Search results for: surgical training
3559 Adaptive Training Methods Designed to Improve a Shorter Resident Curriculum in Obstetrics and Gynecology
Authors: Philippe Judlin, Olivier Morel
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Background: In France, the resident curriculum (RC) in Obstetrics and Gynecology (OBGYN) takes five years. In the course of the last 15 years, this RC has undergone major changes, characterized mainly by successive reductions of work hours. The program used to comprise long and frequent shifts, huge workload, poor supervision and erratic theoretical teaching. A decade ago, the French Ministry of Heath recommended a limitation of shift duration up to 24 hours and a minimum of 11 hours off duty between shifts. Last year, in order to comply with European Union directives, new recommendations have further limited residents’ work hours to 48 hours per week. Methods: Assessment of the residency program adjustments recently made to accommodate the recommendations while improving the training quality in resorting to new methods. Results: The challenge facing program directors was to provide an all-encompassing curriculum to OBGYN residents despite fewer work hours. Program has been dramatically redesigned, and several measures have been put in place: -The resident rotation system has been redesigned. Residents used to make 6-month rotations between 10-12 Departments of OBGYN or Surgery. Fewer Departments, those providing the best teaching, have been kept in the new RC. -Extensive inhouse supervision has been implemented for all kinds of clinical activities. Effectual supervision of residents has proved to be an effective tool to improve the quality of training. -The tutorship system, with academic members individually overseeing residents during their curriculum, has been perfected. It allows a better follow-up of residents’ progresses during the 5-year program. -The set up of an extensive program of lectures encompassing all maters in Obstetrics & Gynecology. These mandatory lectures are available online in a dedicated website. Therefore, face-to-face lectures have been limited in order to fit in the 48-hour limit. -The use of simulation has been significantly increased in obstetrics, materno-fetal medicine and surgery (stressing especially laparoscopic training). -Residents’ feedback has been taken into account in the setup of the new RC. Conclusion: This extensive overhaul of the Obstetrics and Gynecology RC has been in place since last year only. Nevertheless, the new program seems to adequately take into account the new recommendations while providing a better and more consistent teaching to the OBGYN residents.Keywords: education, laparoscopy, residency, simulation
Procedia PDF Downloads 1853558 Teachers’ Perceptions Related to the Guiding Skills within the Application Courses
Authors: Tanimola Kazeem Abiodun
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In Nigeria, both formal education and distance learning opportunities are used in teacher training. Practical courses aim to improve the skills of teacher candidates in a school environment. Teacher candidates attend kindergarten classes under the supervision of a teacher. In this context, the guiding skills of teachers gain importance in terms of shaping candidates’ perceptions about teaching profession. In this study, the teachers’ perceptions related to the guiding skills within the practical courses were determined. Also, the perceptions and applications related to guiding skills were compared. A Likert scale questionnaire and an open-ended question were used to determine perceptions and applications. 120 questionnaires were taken into consideration and analyses of data were performed by using percentage distribution and QSR Nvivo 8 program. In this study, statements related to teachers’ perceptions about the guiding skills were asked and it is determined that almost all the teachers agreed about the importance of these statements. On the other hand, how these guidance skills are applied by teachers is also queried with an open-ended question. Finally, thoughts and applications related to guidance skills were compared to each other. Based on this comparison, it is seen that there are some differences between the thoughts and applications especially related with time management, planning, feedbacks, curriculum, workload, rules and guidance. It can be said that some guidance skills cannot be controlled only by teachers. For example, candidates’ motivation, attention, population and educational environment are also determinative factors for effective guidance. In summary, it is necessary to have prior conditions for teachers to apply these idealized guidance skills for training more successful candidates to pre-school education era. At this point, organization of practical courses by the faculties gains importance and in this context it is crucial for faculties to revise their applications based on more detailed researches.Keywords: teacher training, guiding skills, education, practical courses
Procedia PDF Downloads 4463557 Characterization and Monitoring of the Yarn Faults Using Diametric Fault System
Authors: S. M. Ishtiaque, V. K. Yadav, S. D. Joshi, J. K. Chatterjee
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The DIAMETRIC FAULTS system has been developed that captures a bi-directional image of yarn continuously in sequentially manner and provides the detailed classification of faults. A novel mathematical framework developed on the acquired bi-directional images forms the basis of fault classification in four broad categories, namely, Thick1, Thick2, Thin and Normal Yarn. A discretised version of Radon transformation has been used to convert the bi-directional images into one-dimensional signals. Images were divided into training and test sample sets. Karhunen–Loève Transformation (KLT) basis is computed for the signals from the images in training set for each fault class taking top six highest energy eigen vectors. The fault class of the test image is identified by taking the Euclidean distance of its signal from its projection on the KLT basis for each sample realization and fault class in the training set. Euclidean distance applied using various techniques is used for classifying an unknown fault class. An accuracy of about 90% is achieved in detecting the correct fault class using the various techniques. The four broad fault classes were further sub classified in four sub groups based on the user set boundary limits for fault length and fault volume. The fault cross-sectional area and the fault length defines the total volume of fault. A distinct distribution of faults is found in terms of their volume and physical dimensions which can be used for monitoring the yarn faults. It has been shown from the configurational based characterization and classification that the spun yarn faults arising out of mass variation, exhibit distinct characteristics in terms of their contours, sizes and shapes apart from their frequency of occurrences.Keywords: Euclidean distance, fault classification, KLT, Radon Transform
Procedia PDF Downloads 2633556 Structuring Paraphrases: The Impact Sentence Complexity Has on Key Leader Engagements
Authors: Meaghan Bowman
