Search results for: hospital information system

Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

Abstract:

Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

Procedia PDF Downloads 245

Authors: Tzong-Ying Hao, Mohammad T. Rahmani

Abstract:

The Torre Central building is a 9-story shear wall structure located in Santiago, Chile, and has been instrumented since 2009. Events of different intensity (ambient vibrations, weak and strong earthquake motions) have been recorded, and thus the building can serve as a full-scale benchmark to evaluate the structural health monitoring method developed. The first part of this article presents an analysis of inter-story drifts, and of changes in the first system frequencies (estimated from the relative displacement response of the 8th-floor with respect to the basement from recorded data) as baseline indicators of the occurrence of damage. During 2010 Chile earthquake the system frequencies were detected decreasing approximately 24% in the EW and 27% in NS motions. Near the end of shaking, an increase of about 17% in the EW motion was detected. The structural health monitoring (SHM) method based on changes in wave traveling time (wave method) within a layered shear beam model of structure is presented in the second part of this article. If structural damage occurs the velocity of wave propagated through the structure changes. The wave method measures the velocities of shear wave propagation from the impulse responses generated by recorded data at various locations inside the building. Our analysis and results show that the detected changes in wave velocities are consistent with the observed damages. On this basis, the wave method is proven for actual implementation in structural health monitoring systems.

Keywords: Chile earthquake, damage detection, earthquake response, impulse response, layered shear beam, structural health monitoring, Torre Central building, wave method, wave travel time

Procedia PDF Downloads 354

Authors: Sedef Şahin, Meral Huri

Abstract:

Cerebral Palsy (CP) represents the most frequent cause of physical disability in children with a rate of 2,9 per 1000 live births. The activity-focused intervention is known to improve function and reduce activity limitations and barriers to participation of children with disabilities. The aim of the study was to assess the effects of occupational therapy on level of fatigue, activity performance and satisfaction in children with Unilateral Cerebral Palsy. Twenty-two children with hemiparetic cerebral palsy (mean age: 9,3 ± 2.1years; Gross Motor Function Classification System ( GMFCS) level from I to V (I = 54%, II = 23%, III = 14%, IV= 9%, V= 0%), Manual Ability Classification System (MACS) level from I to V (I = 40%, II = 32%, III = 14%, IV= 10%, V= 4%), were assigned to occupational therapy program for 6 weeks.Visual Analogue Scale (VAS) was used for intensity of the fatigue they experienced at the time on a 10 point Likert scale (1-10).Activity performance and satisfaction were measured with Canadian Occupational Performance Measure (COPM).A client-centered occupational therapy intervention was designed according to results of COPM. The results were compared with nonparametric Wilcoxon test before and after the intervention. Thirteen of the children were right-handed, whereas nine of the children were left handed.Six weeks of intervention showed statistically significant differences in level of fatigue, compared to first assessment(p<0,05). The mean score of first and the second activity performance scores were 4.51 ± 1.70 and 7.35 ± 2.51 respectively. Statistically significant difference between performance scores were found (p<0.01). The mean scores of first and second activity satisfaction scores were of 2.30± 1.05 and 5.51 ± 2.26 respectively. Statistically significant difference between satisfaction assessments were found (p<0.01). Occupational therapy is an evidence-based approach and occupational therapy interventions implemented by therapists were clinically effective on severity of fatigue, activity performance and satisfaction if implemented individually during 6 weeks.

Keywords: activity performance, cerebral palsy, fatigue, occupational therapy

Procedia PDF Downloads 223

Authors: Ramin Mansouri

Abstract:

Due to the contrast of rivers discharge regime with water demands, one of the best ways to use water resources is to regulate the natural flow of the rivers and supplying water needs to construct dams. Optimal utilization of reservoirs, consideration of multiple important goals together at the same is of very high importance. To study about analyzing this method, statistical data of Bakhtiari and Roudbar dam over 46 years (1955 until 2001) is used. Initially an appropriate objective function was specified and using DE algorithm, the rule curve was developed. In continue, operation policy using rule curves was compared to standard comparative operation policy. The proposed method distributed the lack to the whole year and lowest damage was inflicted to the system. The standard deviation of monthly shortfall of each year with the proposed algorithm was less deviated than the other two methods. The Results show that median values for the coefficients of F and Cr provide the optimum situation and cause DE algorithm not to be trapped in local optimum. The most optimal answer for coefficients are 0.6 and 0.5 for F and Cr coefficients, respectively. After finding the best combination of coefficients values F and CR, algorithms for solving the independent populations were examined. For this purpose, the population of 4, 25, 50, 100, 500 and 1000 members were studied in two generations (G=50 and 100). result indicates that the generation number 200 is suitable for optimizing. The increase in time per the number of population has almost a linear trend, which indicates the effect of population in the runtime algorithm. Hence specifying suitable population to obtain an optimal results is very important. Standard operation policy had better reversibility percentage, but inflicts severe vulnerability to the system. The results obtained in years of low rainfall had very good results compared to other comparative methods.

