Search results for: evaluation tool

Authors: Melissa Dorsey

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Moral distress and compassion fatigue plague nurses in the Cardiothoracic Intensive Care Unit (CTICU) and cause an unnecessary level of turnover. Dueling Burnout describes an initiative that was implemented in the CTICU to reduce the level of burnout the nurses endure by encouraging dual roles with collaborating departments. Purpose: Critical care nurses are plagued by burnout, moral distress, and compassion fatigue due to the intensity of care provided. The purpose of the dual role program was to decrease these issues by providing relief from the intensity of the critical care environment while maintaining full-time employment. Relevance/Significance: Burnout, moral distress, and compassion fatigue are leading causes of Cardiothoracic Critical Care (CTCU) turnover. A contributing factor to burnout is the workload related to serving as a preceptor for a constant influx of new nurses (RN). As a result of these factors, the CTICU averages 17% nursing turnover/year. The cost, unit disruption, and, most importantly, distress of the clinical nurses required an innovative approach to create an improved work environment and experience. Strategies/Implementation/Methods: In May 2018, a dual role pilot was initiated for nurses. The dual role constitutes .6 full-time equivalent hours (FTE) worked in CTICU in combination with .3 FTE worked in the Emergency Department (ED). ED nurses who expressed an interest in cross-training to CTICU were also offered the dual role opportunity. The initial hypothesis was that full-time employees would benefit from a change in clinical setting leading to increased engagement and job satisfaction. The dual role also presents an opportunity for professional development through the expansion of clinical skills in another specialty. Success of the pilot led to extending the dual role to areas beyond the ED. Evaluation/Outcomes/Results: The number of dual role clinical nurses has grown to 22. From the dual role cohort, only one has transferred out of CTICU. This is a 5% turnover rate for this group of nurses as compared to the average turnover rate of 17%. A role satisfaction survey conducted with the dual role cohort found that because of working in a dual role, 76.5% decreased their intent to leave, 100% decreased their level of burnout, and 100% reported an increase in overall job satisfaction. Nurses reported the ability to develop skills that are transferable between departments. Respondents emphasized the appreciation gained from working in multiple environments; the dual role served to transform their care. Conclusions/Implications: Dual role is an effective strategy to retain experienced nurses, decrease burnout and turnover, improve collaboration, and provide flexibility to meet staffing needs. The dual role offers RNs an expansion of skills, relief from high acuity and orientee demands, while improving job satisfaction.

Keywords: nursing retention, burnout, pandemic, strategic staffing, leadership

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Authors: P. Asiabi, M. Shahhoseini, R. Favaedi, F. Hassani, N. Nassiri, B. Movaghar, L. Karimian, P. Eftekhariyazdi

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Introduction: Polycystic Ovary Syndrome is a common gynecologic disorder. Many factors including environment, metabolism, hormones and genetics are involved in etiopathogenesis of PCOS. Of genes that have altered expression in human reproductive system disorders are HOX family genes which act as transcription factors in regulation of cell proliferation, differentiation, adhesion and migration. Since recent evidences consider epigenetic factors as causative mechanisms of PCOS, evaluation of association between known epigenetic marks of acetylation/methylation of histone 3 (H3K9ac/me) with regulatory regions of these genes can represent better insight about PCOS. In the current study, cumulus cells (CCs) which have critical roles during folliculogenesis, oocyte maturation, ovulation and fertilization were aimed to monitor epigenetic alterations of HOX genes. Material and methods: CCs were collected from 20 PCOS patients and 20 fertile women (18-36 year) with male infertility problems referred to the Royan Institute to have ICSI under GnRH antagonist protocol. Informed consents were obtained from the participants. Thirty six hours after hCG injection, ovaries were punctured and cumulus oocyte complexes were dissected. Soluble chromatin were extracted from CCs and Chromatin Immune precipitation (ChIP) coupled with Real Time PCR was performed to quantify the epigenetic marks of histone H3K9 acetylation/methylation (H3K9ac/me) on regulatory regions of 15 members of HOX genes from A-D subfamily. Results: Obtained data showed significant increase of H3K9ac epigenetic mark on regulatory regions of HOXA1, HOXB2, HOXC4, HOXD1, HOXD3 and HOXD4 (P < 0.01) and HOXC5 (P < 0.05) and also significant decrease of H3K9ac into regulatory regions of HOXA2, HOXA4, HOXA5, HOXB1 and HOXB5 (P < 0.01) and HOXB3 (P<0.05) in PCOS patients vs. control group. On the other side, there was a significant decrease in incorporation of H3K9me level on regulatory region of HOXA2, HOXA3, HOXA4, HOXA5, HOXB3 and HOXC4 (P≤0.01) and HOXB5 (P < 0.05) in PCOS patients vs. control group. This epigenetic mark (H3K9me2) has significant increase on regulatory region of HOXB1, HOXB2, HOXC5, HOXD1, HOXD3 and HOXD4 (P ≤ 0.01) and HOXB4 (P < 0.05) in patients vs. control group. There were no significant changes in acetylation/methylation levels of H3K9 on regulatory regions of the other studied genes. Conclusion: Current study suggests that epigenetic alterations of HOX genes can be correlated with PCOS and consequently female infertility. This finding might offer additional definitions of PCOS, and eventually provides insight for novel treatments with epidrugs for this disease.

Keywords: epigenetic, HOX genes, PCOS, female infertility

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Authors: Ojas Chaudhari, Ali Nejad Ghafar, Giedrius Zirgulis, Marjan Mousavi, Tommy Ellison, Sandra Pousette, Patrick Fontana

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In Swedish tunnel construction, a critical issue that has been repeatedly acknowledged is corrosion and, consequently, failure of the rock bolts in rock support systems. The defective installation of rock bolts results in the formation of cavities in the cement mortar that is regularly used to fill the area under the dome plates. These voids allow for water-ingress to the rock bolt assembly, which results in corrosion of rock bolt components and eventually failure. In addition, the current installation technique consists of several manual steps with intense labor works that are usually done in uncomfortable and exhausting conditions, e.g., under the roof of the tunnels. Such intense tasks also lead to a considerable waste of materials and execution errors. Moreover, adequate quality control of the execution is hardly possible with the current technique. To overcome these issues, a non-shrinking/expansive cement-based mortar filled in the paper packaging has been developed in this study which properly fills the area under the dome plates without or with the least remaining cavities, ultimately that diminishes the potential of corrosion. This article summarizes the development process and the experimental evaluation of this technique for the installation of rock bolts. In the development process, the cementitious mortar was first developed using specific cement and shrinkage reducing/expansive additives. The mechanical and flow properties of the mortar were then evaluated using compressive strength, density, and slump flow measurement methods. In addition, isothermal calorimetry and shrinkage/expansion measurements were used to elucidate the hydration and durability attributes of the mortar. After obtaining the desired properties in both fresh and hardened conditions, the developed dry mortar was filled in specific permeable paper packaging and then submerged in water bath for specific intervals before the installation. The tests were enhanced progressively by optimizing different parameters such as shape and size of the packaging, characteristics of the paper used, immersion time in water and even some minor characteristics of the mortar. Finally, the developed prototype was tested in a lab-scale rock bolt assembly with various angles to analyze the efficiency of the method in real life scenario. The results showed that the new technique improves the performance of the rock bolts by reducing the material wastage, improving environmental performance, facilitating and accelerating the labor works, and finally enhancing the durability of the whole system. Accordingly, this approach provides an efficient alternative for the traditional way of tunnel bolt installation with considerable advantages for the Swedish tunneling industry.

Keywords: corrosion, durability, mortar, rock bolt

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolisms of macrominerals, those of calcium, phosphorus and magnesium, are closely associated with the metabolism of vitamin D. Particularly magnesium, the second most abundant intracellular cation, is related to biochemical and metabolic processes in the body, such as those of carbohydrates, proteins and lipids. The status of each mineral was investigated in obesity to some extent. Their products and ratios may possibly give much more detailed information about the matter. The aim of this study is to investigate possible relations between each macromineral and some obesity-related parameters. This study was performed on 235 children, whose ages were between 06-18 years. Aside from anthropometric measurements, hematological analyses were performed. TANITA body composition monitor using bioelectrical impedance analysis technology was used to establish some obesity-related parameters including basal metabolic rate (BMR), total fat, mineral and muscle masses. World Health Organization body mass index (BMI) percentiles for age and sex were used to constitute the groups. The values above 99^th percentile were defined as morbid obesity. Those between 95^th and 99^th percentiles were included into the obese group. The overweight group comprised of children whose percentiles were between 95 and 85. Children between the 85^th and 15^th percentiles were defined as normal. Metabolic syndrome (MetS) components (waist circumference, fasting blood glucose, triacylglycerol, high density lipoprotein cholesterol, systolic pressure, diastolic pressure) were determined. High performance liquid chromatography was used to determine Vitamin D status by measuring 25-hydroxy cholecalciferol (25-hydroxy vitamin D₃, 25(OH)D). Vitamin D values above 30.0 ng/ml were accepted as sufficient. SPSS statistical package program was used for the evaluation of data. The statistical significance degree was accepted as p < 0.05. The important points were the correlations found between vitamin D and magnesium as well as phosphorus (p < 0.05) that existed in the group with normal BMI values. These correlations were lost in the other groups. The ratio of phosphorus to magnesium was even much more highly correlated with vitamin D (p < 0.001). The negative correlation between magnesium and total fat mass (p < 0.01) was confined to the MetS group showing the inverse relationship between magnesium levels and obesity degree. In this group, calcium*magnesium product exhibited the highest correlation with total fat mass (p < 0.001) among all groups. Only in the MetS group was a negative correlation found between BMR and calcium*magnesium product (p < 0.05). In conclusion, magnesium is located at the center of attraction concerning its relationships with vitamin D, fat mass and MetS. The ratios and products derived from macrominerals including magnesium have pointed out stronger associations other than each element alone. Final considerations have shown that unique correlations of magnesium as well as calcium*magnesium product with total fat mass have drawn attention particularly in the MetS group, possibly due to the derangements in some basic elements of carbohydrate as well as lipid metabolism.

