Search results for: audit fee lagrange multiplier test

Authors: Aamna Tufail, Catherine Anyanwu

Abstract:

Introduction/Aims: Neurosensory deficits following third molar removal affect the quality of life markedly. The purpose of this audit was to evaluate the incidence of IDN and LN damage and to compare departmental rates to an established standard. A secondary objective was to provide a descriptive summary of identified cases for clinical learning. Materials and Methods: A retrospective audit was conducted by a telephone survey of 101 patients who had third molar extractions performed under LA, IVS, or GA from January 2019 to June 2020 at a District General Hospital. The results were compared to a clinical standard identified as Cheng et al1. Data collection included mode of surgery, mode of anaesthesia, grade of clinician, assessment of difficulty, severity, and duration of symptoms. Results/Statistics: A total of 101 patients had 136 third molars extracted. Age range was 18-84 years. 44% extractions were under LA, 52% under GA, and 4% under IV sedation. 30% were simple extractions, 68% were surgical removals, 2% were unspecified. 89% extractions were performed by an Associate Specialist, 5% by a consultant, and 6% by unspecified grade of clinician. The rate of IDN injuries was 2.9% (n=4), higher than standard (0.3%). The rate of LN injuries was 0.7% (n=1), same as standard (0.7%). The 5 cases of neurosensory deficits are discussed in detail. Conclusions/Clinical Relevance: The rate of ID nerve injuries was higher than the standard. The rate of LN complications was lower than the standard.

Keywords: inferior dental nerve, lingual nerve, nerve injuries, third molars

Procedia PDF Downloads 75

Authors: Bela Sulistyaguna, Yuli Chomsatu Samrotun, Endang Masitoh Wahyuningsih

Abstract:

The purpose of this research was to analyze the influence of company size, liquidity, profitability, leverage, company age, industry type, board of director, board of commissioner, audit committee and public ownership on the corporate social responsibility disclosure. The grand theories of this research are agency theory, stakeholders theory, and legitimacy theory. Analysis of data using multiple linear regression method with SPSS 22.0 for mac. The sample consists of companies listed on the Indonesia Stock Exchange (IDX) and disclosed the Global Reporting Initiative (GRI) sustainability reports from 2013 to 2018. The final sample of this research was 19 companies that obtained by purposive sampling. The results of the research showed that, simultaneously, company size, liquidity, profitability, leverage, company age, industry type, board of director, board of commissioner, audit committee and public ownership has an influence on the corporate social responsibility disclosure. Partially, the results showed that liquidity and leverage has an influence on the corporate social responsibility disclosure. Meanwhile, company size, profitability, company age, industry type, board of director, board of commissioner, audit committee and public ownership has no influence on corporate social responsibility disclosure.

Keywords: corporate social responsibility, CSR disclosure, Indonesia

Procedia PDF Downloads 125

Authors: Suman Dutta, Manish Agrawal, C. S. Jog

Abstract:

Accurate computation of hydrodynamic forces on floating structures and their deformation finds application in the ocean and naval engineering and wave energy harvesting. This manuscript presents a monolithic, finite element strategy for fluid-structure interaction involving hyper-elastic solids partly submerged in an incompressible fluid. A velocity-based Arbitrary Lagrangian-Eulerian (ALE) formulation has been used for the fluid and a displacement-based Lagrangian approach has been used for the solid. The flexibility of the ALE technique permits us to treat the free surface of the fluid as a Lagrangian entity. At the interface, the continuity of displacement, velocity and traction are enforced using the mortar method. In the mortar method, the constraints are enforced in a weak sense using the Lagrange multiplier method. In the literature, the mortar method has been shown to be robust in solving various contact mechanics problems. The time-stepping strategy used in this work reduces to the generalized trapezoidal rule in the Eulerian setting. In the Lagrangian limit, in the absence of external load, the algorithm conserves the linear and angular momentum and the total energy of the system. The use of monolithic coupling with an energy-conserving time-stepping strategy gives an unconditionally stable algorithm and allows the user to take large time steps. All the governing equations and boundary conditions have been mapped to the reference configuration. The use of the exact tangent stiffness matrix ensures that the algorithm converges quadratically within each time step. The robustness and good performance of the proposed method are demonstrated by solving benchmark problems from the literature.

