, characterizes our lives. The term “big data” not only refers to the quantity of data but also to the variety and speed of data generation. These data hold valuable insights that, when extracted and analyzed, facilitate informed decision-making. The 4Vs of big data - velocity, volume, variety, and value - highlight essential aspects, showcasing the rapid generation, vast quantities, diverse sources, and potential value addition of these kinds of data. This surge of information has revolutionized many sectors, such as business for improving decision-making processes, healthcare for clinical record analysis and medical research, education for enhancing teaching methodologies, agriculture for optimizing crop management, finance for risk assessment and fraud detection, media and entertainment for personalized content recommendations, emergency for a real-time response during crisis/events, and also mobility for the urban planning and for the design/management of public and private transport services. Big data's pervasive impact enhances societal aspects, elevating the quality of life, service efficiency, and problem-solving capacities. However, during this transformative era, new challenges arise, including data quality, privacy, data security, cybersecurity, interoperability, the need for advanced infrastructures, and staff training. Within the transportation sector (the one investigated in this research), applications span planning, designing, and managing systems and mobility services. Among the most common big data applications within the transport sector are, for example, real-time traffic monitoring, bus/freight vehicle route optimization, vehicle maintenance, road safety and all the autonomous and connected vehicles applications. Benefits include a reduction in travel times, road accidents and pollutant emissions. Within these issues, the proper transport demand estimation is crucial for sustainable transportation planning. Evaluating the impact of sustainable mobility policies starts with a quantitative analysis of travel demand. Achieving transportation decarbonization goals hinges on precise estimations of demand for individual transport modes. Emerging technologies, offering substantial big data at lower costs than traditional methods, play a pivotal role in this context. Starting from these considerations, this study explores the usefulness impact of big data within transport demand estimation. This research focuses on leveraging (big) data collected during the COVID-19 pandemic to estimate the evolution of the mobility demand in Italy. Estimation results reveal in the post-COVID-19 era, more than 96 million national daily trips, about 2.6 trips per capita, with a mobile population of more than 37.6 million Italian travelers per day. Overall, this research allows us to conclude that big data better enhances rational decision-making for mobility demand estimation, which is imperative for adeptly planning and allocating investments in transportation infrastructures and services.

Keywords: big data, cloud computing, decision-making, mobility demand, transportation

Procedia PDF Downloads 55

Authors: Izabela Kapsa

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Civic participation is an important aspect of democracy. The contemporary model of democracy is based on citizens' participation in political decision-making (deliberative democracy, participatory democracy). This participation takes many forms of activities like display of slogans and symbols, voting, social consultations, political demonstrations, membership in political parties or organizing civil disobedience. The countries of Central and Eastern Europe after 1989 are characterized by great social, economic and political diversity. Civil society is also part of the process of democratization. Civil society, funded by the rule of law, civil rights, such as freedom of speech and association and private ownership, was to play a central role in the development of liberal democracy. Among the many interpretations of concepts, defining the concept of contemporary democracy, one can assume that the terms civil society and democracy, although different in meaning, nowadays overlap. In the post-communist countries, the process of shaping and maturing societies took place in the context of a struggle with a state governed by undemocratic power. State fraud or repudiation of the institution is a representative state, which in the past was the only way to manifest and defend its identity, but after the breakthrough became one of the main obstacles to the development of civil society. In Central and Eastern Europe, there are many obstacles to the development of civil society, for example, the elimination of economic poverty, the implementation of educational campaigns, consciousness-related obstacles, the formation of social capital and the deficit of social activity. Obviously, civil society does not only entail an electoral turnout but a broader participation in the decision-making process, which is impossible without direct and participative democratic institutions. This article considers such broad forms of civic participation and their characteristics in Central and Eastern Europe. The paper is attempts to analyze the functioning of electronic forms of civic participation in Central and Eastern European states. This is not accompanied by a referendum or a referendum initiative, and other forms of political participation, such as public consultations, participative budgets, or e-Government. However, this paper will broadly present electronic administration tools, the application of which results from both legal regulations and increasingly common practice in state and city management. In the comparative analysis, the experiences of post-communist bloc countries will be summed up to indicate the challenges and possible goals for further development of this form of citizen participation in the political process. The author argues that for to function efficiently and effectively, states need to involve their citizens in the political decision-making process, especially with the use of electronic tools.

Keywords: Central and Eastern Europe, e-participation, e-government, post-communism

Procedia PDF Downloads 181

Authors: Chiung-Hui Chen

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With advancements in science and technology, the concept of the Internet of Things (IoT) has gradually developed. The development of the intelligent environment adds intelligence to objects in the living space by using the IoT. In the smart environment, when multiple users share the living space, if different service requirements from different users arise, then the context-aware system will have conflicting situations for making decisions about providing services. Therefore, the purpose of establishing a communication and negotiation mechanism among objects in the intelligent environment is to resolve those service conflicts among users. This study proposes developing a decision-making methodology that uses “Event Agents” as its core. When the sensor system receives information, it evaluates a user’s current events and conditions; analyses object, location, time, and environmental information; calculates the priority of the object; and provides the user services based on the event. Moreover, when the event is not single but overlaps with another, conflicts arise. This study adopts the “Multiple Events Correlation Matrix” in order to calculate the degree values of incidents and support values for each object. The matrix uses these values as the basis for making inferences for system service, and to further determine appropriate services when there is a conflict.

Keywords: internet of things, intelligent object, event agents, negotiation mechanism, degree of similarity

Procedia PDF Downloads 281