Search results for: teaching and learning practice
1693 Diagrid Structural System
Authors: K. Raghu, Sree Harsha
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The interrelationship between the technology and architecture of tall buildings is investigated from the emergence of tall buildings in late 19th century to the present. In the late 19th century early designs of tall buildings recognized the effectiveness of diagonal bracing members in resisting lateral forces. Most of the structural systems deployed for early tall buildings were steel frames with diagonal bracings of various configurations such as X, K, and eccentric. Though the historical research a filtering concept is developed original and remedial technology- through which one can clearly understand inter-relationship between the technical evolution and architectural esthetic and further stylistic transition buildings. Diagonalized grid structures – “diagrids” - have emerged as one of the most innovative and adaptable approaches to structuring buildings in this millennium. Variations of the diagrid system have evolved to the point of making its use non-exclusive to the tall building. Diagrid construction is also to be found in a range of innovative mid-rise steel projects. Contemporary design practice of tall buildings is reviewed and design guidelines are provided for new design trends. Investigated in depths are the behavioral characteristics and design methodology for diagrids structures, which emerge as a new direction in the design of tall buildings with their powerful structural rationale and symbolic architectural expression. Moreover, new technologies for tall building structures and facades are developed for performance enhancement through design integration, and their architectural potentials are explored. By considering the above data the analysis and design of 40-100 storey diagrids steel buildings is carried out using E-TABS software with diagrids of various angle to be found for entire building which will be helpful to reduce the steel requirement for the structure. The present project will have to undertake wind analysis, seismic analysis for lateral loads acting on the structure due to wind loads, earthquake loads, gravity loads. All structural members are designed as per IS 800-2007 considering all load combination. Comparison of results in terms of time period, top storey displacement and inter-storey drift to be carried out. The secondary effect like temperature variations are not considered in the design assuming small variation.Keywords: diagrid, bracings, structural, building
Procedia PDF Downloads 3861692 The Conservation of the Roman Mosaics in the Museum of Sousse, Tunisia: Between Doctrines and Practices
Authors: Zeineb Yousse, Fakher Kharrat
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Mosaic is a part of a broad universal cultural heritage; sometimes it represents a rather essential source for the researches on the everyday life of some of the previous civilizations. Tunisia has one of the finest and largest collections of mosaics in the world, which is essentially exhibited in the Museums of Bardo and Sousse. Restored and reconstituted, they bear witnesses to hard work. Our paper deals with the discipline of conservation of Roman mosaics based on the proceedings of the workshop of the Museum of Sousse. Thus, we highlight two main objectives. In the first place, it is a question of revealing the techniques adopted by professionals to handle mosaics and to which school of conservation these techniques belong. In the second place, we are going to interpret the works initiated to preserve the archaeological heritage in order to protect it in present time and transmit it to future generations. To this end, we paid attention to four Roman mosaics currently exhibited in the Museum of Sousse. These Mosaics show different voids or gaps at the level of their surfaces and the method used to fill these gaps seems to be interesting to analyze. These mosaics are known under the names of: Orpheus Charming the Animals, Gladiator and Bears, Stud farm of Sorothus and finally Head of Medusa. The study on the conservation passes through two chained phases. We start with a small historical overview in order to gather information related to the original location, the date of its composition as well as the description of its image. Afterward, the intervention process is analyzed by handling three complementary elements which are: diagnosis of the existing state, the study of the medium processing and the study of the processing of the tesselatum surface which includes the pictorial composition of the mosaic. Furthermore, we have implemented an evaluation matrix with six operating principles allowing the assessment of the appropriateness of the intervention. These principles are the following: minimal intervention, reversibility, compatibility, visibility, durability, authenticity and enhancement. Various accumulated outcomes are pointing out the techniques used to fill the gaps as well as the level of compliance with the principles of conservation. Accordingly, the conservation of mosaics in Tunisia is a practice that combines various techniques without really arguing about the choice of a particular theory.Keywords: conservation, matrix, museum of Sousse, operating particular theory, principles, Roman mosaics
Procedia PDF Downloads 3291691 High Motivational Salient Face Distractors Slowed Target Detection: Evidence from Behavioral Studies
Authors: Rashmi Gupta
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Rewarding stimuli capture attention involuntarily as a result of an association process that develops quickly during value learning, referred to as the reward or value-driven attentional capture. It is essential to compare reward with punishment processing to get a full picture of value-based modulation in visual attention processing. Hence, the present study manipulated both valence/value (reward as well as punishment) and motivational salience (probability of an outcome: high vs. low) together. Series of experiments were conducted, and there were two phases in each experiment. In phase 1, participants were required to learn to associate specific face stimuli with a high or low probability of winning or losing points. In the second phase, these conditioned stimuli then served as a distractor or prime in a speeded letter search task. Faces with high versus low outcome probability, regardless of valence, slowed the search for targets (specifically the left visual field target) and suggesting that the costs to performance on non-emotional cognitive tasks were only driven by motivational salience (high vs. loss) associated with the stimuli rather than the valence (gain vs. loss). It also suggests that the processing of motivationally salient stimuli is right-hemisphere biased. Together, results of these studies strengthen the notion that our visual attention system is more sensitive to affected by motivational saliency rather than valence, which termed here as motivational-driven attentional capture.Keywords: attention, distractors, motivational salience, valence
