Search results for: expert evaluations
Commenced in January 2007
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Edition: International
Paper Count: 1228

Search results for: expert evaluations

238 An Evaluation Study of Sleep and Sleep-Related Factors in Clinic Clients with Sleep Difficulties

Authors: Chi-Feng Lai, Wen-Chun Liao Liao

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Many people are bothered by sleep difficulties in Taiwan’s society. However, majority of patients get medical treatments without a comprehensive sleep assessment. It is still a big challenge to formulate a comprehensive assessment of sleep difficulties in clinical settings, even though many assessment tools have existed in literature. This study tries to implement reliable and effective ‘comprehensive sleep assessment scales’ in a medical center and to explore differences in sleep-related factors between clinic clients with or without sleep difficulty complaints. The comprehensive sleep assessment (CSA) scales were composed of 5 dimensions: ‘personal factors’, ‘physiological factors’, ‘psychological factors’, ‘social factors’ and ‘environmental factors, and were first evaluated by expert validity and 20 participants with test-retest reliability. The Content Validity Index (CVI) of the CSA was 0.94 and the alpha of the consistency reliability ranged 0.996-1.000. Clients who visited sleep clinic due to sleep difficulties (n=32, 16 males and 16 females, ages 43.66 ±14.214) and gender-and age- matched healthy subjects without sleep difficulties (n=96, 47 males and 49 females, ages 41.99 ±13.69) were randomly recruited at a ratio of 1:3 (with sleep difficulties vs. without sleep difficulties) to compare their sleep and the CSA factors. Results show that all clinic clients with sleep difficulties did have poor sleep quality (PSQI>5) and mild to moderate daytime sleepiness (ESS >11). Personal factors of long working hours (χ2= 10.315, p=0.001), shift workers (χ2= 8.964, p=0.003), night shift (χ2=9.395, p=0.004) and perceived stress (χ2=9.503, p=0.002) were disruptors of sleep difficulties. Physiological factors from physical examination including breathing by mouth, low soft palate, high narrow palate, Edward Angle, tongue hypertrophy, and occlusion of the worn surface were observed in clinic clients. Psychological factors including higher perceived stress (χ2=32.542, p=0.000), anxiety and depression (χ2=32.868, p=0.000); social factors including lack of leisure activities (χ2=39.857, p=0.000), more drinking habits (χ2=1.798, p=0.018), irregular amount and frequency in meals (χ2=5.086, p=0.024), excessive dinner (χ2=21.511, p=0.000), being incapable of getting up on time due to previous poor night sleep (χ2=4.444, p=0.035); and environmental factors including lights (χ2=7.683, p=0.006), noise (χ2=5.086, p=0.024), low or high bedroom temperature (χ2=4.595, p=0.032) were existed in clients. In conclusion, the CSA scales can work as valid and reliable instruments for evaluating sleep-related factors. Findings of this study provide important reference for assessing clinic clients with sleep difficulties.

Keywords: comprehensive sleep assessment, sleep-related factors, sleep difficulties

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237 The Investigation of Effect of Alpha Lipoic Acid against Damage on Neonatal Rat Lung to Maternal Tobacco Smoke Exposure

Authors: Elif Erdem, Nalan Kaya, Gonca Ozan, Durrin Ozlem Dabak, Enver Ozan

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This study was carried out to determine the histological and biochemical changes in the lungs of the rat pups exposed to tobacco smoke during pregnancy period and to investigate the protective effects of alpha lipoic acid, which is administered during pregnancy, on these changes. In our study, 24 six-week old Spraque-Dawley female rats weighing 160 ± 10 g were used (n:7). Rats were randomly divided into four equal groups: group I (control), group II (tobacco smoke), group III (tobacco smoke + alpha lipoic acid) and group IV (alpha lipoic acid). Rats in the group II, group III were exposed to tobacco smoke twice a day for one hour starting from eight weeks before mating and during pregnancy. In addition to tobacco smoke, 20 mg/kg of alpha lipoic acid was administered via oral gavage to the rats in the group III. Only alpha lipoic acid was administered to the rats in the group IV. Once after the delivery, all administrations were stopped. On the 7 and 21th days, the seven pups of all groups were decapitated. A portion of the lung was taken and stained with HE, PAS and Masson. In addition to immunohistochemical staining of surfactant protein A, vascular endothelial growth factor, caspase-3, TUNEL method was also used to determine apoptosis. Biochemical analyzes were performed with some part of the lung tissue specimens. In the histological evaluations performed under light microscopy, inflammatory cell increase, hemorrhagic areas, edema, interalveolar septal thickening, alveolar numbers decrease, degeneration of some bronchi and bronchial epithelium, epithelial cells that were fallen into the lumen and hyaline membrane formation were observed in tobacco smoke group. These findings were ameliorated in tobacco smoke + ALA group. Hyaline membrane formation was not detected in this group. The TUNEL positive cell numbers a significant increase was detected in the tobacco smoke group, whereas a significant decrease was detected in the tobacco smoke + ALA group. In terms of the immunoreactivity of both SP-A and VEGF, a significant decrease was observed in the tobacco smoke group, and a significant increase was observed in the tobacco smoke + ALA group. Regarding the immunoreactivity of caspase-3, there was a significant increase in the group of tobacco smoke and a significant decrease in the group of tobacco smoke + ALA. The malondialdehyde levels were determined to be significantly increased in the tobacco smoke group, and a significant decreased in the tobacco smoke + ALA. Glutathione and superoxide dismutase enzyme activities showed a significant decrease in the group of tobacco smoke and a significant increase in the tobacco smoke + ALA group. In conclusion, we suggest that the exposure to tobacco smoke during pregnancy leads to morphological, histopathological and functional changes on lung development by causing oxidative damage in lung tissues of neonatal rats and the maternal use of alpha lipoic acid can provide a protective effect on the neonatal lung development against this oxidative stress originating from tobacco smoke.

Keywords: alpha lipoic acid, lung, neonate, tobacco smoke, pregnancy

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236 Evaluation Method for Fouling Risk Using Quartz Crystal Microbalance

Authors: Natsuki Kishizawa, Keiko Nakano, Hussam Organji, Amer Shaiban, Mohammad Albeirutty

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One of the most important tasks in operating desalination plants using a reverse osmosis (RO) method is preventing RO membrane fouling caused by foulants found in seawater. Optimal design of the pre-treatment process of RO process for plants enables the reduction of foulants. Therefore, a quantitative evaluation of the fouling risk in pre-treated water, which is fed to RO, is required for optimal design. Some measurement methods for water quality such as silt density index (SDI) and total organic carbon (TOC) have been conservatively applied for evaluations. However, these methods have not been effective in some situations for evaluating the fouling risk of RO feed water. Furthermore, stable management of plants will be possible by alerts and appropriate control of the pre-treatment process by using the method if it can be applied to the inline monitoring system for the fouling risk of RO feed water. The purpose of this study is to develop a method to evaluate the fouling risk of RO feed water. We applied a quartz crystal microbalance (QCM) to measure the amount of foulants found in seawater using a sensor whose surface is coated with polyamide thin film, which is the main material of a RO membrane. The increase of the weight of the sensor after a certain length of time in which the sample water passes indicates the fouling risk of the sample directly. We classified the values as “FP: Fouling Potential”. The characteristics of the method are to measure the very small amount of substances in seawater in a short time: < 2h, and from a small volume of the sample water: < 50mL. Using some RO cell filtration units, a higher correlation between the pressure increase given by RO fouling and the FP from the method than SDI and TOC was confirmed in the laboratory-scale test. Then, to establish the correlation in the actual bench-scale RO membrane module, and to confirm the feasibility of the monitoring system as a control tool for the pre-treatment process, we have started a long-term test at an experimental desalination site by the Red Sea in Jeddah, Kingdom of Saudi Arabia. Implementing inline equipment for the method made it possible to measure FP intermittently (4 times per day) and automatically. Moreover, for two 3-month long operations, the RO operation pressure among feed water samples of different qualities was compared. The pressure increase through a RO membrane module was observed at a high FP RO unit in which feed water was treated by a cartridge filter only. On the other hand, the pressure increase was not observed at a low FP RO unit in which feed water was treated by an ultra-filter during the operation. Therefore, the correlation in an actual scale RO membrane was established in two runs of two types of feed water. The result suggested that the FP method enables the evaluation of the fouling risk of RO feed water.