Keywords: macrominerals, metabolic syndrome, pediatric obesity, vitamin D

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Authors: Sakshi Piplani, Ajit Kumar

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Valproic acid (VPA) is the first synthetic therapeutic agent used to treat epileptic disorders, which account for affecting nearly 1% world population. Teratogenicity caused by VPA has prompted the search for next generation drug with better efficacy and lower side effects. Recent studies have posed HDAC8 as direct target of VPA that causes the teratogenic effect in foetus. We have employed molecular dynamics (MD) and docking simulations to understand the binding mode of VPA and their analogues onto HDAC8. A total of twenty 3D-structures of human HDAC8 isoforms were selected using BLAST-P search against PDB. Multiple sequence alignment was carried out using ClustalW and PDB-3F07 having least missing and mutated regions was selected for study. The missing residues of loop region were constructed using MODELLER and energy was minimized. A set of 216 structural analogues (>90% identity) of VPA were obtained from Pubchem and ZINC database and their energy was optimized with Chemsketch software using 3-D CHARMM-type force field. Four major neurotransmitters (GABAt, SSADH, α-KGDH, GAD) involved in anticonvulsant activity were docked with VPA and its analogues. Out of 216 analogues, 75 were selected on the basis of lower binding energy and inhibition constant as compared to VPA, thus predicted to have anti-convulsant activity. Selected hHDAC8 structure was then subjected to MD Simulation using licenced version YASARA with AMBER99SB force field. The structure was solvated in rectangular box of TIP3P. The simulation was carried out with periodic boundary conditions and electrostatic interactions and treated with Particle mesh Ewald algorithm. pH of system was set to 7.4, temperature 323K and pressure 1atm respectively. Simulation snapshots were stored every 25ps. The MD simulation was carried out for 20ns and pdb file of HDAC8 structure was saved every 2ns. The structures were analysed using castP and UCSF Chimera and most stabilized structure (20ns) was used for docking study. Molecular docking of 75 selected VPA-analogues with PDB-3F07 was performed using AUTODOCK4.2.6. Lamarckian Genetic Algorithm was used to generate conformations of docked ligand and structure. The docking study revealed that VPA and its analogues have more affinity towards ‘hydrophobic active site channel’, due to its hydrophobic properties and allows VPA and their analogues to take part in van der Waal interactions with TYR24, HIS42, VAL41, TYR20, SER138, TRP137 while TRP137 and SER138 showed hydrogen bonding interaction with VPA-analogues. 14 analogues showed better binding affinity than VPA. ADMET SAR server was used to predict the ADMET properties of selected VPA analogues for predicting their druggability. On the basis of ADMET screening, 09 molecules were selected and are being used for in-vivo evaluation using Danio rerio model.

Keywords: HDAC8, docking, molecular dynamics simulation, valproic acid

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Authors: Web Huei Chou, Li Yi Chun, Wenwe Yu, Han Teng Weng, H. Yuan, T. Yang

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The prevalence of dementia is estimated to rise to 78 million by 2030 and 139 million by 2050. Among those affected, Alzheimer's disease is the most common form of dementia, contributing to 60–70% of cases. Addressing this growing challenge is crucial, especially considering the impact on older individuals and their caregivers. To reduce the behavioral and psychological symptoms of dementia, people with dementia use a variety of pharmaceutical and non-pharmacological treatments, and some studies have found the use of non-pharmacological interventions. Treatment of depression, cognitive function, and social activities has potential benefits. Butler developed reminiscence therapy as a method of treating dementia. Through ‘life review,’ individuals can recall their past events, activities, and experiences, which can reduce the depression of the elderly and improve their Quality of life to help give meaning to their lives and help them live independently. The life review process uses a variety of memory triggers, such as household items, past objects, photos, and music, and can be conducted collectively or individually and structured or unstructured. However, despite the advantages of nostalgia therapy, past research has always pointed out that current research lacks rigorous experimental evaluation and cannot describe clear research results and generalizability. Therefore, this study aims to study physiological sensing experiments to find a feasible experimental and verification method to provide clearer design and design specifications for reminiscence therapy and to provide a more widespread application for healthy aging. This study is an ongoing research project, a collaboration between the School of Design at Yunlin University of Science and Technology in Taiwan and the Department of Medical Engineering at Chiba University in Japan. We use traditional rice dishes from Taiwan and Japan as nostalgic content to construct a narrative structure for the elderly in the two countries respectively for life review activities, providing an easy-to-carry nostalgic therapy game with an intuitive interactive design. This experiment is expected to be completed in 36 months. The design team constructed and designed the game after conducting literary and historical data surveys and interviews with elders to confirm the nostalgic historical data in Taiwan and Japan. The Japanese team planned the Electrodermal Activity (EDA) and Blood Volume Pulse (BVP) experimental environments and Data calculation model, and then after conducting experiments on elderly people in two places, the research results were analyzed and discussed together. The research has completed the first 24 months of pre-study, design work, and pre-study and has entered the project acceptance stage.

Keywords: reminiscence therapy, aging health, design research, life review

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Authors: Grâce Chidikofan, François Pinta, A. Benoist, G. Volle, J. Valette

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Statement of the Problem: biomass gasification systems may be relevant for decentralized power generation from recoverable agricultural and wood residues available in rural areas. In recent years, many systems have been implemented in all over the world as especially in Cambodgia, India. Although they have many positive effects, these systems can also affect the environment and human health. Indeed, during the process of biomass gasification, black wastewater containing tars are produced and generally discharged in the local environment either into the rivers or on soil. However, in most environmental assessment studies of biomass gasification systems, the impact of these releases are underestimated, due to the difficulty of identification of their chemical substances. This work deal with the analysis of the environmental impacts of tars from wood gasification in terms of human toxicity cancer effect, human toxicity non-cancer effect, and freshwater ecotoxicity. Methodology: A Life Cycle Assessment (LCA) approach was adopted. The inventory of tars chemicals substances was based on experimental data from a downdraft gasification system. The composition of six samples from two batches of raw materials: one batch made of tree wood species (oak+ plane tree +pine) at 25 % moisture content and the second batch made of oak at 11% moisture content. The tests were carried out for different gasifier load rates, respectively in the range 50-75% and 50-100%. To choose the environmental impacts assessment method, we compared the methods available in SIMAPRO tool (8.2.0) which are taking into account most of the chemical substances. The environmental impacts for 1kg of tars discharged were characterized by ILCD 2011+ method (V.1.08). Findings Experimental results revealed 38 important chemical substances in varying proportion from one test to another. Only 30 are characterized by ILCD 2011+ method, which is one of the best performing methods. The results show that wood species or moisture content have no significant impact on human toxicity noncancer effect (HTNCE) and freshwater ecotoxicity (FWE) for water release. For human toxicity cancer effect (HTCE), a small gap is observed between impact factors of the two batches, either 3.08E-7 CTUh/kg against 6.58E-7 CTUh/kg. On the other hand, it was found that the risk of negative effects is higher in case of tar release into water than on soil for all impact categories. Indeed, considering the set of samples, the average impact factor obtained for HTNCE varies respectively from 1.64 E-7 to 1.60E-8 CTUh/kg. For HTCE, the impact factor varies between 4.83E-07 CTUh/kg and 2.43E-08 CTUh/kg. The variability of those impact factors is relatively low for these two impact categories. Concerning FWE, the variability of impact factor is very high. It is 1.3E+03 CTUe/kg for tars release into water against 2.01E+01 CTUe/kg for tars release on soil. Statement concluding: The results of this study show that the environmental impacts of tars emission of biomass gasification systems can be consequent and it is important to investigate the ways to reduce them. For environmental research, these results represent an important step of a global environmental assessment of the studied systems. It could be used to better manage the wastewater containing tars to reduce as possible the impacts of numerous still running systems all over the world.

