Search results for: clinical decision support systems

Authors: Matthew Montebello

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Student engagement within a virtual learning environment generates masses of data points that can significantly contribute to the learning analytics that lead to decision support. Ideally, similar data is collected during student interaction with a physical learning space, and as a consequence, data is present at a large scale, even in relatively small classes. In this paper, we report of such an occurrence during classes held in a HiFlex modality as we investigate the advantages of adopting such a methodology. We plan to take full advantage of the learner-generated data in an attempt to further enhance the effectiveness of the adopted learning environment. This could shed crucial light on operating modalities that higher education institutions around the world will switch to in a post-COVID era.

Keywords: HiFlex, big data in higher education, learning analytics, virtual learning environment

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Authors: Dorcas I. Adeoye

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Disclosure experience of people living with HIV/AIDS has been a public health concern, it has also been attributed to effective way of limiting the spread of the disease. However, among working people living with HIV, it is a great issue that attracts several consequences, it is also a way of managing HIV and balancing their emotional, physical and social aspect of life. The economic, social and political aspect has been affected since the emergent of HIV. It is also not a medical problem that only needs a medical approach; it is a psychological problem that needs not to be ignored. Work attitude model and consequential theory were used to understanding the experience of disclosure or non-disclosure in the workplace. Work attitude model explains the job satisfaction and the organisational commitment of an employee that have effect on the decision and well-being in the workplace; it can also influence a decision to disclosure one’s health condition, however, consequential theory comes to play when a decision is being made, either to disclose or not, and that will attract consequences (either negative or positive) in which ever decision made. A phenomenological study was conducted among employed people that are infected with HIV/AIDS in a south-eastern region of Nigeria where unemployment rate is high. A one-to-one semi-structured interview was used to gather in-depth information about the experience of 20 working people living with HIV. Participants were recruited in a hospital and for some, hospital serves as their workplace. The outcome of the research shows that participants’ experiences vary. One thing that stood out and was found similar among all participants including participants that have disclosed, planning to disclose, or never intended to disclose, is that workplace is a place not to be trusted despite the positive outcomes disclosure could give in the workplace, and disclosure decision needs to be carefully taken. The study was concluded with recommendations that cover various aspects; however, clearer policies should be followed by all organisations to protect people living with HIV in the workplace.

Keywords: disclosure, employment, HIV/AIDS, Nigeria, workplace

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Authors: Sevinj Asgarova

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Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

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Authors: Tappei Yotsumoto, Atsushi Nomura, Kozo Tanigawa, Kenichi Takahashi, Takao Kawamura, Kazunori Sugahara

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In a human tracking system, expanding a monitoring range of one system is complicating the management of devices and increasing its cost. Therefore, we propose a method to realize a wide-range human tracking by connecting small systems. In this paper, we examined an agent deploy method and information contents across the heterogeneous human tracking systems. By implementing the proposed method, we can construct a human tracking system across heterogeneous systems, and the system can track a target continuously between systems.

Keywords: human tracking system, mobile agent, monitoring, heterogeneous systems

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Authors: Yeonjeong Lee, Kyoung-jae Kim, Youngtae Kim

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This study proposes a novel recommender system that uses data mining and multi-model ensemble techniques to enhance the recommendation performance through reflecting the precise user’s preference. The proposed model consists of two steps. In the first step, this study uses logistic regression, decision trees, and artificial neural networks to predict customers who have high likelihood to purchase products in each product group. Then, this study combines the results of each predictor using the multi-model ensemble techniques such as bagging and bumping. In the second step, this study uses the market basket analysis to extract association rules for co-purchased products. Finally, the system selects customers who have high likelihood to purchase products in each product group and recommends proper products from same or different product groups to them through above two steps. We test the usability of the proposed system by using prototype and real-world transaction and profile data. In addition, we survey about user satisfaction for the recommended product list from the proposed system and the randomly selected product lists. The results also show that the proposed system may be useful in real-world online shopping store.

Keywords: product recommender system, ensemble technique, association rules, decision tree, artificial neural networks

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Authors: A. Gagat-Matuła

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The article is concerned in the issue of social support and quality of life of youth suffering from cerebral palsy, who are temporarily orphaned due to the emigration of a parent. Migration causes multi-aspect consequences in various spheres of life. They are particularly severe for the functioning of families. Temporal parting of parents and children, especially the disabled, is a difficult situation. In this case, the family structure is changed, as well as the quality of life of its members. Children can handle migration parting in a better or worse way; these can be divided into properly functioning and manifesting behaviour disorders. In conditions of the progressing phenomenon of labour migration of Poles and a wide spectrum of consequences for the whole social life, it is essential to undertake actions aimed at support of migrants and their families. This article focuses mainly on social support and quality of families members, of which, are the labour migrants perceived by youth suffering from cerebral palsy. The quantitative method was used in this study. In the study, the Satisfaction with Life Scale (SWLS) by Diener, was used. The analysed group consisted of 50 persons (37 girls and 13 boys), aged 16 years to 18 years, whose parents are labour migrants. The results indicate that the quality of life and social support for youth suffering from cerebral palsy who are temporarily orphaned is at a low and average level.