Keywords: fouling, monitoring, QCM, water quality

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235 Cobalamin, Folate and Metabolic Syndrome Parameters in Pediatric Morbid Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

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Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B12 plays essential roles in fat and protein metabolisms and its cooperation with vitamin B9 is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B12 concentrations were measured using electrochemiluminescence immunoassay. Vitamin B9 was analyzed by an immunoassay analyzer. Values for vitamin B12 < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B9 levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B9 and vitamin B12 levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B12 levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B9 and B12 may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B12 metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B12 and vitamin B9 deficiency in MetS associated with the increased vitamin B12 as well as vitamin B9 deficiency metabolites may add to MetS parameters.

Keywords: children, cobalamin, folate, metabolic syndrome, obesity

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234 Sociology Perspective on Emotional Maltreatment: Retrospective Case Study in a Japanese Elementary School

Authors: Nozomi Fujisaka

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This sociological case study analyzes a sequence of student maltreatment in an elementary school in Japan, based on narratives from former students. Among various forms of student maltreatment, emotional maltreatment has received less attention. One reason for this is that emotional maltreatment is often considered part of education and is difficult to capture in surveys. To discuss the challenge of recognizing emotional maltreatment, it's necessary to consider the social background in which student maltreatment occurs. Therefore, from the perspective of the sociology of education, this study aims to clarify the process through which emotional maltreatment was embraced by students within a Japanese classroom. The focus of this study is a series of educational interactions by a homeroom teacher with 11- or 12-year-old students at a small public elementary school approximately 10 years ago. The research employs retrospective narrative data collected through interviews and autoethnography. The semi-structured interviews, lasting one to three hours each, were conducted with 11 young people who were enrolled in the same class as the researcher during their time in elementary school. Autoethnography, as a critical research method, contributes to existing theories and studies by providing a critical representation of the researcher's own experiences. Autoethnography enables researchers to collect detailed data that is often difficult to verbalize in interviews. These research methods are well-suited for this study, which aims to shift the focus from teachers' educational intentions to students' perspectives and gain a deeper understanding of student maltreatment. The research results imply a pattern of emotional maltreatment that is challenging to differentiate from education. In this study's case, the teacher displayed calm and kind behavior toward students after a threat and an explosion of anger. Former students frequently mentioned this behavior of the teacher and perceived emotional maltreatment as part of education. It was not uncommon for former students to offer positive evaluations of the teacher despite experiencing emotional distress. These findings are analyzed and discussed in conjunction with the deschooling theory and the cycle of violence theory. The deschooling theory provides a sociological explanation for how emotional maltreatment can be overlooked in society. The cycle of violence theory, originally developed within the context of domestic violence, explains how violence between romantic partners can be tolerated due to prevailing social norms. Analyzing the case in association with these two theories highlights the characteristics of teachers' behaviors that rationalize maltreatment as education and hinder students from escaping emotional maltreatment. This study deepens our understanding of the causes of student maltreatment and provides a new perspective for future qualitative and quantitative research. Furthermore, since this research is based on the sociology of education, it has the potential to expand research in the fields of pedagogy and sociology, in addition to psychology and social welfare.

Keywords: emotional maltreatment, education, student maltreatment, Japan

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233 Explaining Irregularity in Music by Entropy and Information Content

Authors: Lorena Mihelac, Janez Povh

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In 2017, we conducted a research study using data consisting of 160 musical excerpts from different musical styles, to analyze the impact of entropy of the harmony on the acceptability of music. In measuring the entropy of harmony, we were interested in unigrams (individual chords in the harmonic progression) and bigrams (the connection of two adjacent chords). In this study, it has been found that 53 musical excerpts out from 160 were evaluated by participants as very complex, although the entropy of the harmonic progression (unigrams and bigrams) was calculated as low. We have explained this by particularities of chord progression, which impact the listener's feeling of complexity and acceptability. We have evaluated the same data twice with new participants in 2018 and with the same participants for the third time in 2019. These three evaluations have shown that the same 53 musical excerpts, found to be difficult and complex in the study conducted in 2017, are exhibiting a high feeling of complexity again. It was proposed that the content of these musical excerpts, defined as “irregular,” is not meeting the listener's expectancy and the basic perceptual principles, creating a higher feeling of difficulty and complexity. As the “irregularities” in these 53 musical excerpts seem to be perceived by the participants without being aware of it, affecting the pleasantness and the feeling of complexity, they have been defined as “subliminal irregularities” and the 53 musical excerpts as “irregular.” In our recent study (2019) of the same data (used in previous research works), we have proposed a new measure of the complexity of harmony, “regularity,” based on the irregularities in the harmonic progression and other plausible particularities in the musical structure found in previous studies. We have in this study also proposed a list of 10 different particularities for which we were assuming that they are impacting the participant’s perception of complexity in harmony. These ten particularities have been tested in this paper, by extending the analysis in our 53 irregular musical excerpts from harmony to melody. In the examining of melody, we have used the computational model “Information Dynamics of Music” (IDyOM) and two information-theoretic measures: entropy - the uncertainty of the prediction before the next event is heard, and information content - the unexpectedness of an event in a sequence. In order to describe the features of melody in these musical examples, we have used four different viewpoints: pitch, interval, duration, scale degree. The results have shown that the texture of melody (e.g., multiple voices, homorhythmic structure) and structure of melody (e.g., huge interval leaps, syncopated rhythm, implied harmony in compound melodies) in these musical excerpts are impacting the participant’s perception of complexity. High information content values were found in compound melodies in which implied harmonies seem to have suggested additional harmonies, affecting the participant’s perception of the chord progression in harmony by creating a sense of an ambiguous musical structure.

Keywords: entropy and information content, harmony, subliminal (ir)regularity, IDyOM

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232 Research on the Environmental Assessment Index of Brownfield Redevelopment in Taiwan: A Case Study on Formosa Chemicals and Fibre Corporation, Changhua Branch

Authors: Min-Chih Yang, Shih-Jen Feng, Bo-Tsang Li

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The concept of “Brownfield” has been developed for nearly 35 years since it was put forward in 《Comprehensive Environmental Response, Compensation, and Liability Act, CERCLA》of USA in 1980 for solving the problem of soil contamination of those old industrial lands, and later, many countries have put forward relevant policies and researches continuously. But the related concept in Taiwan, a country has developed its industry for 60 years, is still in its infancy. This leads to the slow development of Brownfield related research and policy in Taiwan. When it comes to build the foundation of Brownfield development, we have to depend on the related experience and research of other countries. They are four aspects about Brownfield: 1. Contaminated Land; 2. Derelict Land; 3. Vacant Land; 4. Previously Development Land. This study will focus on and deeply investigate the Vacant land and contaminated land. The subject of this study is Formosa Chemicals & Fibre Corporation, Changhua branch in Taiwan. It has been operating for nearly 50 years and contributing a lot to the local economy. But under the influence of the toxic waste and sewage which was drained regularly or occasionally out from the factory, the environment has been destroyed seriously. There are three factors of pollution: 1. environmental toxicants, carbon disulfide, released from producing processes and volatile gases which is hard to monitor; 2. Waste and exhaust gas leakage caused by outdated equipment; 3. the wastewater discharge has seriously damage the ecological environment of the Dadu river estuary. Because of all these bad influences, the factory has been closed nowadays and moved to other places to spare the opportunities for the contaminated lands to re-develop. So we collect information about related Brownfield management experience and policies in different countries as background information to investigate the current Taiwanese Brownfield redevelopment issues and built the environmental assessment framework for it. We hope that we can set the environmental assessment indexes for Formosa Chemicals & Fibre Corporation, Changhua branch according to the framework. By investigating the theory and environmental pollution factors, we will carry out deep analysis and expert questionnaire to set those indexes and prove a sample in Taiwan for Brownfield redevelopment and remediation in the future.