Keywords: biomass gasification, life cycle analysis, LCA, environmental impact, tars

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Authors: Roberta Martino, Viviana Ventre

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Intertemporal choices are choices under conditions of uncertainty in which the consequences are distributed over time. The Discounted Utility Model is the essential reference for describing the individual in the context of intertemporal choice. The model is based on the idea that the individual selects the alternative with the highest utility, which is calculated by multiplying the cardinal utility of the outcome, as if the reception were instantaneous, by the discount function that determines a decrease in the utility value according to how the actual reception of the outcome is far away from the moment the choice is made. Initially, the discount function was assumed to have an exponential trend, whose decrease over time is constant, in line with a profile of a rational investor described by classical economics. Instead, empirical evidence called for the formulation of alternative, hyperbolic models that better represented the actual actions of the investor. Attitudes that do not comply with the principles of classical rationality are termed anomalous, i.e., difficult to rationalize and describe through normative models. The development of behavioral finance, which describes investor behavior through cognitive psychology, has shown that deviations from rationality are due to the limited rationality condition of human beings. What this means is that when a choice is made in a very difficult and information-rich environment, the brain does a compromise job between the cognitive effort required and the selection of an alternative. Moreover, the evaluation and selection phase of the alternative, the collection and processing of information, are dynamics conditioned by systematic distortions of the decision-making process that are the behavioral biases involving the individual's emotional and cognitive system. In this paper we present an original decomposition of the discount function to investigate the psychological principles of hyperbolic discounting. It is possible to decompose the curve into two components: the first component is responsible for the smaller decrease in the outcome as time increases and is related to the individual's impatience; the second component relates to the change in the direction of the tangent vector to the curve and indicates how much the individual perceives the indeterminacy of the future indicating his or her aversion to uncertainty. This decomposition allows interesting conclusions to be drawn with respect to the concept of impatience and the emotional drives involved in decision-making. The contribution that neuroscience can make to decision theory and inter-temporal choice theory is vast as it would allow the description of the decision-making process as the relationship between the individual's emotional and cognitive factors. Neurofinance is a discipline that uses a multidisciplinary approach to investigate how the brain influences decision-making. Indeed, considering that the decision-making process is linked to the activity of the prefrontal cortex and amygdala, neurofinance can help determine the extent to which abnormal attitudes respect the principles of rationality.

Keywords: impatience, intertemporal choice, neurofinance, rationality, uncertainty

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Authors: Ryan C. Igama

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The complexity of disaster risk reduction management paved the way for various innovations and approaches to mitigate the loss of lives and casualties during disaster-related situations. The efficiency of doing response operations during disasters relies on the timely and organized deployment of search, rescue and retrieval teams. Indeed, the assistance provided by the search, rescue, and retrieval teams during disaster operations is a critical service needed to further minimize the loss of lives and casualties. The Armed Forces of the Philippines was mandated to provide humanitarian assistance and disaster relief operations during calamities and disasters. Thus, this study “Interoperability of 505TH Search and Rescue Group and the 205TH Tactical Helicopter Wing of the Philippine Air Force in Search and Rescue Operations: An Assessment” was intended to provide substantial information to further strengthen and promote the capabilities of search and rescue operations in the Philippines. Further, this study also aims to assess the interoperability of the 505th Search and Rescue Group of the Philippine Air Force and the 205th Tactical Helicopter Wing Philippine Air Force. This study was undertaken covering the component units in the Philippine Air Force of the Armed Forces of the Philippines – specifically the 505th SRG and the 205th THW as the involved units who also acted as the respondents of the study. The qualitative approach was the mechanism utilized in the form of focused group discussions, key informant interviews, and documentary analysis as primary means to obtain the needed data for the study. Essentially, this study was geared towards the evaluation of the effectiveness of the interoperability of the two (2) involved PAF units during search and rescue operations. Further, it also delved into the identification of the impacts, gaps, and challenges confronted regarding interoperability as to training, equipment, and coordination mechanism vis-à-vis the needed measures for improvement, respectively. The result of the study regarding the interoperability of the two (2) PAF units during search and rescue operations showed that there was a duplication in terms of functions or tasks in HADR activities, specifically during the conduct of air rescue operations in situations like calamities. In addition, it was revealed that there was a lack of equipment and training for the personnel involved in search and rescue operations which is a vital element during calamity response activities. Based on the findings of the study, it was recommended that a strategic planning workshop/activity must be conducted regarding the duties and responsibilities of the personnel involved in the search and rescue operations to address the command and control and interoperability issues of these units. Additionally, the conduct of intensive HADR-related training for the personnel involved in search and rescue operations of the two (2) PAF Units must also be conducted so they can be more proficient in their skills and sustainably increase their knowledge of search and rescue scenarios, including the capabilities of the respective units. Lastly, the updating of existing doctrines or policies must be undertaken to adapt advancement to the evolving situations in search and rescue operations.

Keywords: interoperability, search and rescue capability, humanitarian assistance, disaster response

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Authors: Virgilio Angelo Gelera Gener

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This study investigates the role of short-term accommodations on the place brand and real estate development of urban areas. It aims to know the perceptions of the general public, real estate developers, as well as city and barangay-level local government units (LGUs) on how these lodgings affect the place brand and land value of a community. It likewise attempts to identify the personal and institutional variables having a great influence on said perceptions in order to provide a better understanding of these establishments and their relevance within urban localities. Using certain sources, Malate, Manila was identified to be the ideal study area of the thesis. This prompted the employment of mixed methods research as the study’s fundamental data gathering and analytical tool. Here, a survey with 350 locals was done, asking them questions that would answer the aforementioned queries. Thereafter, a Pearson Chi-square Test and Multinomial Logistic Regression (MLR) were utilized to determine the variables affecting their perceptions. There were also Focus Group Discussions (FGDs) with the three (3) most populated Malate barangays, as well as Key Informant Interviews (KIIs) with selected city officials and fifteen (15) real estate company representatives. With that, survey results showed that although a 1992 Department of Tourism (DOT) Circular regards short-term accommodations as lodgings mainly for travelers, most people actually use it for their private/intimate moments. Because of this, the survey further revealed that short-term accommodations exhibit a negative place brand among the respondents though they also believe that it’s still one of society’s most important economic players. Statistics from the Pearson Chi-square Test, on the other hand, indicate that there are fourteen (14) out of seventeen (17) variables exhibiting great influence on respondents’ perceptions. Whereas MLR findings show that being born in Malate and being part of a family household was the most significant regardless of socio-economic level and monthly household income. For the city officials, it was revealed that said lodgings are actually the second-highest earners in the City’s lodging industry. It was further stated that their zoning ordinance treats short-term accommodations just like any other lodging enterprise. So it’s perfectly legal for these establishments to situate themselves near residential areas and/or institutional structures. A sit down with barangays, on the other hand, recognized the economic benefits of short-term accommodations but likewise admitted that it contributes a negative place brand to the community. Lastly, real estate developers are amenable to having their projects built near short-term accommodations, for they do not have any bad views against it. They explained that their projects sites have always been motivated by suitability, liability, and marketability factors only. Overall, these findings merit a recalibration of the zoning ordinance and DOT Circular, as well as the imposition of regulations on their sexually suggestive roadside advertisements. Then, once relevant measures are refined for proper implementation, it can also pave the way for spatial interventions (like visual buffer corridors) to better address the needs of the locals, private groups, and government.

Keywords: estate planning, place brand, real estate development, short-term accommodations

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Authors: Igor Faulmann, Arnaud Saj, Roland Maurer

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Spatial cognition consists in a plethora of high level cognitive abilities: among them, the ability to learn and to navigate in large scale environments is probably one of the most complex skills. Navigation is thought to rely on the ability to read a cognitive map, defined as an allocentric representation of ones environment. Those representations are of course intimately related to the two geometrical primitives of the environment: distance and direction. Also, many recent studies point to a predominant hippocampal and para-hippocampal role in spatial cognition, as well as in the more specific cluster of navigational skills. In a previous study in humans, we used a newly validated test assessing cognitive map processing by evaluating the ability to judge relative distances and directions: the CMRT (Cognitive Map Recall Test). This study identified in topographically disorientated patients (1) behavioral differences between the evaluation of distances and of directions, and (2) distinct causality patterns assessed via VLSM (i.e., distinct cerebral lesions cause distinct response patterns depending on the modality (distance vs direction questions). Thus, we hypothesized that: (1) if the CMRT really taps into the same resources as real navigation, there would be hippocampal, parahippocampal, and parietal activation, and (2) there exists underlying neuroanatomical and functional differences between the processing of this two modalities. Aiming toward a better understanding of the neuroanatomical correlates of the CMRT in humans, and more generally toward a better understanding of how the brain processes the cognitive map, we adapted the CMRT as an fMRI procedure. 23 healthy subjects (11 women, 12 men), all living in Geneva for at least 2 years, underwent the CMRT in fMRI. Results show, for distance and direction taken together, than the most active brain regions are the parietal, frontal and cerebellar parts. Additionally, and as expected, patterns of brain activation differ when comparing the two modalities. Furthermore, distance processing seems to rely more on parietal regions (compared to other brain regions in the same modality and also to direction). It is interesting to notice that no significant activity was observed in the hippocampal or parahippocampal areas. Direction processing seems to tap more into frontal and cerebellar brain regions (compared to other brain regions in the same modality and also to distance). Significant hippocampal and parahippocampal activity has been shown only in this modality. This results demonstrated a complex interaction of structures which are compatible with response patterns observed in other navigational tasks, thus showing that the CMRT taps at least partially into the same brain resources as real navigation. Additionally, differences between the processing of distances and directions leads to the conclusion that the human brain processes each modality distinctly. Further research should focus on the dynamics of this processing, allowing a clearer understanding between the two sub-processes.

