Search results for: influence political decision making at varying
15742 Decision Tree Analysis of Risk Factors for Intravenous Infiltration among Hospitalized Children: A Retrospective Study
Authors: Soon-Mi Park, Ihn Sook Jeong
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This retrospective study was aimed to identify risk factors of intravenous (IV) infiltration for hospitalized children. The participants were 1,174 children for test and 424 children for validation, who admitted to a general hospital, received peripheral intravenous injection therapy at least once and had complete records. Data were analyzed with frequency and percentage or mean and standard deviation were calculated, and decision tree analysis was used to screen for the most important risk factors for IV infiltration for hospitalized children. The decision tree analysis showed that the most important traditional risk factors for IV infiltration were the use of ampicillin/sulbactam, IV insertion site (lower extremities), and medical department (internal medicine) both in the test sample and validation sample. The correct classification was 92.2% in the test sample and 90.1% in the validation sample. More careful attention should be made to patients who are administered ampicillin/sulbactam, have IV site in lower extremities and have internal medical problems to prevent or detect infiltration occurrence.Keywords: decision tree analysis, intravenous infiltration, child, validation
Procedia PDF Downloads 17615741 Quoting Jobshops Due Dates Subject to Exogenous Factors in Developing Nations
Authors: Idris M. Olatunde, Kareem B.
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In manufacturing systems, especially job shops, service performance is a key factor that determines customer satisfaction. Service performance depends not only on the quality of the output but on the delivery lead times as well. Besides product quality enhancement, delivery lead time must be minimized for optimal patronage. Quoting accurate due dates is sine quo non for job shop operational survival in a global competitive environment. Quoting accurate due dates in job shops has been a herculean task that nearly defiled solutions from many methods employed due to complex jobs routing nature of the system. This class of NP-hard problems possessed no rigid algorithms that can give an optimal solution. Jobshop operational problem is more complex in developing nations due to some peculiar factors. Operational complexity in job shops emanated from political instability, poor economy, technological know-how, and the non-promising socio-political environment. The mentioned exogenous factors were hardly considered in the previous studies on scheduling problem related to due date determination in job shops. This study has filled the gap created in the past studies by developing a dynamic model that incorporated the exogenous factors for accurate determination of due dates for varying jobs complexity. Real data from six job shops selected from the different part of Nigeria, were used to test the efficacy of the model, and the outcomes were analyzed statistically. The results of the analyzes showed that the model is more promising in determining accurate due dates than the traditional models deployed by many job shops in terms of patronage and lead times minimization.Keywords: due dates prediction, improved performance, customer satisfaction, dynamic model, exogenous factors, job shops
Procedia PDF Downloads 41215740 Challenges and Proposals for Public Policies Aimed At Increasing Energy Efficiency in Low-Income Communities in Brazil: A Multi-Criteria Approach
Authors: Anna Carolina De Paula Sermarini, Rodrigo Flora Calili
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Energy Efficiency (EE) needs investments, new technologies, greater awareness and management on the side of citizens and organizations, and more planning. However, this issue is usually remembered and discussed only in moments of energy crises, and opportunities are missed to take better advantage of the potential of EE in the various sectors of the economy. In addition, there is little concern about the subject among the less favored classes, especially in low-income communities. Accordingly, this article presents suggestions for public policies that aim to increase EE for low-income housing and communities based on international and national experiences. After reviewing the literature, eight policies were listed, and to evaluate them; a multicriteria decision model was developed using the AHP (Analytical Hierarchy Process) and TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) methods, combined with fuzzy logic. Nine experts analyzed the policies according to 9 criteria: economic impact, social impact, environmental impact, previous experience, the difficulty of implementation, possibility/ease of monitoring and evaluating the policies, expected impact, political risks, and public governance and sustainability of the sector. The results found in order of preference are (i) Incentive program for equipment replacement; (ii) Community awareness program; (iii) EE Program with a greater focus on low income; (iv) Staggered and compulsory certification of social interest buildings; (v) Programs for the expansion of smart metering, energy monitoring and digitalization; (vi) Financing program for construction and retrofitting of houses with the emphasis on EE; (vii) Income tax deduction for investment in EE projects in low-income households made by companies; (viii) White certificates of energy for low-income. First, the policy of equipment substitution has been employed in Brazil and the world and has proven effective in promoting EE. For implementation, efforts are needed from the federal and state governments, which can encourage companies to reduce prices, and provide some type of aid for the purchase of such equipment. In second place is the community awareness program, promoting socio-educational actions on EE concepts and with energy conservation tips. This policy is simple to implement and has already been used by many distribution utilities in Brazil. It can be carried out through bids defined by the government in specific areas, being executed by third sector companies with public and private resources. Third on the list is the proposal to continue the Energy Efficiency Program (which obliges electric energy companies to allocate resources for research in the area) by suggesting the return of the mandatory investment of 60% of the resources in projects for low income. It is also relatively simple to implement, requiring efforts by the federal government to make it mandatory, and on the part of the distributors, compliance is needed. The success of the suggestions depends on changes in the established rules and efforts from the interested parties. For future work, we suggest the development of pilot projects in low-income communities in Brazil and the application of other multicriteria decision support methods to compare the results obtained in this study.Keywords: energy efficiency, low-income community, public policy, multicriteria decision making