Procedia PDF Downloads 2201690 Academic, Socio-Cultural and Psychological Satisfaction of International Higher Degree Research Students (IRHD) in Australia
Authors: Baohua Yu
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In line with wider tends in the expansion of international student mobility, the number of international higher degree research students has grown at a significant rate in recent years. In particular, Australia has become a hub for attracting international higher degree research students from around the world. However, research has identified that international higher degree research students often encounter a wide range of academic and socio-cultural challenges in adapting to their new environment. Moreover, this can have a significant bearing on their levels of satisfaction with their studies. This paper outlines the findings of a mixed method study exploring the experiences and perceptions of international higher degree research students in Australia. Findings revealed that IRHD students’ overall and academic satisfaction in Australia were highly related to each other, and they were strongly influenced by their learning and research, moderately influenced by co-national support and intercultural contact ability. Socio-cultural satisfaction seemed to belong to a different domain from academic satisfaction because it was explained by a different set of variables such as living and adaptation and intercultural contact ability. In addition, the most important issues in terms of satisfaction were not directly related to academic studies. Instead, factors such as integration into the community, interacting with other students, relationships with supervisors, and the provision of adequate desk space were often given the greatest weight. Implications for how university policy can better support international doctoral students are discussed.Keywords: international higher degree research students, academic adaptation, socio-cultural adaptation, student satisfaction
Procedia PDF Downloads 3051689 Knee Pain Reduction: Holistic vs. Traditional
Authors: Renee Moten
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Introduction: Knee pain becomes chronic because the therapy used focuses only on the symptoms of knee pain and not the causes of knee pain. Preventing knee injuries is not in the toolbox of the traditional practitioner. This research was done to show that we must reduce the inflammation (holistically), reduce the swelling and regain flexibility before considering any type of exercise. This method of performing the correct exercise stops the bowing of the knee, corrects the walking gait, and starts to relieve knee, hip, back, and shoulder pain. Method: The holistic method that is used to heal knees is called the Knee Pain Recipe. It’s a six step system that only uses alternative medicine methods to reduce, relieve and restore knee joint mobility. The system is low cost, with no hospital bills, no physical therapy, and no painkillers that can cause damage to the kidneys and liver. This method has been tested on 200 women with knee, back, hip, and shoulder pain. Results: All 200 women reduce their knee pain by 50%, some by as much as 90%. Learning about ankle and foot flexibility, along with understanding the kinetic chain, helps improve the walking gait, which takes the pressure off the knee, hip and back. The knee pain recipe also has helped to reduce the need for a cortisone injection, stem cell procedures, to take painkillers, and surgeries. What has also been noted in the research was that if the women's knees were too far gone, the Knee Pain Recipe helped prepare the women for knee replacement surgery. Conclusion: It is believed that the Knee Pain Recipe, when performed by men and women from around the world, will give them a holistic alternative to drugs, injections, and surgeries.Keywords: knee, surgery, healing, holistic
Procedia PDF Downloads 751688 Ultra-High Molecular Weight Polyethylene (UHMWPE) for Radiation Dosimetry Applications
Authors: Malik Sajjad Mehmood, Aisha Ali, Hamna Khan, Tariq Yasin, Masroor Ikram
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Ultra-high molecular weight polyethylene (UHMWPE) is one of the polymers belongs to polyethylene (PE) family having monomer –CH2– and average molecular weight is approximately 3-6 million g/mol. Due its chemical, mechanical, physical and biocompatible properties, it has been extensively used in the field of electrical insulation, medicine, orthopedic, microelectronics, engineering, chemistry and the food industry etc. In order to alter/modify the properties of UHMWPE for particular application of interest, certain various procedures are in practice e.g. treating the material with high energy irradiations like gamma ray, e-beam, and ion bombardment. Radiation treatment of UHMWPE induces free radicals within its matrix, and these free radicals are the precursors of chain scission, chain accumulation, formation of double bonds, molecular emission, crosslinking etc. All the aforementioned physical and chemical processes are mainly responsible for the modification of polymers properties to use them in any particular application of our interest e.g. to fabricate LEDs, optical sensors, antireflective coatings, polymeric optical fibers, and most importantly for radiation dosimetry applications. It is therefore, to check the feasibility of using UHMWPE for radiation dosimetery applications, the compressed sheets of UHMWPE were irradiated at room temperature (~25°C) for total dose values of 30 kGy and 100 kGy, respectively while one were kept un-irradiated as reference. Transmittance data (from 400 nm to 800 nm) of e-beam irradiated UHMWPE and its hybrids were measured by using Muller matrix spectro-polarimeter. As a result significant changes occur in the absorption behavior of irradiated samples. To analyze these (radiation induced) changes in polymer matrix Urbach edge method and modified Tauc’s equation has been used. The results reveal that optical activation energy decreases with irradiation. The values of activation energies are 2.85 meV, 2.48 meV, and 2.40 meV for control, 30 kGy, and 100 kGy samples, respectively. Direct and indirect energy band gaps were also found to decrease with irradiation due to variation of C=C unsaturation in clusters. We believe that the reported results would open new horizons for radiation dosimetery applications.Keywords: electron beam, radiation dosimetry, Tauc’s equation, UHMWPE, Urbach method