Keywords: brownfield, industrial land, redevelopment, assessment index

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231 The Current Importance of the Rules of Civil Procedure in the Portuguese Legal Order: Between Legalism and Adequation

Authors: Guilherme Gomes, Jose Lebre de Freitas

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The rules of Civil Procedure that are defined in the Portuguese Civil Procedure Code of 2013 particularly their articles 552 to 626- represent the model that the legislator thought that would be more suitable for national civil litigation, from the moment the action is brought by the plaintiff to the moment when the sentence is issued. However, procedural legalism is no longer a reality in the Portuguese Civil Procedural Law. According to the article 547 of the code of 2013, the civil judge has a duty to adopt the procedure that better suits the circumstances of the case, whether or not it is the one defined by law. The main goal of our paper is to answer the question whether the formal adequation imposed by this article diminishes the importance of the Portuguese rules of Civil Procedure and their daily application by national civil judges. We will start by explaining the appearance of the abovementioned rules in the Civil Procedure Code of 2013. Then we will analyse, using specific examples that were obtained by the books we read, how the legal procedure defined in the abovementioned code does not suit the circumstances of some specific cases and is totally inefficient in some situations. After that, we will, by using the data obtained in the practical research that we are conducting in the Portuguese civil courts within the scope of our Ph.D. thesis (until now, we have been able to consult 150 civil lawsuits), verify whether and how judges and parties make the procedure more efficient and effective in the case sub judice. In the scope of our research, we have already reached some preliminary findings: 1) despite the fact that the legal procedure does not suit the circumstances of some civil lawsuits, there are only two situations of frequent use of formal adequation (the judge allowing the plaintiff to respond to the procedural exceptions deduced in the written defense and the exemption from prior hearing for the judges who never summon it), 2) the other aspects of procedural adequation (anticipation of the production of expert evidence, waiving of oral argument at the final hearing, written allegations, dismissal of the dispatch on the controversial facts and the examination of witnesses at the domicile of one of the lawyers) are still little used and 3) formal adequation tends to happen by initiative of the judge, as plaintiffs and defendants are afraid of celebrating procedural agreements in most situations. In short, we can say that, in the Portuguese legal order of the 21st century, the flexibility of the legal procedure, as it is defined in the law and applied by procedural subjects, does not affect the importance of the rules of Civil Procedure of the code of 2013.

Keywords: casuistic adequation, civil procedure code of 2013, procedural subjects, rules of civil procedure

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230 Medical Student's Responses to Emotional Content in Doctor-Patient Communication: To Explore Differences in Communication Training of Medical Students and Its Impact on Doctor-Patient Communication

Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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229 Capitalizing 'Ba' in a Knowledge Creation among Medical Researchers in Malaysian Higher Education Institution

Authors: Connie Edang, Siti Arpah Noordin, Shamila Mohamed Shuhidan

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For the past few decades, there are growing numbers of knowledge based industries in Malaysia. As competitive edge has become so important nowadays, the consideration of research and development (R&D) should be put at the highest priority. Alike other industries, HEIs are also contributors to the nation’s development and wealth. Hence, to become a hub for creating a knowledge-based society, HEIs not only responsible for producing skillful human capital, but also to get involved in R&D. With the importance of R&D in today’s modern economy and the rise of Science and Technology, it gives opportunities for researchers to explore this sector as to place Malaysia as a provider in some key strategic industries, including medical and health sciences field. Academic researchers/medical researchers possess unique tacit and skills based in accordance with their experience and professional expert areas. In completing a collaborative research work, there must be platforms to enable the conversion of their knowledge hence beneficial towards creation of new knowledge. The objectives of this study are to: i) explore the knowledge creation activities of medical researchers in the Malaysian Higher Education Institution (HEI); ii) explore the driving forces for knowledge creation activities among the researchers; and iii) explore the interpretation of medical researchers on the establishment of ‘ba’ in the creation of knowledge. Based on the SECI model was introduced by Nonaka and Takeuchi and the Japanese concept of ‘ba’, a qualitative study whereby semi structured interview was used as to gather the informants’ viewpoints and insights based on their experience capitalizing ‘ba’ to support their knowledge creation activities. A single the study was conducted at one of the HEIs located in Sabah. From this study, both face to face and the ICT-assisted tools are found to be significant to support interaction of their knowledge. ICT seems to ease their interaction with other research collaborator. However, this study revealed that interaction conducted in physical settings is still be best preferred by the medical researchers especially situations of whereby their knowledge is hard to be externalized. Moreover, it revealed that motivational factors play important roles as for driving forces affecting their knowledge creation activities. Other than that, the medical researchers addressed that the mix interaction bring forth value in terms of facilitating knowledge creation. Therefore this study would benefit the institution to highly optimize the utilization of good platform so that knowledge can be transferred and be made used by others in appropriate ways.

Keywords: ‘ba’, knowledge creation dynamics, Malaysia, higher education institution, medical researchers

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228 Estimating the Efficiency of a Meta-Cognitive Intervention Program to Reduce the Risk Factors of Teenage Drivers with Attention Deficit Hyperactivity Disorder While Driving

Authors: Navah Z. Ratzon, Talia Glick, Iris Manor

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Attention Deficit Hyperactivity Disorder (ADHD) is a chronic disorder that affects the sufferer’s functioning throughout life and in various spheres of activity, including driving. Difficulties in cognitive functioning and executive functions are often part and parcel of the ADHD diagnosis, and thus form a risk factor in driving. Studies examining the effectiveness of intervention programs for improving and rehabilitating driving in typical teenagers have been conducted in relatively small numbers; while studies on similar programs for teenagers with ADHD have been especially scarce. The aim of the present study has been to examine the effectiveness of a metacognitive occupational therapy intervention program for reducing risk factors in driving among teenagers with ADHD. The present study included 37 teenagers aged 17 to 19. They included 23 teenagers with ADHD divided into experimental (11) and control (12) groups; as well as 14 non-ADHD teenagers forming a second control group. All teenagers taking part in the study were examined in the Tel Aviv University driving lab, and underwent cognitive diagnoses and a driving simulator test. Every subject in the intervention group took part in 3 assessment meetings, and two metacognitive treatment meetings. The control groups took part in two assessment meetings with a follow-up meeting 3 months later. In all the study’s groups, the treatment’s effectiveness was tested by comparing monitoring results on the driving simulator at the first and second evaluations. In addition, the driving of 5 subjects from the intervention group was monitored continuously from a month prior to the start of the intervention, a month during the phase of the intervention and another month until the end of the intervention. In the ADHD control group, the driving of 4 subjects was monitored from the end of the first evaluation for a period of 3 months. The study’s findings were affected by the fact that the ADHD control group was different from the two other groups, and exhibited ADHD characteristics manifested by impaired executive functions and lower metacognitive abilities relative to their peers. The study found partial, moderate, non-significant correlations between driving skills and cognitive functions, executive functions, and perceptions and attitudes towards driving. According to the driving simulator test results and the limited sampling results of actual driving, it was found that a metacognitive occupational therapy intervention may be effective in reducing risk factors in driving among teenagers with ADHD relative to their peers with and without ADHD. In summary, the results of the present study indicate a positive direction that speaks to the viability of using a metacognitive occupational therapy intervention program for reducing risk factors in driving. A further study is required that will include a bigger number of subjects, add actual driving monitoring hours, and assign subjects randomly to the various groups.

