Search results for: multidisciplinary team

Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley

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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.

Keywords: orthognathic surgery, patient information resources, quality improvement project, risks

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Authors: Evridiki Papachristou, Nikolaos Bilalis

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Imagine an apparel industry where fashion design does not begin with a paper-and-pen drawing which is then translated into pattern and later to a 3D model where the designer tries out different fabrics, colours and contrasts. Instead, imagine a fashion designer in the future who produces that initial fashion drawing in a three-dimensional space and won’t leave that environment until the product is done, communicating his/her ideas with the entire development team in true to life 3D. Three-dimensional (3D) technology - while well established in many other industrial sectors like automotive, aerospace, architecture and industrial design, has only just started to open up a whole range of new opportunities for apparel designers. The paper will discuss the process of 3D simulation technology enhanced by high quality visualization of data and its capability to ensure a massive competitiveness in the market. Secondly, it will underline the most frequent problems & challenges that occur in the process chain when various partners in the production of textiles and apparel are working together. Finally, it will offer a perspective of how the Virtual Prototyping Technology will make the global textile and apparel industry change to a level where designs will be visualized on a computer and various scenarios modeled without even having to produce a physical prototype. This state-of-the-art 3D technology has been described as transformative and“disruptive”comparing to the process of the way apparel companies develop their fashion products today. It provides the benefit of virtual sampling not only for quick testing of design ideas, but also reducing process steps and having more visibility.A so called“digital asset” that can be used for other purposes such as merchandising or marketing.

Keywords: 3D visualization, apparel, virtual prototyping, prototyping technology

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Authors: Khaidan Hatami, Mehran Nasiri

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The aim of following research was the analysis between sport motivation and control center of football players of Iran. All the players employed in Iran’s football league are included in the population of the research. So, 360 players, every level 120 players ( Youth, U-21 and adults ) playing in Guilan, Kurdistan and Kermanshah province having professional football league in first and second level league were randomly and selectively taken and included the population. The current research is of descriptive and solidarity types. Instruments of measurement are three personal questionnaires, sport motivation (SMS) of Politer and partners (1995), control center of Berger (1986) which their valid content were confirmed by experts in sport management field. The internal stability of questions were analyzed by Alfa Cronbach respectively for sport obligation questionnaire (0.82) and control center (0.86) to analysis and evaluate data, Kolmogrouf-Smirnov, Spearman Correlation, Kruskal-Wallis test, Whitney U, Freedman and T-Wilcoxon were used in a meaningful level (P ≤ 0/05). The results showed positive and meaningful relation between control center of football players in youth, U-21 and adults and sport motivation of football players. So, it can be concluded, people with internal control against those with external one have more internal sport motivation and follow the team goals with more mental power. So, it’s recommended to coaches to use sport psychologist in their teams to internalize the people’s needs by scientific method by taking the mental issues and the type of control in people on life events.

Keywords: sport motivation, control center, internal, external football players

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Authors: Anupam Sibal

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Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

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Authors: Rula D. Alshareef, Safa S. Alqathmi, Ghadah K. Alkhouldi, Reem O. Bagabas, Farheen B. Hasan

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Safety engineering is among the most crucial considerations in any work environment. Providing mentally, physically, and environmentally safe work conditions must be the top priority of any successful organization. Company X is a local paint production company in Saudi Arabia; in a month, the factory experienced two significant accidents, which indicates that workers’ safety is overlooked. The aim of the research is to examine the risks, assess the root causes and recommend control measures that will eventually contribute to providing a safe workplace. The methodology used is sectioned into three phases, risk identification, assessment, and finally, mitigation. In the identification phase, the team used Rapid Entire Body Assessment (REBA) and National Institute for Occupational Safety and Health Lifting Index (NIOSH LI) tools to holistically establish knowledge about the current risk posed to the factory. The physical hazards in the factory were assessed in two different operations, which are mixing and filling/packaging. For the risk assessment phase, the hazards were deeply analyzed through their severity and impact. Additionally, through risk mitigation, the Rapid Entire Body Assessment (REBA) score decreased from 11 to 7, and the National Institute for Occupational Safety and Health Lifting Index (NIOSH LI) has been reduced from 5.27 to 1.85.