Keywords: ALE, floating body, fluid-structure interaction, monolithic, mortar method

Procedia PDF Downloads 262

Authors: Alena Zemanová, Jan Zeman, Michal Šejnoha

Abstract:

The polymer foil used for manufacturing of laminated glass members behaves in a viscoelastic manner with temperature dependence. This contribution aims at incorporating the time/temperature-dependent behavior of interlayer to our earlier elastic finite element model for laminated glass beams. The model is based on a refined beam theory: each layer behaves according to the finite-strain shear deformable formulation by Reissner and the adjacent layers are connected via the Lagrange multipliers ensuring the inter-layer compatibility of a laminated unit. The time/temperature-dependent behavior of the interlayer is accounted for by the generalized Maxwell model and by the time-temperature superposition principle due to the Williams, Landel, and Ferry. The resulting system is solved by the Newton method with consistent linearization and the viscoelastic response is determined incrementally by the exponential algorithm. By comparing the model predictions against available experimental data, we demonstrate that the proposed formulation is reliable and accurately reproduces the behavior of the laminated glass units.

Keywords: finite element method, finite-strain Reissner model, Lagrange multipliers, generalized Maxwell model, laminated glass, Newton method, Williams-Landel-Ferry equation

Procedia PDF Downloads 413

Authors: Youn-Sung Kim, Jin-Ho Jo, Mi-Sung Kim, Jae-Kun Lee

Abstract:

Accelerated life cycle test is applied to various products or components in order to reduce the time of life cycle test in industry. It must be considered for many test conditions according to the product characteristics for the test and the selection of acceleration parameter is especially very important. We have carried out the general life cycle test and the accelerated life cycle test by applying the acceleration factor (AF) considering the characteristics of brushless DC (BLDC) motor for washing machine. The final purpose of this study is to verify the validity by analyzing the results of the general life cycle test and the accelerated life cycle test. It will make it possible to reduce the life test time through the reasonable accelerated life cycle test.

Keywords: accelerated life cycle test, reliability test, motor for washing machine, brushless dc motor test

Procedia PDF Downloads 589

Authors: Xiaohuan Li, Wangmin Yi, Xinghui Wu

Abstract:

In order to verify the performance of lunar lander structure, landing-impact test is urgently needed. Moreover, the test equipment is necessary for the test. The functions and the key points of the equipment is presented to satisfy the requirements of the test，and the design scheme is proposed. The composition, the major function and the critical parts’ design of the equipment are introduced. By the load test of releasing device and single-beam hoist, and the compatibility test of landing-impact testing system, the rationality and reliability of the equipment is proved.

Keywords: landing-impact test, lunar lander, releasing device, test equipment

Procedia PDF Downloads 597

Authors: Ademuyiwa Agbonyin, Stamatis Zoras, Mohammad Zandi

Abstract:

This paper investigates the extent to which building energy modelling can be informed based on preliminary information provided by infrared thermography using a thermal imaging camera in a walkthrough audit. The case-study building is the Sheffield Cathedral, built in the early 1400s. Based on an informative qualitative report generated from the thermal images taken at the site, the regions showing significant heat loss are input into a computer model of the cathedral within the integrated environmental solution (IES) virtual environment software which performs an energy simulation to determine quantitative heat losses through the building envelope. Building data such as material thermal properties and building plans are provided by the architects, Thomas Ford and Partners Ltd. The results of the modelling revealed the portions of the building with the highest heat loss and these aligned with those suggested by the thermal camera. Retrofit options for the building are also considered, however, may not see implementation due to a desire to conserve the architectural heritage of the building. Results show that thermal imaging in a walk-through audit serves as a useful guide for the energy modelling process. Hand calculations were also performed to serve as a 'control' to estimate losses, providing a second set of data points of comparison.