Procedia PDF Downloads 11715739 Decision Making on Smart Energy Grid Development for Availability and Security of Supply Achievement Using Reliability Merits
Authors: F. Iberraken, R. Medjoudj, D. Aissani
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The development of the smart grids concept is built around two separate definitions, namely: The European one oriented towards sustainable development and the American one oriented towards reliability and security of supply. In this paper, we have investigated reliability merits enabling decision-makers to provide a high quality of service. It is based on system behavior using interruptions and failures modeling and forecasting from one hand and on the contribution of information and communication technologies (ICT) to mitigate catastrophic ones such as blackouts from the other hand. It was found that this concept has been adopted by developing and emerging countries in short and medium terms followed by sustainability concept at long term planning. This work has highlighted the reliability merits such as: Benefits, opportunities, costs and risks considered as consistent units of measuring power customer satisfaction. From the decision making point of view, we have used the analytic hierarchy process (AHP) to achieve customer satisfaction, based on the reliability merits and the contribution of such energy resources. Certainly nowadays, fossil and nuclear ones are dominating energy production but great advances are already made to jump into cleaner ones. It was demonstrated that theses resources are not only environmentally but also economically and socially sustainable. The paper is organized as follows: Section one is devoted to the introduction, where an implicit review of smart grids development is given for the two main concepts (for USA and Europeans countries). The AHP method and the BOCR developments of reliability merits against power customer satisfaction are developed in section two. The benefits where expressed by the high level of availability, maintenance actions applicability and power quality. Opportunities were highlighted by the implementation of ICT in data transfer and processing, the mastering of peak demand control, the decentralization of the production and the power system management in default conditions. Costs were evaluated using cost-benefit analysis, including the investment expenditures in network security, becoming a target to hackers and terrorists, and the profits of operating as decentralized systems, with a reduced energy not supplied, thanks to the availability of storage units issued from renewable resources and to the current power lines (CPL) enabling the power dispatcher to manage optimally the load shedding. For risks, we have razed the adhesion of citizens to contribute financially to the system and to the utility restructuring. What is the degree of their agreement compared to the guarantees proposed by the managers about the information integrity? From technical point of view, have they sufficient information and knowledge to meet a smart home and a smart system? In section three, an application of AHP method is made to achieve power customer satisfaction based on the main energy resources as alternatives, using knowledge issued from a country that has a great advance in energy mutation. Results and discussions are given in section four. It was given us to conclude that the option to a given resource depends on the attitude of the decision maker (prudent, optimistic or pessimistic), and that status quo is neither sustainable nor satisfactory.Keywords: reliability, AHP, renewable energy resources, smart grids
Procedia PDF Downloads 44215738 A Qualitative Exploration of the Socio-Cultural Determinants of Exclusive Breastfeeding Practice among Rural Mothers in Bindawa and Baure Local Government Areas, Katsina, North West Nigeria
Authors: Friday I. Joseph
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Background: Nigeria has an under-five mortality rate that is 128 per 1000 live birth which is higher than the rate for the African region. Optimal breastfeeding practice has the potential to reduce under-five mortality by 13% in developing countries. However, documented exclusive breastfeeding rate in Nigeria from birth to six months is just 17%. Aim: To explore perceptions of the sociocultural factors that influence exclusive breastfeeding for six months among rural mothers in Bindawa and Baure Local Government Area (LGA), Katsina state, North West Nigeria, to inform policies, intervention or strategies to improve exclusive breastfeeding practice in Nigeria. Methods: The social constructionism-interpretivist epistemological approach informed the use of an exploratory study to understand mothers’ experiences and views. Twenty mothers, all from rural areas between 19-35 years old were conveniently sampled from two LGA in Katsina state, north –west Nigeria for semi-structured interviews. Sample size had representation of both Hausa and Fulani ethnic group. Thematic content analysis was utilized for analysis. Results: Three major themes emerged from the study: (1) Breastfeeding initiation - Immediate traditional newborn care practices, birth attendant, place of delivery, the perception of about colostrum determines how soon a mother initiate breastfeeding. (2) Exclusive breastfeeding and introduction of food-Motivation to sustain exclusive breastfeeding relies on the interplay between the obligation to perform traditional rites; mother’s awareness and family support. (3) Decision making about infant feeding – It is not independent of the influence of key social figures like the father, mother-in-law, traditional birth attendant and the health workers. Overall, in spite of awareness of exclusive breastfeeding benefits, mothers expressed concerns that they may not win their family support if they shared contrary views. Conclusions: Health promotion intervention should be tailored, taking cognizant and addressing the sociocultural barriers to the practice of optimal breastfeeding by a focused community and family-based participatory approach. Implementers of interventions should employ culture-sensitive approaches in community-based intervention.Keywords: exclusive breastfeeding, perception, qualitative, sociocultural determinants
Procedia PDF Downloads 18215737 Contraception in Guatemala, Panajachel and the Surrounding Areas: Barriers Affecting Women’s Contraceptive Usage