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Soldiers are taught about the importance of effective communication with repetition of the phrase, “Communication is key.” They receive training in preparing for, and carrying out, interactions between foreign and domestic leaders to gain crucial information about a mission. These interactions are known as Key Leader Engagements (KLEs). For the training of KLEs, doctrine mandates the skills needed to conduct these “engagements” such as how to: behave appropriately, identify key leaders, and employ effective strategies. Army officers in training learn how to confront leaders, what information to gain, and how to ask questions respectfully. Unfortunately, soldiers rarely learn how to formulate questions optimally. Since less complex questions are easier to understand, we hypothesize that semantic complexity affects content understanding, and that age and education levels may have an effect on one’s ability to form paraphrases and judge their quality. In this study, we looked at paraphrases of queries as well as judgments of both the paraphrases’ naturalness and their semantic similarity to the query. Queries were divided into three complexity categories based on the number of relations (the first number) and the number of knowledge graph edges (the second number). Two crowd-sourced tasks were completed by Amazon volunteer participants, also known as turkers, to answer the research questions: (i) Are more complex queries harder to paraphrase and judge and (ii) Do age and education level affect the ability to understand complex queries. We ran statistical tests as follows: MANOVA for query understanding and two-way ANOVA to understand the relationship between query complexity and education and age. A probe of the number of given-level queries selected for paraphrasing by crowd-sourced workers in seven age ranges yielded promising results. We found significant evidence that age plays a role and marginally significant evidence that education level plays a role. These preliminary tests, with output p-values of 0.0002 and 0.068, respectively, suggest the importance of content understanding in a communication skill set. This basic ability to communicate, which may differ by age and education, permits reproduction and quality assessment and is crucial in training soldiers for effective participation in KLEs.Keywords: engagement, key leader, paraphrasing, query complexity, understanding
Procedia PDF Downloads 1603555 Evaluation of Associated Risk Factors and Determinants of near Miss Obstetric Cases at B.P. Koirala Institute of Health Sciences, Dharan
Authors: Madan Khadka, Dhruba Uprety, Rubina Rai
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Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss
Procedia PDF Downloads 1953554 Quick off the Mark with Achilles Tendon Rupture
Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk
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Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.Keywords: orthopaedics, achilles rupture, ultrasound, innovation
Procedia PDF Downloads 1213553 Using Action Based Research to Examine the Effects of Co-Teaching on Middle School and High School Student Achievement in Math and Language Arts
Authors: Kathleen L. Seifert
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Students with special needs are expected to achieve the same academic standards as their general education peers, yet many students with special needs are pulled-out of general content instruction. Because of this, many students with special needs are denied content knowledge from a content expert and instead receive content instruction in a more restrictive setting. Collaborative teaching, where a general education and special education teacher work alongside each other in the same classroom, has become increasingly popular as a means to meet the diverse needs of students in America’s public schools. The idea behind co-teaching is noble; to ensure students with special needs receive content area instruction from a content expert while also receiving the necessary supports to be successful. However, in spite of this noble effort, the effects of co-teaching are not always positive. The reasons why have produced several hypotheses, one of which has to do with lack of proper training and implementation of effective evidence-based co-teaching practices. In order to examine the effects of co-teacher training, eleven teaching pairs from a small mid-western school district in the United States participated in a study. The purpose of the study was to examine the effects of co-teacher training on middle and high school student achievement in Math and Language Arts. A local university instructor provided teachers with training in co-teaching via a three-day workshop. In addition, co-teaching pairs were given the opportunity for direct observation and feedback using the Co-teaching Core Competencies Observation Checklist throughout the academic year. Data are in the process of being collected on both the students enrolled in the co-taught classes as well as on the teachers themselves. Student data compared achievement on standardized assessments and classroom performance across three domains: 1. General education students compared to students with special needs in co-taught classrooms, 2. Students with special needs in classrooms with and without co-teaching, 3. Students in classrooms where teachers were given observation and feedback compared to teachers who refused the observation and feedback. Teacher data compared the perceptions of the co-teaching initiative between teacher pairs who received direct observation and feedback from those who did not. The findings from the study will be shared with the school district and used for program improvement.Keywords: collabortive teaching, collaboration, co-teaching, professional development
Procedia PDF Downloads 1183552 Text-to-Speech in Azerbaijani Language via Transfer Learning in a Low Resource Environment
Authors: Dzhavidan Zeinalov, Bugra Sen, Firangiz Aslanova
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Most text-to-speech models cannot operate well in low-resource languages and require a great amount of high-quality training data to be considered good enough. Yet, with the improvements made in ASR systems, it is now much easier than ever to collect data for the design of custom text-to-speech models. In this work, our work on using the ASR model to collect data to build a viable text-to-speech system for one of the leading financial institutions of Azerbaijan will be outlined. NVIDIA’s implementation of the Tacotron 2 model was utilized along with the HiFiGAN vocoder. As for the training, the model was first trained with high-quality audio data collected from the Internet, then fine-tuned on the bank’s single speaker call center data. The results were then evaluated by 50 different listeners and got a mean opinion score of 4.17, displaying that our method is indeed viable. With this, we have successfully designed the first text-to-speech model in Azerbaijani and publicly shared 12 hours of audiobook data for everyone to use.Keywords: Azerbaijani language, HiFiGAN, Tacotron 2, text-to-speech, transfer learning, whisper
Procedia PDF Downloads 433551 Considerations When Using the Beach Chair Position for Surgery
Authors: Aniko Babits, Ahmad Daoud
