Search results for: healthcare delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3388

Search results for: healthcare delivery

1858 Evaluating Electronic Service Quality in Banking Iran

Authors: Vahid Bairami Rad

Abstract:

With the rapid growth of the Internet and the globalization of the market, most enterprises are trying to attract and win customers in the highly competitive electronic market. Better e-service quality will enhance the relationship with customers and their satisfaction. So the measurement of eservice quality is very important but it is a complex process due to the complex nature of services. Literature predicts that there is a lack of universal definition of e-service quality. The e-service quality measures in banking have great importance in achieving high customer base. This paper proposes a conceptual model for measuring e-service quality in Iranian Banking Iran. Nine dimensions reliability, ease of use, personalization, security and trust, website aesthetic, responsiveness, contact and speed of delivery had been identified. The results of this paper may help to develop a proper scale to measure the e-service quality in Iranian Banking Industry, which may assist to maintain and improve the performance and effectiveness of e-service quality to retain customers.

Keywords: electronic banking, Dimensions, customer service quality, electronic, communication

Procedia PDF Downloads 500
1857 The Link between Strategic Sense-Making and Performance in Dubai Public Sector

Authors: Mohammad Rahman, Guy Burton, Megan Mathias

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Strategic management as an organizational practice was adopted by the public sector in the New Public Management (NPM) era that began in most parts of the world in the 1980s. Strategy as a new public management concept was subscribed by governments in both developed and developing world, as they were persuaded that clearly defined vision, mission and goals, as well as programs and projects - aligned with the goals - could potentially help achieve government vision at the national level and organizational goals at the service-delivery level. The advocates for strategic management in the public sector saw an inherent link between strategy and performance, claiming that the implementation of organizational strategy has an effect on the overall performance of an organization. Arguably, many government entities that have failed in enhancing team and individual performance had poorly-designed strategy or weak strategy implementation. Another key argument about low-level performance is linked with lack of strategic sense-making and orientation by middle managers in particular. Scholars maintain that employees at all levels need to understand strategic management plan in order to facilitate its implementation. Therefore, involving employees (particularly the middle managers) from the beginning potentially helps an organization avoid the drop in performance, and on the contrary would increase their commitment. The United Arab Emirates (UAE) is well known for adopting public sector reform strategies and tools since the 1990s. This observation is contextually pertinent in the case of the Government of Dubai, which has provided a Strategy Execution Guide to all of its entities to achieve high level strategic success in service delivery. The Dubai public sector also adopts road maps for e-Government, Smart Dubai, Expo 2020, investment, environment, education, health and other sectors. Evidently, some of these strategies are bringing tangible (e.g. Smart Dubai transformation) results in a transformational manner. However, the amount of academic research and literature on the strategy process vis-à-vis staff performance in the Government of Dubai is limited. In this backdrop, this study examines how individual performance of public sector employees in Dubai is linked with their sense-making, engagement and orientation with strategy development and implementation processes. Based on a theoretical framework, this study will undertake a sample-based questionnaire survey amongst middle managers in Dubai public sector to (a) measure the level of engagement of middle managers in strategy development and implementation processes as perceived by them; (b) observe the organizational landscape in which role expectations are placed on middle managers; and (c) examine the impact of employee engagement in strategy development process and the conditions for role expectations on individual performance. The paper is expected to provide new insights on the interface between strategic sense-making and performance in order to contribute a better understanding of the current culture/practices of staff engagement in strategic management in the public sector of Dubai.

Keywords: employee performance, government of Dubai, middle managers, strategic sense-making

Procedia PDF Downloads 197
1856 Employee Branding: An Exploratory Study Applied to Nurses in an Organization

Authors: Pawan Hinge, Priya Gupta

Abstract:

Due to cutting edge competitions between organizations and war for talent, the workforce as an asset is gaining significance. The employees are considered as the brand ambassadors of an organization, and their interactions with the clients and customers might impact directly or indirectly on the overall value of the organization. Especially, organizations in the healthcare industry the value of an organization in the perception of their employees can be one of the revenue generating and talent retention strategy. In such context, it is essential to understand that the brand awareness among employees can effect on employer brand image and brand value since the brand ambassadors are the interface between organization and customers and clients. In this exploratory study, we have adopted both quantitative and qualitative approaches for data analysis. Our study shows existing variation among nurses working in different business units of the same organization in terms of their customer interface or interactions and brand awareness.