Keywords: social support, quality of life, migration, cerebral palsy

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Authors: G. M. B. P. Abeysekara, W. A. D. C. Wijerathna

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Terminal choice from the multiple terminals region is not a simple decision and it is very complex, because shipping lines should consider on influential factors for the terminal choice at once according to their requirement. Therefore, terminal choice is a multiple criterion decision making (MCDM) situation under a specially designed decision hierarchy. Identification of perspective of shipping lines regarding terminal choice is vital important for the decision makers regarding container terminals. Thus this study is evaluated perception on main and feeder shipping lines’ regarding port of Colombo container terminals, and ranked terminals according to shipping lines preference. Analytic Hierarchy Process (AHP) model is adapted to this study, since it has features similar to the MCDM, it is weighted every influential factor by using pair wise comparisons, and consistency of the decision makers’ judgments are checked to evaluate trustworthiness of gathered data. And rating method is used to rank the terminals within Port of Colombo by assigning particular preference values with respect to the criteria and sub criteria. According to the findings of this study, main lines’ mainly concern on water depth of approach channel, depth of berth, handling charges and handling equipment facilities. And feeder lines’ main concerns were handling equipment facilities, loading and discharging efficiency, depth of berth and handling charges. Findings of the study suggested concentrating regarding the emphasized areas in order to enhance the competitiveness of terminals, and to increase number of vessel callings at the Port of Colombo. Application of above finding of the terminals within Port of Colombo lead to a far better competition among terminals and would uplift the overall level of services.

Keywords: AHP, Main and feeder shipping lines, criteria, sub criteria

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Authors: Claire Williams

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Randomised controlled Trials (RCTs) of efficacy are still perceived as the gold standard for the generation of evidence, and whilst advances in data collection methods are well developed, this progress has not been matched for the reporting of adverse events (AEs). Assessment and reporting of AEs in clinical trials are fraught with human error and inefficiency and are extremely time and resource intensive. Recent research conducted into the quality of reporting of AEs during clinical trials concluded it is substandard and reporting is inconsistent. Investigators commonly send reports to sponsors who are incorrectly categorised and lacking in critical information, which can complicate the detection of valid safety signals. In our presentation, we will describe an electronic data capture system, which has been designed to support clinical trial processes by reducing the resource burden on investigators, improving overall trial efficiencies, and making trials safer for patients. This proprietary technology was developed using expertise proven in the delivery of the world’s first prospective, phase 3b real-world trial, ‘The Salford Lung Study, ’ which enabled robust safety monitoring and reporting processes to be accomplished by the remote monitoring of patients’ EHRs. This technology enables safety alerts that are pre-defined by the protocol to be detected from the data extracted directly from the patients EHR. Based on study-specific criteria, which are created from the standard definition of a serious adverse event (SAE) and the safety profile of the medicinal product, the system alerts the investigator or study team to the safety alert. Each safety alert will require a clinical review by the investigator or delegate; examples of the types of alerts include hospital admission, death, hepatotoxicity, neutropenia, and acute renal failure. This is achieved in near real-time; safety alerts can be reviewed along with any additional information available to determine whether they meet the protocol-defined criteria for reporting or withdrawal. This active surveillance technology helps reduce the resource burden of the more traditional methods of AE detection for the investigators and study teams and can help eliminate reporting bias. Integration of multiple healthcare data sources enables much more complete and accurate safety data to be collected as part of a trial and can also provide an opportunity to evaluate a drug’s safety profile long-term, in post-trial follow-up. By utilising this robust and proven method for safety monitoring and reporting, a much higher risk of patient cohorts can be enrolled into trials, thus promoting inclusivity and diversity. Broadening eligibility criteria and adopting more inclusive recruitment practices in the later stages of drug development will increase the ability to understand the medicinal products risk-benefit profile across the patient population that is likely to use the product in clinical practice. Furthermore, this ground-breaking approach to AE detection not only provides sponsors with better-quality safety data for their products, but it reduces the resource burden on the investigator and study teams. With the data taken directly from the source, trial costs are reduced, with minimal data validation required and near real-time reporting enables safety concerns and signals to be detected more quickly than in a traditional RCT.

Keywords: more comprehensive and accurate safety data, near real-time safety alerts, reduced resource burden, safer trials

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Authors: Sareh Rajabi, Taha Anjamrooz, Salwa Bheiry