Keywords: cognitive map, navigation, fMRI, spatial cognition

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Authors: Serap Durkut, A. Eser Elcin, Y. Murat Elcin

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Stimuli-sensitive polymeric hydrogels have received extensive attention in the biomedical field due to their sensitivity to physical and chemical stimuli (temperature, pH, ionic strength, light, etc.). This study describes the rheological properties of a novel thermoresponsive poly(N-vinylcaprolactam)-g-collagen hydrogel. In the study, we first synthesized a facile and novel synthetic carboxyl group-terminated thermo-responsive poly(N-vinylcaprolactam)-COOH (PNVCL-COOH) via free radical polymerization. Further, this compound was effectively grafted with native collagen, by utilizing the covalent bond between the carboxylic acid groups at the end of the chains and amine groups of the collagen using cross-linking agent (EDC/NHS), forming PNVCL-g-Col. Newly-formed hybrid hydrogel displayed novel properties, such as increased mechanical strength and thermoresponsive characteristics. PNVCL-g-Col showed low critical solution temperature (LCST) at 38ºC, which is very close to the body temperature. Rheological studies determine structural–mechanical properties of the materials and serve as a valuable tool for characterizing. The rheological properties of hydrogels are described in terms of two dynamic mechanical properties: the elastic modulus G′ (also known as dynamic rigidity) representing the reversible stored energy of the system, and the viscous modulus G″, representing the irreversible energy loss. In order to characterize the PNVCL-g-Col, the rheological properties were measured in terms of the function of temperature and time during phase transition. Below the LCST, favorable interactions allowed the dissolution of the polymer in water via hydrogen bonding. At temperatures above the LCST, PNVCL molecules within PNVCL-g-Col aggregated due to dehydration, causing the hydrogel structure to become dense. When the temperature reached ~36ºC, both the G′ and G″ values crossed over. This indicates that PNVCL-g-Col underwent a sol-gel transition, forming an elastic network. Following temperature plateau at 38ºC, near human body temperature the sample displayed stable elastic network characteristics. The G′ and G″ values of the PNVCL-g-Col solutions sharply increased at 6-9 minute interval, due to rapid transformation into gel-like state and formation of elastic networks. Copolymerization with collagen leads to an increase in G′, as collagen structure contains a flexible polymer chain, which bestows its elastic properties. Elasticity of the proposed structure correlates with the number of intermolecular cross-links in the hydrogel network, increasing viscosity. However, at 8 minutes, G′ and G″ values sharply decreased for pure collagen solutions due to the decomposition of the elastic and viscose network. Complex viscosity is related to the mechanical performance and resistance opposing deformation of the hydrogel. Complex viscosity of PNVCL-g-Col hydrogel was drastically changed with temperature and the mechanical performance of PNVCL-g-Col hydrogel network increased, exhibiting lesser deformation. Rheological assessment of the novel thermo-responsive PNVCL-g-Col hydrogel, exhibited that the network has stronger mechanical properties due to both permanent stable covalent bonds and physical interactions, such as hydrogen- and hydrophobic bonds depending on temperature.

Keywords: poly(N-vinylcaprolactam)-g-collagen, thermoresponsive polymer, rheology, elastic modulus, stimuli-sensitive

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Authors: Massimiliano Biagini, Marco Spinsanti, Gabriella De Angelis, Sara Tomei, Ilaria Ferlenghi, Maria Scarselli, Alessia Biolchi, Alessandro Muzzi, Brunella Brunelli, Silvana Savino, Marzia M. Giuliani, Isabel Delany, Paolo Costantino, Rino Rappuoli, Vega Masignani, Nathalie Norais

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The gram-negative bacterium Neisseria meningitidis serogroup B (MenB) is an exclusively human pathogen representing the major cause of meningitides and severe sepsis in infants and children but also in young adults. This pathogen is usually present in the 30% of healthy population that act as a reservoir, spreading it through saliva and respiratory fluids during coughing, sneezing, kissing. Among surface-exposed protein components of this diplococcus, factor H binding protein is a lipoprotein proved to be a protective antigen used as a component of the recently licensed Bexsero vaccine. fHbp is a highly variable meningococcal protein: to reflect its remarkable sequence variability, it has been classified in three variants (or two subfamilies), and with poor cross-protection among the different variants. Furthermore, the level of fHbp expression varies significantly among strains, and this has also been considered an important factor for predicting MenB strain susceptibility to anti-fHbp antisera. Different methods have been used to assess fHbp expression on meningococcal strains, however, all these methods use anti-fHbp antibodies, and for this reason, the results are affected by the different affinity that antibodies can have to different antigenic variants. To overcome the limitations of an antibody-based quantification, we developed a quantitative Mass Spectrometry (MS) approach. Selected Reaction Monitoring (SRM) recently emerged as a powerful MS tool for detecting and quantifying proteins in complex mixtures. SRM is based on the targeted detection of ProteoTypicPeptides (PTPs), which are unique signatures of a protein that can be easily detected and quantified by MS. This approach, proven to be highly sensitive, quantitatively accurate and highly reproducible, was used to quantify the absolute amount of fHbp antigen in total extracts derived from 105 clinical isolates, evenly distributed among the three main variant groups and selected to be representative of the fHbp circulating subvariants around the world. We extended the study at the genetic level investigating the correlation between the differential level of expression and polymorphisms present within the genes and their promoter sequences. The implications of fHbp expression on the susceptibility of the strain to killing by anti-fHbp antisera are also presented. To date this is the first comprehensive fHbp expression profiling in a large panel of Neisseria meningitidis clinical isolates driven by an antibody-independent MS-based methodology, opening the door to new applications in vaccine coverage prediction and reinforcing the molecular understanding of released vaccines.

Keywords: quantitative mass spectrometry, Neisseria meningitidis, vaccines, bexsero, molecular epidemiology

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Authors: Mohamed Elkashouty, Mohamed Yehia, Ahmed Tawfuk

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The study area is located in the southern part of Giza Governorate at both side of the Nile Valley. A combination of major and trace elements have been used to classify surface- and ground-waters in El Kurimat village, Egypt. The main purpose of the project is to investigate the surface-and ground-waters quality and hydrochemical evaluation. The situation is further complicated by contamination with lithogenic and anthropogenic (agricultural and sewage wastewaters) sources and low groundwater management strategies. The Quaternary aquifer consists of sands and gravels of Pleistocene age intercalated with clay lenses and overlain by silty clay aquitard (Holocene). The semi-pervious silty clay aquitard of the Holocene Nile sediments cover the Quaternary aquifer in most areas. The groundwater flows generally from southwest to northeast. To achieve this target, thirty five and seventy three samples were collected from surface– and ground-waters within summer and winter seasons 2009-2010). Total dissolved solids (TDS), cations, anions, NO2, NO3, PO4 , Al, Ba, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn, As, F, Sb, Se, Sn, Sr and V) were determined in water samples. Grain size analysis was achieved to eight soil samples and measured the organic matter percent in different fractions. The TDS concentration is high in Arab El Ein canal by lithogenic and anthropogenic sources. The average concentrations of TDS in the River Nile are 245 (summer) and 254 ppm (winter). NO3 content ranges from 1.7 to 12 mg/l (summer), while in winter it ranges from 0.4 to 2.4. Most of the toxic metal concentrations are below the drinking and irrigation guidelines except Mn, V, Cr, Al, and Fe, which are higher than the guidelines in some canals and drains. The TDS concentration in groundwater increases toward northeastern and northwestern part of the study area (i.e. toward limestone plateau). It is due to hydrogeological interconnection between Quaternary and Eocene aquifer (saline water), wastewater dump and recharge from wadi El Atfihi wastewater. There is a good match between the hydrogeology and the hydrogeochemistry. Total dissolved solid in groundwater increases toward southwestern part, may be due to hydrogeological interconnection between Quaternary and Eocene aquifer and leakage from agricultural waste water of El Mohut drain. Fe, Mn, Cr, Al, PO4 and NO3 concentrations are high due to anthropogenic sources, therefore they are unsuitable for drinking. The average concentration of Cr, Cu, Fe, Mn &Zn are higher in winter than those in summer due to winter drought. The organic matter content in soil are increases in the northeastern and southwestern part, with different fractions, sue to agricultural wastewaters. Reused of contaminated surface- and ground-waters samples by mixing with fresh water (By AquaChem) was estimated to increase the income per capita.