Keywords: ergonomics, safety, workplace risks, hazards, awkward posture, fatigue, work environment

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Authors: Michael Gerges, Ograbe Ahiakwo, Martin Jaeger, Ahmad Asaad

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Recent advances of Building Information Modeling (BIM) especially in the Middle East have increased remarkably. Dubai has been taking a lead on this by making it mandatory for BIM to be adopted for all projects that involve complex architecture designs. This is because BIM is a dynamic process that assists all stakeholders in monitoring the project status throughout different project phases with great transparency. It focuses on utilizing information technology to improve collaboration among project participants during the entire life cycle of the project from the initial design, to the supply chain, resource allocation, construction and all productivity requirements. In view of this trend, the paper examines the extent of applying BIM in the State of Kuwait, by exploring practitioners’ perspectives on BIM, especially their perspectives on main barriers and main advantages. To this end structured interviews were carried out based on questionnaires and with a range of different construction professionals. The results revealed that practitioners perceive improved communication and mitigated project risks by encouraged collaboration between project participants. However, it was also observed that the full implementation of BIM in the State of Kuwait requires concerted efforts to make clients demanding BIM, counteract resistance to change among construction professionals and offer more training for design team members. This paper forms part of an on-going research effort on BIM and its application in the State of Kuwait and it is on this basis that further research on the topic is proposed.

Keywords: building information modeling, BIM, construction industry, Kuwait

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Authors: Jenny Ngo, Harry De Boer, Jurgen Enders

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Indonesian higher education has experienced significant changes over the last decade. In 1999, the government published an overall strategy for decentralization and enhancement of local autonomy in many sectors, including (higher) education. Indonesian higher education reforms have forced universities to restructure their internal university governance to become more entrepreneurial. These new types of internal university governance are likely to affect the institutions’ leadership and management. This paper discusses the approach and findings of a study on the managerial leadership styles of deans in Indonesian universities. The study aims to get a better understanding of styles exhibited by deans manifested in their behaviors. Using the theories of reasoned action and planned behavior, in combination with the competing values framework, a large-scale survey was conducted to gather information on the deans’ behaviors, attitudes, subjective norms, and perceived behavioral control. Based on the responses of a sample of 218 deans, the study identifies a number of leadership styles: the Master, the Competitive Consultant, the Consensual Goal-Setter, the Focused Team Captain, and the Informed Trust-Builder style. The study demonstrates that attitudes are the primary determinant of the styles that were found. Perceived behavioral control is a factor that explains some managerial leadership styles. By understanding the attitudes of deans in Indonesian universities, and their leadership styles, universities can strengthen their management and governance, and thus improve their effectiveness.

Keywords: deans, Indonesian higher education, leadership and management styles, decentralization

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Authors: Kenneth O. Otasowie, Matthew Ikuabe, Clinton Aigbavboa, Ayodeji Oke

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Construction project cost are not only made up of production costs. This cost comprises of many other elements such as the preparation of a bidding document, cost estimations, drafting contractual agreements and monitoring that contractual obligations are met. Several studies have stressed the need for transaction costs (TC) to be defined in a way that covers all phases of a project and not only the pre-contract phase. Hence, this study aims to appraise transaction cost in South African (SA) construction projects by assessing what constitutes transaction cost, influencing factors and possible optimisation measures. A survey design was adopted. A total number of eighty (80) questionnaires were administered to quantity surveyors, procurement managers and project managers in Guateng Province, SA and seventy-two (72) were returned and found suitable for analysis. Collected data was analysed using percentage, mean item score, standard deviation, one-sample t-test. The findings show that external technical interaction, uncertainty, human factors are the most significant constituents of TC in SA, while technical competency, experience in similar project type and project characteristics are the leading influencing factors. Furthermore, understanding project characteristics, clear communication and technically competent project teams are most of the significant measures for optimising TC in SA construction projects. Therefore, this study recommends that a competent project team and a clear communication are fundamental to proper management of TC in SA construction projects.