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The continuous increase in the world population, resource shortage and the warning of climate change cause various environmental and social issues to the world. Thus, sustainability concept is much needed nowadays. Organizations are progressively falling under strong worldwide pressure to integrate sustainability practices into their project decision-making development. Construction projects in the industry are amongst the most significant, since it is one of the biggest divisions and of main significance for the national economy and hence has a massive effect on the environment and society. So, it is important to discover approaches to incorporate sustainability into the management of those projects. This study presents a combined sustainability index of projects with sustainable transportation which has been formed as per a comprehensive literature review and survey study. Transportation systems enable the movement of goods and services worldwide, and it is leading to economic growth and creating jobs while creating negative impacts on the environment and society. This research is study to quantify the sustainability indicators, through 1) identifying the importance of sustainable transportation indicators that are based on the sustainable practices used for the construction projects and 2) measure the effectiveness of practices through these indicators on the three sustainable pillars. A total 26 sustainability indicators have been selected and grouped under each related sustainability pillars. A survey was used to collect the opinion about the sustainability indicators by a scoring system. A combined sustainability index considering three sustainable pillars can be helpful in evaluating the transportation sustainable practices of a project and making decisions regarding project selection. In addition to focus on the issue of financial resource allocation in a project selection, the decision-maker could take into account the sustainability as an important key in addition to the project’s return and risk. The purpose of this study is to measure the performance of transportation sustainability which allow companies to assess multiple projects selection. This is useful to decision makers to rank and focus more on future sustainable projects.

Keywords: sustainable transportation, transportation performances, sustainable indicators, sustainable construction practice, sustainability

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Authors: Ibrahim A. Al-Sulaihi, Khalid S. Al-Gahtani, Abdullah M. Al-Sugair, Aref A. Abadel

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Achieving environmental sustainability is one of the important issues considered in many countries’ vision. Green/Sustainable building is widely used terminology for describing a friendly environmental construction. Applying sustainable practices has a significant importance in various fields, including construction field that consumes an enormous amount of resource and causes a considerable amount of waste. The need for sustainability is increased in the regions that suffering from the limitation of natural resource and extreme weather conditions such as Saudi Arabia. Since buildings designs are getting sophisticated, the need for tools, which support decision-making for sustainability issues, is increasing, especially in the design and preconstruction stages. In this context, Building Information Modeling (BIM) can aid in performing complex building performance analyses to ensure an optimized sustainable building design. Accordingly, this paper introduces a roadmap towards developing a systematic approach for presenting the sustainability of buildings using BIM. The approach includes set of main processes including; identifying the sustainability parameters that can be used for sustainability assessment in Saudi Arabia, developing sustainability assessment method that fits the special circumstances in the Kingdom, identifying the sustainability requirements and BIM functions that can be used for satisfying these requirements, and integrating these requirements with identified functions. As a result, the sustainability-BIM approach can be developed which helps designers in assessing the sustainability and exploring different design alternatives at the early stage of the construction project.

Keywords: green buildings, sustainability, BIM, rating systems, environment, Saudi Arabia

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Authors: Mikel Alonso López

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The early eighties saw the rise of a new research trend in several prestigious journals, mainly articles that related emotions with the decision-making processes of the consumer, and stopped treating them as external elements. That is why we ask questions such as: what are emotions? Are there different types of emotions? What components do they have? Which theories exist about them? In this study, we will review the main theories and components of emotion analysing the cognitive factor and the different emotional states that are generally recognizable with a focus in the classic debate as to whether they occur before the cognitive process or the affective process.

Keywords: emotion, consumer behaviour, feelings, decision making

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Authors: Shivakumar M, Leslie Edward S Lewis, Shashikala Devadiga, Sonia Khurana

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Introduction: Methylxanthines are used for the treatment of AOP, to facilitate extubation and as a prophylactic agent to prevent apnea. Though the popularity of Caffeine has risen, it is expensive in a resource constrained developing countries like India. Objective: To evaluate the cost-effectiveness of Caffeine compared with Aminophylline treatment for AOP with respect to additional ventilatory resource utilized in different birth weight categorization. Design, Settings and Participants – Single centered, retrospective economic evaluation was done. Participants included preterm newborns with < 34 completed weeks of gestation age that were recruited under an Indian Council of Medical Research funded randomized clinical trial. Per protocol data was included from Neonatal Intensive Care Unit, Kasturba Hospital, Manipal, India between April 2012 and December 2014. Exposure: Preterm neonates were randomly allocated to either Caffeine or Aminophylline as per the trial protocol. Outcomes and Measures – We assessed surfactant requirement, duration of Invasive and Non-Invasive Ventilation, Total Methylxanthine cost and additional cost for respiratory support bared by the payers per day during hospital stay. For the purpose of this study Newborns were stratified as Category A – < 1000g, Category B – 1001 to 1500g and Category C – 1501 to 2500g. Results: Total 146 (Caffeine -72 and Aminophylline – 74) babies with Mean ± SD gestation age of 29.63 ± 1.89 weeks were assessed. 32.19% constitute of Category A, 55.48% were B and 12.33% were C. The difference in median duration of additional NIV and IMV support was statistically insignificant. However 60% of neonates who received Caffeine required additional surfactant therapy (p=0.02). The total median (IQR) cost of Caffeine was significantly high with Rs.10535 (Q3-6317.50, Q1-15992.50) where against Aminophylline cost was Rs.352 (Q3-236, Q1-709) (p < 0.001). The additional costs spent on respiratory support per day in neonates on either Methylxanthines were found to be statistically insignificant in the entire weight based category of our study. Whereas in Category B, the median O2 charges per day were found to have more in Caffeine treated newborns (p=0.05) with border line significance. In category A, providing one day NIV or IMV support significantly increases the unit log cost of Caffeine by 13.6% (CI – 95% ranging from 4 to 24; p=0.005) over log cost of Aminophylline. Conclusion: Cost of Caffeine is expensive than Aminophylline. It was found to be equally efficacious in reducing the number duration of NIV or IMV support. However adjusted with the NIV and IMV days of support, neonates fall in category A and category B who were on Caffeine pays excess amount of respiratory charges per day over aminophylline. In perspective of resource poor settings Aminophylline is cost saving and economically approachable.