Procedia PDF Downloads 4081687 Peer Support Groups as a Tool to Increase Chances of Passing General Practice UK Qualification Exams
Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie
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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.Keywords: peer support, medical education, pastoral support, MRCGP exams
Procedia PDF Downloads 1351686 Multicenter Baseline Survey to Outline Antimicrobial Prescribing Practices at Six Public Sectortertiary Care Hospitals in a Low Middle Income Country
Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed
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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics
Procedia PDF Downloads 1041685 Urban Forest Innovation Lab as a Driver to Boost Forest Bioeconomy
Authors: Carmen Avilés Palacios, Camilo Muñoz Arenas, Joaquín García Alfonso, Jesús González Arteaga, Alberto Alcalde Calonge
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There is a need for review of the consumption and production models of industrialized states in accordance with the Paris Agreement and the Sustainable Development Goals (1) (OECD, 2016). This constitutes the basis of the bioeconomy (2) that is focused on striking a balance between economic development, social development and environmental protection. Bioeconomy promotes the adequate use and consumption of renewable natural resources (3) and involves developing new products and services adapted to the principles of circular economy: more sustainable (reusable, biodegradable, renewable and recyclable) and with a lower carbon footprint (4). In this context, Urban Forest Innovation Lab (UFIL) grows, an Urban Laboratory for experimentation focused on promoting entrepreneurship in forest bioeconomy (www.uiacuenca.es). UFIL generates local wellness taking sustainable advantage of an endogenous asset, forests. UFIL boosts forest bioeconomy opening its doors of knowledge to pioneers in this field, giving the opportunity to be an active part of a change in the way of understanding the exploitation of natural resources, discovering business, learning strategies and techniques and incubating business ideas So far now, 100 entrepreneurs are incubating their nearly 30 new business plans. UFIL has promoted an ecosystem to connect the rural-urban world that promotes sustainable rural development around the forest.Keywords: bioeconomy, forestry, innovation, entrepreneurship
Procedia PDF Downloads 1161684 Ontology Expansion via Synthetic Dataset Generation and Transformer-Based Concept Extraction
Authors: Andrey Khalov
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The rapid proliferation of unstructured data in IT infrastructure management demands innovative approaches for extracting actionable knowledge. This paper presents a framework for ontology-based knowledge extraction that combines relational graph neural networks (R-GNN) with large language models (LLMs). The proposed method leverages the DOLCE framework as the foundational ontology, extending it with concepts from ITSMO for domain-specific applications in IT service management and outsourcing. A key component of this research is the use of transformer-based models, such as DeBERTa-v3-large, for automatic entity and relationship extraction from unstructured texts. Furthermore, the paper explores how transfer learning techniques can be applied to fine-tune large language models (LLaMA) for using to generate synthetic datasets to improve precision in BERT-based entity recognition and ontology alignment. The resulting IT Ontology (ITO) serves as a comprehensive knowledge base that integrates domain-specific insights from ITIL processes, enabling more efficient decision-making. Experimental results demonstrate significant improvements in knowledge extraction and relationship mapping, offering a cutting-edge solution for enhancing cognitive computing in IT service environments.Keywords: ontology expansion, synthetic dataset, transformer fine-tuning, concept extraction, DOLCE, BERT, taxonomy, LLM, NER
Procedia PDF Downloads 141683 Green Windows of Opportunity in Latin American Countries
Authors: Fabianna Bacil, Zenathan Hasannundin, Clovis Freire
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The green transition opens green windows of opportunity – temporary moments in which there are lower barriers and shorter learning periods for developing countries to enter emerging technologies and catch-up. However, taking advantage of these windows requires capabilities in national sectoral systems to adopt and develop technologies linked to green sectors as well as strong responses to build the required knowledge, skills, and infrastructure and foster the growth of targeted sectors. This paper uses UNCTAD’s frontier technology readiness index to analyse the current position of Latin America and the Caribbean to use, adopt, and adapt frontier technologies, examining the preconditions in the region to take up windows of opportunity that arise with the green transition. The index highlights the inequality across countries in the region, as well as gaps in capabilities dimensions, especially in terms of R&D. Moving to responses, it highlights industrial policies implemented to foster the growth of green technologies, emphasising the essential role played by the state to build and strengthen capabilities and provide infant industry protection that enables the growth of these sectors. Overall, while there are exceptions, especially in the Brazilian case, countries in Latin America and the Caribbean should focus on strengthening their capabilities to be better positioned, especially in terms of knowledge creation, infrastructure, and financing availability.Keywords: Green technologies, Industrial policy, Latin America, windows of opportunity