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Introduction: The beach chair position (BCP) is a good approach to almost all types of shoulder procedures. However, moving an anaesthetized patient from the supine to sitting position may pose a risk of cerebral hypoperfusion and potential cerebral ischaemia as a result of significant reductions in blood pressure and cardiac output. Hypocapnia in ventilated patients and impaired blood flow to the vertebral artery due to hyperextension, rotation, or tilt of the head may have an impact too. Co-morbidities that may increase the risk of cerebral ischaemia in the BCP include diabetes with autonomic neuropathy, cerebrovascular disease, cardiac disease, severe hypertension, generalized vascular disease, history of fainting, and febrile conditions. Beach chair surgery requires a careful anaesthetic and surgical management to optimize patient safety and minimize the risk of adverse outcomes. Methods: We describe the necessary steps for optimal patient positioning and the aims of intraoperative management, including anaesthetic techniques to ensure patient safety in the BCP. Results: Regardless of the anaesthetic technique, adequate patient positioning is paramount in the BCP. The key steps to BCP are aimed at optimizing surgical success and minimizing the risk of severe neurovascular complications. The primary aim of anaesthetic management is to maintain cardiac output and mean arterial pressure (MAP) to protect cerebral perfusion. Blood pressure management includes treating a fall in MAP of more than 25% from baseline or a MAP less than 70 mmHg. This can be achieved by using intravenous fluids or vasopressors. A number of anaesthetic techniques could also improve cerebral oxygenation, including avoidance of intermittent positive pressure ventilation (IPPV) with general anaesthesia (GA), using regional anaesthesia, maintaining normocapnia and normothermia, and the application of compression stockings. Conclusions: In summary, BCP is a reliable and effective position to perform shoulder procedures. Simple steps to patient positioning and careful anaesthetic management could maximize patient safety and avoid unwanted adverse outcomes in patients undergoing surgery in BCP.Keywords: beach chair position, cerebral oxygenation, cerebral perfusion, sitting position
Procedia PDF Downloads 883550 Explore the Effect of Telecare for the Elderly in Preventing and Delaying the Quality of Disability Care with Bluetooth Brainwave Equipment
Authors: Jui-Chen Huang
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The purpose of this study is to explore the effects of telecare on preventing and delaying the quality of disability care in elderly people with portable comfort Bluetooth brainwave devices with remote healthcare functions. Through the teaching videos and remotely teaching the elderly, which had ever learned the care courses of the prevent and delay disability, these elderly did muscle strength training. Then this paper explores the effect of training with the data by SPSS 18.0 statistical software. The data is collected with pre-test, post-test and analyze data from the measure of the Bluetooth brain wave equipment including the pressure index, relaxation index, attention and fatigue index of the elderly. In this study, 30 elderly people who had taken preventive and delayed disability care courses were studied to explore the effect of their care quality improvement. The results showed that the pressure index, relaxation index, attention, and fatigue index of the elderly had statistically significant differences in two months. It can be seen that elderly people who have been treated to prevent and delay disability care courses can significantly improve their care quality if they continue to receive intensive training to prevent and delay disability through remote mode. This telecare is applied to the elderly program that has been used to prevent and delay disability care courses. It is worth continuing to promote, and it is recommended that follow-up studies be conducted in a longer-term manner to explore long-term benefits. It can solve the current insufficiency of long-term care resources, but the demand is urgent.Keywords: telecare, bluetooth brainwave equipment, prevention and delay of disability, the elderly, care quality
Procedia PDF Downloads 1483549 Confirming the Factors of Professional Readiness in Athletic Training
Authors: Philip A. Szlosek, M. Susan Guyer, Mary G. Barnum, Elizabeth M. Mullin
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In the United States, athletic training is a healthcare profession that encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of or in collaboration with a physician and are recognized by the American Medical Association as allied healthcare professionals. Internationally, this profession is often known as athletic therapy. As healthcare professionals, athletic trainers must be prepared for autonomous practice immediately after graduation. However, new athletic trainers have been shown to have clinical areas of strength and weakness.To better assess professional readiness and improve the preparedness of new athletic trainers, the factors of athletic training professional readiness must be defined. Limited research exists defining the holistic aspects of professional readiness needed for athletic trainers. Confirming the factors of professional readiness in athletic training could enhance the professional preparation of athletic trainers and result in more highly prepared new professionals. The objective of this study was to further explore and confirm the factors of professional readiness in athletic training. Authors useda qualitative design based in grounded theory. Participants included athletic trainers with greater than 24 months of experience from a variety of work settings from each district of the National Athletic Trainer’s Association. Participants took the demographic questionnaire electronically using Qualtrics Survey Software (Provo UT). After completing the demographic questionnaire, 20 participants were selected to complete one-on-one interviews using GoToMeeting audiovisual web conferencing software. IBM Statistical Package for the Social Sciences (SPSS, v. 21.0) was used to calculate descriptive statistics for participant demographics. The first author transcribed all interviews verbatim and utilized a grounded theory approach during qualitative data analysis. Data were analyzed using a constant comparative analysis and open and axial coding. Trustworthiness was established using reflexivity, member checks, and peer reviews. Analysis revealed four overarching themes, including management, interpersonal relations, clinical decision-making, and confidence. Management was categorized as athletic training services not involving direct patient care and was divided into three subthemes, including administration skills, advocacy, and time management. Interpersonal Relations was categorized as the need and ability of the athletic trainer to properly interact with others. Interpersonal relations was divided into three subthemes, including personality traits, communication, and collaborative practice. Clinical decision-making was categorized as the skills and attributes required by the athletic trainer whenmaking clinical decisions related to patient care. Clinical decision-making was divided into three subthemes including clinical skills, continuing education, and reflective practice. The final theme was confidence. Participants discussed the importance of confidence regarding relationships building, clinical and administrative duties, and clinical decision-making. Overall, participants explained the value of a well-rounded athletic trainer and emphasized that athletic trainers need communication and organizational skills, the ability to collaborate, and must value self-reflection and continuing education in addition to having clinical expertise. Future research should finalize a comprehensive model of professional readiness for athletic training, develop a holistic assessment instrument for athletic training professional readiness, and explore the preparedness of new athletic trainers.Keywords: autonomous practice, newly certified athletic trainer, preparedness for professional practice, transition to practice skills
Procedia PDF Downloads 1493548 The Preparation and Training of Expert Studio Reviewers
Authors: Diane M. Bender