Keywords: surface water, groundwater, major ions, toxic metals

Procedia PDF Downloads 287

Authors: Kari Björn

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Introduction of games has expanded the application area of computer-aided learning tools to wide variety of age groups of learners. Serious games engage the learners into a real-world -type of simulation and potentially enrich the learning experience. Institutional background of a Bachelor’s level engineering program in Information and Communication Technology is introduced, with detailed focus on one of its majors, Health Technology. As part of a Customer Oriented Software Application thematic semester, one particular course of “eHealth Business and Solutions” is described and reflected in a gamified framework. Learning a consistent view into vast literature of business management, strategies, marketing and finance in a very limited time enforces selection of topics relevant to the industry. Health Technology is a novel and growing industry with a growing sector in consumer wearable devices and homecare applications. The business sector is attracting new entrepreneurs and impatient investor funds. From engineering education point of view the sector is driven by miniaturizing electronics, sensors and wireless applications. However, the market is highly consumer-driven and usability, safety and data integrity requirements are extremely high. When the same technology is used in analysis or treatment of patients, very strict regulatory measures are enforced. The paper introduces a course structure using gamification as a tool to learn the most essential in a new market: customer value proposition design, followed by a market entry game. Students analyze the existing market size and pricing structure of eHealth web-service market and enter the market as a steering group of their company, competing against the legacy players and with each other. The market is growing but has its rules of demand and supply balance. New products can be developed with an R&D-investment, and targeted to market with unique quality- and price-combinations. Product cost structure can be improved by investing to enhanced production capacity. Investments can be funded optionally by foreign capital. Students make management decisions and face the dynamics of the market competition in form of income statement and balance sheet after each decision cycle. The focus of the learning outcome is to understand customer value creation to be the source of cash flow. The benefit of gamification is to enrich the learning experience on structure and meaning of financial statements. The paper describes the gamification approach and discusses outcomes after two course implementations. Along the case description of learning challenges, some unexpected misconceptions are noted. Improvements of the game or the semi-gamified teaching pedagogy are discussed. The case description serves as an additional support to new game coordinator, as well as helps to improve the method. Overall, the gamified approach has helped to engage engineering student to business studies in an energizing way.

Keywords: engineering education, integrated curriculum, learning experience, learning outcomes

Procedia PDF Downloads 234

Authors: Dolly Kumari, H. Lhungdim

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Maternal health is one of the crucial health indicators for any country. 5th goal of Millennium Development Goals is also emphasising on improvement of maternal health. Soon after Independence government of India realizing the importance of maternal and child health care services, and took steps to strengthen in 1st and 2nd five year plans. In past decade the other health indicator which is life expectancy at birth has been observed remarkable improvement. But still maternal mortality is high in India and in some states it is observe much higher than national average. Government of India pour lots of fund and initiate National Rural Health Mission (NRHM) in 2005 to improve maternal health in country by providing affordable and accessible health care services. Accredited Social Heath Activist (ASHA) is one of the key components of the NRHM. Mainly ASHAs are selected female aged 25-45 years from village itself and accountable for the monitoring of maternal health care for the same village. ASHA are trained to works as an interface between the community and public health system. This study tries to assess the role of ASHA in utilizing maternal health care services and to see the level of awareness about benefits given under JSY scheme and utilization of those benefits by eligible women. For the study concurrent evaluation data from National Rural health Mission (NRHM), initiated by government of India in 2005 has been used. This study is based on 78205 currently married women from 70 different districts of India. Descriptive statistics, chi2 test and binary logistic regression have been used for analysis. The probability of institutional delivery increases by 2.03 times (p<0.001) while if ASHA arranged or helped in arranging transport facility the probability of institutional delivery is increased by 1.67 times (p<0.01) than if she is not arranging transport facility. Further if ASHA facilitated to get JSY card to the pregnant women probability of going for full ANC is increases by 1.36 times (p<0.05) than reference. However if ASHA discuses about institutional delivery and approaches to get register than probability of getting TT injection is 1.88 and 1.64 times (p<0.01) higher than that if she did not discus. Further, Probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 years. The probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 year of age than before 18 years, it is also 1.28 times (p<0.001) and 1.32 times (p<0.001) higher among women have 1 to 8 year of schooling and with 9 and above years of schooling respectively than the women who never attended school. Those women who are working have 1.13 times (p<0.001) higher probability of getting benefits from JSY scheme than not working women. Surprisingly women belongs to wealthiest quintile are .53times (P<0.001) less aware about JSY scheme. Results conclude that work done by ASHA has great influence on maternal health care utilization in India. But results also show that still substantial numbers of needed population are far from utilization of these services. Place of delivery is significantly influenced by referral and transport facility arranged by ASHA.

Keywords: institutional delivery, JSY beneficiaries, referral faculty, public health

Procedia PDF Downloads 318

Authors: Milica Carević, Katarina Banjanac, Marija ĆOrović, Ana Milivojević, Nevena Prlainović, Aleksandar Marinković, Dejan Bezbradica

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Nowadays, considering the growing awareness of functional food beneficial effects on human health, due attention is dedicated to the research in the field of obtaining new prominent products exhibiting improved physiological and physicochemical characteristics. Therefore, different approaches to valuable bioactive compounds synthesis have been proposed. β-Galactosidase, for example, although mainly utilized as hydrolytic enzyme, proved to be a promising tool for these purposes. Namely, under the particular conditions, such as high lactose concentration, elevated temperatures and low water activities, reaction of galactose moiety transfer to free hydroxyl group of the alternative acceptor (e.g. different sugars, alcohols or aromatic compounds) can generate a wide range of potentially interesting products. Up to now, galacto-oligosaccharides and lactulose have attracted the most attention due to their inherent prebiotic properties. The goal of this study was to obtain a novel product sorbitol galactoside, using the similar reaction mechanism, namely transgalactosylation reaction catalyzed by β-galactosidase from Aspergillus oryzae. By using sugar alcohol (sorbitol) as alternative acceptor, a diverse mixture of potential prebiotics is produced, enabling its more favorable functional features. Nevertheless, an introduction of alternative acceptor into the reaction mixture contributed to the complexity of reaction scheme, since several potential reaction pathways were introduced. Therefore, the thorough optimization using response surface method (RSM), in order to get an insight into different parameter (lactose concentration, sorbitol to lactose molar ratio, enzyme concentration, NaCl concentration and reaction time) influences, as well as their mutual interactions on product yield and productivity, was performed. In view of product yield maximization, the obtained model predicted optimal lactose concentration 500 mM, the molar ratio of sobitol to lactose 9, enzyme concentration 0.76 mg/ml, concentration of NaCl 0.8M, and the reaction time 7h. From the aspect of productivity, the optimum substrate molar ratio was found to be 1, while the values for other factors coincide. In order to additionally, improve enzyme efficiency and enable its reuse and potential continual application, immobilization of β-galactosidase onto tailored silica nanoparticles was performed. These non-porous fumed silica nanoparticles (FNS)were chosen on the basis of their biocompatibility and non-toxicity, as well as their advantageous mechanical and hydrodinamical properties. However, in order to achieve better compatibility between enzymes and the carrier, modifications of the silica surface using amino functional organosilane (3-aminopropyltrimethoxysilane, APTMS) were made. Obtained support with amino functional groups (AFNS) enabled high enzyme loadings and, more importantly, extremely high expressed activities, approximately 230 mg proteins/g and 2100 IU/g, respectively. Moreover, this immobilized preparation showed high affinity towards sorbitol galactoside synthesis. Therefore, the findings of this study could provided a valuable contribution to the efficient production of physiologically active galactosides in immobilized enzyme reactors.