Keywords: ADHD, driving, driving monitoring, metacognitive intervention, occupational therapy, simulator, teenagers

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227 Energy Efficiency Line Guides for School Buildings in Florence in a Postgraduate Master Course

Authors: Lucia Ceccherini Nelli, Alessandra Donato

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The ABITA Master course of the University of Florence offered by the Department of Architecture covers nearly all the energy-relevant issues that can arise in public and private companies and sectors. The main purpose of the Master course, active since 2003, is to analyse the energy consumption of building technologies, components, and structures at the conceptual design stage, so it could be very helpful, for designers, when making decisions related to the selection of the most suitable design alternatives and for the materials choice that will be used in an energy-efficient building. The training course provides a solid basis for increasing the knowledge and skills of energy managers and is developed with an emphasis on practical experiences related to the knowledge through case studies, measurements, and verification of energy-efficient solutions in buildings, in the industry and in the cities. The main objectives are: i)To raise the professional standards of those engaged in energy auditing, ii) To improve the practice of energy auditors by encouraging energy auditing professionals in a continuing education program of professional development, iii) Implement in the use of instrumentations for the typical measurements, iv) To propose an integrated methodology that links energy analysis tools with green building certification systems. This methodology will be applied at the early design stage of a project’s life. The final output of the practical training is to achieve an elevated professionalism in the study of environmental design and Energy management in buildings. The results are the redaction of line guides instruction for the energy refurbishment of Public schools in Florence. The school heritage of the Municipality of Florence requires interventions for the control of energy performance, as old construction buildings are often made without taking into account the necessary envelope performance. For this reason, every year, the Master's course aims to study groups of public schools to enable the Municipality to carry out energy redevelopment interventions on the existing building heritage. The future challenges of the education and training program are related to follow-up activities, the development of interactive tools and the curriculum's customization to meet the constantly growing needs of energy experts from industry.

Keywords: expert in energy, energy auditing, public buildings, thermal analysis

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226 Development of Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Guideline Adherence in Emergency Department: Modified Delphi Study

Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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225 Variable Mapping: From Bibliometrics to Implications

Authors: Przemysław Tomczyk, Dagmara Plata-Alf, Piotr Kwiatek

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Literature review is indispensable in research. One of the key techniques used in it is bibliometric analysis, where one of the methods is science mapping. The classic approach that dominates today in this area consists of mapping areas, keywords, terms, authors, or citations. This approach is also used in relation to the review of literature in the field of marketing. The development of technology has resulted in the fact that researchers and practitioners use the capabilities of software available on the market for this purpose. The use of science mapping software tools (e.g., VOSviewer, SciMAT, Pajek) in recent publications involves the implementation of a literature review, and it is useful in areas with a relatively high number of publications. Despite this well-grounded science mapping approach having been applied in the literature reviews, performing them is a painstaking task, especially if authors would like to draw precise conclusions about the studied literature and uncover potential research gaps. The aim of this article is to identify to what extent a new approach to science mapping, variable mapping, takes advantage of the classic science mapping approach in terms of research problem formulation and content/thematic analysis for literature reviews. To perform the analysis, a set of 5 articles on customer ideation was chosen. Next, the analysis of key words mapping results in VOSviewer science mapping software was performed and compared with the variable map prepared manually on the same articles. Seven independent expert judges (management scientists on different levels of expertise) assessed the usability of both the stage of formulating, the research problem, and content/thematic analysis. The results show the advantage of variable mapping in the formulation of the research problem and thematic/content analysis. First, the ability to identify a research gap is clearly visible due to the transparent and comprehensive analysis of the relationships between the variables, not only keywords. Second, the analysis of relationships between variables enables the creation of a story with an indication of the directions of relationships between variables. Demonstrating the advantage of the new approach over the classic one may be a significant step towards developing a new approach to the synthesis of literature and its reviews. Variable mapping seems to allow scientists to build clear and effective models presenting the scientific achievements of a chosen research area in one simple map. Additionally, the development of the software enabling the automation of the variable mapping process on large data sets may be a breakthrough change in the field of conducting literature research.

Keywords: bibliometrics, literature review, science mapping, variable mapping

Procedia PDF Downloads 93
224 L2 Exposure Environment, Teaching Skills, and Beliefs about Learners’ Out-of-Class Learning: A Survey on Teachers of English as a Foreign Language

Authors: Susilo Susilo

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In the process of foreign language acquisition, L2 exposure has been evidently assumed efficient for learners to help increase their proficiency. However, to get enough L2 exposure in the context of learning English as a foreign language is not as easy as that of the first language learning context. Therefore, beyond the classroom L2 exposure is helpful for EFL learners to achieve the language tasks. Alongside the rapid development of technology and media, English as a foreign language is virtually used in the social media of almost all regions, affecting the faces of Teaching English as a Foreign Language (TEFL). This different face of TEFL unavoidably intrigues teachers to treat their students differently in the classroom in order that they can put more effort in maximizing beyond-the-class learning to help improve their in-class achievements. The study aims to investigate: 1) EFL teachers’ teaching skills and beliefs about students’ out-of-class activities in different L2 exposure environments, and 2) the effect on EFL teachers’ teaching skills and beliefs about students’ out-of-class activities of different L2 exposure environments. This is a survey for 80 EFL teachers from Senior High Schools in three regions of two provinces in Indonesia. A questionnaire using a four-point Likert scale was distributed to the respondents to elicit data. The questionnaires were developed by reffering to the constructs of teaching skills (i.e. teaching preparation, teaching action, and teaching evaluation) and beliefs about out-of-class learning (i.e. setting, process and atmosphere), which have been taken from some expert definitions. The internal consistencies for those constructs were examined by using Cronbach Alpha. The data of the study were analyzed by using SPSS program, i.e. descriptive statistics and independent sample t-test. The standard for determining the significance was p < .05. The results revealed that: 1) teaching skills performed by the teachers of English as a foreign language in different exposure environments showed various focus of teaching skills, 2) the teachers showed various ways of beliefs about students’ out-of-class activities in different exposure environments, 3) there was a significant difference in the scores for NNESTs’ teaching skills in urban regions (M=34.5500, SD=4.24838) and those in rural schools (M=24.9500, SD=2.42794) conditions; t (78)=12.408, p = 0.000; and 4) there was a significant difference in the scores for NNESTs’ beliefs about students’ out-of-class activities in urban schools (M=36.9250, SD=6.17434) and those in rural regions (M=29.4250, SD=4.56793) conditions; t (78)=6.176, p = 0.000. These results suggest that different L2 exposure environments really do have effects on teachers’ teaching skills and beliefs about their students’ out-of-class learning.