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In design education, professional education is delivered in a studio, where students learn and understand their discipline. This learning methodology culminates in a final review, where students present their work before instructors and invited reviewers, known as jurors. These jurors are recognized experts who add a wide diversity of opinions in their feedback to students. This feedback can be provided in multiple formats, mainly a verbal critique of the work. To better understand how these expert reviewers prepare for a studio review, a survey was distributed to reviewers at a multi-disciplinary design school within the United States. Five design disciplines are involved in this case study: architecture, graphic design, industrial design, interior design, and landscape architecture. Respondents (n=122) provided information about if and how they received training on how to critique and participate in a final review. Common forms of training included mentorship, modeled behavior from other designers/past professors, workshops on critique from the instructing faculty prior to the crit session, and by being a practicing design professional. Respondents also gave feedback about how much the instructor provided course materials prior to the review in order to better prepare for student interaction. Finally, respondents indicated if they had interaction, and in what format, with students prior to the final review. Typical responses included participation in studio desk crits, a midterm jury member, meetings with students, and email or social media correspondence. While the focus of this study is the studio review, the findings are equally applicable to other disciplines. Suggestions will be provided on how to improve the preparation of guests in the learning process and how their interaction can positively influence student engagement.Keywords: critique, design, education, evaluation, juror
Procedia PDF Downloads 803547 Inferential Reasoning for Heterogeneous Multi-Agent Mission
Authors: Sagir M. Yusuf, Chris Baber
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We describe issues bedeviling the coordination of heterogeneous (different sensors carrying agents) multi-agent missions such as belief conflict, situation reasoning, etc. We applied Bayesian and agents' presumptions inferential reasoning to solve the outlined issues with the heterogeneous multi-agent belief variation and situational-base reasoning. Bayesian Belief Network (BBN) was used in modeling the agents' belief conflict due to sensor variations. Simulation experiments were designed, and cases from agents’ missions were used in training the BBN using gradient descent and expectation-maximization algorithms. The output network is a well-trained BBN for making inferences for both agents and human experts. We claim that the Bayesian learning algorithm prediction capacity improves by the number of training data and argue that it enhances multi-agents robustness and solve agents’ sensor conflicts.Keywords: distributed constraint optimization problem, multi-agent system, multi-robot coordination, autonomous system, swarm intelligence
Procedia PDF Downloads 1523546 Mindfulness and Mental Resilience Training for Pilots: Enhancing Cognitive Performance and Stress Management
Authors: Nargiza Nuralieva
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The study delves into assessing the influence of mindfulness and mental resilience training on the cognitive performance and stress management of pilots. Employing a meticulous literature search across databases such as Medline and Google Scholar, the study used specific keywords to target a wide array of studies. Inclusion criteria were stringent, focusing on peer-reviewed studies in English that utilized designs like randomized controlled trials, with a specific interest in interventions related to mindfulness or mental resilience training for pilots and measured outcomes pertaining to cognitive performance and stress management. The initial literature search identified a pool of 123 articles, with subsequent screening resulting in the exclusion of 77 based on title and abstract. The remaining 54 articles underwent a more rigorous full-text screening, leading to the exclusion of 41. Additionally, five studies were selected from the World Health Organization's clinical trials database. A total of 11 articles from meta-analyses were retained for examination, underscoring the study's dedication to a meticulous and robust inclusion process. The interventions varied widely, incorporating mixed approaches, Cognitive behavioral Therapy (CBT)-based, and mindfulness-based techniques. The analysis uncovered positive effects across these interventions. Specifically, mixed interventions demonstrated a Standardized Mean Difference (SMD) of 0.54, CBT-based interventions showed an SMD of 0.29, and mindfulness-based interventions exhibited an SMD of 0.43. Long-term effects at a 6-month follow-up suggested sustained impacts for both mindfulness-based (SMD: 0.63) and CBT-based interventions (SMD: 0.73), albeit with notable heterogeneity.Keywords: mindfulness, mental resilience, pilots, cognitive performance, stress management
Procedia PDF Downloads 543545 Neural Network based Risk Detection for Dyslexia and Dysgraphia in Sinhala Language Speaking Children
Authors: Budhvin T. Withana, Sulochana Rupasinghe
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The educational system faces a significant concern with regards to Dyslexia and Dysgraphia, which are learning disabilities impacting reading and writing abilities. This is particularly challenging for children who speak the Sinhala language due to its complexity and uniqueness. Commonly used methods to detect the risk of Dyslexia and Dysgraphia rely on subjective assessments, leading to limited coverage and time-consuming processes. Consequently, delays in diagnoses and missed opportunities for early intervention can occur. To address this issue, the project developed a hybrid model that incorporates various deep learning techniques to detect the risk of Dyslexia and Dysgraphia. Specifically, Resnet50, VGG16, and YOLOv8 models were integrated to identify handwriting issues. The outputs of these models were then combined with other input data and fed into an MLP model. Hyperparameters of the MLP model were fine-tuned using Grid Search CV, enabling the identification of optimal values for the model. This approach proved to be highly effective in accurately predicting the risk of Dyslexia and Dysgraphia, providing a valuable tool for early detection and intervention. The Resnet50 model exhibited a training accuracy of 0.9804 and a validation accuracy of 0.9653. The VGG16 model achieved a training accuracy of 0.9991 and a validation accuracy of 0.9891. The MLP model demonstrated impressive results with a training accuracy of 0.99918, a testing accuracy of 0.99223, and a loss of 0.01371. These outcomes showcase the high accuracy achieved by the proposed hybrid model in predicting the risk of Dyslexia and Dysgraphia.Keywords: neural networks, risk detection system, dyslexia, dysgraphia, deep learning, learning disabilities, data science
Procedia PDF Downloads 633544 Soccer, a Major Social Changing Factor: Kosovo Case
Authors: Armend Kelmendi, Adnan Ahmeti