Keywords: construction projects, project cost, South Africa, transaction cost

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Authors: Pratheesh Jakkala

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This paper addresses the use of breakout sessions to conduct successful weekly physics recitations for College Physics I and II at a large University in remote teaching method during COVID-19 pandemic. All breakout sessions are synchronous, conducted live, and handled by teaching assistants. A two-prong approach is used to maintain the integrity of recitations. Three different conference platforms WebEx, Zoom, and Canvas conferences, were tested, and BigBlue button using Canvas was adopted. The results and experiences of all three learning platforms are presented in this paper. Recitation questions were assigned on WebAssign learning platform and a standard five-question template developed by the instructor was used for group discussions and active peer-peer engagement. Breakout sessions feature of BigBlueButton in Canvas conferences was successfully implemented. Each breakout session consists of a team of 4 students. An online whiteboard, chat window options were used for live teamwork. Student peer-peer interactions, Teaching Assistants’ interaction with students were video and audio recorded. A total of 72 students in College Physics II and 55 students in College Physics I was enrolled. 82% of students agreed that method under study is better than previous methods. The study addressed the quality of student teamwork, student attitude towards problem-solving, and student performance in the exams.

Keywords: recitations, breakout rooms, online learning platforms, COVID pandemic

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Authors: Angkana Tungkasamit, Ladda Silanoi , Teerachai Nethanomsak, Sitthipon Art-in, Siribhong Bhiasiri

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As the date for the commencement of the ASEAN Community in Year 2015 is approaching, it has become apparent to all that there is an urgent need to get Thai people ready to meet the challenge of entering into the Community confidently. Our research team has been organized by the Faculty of Education, Khon Kaen University with the task of training administrators and teachers of the schools along the borders with Laos People’s Democratic Republic and the Kingdom of Cambodia to be able to develop supplementary courses on ASEAN Community. The course to be developed is based on the essential elements of the Community, i.e. general backgrounds of the member countries, the education, social and economic life in the Community and social skills needed for a good citizen of the ASEAN Community. The study, based on learning outcome and learning management process as a basis for inquiry, was a research and development in nature using participative action research as a means to achieve the goal of helping school administrators and teachers to learn how to develop supplementary courses to be used in their schools. A post-workshop evaluation of the outcome was made and found that, besides the successfully completed supplementary course, the participants were satisfied with their participation in the workshop because they had participated in every step of the development activity, from the beginning to the end.

Keywords: development of supplementary course, ASEAN community, social studies, northeastern border area of Thailand

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Authors: M. Gulam Kibria, Shourav Ahmed, Kais Zaman

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In system analysis, the information on the uncertain input variables cause uncertainty in the system responses. Different probabilistic approaches for uncertainty representation and propagation in such cases exist in the literature. Different uncertainty representation approaches result in different outputs. Some of the approaches might result in a better estimation of system response than the other approaches. The NASA Langley Multidisciplinary Uncertainty Quantification Challenge (MUQC) has posed challenges about uncertainty quantification. Subproblem A, the uncertainty characterization subproblem, of the challenge posed is addressed in this study. In this subproblem, the challenge is to gather knowledge about unknown model inputs which have inherent aleatory and epistemic uncertainties in them with responses (output) of the given computational model. We use two different methodologies to approach the problem. In the first methodology we use sampling-based uncertainty propagation with first order error analysis. In the other approach we place emphasis on the use of Percentile-Based Optimization (PBO). The NASA Langley MUQC’s subproblem A is developed in such a way that both aleatory and epistemic uncertainties need to be managed. The challenge problem classifies each uncertain parameter as belonging to one the following three types: (i) An aleatory uncertainty modeled as a random variable. It has a fixed functional form and known coefficients. This uncertainty cannot be reduced. (ii) An epistemic uncertainty modeled as a fixed but poorly known physical quantity that lies within a given interval. This uncertainty is reducible. (iii) A parameter might be aleatory but sufficient data might not be available to adequately model it as a single random variable. For example, the parameters of a normal variable, e.g., the mean and standard deviation, might not be precisely known but could be assumed to lie within some intervals. It results in a distributional p-box having the physical parameter with an aleatory uncertainty, but the parameters prescribing its mathematical model are subjected to epistemic uncertainties. Each of the parameters of the random variable is an unknown element of a known interval. This uncertainty is reducible. From the study, it is observed that due to practical limitations or computational expense, the sampling is not exhaustive in sampling-based methodology. That is why the sampling-based methodology has high probability of underestimating the output bounds. Therefore, an optimization-based strategy to convert uncertainty described by interval data into a probabilistic framework is necessary. This is achieved in this study by using PBO.