Keywords: reservoirs, differential evolution, dam, Optimal operation

Procedia PDF Downloads 66

Authors: Ran Goldblatt, Nicholas Jones, Jennifer Mannix, Brad Bottoms

Abstract:

Accurate, complete, and up-to-date geospatial information is the foundation of successful disaster management. When the 2010 Haiti Earthquake struck, accurate and timely information on the distribution of critical infrastructure was essential for the disaster response community for effective search and rescue operations. Existing geospatial datasets such as Google Maps did not have comprehensive coverage of these features. In the days following the earthquake, many organizations released high-resolution satellite imagery, catalyzing a worldwide effort to map Haiti and support the recovery operations. Of these organizations, OpenStreetMap (OSM), a collaborative project to create a free editable map of the world, used the imagery to support volunteers to digitize roads, buildings, and other features, creating the most detailed map of Haiti in existence in just a few weeks. However, large portions of the island are still not fully covered by OSM. There is an increasing need for a tool to automatically identify which areas in Haiti, as well as in other countries vulnerable to disasters, that are not fully mapped. The objective of this project is to leverage different types of remote sensing measurements, together with machine learning approaches, in order to identify geographical areas where OSM coverage of building footprints is incomplete. Several remote sensing measures and derived products were assessed as potential predictors of OSM building footprints coverage, including: intensity of light emitted at night (based on VIIRS measurements), spectral indices derived from Sentinel-2 satellite (normalized difference vegetation index (NDVI), normalized difference built-up index (NDBI), soil-adjusted vegetation index (SAVI), urban index (UI)), surface texture (based on Sentinel-1 SAR measurements)), elevation and slope. Additional remote sensing derived products, such as Hansen Global Forest Change, DLR`s Global Urban Footprint (GUF), and World Settlement Footprint (WSF), were also evaluated as predictors, as well as OSM street and road network (including junctions). Using a supervised classification with a random forest classifier resulted in the prediction of 89% of the variation of OSM building footprint area in a given cell. These predictions allowed for the identification of cells that are predicted to be covered but are actually not mapped yet. With these results, this methodology could be adapted to any location to assist with preparing for future disastrous events and assure that essential geospatial information is available to support the response and recovery efforts during and following major disasters.

Keywords: disaster management, Haiti, machine learning, OpenStreetMap, remote sensing

Procedia PDF Downloads 110

Authors: Umedov Mekhroz, Griaznova Svetlana

Abstract:

In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

Procedia PDF Downloads 75

Authors: S. Bouameur, S. Chirani

Abstract:

The aim of this study was to evaluate the potential use of EthylCellulose in the preparation of microspheres as a Drug Delivery System for sustained release of phenobarbital. The microspheres were prepared by solvent evaporation technique using ethylcellulose as polymer matrix with a ratio 1:2, dichloromethane as solvent and Polyvinyl alcohol 1% as processing medium to solidify the microspheres. Size, shape, drug loading capacity and entrapement efficiency were studied.

Keywords: phenobarbital, microspheres, ethylcellulose, polyvinylacohol

Procedia PDF Downloads 352

Authors: Abdullah Al Farwan, Ya Zhang

Abstract:

In today’s educational arena, it is critical to understand educational data and be able to evaluate important aspects, particularly data on student achievement. Educational Data Mining (EDM) is a research area that focusing on uncovering patterns and information in data from educational institutions. Teachers, if they are able to predict their students' class performance, can use this information to improve their teaching abilities. It has evolved into valuable knowledge that can be used for a wide range of objectives; for example, a strategic plan can be used to generate high-quality education. Based on previous data, this paper recommends employing data mining techniques to forecast students' final grades. In this study, five data mining methods, Decision Tree, JRip, Naive Bayes, Multi-layer Perceptron, and Random Forest with wrapper feature selection, were used on two datasets relating to Portuguese language and mathematics classes lessons. The results showed the effectiveness of using data mining learning methodologies in predicting student academic success. The classification accuracy achieved with selected algorithms lies in the range of 80-94%. Among all the selected classification algorithms, the lowest accuracy is achieved by the Multi-layer Perceptron algorithm, which is close to 70.45%, and the highest accuracy is achieved by the Random Forest algorithm, which is close to 94.10%. This proposed work can assist educational administrators to identify poor performing students at an early stage and perhaps implement motivational interventions to improve their academic success and prevent educational dropout.

Keywords: classification algorithms, decision tree, feature selection, multi-layer perceptron, Naïve Bayes, random forest, students’ academic performance

Procedia PDF Downloads 151

Authors: Y. P. Raghavendra Babu

Abstract:

Electrocution is a common cause of morbidity and mortality as electricity is an indispensible part of today’s World. Deaths due to electrocution which are witnessed do not pose a problem at the manner and cause of death. However un-witnessed deaths can raise suspicion of manner of death. A case of fatal electrocution is reported here which was diagnosed to be accidental in manner with the help of reconstruction of events by proper investigation.

Keywords: electrocution, manner of death, reconstruction of events, health information

Procedia PDF Downloads 251

Authors: Yen-Mei Lee

Abstract:

Mobile learning (m-learning) has been applied in the education field not only because it is an alternative to web-based learning but also it possesses the ‘anytime, anywhere’ learning features. However, most studies focus on the technology-related issue, such as usability and functionality instead of addressing m-learning from the motivational perspective. Accordingly, the main purpose of the current paper is to integrate critical factors from different motivational theories and related findings to have a better understand the catalysts of an individual’s learning motivation toward m-learning. The main research question for this study is stated as follows: based on different motivational perspectives, what factors of applying mobile devices as medium can facilitate people’s learning motivations? Self-Determination Theory (SDT), Uses and Gratification Theory (UGT), Malone and Lepper’s taxonomy of intrinsic motivation theory, and different types of motivation concepts were discussed in the current paper. In line with the review of relevant studies, three motivating factors with five essential elements are proposed. The first key factor is autonomy. Learning on one’s own path and applying personalized format are two critical elements involved in the factor of autonomy. The second key factor is to apply a build-in instant feedback system during m-learning. The third factor is creating an interaction system, including communication and collaboration spaces. These three factors can enhance people’s learning motivations when applying mobile devices as medium toward learning. To sum up, in the currently proposed paper, with different motivational perspectives to discuss the m-learning is different from previous studies which are simply focused on the technical or functional design. Supported by different motivation theories, researchers can clearly understand how the mobile devices influence people’s leaning motivation. Moreover, instructional designers and educators can base on the proposed factors to build up their unique and efficient m-learning environments.