Keywords: brand awareness, brand image, brand value, customer interface

Procedia PDF Downloads 285
1855 Podcasting as an Instructional Method: Case Study of a School Psychology Class

Authors: Jeff A. Tysinger, Dawn P. Tysinger

Abstract:

There has been considerable growth in online learning. Researchers continue to explore the impact various methods of delivery. Podcasting is a popular method for sharing information. The purpose of this study was to examine the impact of student motivation and the perception of the acquisition of knowledge in an online environment of a skill-based class. 25 students in a school psychology graduate class completed a pretest and posttest examining podcast use and familiarity. In addition, at the completion of the course they were administered a modified version of the Instructional Materials Motivation Survey. The four subscales were examined (attention, relevance, confidence, and satisfaction). Results indicated that students are motivated, they perceive podcasts as positive instructional tools, and students are successful in acquiring the needed information. Additional benefits of using podcasts and recommendations in school psychology training are discussed.

Keywords: motivation, online learning, pedagogy, podcast

Procedia PDF Downloads 131
1854 Nigerian Football System: Examining Meso-Level Practices against a Global Model for Integrated Development of Mass and Elite Sport

Authors: I. Derek Kaka’an, P. Smolianov, D. Koh Choon Lian, S. Dion, C. Schoen, J. Norberg

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This study was designed to examine mass participation and elite football performance in Nigeria with reference to advance international football management practices. Over 200 sources of literature on sport delivery systems were analyzed to construct a globally applicable model of elite football integrated with mass participation, comprising of the following three levels: macro- (socio-economic, cultural, legislative, and organizational), meso- (infrastructures, personnel, and services enabling sport programs) and micro-level (operations, processes, and methodologies for development of individual athletes). The model has received scholarly validation and showed to be a framework for program analysis that is not culturally bound. The Smolianov and Zakus model has been employed for further understanding of sport systems such as US soccer, US Rugby, swimming, tennis, and volleyball as well as Russian and Dutch swimming. A questionnaire was developed using the above-mentioned model. Survey questions were validated by 12 experts including academicians, executives from sport governing bodies, football coaches, and administrators. To identify best practices and determine areas for improvement of football in Nigeria, 120 coaches completed the questionnaire. Useful exemplars and possible improvements were further identified through semi-structured discussions with 10 Nigerian football administrators and experts. Finally, content analysis of Nigeria Football Federation’s website and organizational documentation was conducted. This paper focuses on the meso-level of Nigerian football delivery, particularly infrastructures, personnel, and services enabling sport programs. This includes training centers, competition systems, and intellectual services. Results identified remarkable achievements coupled with great potential to further develop football in different types of public and private organizations in Nigeria. These include: assimilating football competitions with other cultural and educational activities, providing favorable conditions for employees of all possible organizations to partake and help in managing football programs and events, providing football coaching integrated with counseling for prevention of antisocial conduct, and improving cooperation between football programs and organizations for peace-making and advancement of international relations, tourism, and socio-economic development. Accurate reporting of the sports programs from the media should be encouraged through staff training for better awareness of various events. The systematic integration of these meso-level practices into the balanced development of mass and high-performance football will contribute to international sport success as well as national health, education, and social harmony.

Keywords: football, high performance, mass participation, Nigeria, sport development

Procedia PDF Downloads 252
1853 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic

Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

Abstract:

Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

Procedia PDF Downloads 82
1852 Agent-Base Modeling of IoT Applications by Using Software Product Line

Authors: Asad Abbas, Muhammad Fezan Afzal, Muhammad Latif Anjum, Muhammad Azmat

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The Internet of Things (IoT) is used to link up real objects that use the internet to interact. IoT applications allow handling and operating the equipment in accordance with environmental needs, such as transportation and healthcare. IoT devices are linked together via a number of agents that act as a middleman for communications. The operation of a heat sensor differs indoors and outside because agent applications work with environmental variables. In this article, we suggest using Software Product Line (SPL) to model IoT agents and applications' features on an XML-based basis. The contextual diversity within the same domain of application can be handled, and the reusability of features is increased by XML-based feature modelling. For the purpose of managing contextual variability, we have embraced XML for modelling IoT applications, agents, and internet-connected devices.

Keywords: IoT agents, IoT applications, software product line, feature model, XML

Procedia PDF Downloads 94
1851 An Enhanced Connectivity Aware Routing Protocol for Vehicular Ad Hoc Networks

Authors: Ahmadu Maidorawa, Kamalrulnizam Abu Bakar

Abstract:

This paper proposed an Enhanced Connectivity Aware Routing (ECAR) protocol for Vehicular Ad hoc Network (VANET). The protocol uses a control broadcast to reduce the number of overhead packets needed in a route discovery process. It is also equipped with an alternative backup route that is used whenever a primary path to destination failed, which highly reduces the frequent launching and re-launching of the route discovery process that waste useful bandwidth and unnecessarily prolonging the average packet delay. NS2 simulation results show that the performance of ECAR protocol outperformed the original connectivity aware routing (CAR) protocol by reducing the average packet delay by 28%, control overheads by 27% and increased the packet delivery ratio by 22%.