Keywords: methylxanthines include caffeine and aminophylline, AOP (apnea of prematurity), IMV (invasive mechanical ventilation), NIV (non invasive ventilation), category a – <1000g, category b – 1001 to 1500g and category c – 1501 to 2500g

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Authors: Hussah Alotaishan

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In today’s globally-driven modern cities diverse groups of new visitors face various challenges when attempting to find their desired location if culture and language are barriers. The most common way-showing tools such as directional and identificational signs are the most problematic and their usefulness can be limited or even non-existent. It is argued new methods should be implemented that could support or replace such conventional literacy and language dependent way-finding aids. It has been concluded in recent research studies that local urban features in complex pedestrian spaces are worthy of further study in order to reveal if they do function as way-showing clues. Some researchers propose a more comprehensive approach to the complex perception of buildings, façade design and surface patterns, while some have been questioning whether we necessarily need directional signs or can other methods deliver the same message but in a clearer manner for a wider range of users. This study aimed to test to what extent do existent environmental and urban features through the city center area of Swansea in the UK facilitate the way-finding process of a first time visitor. The three-hour experiment was set to attempt to find 11 visitor attractions ranging from recreational, historical, educational and religious locations. The challenge was attempting to find as many as possible when no prior geographical knowledge of their whereabouts was established. The only clues were 11 pictures representing each of the locations that had been acquired from the city of Swansea official website. An iPhone and a heart-rate tracker wristwatch were used to record the route was taken and stress levels, and take record photographs of destinations or decision-making points throughout the journey. This paper addresses: current limitations in understanding the ways that the physical environment can be intentionally deployed to facilitate pedestrians while finding their way around, without or with a reduction in language dependent signage; investigates visitor perceptions of their surroundings by indicating what urban elements manifested an impact on the way-finding process. The initial findings support the view that building facades and street features, such as width, could facilitate the decision-making process if strategically employed. However, more importantly, the anticipated features of a specific place construed from a promotional picture can also be misleading and create confusion that may lead to getting lost.

Keywords: pedestrian way-finding, environmental features, urban way-showing, environmental affordance

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Authors: T. S. Sowmya Bhaskaran, Shekhar Seshadri

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This study aims to study the clinical features of with a history of Child Sexual Abuse (CSA). A chart review of 40 children (<16 years) with history of CSA evaluated at the Department of Child and Adolescent Psychiatry of NIMHANS during a two year period was performed. Results:The most common form of abuse was contact penetrative abuse (65%) followed by non-contact penetrative abuse (32.5%). 75% (N=30) had a psychiatric diagnosis at baseline. 50% of these children had one or more psychiatric comorbidities. Anxiety disorder was the most common diagnosis (27.5%) which included PTSD (11%) followed by Depressive disorder (25.2%). Children abused by multiple perpetrators were found to be more likely to have depression, to having a comorbid psychiatric disorder and more prone to exhibit sexualized behaviour. Children who also experienced physical violence at home were more likely to develop psychiatric illness following child sexual abuse. Psychiatric morbidity is high in clinic population of children with history of CSA. It is important to increase the awareness regarding the consequences of CSA in order to increase help seeking.

Keywords: child sexual abuse, India, tertiary care centre, clinical characteristics

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Authors: Preeti Nakhat, Neeta Sinha

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Career plays an indispensable role in shaping one’s outlook on life. Choosing right career adds 'feathers to the life' whereas wrong career decision 'takes a toll 'in one’s life. It is pivotal for the students to know the career opportunities related to their field where they can escalate and excel. With the aim to comprehend certainty and indecisiveness in career decision among college students, a study will be conducted. The study focuses to gain insight on decisiveness and indecisiveness of career among the students. The hypotheses for the study are (1) There is no relation between the medium of education (vernacular/English medium) and career decisiveness among the college students. (2) There is no relation between the faculty(science, commerce, arts)chosen and career decisiveness. (3)There is no relation between father’s qualification and career decisiveness. To test the aforementioned hypotheses, a survey questionnaire will be used. The questionnaire is 'Career decision scale' by Samuel H. Osipow. This study will include 200 college going students. The data will be collected from first, second, third, and fourth year students. Statistical analysis of the data collected with be done through SPSS/Excel calculation and then the hypotheses will be tested.