Keywords: autonomy, learning motivation, mobile learning (m-learning), motivational perspective

Procedia PDF Downloads 166

Authors: Yassine Bouzouita, Oumaima Belghith, Cyrine Zitoun, Charles Bonneau

Abstract:

Performance measurement framework (PMF) is an essential tool in any organization to assess the performance of its processes. It guides businesses to stay on track with their objectives and benchmark themselves from the market. With the growing trend of the digital transformation of business processes, led by innovations in artificial intelligence (AI) & Big Data applications, developing a mature system capable of capturing the impact of digital solutions across different industries became a necessity. Based on the conducted research, no such system has been developed in academia nor the industry. In this context, this paper covers a variety of methodologies on performance measurement, overviews the major AI and big data applications in the banking sector, and covers an exhaustive list of relevant metrics. Consequently, this paper is of interest to both researchers and practitioners. From an academic perspective, it offers a comparative analysis of the reviewed performance measurement frameworks. From an industry perspective, it offers exhaustive research, from market leaders, of the major applications of AI and Big Data technologies, across the different departments of an organization. Moreover, it suggests a standardized classification model with a well-defined structure of intelligent digital solutions. The aforementioned classification is mapped to a centralized library that contains an indexed collection of potential metrics for each application. This library is arranged in a manner that facilitates the rapid search and retrieval of relevant metrics. This proposed framework is meant to guide professionals in identifying the most appropriate AI and big data applications that should be adopted. Furthermore, it will help them meet their business objectives through understanding the potential impact of such solutions on the entire organization.

Keywords: AI and Big Data applications, impact assessment, metrics, performance measurement

Procedia PDF Downloads 185

Authors: Md. Kumruzzaman, Anutosh Das, Md. Mosharraf Hossain

Abstract:

Historically, rapid urban growth activities are considered one of the main culprits behind urban floods or waterlogging. The increased unplanned urbanization of many areas of Dhaka has resulted in waterlogging, urban floods, and increasing groundwater depth. To determine potential groundwater recharge from precipitation, the study is being conducted to examine the changes in land use/land cover (LULC) and urban runoff extent based on the NRCS-CN from 2005–2021. Four kinds of land use are used to examine the LULC change: built-up, bare land, vegetation, and water body. These categories are used for the years 2005, 2010, 2015, and 2021. The built-up area is growing at a relatively fast rate: 7.43%, 17.4%, and 5.21%, respectively, between the years 2005 and 2010, 2010 and 2015, and 2015 and 2021. As the amount of impervious surface rose in Dhaka city, stormwater discharge increased from 2005 to 2021. In 2005, 2010, 2015, and 2021, heavy stormwater runoff regions made up around 24.873%, 32.616%, 49.118%, and 55.986% of the entire Dhaka city. Stormwater runoff accounted for around 53.738%, 55.092%, 63.472%, and 67.061% of the total rainfall in 2005, 2010, 2015, and 2021, respectively. Between 2005 and 2021, a significant portion of the natural land cover was altered because of the expanding impervious surface, which also harmed the natural drainage system. Due to careless growth, the potential for stormwater runoff and groundwater recharge in Dhaka city worsens every year. Concerning this situation, a sustainable urban drainage system (SUDS) can be the best possible solution for minimizing the stormwater runoff and groundwater recharge problem.

Keywords: LULC, impervious surface, stormwater runoff, groundwater recharge, SUDS

Procedia PDF Downloads 64

Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

Abstract:

Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

Procedia PDF Downloads 218

Authors: Qin Xvelian

Abstract:

organic renewal" based on the development of existing resources in high-density urban areas has become the mainstream of urban development in the new era. As an important stock resource of public space in high-density urban areas, promoting its value remodeling is an effective way to alleviate the shortage of public space resources. However, due to the lack of evaluation links in the process of underpass space renewal, a large number of underpass space resources have been left idle, facing the problems of low space conversion efficiency, lack of accuracy in development decision-making, and low adaptability of functional positioning to citizens' needs. Therefore, it is of great practical significance to construct the evaluation system of under-bridge space renewal potential and explore the renewal mode. In this paper, some of the under-bridge spaces in the main urban area of Chongqing are selected as the research object. Through the questionnaire interviews with the users of the built excellent space under the bridge, three types of six levels and twenty-two potential evaluation indexes of "objective demand factor, construction feasibility factor and construction suitability factor" are selected, including six levels of land resources, infrastructure, accessibility, safety, space quality and ecological environment. The analytical hierarchy process and expert scoring method are used to determine the index weight, construct the potential evaluation system of the space under the bridge in high-density urban areas of Chongqing, and explore the direction of renewal and utilization of its suitability. To provide feasible theoretical basis and scientific decision support for the use of under bridge space in the future.