Keywords: alternative path, primary path, protocol, routing, VANET, vehicular ad hoc networks

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1850 The Increasing Importance of the Role of AI in Higher Education

Authors: Joshefina Bengoechea Fernandez, Alex Bell

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In its 2021 guidance for policy makers, the UNESCO has proposed 4 areas where AI can be applied in educational settings: These are: 1) Education management and delivery; 2) Learning and assessment; 3) Empowering teachers and facilitating teaching, and 4) Providing lifelong learning possibilities (UNESCO, 2021). Like with wblockchain technologies, AI will automate the management of educational institutions. These include, but are not limited to admissions, timetables, attendance, and homework monitoring. Furthermore, AI will be used to select relevant learning content across learning platforms for each student, based on his or her personalized needs. A problem educators face is the “one-size-fits-all” approach that does not work with a diverse student population. The purpose of this paper is to illustrate if the implementation of Technology is the solution to the Problems faced in Higher Education. The paper builds upon a constructivist approach, combining a literature review and research on key publications and academic reports.

Keywords: artificial intelligence, learning platforms, students personalised needs, life- long learning, privacy, ethics

Procedia PDF Downloads 104
1849 The Need for Sustaining Hope during Communication of Unfavourable News in the Care of Children with Palliative Care Needs: The Experience of Mothers and Health Professionals in Jordan

Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

Procedia PDF Downloads 217
1848 Analytics Model in a Telehealth Center Based on Cloud Computing and Local Storage

Authors: L. Ramirez, E. Guillén, J. Sánchez

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Some of the main goals about telecare such as monitoring, treatment, telediagnostic are deployed with the integration of applications with specific appliances. In order to achieve a coherent model to integrate software, hardware, and healthcare systems, different telehealth models with Internet of Things (IoT), cloud computing, artificial intelligence, etc. have been implemented, and their advantages are still under analysis. In this paper, we propose an integrated model based on IoT architecture and cloud computing telehealth center. Analytics module is presented as a solution to control an ideal diagnostic about some diseases. Specific features are then compared with the recently deployed conventional models in telemedicine. The main advantage of this model is the availability of controlling the security and privacy about patient information and the optimization on processing and acquiring clinical parameters according to technical characteristics.

Keywords: analytics, telemedicine, internet of things, cloud computing

Procedia PDF Downloads 325
1847 A Taxonomy of Routing Protocols in Wireless Sensor Networks

Authors: A. Kardi, R. Zagrouba, M. Alqahtani

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The Internet of Everything (IoE) presents today a very attractive and motivating field of research. It is basically based on Wireless Sensor Networks (WSNs) in which the routing task is the major analysis topic. In fact, it directly affects the effectiveness and the lifetime of the network. This paper, developed from recent works and based on extensive researches, proposes a taxonomy of routing protocols in WSNs. Our main contribution is that we propose a classification model based on nine classes namely application type, delivery mode, initiator of communication, network architecture, path establishment (route discovery), network topology (structure), protocol operation, next hop selection and latency-awareness and energy-efficient routing protocols. In order to provide a total classification pattern to serve as reference for network designers, each class is subdivided into possible subclasses, presented, and discussed using different parameters such as purposes and characteristics.

Keywords: routing, sensor, survey, wireless sensor networks, WSNs

Procedia PDF Downloads 182
1846 Automated System: Managing the Production and Distribution of Radiopharmaceuticals