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The purpose of our study was to assess the impact of soccer in the overall wealth fare (education, health, and economic prosperity) of youth in Kosovo (age: 7-18). The research conducted measured a number of parameters (training methodologies, conditions, community leadership impact) in a sample consisting of 6 different football clubs’ academies across the country. Fifty (50) male and female football youngsters volunteered in this study. To generate more reliable results, the analysis was conducted with the help of a set of effective project management tools and techniques (Gantt chart, Logic Network, PERT chart, Work Breakdown Structure, and Budgeting Analysis). The interviewees were interviewed under a specific lens of categories (impact in education, health, and economic prosperity). A set of questions were asked i.e. what has football provided to you and the community you live in?; Did football increase your confidence and shaped your life for better?; What was the main reason you started training in football? The results generated explain how a single sport, namely that of football in Kosovo can make a huge social change, improving key social factors in a society. There was a considerable difference between the youth clubs as far as training conditions are concerned. The study found out that despite financial constraints, two out of six clubs managed to produce twice as more talented players that were introduced to professional primary league teams in Kosovo and Albania, including other soccer teams in the region, Europe, and Asia. The study indicates that better sports policy must be formulated and associated with important financial investments in soccer for it to be considered fruitful and beneficial for players of 18 plus years of age, namely professionals.Keywords: youth, prosperity, conditions, investments, growth, free movement
Procedia PDF Downloads 2393543 Rectus Sheath Block to Extend the Effectiveness of Post Operative Epidural Analgesia
Authors: Sugam Kale, Arif Uzair Bin Mohammed Roslan, Cindy Lee, Syed Beevee Mohammed Ismail
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Preemptive analgesia is an established concept in the modern practice of anaesthesia. To be most effective, it is best instituted earlier than the surgical stimulus and should last beyond the offset of surgically induced pain till healing is complete. Whereas the start of afferent pain blockade with regional anaesthesia is common, its effect often falls short to cover the entire period of pain impulses making their way to CNS in the post-operative period. We tried to use a combination of two regional anaesthetic techniques used sequentially to overcome this handicap. Madam S., a 56 year old lady, was scheduled for elective surgery for pancreatic cancer. She underwent laparotomy and distal pancreatectomy, splenectomy, bilateral salpingo oophorectomy, and sigmoid colectomy. Surgery was expected to be extensive, and it was presumed that the standard pain relief with PCA with opiates and oral analgesics would not be adequate. After counselling the patient pre-operative about the technique of regional anaesthesia techniques, including epidural catheterization and rectus sheath catheter placement, their benefits, and potential complications, informed consent was obtained. Epidural catheter was placed awake, and general anaesthesia was then induced. Epidural infusion of local anaesthetics was started prior to surgical incision and was continued till 60 hours into the postoperative period. Before skin closure, the surgeons inserted commercially available rectus sheath catheters bilaterally along the midline incision used for laparotomy. After 46 hours post-op, local anaesthetic infusion via these was started as bridging while the epidural infusion rate was tapered off. The epidural catheter was removed at 75 hours. Elastomeric pumps were used to provide local anaesthetic infusion with the ability to vary infusion rates. Acute pain service followed up the patient’s vital signs and effectiveness of pain relief twice daily or more frequently as required. Rectus sheath catheters were removed 137 hours post-op. The patient had good post-op analgesia with the minimal additional analgesic requirement. For the most part, the visual analog score (VAS) for pain remained at 1-3 on a scale of 1 to 10. Haemodynamics remained stable, and surgical recovery was as expected. Minimal opiate requirement after an extensive laparotomy also translates to the early return of intestinal motility. Our experience was encouraging, and we are hoping to extend this combination of two regional anaesthetic techniques to patients undergoing similar surgeries. Epidural analgesia is denser and offers excellent pain relief for both visceral and somatic pain in the first few days after surgery. As the pain intensity grows weaker, rectus sheath block and oral analgesics provide almost the same degree of pain relief after the epidural catheter is removed. We discovered that the background infusion of local anaesthetic down the rectus sheath catherter largely reduced the requirement for other classes of analgesics. We aim to study this further with a larger patient cohort and hope that it may become an established clinical practice that benefits patients everywhere.Keywords: rectus sheath, epidural infusion, post operative analgesia, elastomeric
Procedia PDF Downloads 1313542 Assessment and Evaluation of Football Performance
Authors: Bulus Kpame, Mukhtar Mohammed Alhaji, Garba Jibril
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In any team sport, the most important variables that should be used to measure performance are physical condition, and technical and tactical performance. In a complex game like football, it is extremely difficult to measure the relative importance of each of these variables. However, physical fitness itself has been shown to consist of several components, like endurance, strength, flexibility, agility, coordination and speed. Each of these components has been shown to consist of several subcomponents. This paper attempts to describe a test battery to assess and evaluate physical performance in football players. This battery comprises a functional, structured training session of about 2.5hrs. it consists of quality rating of the warm-up procedure, tests of flexibility, football skills, power, speed, and endurance. Acceptable values for performance in each of the tests are also presented under each test. It is hoped that this battery of tests will be helpful to the coach in determining the effect of a specific training program. It would also be helpful to train physician and trainer, to monitor progress during rehabilitation after sustaining any injury.Keywords: assessment, evaluation, performance, programs
Procedia PDF Downloads 4063541 Biorisk Management Education for Undergraduates Studying Clinical Microbiology at University in Japan
Authors: Shuji Fujimoto, Fumiko Kojima, Mika Shigematsu
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Biorisk management (Biosafety/Biosecurity) is required for anyone working in a clinical laboratory (including medical/clinical research laboratories) where infectious agents and potentially hazardous biological materials are examined/stored. Proper education and training based on international standards of biorisk management should be provided not only as a part of laboratory safety program in work place but also as a part of introductory training at educational institutions for continuity and to elevate overall baseline of the biorisk management. We reported results of the pilot study of biorisk management education for graduate students majored in laboratory diagnostics previously. However, postgraduate education is still late in their profession and the participants’ interview also revealed importance and demands of earlier biorisk management education for undergraduates. The aim of this study is to identify the need for biosafety/biosecurity education and training program which is designed for undergraduate students who are entering the profession in clinical microbiology. We modified the previous program to include more basic topics and explanations (risk management, principles of safe clinical lab practices, personal protective equipment, disinfection, disposal of biological substances) and provided incorporating in the routine educational system for faculty of medical sciences in Kyushu University. The results of the pre and post examinations showed that the knowledge of the students on biorisk control had developed effectively as a proof of effectiveness of the program even in the undergraduate students. Our study indicates that administrating the basic biorisk management program in the earlier stage of learning will add positive impact to the understanding of biosafety to the health professional education.Keywords: biorisk management, biosafety, biosecurity, clinical microbiology, education for undergraduates