Keywords: historic buildings, energy retrofit, thermal comfort, software modelling, energy modelling

Procedia PDF Downloads 145

Authors: Bassem Saleh, Hussam Nusair, Nariman Al Zubadi, Shams Al Shloul, Usama Saleh

Abstract:

The nursing round system (NRS) means checking patients on an hourly basis during the A (0700–2200 h) shift and once every 2 h during the B (2200–0700 h) by the assigned nursing staff. The overall goal of this prospective study is to implement an NRS in a major rehabilitation centre—Sultan Bin Abdulaziz Humanitarian City—in the Riyadh area of the Kingdom of Saudi Arabia. The purposes of this study are to measure the effect of the NRS on: (i) the use of patient call light; (ii) the number of incidences of patients’ fall; (iii) the number of incidences of hospital-acquired bed sores; and (iv) the level of patients’ satisfaction. All patients hospitalized in the male stroke unit will be involved in this study. For the period of 8 weeks (17 December 2009–17 February 2010) All Nursing staff on the unit will record each call light and the patient’s need. Implementation of the NRS would start on 18 February 2010 and last for 8 weeks, until 18 April 2010. Data collected throughout this period will be compared with data collected during the 8 weeks period immediately preceding the implementation of the NRS (17 December 2009–17 February 2010) in order to measure the impact of the call light use. The following information were collected on all subjects involved in the study: (i) the Demographic Information Form; (ii) authors’ developed NRS Audit Form; (iii) Patient Call Light Audit Form; (iv) Patient Fall Audit Record; (v) Hospital-Acquired Bed Sores Audit Form; and (vi) hospital developed Patient Satisfaction Records. The findings suggested that a significant reduction on the use of call bell (P < 0.001), a significant reduction of fall incidence (P < 0.01) while pressure ulcer reduced by 50% before and after the implementation of NRS. In addition, the implementation of NRS increased patient satisfaction by 7/5 (P < 0.05).

Keywords: call light, patient-care management, patient safety, patient satisfaction, rounds

Procedia PDF Downloads 351

Authors: Akhilesh G. Naik, Dipankar Pal

Abstract:

In today’s scenario, the complexity of digital signal processing (DSP) applications and various microcontroller architectures have been increasing to such an extent that the traditional approaches to multiplier design in most processors are becoming outdated for being comparatively slow. Modern processing applications require suitable pipelined approaches, and therefore, algorithms that are friendlier with pipelined architectures. Traditional algorithms like Wallace Tree, Radix-4 Booth, Radix-8 Booth, Dadda architectures have been proven to be comparatively slow for pipelined architectures. These architectures, therefore, need to be optimized or combined with other architectures amongst them to enhance its performances and to be made suitable for pipelined hardware/architectures. Recently, Vedic algorithm mathematically has proven to be efficient by appearing to be less complex and with fewer steps for its output establishment and have assumed renewed importance. This paper describes and shows how the Vedic algorithm can be better suited for pipelined architectures and also can be combined with traditional architectures and algorithms for enhancing its ability even further. In this paper, we also established that for complex applications on DSP and other microcontroller architectures, using Vedic approach for multiplication proves to be the best available and efficient option.