Authors: Natasha Bhate
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Contraception is important in helping to reduce maternal and infant mortality rates by allowing women to control the number and spacing in-between their children. It also reduces the need for unsafe abortions. Women worldwide use contraception; however, the contraceptive prevalence rate is still relatively low in Central American countries like Guatemala. There is also an unmet need for contraception in Guatemala, which is more significant in rural, indigenous women due to barriers preventing contraceptive use. The study objective was to investigate and analyse the current barriers women face, in Guatemala, Panajachel and the surrounding areas, in using contraception, with a view of identifying ways to overcome these barriers. This included exploring the contraceptive barriers women believe exist and the influence of males in contraceptive decision making. The study took place at a charity in Panajachel, Guatemala, and had a cross-sectional, qualitative design to allow an in-depth understanding of information gathered. This particular study design was also chosen to help inform the charity with qualitative research analysis, in view of their intent to create a local reproductive health programme. A semi-structured interview design, including photo facilitation to improve cross-cultural communication, with interpreter assistance, was utilized. A pilot interview was initially conducted with small improvements required. Participants were recruited through purposive and convenience sampling. The study host at the charity acted as a gatekeeper; participants were identified through attendance of the charity’s women’s-initiative programme workshops. 20 participants were selected and agreed to study participation with two not attending; a total of 18 participants were interviewed in June 2017. Interviews were audio-recorded and data were stored on encrypted memory sticks. Framework analysis was used to analyse the data using NVivo11 software. The University of Leeds granted ethical approval for the research. Religion, language, the community, and fear of sickness were examples of existing contraceptive barrier themes recognized by many participants. The influence of men was also an important barrier identified, with themes of machismo and abuse preventing contraceptive use in some women. Women from more rural areas were believed to still face barriers which some participants did not encounter anymore, such as distance and affordability of contraceptives. Participants believed that informative workshops in various settings were an ideal method of overcoming existing contraceptive barriers and allowing women to be more empowered. The involvement of men in such workshops was also deemed important by participants to help reduce their negative influence in contraceptive usage. Overall, four recommendations following this study were made, including contraceptive educational courses, a gender equality campaign, couple-focused contraceptive workshops, and further qualitative research to gain a better insight into men’s opinions regarding women using contraception.Keywords: barrier, contraception, machismo, religion
Procedia PDF Downloads 12615736 A Basic Metric Model: Foundation for an Evidence-Based HRM System
Authors: K. M. Anusha, R. Krishnaveni
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Crossing a decade of the 21st century, the paradigm of human resources can be seen evolving with the strategic gene induced into it. There seems to be a radical shift descending as the corporate sector calls on its HR team to become strategic rather than administrative. This transferal eventually requires the metrics employed by these HR teams not to be just operationally reactive but to be aligned to an evidence-based strategic thinking. Realizing the growing need for a prescriptive metric model for effective HR analytics, this study has designed a conceptual framework for a basic metric model that can assist IT-HRM professionals to transition to a practice of evidence-based decision-making to enhance organizational performance.Keywords: metric model, evidence based HR, HR analytics, strategic HR practices, IT sector
Procedia PDF Downloads 40315735 Anisotropic Behavior of Sand Stabilized with Colloidal Silica
Authors: Eleni Maria Pavlopoulou, Vasiliki N. Georgiannou, Filippos C. Chortis
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The response of M31 sand stabilized with colloidal silica (CS) aqueous gel is investigated in the laboratory. CS is introduced in the water regime, forming a hydrosol. The low viscosity hydrosol thickens in a controllable manner to form a stable, non-toxic gel; the gel fills the pore space, retains the pore water, and supports the grain structure. The role of colloidal silica on subsequent sand behavior is examined with the aid of direct shear, triaxial, and normal compression tests. Under the examined loading modes, while the strength of the treated sand is enhanced, its stiffness may reduce, and its compressibility increase. However, in most geotechnical problems, the loading conditions are complex, involving changes in both stress magnitude and direction. Rotation of principal stresses (σ1, σ2, σ3) in varying amounts expressed as angle α, (from α=0° to 90°) in concurrence with increasing shear stress loading is commonly encountered in soil structures such as foundations, embankments, underwater slopes. To assess the influence of anisotropy on the response of sands before and after their stabilization, hollow cylinder tests were performed. The behavior of stabilized sand is compared with the characteristic sand behavior, i.e., a reduction in peak stress ratio associated with a softer stress-strain response with the increasing angle a. The influence of the magnitude of the intermediate principal stress (σ2) on the mechanical response of treated and untreated sand is also examined.Keywords: anisotropy, colloidal silica, laboratory tests, sands, soil stabilization
Procedia PDF Downloads 13515734 Influence of Irregularities in Plan and Elevation
Authors: Houmame Benbouali
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Some architectural conditions required some shapes often lead to an irregular distribution of masses, rigidities and resistances. The main object of the present study consists in estimating the influence of the irregularity both in plan and in elevation which presenting some structures on the dynamic characteristics and his influence on the behavior of this structures. To do this, it is necessary to apply both dynamic methods proposed by the RPA99 (spectral modal method and method of analysis by accelerogram) on certain similar prototypes and to analyze the parameters measuring the answer of these structures and to proceed to a comparison of the results.Keywords: irregularity, seismic, response, structure, ductility