Keywords: career decisiveness, career indecisiveness, college students, career

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Authors: Maria Janet, Anita David, P. Vijayasamundeeswarimaria

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Introduction: The main purpose of this study is to compare the effectiveness of web-based and blended learning on Paediatric Basic Life Support on competency among undergraduate nursing students in selected nursing colleges in Chennai. Materials and methods: A descriptive pre-test and post-test study design were used for this study. Samples of 100 Fourth year B.Sc., nursing students at Sri Ramachandra Faculty of Nursing SRIHER, Chennai, 100 Fourth year B.Sc., nursing students at Apollo College of Nursing, Chennai, were selected by purposive sampling technique. The instrument used for data collection was Knowledge Questionnaire on Paediatric Basic Life Support (PBLS). It consists of 29 questions on the general expansion of Basic Life Support and Cardiopulmonary Resuscitation, Prerequisites of Basic Life Support, and Knowledge on Paediatric Basic Life Support in which each question has four multiple choices answers, each right answer carrying one mark and no negative scoring. This questionnaire was formed with reference to AHA 2020 (American Heart Association) revised guidelines. Results: After the post-test, in the web-based learning group, 58.8% of the students had an inadequate level of objective performance score, while 41.1% of them had an adequate level of objective performance score. In the blended learning group, 26.5% of the students had an inadequate level of an objective performance score, and 73.4% of the students had an adequate level of an objective performance score. There was an association between the post-test level of knowledge and the demographic variables of undergraduate nursing students undergoing blended learning. The age was significant at a p-value of 0.01, and the performance of BLS before was significant at a p-value of 0.05. The results show that there was a significant positive correlation between knowledge and objective performance score of undergraduate nursing students undergoing web-based learning on paediatric basic life support.

Keywords: basic life support, paediatric basic life support, web-based learning, blended learning

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Authors: Teresa Leary Handy

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As awareness of the importance of diversity has increased in society, higher education has also begun to recognize the importance of supporting faculty of color. In the university setting, faculty women of color specifically encounter barriers that impact their level of job satisfaction, retention rates, and pedagogical practices. These barriers and challenges not only undermine faculty diversity efforts but also hinder the ability of colleges and universities to provide a supportive environment that fosters students' academic success and sense of belonging. Faculty who are marginalized and on the periphery in higher education institutions need support so that they can feel confident in building a student’s sense of belonging which can impact a student’s academic success and goal of earning a college degree. This study examined and sought to understand the importance of supporting faculty of color, specifically women faculty of color, and how this type of faculty support can impact student academic success and a student’s sense of belonging. The study furthered original research on strategies to move an institution forward on the equity spectrum to support belonging and inclusions as core culture elements.

Keywords: equity, inclusion, belonging, women, faculty support

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Authors: Mohammad H. Yarmohammadian, Fatemeh Rezaei

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Introduction: Improving patient safety in health systems is one of the main priorities in healthcare systems, so clinical risk management in organizations has become increasingly significant. Although several tools have been developed for clinical risk management, each has its own limitations. Aims: This study aims to develop a comprehensive tool that can complete the limitations of each risk assessment and management tools with the advantage of other tools. Methods: Procedure was determined in two main stages included development of an initial model during meetings with the professors and literature review, then implementation and verification of final model. Subjects and Methods: This study is a quantitative − qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment of the two parts of the fourth phase and seven phases of the research was conducted. Purposive and stratification sampling of various responsible teams for the selected process was conducted in the operating room. Final model verified in eight phases through application of activity breakdown structure, failure mode and effects analysis (FMEA), healthcare risk priority number (RPN), root cause analysis (RCA), FT, and Eindhoven Classification model (ECM) tools. This model has been conducted typically on patients admitted in a day-clinic ward of a public hospital for surgery in October 2012 to June. Statistical Analysis Used: Qualitative data analysis was done through content analysis and quantitative analysis done through checklist and edited RPN tables. Results: After verification the final model in eight-step, patient's admission process for surgery was developed by focus discussion group (FDG) members in five main phases. Then with adopted methodology of FMEA, 85 failure modes along with its causes, effects, and preventive capabilities was set in the tables. Developed tables to calculate RPN index contain three criteria for severity, two criteria for probability, and two criteria for preventability. Tree failure modes were above determined significant risk limitation (RPN > 250). After a 3-month period, patient's misidentification incidents were the most frequent reported events. Each RPN criterion of misidentification events compared and found that various RPN number for tree misidentification reported events could be determine against predicted score in previous phase. Identified root causes through fault tree categorized with ECM. Wrong side surgery event was selected by focus discussion group to purpose improvement action. The most important causes were lack of planning for number and priority of surgical procedures. After prioritization of the suggested interventions, computerized registration system in health information system (HIS) was adopted to prepare the action plan in the final phase. Conclusion: Complexity of health care industry requires risk managers to have a multifaceted vision. Therefore, applying only one of retrospective or prospective tools for risk management does not work and each organization must provide conditions for potential application of these methods in its organization. The results of this study showed that the integrated clinical risk management model can be used in hospitals as an efficient tool in order to improve clinical governance.