Keywords: belief about EFL out-of-class learning, L2 exposure environment, teachers of English as a foreign language, teaching skills

Procedia PDF Downloads 319
223 Air Handling Units Power Consumption Using Generalized Additive Model for Anomaly Detection: A Case Study in a Singapore Campus

Authors: Ju Peng Poh, Jun Yu Charles Lee, Jonathan Chew Hoe Khoo

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The emergence of digital twin technology, a digital replica of physical world, has improved the real-time access to data from sensors about the performance of buildings. This digital transformation has opened up many opportunities to improve the management of the building by using the data collected to help monitor consumption patterns and energy leakages. One example is the integration of predictive models for anomaly detection. In this paper, we use the GAM (Generalised Additive Model) for the anomaly detection of Air Handling Units (AHU) power consumption pattern. There is ample research work on the use of GAM for the prediction of power consumption at the office building and nation-wide level. However, there is limited illustration of its anomaly detection capabilities, prescriptive analytics case study, and its integration with the latest development of digital twin technology. In this paper, we applied the general GAM modelling framework on the historical data of the AHU power consumption and cooling load of the building between Jan 2018 to Aug 2019 from an education campus in Singapore to train prediction models that, in turn, yield predicted values and ranges. The historical data are seamlessly extracted from the digital twin for modelling purposes. We enhanced the utility of the GAM model by using it to power a real-time anomaly detection system based on the forward predicted ranges. The magnitude of deviation from the upper and lower bounds of the uncertainty intervals is used to inform and identify anomalous data points, all based on historical data, without explicit intervention from domain experts. Notwithstanding, the domain expert fits in through an optional feedback loop through which iterative data cleansing is performed. After an anomalously high or low level of power consumption detected, a set of rule-based conditions are evaluated in real-time to help determine the next course of action for the facilities manager. The performance of GAM is then compared with other approaches to evaluate its effectiveness. Lastly, we discuss the successfully deployment of this approach for the detection of anomalous power consumption pattern and illustrated with real-world use cases.

Keywords: anomaly detection, digital twin, generalised additive model, GAM, power consumption, supervised learning

Procedia PDF Downloads 128
222 An Evaluation of the Relationship between the Anthropometric Measurements and Blood Lipid Profiles in Adolescents

Authors: Nalan Hakime Nogay

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Childhood obesity is a significant health issue that is currently on the rise all over the world. In recent years, the relationship between childhood obesity and cardiovascular disease risk has been pointed out. The purpose of this study is to evaluate the relationship between some of the anthropometric indicators and blood lipid levels in adolescents. The present study has been conducted on a total of 252 adolescents -200 girls and 52 boys- within an age group of 12 to 18 years. Blood was drawn from each participant in the morning -after having fasted for 10 hours from the day before- to analyze their total cholesterol, HDL, LDL and triglyceride levels. Their body weight, height, waist circumference, subscapular skinfold thicknesses and triceps skinfold thicknesses measurements were taken and their individual waist/height ratios, BMI and body fat ratios were calculated. The blood lipid levels of the participants were categorized as acceptable, borderline and high in accordance with the 2011 Expert Panel Integrated Guidelines. The body fat ratios, total blood cholesterol and HDL levels of the girls were significantly higher than the boys whereas their waist circumference values were lower. The triglyceride levels, total cholesterol/HDL, LDL/HDL, triglyceride/HDL ratios of the group with the BMI ≥ 95 percentile ratio (the obese group) were higher than the groups that were considered to be overweight and normal weight as per their respective BMI values, while the HDL level of the obese group was lower; a fact that was found to be statistically significant. No significant relationship could be established, however, between the total blood cholesterol and LDL levels with their anthropometric measurements. The BMI, waist circumference, waist/height ratio, body fat ratio and triglyceride level of the group with the higher triglyceride level ( ≥ 130mg/dl) were found to be significantly higher compared to borderline (90-129 mg/dl) and the normal group (< 90 mg/dl). The BMI, waist circumference, waist/height ratio values of the group with the lower HDL level ( < 40 mg/dl) were significantly higher than the normal ( > 45 mg/dl) and borderline (40-45 mg/dl) groups. All of the anthropometric measurements of the group with the higher triglyceride/HDL ratio ( ≥ 3) were found to be significantly higher than that of the group with the lower ratio (< 3). Having a high BMI, waist/height ratio and waist circumference is related to low HDL and high blood triglyceride and triglyceride/HDL ratio. A high body fat ratio, on the other hand, is associated with a low HDL and high triglyceride/HDL ratio. Tackling childhood and adolescent obesity are important in terms of preventing cardiovascular diseases.

Keywords: adolescent, body fat, body mass index, lipid profile

Procedia PDF Downloads 244
221 Mechanical Properties of Enset Fibers Obtained from Different Breeds of Enset Plant

Authors: Diriba T. Balcha, Boris Kulig, Oliver Hensel, Eyassu Woldesenbet

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Enset fiber is agricultural waste and available in a surplus amount in Ethiopia. However, the hypothesized variation in properties of this fiber due to diversity of its plant source breed, fiber position within plant stem and chemical treatment duration had not proven that its application for the development of composite products is problematic. Currently, limited data are known on the functional properties of the fiber as a potential functional fiber. Thus, an effort is made in this study to narrow the knowledge gaps by characterizing it. The experimental design was conducted using Design-Expert software and the tensile test was conducted on Enset fiber from 10 breeds: Dego, Dirbo, Gishera, Itine, Siskela, Neciho, Yesherkinke, Tuzuma, Ankogena, and Kucharkia. The effects of 5% Na-OH surface treatment duration and fiber location along and across the plant pseudostem was also investigated. The test result shows that the rupture stress variation is not significant among the fibers from 10 Enset breeds. However, strain variation is significant among the fibers from 10 Enset breeds that breed Dego fiber has the highest strain before failure. Surface treated fibers showed improved rupture strength and elastic modulus per 24 hours of treatment duration. Also, the result showed that chemical treatment can deteriorate the load-bearing capacity of the fiber. The raw fiber has the higher load-bearing capacity than the treated fiber. And, it was noted that both the rupture stress and strain increase in the top to bottom gradient, whereas there is no significant variation across the stem. Elastic modulus variation both along and across the stem was insignificant. The rupture stress, elastic modulus, and strain result of Enset fiber are 360.11 ± 181.86 MPa, 12.80 ± 6.85 GPa and 0.04 ± 0.02 mm/mm, respectively. These results show that Enset fiber is comparable to other natural fibers such as abaca, banana, and sisal fibers and can be used as alternatives natural fiber for composites application. Besides, the insignificant variation of properties among breeds and across stem is essential for all breeds and all leaf sheath of the Enset fiber plant for fiber extraction. The use of short natural fiber over the long is preferable to reduce the significant variation of properties along the stem or fiber direction. In conclusion, Enset fiber application for composite product design and development is mechanically feasible.

Keywords: Agricultural waste, Chemical treatment, Fiber characteristics, Natural fiber

Procedia PDF Downloads 208
220 Estimating the Ladder Angle and the Camera Position From a 2D Photograph Based on Applications of Projective Geometry and Matrix Analysis

Authors: Inigo Beckett

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In forensic investigations, it is often the case that the most potentially useful recorded evidence derives from coincidental imagery, recorded immediately before or during an incident, and that during the incident (e.g. a ‘failure’ or fire event), the evidence is changed or destroyed. To an image analysis expert involved in photogrammetric analysis for Civil or Criminal Proceedings, traditional computer vision methods involving calibrated cameras is often not appropriate because image metadata cannot be relied upon. This paper presents an approach for resolving this problem, considering in particular and by way of a case study, the angle of a simple ladder shown in a photograph. The UK Health and Safety Executive (HSE) guidance document published in 2014 (INDG455) advises that a leaning ladder should be erected at 75 degrees to the horizontal axis. Personal injury cases can arise in the construction industry because a ladder is too steep or too shallow. Ad-hoc photographs of such ladders in their incident position provide a basis for analysis of their angle. This paper presents a direct approach for ascertaining the position of the camera and the angle of the ladder simultaneously from the photograph(s) by way of a workflow that encompasses a novel application of projective geometry and matrix analysis. Mathematical analysis shows that for a given pixel ratio of directly measured collinear points (i.e. features that lie on the same line segment) from the 2D digital photograph with respect to a given viewing point, we can constrain the 3D camera position to a surface of a sphere in the scene. Depending on what we know about the ladder, we can enforce another independent constraint on the possible camera positions which enables us to constrain the possible positions even further. Experiments were conducted using synthetic and real-world data. The synthetic data modeled a vertical plane with a ladder on a horizontally flat plane resting against a vertical wall. The real-world data was captured using an Apple iPhone 13 Pro and 3D laser scan survey data whereby a ladder was placed in a known location and angle to the vertical axis. For each case, we calculated camera positions and the ladder angles using this method and cross-compared them against their respective ‘true’ values.