Authors: Shayma Mohammed, Adel Trabelsi

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Radiopharmacy is the art of preparing high-quality, radioactive, medicinal products for use in diagnosis and therapy. Radiopharmaceuticals unlike normal medicines, this dual aspect (radioactive, medical) makes their management highly critical. One of the most convincing applications of modern technologies is the ability to delegate the execution of repetitive tasks to programming scripts. Automation has found its way to the most skilled jobs, to improve the company's overall performance by allowing human workers to focus on more important tasks than document filling. This project aims to contribute to implement a comprehensive system to insure rigorous management of radiopharmaceuticals through the use of a platform that links the Nuclear Medicine Service Management System to the Nuclear Radio-pharmacy Management System in accordance with the recommendations of World Health Organization (WHO) and International Atomic Energy Agency (IAEA). In this project we attempt to build a web application that targets radiopharmacies, the platform is built atop the inherently compatible web stack which allows it to work in virtually any environment. Different technologies are used in this project (PHP, Symfony, MySQL Workbench, Bootstrap, Angular 7, Visual Studio Code and TypeScript). The operating principle of the platform is mainly based on two parts: Radiopharmaceutical Backoffice for the Radiopharmacian, who is responsible for the realization of radiopharmaceutical preparations and their delivery and Medical Backoffice for the Doctor, who holds the authorization for the possession and use of radionuclides and he/she is responsible for ordering radioactive products. The application consists of sven modules: Production, Quality Control/Quality Assurance, Release, General Management, References, Transport and Stock Management. It allows 8 classes of users: The Production Manager (PM), Quality Control Manager (QCM), Stock Manager (SM), General Manager (GM), Client (Doctor), Parking and Transport Manager (PTM), Qualified Person (QP) and Technical and Production Staff. Digital platform bringing together all players involved in the use of radiopharmaceuticals and integrating the stages of preparation, production and distribution, Web technologies, in particular, promise to offer all the benefits of automation while requiring no more than a web browser to act as a user client, which is a strength because the web stack is by nature multi-platform. This platform will provide a traceability system for radiopharmaceuticals products to ensure the safety and radioprotection of actors and of patients. The new integrated platform is an alternative to write all the boilerplate paperwork manually, which is a tedious and error-prone task. It would minimize manual human manipulation, which has proven to be the main source of error in nuclear medicine. A codified electronic transfer of information from radiopharmaceutical preparation to delivery will further reduce the risk of maladministration.

Keywords: automated system, management, radiopharmacy, technical papers

Procedia PDF Downloads 156
1845 Preparation and Characterization of Poly (ε-caprolactone) Loaded with Layered Double Hydroxide Nanohybrid Intercalated with Alendronate for Osteoporosis Treatment

Authors: Seyedeh Faranak Baniahmad, Soroor Yousefi

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Osteoporosis is a bone disease which increases the bone fracture risk, reduces the bone mineral density (BMD) and alters the amount and variety of proteins in bones. Antiresorptive therapy is one the most popular Osteoporosis treatment methods. In this method the bisphosphonates, hormones, calcitonin or the selective estrogen receptor modulators is replaced. In order to reduce undesirable effects and to increase the bioavailability of drug agents, the controlled drug delivery systems have been utilized. In current study, the controlled release of Alendronate from LDH-PCL with (0, 5, 10, 15 % wt. of LDH) was investigated. The results showed that the release of alendronate from the lamellar LDH incorporated into the PCL matrix is much slower than the release of alendronate from the PCL. Therefore such systems are very promising, in which the antiresorptive drug has to remain in the matrix for longer time and can be released in controlled manner.

Keywords: osteoporosis, alendronate, poly (ε–caprolactone), layered double hydroxide

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1844 Microbial Contamination of Cell Phones of Health Care Workers: Case Study in Mampong Municipal Government Hospital, Ghana

Authors: Francis Gyapong, Denis Yar

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The use of cell phones has become an indispensable tool in the hospital's settings. Cell phones are used in hospitals without restrictions regardless of their unknown microbial load. However, the indiscriminate use of mobile devices, especially at health facilities, can act as a vehicle for transmitting pathogenic bacteria and other microorganisms. These potential pathogens become exogenous sources of infection for the patients and are also a potential health hazard for self and as well as family members. These are a growing problem in many health care institutions. Innovations in mobile communication have led to better patient care in diabetes, asthma, and increased in vaccine uptake via SMS. Notwithstanding, the use of cell phones can be a great potential source for nosocomial infections. Many studies reported heavy microbial contamination of cell phones among healthcare workers and communities. However, limited studies have been reported in our region on bacterial contamination on cell phones among healthcare workers. This study assessed microbial contamination of cell phones of health care workers (HCWs) at the Mampong Municipal Government Hospital (MMGH), Ghana. A cross-sectional design was used to characterize bacterial microflora on cell phones of HCWs at the MMGH. A total of thirty-five (35) swab samples of cell phones of HCWs at the Laboratory, Dental Unit, Children’s Ward, Theater and Male ward were randomly collected for laboratory examinations. A suspension of the swab samples was each streak on blood and MacConkey agar and incubated at 37℃ for 48 hours. Bacterial isolates were identified using appropriate laboratory and biochemical tests. Kirby-Bauer disc diffusion method was used to determine the antimicrobial sensitivity tests of the isolates. Data analysis was performed using SPSS version 16. All mobile phones sampled were contaminated with one or more bacterial isolates. Cell phones from the Male ward, Dental Unit, Laboratory, Theatre and Children’s ward had at least three different bacterial isolates; 85.7%, 71.4%, 57.1% and 28.6% for both Theater and Children’s ward respectively. Bacterial contaminants identified were Staphylococcus epidermidis (37%), Staphylococcus aureus (26%), E. coli (20%), Bacillus spp. (11%) and Klebsiella spp. (6 %). Except for the Children ward, E. coli was isolated at all study sites and predominant (42.9%) at the Dental Unit while Klebsiella spp. (28.6%) was only isolated at the Children’s ward. Antibiotic sensitivity testing of Staphylococcus aureus indicated that they were highly sensitive to cephalexin (89%) tetracycline (80%), gentamycin (75%), lincomycin (70%), ciprofloxacin (67%) and highly resistant to ampicillin (75%). Some of these bacteria isolated are potential pathogens and their presence on cell phones of HCWs could be transmitted to patients and their families. Hence strict hand washing before and after every contact with patient and phone be enforced to reduce the risk of nosocomial infections.