Procedia PDF Downloads 2103540 Thriving Organisations: Recommendations to Create a Workplace Culture That Prioritises Both Well-being and Performance Equally
Authors: Clare Victoria Martin
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With reports of increased mental health problems and a lack of proactive, consistent well-being initiatives, well-being is a topical issue in the workplace, as well as a wider public health concern. Additionally, workplace well-being is closely linked to performance, both from a business perspective and in psychological research. Businesses are therefore becoming increasingly motivated to promote well-being, yet there are still barriers, including a lack of evidence-based workplace interventions, issues with measuring effectiveness and problems creating lasting cultural change. This review aimed to collate workplace well-being research to propose a comprehensive new model for delivering evidence-based workplace well-being training with a real potential for lasting impact. Method: A narrative review was conducted to meta-synthesise relevant research. Thematic analysis was then adopted as a systematic method of identifying key themes from the review to lead to practical recommendations. Interventions focusing on strengths, psychological capital, mindfulness and positivity (SPMP) dominated the research in this area, suggesting benefits of incorporating all four into training. However, to avoid a ‘quick fix’ mentality, the concept of training ‘well-being ambassadors’ as a preventative counterpart to mental health ‘first aiders’ was proposed alongside a new ‘REST and RISE’ model: well-being interventions should be ‘relatable’, ‘enjoyable’, ‘sociable’ and ‘trackable’ (REST) in order to increase ‘resilience’, ‘innovation’, ‘strengths’ and ‘engagement’ (RISE). If the REST principles are applied to interventions focusing on SPMP, research suggests individuals will RISE. Future research should empirically test this new well-being ambassador programme and REST/RISE model in an applied setting.Keywords: performance, positive psychology, thriving, workplace well-being
Procedia PDF Downloads 1163539 On Developing a Core Guideline for English Language Training Programs in Business Settings
Authors: T. Ito, K. Kawaguchi, R. Ohta
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The purpose of this study is to provide a guideline to assist globally-minded companies in developing task-based English-language programs for their employees. After conducting an online self-assessment questionnaire comprised of 45 job-related tasks, we analyzed responses received from 3,000 Japanese company employees and developed a checklist that considered three areas: (i) the percentage of those who need to accomplish English-language tasks in their workplace (need for English), (ii) a five-point self-assessment score (task performance level), and (iii) the impact of previous task experience on perceived performance (experience factor). The 45 tasks were graded according to five proficiency levels. Our results helped us to create a core guideline that may assist companies in two ways: first, in helping determine which tasks employees with a certain English proficiency should be able to satisfactorily carry out, and secondly, to quickly prioritize which business-related English skills they would need in future English language programs.Keywords: business settings, can-do statements, English language training programs, self-assessment, task experience
Procedia PDF Downloads 2503538 Mental Imagery as an Auxiliary Tool to the Performance of Elite Competitive Swimmers of the University of the East Manila
Authors: Hillary Jo Muyalde
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Introduction: Elite athletes train regularly to enhance their physical endurance, but sometimes, training sessions are not enough. When competition comes, these athletes struggle to find focus. Mental imagery is a psychological technique that helps condition the mind to focus and eventually help improve performance. This study aims to help elite competitive swimmers of the University of the East improve their performance with Mental Imagery as an auxiliary tool. Methodology: The study design used was quasi-experimental with a purposive sampling technique and a within-subject design. It was conducted with a total of 41 participants. The participants were given a Sport Imagery Ability Questionnaire (SIAQ) to measure imagery ability and the Mental Imagery Program. The study utilized a Paired T-test for data analysis where the participants underwent six weeks of no mental imagery training and were compared to six weeks with the Mental Imagery Program (MIP). The researcher recorded the personal best time of participants in their respective specialty stroke. Results: The results of the study showed a t-value of 17.804 for Butterfly stroke events, 9.922 for Backstroke events, 7.787 for Breaststroke events, and 17.440 in Freestyle. This indicated that MIP had a positive effect on participants’ performance. The SIAQ result also showed a big difference where -10.443 for Butterfly events, -5.363 for Backstroke, -7.244 for Breaststroke events, and -10.727 for Freestyle events, which meant the participants were able to image better than before MIP. Conclusion: In conclusion, the findings of this study showed that there is indeed an improvement in the performance of the participants after the application of the Mental Imagery Program. It is recommended from this study that the participants continue to use mental imagery as an auxiliary tool to their training regimen for continuous positive results.Keywords: mental Imagery, personal best time, SIAQ, specialty stroke
Procedia PDF Downloads 793537 Energy Metabolism and Mitochondrial Biogenesis in Muscles of Rats Subjected to Cold Water Immersion
Authors: Bosiacki Mateusz, Anna Lubkowska, Dariusz Chlubek, Irena Baranowska-Bosiacka