Keywords: image analysis, projective geometry, homography, photogrammetry, ladders, Forensics, Mathematical modeling, planar geometry, matrix analysis, collinear, cameras, photographs

Procedia PDF Downloads 27
219 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning

Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

Procedia PDF Downloads 70
218 Validation of Global Ratings in Clinical Performance Assessment

Authors: S. J. Yune, S. Y. Lee, S. J. Im, B. S. Kam, S. Y. Baek

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This study aimed to determine the reliability of clinical performance assessments, having been emphasized by ability-based education, and professors overall assessment methods. We addressed the following problems: First, we try to find out whether there is a difference in what we consider to be the main variables affecting the clinical performance test according to the evaluator’s working period and the number of evaluation experience. Second, we examined the relationship among the global rating score (G), analytic global rating score (Gc), and the sum of the analytical checklists (C). What are the main factors affecting clinical performance assessments in relation to the numbers of times the evaluator had administered evaluations and the length of their working period service? What is the relationship between overall assessment score and analytic checklist score? How does analytic global rating with 6 components in OSCE and 4 components in sub-domains (Gc) CPX: aseptic practice, precision, systemic approach, proficiency, successfulness, and attitude overall assessment score and task-specific analytic checklist score sum (C) affect the professor’s overall global rating assessment score (G)? We studied 75 professors who attended a 2016 Bugyeoung Consortium clinical skills performances test evaluating third and fourth year medical students at the Pusan National University Medical school in South Korea (39 prof. in OSCE, 36 prof. in CPX; all consented to participate in our study). Each evaluator used 3 forms; a task-specific analytic checklist, subsequent analytic global rating scale with sub-6 domains, and overall global scale. After the evaluation, the professors responded to the questionnaire on the important factors of clinical performance assessment. The data were analyzed by frequency analysis, correlation analysis, and hierarchical regression analysis using SPSS 21.0. Their understanding of overall assessment was analyzed by dividing the subjects into groups based on experiences. As a result, they considered ‘precision’ most important in overall OSCE assessment, and ‘precise accuracy physical examination’, ‘systemic approaches to taking patient history’, and ‘diagnostic skill capability’ in overall CPX assessment. For OSCE, there was no clear difference of opinion about the main factors, but there was for CPX. Analytic global rating scale score, overall rating scale score, and analytic checklist score had meaningful mutual correlations. According to the regression analysis results, task-specific checklist score sum had the greatest effect on overall global rating. professors regarded task-specific analytic checklist total score sum as best reflecting overall OSCE test score, followed by aseptic practice, precision, systemic approach, proficiency, successfulness, and attitude on a subsequent analytic global rating scale. For CPX, subsequent analytic global rating scale score, overall global rating scale score, and task-specific checklist score had meaningful mutual correlations. These findings support explanations for validity of professors’ global rating in clinical performance assessment.

Keywords: global rating, clinical performance assessment, medical education, analytic checklist

Procedia PDF Downloads 215
217 Exploring the Motivations That Drive Paper Use in Clinical Practice Post-Electronic Health Record Adoption: A Nursing Perspective

Authors: Sinead Impey, Gaye Stephens, Lucy Hederman, Declan O'Sullivan

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Continued paper use in the clinical area post-Electronic Health Record (EHR) adoption is regularly linked to hardware and software usability challenges. Although paper is used as a workaround to circumvent challenges, including limited availability of a computer, this perspective does not consider the important role paper, such as the nurses’ handover sheet, play in practice. The purpose of this study is to confirm the hypothesis that paper use post-EHR adoption continues as paper provides both a cognitive tool (that assists with workflow) and a compensation tool (to circumvent usability challenges). Distinguishing the different motivations for continued paper-use could assist future evaluations of electronic record systems. Methods: Qualitative data were collected from three clinical care environments (ICU, general ward and specialist day-care) who used an electronic record for at least 12 months. Data were collected through semi-structured interviews with 22 nurses. Data were transcribed, themes extracted using an inductive bottom-up coding approach and a thematic index constructed. Findings: All nurses interviewed continued to use paper post-EHR adoption. While two distinct motivations for paper use post-EHR adoption were confirmed by the data - paper as a cognitive tool and paper as a compensation tool - further finding was that there was an overlap between the two uses. That is, paper used as a compensation tool could also be adapted to function as a cognitive aid due to its nature (easy to access and annotate) or vice versa. Rather than present paper persistence as having two distinctive motivations, it is more useful to describe it as presenting on a continuum with compensation tool and cognitive tool at either pole. Paper as a cognitive tool referred to pages such as nurses’ handover sheet. These did not form part of the patient’s record, although information could be transcribed from one to the other. Findings suggest that although the patient record was digitised, handover sheets did not fall within this remit. These personal pages continued to be useful post-EHR adoption for capturing personal notes or patient information and so continued to be incorporated into the nurses’ work. Comparatively, the paper used as a compensation tool, such as pre-printed care plans which were stored in the patient's record, appears to have been instigated in reaction to usability challenges. In these instances, it is expected that paper use could reduce or cease when the underlying problem is addressed. There is a danger that as paper affords nurses a temporary information platform that is mobile, easy to access and annotate, its use could become embedded in clinical practice. Conclusion: Paper presents a utility to nursing, either as a cognitive or compensation tool or combination of both. By fully understanding its utility and nuances, organisations can avoid evaluating all incidences of paper use (post-EHR adoption) as arising from usability challenges. Instead, suitable remedies for paper-persistence can be targeted at the root cause.

Keywords: cognitive tool, compensation tool, electronic record, handover sheet, nurse, paper persistence

Procedia PDF Downloads 413
216 Transparency Obligations under the AI Act Proposal: A Critical Legal Analysis

Authors: Michael Lognoul

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In April 2021, the European Commission released its AI Act Proposal, which is the first policy proposal at the European Union level to target AI systems comprehensively, in a horizontal manner. This Proposal notably aims to achieve an ecosystem of trust in the European Union, based on the respect of fundamental rights, regarding AI. Among many other requirements, the AI Act Proposal aims to impose several generic transparency obligationson all AI systems to the benefit of natural persons facing those systems (e.g. information on the AI nature of systems, in case of an interaction with a human). The Proposal also provides for more stringent transparency obligations, specific to AI systems that qualify as high-risk, to the benefit of their users, notably on the characteristics, capabilities, and limitations of the AI systems they use. Against that background, this research firstly presents all such transparency requirements in turn, as well as related obligations, such asthe proposed obligations on record keeping. Secondly, it focuses on a legal analysis of their scope of application, of the content of the obligations, and on their practical implications. On the scope of transparency obligations tailored for high-risk AI systems, the research notably notes that it seems relatively narrow, given the proposed legal definition of the notion of users of AI systems. Hence, where end-users do not qualify as users, they may only receive very limited information. This element might potentially raise concern regarding the objective of the Proposal. On the content of the transparency obligations, the research highlights that the information that should benefit users of high-risk AI systems is both very broad and specific, from a technical perspective. Therefore, the information required under those obligations seems to create, prima facie, an adequate framework to ensure trust for users of high-risk AI systems. However, on the practical implications of these transparency obligations, the research notes that concern arises due to potential illiteracy of high-risk AI systems users. They might not benefit from sufficient technical expertise to fully understand the information provided to them, despite the wording of the Proposal, which requires that information should be comprehensible to its recipients (i.e. users).On this matter, the research points that there could be, more broadly, an important divergence between the level of detail of the information required by the Proposal and the level of expertise of users of high-risk AI systems. As a conclusion, the research provides policy recommendations to tackle (part of) the issues highlighted. It notably recommends to broaden the scope of transparency requirements for high-risk AI systems to encompass end-users. It also suggests that principles of explanation, as they were put forward in the Guidelines for Trustworthy AI of the High Level Expert Group, should be included in the Proposal in addition to transparency obligations.