Keywords: mobile phones, bacterial contamination, patients, MMGH

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1843 Forecasting Silver Commodity Prices Using Geometric Brownian Motion: A Stochastic Approach

Authors: Sina Dehghani, Zhikang Rong

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Historically, a variety of approaches have been taken to forecast commodity prices due to the significant implications of these values on the global economy. An accurate forecasting tool for a valuable commodity would significantly benefit investors and governmental agencies. Silver, in particular, has grown significantly as a commodity in recent years due to its use in healthcare and technology. This manuscript aims to utilize the Geometric Brownian Motion predictive model to forecast silver commodity prices over multiple 3-year periods. The results of the study indicate that the model has several limitations, particularly its inability to work effectively over longer periods of time, but still was extremely effective over shorter time frames. This study sets a baseline for silver commodity forecasting with GBM, and the model could be further strengthened with refinement.

Keywords: geometric Brownian motion, commodity, risk management, volatility, stochastic behavior, price forecasting

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1842 Digital Advance Care Planning and Directives: Early Observations of Adoption Statistics and Responses from an All-Digital Consumer-Driven Approach

Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

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Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

Procedia PDF Downloads 327
1841 Evaluation and Selection of SaaS Product Based on User Preferences

Authors: Boussoualim Nacira, Aklouf Youcef

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Software as a Service (SaaS) is a software delivery paradigm in which the product is not installed on-premise, but it is available on Internet and Web. The customers do not pay to possess the software itself but rather to use it. This concept of pay per use is very attractive. Hence, we see increasing number of organizations adopting SaaS. However, each customer is unique, which leads to a very large variation in the requirements off the software. As several suppliers propose SaaS products, the choice of this latter becomes a major issue. When multiple criteria are involved in decision making, we talk about a problem of «Multi-Criteria Decision-Making» (MCDM). Therefore, this paper presents a method to help customers to choose a better SaaS product satisfying most of their conditions and alternatives. Also, we know that a good method of adaptive selection should be based on the correct definition of the different parameters of choice. This is why we started by extraction and analysis the various parameters involved in the process of the selection of a SaaS application.

Keywords: cloud computing, business operation, Multi-Criteria Decision-Making (MCDM), Software as a Service (SaaS)

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1840 IoT: State-of-the-Art and Future Directions

Authors: Bashir Abdu Muzakkari, Aisha Umar Sulaiman, Mohamed Afendee Muhamad, Sanah Abdullahi Muaz

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The field of the Internet of Things (IoT) is rapidly expanding and has the potential to completely change how we work, live, and interact with the world. The Internet of Things (IoT) is the term used to describe a network of networked physical objects, including machinery, vehicles, and buildings, which are equipped with electronics, software, sensors, and network connectivity. This review paper aims to provide a comprehensive overview of the current state of IoT, including its definition, key components, development history, and current applications. The paper will also discuss the challenges and opportunities presented by IoT, as well as its potential impact on various industries, such as healthcare, agriculture, and transportation. In addition, this paper will highlight the ethical and security concerns associated with IoT and the need for effective solutions to address these challenges. The paper concludes by highlighting the prospects of IoT and the directions for future research in this field.