Keywords: high density urban area, potential evaluation, space under bridge, updated using

Procedia PDF Downloads 45

Authors: Jenan Abu Qadourah

Abstract:

With the depletion of traditional fossil resources and the growing human population, it is now more important than ever to reduce our energy usage and harmful emissions. In the Mediterranean region, the intense solar radiation contributes to summertime overheating, which raises energy costs and building carbon footprints, alternatively making it suitable for the installation of solar energy systems. In urban settings, where multi-story structures predominate and roof space is limited, photovoltaic integrated shading devices (PVSD) are a clean solution for building designers. However, incorporating photovoltaic (PV) systems into a building's envelope is a complex procedure that, if not executed correctly, might result in the PV system failing. As a result, potential PVSD design solutions must be assessed based on their overall energy performance from the project's early design stage. Therefore, this paper aims to investigate and compare the possible impact of various PVSDs on the energy performance of new apartments in the Mediterranean region, with a focus on Amman, Jordan. To achieve the research aim, computer simulations were performed to assess and compare the energy performance of different PVSD configurations. Furthermore, an energy index was developed by taking into account all energy aspects, including the building's primary energy demand and the PVSD systems' net energy production. According to the findings, the PVSD system can meet 12% to 43% of the apartment building's electricity needs. By highlighting the potential interest in PVSD systems, this study aids the building designer in producing more energy-efficient buildings and encourages building owners to install PV systems on the façade of their buildings.

Keywords: photovoltaic integrated shading device, solar energy, architecture, energy performance, simulation, overall energy index, Jordan

Procedia PDF Downloads 67

Authors: Majed A. Alsalem

Abstract:

In our contemporary world, literacy is an essential skill that enables students to increase their efficiency in managing the many assignments they receive that require understanding and knowledge of the world around them. In addition, literacy enhances student participation in society improving their ability to learn about the world and interact with others and facilitating the exchange of ideas and sharing of knowledge. Therefore, literacy needs to be studied and understood in its full range of contexts. It should be seen as social and cultural practices with historical, political, and economic implications. This study aims to rebuild and reorganize the instructional designs that have been used for deaf and hard-of-hearing (DHH) students to improve their literacy level. The most critical part of this process is the teachers; therefore, teachers will be the center focus of this study. Teachers’ main job is to increase students’ performance by fostering strategies through collaborative teamwork, higher-order thinking, and effective use of new information technologies. Teachers, as primary leaders in the learning process, should be aware of new strategies, approaches, methods, and frameworks of teaching in order to apply them to their instruction. Literacy from a wider view means acquisition of adequate and relevant reading skills that enable progression in one’s career and lifestyle while keeping up with current and emerging innovations and trends. Moreover, the nature of literacy is changing rapidly. The notion of new literacy changed the traditional meaning of literacy, which is the ability to read and write. New literacy refers to the ability to effectively and critically navigate, evaluate, and create information using a range of digital technologies. The term new literacy has received a lot of attention in the education field over the last few years. New literacy provides multiple ways of engagement, especially to those with disabilities and other diverse learning needs. For example, using a number of online tools in the classroom provides students with disabilities new ways to engage with the content, take in information, and express their understanding of this content. This study will provide teachers with the highest quality of training sessions to meet the needs of DHH students so as to increase their literacy levels. This study will build a platform between regular instructional designs and digital materials that students can interact with. The intervention that will be applied in this study will be to train teachers of DHH to base their instructional designs on the notion of Technology Acceptance Model (TAM) theory. Based on the power analysis that has been done for this study, 98 teachers are needed to be included in this study. This study will choose teachers randomly to increase internal and external validity and to provide a representative sample from the population that this study aims to measure and provide the base for future and further studies. This study is still in process and the initial results are promising by showing how students have engaged with digital books.

Keywords: deaf and hard of hearing, digital books, literacy, technology

Procedia PDF Downloads 476

Authors: Cinzia Federico, Gaetano Giudice, Salvatore Inguaggiato, Marco Liuzzo, Maria Pedone, Fabio Vita, Christoph Kern, Leonardo La Pica, Giovannella Pecoraino, Lorenzo Calderone, Vincenzo Francofonte

Abstract:

The periods of increased fumarolic activity at La Fossa volcano have been characterized, since early 80's, by changes in the gas chemistry and in the output rate of fumaroles. Excepting the direct measurements of the steam output from fumaroles performed from 1983 to 1995, the mass output of the single gas species has been recently measured, with various methods, only sporadically or for short periods. Since 2008, a scanning DOAS system is operating in the Palizzi area for the remote measurement of the in-plume SO₂ flux. On these grounds, the need of a cross-comparison of different methods for the in situ measurement of the output rate of different gas species is envisaged. In 2015, two field campaigns have been carried out, aimed at: 1. The mapping of the concentration of CO₂, H₂S and SO₂ in the fumarolic plume at 1 m from the surface, by using specific open-path diode tunable lasers (GasFinder Boreal Europe Ltd.) and an Active DOAS for SO₂, respectively; these measurements, coupled to simultaneous ultrasonic wind speed and meteorological data, have been elaborated to obtain the dispersion map and the output rate of single species in the overall fumarolic field; 2. The mapping of the concentrations of CO₂, H₂S, SO₂, H₂O in the fumarolic plume at 0.5 m from the soil, by using an integrated system, including IR spectrometers and specific electrochemical sensors; this has provided the concentration ratios of the analysed gas species and their distribution in the fumarolic field; 3. The in-fumarole sampling of vapour and measurement of the steam output, to validate the remote measurements. The dispersion map of CO₂, obtained from the tunable laser measurements, shows a maximum CO₂ concentration at 1m from the soil of 1000 ppmv along the rim, and 1800 ppmv in the inner slopes. As observed, the largest contribution derives from a wide fumarole of the inner-slope, despite its present outlet temperature of 230°C, almost 200°C lower than those measured at the rim fumaroles. Actually, fumaroles in the inner slopes are among those emitting the largest amount of magmatic vapour and, during the 1989-1991 crisis, reached the temperature of 690°C. The estimated CO₂ and H₂S fluxes are 400 t/d and 4.4 t/d, respectively. The coeval SO₂ flux, measured by the scanning DOAS system, is 9±1 t/d. The steam output, recomputed from CO₂ flux measurements, is about 2000 t/d. The various direct and remote methods (as described at points 1-3) have produced coherent results, which encourage to the use of daily and automatic DOAS SO₂ data, coupled with periodic in-plume measurements of different acidic gases, to obtain the total mass rates.