Keywords: β-galactosidase, immobilization, silica nanoparticles, transgalactosylation

Procedia PDF Downloads 293

Authors: O. D. Ohijeagbon, Oluseyi O. Ajayi, M. Ogbonnaya, Ahmeh Attabo

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This study analyzed the electricity generation potential from wind at seven sites spread across seven states of the North-Central region of Nigeria. Twenty-one years (1987 to 2007) wind speed data at a height of 10m were assessed from the Nigeria Meteorological Department, Oshodi. The data were subjected to different statistical tests and also compared with the two-parameter Weibull probability density function. The outcome shows that the monthly average wind speeds ranged between 2.2 m/s in November for Bida and 10.1 m/s in December for Jos. The yearly average ranged between 2.1m/s in 1987 for Bida and 11.8 m/s in 2002 for Jos. Also, the power density for each site was determined to range between 29.66 W/m2 for Bida and 864.96 W/m2 for Jos, Two parameters (k and c) of the Weibull distribution were found to range between 2.3 in Lokoja and 6.5 in Jos for k, while c ranged between 2.9 in Bida and 9.9m/s in Jos. These outcomes points to the fact that wind speeds at Jos, Minna, Ilorin, Makurdi and Abuja are compatible with the cut-in speeds of modern wind turbines and hence, may be economically feasible for wind-to-electricity at and above the height of 10 m. The study further assessed the potential and economic viability of standalone wind generation systems for off-grid rural communities located in each of the studied sites. A specific electric load profile was developed to suite hypothetic communities, each consisting of 200 homes, a school and a community health center. Assessment of the design that will optimally meet the daily load demand with a loss of load probability (LOLP) of 0.01 was performed, considering 2 stand-alone applications of wind and diesel. The diesel standalone system (DSS) was taken as the basis of comparison since the experimental locations have no connection to a distribution network. The HOMER® software optimizing tool was utilized to determine the optimal combination of system components that will yield the lowest life cycle cost. Sequel to the analysis for rural community utilization, a Distributed Generation (DG) analysis that considered the possibility of generating wind power in the MW range in order to take advantage of Nigeria’s tariff regime for embedded generation was carried out for each site. The DG design incorporated each community of 200 homes, freely catered for and offset from the excess electrical energy generated above the minimum requirement for sales to a nearby distribution grid. Wind DG systems were found suitable and viable in producing environmentally friendly energy in terms of life cycle cost and levelised value of producing energy at Jos ($0.14/kWh), Minna ($0.12/kWh), Ilorin ($0.09/kWh), Makurdi ($0.09/kWh), and Abuja ($0.04/kWh) at a particluar turbine hub height. These outputs reveal the value retrievable from the project after breakeven point as a function of energy consumed Based on the results, the study demonstrated that including renewable energy in the rural development plan will enhance fast upgrade of the rural communities.

Keywords: wind speed, wind power, distributed generation, cost per kilowatt-hour, clean energy, North-Central Nigeria

Procedia PDF Downloads 502

Authors: John Doe

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This paper presents the research project “Escape Through Culture”, which is co-funded by the European Union and national resources through the Operational Programme “Competitiveness, Entrepreneurship and Innovation” 2014-2020 and the Single RTDI State Aid Action "RESEARCH - CREATE - INNOVATE". The project implementation is assumed by three partners, (1) the Computer Technology Institute and Press "Diophantus" (CTI), experienced with the design and implementation of serious games, natural language processing and ICT in education, (2) the Laboratory of Environmental Communication and Audiovisual Documentation (LECAD), part of the University of Thessaly, Department of Architecture, which is experienced with the study of creative transformation and reframing of the urban and environmental multimodal experiences through the use of AR and VR technologies, and (3) “Apoplou”, an IT Company with experience in the implementation of interactive digital applications. The research project proposes the design of innovative infrastructure of digital educational escape games for mobile devices and computers, with the use of Virtual Reality and Augmented Reality for the promotion of Greek cultural heritage in Greece and abroad. In particular, the project advocates the combination of Greek cultural heritage and literature, digital technologies advancements and the implementation of innovative gamifying practices. The cultural experience of the players will take place in 3 layers: (1) In space: the digital games produced are going to utilize the dual character of the space as a cultural landscape (the real space - landscape but also the space - landscape as presented with the technologies of augmented reality and virtual reality). (2) In literary texts: the selected texts of Greek writers will support the sense of place and the multi-sensory involvement of the user, through the context of space-time, language and cultural characteristics. (3) In the philosophy of the "escape game" tool: whether played in a computer environment, indoors or outdoors, the spatial experience is one of the key components of escape games. The innovation of the project lies both in the junction of Augmented/Virtual Reality with the promotion of cultural points of interest, as well as in the interactive, gamified practices of literary texts. The digital escape game infrastructure will be highly interactive, integrating the projection of Greek landscape cultural elements and digital literary text analysis, supporting the creation of escape games, establishing and highlighting new playful ways of experiencing iconic cultural places, such as Elefsina, Skiathos etc. The literary texts’ content will relate to specific elements of the Greek cultural heritage depicted by prominent Greek writers and poets. The majority of the texts will originate from Greek educational content available in digital libraries and repositories developed and maintained by CTI. The escape games produced will be available for use during educational field trips, thematic tourism holidays, etc. In this paper, the methodology adopted for infrastructure development will be presented. The research is based on theories of place, gamification, gaming development, making use of corpus linguistics concepts and digital humanities practices for the compilation and the analysis of literary texts.

Keywords: escape games, cultural landscapes, gamification, digital humanities, literature

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Authors: Maria Reznakova, Michala Strnadova, Lukas Reznak

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Successful achievement of strategic goals requires an effective performance management system, i.e. determining the appropriate indicators measuring the rate of goal achievement. Assuming that the goal of the owners is to grow the assets they invested in, it is vital to identify the key performance indicators, which contribute to value creation. These indicators are known as value drivers. Based on the undertaken literature search, a value driver is defined as any factor that affects the value of an enterprise. The important factors are then monitored by both financial and non-financial indicators. Financial performance indicators are most useful in strategic management, since they indicate whether a company's strategy implementation and execution are contributing to bottom line improvement. Non-financial indicators are mainly used for short-term decisions. The identification of value drivers, however, is problematic for companies which are not publicly traded. Therefore financial ratios continue to be used to measure the performance of companies, despite their considerable criticism. The main drawback of such indicators is the fact that they are calculated based on accounting data, while accounting rules may differ considerably across different environments. For successful enterprise performance management it is vital to avoid factors that may reduce (or even destroy) its value. Among the known factors reducing the enterprise value are the lack of capital, lack of strategic management system and poor quality of production. In order to gain further insight into the topic, the paper presents results of the research identifying factors that adversely affect the performance of mechanical engineering enterprises in the Czech Republic. The research methodology focuses on both the qualitative and the quantitative aspect of the topic. The qualitative data were obtained from a questionnaire survey of the enterprises senior management, while the quantitative financial data were obtained from the Analysis Major Database for European Sources (AMADEUS). The questionnaire prompted managers to list factors which negatively affect business performance of their enterprises. The range of potential factors was based on a secondary research – analysis of previously undertaken questionnaire surveys and research of studies published in the scientific literature. The results of the survey were evaluated both in general, by average scores, and by detailed sub-analyses of additional criteria. These include the company specific characteristics, such as its size and ownership structure. The evaluation also included a comparison of the managers’ opinions and the performance of their enterprises – measured by return on equity and return on assets ratios. The comparisons were tested by a series of non-parametric tests of statistical significance. The results of the analyses show that the factors most detrimental to the enterprise performance include the incompetence of responsible employees and the disregard to the customers‘ requirements.

Keywords: business value, financial ratios, performance measurement, value drivers

Procedia PDF Downloads 217

Authors: Jenifer Alam, Rima Chatterjee

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Upper Assam sedimentary basin is one of the oldest commercially producing basins of India. Being in a tectonically active zone, estimation of tectonic strain and stress magnitudes has vast application in hydrocarbon exploration and exploitation. This East North East –West South West trending shelf-slope basin encompasses the Bramhaputra valley extending from Mikir Hills in the southwest to the Naga foothills in the northeast. Assam Shelf lying between the Main Boundary Thrust (MBT) and Naga Thrust area is comparatively free from thrust tectonics and depicts normal faulting mechanism. The study area is bounded by the MBT and Main Central Thrust in the northwest. The Belt of Schuppen in the southeast, is bordered by Naga and Disang thrust marking the lower limit of the study area. The entire Assam basin shows low-level seismicity compared to other regions of northeast India. Pore pressure (PP), vertical stress magnitude (SV) and horizontal stress magnitudes have been estimated from two wells - N1 and T1 located in Upper Assam. N1 is located in the Assam gap below the Bramhaputra river while T1, lies in the Belt of Schuppen. N1 penetrates geological formations from top Alluvial through Dhekiajuli, Girujan, Tipam, Barail, Kopili, Sylhet and Langpur to the granitic basement while T1 in trusted zone crosses through Girujan Suprathrust, Tipam Suprathrust, Barail Suprathrust to reach Naga Thrust. Normal compaction trend is drawn through shale points through both wells for estimation of PP using the conventional Eaton sonic equation with an exponent of 1.0 which is validated with Modular Dynamic Tester and mud weight. Observed pore pressure gradient ranges from 10.3 MPa/km to 11.1 MPa/km. The SV has a gradient from 22.20 to 23.80 MPa/km. Minimum and maximum horizontal principal stress (Sh and SH) magnitudes under isotropic conditions are determined using poroelastic model. This approach determines biaxial tectonic strain utilizing static Young’s Modulus, Poisson’s Ratio, SV, PP, leak off test (LOT) and SH derived from breakouts using prior information on unconfined compressive strength. Breakout derived SH information is used for obtaining tectonic strain due to lack of measured SH data from minifrac or hydrofracturing. Tectonic strain varies from 0.00055 to 0.00096 along x direction and from -0.0010 to 0.00042 along y direction. After obtaining tectonic strains at each well, the principal horizontal stress magnitudes are calculated from linear poroelastic model. The magnitude of Sh and SH gradient in normal faulting region are 12.5 and 16.0 MPa/km while in thrust faulted region the gradients are 17.4 and 20.2 MPa/km respectively. Model predicted Sh and SH matches well with the LOT data and breakout derived SH data in both wells. It is observed from this study that the stresses SV>SH>Sh prevailing in the shelf region while near the Naga foothills the regime changes to SH≈SV>Sh area corresponds to normal faulting regime. Hence this model is a reliable tool for predicting stress magnitudes from well logs under active tectonic regime in Upper Assam Basin.