Procedia PDF Downloads 631682 Using Multiple Strategies to Improve the Nursing Staff Edwards Lifesciences Hemodynamic Monitoring Correctness of Operation
Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu
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Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care
Procedia PDF Downloads 811681 A Palmprint Identification System Based Multi-Layer Perceptron
Authors: David P. Tantua, Abdulkader Helwan
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Biometrics has been recently used for the human identification systems using the biological traits such as the fingerprints and iris scanning. Identification systems based biometrics show great efficiency and accuracy in such human identification applications. However, these types of systems are so far based on some image processing techniques only, which may decrease the efficiency of such applications. Thus, this paper aims to develop a human palmprint identification system using multi-layer perceptron neural network which has the capability to learn using a backpropagation learning algorithms. The developed system uses images obtained from a public database available on the internet (CASIA). The processing system is as follows: image filtering using median filter, image adjustment, image skeletonizing, edge detection using canny operator to extract features, clear unwanted components of the image. The second phase is to feed those processed images into a neural network classifier which will adaptively learn and create a class for each different image. 100 different images are used for training the system. Since this is an identification system, it should be tested with the same images. Therefore, the same 100 images are used for testing it, and any image out of the training set should be unrecognized. The experimental results shows that this developed system has a great accuracy 100% and it can be implemented in real life applications.Keywords: biometrics, biological traits, multi-layer perceptron neural network, image skeletonizing, edge detection using canny operator
Procedia PDF Downloads 3711680 Grey Wolf Optimization Technique for Predictive Analysis of Products in E-Commerce: An Adaptive Approach
Authors: Shital Suresh Borse, Vijayalaxmi Kadroli
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E-commerce industries nowadays implement the latest AI, ML Techniques to improve their own performance and prediction accuracy. This helps to gain a huge profit from the online market. Ant Colony Optimization, Genetic algorithm, Particle Swarm Optimization, Neural Network & GWO help many e-commerce industries for up-gradation of their predictive performance. These algorithms are providing optimum results in various applications, such as stock price prediction, prediction of drug-target interaction & user ratings of similar products in e-commerce sites, etc. In this study, customer reviews will play an important role in prediction analysis. People showing much interest in buying a lot of services& products suggested by other customers. This ultimately increases net profit. In this work, a convolution neural network (CNN) is proposed which further is useful to optimize the prediction accuracy of an e-commerce website. This method shows that CNN is used to optimize hyperparameters of GWO algorithm using an appropriate coding scheme. Accurate model results are verified by comparing them to PSO results whose hyperparameters have been optimized by CNN in Amazon's customer review dataset. Here, experimental outcome proves that this proposed system using the GWO algorithm achieves superior execution in terms of accuracy, precision, recovery, etc. in prediction analysis compared to the existing systems.Keywords: prediction analysis, e-commerce, machine learning, grey wolf optimization, particle swarm optimization, CNN
Procedia PDF Downloads 1131679 Estimation of Carbon Losses in Rice: Wheat Cropping System of Punjab, Pakistan
Authors: Saeed Qaisrani
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The study was conducted to observe carbon and nutrient loss by burning of rice residues on rice-wheat cropping system The rice crop was harvested to conduct the experiment in a randomized complete block design (RCBD) with factors and 4 replications with a net plot size of 10 m x 20 m. Rice stubbles were managed by two methods i.e. Incorporation & burning of rice residues. Soil samples were taken to a depth of 30 cm before sowing & after harvesting of wheat. Wheat was sown after harvesting of rice by three practices i.e. Conventional tillage, Minimum tillage and Zero tillage to observe best tillage practices. Laboratory and field experiments were conducted on wheat to assess best tillage practice and residues management method with estimation of carbon losses. Data on the following parameters; establishment count, plant height, spike length, number of grains per spike, biological yield, fat content, carbohydrate content, protein content, and harvest index were recorded to check wheat quality & ensuring food security in the region. Soil physico-chemical analysis i.e. pH, electrical conductivity, organic matter, nitrogen, phosphorus, potassium, and carbon were done in soil fertility laboratory. Substantial results were found on growth, yield and related parameters of wheat crop. The collected data were examined statistically with economic analysis to estimate the cost-benefit ratio of using different tillage techniques and residue management practices. Obtained results depicted that Zero tillage method have positive impacts on growth, yield and quality of wheat, Moreover, it is cost effective methodology. Similarly, Incorporation is suitable and beneficial method for soil due to more nutrients provision and reduce the need of fertilizers. Burning of rice stubbles has negative impact including air pollution, nutrient loss, microbes died and carbon loss. Recommended the zero tillage technology to reduce carbon losses along with food security in Pakistan.Keywords: agricultural agronomy, food security, carbon sequestration, rice-wheat cropping system
Procedia PDF Downloads 2771678 A Risk-Based Approach to Construction Management
Authors: Chloe E. Edwards, Yasaman Shahtaheri