Procedia PDF Downloads 37415733 Minorities and Soccer in the Middle East: Yelling From the Touchline
Authors: Saeb Farhan Al Ganideh
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We draw on insights from theories of group threat and identity to explore how soccer rivalries can decode the relationship between ethnic minorities and local societies. How ethnic minorities used soccer, in the Arab countries of the Middle East, to express their racial-ethnic heritage is the main question that this paper grapples with at its most general level. The rhetoric around soccer and minorities in the Middle East show that ethnic minorities’ soccer clubs have faced varying degrees of discrimination. The paper relies on an analysis of 4 ethnic minorities’ soccer clubs, namely, Circassians in Jordan, Kurds in Syria, Sahrawis in Morocco, and Amazighs in Algeria, focusing on previous and current performance of these clubs. Ethnic minorities’ soccer clubs were the pinnacle in the Middle East region a few decades ago. Nonetheless, these soccer clubs, currently, fighting for not only their place in their countries’ local competitions but also for their existence as soccer clubs. Minorities’ soccer clubs have been plagued with challenges related to the change in political and social contexts in these countries.Keywords: minorities, rivalries, soccer, middle east
Procedia PDF Downloads 52215732 Scheduled Maintenance and Downtime Cost in Aircraft Maintenance Management
Authors: Remzi Saltoglu, Nazmia Humaira, Gokhan Inalhan
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During aircraft maintenance scheduling, operator calculates the budget of the maintenance. Usually, this calculation includes only the costs that are directly related to the maintenance process such as cost of labor, material, and equipment. In some cases, overhead cost is also included. However, in some of those, downtime cost is neglected claiming that grounding is a natural fact of maintenance; therefore, it is not considered as part of the analytical decision-making process. Based on the normalized data, we introduce downtime cost with its monetary value and add its seasonal character. We envision that the rest of the model, which works together with the downtime cost, could be checked with the real life cases, through the review of MRO cost and airline spending in the particular and scheduled maintenance events.Keywords: aircraft maintenance, downtime, downtime cost, maintenance cost
Procedia PDF Downloads 35315731 Managing Virtual Teams in a Pandemic
Authors: M. Jafari Toosy, A. Zamani
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This article, considering the result of pandemics at the international level and all activities and projects performed virtually and the need for resource management and virtual teams in this period identifies the components of virtual management after searching the available resources. Exploration of virtual management in the pandemic era is explored in 10 international articles. The results of research with this method and according to the tasks and topics related to management knowledge and definition of virtual teams can be divided into topics such as planning, decision making, control, organization, leadership, attention to growth and capability, resources and facilities, Communication, creativity, innovation and security. In order to explain the nature of virtual management, a definition of virtual management was provided.Keywords: management, virtual, virtual team management, pandemic, team
Procedia PDF Downloads 18515730 Decentralized Forest Policy for Natural Sal (Shorea robusta) Forests Management in the Terai Region of Nepal
Authors: Medani Prasad Rijal
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The study outlines the impacts of decentralized forest policy on natural Sal (shorea robusta) forests in the Terai region of Nepal. The government has implemented community forestry program to manage the forest resources and improve the livelihood of local people collectively. The forest management authorities such as conserve, manage, develop and use of forest resources were shifted to the local communities, however, the ownership right of the forestland retained by the government. Local communities took the decision on harvesting, distribution, and sell of forest products by fixing the prices independently. The local communities were putting the low value of forest products and distributed among the user households on the name of collective decision. The decision of low valuation is devaluating the worth of forest products. Therefore, the study hypothesized that decision-making capacities are equally prominent next to the decentralized policy and program formulation. To accomplish the study, individual to group level discussions and questionnaire survey methods were applied with executive committee members and user households. The study revealed that the local intuition called Community Forest User Group (CFUG) committee normally took the decisions on consensus basis. Considering to the access and affording capacity of user households having poor economic backgrounds, low pricing mechanism of forest products has been practiced, even though the Sal timber is far expensive in the local market. The local communities thought that low pricing mechanism is accessible to all user households from poor to better off households. However, the analysis of forest products distribution opposed the assumption as most of the Sal timber, which is the most valuable forest product of community forest only purchased by the limited households of better economic conditions. Since the Terai region is heterogeneous by socio-economic conditions, better off households always have higher affording capacity and possibility of taking higher timber benefits because of low price mechanism. On the other hand, the minimum price rate of forest products has poor contribution in community fund collection. Consequently, it has poor support to carry out poverty alleviation activities to poor people. The local communities have been fixed Sal timber price rate around three times cheaper than normal market price, which is a strong evidence of forest product devaluation itself. Finally, the study concluded that the capacity building of local executives as the decision-makers of natural Sal forests is equally indispensable next to the policy and program formulation for effective decentralized forest management. Unilateral decentralized forest policy may devaluate the forest products rather than devolve of power to the local communities and empower to them.Keywords: community forestry program, decentralized forest policy, Nepal, Sal forests, Terai