Keywords: internet of things, IoT, sensors, network

Procedia PDF Downloads 174
1839 Impact of Node Density and Transmission Range on the Performance of OLSR and DSDV Routing Protocols in VANET City Scenarios

Authors: Yassine Meraihi, Dalila Acheli, Rabah Meraihi

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Vehicular Ad hoc Network (VANET) is a special case of Mobile Ad hoc Network (MANET) used to establish communications and exchange information among nearby vehicles and between vehicles and nearby fixed infrastructure. VANET is seen as a promising technology used to provide safety, efficiency, assistance and comfort to the road users. Routing is an important issue in Vehicular Ad Hoc Network to find and maintain communication between vehicles due to the highly dynamic topology, frequently disconnected network and mobility constraints. This paper evaluates the performance of two most popular proactive routing protocols OLSR and DSDV in real city traffic scenario on the basis of three metrics namely Packet delivery ratio, throughput and average end to end delay by varying vehicles density and transmission range.

Keywords: DSDV, OLSR, quality of service, routing protocols, VANET

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1838 Characterization of Alloyed Grey Cast Iron Quenched and Tempered for a Smooth Roll Application

Authors: Mohamed Habireche, Nacer E. Bacha, Mohamed Djeghdjough

Abstract:

In the brick industry, smooth double roll crusher is used for medium and fine crushing of soft to medium hard material. Due to opposite inward rotation of the rolls, the feed material is nipped between the rolls and crushed by compression. They are subject to intense wear, known as three-body abrasion, due to the action of abrasive products. The production downtime affecting productivity stems from two sources: the bi-monthly rectification of the roll crushers and their replacement when they are completely worn out. Choosing the right material for the roll crushers should result in longer machine cycles, and reduced repair and maintenance costs. All roll crushers are imported from outside Algeria. This results in sometimes very long delivery times which handicap the brickyards, in particular in respecting delivery times and honored the orders made by customers. The aim of this work is to investigate the effect of alloying additions on microstructure and wear behavior of grey lamellar cast iron for smooth roll crushers in brick industry. The base gray iron was melted in an induction furnace with low frequency at a temperature of 1500 °C, in which return cast iron scrap, new cast iron ingot, and steel scrap were added to the melt to generate the desired composition. The chemical analysis of the bar samples was carried out using Emission Spectrometer Systems PV 8050 Series (Philips) except for the carbon, for which a carbon/sulphur analyser Elementrac CS-i was used. Unetched microstructure was used to evaluate the graphite flake morphology using the image comparison measurement method. At least five different fields were selected for quantitative estimation of phase constituents. The samples were observed under X100 magnification with a Zeiss Axiover T40 MAT optical microscope equipped with a digital camera. SEM microscope equipped with EDS was used to characterize the phases present in the microstructure. The hardness (750 kg load, 5mm diameter ball) was measured with a Brinell testing machine for both treated and as-solidified condition test pieces. The test bars were used for tensile strength and metallographic evaluations. Mechanical properties were evaluated using tensile specimens made as per ASTM E8 standards. Two specimens were tested for each alloy. From each rod, a test piece was made for the tensile test. The results showed that the quenched and tempered alloys had best wear resistance at 400 °C for alloyed grey cast iron (containing 0.62%Mn, 0.68%Cr, and 1.09% Cu) due to fine carbides in the tempered matrix. In quenched and tempered condition, increasing Cu content in cast irons improved its wear resistance moderately. Combined addition of Cu and Cr increases hardness and wear resistance for a quenched and tempered hypoeutectic grey cast iron.

Keywords: casting, cast iron, microstructure, heat treating

Procedia PDF Downloads 105
1837 Improving Library Service Quality in Local City of Indonesia

Authors: Prima Fithri, Afri Adnan, Verra Syahmer

Abstract:

Library as a public service should be able to provide excellent and quality service. The criteria that should be available in the library is having the collection which relevant, actual and reliable, qualified and professional employee, delivery system that prompt and appropriate as well as supported by proper infrastructure. The aim of this study is to show the performance as an effort to provide quality of services that appropriate with the needs and desires of user. Then, in this research has been carried out the calculation of the gap between the perceptions and expectations of user about the services of the library. The Sevqual and QFD methods are used in this study. Servqual method for measuring the value of the gap that occurs in the dimensions of service quality and QFD method for determine priority repairment that need to be done to improve the quality of services that occur in the dimensions of service quality. From 97 questionaires, shows that value of the gap that occurs in the dimensions of service quality using by Servqual is 27.7% dimensions of responsiveness. It show how much user expectations are not met by the quality of existing services. Construction of the library and standard library becomes priority improvements that need to be done to improve the quality of service that occurs in the dimensions of service quality using the QFD.