Keywords: DOAS, fumaroles, plume, tunable laser

Procedia PDF Downloads 384

Authors: Aynura Valiyeva, Basil John Thomas

Abstract:

Intra-firm communication is critical for building synergy amongst internal business units of a firm, where employees from various functional departments and ranks incorporate their decision-making, understanding of organizational objectives, as well as common norms and culture for better organizational effectiveness. This study builds on and assesses a framework of the causes and consequences of effective communication in business interactions between customer and supplier firms, and the path for efficient communication within a firm. The proposed study’s structural equation modeling (SEM) analysis based on 352 sample responses collected from firm representatives at different job positions ranging from marketing to logistics operations, reveals that, in the frame of reference of intra-organizational communication, organization characteristics and shared values, top management support and style of leadership, as well as information technology, are all significantly related to communication effectiveness. Furthermore, the frequency and variety of interactions enhance the outcome of communication, that improves a company’s performance. The results reveal that cultural factors are significantly related to communication effectiveness, as well as the shared beliefs and goals. In terms of organizational factors, leadership style, top management support and information technology are significant determinants of effective communication. Among the contextual factors, interaction frequency and diversity are found to be priority factors. This study also tests the relationship between supplier and supplier firm performance in the context of communication effectiveness, and finds that they are closely related, when trust and commitment is built between business partners. When firms do business in other multicultural contexts, language and shared values with destination country must be considered significant elements of communication process.

Keywords: business performance, intra-firm communication, inter-firm communication, structural equation modeling

Procedia PDF Downloads 85

Authors: Yu-Jia Jian, Emily Chia-Yu Su, Hui-Ling Hsu, Jian-Jhih Chen

Abstract:

Coronary artery is the major supplier of myocardial blood flow. When fat and cholesterol are deposit in the coronary arterial wall, narrowing and stenosis of the artery occurs, which may lead to myocardial ischemia and eventually infarction. According to the World Health Organization (WHO), estimated 740 million people have died of coronary heart disease in 2015. According to Statistics from Ministry of Health and Welfare in Taiwan, heart disease (except for hypertensive diseases) ranked the second among the top 10 causes of death from 2013 to 2016, and it still shows a growing trend. According to American Heart Association (AHA), the risk factors for coronary heart disease including: age (> 65 years), sex (men to women with 2:1 ratio), obesity, diabetes, hypertension, hyperlipidemia, smoking, family history, lack of exercise and more. We have collected a dataset of 421 patients from a hospital located in northern Taiwan who received coronary computed tomography (CT) angiography. There were 300 males (71.26%) and 121 females (28.74%), with age ranging from 24 to 92 years, and a mean age of 56.3 years. Prior to coronary CT angiography, basic data of the patients, including age, gender, obesity index (BMI), diastolic blood pressure, systolic blood pressure, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary heart disease and exercise habits, were collected and used as input variables. The output variable of the prediction module is the degree of coronary artery stenosis. The output variable of the prediction module is the narrow constriction of the coronary artery. In this study, the dataset was randomly divided into 80% as training set and 20% as test set. Four machine learning algorithms, including logistic regression, stepwise regression, neural network and decision tree, were incorporated to generate prediction results. We used area under curve (AUC) / accuracy (Acc.) to compare the four models, the best model is neural network, followed by stepwise logistic regression, decision tree, and logistic regression, with 0.68 / 79 %, 0.68 / 74%, 0.65 / 78%, and 0.65 / 74%, respectively. Sensitivity of neural network was 27.3%, specificity was 90.8%, stepwise Logistic regression sensitivity was 18.2%, specificity was 92.3%, decision tree sensitivity was 13.6%, specificity was 100%, logistic regression sensitivity was 27.3%, specificity 89.2%. From the result of this study, we hope to improve the accuracy by improving the module parameters or other methods in the future and we hope to solve the problem of low sensitivity by adjusting the imbalanced proportion of positive and negative data.