Procedia PDF Downloads 33315729 Modeling Route Selection Using Real-Time Information and GPS Data
Authors: William Albeiro Alvarez, Gloria Patricia Jaramillo, Ivan Reinaldo Sarmiento
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Understanding the behavior of individuals and the different human factors that influence the choice when faced with a complex system such as transportation is one of the most complicated aspects of measuring in the components that constitute the modeling of route choice due to that various behaviors and driving mode directly or indirectly affect the choice. During the last two decades, with the development of information and communications technologies, new data collection techniques have emerged such as GPS, geolocation with mobile phones, apps for choosing the route between origin and destination, individual service transport applications among others, where an interest has been generated to improve discrete choice models when considering the incorporation of these developments as well as psychological factors that affect decision making. This paper implements a discrete choice model that proposes and estimates a hybrid model that integrates route choice models and latent variables based on the observation on the route of a sample of public taxi drivers from the city of Medellín, Colombia in relation to its behavior, personality, socioeconomic characteristics, and driving mode. The set of choice options includes the routes generated by the individual service transport applications versus the driver's choice. The hybrid model consists of measurement equations that relate latent variables with measurement indicators and utilities with choice indicators along with structural equations that link the observable characteristics of drivers with latent variables and explanatory variables with utilities.Keywords: behavior choice model, human factors, hybrid model, real time data
Procedia PDF Downloads 15215728 Production of Clean Reusable Distillery Waste Water Using Activated Carbon Prepared from Waste Orange Peels
Authors: Joseph Govha, Sharon Mudutu
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The research details the treatment of distillery waste water by making use of activated carbon prepared from orange peels as an adsorbent. Adsorption was carried out at different conditions to determine the optimum conditions that work best for the removal of color in distillery waste water using orange peel activated carbon. Adsorption was carried out at different conditions by varying contact time, adsorbent dosage, pH, testing for color intensity and Biological Oxygen Demand. A maximum percentage color removal of 88% was obtained at pH 7 at an adsorbent dosage of 1g/20ml. Maximum adsorption capacity was obtained from the Langmuir isotherm at R2=0.98.Keywords: distillery, waste water, orange peel, activated carbon, adsorption
Procedia PDF Downloads 30215727 The Analysis of Spatial Development: Malekan City
Authors: Rahim Sarvar, Bahram Azadbakht, Samira Safaee
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The leading goal of all planning is to attain sustainable development, regional balance, suitable distribution of activities, and maximum use of environmental capabilities in the process of development of regions. Intensive concentration of population and activities in one or some limited geographical locality is of main characteristics of most developing countries, especially Iran. Not considering the long-term programs and relying on temporary and superficial plans by people in charge of decision-making to attain their own objectives causes obstacles, resulting in unbalance development. The basic reason for these problems is to establish the development planning while economic aspects are merely considered and any attentions are not paid to social and regional feedbacks, what have been ending up to social and economic inequality, unbalanced distribution of development among the regions as well. In addition to study of special planning and structure of the county of Malekan, this research tries to achieve some other aims, i.e. recognition and introduction of approaches in order to utilize resources optimally, to distribute the population, activities, and facilities in optimum fashion, and to investigate and identify the spatial development potentials of the County. Based on documentary, descriptive, analytical, and field studies, this research employs maps to analyze the data, investigates the variables, and applies SPSS, Auto CAD, and Arc View software. The results show that the natural factors have a significant influence on spatial layout of settlements; distribution of facilities and functions are not equal among the rural districts of the county; and there is a spatial equivalence in the region area between population and number of settlements.Keywords: development, entropy index, Malekan City, planning, regional equilibrium
Procedia PDF Downloads 43915726 Performance Analysis of Search Medical Imaging Service on Cloud Storage Using Decision Trees
Authors: González A. Julio, Ramírez L. Leonardo, Puerta A. Gabriel
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Telemedicine services use a large amount of data, most of which are diagnostic images in Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7) formats. Metadata is generated from each related image to support their identification. This study presents the use of decision trees for the optimization of information search processes for diagnostic images, hosted on the cloud server. To analyze the performance in the server, the following quality of service (QoS) metrics are evaluated: delay, bandwidth, jitter, latency and throughput in five test scenarios for a total of 26 experiments during the loading and downloading of DICOM images, hosted by the telemedicine group server of the Universidad Militar Nueva Granada, Bogotá, Colombia. By applying decision trees as a data mining technique and comparing it with the sequential search, it was possible to evaluate the search times of diagnostic images in the server. The results show that by using the metadata in decision trees, the search times are substantially improved, the computational resources are optimized and the request management of the telemedicine image service is improved. Based on the experiments carried out, search efficiency increased by 45% in relation to the sequential search, given that, when downloading a diagnostic image, false positives are avoided in management and acquisition processes of said information. It is concluded that, for the diagnostic images services in telemedicine, the technique of decision trees guarantees the accessibility and robustness in the acquisition and manipulation of medical images, in improvement of the diagnoses and medical procedures in patients.Keywords: cloud storage, decision trees, diagnostic image, search, telemedicine