Keywords: aleatory uncertainty, epistemic uncertainty, first order error analysis, uncertainty quantification, percentile-based optimization

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Authors: Liaqat Ali, Khalid Farooq, Shafieullah Khan, Nasir Orakzai, Qudratullah

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Objectives: To determine the risk factors for high resistance of ciprofloxacin in complicated urinary tract infections. Materials and Methods: It is an analytical study that was conducted in the department of Urology (Team ‘C’) at Institute of Kidney Diseases Hayatabad Peshawar from 1st June 2012 till 31st December 2012. Total numbers of 100 patients with complicated UTI was selected in the study. Multivariate analysis and linear regression were performed for the detection of risk factors. All the data was recorded on structured Proforma and was analyzed on SPSS version 17. Results: The mean age of the patient was 55.6 years (Range 3-82 years). 62 patients were male while 38 patients were female. 66 isolates of E-Coli were found sensitive to ciprofloxacin while 34 isolates were found Resistant for ciprofloxacin. Using multivariate analysis and linear regression, an increasing age above 50 (p=0.002) History of urinary catheterization especially for bladder outflow obstruction (p=0.001) and previous multiple use of ciprofloxacin (p=0.001) and poor brand of ciprofloxacin were found to be independent risk factors for high resistance of ciprofloxacin. Conclusion: UTI is common illness across the globe with increasing trend of antimicrobial resistance for ciprofloxacin against E Coli in complicated UTI. The risk factors for emerging resistance are increasing age, urinary catheterization and multiple use and poor brand of ciprofloxacin.

Keywords: urinary tract infection, ciprofloxacin, urethral catheterization, antimicrobial resistance

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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

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Authors: Paul Lawrence Filomeno, John Robert Medina, Anna Lisa Ong-Lim, Leonila Dans

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Introduction: In most hospitals, pediatric residents are part of the frontline team who interacts with medically underserved patients. Despite of these daily encounters, little is known regarding their attitudes and behaviors towards caring for these underserved patients. Objectives: This study measured the pediatric resident physicians’ attitudes and behaviors towards underserved patients and determine its association. Methodology: The study utilized a cross-sectional mixed methodology, combining the use of a self-administered questionnaire survey using the Learner’s Needs Assessment tool, measuring both attitudes and behaviors towards the underserved. This is followed by a focus group discussion (FGD) involving a sample of residents at the Philippine General Hospital. Results: The response rate was 100% among 62 residents. Overall, 78% of pediatric residents acknowledged the issues of medically underserved to be very important. Volunteerism (behaviors) was only 27% during residency, and was projected to be 90% in future practice. No significant association was noted between their attitudes and behaviors. The FGD revealed that factors (i.e. burnout) causes strains in residents towards the underserved. Frustration from genuine concern for the underserved children was apparent. Conclusion: Among PGH pediatric residents, their attitudes and behaviors are noted to be positive towards the underserved. There was no significant correlation noted between having positive attitudes and volunteerism (behaviors) of the residents towards the underserved. Despite this, residents pointed out certain factors (i.e. burnout) that affect their attitudes and behaviors. The study results may serve as the basis for curriculum enhancements tailored to promote resident well-being, molding them to become the ‘5-star pediatricians’ who will genuinely be ready to serve the underserved.

Keywords: pediatric residents, attitudes, behaviors, underserved children

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Authors: Renata Martins Pacheco, João Claro

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Wildfires are becoming an increasing concern worldwide, causing substantial social, economic, and environmental disruptions. This situation is especially relevant in Mediterranean-climate regions, present in all the five continents of the world, in which fire is not only a natural component of the environment but also perhaps one of the most important evolutionary forces. The rise in wildfire occurrences and their associated impacts suggests the need for identifying knowledge gaps and enhancing the basis of scientific evidence on how managers and policymakers may act effectively to address them. Considering that the main goal of a systematic map is to collate and catalog a body of evidence to describe the state of knowledge for a specific topic, it is a suitable approach to be used for this purpose. In this context, the aim of this study is to systematically map the research trends in wildfire management practices in Mediterranean-climate regions. A total of 201 wildfire management studies were analyzed and systematically mapped in terms of their: Year of publication; Place of study; Scientific outlet; Research area (Web of Science) or Research field (Scopus); Wildfire phase; Central research topic; Main objective of the study; Research methods; and Main conclusions or contributions. The results indicate that there is an increasing number of studies being developed on the topic (most from the last 10 years), but more than half of them are conducted in few Mediterranean countries (60% of the analyzed studies were conducted in Spain, Portugal, Greece, Italy or France), and more than 50% are focused on pre-fire issues, such as prevention and fuel management. In contrast, only 12% of the studies focused on “Economic modeling” or “Human factors and issues,” which suggests that the triple bottom line of the sustainability argument (social, environmental, and economic) is not being fully addressed by fire management research. More than one-fourth of the studies had their objective related to testing new approaches in fire or forest management, suggesting that new knowledge is being produced on the field. Nevertheless, the results indicate that most studies (about 84%) employed quantitative research methods, and only 3% of the studies used research methods that tackled social issues or addressed expert and practitioner’s knowledge. Perhaps this lack of multidisciplinary studies is one of the factors hindering more progress from being made in terms of reducing wildfire occurrences and their impacts.