Keywords: decision support, computed tomography, coronary artery, machine learning

Procedia PDF Downloads 217

Authors: Francesca Nardi, Kashish Aneja, Katherine Ginsbach

Abstract:

The COVID-19 pandemic has demonstrated both a need for evidence-based and rights-based public health policy and how challenging it can be to make effective decisions with limited information, evidence, and data. The O’Neill Institute, in conjunction with several partners, has been working since the beginning of the pandemic to collect, analyze, and distribute critical data on public health policies enacted in response to COVID-19 around the world in the COVID-19 Law Lab. Well-designed laws and policies can help build strong health systems, implement necessary measures to combat viral transmission, enforce actions that promote public health and safety for everyone, and on the individual level have a direct impact on health outcomes. Poorly designed laws and policies, on the other hand, can fail to achieve the intended results and/or obstruct the realization of fundamental human rights, further disease spread, or cause unintended collateral harms. When done properly, laws can provide the foundation that brings clarity to complexity, embrace nuance, and identifies gaps of uncertainty. However, laws can also shape the societal factors that make disease possible. Law is inseparable from the rest of society, and COVID-19 has exposed just how much laws and policies intersects all facets of society. In the COVID-19 context, evidence-based and well-informed law and policy decisions—made at the right time and in the right place—can and have meant the difference between life or death for many. Having a solid evidentiary base of legal information can promote the understanding of what works well and where, and it can drive resources and action to where they are needed most. We know that legal mechanisms can enable nations to reduce inequities and prepare for emerging threats, like novel pathogens that result in deadly disease outbreaks or antibiotic resistance. The collection and analysis of data on these legal mechanisms is a critical step towards ensuring that legal interventions and legal landscapes are effectively incorporated into more traditional kinds of health science data analyses. The COVID-19 Law Labs see a unique opportunity to collect and analyze this kind of non-traditional data to inform policy using laws and policies from across the globe and across diseases. This global view is critical to assessing the efficacy of policies in a wide range of cultural, economic, and demographic circumstances. The COVID-19 Law Lab is not just a collection of legal texts relating to COVID-19; it is a dataset of concise and actionable legal information that can be used by health researchers, social scientists, academics, human rights advocates, law and policymakers, government decision-makers, and others for cross-disciplinary quantitative and qualitative analysis to identify best practices from this outbreak, and previous ones, to be better prepared for potential future public health events.

Keywords: public health law, surveillance, policy, legal, data

Procedia PDF Downloads 131

Authors: Mustafa Kucukoduk, Evren Yildiztugay, A. Hediye Sekmen, Ismail Turkan, Yavuz Bagci

Abstract:

In this study, physiological and biochemical responses of Centaurea tuzgoluensis, a Turkish endemic halophyte, to salinity were studied. Therefore, the changes in shoot growth, leaf relative water content (RWC), ion concentrations, lipid peroxidation, hydroxyl (OH.) radical scavenging activity, proline (Pro) content, and antioxidant system [superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX) and glutathione reductase (GR)] were investigated. The 60 days (d) old C. tuzgoluensis seedlings were subjected to 0, 150 and 300 mM NaCl for 7 d and 14 d. The relative shoot growth was generally did not change in the 150 mM NaCl, but reduced with 300 mM NaCl stress at 7 d and 14 d. RWC was higher in 150 mM NaCl-treated leaves than that of 300 mM NaCl. Salinity decreased K+/Na+ ratio, but increased Na+, Cl, Ca+2 and Na+/Cl ratio in the leaves. On the other hand, it did not change or increase the K+ content at 150 and 300 mM NaCl, respectively. MDA content in the 150 and 300 mM NaCl-treated leaves remained close to control at 7 d. This was related to enhanced activities of SOD, CAT, APX and GR enzymes, and their isoenzymes especially Fe-SOD in the leaves. On the other hand, the higher sensitivity to 300 mM NaCl at 14 d was associated with inadequate increase in antioxidant enzymes and the decreased OH radical scavenging activity. All these results suggest that C. tuzgoluensis has different antioxidant metabolisms between short- (7 d) and long-term (14 d) salt treatments and salinity tolerance of C. tuzgoluensis might be closely related to increased capacity of antioxidative system to scavenge reactive oxygen species (ROS) and accumulation of osmoprotectant proline under salinity conditions.

Keywords: antioxidant enzymes, endemic halophyte, ion exchange, lipid peroxidation, antioxidant, enzymes, endemic halophyte, ion exchange, lipid peroxidation, proline, Centaurea tuzgoluensis

Procedia PDF Downloads 282

Authors: Yongsheng Guo

Abstract:

This study explores the perceptions and conducts of Chinese foreign direct investment (FDI) in Africa from ethical and cultural perspectives. It offers a better understanding of how ethical and cultural factors affect Chinese investment in Africa and how the investment projects performed in Africa from both Chinese investors and African stakeholders’ perceptions. It adopted a grounded theory approach and conducted 30 in-depth interviews with corporate managers. Grounded theory models are developed to link the ethical and cultural factors, actions, and consequences. Results reveal that some ethical concepts like the unity of humans and nature, benevolence, virtue and responsibility, and cultural traits including propriety, righteousness, sincerity, equilibrium, long-term orientation, and principles affect Chinese investors when making investments in Africa. Most Chinese investors harmonize with local managers, cooperate with each other, and are gentle and courteous to partners. They take stable and steady actions and invest in infrastructure and agriculture projects and adopt a virtue governance system in the organization. This study finds that consequently, Chinese investors and local partners take complementary advantages, make achievements sequentially, and therefore both sides can win. They recognize great potentials and make sustainable development in Africa to achieve the Great Together in the future. This study proposes a Chinese ethics and governance system including economic, social, and political perspectives and compares it with alternative systems. It makes implications to the world island theory and propose suggestions to solve the Clash of Civilizations problem.