Procedia PDF Downloads 20415725 Stroke Prevention in Patients with Atrial Fibrillation and Co-Morbid Physical and Mental Health Problems
Authors: Dina Farran, Mark Ashworth, Fiona Gaughran
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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems
Procedia PDF Downloads 4915724 Implementation of A Treatment Escalation Plan During The Covid 19 Outbreak in Aneurin Bevan University Health Board
Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman
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For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.Keywords: acute medicine, clinical governance, intensive care, patient centered decision making
Procedia PDF Downloads 17615723 Nonlinear Analysis of Steel Fiber Reinforced Concrete Frames Considering Shear Behaviour of Members under Varying Axial Load
Authors: Habib Akbarzadeh Bengar, Mohammad Asadi Kiadehi, Ali Rameeh
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The result of the past earthquakes has shown that insufficient amount of stirrups and brittle behavior of concrete lead to the shear and flexural failure in reinforced concrete (RC) members. In this paper, an analytical model proposed to predict the nonlinear behavior of RC and SFRC elements and frames. In this model, some important parameter such as shear effect, varying axial load, and longitudinal bar buckling are considered. The results of analytical model were verified with experimental tests. The results of verification have shown that the proposed analytical model can predict the nonlinear behavior of RC and SFRC members and also frames accurately. In addition, the results have shown that use of steel fibers increased bearing capacity and ductility of RC frame. Due to this enhancement in shear strength and ductility, insufficient amount of stirrups, which resulted in shear failure, can be offset with usage of the steel fibers. In addition to the steps taken, to analyze the effects of fibers percentages on the bearing capacity and ductility of frames parametric studies have been performed to investigate of these effects.Keywords: nonlinear analysis, SFRC frame, shear failure, varying an axial load
Procedia PDF Downloads 21815722 Optimization of Dez Dam Reservoir Operation Using Genetic Algorithm
Authors: Alireza Nikbakht Shahbazi, Emadeddin Shirali
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Since optimization issues of water resources are complicated due to the variety of decision making criteria and objective functions, it is sometimes impossible to resolve them through regular optimization methods or, it is time or money consuming. Therefore, the use of modern tools and methods is inevitable in resolving such problems. An accurate and essential utilization policy has to be determined in order to use natural resources such as water reservoirs optimally. Water reservoir programming studies aim to determine the final cultivated land area based on predefined agricultural models and water requirements. Dam utilization rule curve is also provided in such studies. The basic information applied in water reservoir programming studies generally include meteorological, hydrological, agricultural and water reservoir related data, and the geometric characteristics of the reservoir. The system of Dez dam water resources was simulated applying the basic information in order to determine the capability of its reservoir to provide the objectives of the performed plan. As a meta-exploratory method, genetic algorithm was applied in order to provide utilization rule curves (intersecting the reservoir volume). MATLAB software was used in order to resolve the foresaid model. Rule curves were firstly obtained through genetic algorithm. Then the significance of using rule curves and the decrease in decision making variables in the system was determined through system simulation and comparing the results with optimization results (Standard Operating Procedure). One of the most essential issues in optimization of a complicated water resource system is the increasing number of variables. Therefore a lot of time is required to find an optimum answer and in some cases, no desirable result is obtained. In this research, intersecting the reservoir volume has been applied as a modern model in order to reduce the number of variables. Water reservoir programming studies has been performed based on basic information, general hypotheses and standards and applying monthly simulation technique for a statistical period of 30 years. Results indicated that application of rule curve prevents the extreme shortages and decrease the monthly shortages.Keywords: optimization, rule curve, genetic algorithm method, Dez dam reservoir
Procedia PDF Downloads 26515721 Inclusive Cities Decision Matrix Based on a Multidimensional Approach for Sustainable Smart Cities
Authors: Madhurima S. Waghmare, Shaleen Singhal
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The concept of smartness, inclusion, sustainability is multidisciplinary and fuzzy, rooted in economic and social development theories and policies which get reflected in the spatial development of the cities. It is a challenge to convert these concepts from aspirations to transforming actions. There is a dearth of assessment and planning tools to support the city planners and administrators in developing smart, inclusive, and sustainable cities. To address this gap, this study develops an inclusive cities decision matrix based on an exploratory approach and using mixed methods. The matrix is soundly based on a review of multidisciplinary urban sector literature and refined and finalized based on inputs from experts and insights from case studies. The application of the decision matric on the case study cities in India suggests that the contemporary planning tools for cities need to be multidisciplinary and flexible to respond to the unique needs of the diverse contexts. The paper suggests that a multidimensional and inclusive approach to city planning can play an important role in building sustainable smart cities.Keywords: inclusive-cities decision matrix, smart cities in India, city planning tools, sustainable cities
Procedia PDF Downloads 15615720 A Comparative Study of Cognitive Factors Affecting Social Distancing among Vaccinated and Unvaccinated Filipinos
Authors: Emmanuel Carlo Belara, Albert John Dela Merced, Mark Anthony Dominguez, Diomari Erasga, Jerome Ferrer, Bernard Ombrog