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Risk management plays a fundamental role in project planning and delivery. The purpose of incorporating risk management into project management practices is to identify and address uncertainties related to key project-related activities. The uncertainties, known as risk events, can relate to project deliverables that are quantifiable and are often measured by impact to project schedule, cost, or environmental impact. Risk management should be incorporated as an iterative practice throughout the planning, execution, and commissioning phases of a project. This paper specifically examines how risk management contributes to effective project planning and delivery through a case study of a transportation project. This case study focused solely on impacts to project schedule regarding three milestones: readiness for delivery, readiness for testing and commissioning, and completion of the facility. The case study followed the ISO 31000: Risk Management – Guidelines. The key factors that are outlined by these guidelines include understanding the scope and context of the project, conducting a risk assessment including identification, analysis, and evaluation, and lastly, risk treatment through mitigation measures. This process requires continuous consultation with subject matter experts and monitoring to iteratively update the risks accordingly. The risk identification process led to a total of fourteen risks related to design, permitting, construction, and commissioning. The analysis involved running 1,000 Monte Carlo simulations through @RISK 8.0 Industrial software to determine potential milestone completion dates based on the project baseline schedule. These dates include the best case, most likely case, and worst case to provide an estimated delay for each milestone. Evaluation of these results provided insight into which risks were the highest contributors to the projected milestone completion dates. Based on the analysis results, the risk management team was able to provide recommendations for mitigation measures to reduce the likelihood of risks occurring. The risk management team also provided recommendations for managing the identified risks and project activities moving forward to meet the most likely or best-case milestone completion dates.Keywords: construction management, monte carlo simulation, project delivery, risk assessment, transportation engineering
Procedia PDF Downloads 1071677 Perceived Barriers and Benefits of Technology-Based Progress Monitoring for Non-Academic Individual Education Program Goals
Authors: A. Drelick, T. Sondergeld, M. Decarlo-Tecce, K. McGinley
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In 1975, a free, appropriate public education (FAPE) was granted for all students in the United States regardless of their disabilities. As a result, the special education landscape has been reshaped through new policies and legislation. Progress monitoring, a specific component of an Individual Education Program (IEP) calls, for the use of data collection to determine the appropriateness of services provided to students with disabilities. The recent US Supreme Court ruling in Endrew F. v. Douglas County warrants giving increased attention to student progress, specifically pertaining to improving functional, or non-academic, skills that are addressed outside the general education curriculum. While using technology to enhance data collection has become a common practice for measuring academic growth, its application for non-academic IEP goals is uncertain. A mixed-methods study examined current practices and rationales for implementing technology-based progress monitoring focused on non-academic IEP goals. Fifty-seven participants responded to an online survey regarding their progress monitoring programs for non-academic goals. After isolated analysis and interpretation of quantitative and qualitative results, data were synthesized to produce meta-inferences that drew broader conclusions on the topic. For the purpose of this paper, specific focus will be placed on the perceived barriers and benefits of implementing technology-based progress monitoring protocols for non-academic IEP goals. The findings of this study highlight facts impacting the use of technology-based progress monitoring. Perceived barriers to implementation include: (1) lack of training, (2) access to technology, (3) outdated or inoperable technology, (4) reluctance to change, (5) cost, (6) lack of individualization within technology-based programs, and (7) legal issues in special education; while perceived benefits include: (1) overall ease of use, (2) accessibility, (3) organization, (4) potential for improved presentation of data, (5) streamlining the progress-monitoring process, and (6) legal issues in special education. Based on these conclusions, recommendations are made to IEP teams, school districts, and software developers to improve the progress-monitoring process for functional skills.Keywords: special education, progress monitoring, functional skills, technology
Procedia PDF Downloads 2471676 Corporate Governance of Intellectual Capital: The Impact of Intellectual Capital Reporting
Authors: Cesar Julio Recalde
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Background: The role of intangible assets in today´s society is undeniable and continuously growing. More than 80% of corporate market is related to intellectual capital(IC). However, corporate governance principles and practices seem strongly based and oriented towards tangible assets. The impact of intangible assets on corporate governance might require prevention and adaptative actions. Adherence to voluntary mechanisms of intellectual capital reporting (ICR) seems to be a gateway towards adapting corporate governance to intangible assets influence and a conceptual cornerstone. The impact of adherence to intellectual capital reporting on corporate governance and performance needs to be evaluated. Purposes: This work has a sequential two folded purpose: (1) exploring the influences exerted by IC on corporate governance theory and practice, and within that context (2) analyzing the impact of adherence to voluntary mechanisms of ICR on corporate governance. Design and summary: This work employs the theory of the firm and agency theory in order to conceptually explore the effects of each dimension of IC on key corporate governance issues, namely property rights and control by shareholders and residual claims by stakeholders, fiduciary duties of management and the board, opportunistic behavior and transparency. A comprehensive IC taxonomy and map is presented. Within the resulting context, internal and external impact of ICR on corporate governance and performance is conceptually analyzed. IRC constraint and barriers are