Keywords: failure modes and effective analysis, risk management, root cause analysis, model

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Authors: Helen Nelly Naiga, Christopher Garimoi Orach

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Introduction: Long-acting reversible contraceptive (LARC) methods are highly effective. However, LARC use in Uganda is low (13%). We assessed the factors associated with the use of long-acting reversible contraceptives among women of reproductive age (15-49 yrs) in Jinja District. Methods: We conducted a facility-based cross-sectional study. A total of 314 women aged 15–49 years attending public health facilities (1 hospital and 3 health center IV) in Jinja district, were randomly selected. A total of 6 key informants and 6 in-depth interviews were conducted. Logistic regression analysis was conducted using Stata version 14. Qualitative data were analysed using thematic analysis. Results: The study found that 40.45% of the respondents had ever used LARC. The commonest LARC method used was implanting (38.22%). The factors significantly associated with use of LARC were employment (AOR =2.91; 95% CI (1.05-8.08), access to LARC methods (AOR =4.48; 95% CI (1.24-16.21), husband support (AOR =4.90; 95% CI (1.56-15.41), and experience of no side effects (AOR =3.48; 95% CI (1.00-12.19). Conclusion and recommendations: The study showed that 4 in 10 women of reproductive age in Jinja District were using LARC. The factors associated with LARC use were employment, husband support, access to LARC methods, and the lack of side effects. There is a need to strengthen client education, improve accessibility to LARC methods at all levels of health centers, improve male partner’s decision-making in LARC use and manage the side effects effectively.

Keywords: family planning, implants, intrauterine device, long-acting reversible contraceptives (LARC)

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Authors: Bollu Mounica

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Background: Nowadays drug related problems were seen very commonly within the health care practice. These could result in the medication errors, adverse events, drug interactions and harm to patients. Pharmacist has an identified role in minimizing and preventing such type of problems. Objectives: To detect the incidence of drug related problems for the hospitalized patient, and to analyze the clinical pharmacist interventions performed during the review of prescription orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large tertiary care teaching hospital. Methods: It was a retrospective, observational and interventional study. The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. For a period starting November 2012 until December 2014, the inpatient medication charts and orders were identified and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services in a tertiary care teaching hospital on routine daily activities. Data was collected and evaluated. The causes of this problem were identified. Results: A total of 360 patients were followed. Male (71.66%) predominance was noted over females (28.33%). Drug related problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors (26.11%), improper drug selection (17.22%), followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing (26.11%), and drug change (18.05%). Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Conclusion: Our study showed that the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes needed in the prescriptions. In this context, routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of DRPs and may prevent their occurrence.

Keywords: drug related problems, clinical pharmacist, drug prescriptions, drug related problems, intervention

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

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Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of ANC include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding antenatal care. Methodology: A descriptive KAP study was conducting in public hospitals in Sana'a City-Yemen. The study population was included all pregnant women that intended to the prenatal department and clinical outpatient department, the final sample size was 371 pregnant women, a self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women were had correct answers in total knowledge regarding antenatal care, and about two-thirds (67%) of pregnant women were had performance practice regarding antenatal care and two-third (68%) of pregnant women were had a positive attitude. Conclusions & Recommendations: We concluded that a significant association between overall knowledge and practice level toward antenatal care and demographic characteristics of pregnant women, women (residence place, level of education, did your husband support you in attending antenatal care and place of delivery of the last baby), at (P-value ≤ 0.05). We recommended more education and training courses, lecturers and education sessions in clinical facilitators focused ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: antenatal care, knowledge, practice, attitude, pregnant women

Procedia PDF Downloads 194

Authors: Florenda B. Cardinoza

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This study was conducted to determine the determinants of Grade III and grade VI pupils’ performance in the National Achievement Test in the Division of Cavite City, School Year 2011-2012. Specifically, the research aimed to: (1) describe the demographic profile of the respondents in terms of age, sex, birth order, family size, family income, and occupation of parents; (2) determine the level of attitude towards NAT; and (3) describe the degree of relationship between the following variables: school support, teachers’ support, and lastly family support for the pupils’ performance in 2012 NAT. The study used the descriptive-correlation research method to investigate the determinants of pupils’ performance in the National Achievement Test of Public Elementary Schools in the Division of Cavite City. The instrument used in data gathering was a self-structured survey. The NAT result for SY 2011-2012 provided by NETRC and DepEd Cavite City was also utilized. The statistical tools used to process and analyze the data were frequency distribution, percentage, mean, standard deviation, Kruskall Wallis, Mann-Whitney, t-test for independent samples, One-way ANOVA, and Spearman Rank Correlational Coefficient. Results revealed that there were more female students than males in the Division of Cavite City; out of 659 respondents, 345 were 11 years old and above; 390 were females; 283 were categorized as first child in the family; 371 of the respondents were from small family; 327 had Php5000 and below family income; 450 of the fathers’ respondents were non professionals; and 431 of the mothers respondents had no occupation. The attitude towards NAT, with a mean of 1.65 and SD of .485, shows that respondents considered NAT important. The school support towards NAT, with a mean of 1.89 and SD of .520, shows that respondents received school support. The pupils had a very high attitude towards teachers’ support in NAT with a mean of 1.60 and SD of .572. Family support, with t-test of 16.201 with a p-value of 0.006, shows significant at 5 percent level. Thus, the determinants of pupils’ performance in NAT in terms of family support for NAT preparation is not significant according to their family income. The grade level, with the t-test is 4.420 and a p-value of 0.000, is significant at 5 percent level. Therefore, the determinants of pupils’ performance in NAT in terms of grade level for NAT preparation vary according to their grade level. For the determinants of pupils’ performance of NAT sample test for attitude towards NAT, school support, teachers’ support, and family support were noted highly significant with a p value of 0.000.