Keywords: wildfire, Mediterranean-climate regions, management, policy

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Authors: Moataz M. Hamed, Khalid S. M. Al Hagla, Zeyad El Sayad

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Thinking in design energy-efficiency and high-performance green buildings require a different design mechanism and design approach than conventional buildings to achieve more sustainable result. By reasoning about specific issues at the correct time in the design process, the design team can minimize negative impacts, maximize building performance and keep both first and operation costs low. This paper attempts to investigate and exploit the sustainable dimension of building information modeling (BIM) in designing high-performance green buildings that require less energy for operation, emit less carbon dioxide and provide a conducive indoor environment for occupants through early phases of the design process. This objective was attained by a critical and extensive literature review that covers the following issues: the value of considering green strategies in the early design stage, green design workflow, and BIM-based performance analysis. Then the research proceeds with a case study that provides an in-depth comparative analysis of building performance evaluation between an office building in Alexandria, Egypt that was designed by the conventional design process with the same building if taking into account sustainability consideration and BIM-based sustainable analysis integration early through the design process. Results prove that using sustainable capabilities of building information modeling (BIM) in early stages of the design process side by side with green design workflow promote buildings performance and sustainability outcome.

Keywords: BIM, building performance analysis, BIM-based sustainable analysis, green building design

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Authors: Bilge Ozel

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Cities are high-complex living organisms and are subjects to continuous transformations produced by the stress that derives from changing conditions. Today the metropolises are seen like “development engines” of the countries and accordingly they become the centre of better living conditions that encourages demographic growth which constitutes the main reason of the changes. Indeed, the potential for economic advancement of the cities directly represents the economic status of their countries. The term of “resilience”, which sees the changes as natural processes and represents the flexibility and adaptability of the systems in the face of changing conditions, becomes a key concept for the development of urban transformation policies. The term of “resilience” derives from the Latin word ‘resilire’, which means ‘bounce’, ‘jump back’, refers to the ability of a system to withstand shocks and still maintain the basic characteristics. A resilient system does not only survive the potential risks and threats but also takes advantage of the positive outcomes of the perturbations and ensures adaptation to the new external conditions. When this understanding is taken into the urban context - or rather “urban resilience” - it delineates the capacity of cities to anticipate upcoming shocks and changes without undergoing major alterations in its functional, physical, socio-economic systems. Undoubtedly, the issue of coordinating the urban systems in a “resilient” form is a multidisciplinary and complex process as the cities are multi-layered and dynamic structures. The concept of “urban transformation” is first launched in Europe just after World War II. It has been applied through different methods such as renovation, revitalization, improvement and gentrification. These methods have been in continuous advancement by acquiring new meanings and trends over years. With the effects of neoliberal policies in the 1980s, the concept of urban transformation has been associated with economic objectives. Subsequently this understanding has been improved over time and had new orientations such as providing more social justice and environmental sustainability. The aim of this research is to identify the most applied urban transformation methods in Turkey and its main reasons of being selected. Moreover, investigating the lacking and limiting points of the urban transformation policies in the context of “urban resilience” in a comparative way with European interventions. The emblematic examples, which symbolize the breaking points of the recent evolution of urban transformation concepts in Europe and Turkey, are chosen and reviewed in a critical way.