Keywords: foreign direct investment, ethics, national culture, China, Africa

Procedia PDF Downloads 65

Authors: Ahmed Elaksher

Abstract:

Over the last few years, significant progresses have been made and new approaches have been proposed for efficient collection of 3D spatial data from Unmanned aerial vehicles (UAVs) with reduced costs compared to imagery from satellite or manned aircraft. In these systems, a low-cost GPS unit provides the position, velocity of the vehicle, a low-quality inertial measurement unit (IMU) determines its orientation, and off-the-shelf cameras capture the images. Structure from Motion (SfM) and photogrammetry are the main tools for 3D surface reconstruction from images collected by these systems. Unlike traditional techniques, SfM allows the computation of calibration parameters using point correspondences across images without performing a rigorous laboratory or field calibration process and it is more flexible in that it does not require consistent image overlap or same rotation angles between successive photos. These benefits make SfM ideal for UAVs aerial mapping. In this paper, a direct comparison between SfM Digital Elevation Models (DEM) and those generated through traditional photogrammetric techniques was performed. Data was collected by a 3DR IRIS+ Quadcopter with a Canon PowerShot S100 digital camera. Twenty ground control points were randomly distributed on the ground and surveyed with a total station in a local coordinate system. Images were collected from an altitude of 30 meters with a ground resolution of nine mm/pixel. Data was processed with PhotoScan, VisualSFM, Imagine Photogrammetry, and a photogrammetric algorithm developed by the author. The algorithm starts with performing a laboratory camera calibration then the acquired imagery undergoes an orientation procedure to determine the cameras’ positions and orientations. After the orientation is attained, correlation based image matching is conducted to automatically generate three-dimensional surface models followed by a refining step using sub-pixel image information for high matching accuracy. Tests with different number and configurations of the control points were conducted. Camera calibration parameters estimated from commercial software and those obtained with laboratory procedures were comparable. Exposure station positions were within less than few centimeters and insignificant differences, within less than three seconds, among orientation angles were found. DEM differencing was performed between generated DEMs and few centimeters vertical shifts were found.

Keywords: UAV, photogrammetry, SfM, DEM

Procedia PDF Downloads 274

Authors: Peter Olasupo Ogunjuyigbe, Sarafa Shittu

Abstract:

This paper emphasizes the relevance of conjugal relationship and spousal communication towards enhancing men’s involvement in contraceptive use among the Yorubas of South Western Nigeria. An understanding of males influence and the role they play in reproductive decision making can throw better light on mechanisms through which egalitarianness of husband/wife decision making influences contraceptive use. The objective of this study was to investigate how close conjugal relationships can be a good indicator of joint decision making among couples using data derived from a survey conducted in three states of South Western Nigeria. The study sample consisted of five hundred and twenty one (521) male respondents aged 15-59 years and five hundred and forty seven (547) female respondents aged 15-49 years. The study used both quantitative and qualitative approached to elicit information from the respondents. In order that the study would be truly representative of the towns, each of the study locations in the capital cities was divided into four strata: The traditional area, the migrant area, the mixed area (i.e. traditional and migrant), and the elite area. In the rural areas, selection of the respondents was by simple random sampling technique. However, the random selection was made in such a way that all the different parts of the locations were represented. Generally, the data collected were analysed at univariate, bivariate, and multivariate levels. Logistic regression models were employed to examine the interrelationships between male reproductive behaviour, conjugal relationship and contraceptive use. The study indicates that current use of contraceptive is high among this major ethnic group in Nigeria because of the improved level of communication among couples. The problem, however, is that men still have lower exposure rate when it comes to question of family planning information, education and counseling. This has serious implications on fertility regulation in Nigeria.

Keywords: behavior, conjugal, communication, counseling, spouse

Procedia PDF Downloads 124

Authors: Tania Vazquez, Aida Huerta

Abstract:

Way to get our food has changed over the time, and it is a daily necessity. Nowadays we found a lot of problems involved with the economy, environment, and society, which affect the agrifood system. Some problems as construction of big cities and growing population have been increasing demand food directly. Due to the countryside are far away from the city, another alternative systems have come from, such as Urban Agriculture (UA). UA system offers food production into the cities, products with characteristics as quality, healthy and good prices, close to the customers, recycling culture and the promote environmental education. Last years in Mexico City urban gardens have taken strongly in various politic delegations. There are establishment’s public and private initiatives. Moreover, these places have had different issues like low income, many activities, few workers, low production, lack of training and advice, devaluation of your work and low sales, all these shortcomings generate the devaluation of their work. The aim of this paper is to evaluate a business plan in Mexico City´s urban gardens that contribute to ensuring economic, environmental and social sustainability; to adjust business plan for this places so that they reach viability over time. As a part of soft systems methodology developed of Peter Checkland, we interviewed owners of urban gardens and we found that recurring problem was lack planning manager activities and a master plan about their business. We evaluate the business plan based on “Ten principles in sustainable food value chain development” proposed for Food and Agriculture Organization of the United Nations (FAO). With this study was possible measure, understand and improve performance of business plan in the three pillars of the sustainability in addition to this it allowed us to fit in with the needs of urban gardens.