Keywords: achievement, determinants, national, performance, public, pupils', test

Procedia PDF Downloads 351

Authors: Birgit Reime, Sonja Gscheidle, Toni Hübener, Lara Hübener

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Suicide in individuals under 30 years is a global public health concern. The objective of this study was to identify strategies for the prevention of suicide and suicidal behavior preferred by adolescents and young adults who are vulnerable to suicidal behavior and by relevant experts. Using semi-structured interviews with n= 17 adolescents and young adults (18-25 years of age) and with n= 11 experts from relevant fields, we have applied an inductive approach and applied thematic content analysis. Six strategies for suicide prevention in young individuals were reported. These were digital solutions with appealing designs, anonymous support, trained peer support, spiritual support, improving existing structures, and raising suicide literacy. Accessibility of anonymous digital support may contribute to suicide prevention in young people.

Keywords: suicide prevention, adolescents, E-health, Germany

Procedia PDF Downloads 187

Authors: Siri-Orn Champatong

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The objectives of this research were to study the attitude of service marketing mix that affected the decision making behavior to use fitness service in case of the fitness in Thailand. This study employed by survey research and questionnaire was used to collect the data from 400 of consumers who have used the service and interested in using the service in the future. The descriptive statistics and multiple regression analysis were used to analyze data. The results revealed that the attitude toward overall marketing mix was at moderate level. For particulars, attitude toward product and service aspects were at good level, however, attitude toward price, place, promotion, people, physical evidence and service quality aspects were at moderate level. The hypothesis testing results showed that attitude toward each aspect affected word of mouth, however, attitude toward product and service, place, promotion, people and physical evidence affected tendency to use fitness service at .05 statistically significant level.

Keywords: decision making behavior, fitness, marketing mix, marketing service

Procedia PDF Downloads 343

Authors: Bernabeo R. Alberto

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Unmanned aerial vehicles (UAV) platforms or remotely piloted aircraft system (Rpas) - with dedicated sensors - are fundamental support to the planning, running, and control of the territory in which public safety is or may be at risk for post-disaster assessments such as flooding or landslides, for searching lost people, for crime and accident scene photography, for assisting traffic control at major events, for teaching geography, history, natural science and all those subjects that require a continuous cyclical process of observation, evaluation and interpretation. Through the use of proximal remote sensing information related to anthropic landscape and nature integration, there is an opportunity to improve knowledge and management decision-making for the safeguarding of the environment, for farming, wildlife management, land management, mapping, glacier monitoring, atmospheric monitoring, for the conservation of archeological, historical, artistic and architectural sites, allowing an exact delimitation of the site in the territory. This paper will go over many different mission types. Within each mission type, it will give a broad overview to familiarize the reader but not make them an expert. It will also give detailed information on the payloads and other testing parameters the Unmanned Aerial Vehicles (UAV) use to complete a mission. The project's goal is to improve satellite maps about the stress of the plants, air quality monitoring, and related health issues.

Keywords: proximal remote sensing, remotely piloted aircraft system, risk, safety, unmanned aerial vehicle

Procedia PDF Downloads 23

Authors: N. Stoeva, I. Spassova, R. Nickolov, M. Khristova

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Exhaust gases from stationary and mobile combustion sources contain nitrogen oxides that cause a variety of environmentally harmful effects. The most common approach of their elimination is the catalytic reaction in the exhaust using various reduction agents such as NH3, CO and hydrocarbons. Transition metals (Co, Ni, Cu, etc.) are the most widely used as active components for deposition on various supports. However, since the interaction between different catalyst components have been extensively studied in different types of reaction systems, the possible cooperation between active components and the support material and the underlying mechanisms have not been thoroughly investigated. The support structure may affect how these materials maintain an active phase. The objective is to investigate the addition of carbonaceous materials with different nature and texture characteristics on the properties of the resulting silica-carbon support and how it influences of the catalytic properties of the supported copper and cobalt catalysts for reduction of NO with CO. The versatility of the physico-chemical properties of the composites and the supported copper and cobalt catalysts are discussed with an emphasis on the relationship of the properties with the catalytic performance. The catalysts were prepared by sol-gel process and were characterized by XRD, XPS, AAS and BET analysis. The catalytic experiments were carried out in catalytic flow apparatus with isothermal flow reactor in the temperature range 20–300оС. After the catalytic test temperature-programmed desorption (TPD) was carried out. The transient response method was used to study the interaction of the gas phase with the catalyst surface. The role of the interaction between the support and the active phase on the catalyst’s activity in the studied reaction was discussed. We suppose the carbon particles with small sizes to participate in the formation of the active sites for the reduction of NO with CO along with their effect on the kind of deposited metal oxide phase. The existence of micropore texture for some of composites also influences by mass-transfer limitations.