Keywords: resilience, urban dynamics, urban resilience, urban transformation

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: Aisha Adam

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This study critically examines the transformative impact of automated decision-making (ADM) and artificial intelligence (AI) systems on South African labour law. As AI technologies increasingly infiltrate workplaces, existing liability frameworks face challenges in addressing the unique complexities presented by these innovations. This article explores the necessity of redefining liability to accommodate the nuanced landscape of ADM and AI within South African labour law. It emphasises the importance of ensuring responsible deployment and safeguarding the rights of workers amid evolving technological dynamics. This research investigates the central concern of fairness, bias, and discrimination in ADM and AI decision-making. Focusing on algorithmic bias and discriminatory outcomes, the paper advocates for the integration of mechanisms within the South African legal framework, particularly under the Promotion of Equality and Prevention of Unfair Discrimination Act (PEPUDA) and the Employment Equity Act (EEA). The study scrutinises the shifting dynamics of the employment relationship, calling for clear guidelines on the responsibilities and liabilities of employers, employees, and technology providers. Furthermore, the article analyses legal and policy responses to ADM and AI within South African labour law, exploring potential amendments to legislation, guidelines, and codes of practice. It assesses the role of regulatory bodies, specifically the Commission for Conciliation, Mediation, and Arbitration (CCMA), in overseeing and enforcing responsible practices in the workplace. Lastly, the research evaluates the impact of ADM and AI on human and social rights in the South African context. Emphasising the protection of constitutional rights, including fair labour practices, privacy, and equality, the study proposes remedies and safeguards. It advocates for a multidisciplinary approach involving legal, technological, and ethical considerations to redefine liability in South African labour law effectively. The article contends that a shift from accountability to responsibility is crucial for promoting fairness, antidiscrimination, and the protection of human and social rights in the age of automated decision-making. It calls for collaborative efforts among stakeholders to shape responsible practices and redefine liability in this evolving technological landscape.

Keywords: automated decision-making, artificial intelligence, labour law, vicarious liability

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Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

Abstract:

Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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Authors: Adel A. Ghobbar, Ahmad Bakkar

Abstract:

Although special care is given to maintenance, aircraft systems fail, and these failures cause delays and cancellations. The occurrence of Delays and Cancellations affects operators and manufacturers negatively. To reduce technical delays and cancellations, one should be able to determine the important systems causing them. The goal of this research is to find a method to define the most expensive delays and cancellations systems for Airline operators. A predictive model was introduced to forecast the failure and their impact after carrying out research that identifies relevant information to tackle the problems faced while answering the questions of this paper. Data were obtained from the manufacturers’ services reliability team database. Subsequently, delays and cancellations evaluation methods were identified. No cost estimation methods were used due to their complexity. The model was developed, and it takes into account the frequency of delays and cancellations and uses weighting factors to give an indication of the severity of their duration. The weighting factors are based on customer experience. The data Analysis approach has shown that delays and cancellations events are not seasonal and do not follow any specific trends. The use of weighting factor does have an influence on the shortlist over short periods (Monthly) but not the analyzed period of three years. Landing gear and the navigation system are among the top 3 factors causing delays and cancellations for all three aircraft types. The results did confirm that the cooperation between certain operators and manufacture reduce the impact of delays and cancellations.

Keywords: reliability, availability, delays & cancellations, aircraft maintenance

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Authors: Mohamed Khaled Ahmed Azzam

Abstract:

Complete dentures, a non biological appliance, were and are still used to replace missing teeth and surrounding structures. Its main objectives are esthetics, speech, function and psychological state improvement. Dentists must realize that, just as dentate patients vary in their dental treatment complexity; edentulous patients also vary in the difficulty of their treatment plan. There are two main problems facing the removable Prosthodontist which harden his/her task how to please his patient with their new dentures being: Denture construction which however its fabrication is at the highest standards still is an unpleasant experience to all patients in the beginning and improves by time. This varies from one to several years according to the patient’s attitude, age, gender, socio-economical level and culture. The second problem of edentulous patients is both physical and psychological. Good interview, communication and note how patients present themselves for the concerns of their appearance, overall attitude and expectations concerning treatment is very important physically. On the psychological aspect patients have great difficulty to cope with new dentures to the extent of not using them at all. Hence their mind preparation should be commenced from day one by more than one method. This had a great impact on the acceptance which led to habituation to their dentures and patients were appreciative and pleased. In conclusion to successfully treat edentulous patients a great deal of information is required to complete a proper diagnosis, including patient mental attitude, past and present medical and dental conditions, and extra and intra-oral examinations. In addition to the clinical experience and skill of the whole dental team.