Keywords: aI act proposal, explainability of aI, high-risk aI systems, transparency requirements

Procedia PDF Downloads 268
215 Experiences and Challenges of Community Participation in Urban Renewal Projects: A Case Study of Bhendi Bazzar, Mumbai, India

Authors: Madhura Yadav

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Urban redevelopment planning initiatives in developing countries have been largely criticised due to top-down planning approach and lack of involvement of the targeted beneficiaries which have led to a challenging situation which is contrary to the perceived needs of beneficiaries. Urban renewal projects improve the lives of people and meaningful participation of community plays a pivotal role. Public perceptions on satisfaction and participation have been given less priority in the investigation, which hinders effective planning and implementation of urban renewal projects. Moreover, challenges of community participation in urban renewal projects are less documented, particularly in relation to public participation and satisfaction. There is a need for new paradigm shift focusing on community participatory approach in urban renewal projects. The over 125-year-old Bhendi Bazar in Mumbai, India is the country’s first ever cluster redevelopment project, popularly known as Bhendi Bazaar redevelopment and it will be one of the largest projects for urban rejuvenation of one of Mumbai’s oldest and dying inner city areas. The project is led by the community trust, inputs were taken from various stakeholders, including residents, commercial tenants and expert consultants to shape the master plan and design of the project. The project started in 2016 but there is a significant delay in implementing the project. The study aimed at studying and assessing public perceptions on satisfaction and the relationship between community participation and community satisfaction in Bhendi Bazaar of Mumbai, India. Furthermore, the study will outline the challenges and problems of community participation in urban renewal projects and it suggests recommendations for the future. The qualitative and quantitative methods such as reconnaissance survey, key informant interviews, focus group discussions, walking interviews, a narrative inquiry is used for analysis of data. Preliminary findings revealed that all tenants are satisfied for the redevelopment of an area but the willingness of residential tenants to move in transit accommodation has made the projects successful and reductant of some residential and commercial tenants, regulatory provisions rising to face challenges in implementation. Experiences from the case study can help to understand dynamics behind public participation and government. At the same time, they serve as an inspiration and learning opportunity for future projects to ensure that they are sustainable not only from an economic standpoint but also, a social perspective.

Keywords: urban renewal, Bhendi Bazaar, community participation, satisfaction, social perspective

Procedia PDF Downloads 150
214 A Systematic Map of the Research Trends in Wildfire Management in Mediterranean-Climate Regions

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

Procedia PDF Downloads 101
213 Development of Coir Reinforced Composite for Automotive Parts Application

Authors: Okpala Charles Chikwendu, Ezeanyim Okechukwu Chiedu, Onukwuli Somto Kenneth

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The demand for lightweight and fuel-efficient automobiles has led to the use of fiber-reinforced polymer composites in place of traditional metal parts. Coir, a natural fiber, offers qualities such as low cost, good tensile strength, and biodegradability, making it a potential filler material for automotive components. However, poor interfacial adhesion between coir and polymeric matrices has been a challenge. To address poor interfacial adhesion with polymeric matrices due to their moisture content and method of preparation, the extracted coir was chemically treated using NaOH. To develop a side view mirror encasement by investigating the mechanical effect of fiber percentage composition, fiber length and percentage composition of Epoxy in a coir fiber reinforced composite, polyester was adopted as the resin for the mold, while that of the product is Epoxy. Coir served as the filler material for the product. Specimens with varied compositions of fiber loading (15, 30 and 45) %, length (10, 15, 20, 30 and 45) mm, and (55, 70, 85) % weight of epoxy resin were fabricated using hand lay-up technique, while those specimens were later subjected to mechanical tests (Tensile, Flexural and Impact test). The results of the mechanical test showed that the optimal solution for the input factors is coir at 45%, epoxy at 54.543%, and 45mm coir length, which was used for the development of a vehicle’s side view mirror encasement. The optimal solutions for the response parameters are 49.333 Mpa for tensile strength, flexural for 57.118 Mpa, impact strength for 34.787 KJ/M2, young modulus for 4.788 GPa, stress for 4.534 KN, and 20.483 mm for strain. The models that were developed using Design Expert software revealed that the input factors can achieve the response parameters in the system with 94% desirability. The study showed that coir is quite durable for filler material in an epoxy composite for automobile applications and that fiber loading and length have a significant effect on the mechanical behavior of coir fiber-reinforced epoxy composites. The coir's low density, considerable tensile strength, and bio-degradability contribute to its eco-friendliness and potential for reducing the environmental hazards of synthetic automotive components.

Keywords: coir, composite, coir fiber, coconut husk, polymer, automobile, mechanical test

Procedia PDF Downloads 37
212 Association of Body Composition Parameters with Lower Limb Strength and Upper Limb Functional Capacity in Quilombola Remnants

Authors: Leonardo Costa Pereira, Frederico Santos Santana, Mauro Karnikowski, Luís Sinésio Silva Neto, Aline Oliveira Gomes, Marisete Peralta Safons, Margô Gomes De Oliveira Karnikowski

Abstract:

In Brazil, projections of population aging follow all world projections, the birth rate tends to be surpassed by the mortality rate around the year 2045. Historically, the population of Brazilian blacks suffered for several centuries from the oppression of dominant classes. A group, especially of blacks, stands out in relation to territorial, historical and social aspects, and for centuries they have isolated themselves in small communities, in order to maintain their freedom and culture. The isolation of the Quilombola communities generated socioeconomic effects as well as the health of these blacks. Thus, the objective of the present study is to verify the association of body composition parameters with lower and upper limb strength and functional capacity in Quilombola remnants. The research was approved by ethics committee (1,771,159). Anthropometric evaluations of hip and waist circumference, body mass and height were performed. In order to verify the body composition, the relationship between stature and body mass (BM) was performed, generating the body mass index (BMI), as well as the dual-energy X-ray absorptiometry (DEXA) test. The Time Up and Go (TUG) test was used to evaluate the functional capacity, and a maximum repetition test (1MR) for knee extension and handgrip (HG) was applied for strength magnitude analysis. Statistical analysis was performed using the statistical package SPSS 22.0. Shapiro Wilk's normality test was performed. For the possible correlations, the suggestions of the Pearson or Spearman tests were adopted. The results obtained after the interpretation identified that the sample (n = 18) was composed of 66.7% of female individuals with mean age of 66.07 ± 8.95 years. The sample’s body fat percentage (%BF) (35.65 ± 10.73) exceeds the recommendations for age group, as well as the anthropometric parameters of hip (90.91 ± 8.44cm) and waist circumference (80.37 ± 17.5cm). The relationship between height (1.55 ± 0.1m) and body mass (63.44 ± 11.25Kg) generated a BMI of 24.16 ± 7.09Kg/m2, that was considered normal. The TUG performance was 10.71 ± 1.85s. In the 1MR test, 46.67 ± 13.06Kg and in the HG 23.93±7.96Kgf were obtained, respectively. Correlation analyzes were characterized by the high frequency of significant correlations for height, dominant arm mass (DAM), %BF, 1MR and HG variables. In addition, correlations between HG and BM (r = 0.67, p = 0.005), height (r = 0.51, p = 0.004) and DAM (r = 0.55, p = 0.026) were also observed. The strength of the lower limbs correlates with BM (r = 0.69, p = 0.003), height (r = 0.62, p = 0.01) and DAM (r = 0.772, p = 0.001). In this way, we can conclude that not only the simple spatial relationship of mass and height can influence in predictive parameters of strength or functionality, being important the verification of the conditions of the corporal composition. For this population, height seems to be a good predictor of strength and body composition.