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Social distancing errors are a common prevalence between vaccinated and unvaccinated in the Filipino community. This study aims to identify and relate the factors on how they affect our daily lives. Observed factors include memory, attention, anxiety, decision-making, and stress. Upon applying the ergonomic tools and statistical treatment such as t-test and multiple linear regression, stress and attention turned out to have the most impact to the errors of social distancing.Keywords: vaccinated, unvaccinated, socoal distancing, filipinos
Procedia PDF Downloads 20115719 Political Corruption in an Authoritarian Regime: a Story from the Kingdom of Morocco
Authors: Noureddine Radouai
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Corruption is an endemic phenomenon in many countries around the globe. Morocco, as an authoritarian regime, relies on corruption for monarchy survival. I analyze the Makhzen structure and methods that it follows to exchange corruption for political loyalty. The abuse of power in Morocco is sponsored by the monarch itself as it is its way to remain its importance in the regime.Keywords: corruption, Clientelism, authoritarian regime, Morocco
Procedia PDF Downloads 14015718 Multi-Criteria Goal Programming Model for Sustainable Development of India
Authors: Irfan Ali, Srikant Gupta, Aquil Ahmed
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Every country needs a sustainable development (SD) for its economic growth by forming suitable policies and initiative programs for the development of different sectors of the country. This paper is comprised of modeling and optimization of different sectors of India that form a multi-criterion model. In this paper, we developed a fractional goal programming (FGP) model that helps in providing the efficient allocation of resources simultaneously by achieving the sustainable goals in gross domestic product (GDP), electricity consumption (EC) and greenhouse gasses (GHG) emission by the year 2030. Also, a weighted model of FGP is presented to obtain varying solution according to the priorities set by the policy maker for achieving future goals of GDP growth, EC, and GHG emission. The presented models provide a useful insight to the decision makers for implementing strategies in a different sector.Keywords: sustainable and economic development, multi-objective fractional programming, fuzzy goal programming, weighted fuzzy goal programming
Procedia PDF Downloads 22315717 The United States Film Industry and Its Impact on Latin American Identity Rationalizations
Authors: Alfonso J. García Osuna
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Background and Significance: The objective of this paper is to analyze the inception and development of identity archetypes in early XX century Latin America, to explore their roots in United States culture, to discuss the influences that came to bear upon Latin Americans as the United States began to export images of standard identity paradigms through its film industry, and to survey how these images evolved and impacted Latin Americans’ ideas of national distinctiveness from the early 1900s to the present. Therefore, the general hypothesis of this work is that United States film in many ways influenced national identity patterning in its neighbors, especially in those nations closest to its borders, Cuba and Mexico. Very little research has been done on the social impact of the United States film industry on the country’s southern neighbors. From a historical perspective, the US’s influence has been examined as the projection of political and economic power, that is to say, that American influence is seen as a catalyst to align the forces that the US wants to see wield the power of the State. But the subtle yet powerful cultural influence exercised by film, the eminent medium for exporting ideas and ideals in the XX century, has not been significantly explored. Basic Methodologies and Description: Gramscian Marxist theory underpins the study, where it is argued that film, as an exceptional vehicle for culture, is an important site of political and social struggle; in this context, it aims to show how United States capitalist structures of power not only use brute force to generate and maintain control of overseas markets, but also promote their ideas through artistic products such as film in order to infiltrate the popular culture of subordinated peoples. In this same vein, the work of neo-Marxist theoreticians of popular culture is employed in order to contextualize the agency of subordinated peoples in the process of cultural assimilations. Indication of the Major Findings of the Study: The study has yielded much data of interest. The salient finding is that each particular nation receives United States film according to its own particular social and political context, regardless of the amount of pressure exerted upon it. An example of this is the unmistakable dissimilarity between Cuban and Mexican reception of US films. The positive reception given in Cuba to American film has to do with the seamless acceptance of identity paradigms that, for historical reasons discussed herein, were incorporated into the national identity grid quite unproblematically. Such is not the case with Mexico, whose express rejection of identity paradigms offered by the United States reflects not only past conflicts with the northern neighbor, but an enduring recognition of the country’s indigenous roots, one that precluded such paradigms. Concluding Statement: This paper is an endeavor to elucidate the ways in which US film contributed to the outlining of Latin American identity blueprints, offering archetypes that would be accepted or rejected according to each nation’s particular social requirements, constraints and ethnic makeup.Keywords: film studies, United States, Latin America, identity studies
Procedia PDF Downloads 29815716 Women Participation in Agriculture and Rural Development Activities in Kwacciyar-Lalle and Mogonho Communities of Sokoto State, Nigeria
Authors: B. Z. Abubakar, J. P. Voh, B. F. Umar, S. Khalid, A. A. Barau, J. Aigbe