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Exposure to cold temperatures can be considered a stressor that can lead to adaptive responses. The present study hypothesized the possibility of a positive effect of cold water exercise on mitochondrial biogenesis and muscle energy metabolism in aging rats. The purpose of this study was to evaluate the effects of cold water exercise on energy status, purine compounds, and mitochondrial biogenesis in the muscles of aging rats as indicators of the effects of cold water exercise and their usefulness in monitoring adaptive changes. The study was conducted on 64 aging rats of both sexes, 15 months old at the time of the experiment. The rats (male and female separately) were randomly assigned to the following study groups: control, sedentary animals; 5°C groups animals - training swimming in cold water at 5°C; 36°C groups - animals training swimming in water at thermal comfort temperature. The study was conducted with the approval of the Local Ethical Committee for Animal Experiments. The animals in the experiment were subjected to swimming training for 9 weeks. During the first week of the study, the duration of the first swimming training was 2 minutes (on the first day), increasing daily by 0.5 minutes up to 4 minutes on the fifth day of the first week. From the second to the eighth week, the swimming training was 4 minutes per day, five days a week. At the end of the study, forty-eight hours after the last swim training, the animals were dissected. In the skeletal muscle tissue of the thighs of the rats, we determined the concentrations of ATP, ADP, AMP, Ado (HPLC), PGC-1a protein expression (Western blot), PGC1A, Mfn1, Mfn2, Opa1, and Drp1 gene expression (qRT PCR). The study showed that swimming in water at a thermally comfortable temperature improved the energy metabolism of the aging rat muscles by increasing the metabolic rate (increase in ATP, ADP, TAN, AEC) and enhancing mitochondrial fusion (increase in mRNA expression of regulatory proteins Mfn1 and Mfn2). Cold water swimming improved muscle energy metabolism in aging rats by increasing the rate of muscle energy metabolism (increase in ATP, ADP, TAN, AEC concentrations) and enhancing mitochondrial biogenesis and dynamics (increase in the mRNA expression of proteins of fusion-regulating factors – Mfn1, Mfn2, and Opa1, and the factor regulating mitochondrial fission – Drp1). The concentration of high-energy compounds and the expression of proteins regulating mitochondrial dynamics in the muscle may be a useful indicator in monitoring adaptive changes occurring in aging muscles under the influence of exercise in cold water. It represents a short-term adaptation to changing environmental conditions and has a beneficial effect on maintaining the bioenergetic capacity of muscles in the long term. Conclusion: exercise in cold water can exert positive effects on energy metabolism, biogenesis and dynamics of mitochondria in aging rat muscles. Enhancement of mitochondrial dynamics under cold water exercise conditions can improve mitochondrial function and optimize the bioenergetic capacity of mitochondria in aging rat muscles.Keywords: cold water immersion, adaptive responses, muscle energy metabolism, aging
Procedia PDF Downloads 793536 Neural Network-based Risk Detection for Dyslexia and Dysgraphia in Sinhala Language Speaking Children
Authors: Budhvin T. Withana, Sulochana Rupasinghe
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The problem of Dyslexia and Dysgraphia, two learning disabilities that affect reading and writing abilities, respectively, is a major concern for the educational system. Due to the complexity and uniqueness of the Sinhala language, these conditions are especially difficult for children who speak it. The traditional risk detection methods for Dyslexia and Dysgraphia frequently rely on subjective assessments, making it difficult to cover a wide range of risk detection and time-consuming. As a result, diagnoses may be delayed and opportunities for early intervention may be lost. The project was approached by developing a hybrid model that utilized various deep learning techniques for detecting risk of Dyslexia and Dysgraphia. Specifically, Resnet50, VGG16 and YOLOv8 were integrated to detect the handwriting issues, and their outputs were fed into an MLP model along with several other input data. The hyperparameters of the MLP model were fine-tuned using Grid Search CV, which allowed for the optimal values to be identified for the model. This approach proved to be effective in accurately predicting the risk of Dyslexia and Dysgraphia, providing a valuable tool for early detection and intervention of these conditions. The Resnet50 model achieved an accuracy of 0.9804 on the training data and 0.9653 on the validation data. The VGG16 model achieved an accuracy of 0.9991 on the training data and 0.9891 on the validation data. The MLP model achieved an impressive training accuracy of 0.99918 and a testing accuracy of 0.99223, with a loss of 0.01371. These results demonstrate that the proposed hybrid model achieved a high level of accuracy in predicting the risk of Dyslexia and Dysgraphia.Keywords: neural networks, risk detection system, Dyslexia, Dysgraphia, deep learning, learning disabilities, data science
Procedia PDF Downloads 1123535 Trial of Resorbable versus Non-Resorbable Sutures for Traumatic Lacerations of the Face: A Demonstration of Maxillo-Facial Trainee Led Research
Authors: R. Botrugno, S Basyuni, G. Nugent, I. Jenkyn, A. Ferro, H. Bennett, C. Hjalmarsson, J. Chu, V. Santhanam
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This trainee led randomised controlled trial (RCT) aims to assess various outcomes for resorbable versus non-resorbable sutures for traumatic lacerations to the face. Within this trial of resorbable versus non-resorbable sutures for traumatic lacerations of the face (TORNFace), patient recruitment was facilitated by trainees who were employed at an NHS University Teaching Hospital in the United Kingdom. The trainees received appropriate training prior to recruiting patients for the trial. This included the completion of a national research e-learning module and face-to-face training that was provided locally. The locally delivered training provided an understanding of the eligibility criteria for the trial and the consent process. Existing trainee skills were utilised involving clinical photography to record baseline data and delivering the intervention based on the treatment arm selected. Eligible patients who required primary closure of traumatic lacerations of the face were randomised into one of two treatment arms. These comprised of resorbable (vicryl rapide) or non-resorbable sutures (ethilon). Primarily the cosmetic outcome was assessed. Secondary outcomes included: complications rates, health care economics, and patient-reported outcomes. Remote follow-up of recruited patients utilised photographs of the facial laceration which had received the intervention. These took place at 1 week, 3 months and 6 months post-intervention. This study aims to demonstrate an example of trainee-led research within the specialty of oral and maxillofacial surgery. The available data for the randomised controlled trial will also be presented.Keywords: laceration, suture, trauma, trial
Procedia PDF Downloads 1363534 Maritime English Communication Training for Japanese VTS Operators in the Congested Area Including the Narrow Channel of Akashi Strait
Authors: Kenji Tanaka, Kazumi Sugita, Yuto Mizushima