Keywords: African Continental Ancestry Group, body composition, functional capacity, strength

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211 Investigating the Relationship between Job Satisfaction, Role Identity, and Turnover Intention for Nurses in Outpatient Department

Authors: Su Hui Tsai, Weir Sen Lin, Rhay Hung Weng

Abstract:

There are numerous outpatient departments at hospitals with enormous amounts of outpatients. Although the work of outpatient nursing staff does not include the ward, emergency and critical care units that involve patient life-threatening conditions, the work is cumbersome and requires facing and dealing with a large number of outpatients in a short period of time. Therefore, nursing staff often do not feel satisfied with their work and cannot identify with their professional role, leading to intentions to leave their job. Thus, the main purpose of this study is to explore the correlation between the job satisfaction and role identity of nursing staff with turnover intention. This research was conducted using a questionnaire, and the subjects were outpatient nursing staff in three regional hospitals in Southern Taiwan. A total of 175 questionnaires were distributed, and 166 valid questionnaires were returned. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The influence of role identity and job satisfaction on nursing staff’s turnover intention was analyzed by descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. Results showed that 'role identity' had significant differences in different types of marriages. Job satisfaction of 'grasp of environment' had significant differences in different levels of education. Job satisfaction of 'professional growth' and 'shifts and days off' showed significant differences in different types of marriages. 'Role identity' and 'job satisfaction' were negatively correlated with turnover intention respectively. Job satisfaction of 'salary and benefits' and 'grasp of environment' were significant predictors of role identity. The higher the job satisfaction of 'salary and benefits' and 'grasp of environment', the higher the role identity. Job satisfaction of 'patient and family interaction' were significant predictors of turnover intention. The lower the job satisfaction of 'patient and family interaction', the higher the turnover intention. This study found that outpatient nursing staff had the lowest satisfaction towards salary structure. It is recommended that bonuses, promotion opportunities and other incentives be established to increase the role identity of outpatient nursing staff. The results showed that the higher the job satisfaction of 'salary and benefits' and 'grasp of environment', the higher the role identity. It is recommended that regular evaluations be conducted to reward nursing staff with excellent service and invite nursing staff to share their work experiences and thoughts, to enhance nursing staff’s expectation and identification of their occupational role, as well as instilling the concept of organizational service and organizational expectations of emotional display. The results showed that the lower the job satisfaction of 'patient and family interaction', the higher the turnover intention. It is recommended that interpersonal communication and workplace violence prevention educational training courses be organized to enhance the communication and interaction of nursing staff with patients and their families.

Keywords: outpatient, job satisfaction, turnover, intention

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210 Conflicts of Interest in the Private Sector and the Significance of the Public Interest Test

Authors: Opemiposi Adegbulu

Abstract:

Conflicts of interest is an elusive, diverse and engaging subject, a cross-cutting problem of governance; all levels of governance, ranging from local to global, public to corporate or financial sectors. In all these areas, its mismanagement could lead to the distortion of decision-making processes, corrosion of trust and the weakening of administration. According to Professor Peters, an expert in the area, conflict of interest, a problem at the root of many scandals has “become a pervasive ethical concern in our professional, organisational, and political life”. Conflicts of interest corrode trust, and like in the public sector, trust is mandatory for the market, consumers/clients, shareholders and other stakeholders in the private sector. However, conflicts of interest in the private sector are distinct and must be treated in like manner when regulatory efforts are made to address them. The research looks at identifying conflicts of interest in the private sector and differentiating them from those in the public sector. The public interest is submitted as a criterion which allows for such differentiation. This is significant because it would for the use of tailor-made or sector-specific approaches to addressing this complex issue. This is conducted through extensive review of literature and theories on the definition of conflicts of interest. This study will employ theoretical, doctrinal and comparative methods. The nature of conflicts of interest in the private sector will be explored, through an analysis of the public sector where the notion of conflicts of interest appears more clearly identified, reasons, why they are of business ethics concern, will be advanced, and then, once again, looking at public sector solutions and other solutions, the study will identify ways of mitigating and managing conflicts in the private sector. An exploration of public sector conflicts of interest and solutions will be carried out because the typologies of conflicts of interest in both sectors appear very similar at the core and thus, lessons can be learnt with regards to the management of these issues in the private sector. Conflicts of interest corrode trust, and like in the public sector, trust is mandatory for the market, consumers/clients, shareholders and other stakeholders in the private sector. This research will then focus on some specific challenges to understanding and identifying conflicts of interest in the private sector; origin, diverging theories, the psychological barrier to the definition, similarities with public sector conflicts of interest due to the notions of corrosion of trust, ‘being in a particular kind of situation,’ etc. The notion of public interest will be submitted as a key element at the heart of the distinction between public sector and private sector conflicts of interests. It will then be proposed that the appreciation of the notion of conflicts of interest differ according to sector, country to country, based on the public interest test, using the United Kingdom (UK), the United States of America (US), France and the Philippines as illustrations.

Keywords: conflicts of interest, corporate governance, global governance, public interest

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209 An Assessment of Suitable Alternative Public Transport System in Mid-Sized City of India

Authors: Sanjeev Sinha, Samir Saurav

Abstract:

The rapid growth of urban areas in India has led to transportation challenges like traffic congestion and an increase in accidents. Despite efforts by state governments and local administrations to improve urban transport, the surge in private vehicles has worsened the situation. Patna, located in Bihar State, is an example of the trend of increasing reliance on private motor vehicles, resulting in vehicular congestion and emissions. The existing transportation infrastructure is inadequate to meet future travel demands, and there has been a notable increase in the share of private vehicles in the city. Additionally, there has been a surge in economic activities in the region, which has increased the demand for improved travel convenience and connectivity. To address these challenges, a study was conducted to assess the most suitable transit mode for the proposed transit corridor outlined in the Comprehensive Mobility Plan (CMP) for Patna. The study covered four stages: developing screening criteria, evaluating parameters for various alternatives, qualitative and quantitative evaluations of alternatives, and implementation options for the most viable alternative. The study suggests that a mass transit system such as a metro rail is necessary to enhance Patna's urban public transport system. The New Metro Policy 2017 outlines specific prerequisites for submitting a Metro Rail Project Proposal to the Ministry of Housing and Urban Affairs (MoHUA), including the preparation of a CMP, the formation of an Urban Metropolitan Transport Authority (UMTA), the creation of an Alternative Analysis Report, the development of a Detailed Project Report, a Multi-Modal Integration Plan, and a Transit-Oriented Development (TOD) Plan. In 2018, the Comprehensive Mobility Plan for Patna was prepared, setting the stage for the subsequent steps in the metro rail project proposal. The results indicated that from the screening and analysis of qualitative parameters for different alternative modes in Patna, it is inferred that the Metro Rail and Monorail score 82.25 and 70.50, respectively, on a scale of 100. Based on the initial analysis and alternative evaluation in the form of quantitative analysis, the Metro Rail System significantly outperformed the Monorail system. The Metro Rail System has a positive Economic Net Present Value (ENPV) at a 14% internal rate of return, while the Monorail has a negative value. In conclusion, the study recommends choosing metro rail over monorail for the proposed transit corridor in Patna. However, the lack of broad-based technical expertise may result in implementation delays and increased costs for monorail.

Keywords: comprehensive mobility plan, alternative analysis, mobility corridors, mass transit system

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