Keywords: library, service quality, service quality, QFD

Procedia PDF Downloads 578
1836 Visualize Global Warming and Its Consequences Using Augmented Reality

Authors: K. R. Parvathy, R. Rao Bhavani , M. L. McLain, Kamal Bijlani, R. Jayakrishnan

Abstract:

Augmented Reality (AR) technology is considered to be an important emerging technology used in education today. One potentially key use of AR in education is to teach socio-scientific issues (SSI), topics that inure students towards social conscience and critical thinking. This work uses multiple markers and virtual buttons that interact with each other, creating a life-like visual spectacle. Learning about issues such as global warming by using AR technology, students will have an increased sense of experiencing immersion, immediacy, and presence, thereby enhancing their learning as well as likely improving their ability to make better informed decisions about considerations of such issues. Another advantage of AR is that it is a low cost technology, making it advantageous for educators to adapt to their classrooms. Also in this work we compare the effectiveness of AR versus ordinary video by polling a group of students to assess the content understandability, effectiveness and interaction of both the delivery methods.

Keywords: augmented reality, global warming, multiple markers, virtual buttons

Procedia PDF Downloads 400
1835 Interpersonal Competence Related to the Practice Learning of Occupational Therapy Students in Hong Kong

Authors: Lik Hang Gary Wong

Abstract:

Background: Practice learning is crucial for preparing the healthcare profession to meet the real challenge upon graduation. Students are required to demonstrate their competence in managing interpersonal challenges, such as teamwork with other professionals and communicating well with the service users, during the placement. Such competence precedes clinical practice, and it may eventually affect students' actual performance in a clinical context. Unfortunately, there were limited studies investigating how such competence affects students' performance in practice learning. Objectives: The aim of this study is to investigate how self-rated interpersonal competence affects students' actual performance during clinical placement. Methods: 40 occupational therapy students from Hong Kong were recruited in this study. Prior to the clinical placement (level two or above), they completed an online survey that included the Interpersonal Communication Competence Scale (ICCS) measuring self-perceived competence in interpersonal communication. Near the end of their placement, the clinical educator rated students’ performance with the Student Practice Evaluation Form - Revised edition (SPEF-R). The SPEF-R measures the eight core competency domains required for an entry-level occupational therapist. This study adopted the cross-sectional observational design. Pearson correlation and multiple regression are conducted to examine the relationship between students' interpersonal communication competence and their actual performance in clinical placement. Results: The ICCS total scores were significantly correlated with all the SPEF-R domains, with correlation coefficient r ranging from 0.39 to 0.51. The strongest association was found with the co-worker communication domain (r = 0.51, p < 0.01), followed by the information gathering domain (r = 0.50, p < 0.01). Regarding the ICCS total scores as the independent variable and the rating in various SPEF-R domains as the dependent variables in the multiple regression analyses, the interpersonal competence measures were identified as a significant predictor of the co-worker communication (R² = 0.33, β = 0.014, SE = 0.006, p = 0.026), information gathering (R² = 0.27, β = 0.018, SE = 0.007, p = 0.011), and service provision (R² = 0.17, β = 0.017, SE = 0.007, p = 0.020). Moreover, some specific communication skills appeared to be especially important to clinical practice. For example, immediacy, which means whether the students were readily approachable on all social occasions, correlated with all the SPEF-R domains, with r-values ranging from 0.45 to 0.33. Other sub-skills, such as empathy, interaction management, and supportiveness, were also found to be significantly correlated to most of the SPEF-R domains. Meanwhile, the ICCS scores correlated differently with the co-worker communication domain (r = 0.51, p < 0.01) and the communication with the service user domain (r = 0.39, p < 0.05). It suggested that different communication skill sets would be required for different interpersonal contexts within the workplace. Conclusion: Students' self-perceived interpersonal communication competence could predict their actual performance during clinical placement. Moreover, some specific communication skills were more important to the co-worker communication but not to the daily interaction with the service users. There were implications on how to better prepare the students to meet the future challenge upon graduation.

Keywords: interpersonal competence, clinical education, healthcare professional education, occupational therapy, occupational therapy students

Procedia PDF Downloads 72
1834 AI-Driven Strategies for Sustainable Electronics Repair: A Case Study in Energy Efficiency

Authors: Badiy Elmabrouk, Abdelhamid Boujarif, Zhiguo Zeng, Stephane Borrel, Robert Heidsieck

Abstract:

In an era where sustainability is paramount, this paper introduces a machine learning-driven testing protocol to accurately predict diode failures, merging reliability engineering with failure physics to enhance repair operations efficiency. Our approach refines the burn-in process, significantly curtailing its duration, which not only conserves energy but also elevates productivity and mitigates component wear. A case study from GE HealthCare’s repair center vividly demonstrates the method’s effectiveness, recording a high prediction of diode failures and a substantial decrease in energy consumption that translates to an annual reduction of 6.5 Tons of CO2 emissions. This advancement sets a benchmark for environmentally conscious practices in the electronics repair sector.