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This paper introduces a noteworthy form of English communication training for the officers and operators of the Osaka-Bay Marine Traffic Information Service (Osaka MARTIS) of the Japan Coast Guard working in the congested area at the Akashi Strait in Hyogo Prefecture, Japan. The authors of this paper, Marine Technical College’s (MTC) English language instructors, have been holding about forty lectures and exercises in basic and normal Maritime English (ME) for several groups of MARTIS personnel at Osaka MARTIS annually since they started the training in 2005. Trainees are expected to be qualified Maritime Third-Class Radio Operators who are responsible for providing safety information to a daily average of seven to eight hundred vessels that pass through the Akashi Strait, one of Japan’s narrowest channels. As of 2022, the instructors are conducting 55 remote lessons at MARTIS. One lesson is 90 minutes long. All 26 trainees are given oral and written assessments. The trainees need to pass the examination to become qualified operators every year, requiring them to train and maintain their linguistic levels even during the pandemic of Corona Virus Disease-19 (COVID-19). The vessel traffic information provided by Osaka MARTIS in Maritime English language is essential to the work involving the use of very high frequency (VHF) communication between MARTIS and vessels in the area. ME is the common language mainly used on board merchant, fishing, and recreational vessels, normally at sea. ME was edited and recommended by the International Maritime Organization in the 1970s, was revised in 2002, and has undergone continual revision. The vessel’s circumstances are much more serious at the strait than those at the open sea, so these vessels need ME to receive guidance from the center when passing through the narrow strait. The imminent and challenging situations at the strait necessitate that textbooks’ contents include the basics of the phrase book for seafarers as well as specific and additional navigational information, pronunciation exercises, notes on keywords and phrases, explanations about collocations, sample sentences, and explanations about the differences between synonyms especially those focusing on terminologies necessary for passing through the strait. Additionally, short Japanese-English translation quizzes about these topics, as well as prescribed readings about the maritime sector, are include in the textbook. All of these exercises have been trained in the remote education system since the outbreak of COVID-19. According to the guidelines of ME edited in 2009, the lowest level necessary for seafarers is B1 (lower individual users) of The Common European Framework of Reference for Languages: Learning, Teaching, Assessment (CEFR). Therefore, this vocational ME language training at Osaka MARTIS aims for its trainees to communicate at levels higher than B1. A noteworthy proof of improvement from this training is that most of the trainees have become qualified marine radio communication officers.Keywords: akashi strait, B1 of CEFR, maritime english communication training, osaka martis
Procedia PDF Downloads 1213533 The Effect of Artificial Intelligence on Autism Attitudes and Laws
Authors: Nermin Noshi Esraeil Abdalla
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Inclusive schooling offerings for college kids with Autism stays in its early developmental levels in Thailand. despite many greater youngsters with autism are attending schools since the Thai authorities brought the training Provision for human beings with Disabilities Act in 2008, the services students with autism and their families obtain are typically missing. This quantitative examine used attitude and Preparedness to educate college students with Autism Scale (APTSAS) to investigate 110 number one faculty teachers’ attitude and preparedness to educate college students with autism inside the widespread training school room. Descriptive statistical evaluation of the records discovered that scholar behavior changed into the most good sized factor in constructing teachers’ terrible attitudes students with autism. the majority of teachers additionally indicated that their pre-service schooling did not put together them to fulfill the mastering needs of children with autism especially, folks who are non-verbal. The take a look at is substantial and offers path for enhancing trainer education for inclusivity in Thailand.Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills
Procedia PDF Downloads 203532 Teachers’ Perception of the Implementation of Inclusive Creative Arts Education
Authors: William Kwabena Nantwi
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This quantitative study investigates Creative Arts teachers' perceptions regarding the implementation of an Inclusive Creative Arts curriculum. The research employs a descriptive approach utilizing a 5-point Likert scale questionnaire comprising 15 items to gather data from Creative Arts educators. The Census with a disproportionate stratified sampling method was utilized to select 226 teachers from five educational circuits (Circuit A, B, C, D & E) within Offinso Municipality, Ghana. The findings indicate that most Creative Arts teachers hold a positive perception towards implementing an inclusive Creative Arts curriculum. Positive perceptions and attitudes among teachers are correlated with increased student engagement and participation in class activities. This study recommends organizing workshops and in-service training sessions focused on inclusive Creative Arts education for Creative Arts teachers. Additionally, it suggests that Colleges of Education and Universities responsible for teacher training integrate foundational courses in Creative Arts and Special Education into their primary education teacher preparation programs.Keywords: perception, attitude, inclusive education, creative art, creative arts teachers, Ghana
Procedia PDF Downloads 283531 Early Outcomes and Lessons from the Implementation of a Geriatric Hip Fracture Protocol at a Level 1 Trauma Center
Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson
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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization
Procedia PDF Downloads 763530 Elements of Sector Benchmarking in Physical Education Curriculum: An Indian Perspective
Authors: Kalpana Sharma, Jyoti Mann
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The study was designed towards institutional analysis for a clear understanding of the process involved in functioning and layout of determinants influencing physical education teacher’s education program in India. This further can be recommended for selection of parameters for creating sector benchmarking for physical education teachers training institutions across India. 165 stakeholders involving students, teachers, parents, administrators were surveyed from the identified seven institutions and universities from different states of India. They were surveyed on the basis of seven broad parameters which were associated with the post graduate physical education program in India. A physical education program assessment tool of 52 items was designed to administer it among the stakeholders selected for the survey. An item analysis of the contents was concluded through the review process from selected experts working in higher education with experience in teacher training program in physical education. The data was collected from the stakeholders of the selected institutions through Physical Education Program Assessment Tool (PEPAT). The hypothesis that PE teacher education program is independent of physical education institutions was significant. The study directed a need towards robust admission process emphasizing on identification, selection of potential candidates and quality control of intake with the scientific process developed according to the Indian education policies and academic structure. The results revealed that the universities do not have similar functional and delivery process related to the physical education teacher training program. The study reflects towards the need for physical education universities and institutions to identify the best practices to be followed regarding the functioning of delivery of physical education programs at various institutions through strategic management studies on the identified parameters before establishing strict standards and norms for achieving excellence in physical education in India.Keywords: assessment, benchmarking, curriculum, physical education, teacher education
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