identified. Intellectual liabilities are presented within the context of IRC. Finally, IRC regulatory framework is surveyed. Findings: Relevant conclusions were rendered on the influence of intellectual capital on corporate governance. Sufficient evidence of a positive impact of IRC on corporate governance and performance was found. Additionally, it was found that IRC exerts a leveraging effect on IC itself. Intellectual liabilities are insufficiently researched and seem to have a relevant importance on IC measuring. IRC regulatory framework was found to be insufficiently developed to capture the essence of intangible assets and to meet corporate governance challenges facing IC. Originality: This work develops a progressive approach to conceptually analyze the mutual influences between IC and corporate governance. An epistemic ideogram represents the intersection of analyzed theories. An IC map is presented. The relatively new topic of intellectual liabilities is conceptually analyzed in the context of IRC. Social liabilities and client liabilities are presented.Keywords: corporate governance, intellectual capital, intellectual capital reporting, intellectual assets, intellectual liabilities, voluntary mechanisms, regulatory framework
Procedia PDF Downloads 3861675 Assessing Professionalism, Communication, and Collaboration among Emergency Physicians by Implementing a 360-Degree Evaluation
Authors: Ahmed Al Ansari, Khalid Al Khalifa
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Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.Keywords: MSF system, emergency, validity, generalizability
Procedia PDF Downloads 3571674 Efficacy of Self-Assessment Metacognitive Strategy on Academic Performance Among Upper Basic Students in Ankpa, Kogi State, Nigeria
Authors: Daodu Joshua Rotimi
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This study investigated the Efficacy of Self-Assessment Metacognitive Strategy on Academic performance in Energy Concepts among Upper Basic Science Students in Ankpa, Kogi State, Nigeria. The research design adopted for the study was a Quasi-experimental control group design which employed a pretest, posttest of the experimental and control groups. The population of the study consisted of one hundred and twenty-four (124) JSSII Students; sixty-five (65) for the experimental group and (59) for the control group. The instrument used for the study was the Energy Concept Performance Test (ECPT), with a reliability coefficient of 0.80. Two research questions were answered using descriptive statistics of mean and standard deviation, while two hypotheses were tested using a t-test at P≤0.05 level of significance. The findings of the study revealed that the use of the Self-Assessment Metacognitive Strategy has a positive effect on students’ performance in energy concepts among upper Basic Science Students leading to high academic performance; also, there is no significant difference in the mean Academic Performance scores between Male and Female students taught Energy Concept using Self-Assessment Metacognitive Strategy. Based on the research findings, recommendations were made, which include that Secondary school teachers should be encouraged the use Self-Assessment Metacognitive strategy so as to make the learning process attractive, interactive and enriching to the learners.Keywords: metacognition, self-assessment, performance, efficacy
Procedia PDF Downloads 1231673 3D Object Detection for Autonomous Driving: A Comprehensive Review
Authors: Ahmed Soliman Nagiub, Mahmoud Fayez, Heba Khaled, Said Ghoniemy
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Accurate perception is a critical component in enabling autonomous vehicles to understand their driving environment. The acquisition of 3D information about objects, including their location and pose, is essential for achieving this understanding. This survey paper presents a comprehensive review of 3D object detection techniques specifically tailored for autonomous vehicles. The survey begins with an introduction to 3D object detection, elucidating the significance of the third dimension in perceiving the driving environment. It explores the types of sensors utilized in this context and the corresponding data extracted from these sensors. Additionally, the survey investigates the different types of datasets employed, including their formats, sizes, and provides a comparative analysis. Furthermore, the paper categorizes and thoroughly examines the perception methods employed for 3D object detection based on the diverse range of sensors utilized. Each method is evaluated based on its effectiveness in accurately detecting objects in a three-dimensional space. Additionally, the evaluation metrics used to assess the performance of these methods are discussed. By offering a comprehensive overview of 3D object detection techniques for autonomous vehicles, this survey aims to advance the field of perception systems. It serves as a valuable resource for researchers and practitioners, providing insights into the techniques, sensors, and evaluation metrics employed in 3D object detection for autonomous vehicles.Keywords: computer vision, 3D object detection, autonomous vehicles, deep learning
Procedia PDF Downloads 621672 Employees and Their Perception of Soft Skills on Their Employability
Authors: Sukrita Mukherjee, Anindita Chaudhuri
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Soft skills are a crucial aspect for employees, and these skills are not confined to any particular field rather, it guarantees further career growth and job opportunities for employees who are seeking growth. Soft skills are also regarded as personality-specific skills that are observable and are qualitative in nature, which determines an employee’s strengths as a leader. When an employee intends to hold his job, then the person must make effective use of his personal resources, that, in turn, impacts his employability in a positive manner. An employee at his workplace is expected to make effective use of his personal resources. The resources that are to be used by the employee are generally of two types. First type of resources are occupation related, which is related with the educational background of the employee, and the second type of resources are the psychological resources of the employee, such as self-knowledge, career orientation awareness, sense of purpose and emotional literacy, that are considered crucial for an employee in his workplace. The present study is a qualitative study which includes 10 individuals working in IT Sector and Service Industry, respectively. For IT sector, graduate people are considered, and for the Service Industry, individuals who have done a Professional course in order to get into the industry are considered. The emerging themes from the findings after thematic analysis reveal that different aspect of Soft skills such as communication, decision making, constant learning, keeping oneself updated with the latest technological advancement, emotional intelligence are some of the important factors that helps an employee not only to sustain his job, but also grow in his workplace.Keywords: employabiliy, soft skils, employees, resources, workplace