Keywords: complete dentures, edentulous patients, management of denture, psychological mind preparation

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Authors: Shavindrie Cooray

Abstract:

It is vital that students are supported in having balanced conversations about topics that might be controversial. This process is crucial to the development of critical thinking skills. This can be difficult to attain in e-learning environments, with some research finding students report a perceived loss in the quality of knowledge exchange and performance. This research investigated if Systems Theory could be applied to structure the discussion, improve information sharing, and reduce conflicts when students are working in online environments. This research involved 160 participants across four categories of student groups at a college in the Northeastern US. Each group was provided with a shared problem, and each group was expected to make a proposal for a solution. Two groups worked face-to-face; the first face to face group engaged with the problem and each other with no intervention from a facilitator; a second face to face group worked on the problem using Systems tools to facilitate problem structuring, group discussion, and decision-making. There were two types of virtual teams. The first virtual group also used Systems tools to facilitate problem structuring and group discussion. However, all interactions were conducted in a synchronous virtual environment. The second type of virtual team also met in real time but worked with no intervention. Findings from the study demonstrated that the teams (both virtual and face-to-face) using Systems tools shared more information with each other than the other teams; additionally, these teams reported an increased level of disagreement amongst their members, but also expressed more confidence and satisfaction with the experience and resulting decision compared to the other groups.

Keywords: e-learning, virtual teams, systems approach, conflicts

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Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

Abstract:

Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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Authors: Sai-Kit Choi

Abstract:

While traditional social services heavily depended on Government funding and support, there were always time lag, and resources mismatch with the fast growing and changing social needs. This study aims at investigating the effectiveness of implementing Circular Economy concept in a social service setting with comparison to Government Policy in response to social needs in 3 areas: response time, suitability, and community participation. To investigate the effectiveness of implementing Circular Economy concept in a social service setting, a real service model, a community resources sharing platform, was set up and statistics of the first 6 months’ operation data were used as comparison with traditional social services. Literature review was conducted as a reference basis of traditional social services under Government Policy. Case studies were conducted to provide the qualitative perspectives of the innovative approach. The results suggest that the Circular Economy model showed extraordinarily high level of community participation. In addition, it could utilize community resources in response precisely to the burning social needs. On the other hand, the available resources were unstable when comparing to those services supported by Government funding. The research team concluded that Circular Economy has high potential in applications in social service, especially in certain areas, such as resources sharing platform. Notwithstanding, it should be aware of the stability of resources when the services targeted to support some crucial needs.

Keywords: circular economy, social innovation, community participation, sharing economy, social response

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Authors: Ahmed Elzainy, Abir El Sadik, Waleed Al Abdulmonem, Ahmad Alamro, Homaidan Al-Homaidan

Abstract:

Problem-based learning (PBL) is an educational modality which stimulates critical and creative thinking. PBL has been practiced in the college of medicine, Qassim University, Saudi Arabia, since the 2002s with offline face to face activities. Therefore, crucial technological changes in paperless work were needed. The aim of the present study was to design and implement the digitalization of the PBL activities and to evaluate its impact on students' and tutors’ performance. This approach promoted the involvement of all stakeholders after their awareness of the techniques of using online tools. IT support, learning resources facilities, and required multimedia were prepared. Students’ and staff perception surveys reflected their satisfaction with these remarkable changes. The students were interested in the new digitalized materials and educational design, which facilitated the conduction of PBL sessions and provided sufficient time for discussion and peer sharing of knowledge. It enhanced the tutors for supervision and tracking students’ activities on the Learning Management System. It could be concluded that introducing of digitalization of the PBL activities promoted the students’ performance, engagement and enabled a better evaluation of PBL materials and getting prompt students as well as staff feedback. These positive findings encouraged the college to implement the digitalization approach in other educational activities, such as Team-Based Learning, as an additional opportunity for further development.