Keywords: Eaton, strain, stress, poroelastic model

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Authors: Siti Zabedah Saidin, Aidi Ahmi, Azharudin Ali, Wan Norhayati Wan Ahmad

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In today's increasingly complex and interconnected world, the concept of sustainability has transcended mere corporate social responsibility, evolving into a fundamental driver of organizational behaviour and disclosure. This content analysis study delves into the Malaysian federal-level statutory bodies’ annual report for the year 2021, aiming to elucidate the extent of sustainability disclosures within the non-financial sections of these reports. The escalating global emphasis on sustainability has prompted organizations to embrace transparency as a means to demonstrate their commitment to environmental, social, and governance (ESG) considerations. Voluntary sustainability disclosure has emerged as a crucial channel through which organizations communicate their efforts, initiatives, and impacts in these areas, thereby fostering trust and accountability with stakeholders. The study aims to identify and examine the types of sustainability information disclosed voluntarily by the federal-level statutory bodies, concentrating on the non-financial sections of the annual reports. To achieve this, the study adopts a simplified disclosure index, a pragmatic tool that quantifies the extent of sustainability reporting in a standardized manner. Using convenience sampling, the study selects a sample of annual reports from the federal-level statutory bodies in Malaysia, as provided on their respective websites. The content analysis is centred on the non-financial sections of these reports, allowing for an in-depth exploration of sustainability disclosures. The findings of the study present the extent to which Malaysian federal-level statutory bodies embrace sustainability reporting. Through thorough content analysis, the study uncovered diverse dimensions of sustainability information, encompassing environmental impact assessments, social engagement endeavours, and governance frameworks. This reveals a deliberate effort by these bodies to encapsulate their holistic organizational contributions and challenges, transcending traditional financial metrics. This research contributes to the existing literature by providing insights into the evolving landscape of sustainability disclosure practices among Malaysian federal-level statutory bodies. The findings underline the proactive nature of these bodies in voluntarily sharing sustainability-related information, reflecting their recognition of the interconnectedness between organizational success and societal well-being. Furthermore, the study underscores the potential influence of regulatory guidelines and societal expectations in shaping the extent and nature of voluntary sustainability disclosures. Organizations are not merely responding to regulatory mandates but are actively aligning with global sustainability goals and stakeholder expectations. As organizations continue to navigate the intricate web of stakeholder expectations and sustainability imperatives, this study enriches the discourse surrounding transparency and sustainability reporting. The analysis emphasizes the important role of non-financial disclosures in portraying a holistic organizational narrative. In an era where stakeholders demand accountability, and the interconnectedness of global challenges necessitates collaborative action, the voluntary disclosure of sustainability information stands as a testament to the commitment of Malaysian federal-level statutory bodies in shaping a more sustainable future.

Keywords: voluntary disclosure, sustainability information, annual report, federal-level statutory body

Procedia PDF Downloads 47

Authors: Ahlad Neti, Elisa Arch, Martha Hall

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Studies have shown that individuals who use Ankle-Foot-Orthoses (AFOs) have a high level of dissatisfaction regarding their current AFOs. Studies point to the focus on technical design with little attention given to the user perspective as a source of AFO designs that leave users dissatisfied. To design a new AFO that satisfies users and thereby improves their quality of life, the reasons for their dissatisfaction and their wants and needs for an improved AFO design must be identified. There has been little research into the user perspective on AFO use and desired improvements, so the relationship between AFO design and satisfaction in daily use must be assessed to develop appropriate metrics and constraints prior to designing a novel AFO. To assess the user perspective on AFO design, structured interviews were conducted with 7 individuals (average age of 64.29±8.81 years) who use AFOs. All interviews were transcribed and coded to identify common themes using Grounded Theory Method in NVivo 12. Qualitative analysis of these results identified sources of user dissatisfaction such as heaviness, bulk, and uncomfortable material and overall needs and wants for an AFO. Beyond the user perspective, certain objective factors must be considered in the construction of metrics and constraints to ensure that the AFO fulfills its medical purpose. These more objective metrics are rooted in a common medical device market and technical standards. Given the large body of research concerning these standards, these objective metrics and constraints were derived through a literature review. Through these two methods, a comprehensive list of metrics and constraints accounting for both the user perspective on AFO design and the AFO’s medical purpose was compiled. These metrics and constraints will establish the framework for designing a new AFO that carries out its medical purpose while also improving the user experience. The metrics can be categorized into several overarching areas for AFO improvement. Categories of user perspective related metrics include comfort, discreteness, aesthetics, ease of use, and compatibility with clothing. Categories of medical purpose related metrics include biomechanical functionality, durability, and affordability. These metrics were used to guide an iterative prototyping process. Six concepts were ideated and compared using system-level analysis. From these six concepts, two concepts – the piano wire model and the segmented model – were selected to move forward into prototyping. Evaluation of non-functional prototypes of the piano wire and segmented models determined that the piano wire model better fulfilled the metrics by offering increased stability, longer durability, fewer points for failure, and a strong enough core component to allow a sock to cover over the AFO while maintaining the overall structure. As such, the piano wire AFO has moved forward into the functional prototyping phase, and healthy subject testing is being designed and recruited to conduct design validation and verification.

Keywords: ankle-foot orthotic, assistive technology, human centered design, medical devices

Procedia PDF Downloads 148

Authors: Daniel Martin Fellows, Sean P. Walton, Jennifer Thompson, Oubay Hassan, Ella Quigley, Kevin Tinkham

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Fire performance is a crucial aspect to consider when designing cladding products, and testing this performance is extremely expensive. Appropriate use of numerical simulation of fire performance has the potential to reduce the total number of fire tests required when designing a product by eliminating poor-performing design ideas early in the design phase. Due to the complexity of fire and the large spectrum of failures it can cause, multi-disciplinary models are needed to capture the complex fire behavior and its structural effects on its surroundings. Working alongside Tata Steel U.K., the authors have focused on completing a coupled CFD-FEA simulation model suited to test Polyisocyanurate (PIR) based sandwich panel products to gain confidence before costly experimental standards testing. The sandwich panels are part of a thermally insulating façade system primarily for large non-domestic buildings. The work presented in this paper compares two coupling methodologies of a replicated physical experimental standards test LPS 1181-1, carried out by Tata Steel U.K. The two coupling methodologies that are considered within this research are; one-way and two-way. A one-way coupled analysis consists of importing thermal data from the CFD solver into the FEA solver. A two-way coupling analysis consists of continuously importing the updated changes in thermal data, due to the fire's behavior, to the FEA solver throughout the simulation. Likewise, the mechanical changes will also be updated back to the CFD solver to include geometric changes within the solution. For CFD calculations, a solver called Fire Dynamic Simulator (FDS) has been chosen due to its adapted numerical scheme to focus solely on fire problems. Validation of FDS applicability has been achieved in past benchmark cases. In addition, an FEA solver called ABAQUS has been chosen to model the structural response to the fire due to its crushable foam plasticity model, which can accurately model the compressibility of PIR foam. An open-source code called FDS-2-ABAQUS is used to couple the two solvers together, using several python modules to complete the process, including failure checks. The coupling methodologies and experimental data acquired from Tata Steel U.K are compared using several variables. The comparison data includes; gas temperatures, surface temperatures, and mechanical deformation of the panels. Conclusions are drawn, noting improvements to be made on the current coupling open-source code FDS-2-ABAQUS to make it more applicable to Tata Steel U.K sandwich panel products. Future directions for reducing the computational cost of the simulation are also considered.