Procedia PDF Downloads 631671 Cognitive Benefits of Being Bilingual: The Effect of Language Learning on the Working Memory in Emerging Miao-Mandarin Juveniles in Rural Regions of China
Authors: Peien Ma
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Bilingual effect/advantage theorized the positive effect of being bilingual on general cognitive abilities, but it was unknown which factors tend to modulate these bilingualism effects on working memory capacity. This study imposed empirical field research on a group of low-SES emerging bilinguals, Miao people, in the hill tribes of rural China to investigate whether bilingualism affected their verbal working memory performance. 20 Miao-Chinese bilinguals (13 girls and 7 boys with a mean age of 11.45, SD=1.67) and 20 Chinese monolingual peers (13 girls and 7 boys with a mean age of 11.6, SD=0.68) were recruited. These bilingual and monolingual juveniles, matched on age, sex, socioeconomic status, and educational status, completed a language background questionnaire and a standard forward and backward digit span test adapted from Wechsler Adult Intelligence Scale-Revised (WAIS-R). The results showed that bilinguals earned a significantly higher overall mean score of the task, suggesting the superiority of working memory ability over the monolinguals. And bilingual cognitive benefits were independent of proficiency levels in learners’ two languages. The results suggested that bilingualism enhances working memory in sequential bilinguals from low SES backgrounds and shed light on our understanding of the bilingual advantage from a psychological and social perspective.Keywords: bilingual effects, heritage language, Miao/Hmong language Mandarin, working memory
Procedia PDF Downloads 1571670 Challenges and Practical Tips for Advance Care Planning and End-of-Life Communications With Cancer Patients in Global Pandemic
Authors: Poonam Goswami
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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.Keywords: advance care planning, end of life, cancer, global, pandemic
Procedia PDF Downloads 1291669 Surrogacy: A Comparative, Legal, Children’s Rights Perspective
Authors: Ronli Sifris
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The last Australian Parliamentary inquiry into surrogacy took place in 2016. Since then, a number of countries have reviewed their surrogacy laws, including countries such as New Zealand and the United Kingdom, which traditionally have invoked similar legal approaches to Australia on a broad range of issues. The time is ripe to reform Australia’s surrogacy laws with a view to putting in place a system that best protects the rights of all parties to a surrogacy arrangement, and especially the rights of the child. There are two specific, linked issues which tend to be particularly contentious in the surrogacy context. The first relates to legal parentage. There are questions around whether the surrogate or the intended parents should be deemed the legal parents of a child born through surrogacy and what should be the process for any transfer of parentage. The second key issue relates to compensation and whether a surrogate should be compensated for the reproductive labour inherent in conceiving, gestating, and birthing a child. This paper will invoke a comparative analysis with a view to considering how different countries are regulating surrogacy and which approach best protects the rights all parties involved in the surrogacy arrangement, especially the rights of the children born through surrogacy. The specific countries to be considered are Australia, Canada, and California (United States). I have selected these countries for the following reasons: Australia is the jurisdiction where the author is based, it is, therefore, the jurisdiction with which she has the most familiarity. It allows altruistic surrogacy only and post-birth parentage orders in favour of the intended parents of children born through altruistic surrogacy California, as a jurisdiction allowing for compensated surrogacy and pre-birth parentage orders in favour of the intended parents, sits at the other end of the spectrum to Australia thereby providing an interesting point of comparison. Canada sits somewhere in the middle; it ostensibly allows only altruistic surrogacy, but in practice, many aspects of the Canadian process resemble compensated surrogacy. In addition to conducting a comparative analysis with other countries, the paper will also consider international human rights law as its overarching framework for determining the approach that best protects the rights of a child born through surrogacy. Particular attention will be paid to the United Nations Convention on the Rights of the Child as the key children’s rights treaty. The European Court of Human Rights will also be extensively considered as it has decided a number of cases relating to the rights of children born through surrogacy.Keywords: surrogacy, children’s rights, australia, compensation, parentage
Procedia PDF Downloads 1301668 An Assessment of Inferior Dental (IDN) and Lingual Nerve (LN) Injuries Following Third Molar Removal Under LA, IVS, and GA - An Audit and Case-Series
Authors: Aamna Tufail, Catherine Anyanwu