Keywords: business plan, Mexico City, urban agriculture, urban gardens

Procedia PDF Downloads 383

Authors: J. N. Nackler, K. Saleh Pascha, W. Winter

Abstract:

WHISCERS™ (Whole House In-Situ Carbon and Energy Reduction Solution) is an innovative process for Internal Wall Insulation (IWI) for energy-efficient retrofitting of heritage building, which uses laser measuring to determine the dimensions of a room, off-site insulation board cutting and rapid installation to complete the process. As part of a multinational investigation consortium the Austrian part adapted the WHISCERS system to local conditions of Vienna where most historical buildings have valuable stucco facades, precluding the application of an external insulation. The Austrian project contribution addresses the replacement of commonly used extruded polystyrene foam (XPS) with renewable materials such as wood and wood products to develop a more sustainable IWI system. As the timber industry is a major industry in Austria, a new innovative and more sustainable IWI solution could also open up new markets. The first approach of investigation was the Life Cycle Assessment (LCA) to define the performance of wood fibre board as insulation material in comparison to normally used XPS-boards. As one of the results the global-warming potential (GWP) of wood-fibre-board is 15 times less the equivalent to carbon dioxide while in the case of XPS it´s 72 times more. The hygrothermal simulation program WUFI was used to evaluate and simulate heat and moisture transport in multi-layer building components of the developed IWI solution. The results of the simulations prove in examined boundary conditions of selected representative brickwork constructions to be functional and usable without risk regarding vapour diffusion and liquid transport in proposed IWI. In a further stage three different solutions were developed and tested (1 - glued/mortared, 2 - with soft board, connected to wall with gypsum board as top layer, 3 - with soft board and clay board as top layer). All three solutions presents a flexible insulation layer out of wood fibre towards the existing wall, thus compensating irregularities of the wall surface. From first considerations at the beginning of the development phase, three different systems had been developed and optimized according to assembly technology and tested as small specimen in real object conditions. The built prototypes are monitored to detect performance and building physics problems and to validate the results of the computer simulation model. This paper illustrates the development and application of the Internal Wall Insulation system.

Keywords: internal insulation, wood fibre, hygrothermal simulations, monitoring, clay, condensate

Procedia PDF Downloads 206

Authors: Subodh Nath Patel, Raja Raman, Mananshi Adhikary, Jitendra Mathur, Sandip Bhattacharyya

Abstract:

The composition adjustment by sealed argon bubbling–oxygen blowing (CAS-OB) process is a process designed for adjusting steel composition and temperature during secondary metallurgy. One of the equipment in the said process is a snorkel or bell, fixed to a movable bracket. Snorkel serves the purpose of feeding ferroalloys into the liquid metal simultaneously removing gases to the gas cleaning system through its port at its top. The bell-shaped snorkel consists of two parts. The upper part has an inside liner, and the lower part is lined on both side with high-alumina castable reinforced with 2% stainless steel needles. Both the parts are coupled with a flange bolt system. These flanges were found to get buckled during operation, and the gap was generating between them. This problem was chronic since its. It was expected to give a life of 80 heats, but it was failing within 45-50 heats. After every 25-30 heats, it had to be repaired by changing and/or tightening its nuts and bolts. Visual observation, microstructural analysis through optical microscopes and SEM, hardness measurement and thermal strain calculation were carried out to find out the root cause of this problem. The calculated thermal strain was compared with actual thermal strain; comparison of the two revealed that thermal strain was responsible for buckling. Finite element analysis (FEA) was carried out to reaffirm the effect temperature on the flanges. FEA was also used in the modification in the design of snorkel flange to accommodate thermal strain. Thermal insulation was also recommended which increased its life from 45 heats to 65 heats, impacting business process positively.

Keywords: CAS OB process, finite element analysis, snorkel, thermal strain

Procedia PDF Downloads 125

Authors: Ehsan Ahmed Yahia

Abstract:

Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

Procedia PDF Downloads 88

Authors: Fatma Koksal Çakirlar, Si̇nem Ozdemir, Selcan Akyol, Revazi̇ye Gulesen, Murat Gunaydin, Nevri̇ye Gonullu, Belkis Levent, Nuri̇ Kiraz

Abstract:

Vibrio cholerae O1 and O139 are the causative agent of epidemic or pandemic cholera. V. cholerae O1 is generally accepted as a non-invasive enterotoxigenic organism causing gastroenteritis of various severities. Non-O1 V. cholerae can cause small outbreaks of diarrhea due to consumption of contaminated food and water. Particularly, the patients with achlorydria have a risk for vibrio infections. There are numerous case reports of bacteremia caused by vibrio in patients with predisposing conditions like cirrhosis, nephrotic syndrome, diabetes, hematologic malignancy, gastrectomy, and AIDS. We described in this study the first case of nontoxigenic, non-01/non-O139 V. cholerae isolated from the blood culture of a 77-year-old female patient with hipertension, diabetes, coronary artery disease, gout and about 9 years ago migrated breast cancer history. The patient with complaints of shortness of breath, fever and malaise admitted to our emergency clinic were evaluated. There was no diarrhea or abdominal symptoms in the patient. No growth in her urine culture, but blood culture (BACTEC 9120 system, Becton Dickinson, USA) was positive for non-01/non-O139 V. cholerae that was identified by conventional methods and Phoenix automated system (BD Diagnostic Systems, Sparks, MD). It does not secrete the cholera toxin. The agglutination test was negative with polyvalent O1 antisera and O139 antiserum. Empirically ceftriaxone was administered to the patient and she was discharged with improvement in general condition. In this study we report bacteremia by non-01/non-O139 V. cholerae that is rare in the worldwide and first in Turkey.

Keywords: bacteremia, blood culture, immunocompromised patient, Non-O1 vibrio cholerae

Procedia PDF Downloads 204

Authors: D. M. Lewis, L. Frisby, U. Stead

Abstract:

Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

Procedia PDF Downloads 90