Keywords: multimedia in PBL, online PBL, problem-based learning, PBL digitalization

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Authors: Mehmet Sener, Emre Kishali

Abstract:

The establishment of republic brought radical changes related to the modernization of life in early republican Turkey considering the revolutions in socio-economical, cultural and political aspects. These changes also had many influences on the formation of city planning and architectural medium that the arrangements related with health facility production had an important place amongst them. While the health services were witnessing great transformations with all its sides, socio-cultural and architectural framework of these facilities necessitated the adaption of new conceptual approaches which led to the construction new hospital buildings by the republican state with a name ‘Sample Hospital’. In this period, the state constructed sample hospitals in some cities (Adana, Ankara, Erzurum, İstanbul, Konya, Sivas and Trabzon) for the aim of being a good example for further hospitals sheltering all the characteristics of a contemporary health complex for that day. In this study, these six hospitals will firstly be elucidated considering their historical evaluations and current situations. Then, being one of the most significant modern heritages of republican history, the ways to provide the interrelationship of these complexes with the rapidly evolving current world will be discussed by proposing solutions or approaches coming from the fields of city planning, architectural preservation, engineering and architectural history together with an awareness of the socio-economic conditions, health services and architectural medium of Turkey. These hospitals are complexes composed of building ensembles which have functional relationships with each other. So, some strategies will be proposed for the preservation, renovation, and refurbishment of these complexes with an awareness of the possibility of the conflict between conservation practices and today’s health facility standards. Accordingly, the addition or removal of some elements in the complex or the suggestion of some architectural changes for the modernization of these health facilities will be investigated considering the requirements of the contemporary architectural design of health facilities. Since these hospitals are highly complex structures and have vastly changing design and construction standards, they cannot be used without adopting necessary architectural and technological interventions. So, the adaptive re-use of these buildings instead of demolition or the preservation of their overall characteristics becomes inevitable for the sustaining of these health facility heritages in Turkey. In this context, a multidisciplinary analysis will be made in this study on ‘Sample Hospital’ concept and buildings existing in Turkish modern architectural history within the framework of the adaptive reuse of these health complexes.

Keywords: adaptive re-use, conservation, early republican Turkey, sample hospital

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Authors: Scott McCutcheon, Karen Schreder

Abstract:

Higher education is facing a new reality. Student connection with coursework, instructor, and peers competes with online gaming, screen time, and instant gratification. Pedagogical methods that align student connection and critical thinking in a content-rich environment are important in supporting student learning, a sense of community, and emotional health. This mixed methods study focuses on exploring how the use of educational escape rooms (EERs) can support student learning and learning retention while fostering engagement with each other, the instructor, and the coursework. EERs are content-specific, cooperative, team-based learning activities designed to be completed within a short segment of a typical class. Data for the study was collected over three semesters and includes results from the implementation of EERs in science-based and liberal studies courses taught by different instructors. Twenty-seven students were surveyed regarding their learning experiences with this pedagogy, and interviews with four student volunteers were conducted to add depth to the survey data. A key finding from this research indicates that students felt more connected to each other and the course content after participating in the escape room activity. Additional findings point to increased engagement and comprehension of the class material. Data indicates that the use of an EER pedagogy supports student engagement, well-being, subject comprehension, and student-student and student-instructor connection.

Keywords: gamification, innovative pedagogy, student engagement, student emotional well being

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Authors: Hossein Barri Ghazani

Abstract:

Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

Procedia PDF Downloads 142

Authors: Mokhtari Karchegani Amir, Maboudi Samad, Azadi Reza, Dastanian Raoof

Abstract:

Marun's petrochemical cracking furnaces have a very comprehensive operating control system for combustion and related equipment, utilizing advanced instrument circuits. However, after several years of operation, numerous problems arose in the pyrolysis furnaces. A team of experts conducted an audit, revealing that the furnaces were over-designed, leading to excessive consumption of air and fuel. This issue was related to the burners' shutter settings, which had not been configured properly. The operations department had responded by increasing the induced draft fan speed and forcing the instrument switches to counteract the wind effect in the combustion chamber. Using Fluent and Gambit software, the furnaces were analyzed. The findings indicated that this situation elevated the convection part's temperature, causing uneven heat distribution inside the furnace. Consequently, this led to overheating in the convection section and excessive cracking within the coils in the radiation section. The increased convection temperature damaged convection parts and resulted in equipment blockages downstream of the furnaces due to the production of more coke and tar in the process. To address these issues, corrective actions were implemented. The excess air for burners and combustion chambers was properly set, resulting in improved efficiency, reduced emissions of environmentally harmful gases, prevention of creep in coils, decreased fuel consumption, and lower maintenance costs.

Keywords: furnace, coke, CFD analysis, over cracking

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