Keywords: maintenance, burn-in, failure physics, reliability testing

Procedia PDF Downloads 68
1833 Real-Time Episodic Memory Construction for Optimal Action Selection in Cognitive Robotics

Authors: Deon de Jager, Yahya Zweiri, Dimitrios Makris

Abstract:

The three most important components in the cognitive architecture for cognitive robotics is memory representation, memory recall, and action-selection performed by the executive. In this paper, action selection, performed by the executive, is defined as a memory quantification and optimization process. The methodology describes the real-time construction of episodic memory through semantic memory optimization. The optimization is performed by set-based particle swarm optimization, using an adaptive entropy memory quantification approach for fitness evaluation. The performance of the approach is experimentally evaluated by simulation, where a UAV is tasked with the collection and delivery of a medical package. The experiments show that the UAV dynamically uses the episodic memory to autonomously control its velocity, while successfully completing its mission.

Keywords: cognitive robotics, semantic memory, episodic memory, maximum entropy principle, particle swarm optimization

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1832 Gamma-Hydroxybutyrate (GHB): A Review for the Prehospital Clinician

Authors: Theo Welch

Abstract:

Background: Gamma-hydroxybutyrate (GHB) is a depressant of the central nervous system with euphoric effects. It is being increasingly used recreationally in the United Kingdom (UK) despite associated morbidity and mortality. Due to the lack of evidence, healthcare professionals remain unsure as to the optimum management of GHB acute toxicity. Methods: A literature review was undertaken of its pharmacology and the emergency management of its acute toxicity.Findings: GHB is inexpensive and readily available over the Internet. Treatment of GHB acute toxicity is supportive. Clinicians should pay particular attention to the airway as emesis is common. Intubation is required in a minority of cases. Polydrug use is common and worsens prognosis. Conclusion: An inexpensive and readily available drug, GHB acute toxicity can be difficult to identify and treat. GHB acute toxicity is generally treated conservatively. Further research is needed to ascertain the indications, benefits, and risks of intubating patients with GHB acute toxicity. instructions give you guidelines for preparing papers for the conference.

Keywords: GHB, gamma-hydroxybutyrate, prehospital, emergency, toxicity, management

Procedia PDF Downloads 201
1831 Rule-Based Expert System for Headache Diagnosis and Medication Recommendation

Authors: Noura Al-Ajmi, Mohammed A. Almulla

Abstract:

With the increased utilization of technology devices around the world, healthcare and medical diagnosis are critical issues that people worry about these days. Doctors are doing their best to avoid any medical errors while diagnosing diseases and prescribing the wrong medication. Subsequently, artificial intelligence applications that can be installed on mobile devices such as rule-based expert systems facilitate the task of assisting doctors in several ways. Due to their many advantages, the usage of expert systems has increased recently in health sciences. This work presents a backward rule-based expert system that can be used for a headache diagnosis and medication recommendation system. The structure of the system consists of three main modules, namely the input unit, the processing unit, and the output unit.

Keywords: headache diagnosis system, prescription recommender system, expert system, backward rule-based system

Procedia PDF Downloads 215
1830 Comparison of Incidence and Risk Factors of Early Onset and Late Onset Preeclampsia: A Population Based Cohort Study

Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

Abstract:

Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

Procedia PDF Downloads 141
1829 Mixed Model Sequencing in Painting Production Line

Authors: Unchalee Inkampa, Tuanjai Somboonwiwat

Abstract:

Painting process of automobiles and automobile parts, which is a continuous process based on EDP (Electrode position paint, EDP). Through EDP, all work pieces will be continuously sent to the painting process. Work process can be divided into 2 groups based on the running time: Painting Room 1 and Painting Room 2. This leads to continuous operation. The problem that arises is waiting for workloads onto Painting Room. The grading process EDP to Painting Room is a major problem. Therefore, this paper aim to develop production sequencing method by applying EDP to painting process. It also applied fixed rate launching for painting room and earliest due date (EDD) for EDP process and swap pairwise interchange for waiting time to a minimum of machine. The result found that the developed method could improve painting reduced waiting time, on time delivery, meeting customers wants and improved productivity of painting unit.

Keywords: sequencing, mixed model lines, painting process, electrode position paint

Procedia PDF Downloads 420