Keywords: fire engineering, numerical coupling, sandwich panels, thermo fluids

Procedia PDF Downloads 76

Authors: Sarah Hazelwood, Janice Hay

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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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Authors: Delphine Ribes Lemay, Valentine Bernasconi, André Andrade, Lara DéFayes, Mathieu Salzmann, FréDéRic Kaplan, Nicolas Henchoz

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Digitization and preservation of large heritage induce high maintenance costs to keep up with the technical standards and ensure sustainable access. Creating impactful usage is instrumental to justify the resources for long-term preservation. The Museum für Gestaltung of Zurich holds one of the biggest poster collections of the world from which 52’000 were digitised. In the process of building a digital installation to valorize the collection, one objective was to develop an algorithm capable of predicting the next poster to show according to the ones already displayed. The work presented here describes the steps to build an algorithm able to automatically create sequences of posters reflecting associations performed by curator and professional designers. The exposed challenge finds similarities with the domain of song playlist algorithms. Recently, artificial intelligence techniques and more specifically, deep-learning algorithms have been used to facilitate their generations. Promising results were found thanks to Recurrent Neural Networks (RNN) trained on manually generated playlist and paired with clusters of extracted features from songs. We used the same principles to create the proposed algorithm but applied to a challenging medium, posters. First, a convolutional autoencoder was trained to extract features of the posters. The 52’000 digital posters were used as a training set. Poster features were then clustered. Next, an RNN learned to predict the next cluster according to the previous ones. RNN training set was composed of poster sequences extracted from a collection of books from the Gestaltung Museum of Zurich dedicated to displaying posters. Finally, within the predicted cluster, the poster with the best proximity compared to the previous poster is selected. The mean square distance between features of posters was used to compute the proximity. To validate the predictive model, we compared sequences of 15 posters produced by our model to randomly and manually generated sequences. Manual sequences were created by a professional graphic designer. We asked 21 participants working as professional graphic designers to sort the sequences from the one with the strongest graphic line to the one with the weakest and to motivate their answer with a short description. The sequences produced by the designer were ranked first 60%, second 25% and third 15% of the time. The sequences produced by our predictive model were ranked first 25%, second 45% and third 30% of the time. The sequences produced randomly were ranked first 15%, second 29%, and third 55% of the time. Compared to designer sequences, and as reported by participants, model and random sequences lacked thematic continuity. According to the results, the proposed model is able to generate better poster sequencing compared to random sampling. Eventually, our algorithm is sometimes able to outperform a professional designer. As a next step, the proposed algorithm should include a possibility to create sequences according to a selected theme. To conclude, this work shows the potentiality of artificial intelligence techniques to learn from existing content and provide a tool to curate large sets of data, with a permanent renewal of the presented content.

Keywords: Artificial Intelligence, Digital Humanities, serendipity, design research

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Authors: Burak Oksuzoglu, Savas Yildirim, Ferhat Kutlu

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Opinion mining (OM) is one of the natural language processing (NLP) problems to determine the polarity of opinions, mostly represented on a positive-neutral-negative axis. The data for OM is usually collected from various social media platforms. In an era where social media has considerable control over companies’ futures, it’s worth understanding social media and taking actions accordingly. OM comes to the fore here as the scale of the discussion about companies increases, and it becomes unfeasible to gauge opinion on individual levels. Thus, the companies opt to automize this process by applying machine learning (ML) approaches to their data. For the last two decades, OM or sentiment analysis (SA) has been mainly performed by applying ML classification algorithms such as support vector machines (SVM) and Naïve Bayes to a bag of n-gram representations of textual data. With the advent of deep learning and its apparent success in NLP, traditional methods have become obsolete. Transfer learning paradigm that has been commonly used in computer vision (CV) problems started to shape NLP approaches and language models (LM) lately. This gave a sudden rise to the usage of the pretrained language model (PTM), which contains language representations that are obtained by training it on the large datasets using self-supervised learning objectives. The PTMs are further fine-tuned by a specialized downstream task dataset to produce efficient models for various NLP tasks such as OM, NER (Named-Entity Recognition), Question Answering (QA), and so forth. In this study, the traditional and modern NLP approaches have been evaluated for OM by using a sizable corpus belonging to a large private company containing about 76,000 comments in Turkish: SVM with a bag of n-grams, and two chosen pre-trained models, multilingual universal sentence encoder (MUSE) and bidirectional encoder representations from transformers (BERT). The MUSE model is a multilingual model that supports 16 languages, including Turkish, and it is based on convolutional neural networks. The BERT is a monolingual model in our case and transformers-based neural networks. It uses a masked language model and next sentence prediction tasks that allow the bidirectional training of the transformers. During the training phase of the architecture, pre-processing operations such as morphological parsing, stemming, and spelling correction was not used since the experiments showed that their contribution to the model performance was found insignificant even though Turkish is a highly agglutinative and inflective language. The results show that usage of deep learning methods with pre-trained models and fine-tuning achieve about 11% improvement over SVM for OM. The BERT model achieved around 94% prediction accuracy while the MUSE model achieved around 88% and SVM did around 83%. The MUSE multilingual model shows better results than SVM, but it still performs worse than the monolingual BERT model.

Keywords: BERT, MUSE, opinion mining, pretrained language model, SVM, Turkish

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Authors: Avadh Bihari

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Corporate social responsibility (CSR) has become a global parameter to define corporates' ethical and responsible behaviour. It was a voluntary practice in India till 2013, driven by various guidelines, which has become a mandate since 2014 under the Companies Act, 2013. This has compelled the corporates to redesign their CSR strategies by bringing in structures, planning, accountability, and transparency in their processes with a mandate to 'comply or explain'. Based on the author's M.Phil. dissertation, this paper presents the changes in organisational practices and institutional mechanisms of third-sector organisations (TSOs) with the theoretical frameworks of institutionalism and co-optation. It became an interesting case as India is the only country to have a law on CSR, which is not only mandating the reporting but the spending too. The space of CSR in India is changing rapidly and affecting multiple institutions, in the context of the changing roles of the state, market, and TSOs. Several factors such as stringent regulation on foreign funding, mandatory CSR pushing corporates to look out for NGOs, and dependency of Indian NGOs on CSR funds have come to the fore almost simultaneously, which made it an important area of study. Further, the paper aims at addressing the gap in the literature on the effects of mandated CSR on the functioning of TSOs through the empirical and theoretical findings of this study. The author had adopted an interpretivist position in this study to explore changes in organisational practices from the participants' experiences. Data were collected through in-depth interviews with five corporate officials, eleven officials from six TSOs, and two academicians, located at Mumbai and Delhi, India. The findings of this study show the legislation has institutionalised CSR, and TSOs get co-opted in the process of implementing mandated CSR. Seventy percent of the corporates implement their CSR projects through TSOs in India; this has affected the organisational practices of TSOs to a large extent. They are compelled to recruit expert workforce, create new departments for monitoring & evaluation, communications, and adopt management practices of project implementation from corporates. These are attempts to institutionalise the TSOs so that they can produce calculated results as demanded by corporates. In this process, TSOs get co-opted in a struggle to secure funds and lose their autonomy. The normative, coercive, and mimetic isomorphisms of institutionalism come into play as corporates are mandated to take up CSR, thereby influencing the organisational practices of TSOs. These results suggest that corporates and TSOs require an understanding of each other's work culture to develop mutual respect and work towards the goal of sustainable development of the communities. Further, TSOs need to retain their autonomy and understanding of ground realities without which they become an extension of the corporate-funder. For a successful CSR project, engagement beyond funding is required from corporate, through their involvement and not interference. CSR-led community development can be structured by management practices to an extent, but cannot overshadow the knowledge and experience of TSOs.

Keywords: corporate social responsibility, institutionalism, organisational practices, third-sector organisations

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Authors: S. C. Lin, W. W. Cheng, M. S. Wu

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This study attempted to investigate the connection between teacher professional development program and students’ Learning. This study took Readers’ Theater Teaching Program (RTTP) for professional development as an example to inquiry how participants apply their new knowledge and skills learned from RTTP to their teaching practice and how the impact influence students learning. The goals of the RTTP included: 1) to enhance teachers RT content knowledge; 2) to implement RT instruction in teachers’ classrooms in response to their professional development. 2) to improve students’ ability of reading fluency in professional development teachers’ classrooms. This study was a two-year project. The researchers applied mixed methods to conduct this study including qualitative inquiry and one-group pretest-posttest experimental design. In the first year, this study focused on designing and implementing RTTP and evaluating participants’ satisfaction of RTTP, what they learned and how they applied it to design their English reading curriculum. In the second year, the study adopted quasi-experimental design approach and evaluated how participants RT instruction influenced their students’ learning, including English knowledge, skill, and attitudes. The participants in this study composed two junior high school English teachers and their students. Data were collected from a number of different sources including teaching observation, semi-structured interviews, teaching diary, teachers’ professional development portfolio, Pre/post RT content knowledge tests, teacher survey, and students’ reading fluency tests. To analyze the data, both qualitative and quantitative data analysis were used. Qualitative data analysis included three stages: organizing data, coding data, and analyzing and interpreting data. Quantitative data analysis included descriptive analysis. The results indicated that average percentage of correct on pre-tests in RT content knowledge assessment was 40.75% with two teachers ranging in prior knowledge from 35% to 46% in specific RT content. Post-test RT content scores ranged from 70% to 82% correct with an average score of 76.50%. That gives teachers an average gain of 35.75% in overall content knowledge as measured by these pre/post exams. Teachers’ pre-test scores were lowest in script writing and highest in performing. Script writing was also the content area that showed the highest gains in content knowledge. Moreover, participants hold a positive attitude toward RTTP. They recommended that the approach of professional learning community, which was applied in RTTP was benefit to their professional development. Participants also applied the new skills and knowledge which they learned from RTTP to their practices. The evidences from this study indicated that RT English instruction significantly influenced students’ reading fluency and classroom climate. The result indicated that all of the experimental group students had a big progress in reading fluency after RT instruction. The study also found out several obstacles. Suggestions were also made.

Keywords: teacher’s professional development, program evaluation, readers’ theater, english reading instruction, english reading fluency

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Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

Procedia PDF Downloads 125