Keywords: catalysts, no reduction, composites, bet analysis

Procedia PDF Downloads 424

Authors: Hebberly Ahatlan

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The process of digitizing energy systems involves transforming traditional energy infrastructure into interconnected, data-driven systems that enhance efficiency, sustainability, and responsiveness. As smart grids become increasingly integral to the efficient distribution and management of electricity from both fossil and renewable energy sources, the energy industry faces strategic challenges associated with digitalization and interoperability — particularly in the context of modern energy business models, such as virtual power plants (VPPs). The critical challenge in modern smart grids is to seamlessly integrate diverse technologies and systems, including virtualization, grid computing and service-oriented architecture (SOA), across the entire energy ecosystem. Achieving this requires addressing issues like semantic interoperability, IT/OT convergence, and digital asset scalability, all while ensuring security and risk management. This paper proposes a four-layer digitalization framework to tackle these challenges, encompassing persistent data protection, trusted key management, secure messaging, and authentication of IoT resources. Data assets generated through this framework enable AI systems to derive insights for improving smart grid operations, security, and revenue generation. Furthermore, this paper also proposes a Trusted Energy Interoperability Alliance as a universal guiding standard in the development of this digitalization framework to support more dynamic and interoperable energy markets.

Keywords: digitalization, IT/OT convergence, semantic interoperability, VPP, energy blockchain

Procedia PDF Downloads 184

Authors: H. Erbiyik, A. Bal, M. Sirakaya, Ö. Yesildal, E. Yolcu

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The emergence of many environmental issues began with the Industrial Revolution. The depletion of natural resources and emerging environmental challenges over time requires enterprises and managers to take into consideration environmental factors while managing business. If we take notice of these causes; the design and implementation of environmentally friendly green purchasing, production and waste management systems become very important at green logistics systems. Companies can adopt green supply chain with the awareness of these facts. The concept of green supply chain constitutes from green purchasing, green production, green logistics, waste management and reverse logistics. In this study, we wanted to identify the concept of green supply chain and why green supply chain should be applied. In the practice part of the study an analytic hierarchy process (AHP) study is conducted on an aluminum production company to evaluate suppliers.

Keywords: aluminum sector, analytic hierarchy process, decision making, green logistics

Procedia PDF Downloads 356

Authors: R. B. Ogunrinde, C. C. Jibunoh

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In this paper, a spectral decomposition method is developed for the direct integration of stiff and nonstiff homogeneous linear (ODE) systems with linear, constant, or zero right hand sides (RHSs). The method does not require iteration but obtains solutions at any random points of t, by direct evaluation, in the interval of integration. All the numerical solutions obtained for the class of systems coincide with the exact theoretical solutions. In particular, solutions of homogeneous linear systems, i.e. with zero RHS, conform to the exact analytical solutions of the systems in terms of t.

Keywords: spectral decomposition, linear RHS, homogeneous linear systems, eigenvalues of the Jacobian

Procedia PDF Downloads 330

Authors: Joel Thomas, Alexa Squirini

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The key argument of this research is that every element of systems interoperability is an enabler of regional disaster resilience, and arguably should become a focal point for standardized measurement of communities’ ability to work together. Few resilience research efforts have focused on the development and application of solutions that measurably improve communities’ ability to work together at a regional level, yet a majority of the most devastating and disruptive disasters are those that have had a regional impact. The key findings of the research include a unique theoretical, mathematical, and operational approach to tangibly and defensibly measure and assess systems interoperability required to support crisis information management activities performed by governments, the private sector, and humanitarian organizations. A most effective way for communities to measurably improve regional disaster resilience is through deliberately executed disaster preparedness activities. Developing interoperable crisis information management capabilities is a crosscutting preparedness activity that greatly affects a community’s readiness and ability to work together in times of crisis. Thus, improving communities’ human and technical posture to work together in advance of a crisis, with the ultimate goal of enabling information sharing to support coordination and the careful management of available resources, is a primary means by which communities may improve regional disaster resilience. This model describes how systems interoperability can be qualitatively and quantitatively assessed when characterized as five forms of capital: governance; standard operating procedures; technology; training and exercises; and usage. The unique measurement framework presented defines the relationships between systems interoperability, information sharing and safeguarding, operational coordination, community preparedness and regional disaster resilience, and offers a means by which to implement real-world solutions and measure progress over the course of a multi-year program. The model is being developed and piloted in partnership with the U.S. Department of Homeland Security (DHS) Science and Technology Directorate (S&T) and the North Atlantic Treaty Organization (NATO) Advanced Regional Civil Emergency Coordination Pilot (ARCECP) with twenty-three organizations in Bosnia and Herzegovina, Croatia, Macedonia, and Montenegro. The intended effect of the model implementation is to enable communities to answer two key questions: 'Have we measurably improved crisis information management capabilities as a result of this effort?' and, 'As a result, are we more resilient?'

Keywords: disaster, interoperability, measurement, resilience

Procedia PDF Downloads 143