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The study was conducted to identify and assess the various community development programmes designed and executed by Sokoto Agricultural and Community Development Project (SACDP) with the assistance of International Funds for Agricultural Development (IFAD) among women beneficiaries in Kwacciyar-lalle and Mogonho communities of Sokoto state. A simple random sampling technique was employed to select 20 project beneficiaries in each of the selected communities, making a total of 40 beneficiaries. Structured questionnaire, descriptive statistics such as frequencies and percentages and also participatory methodologies such as focus group discussion and pair wise ranking were used to analyze the data. Results showed that majority of the beneficiaries (75%) were married and undertook animal rearing as their major occupation. Results further showed that (85%) of the beneficiaries were involved in decision making, which enhanced their participation. Pair-wise ranking showed dug well as the most preferred activity, followed by construction of Islamic school in Kwacciyar-lalle while well construction followed by provision of improved animal species were most preferred in Mogonho. Recommendations made in the light of achieving people’s participation include provision of more infrastructural facilities and working materials.Keywords: community development, focus group, pair-wise ranking, infrastructure
Procedia PDF Downloads 37215715 The Amount of Information Processing and Balance Performance in Children: The Dual-Task Paradigm
Authors: Chin-Chih Chiou, Tai-Yuan Su, Ti-Yu Chen, Wen-Yu Chiu, Chungyu Chen
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The purpose of this study was to investigate the effect of reaction time (RT) or balance performance as the number of stimulus-response choices increases, the amount of information processing of 0-bit and 1-bit conditions based on Hick’s law, using the dual-task design. Eighteen children (age: 9.38 ± 0.27 years old) were recruited as the participants for this study, and asked to assess RT and balance performance separately and simultaneously as following five conditions: simple RT (0-bit decision), choice RT (1-bit decision), single balance control, balance control with simple RT, and balance control with choice RT. Biodex 950-300 balance system and You-Shang response timer were used to record and analyze the postural stability and information processing speed (RT) respectively for the participants. Repeated measures one-way ANOVA with HSD post-hoc test and 2 (balance) × 2 (amount of information processing) repeated measures two-way ANOVA were used to test the parameters of balance performance and RT (α = .05). The results showed the overall stability index in the 1-bit decision was lower than in 0-bit decision, and the mean deflection in the 1-bit decision was lower than in single balance performance. Simple RTs were faster than choice RTs both in single task condition and dual task condition. It indicated that the chronometric approach of RT could use to infer the attention requirement of the secondary task. However, this study did not find that the balance performance is interfered for children by the increasing of the amount of information processing.Keywords: capacity theory, reaction time, Hick’s law, balance
Procedia PDF Downloads 45215714 Supervised Machine Learning Approach for Studying the Effect of Different Joint Sets on Stability of Mine Pit Slopes Under the Presence of Different External Factors
Authors: Sudhir Kumar Singh, Debashish Chakravarty
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Slope stability analysis is an important aspect in the field of geotechnical engineering. It is also important from safety, and economic point of view as any slope failure leads to loss of valuable lives and damage to property worth millions. This paper aims at mitigating the risk of slope failure by studying the effect of different joint sets on the stability of mine pit slopes under the influence of various external factors, namely degree of saturation, rainfall intensity, and seismic coefficients. Supervised machine learning approach has been utilized for making accurate and reliable predictions regarding the stability of slopes based on the value of Factor of Safety. Numerous cases have been studied for analyzing the stability of slopes using the popular Finite Element Method, and the data thus obtained has been used as training data for the supervised machine learning models. The input data has been trained on different supervised machine learning models, namely Random Forest, Decision Tree, Support vector Machine, and XGBoost. Distinct test data that is not present in training data has been used for measuring the performance and accuracy of different models. Although all models have performed well on the test dataset but Random Forest stands out from others due to its high accuracy of greater than 95%, thus helping us by providing a valuable tool at our disposition which is neither computationally expensive nor time consuming and in good accordance with the numerical analysis result.Keywords: finite element method, geotechnical engineering, machine learning, slope stability
Procedia PDF Downloads 10115713 Increasing Employee Productivity and Work Well-Being by Employing Affective Decision Support and a Knowledge-Based System
Authors: Loreta Kaklauskiene, Arturas Kaklauskas
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This employee productivity and work well-being effective system aims to maximise the work performance of personnel and boost well-being in offices. Affective computing, decision support, and knowledge-based systems were used in our research. The basis of this effective system is our European Patent application (No: EP 4 020 134 A1) and two Lithuanian patents (LT 6841, LT 6866). Our study examines ways to support efficient employee productivity and well-being by employing mass-customised, personalised office environment. Efficient employee performance and well-being are managed by changing mass-customised office environment factors such as air pollution levels, humidity, temperature, data, information, knowledge, activities, lighting colours and intensity, scents, media, games, videos, music, and vibrations. These aspects of management generate a customised, adaptive environment for users taking into account their emotional, affective, and physiological (MAP) states measured and fed into the system. This research aims to develop an innovative method and system which would analyse, customise and manage a personalised office environment according to a specific user’s MAP states in a cohesive manner. Various values of work spaces (e.g., employee utilitarian, hedonic, perceived values) are also established throughout this process, based on the measurements that describe MAP states and other aspects related to the office environment. The main contribution of our research is the development of a real-time mass-customised office environment to boost employee performance and well-being. Acknowledgment: This work was supported by Project No. 2020-1-LT01-KA203-078100 “Minimizing the influence of coronavirus in a built environment” (MICROBE) from the European Union’s Erasmus + program.Keywords: effective decision support and a knowledge-based system, human resource management, employee productivity and work well-being, affective computing
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