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Introduction/Aims: Neurosensory deficits following third molar removal affect the quality of life markedly. The purpose of this audit was to evaluate the incidence of IDN and LN damage and to compare departmental rates to an established standard. A secondary objective was to provide a descriptive summary of identified cases for clinical learning. Materials and Methods: A retrospective audit was conducted by a telephone survey of 101 patients who had third molar extractions performed under LA, IVS, or GA from January 2019 to June 2020 at a District General Hospital. The results were compared to a clinical standard identified as Cheng et al1. Data collection included mode of surgery, mode of anaesthesia, grade of clinician, assessment of difficulty, severity, and duration of symptoms. Results/Statistics: A total of 101 patients had 136 third molars extracted. Age range was 18-84 years. 44% extractions were under LA, 52% under GA, and 4% under IV sedation. 30% were simple extractions, 68% were surgical removals, 2% were unspecified. 89% extractions were performed by an Associate Specialist, 5% by a consultant, and 6% by unspecified grade of clinician. The rate of IDN injuries was 2.9% (n=4), higher than standard (0.3%). The rate of LN injuries was 0.7% (n=1), same as standard (0.7%). The 5 cases of neurosensory deficits are discussed in detail. Conclusions/Clinical Relevance: The rate of ID nerve injuries was higher than the standard. The rate of LN complications was lower than the standard.Keywords: inferior dental nerve, lingual nerve, nerve injuries, third molars
Procedia PDF Downloads 921667 Implementation of Inclusive Education in DepEd-Dasmarinas: Basis for Inclusion Program Framework
Authors: Manuela S. Tolentino, John G. Nepomuceno
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The purpose of this investigation was to assess the implementation of inclusive education (IE) in 6 elementary and 5 secondary public schools in the City Schools Division of Dasmarinas. Participants in this study were 11 school heads, 73 teachers, 22 parents and 22 students (regular and with special needs) who were selected using purposive sampling. A 30-item questionnaire was used to gather data on the extent of the implementation of IE in the division while focus group discussion (FGD) was used to gather insights on what facilitate and hinder the implementation of the IE program. This study assessed the following variables: school culture and environment, inclusive education policy implementation, and curriculum design and practices. Data were analyzed using frequency count, mean and ranking. Results revealed that participants have similar assessment on the extent of the implementation of IE. School heads rated school culture and environment as highest in terms of implementation while teachers and pupils chose curriculum design and practices. On the other hand, parents felt that inclusive education policies are implemented best. School culture and environment are given high ratings. Participants perceived that the IE program in the division is making everyone feel welcome regardless of age, sex, social status, physical, mental and emotional state; students with or without disability are equally valued, and students help each. However, some aspects of the IE program implementation are given low ratings namely: partnership between staff, parents and caregivers, school’s effort to minimize discriminatory practice, and stakeholders sharing the philosophy of inclusion. As regards education policy implementation, indicators with the highest ranks were school’s effort to admit students from the locality especially students with special needs, and the implementation of the child protection policy and anti-bullying policy. The results of the FGD revealed that both school heads and teachers possessed the welcoming gesture to accommodate students with special needs. This can be linked to the increasing enrolment of SNE in the division. However, limitations of the teachers’ knowledge on handling learners, facilities and collaboration among stakeholders hinder the implementation of IE program. Based on the findings, inclusion program framework was developed for program enhancement. This will be the basis for the improvement of the program’s efficiency, the relationship between stakeholders, and formulation of solutions.Keywords: inclusion, inclusive education, framework, special education
Procedia PDF Downloads 1711666 Defining a Reference Architecture for Predictive Maintenance Systems: A Case Study Using the Microsoft Azure IoT-Cloud Components
Authors: Walter Bernhofer, Peter Haber, Tobias Mayer, Manfred Mayr, Markus Ziegler
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Current preventive maintenance measures are cost intensive and not efficient. With the available sensor data of state of the art internet of things devices new possibilities of automated data processing emerge. Current advances in data science and in machine learning enable new, so called predictive maintenance technologies, which empower data scientists to forecast possible system failures. The goal of this approach is to cut expenses in preventive maintenance by automating the detection of possible failures and to improve efficiency and quality of maintenance measures. Additionally, a centralization of the sensor data monitoring can be achieved by using this approach. This paper describes the approach of three students to define a reference architecture for a predictive maintenance solution in the internet of things domain with a connected smartphone app for service technicians. The reference architecture is validated by a case study. The case study is implemented with current Microsoft Azure cloud technologies. The results of the case study show that the reference architecture is valid and can be used to achieve a system for predictive maintenance execution with the cloud components of Microsoft Azure. The used concepts are technology platform agnostic and can be reused in many different cloud platforms. The reference architecture is valid and can be used in many use cases, like gas station maintenance, elevator maintenance and many more.Keywords: case study, internet of things, predictive maintenance, reference architecture
Procedia PDF Downloads 2511665 Improving Functionality of Radiotherapy Department Through: Systemic Periodic Clinical Audits
Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan
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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.Keywords: audit, clinical, radiotherapy, improving functionality
Procedia PDF Downloads 881664 Audit Examining Maternity Assessment Suite Triage Compliance with Birmingham Symptom Specific Obstetric Triage System in a London Teaching Hospital
Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric
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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage
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