Keywords: Wallace Tree, Radix-4 Booth, Radix-8 Booth, Dadda, Vedic, Single-Stage Karatsuba (SSK), Looped Karatsuba (LK)

Procedia PDF Downloads 149

Authors: Rodrigo Antunes, Olga Borisevich, David Demange

Abstract:

In future nuclear fusion reactors, tritium self-sufficiency will be ensured by tritium (3H) production via reactions between the fusion neutrons and lithium. To favor tritium breeding, a neutron multiplier must also be used. Both tritium breeder and neutron multiplier will be placed in the so-called Breeding Blanket (BB). For the European Helium-Cooled Pebble Bed (HCPB) BB concept, the tritium production and neutron multiplication will be ensured by neutron bombardment of Li4SiO4 and Be pebbles, respectively. The produced tritium is extracted from the pebbles by purging them with large flows of He (~ 104 Nm3h-1), doped with small amounts of H2 (~ 0.1 vol%) to promote tritium extraction via isotopic exchange (producing HT). Due to the presence of oxygen in the pebbles, production of tritiated water is unavoidable. Therefore, the purging gas downstream of the BB will be composed by Q2/Q2O/He (Q = 1H, 2H, 3H), with Q2/Q2O down to ppm levels, which must be further processed for tritium recovery. A two-stage continuous approach, where zeolite membranes (ZMs) are followed by a catalytic membrane reactor (CMR), has been recently proposed to fulfil this task. The tritium recovery from Q2/Q2O/He is ensured by the CMR, that requires a reduction of the gas flow coming from the BB and a pre-concentration of Q2 and Q2O to be efficient. For this reason, and to keep this stage with reasonable dimensions, ZMs are required upfront to reduce as much as possible the He flows and concentrate the Q2/Q2O species. Therefore, experimental activities have been carried out at the Tritium Laboratory Karlsruhe (TLK) to test the separation performances of different zeolite membranes for H2/H2O/He. First experiments have been performed with binary mixtures of H2/He and H2O/He with commercial MFI-ZSM5 and NaA zeolite-type membranes. Only the MFI-ZSM5 demonstrated selectivity towards H2, with a separation factor around 1.5, and H2 permeances around 0.72 µmolm-2s-1Pa-1, rather independent for feed concentrations in the range 0.1 vol%-10 vol% H2/He. The experiments with H2O/He have demonstrated that the separation factor towards H2O is highly dependent on the feed concentration and temperature. For instance, at 0.2 vol% H2O/He the separation factor with NaA is below 2 and around 1000 at 5 vol% H2O/He, at 30°C. Overall, both membranes demonstrated complementary results at equivalent temperatures. In fact, at low feed concentrations ( ≤ 1 vol% H2O/He) MFI-ZSM5 separates better than NaA, whereas the latter has higher separation factors for higher inlet water content ( ≥ 5 vol% H2O/He). In this contribution, the results obtained with both MFI-ZSM5 and NaA membranes for H2/He and H2O/H2 mixtures at different concentrations and temperatures are compared and discussed.

Keywords: nuclear fusion, gas separation, tritium processes, zeolite membranes

Procedia PDF Downloads 270

Authors: Dalson Figueiredo, Enivaldo Rocha, Ranulfo Paranhos, José Alexandre

Abstract:

This paper analyzes the effects of institutional capacity on corruption. Methodologically, the research design combines both descriptive and multivariate statistics to examine two original datasets based on secondary data. In particular, we employ a principal component model to estimate an indicator of institutional capacity for both state audit institutions and subnational judiciary courts. Then, we estimate the effect of institutional capacity on two dependent variables: (1) incidence of administrative irregularities and (2) time elapsed to judge corruption cases. The preliminary results using ordinary least squares, negative binomial and Tobit models suggest the same conclusions: higher the institutional audit capacity, higher is the probability of detecting a corruption case. On the other hand, higher the institutional capacity of state judiciary, the lower is the time to judge corruption cases.

Keywords: institutional capacity, corruption, state level institutions, evidence from Brazil

Procedia PDF Downloads 337

Authors: Nur Imroatun Sholihat, Gresika Bunga Sylvana

Abstract:

Currently, cyber attack became an incredibly serious problem due to its increasing trend all over the world. Therefore, information security becomes prominent for every organization including public sector organization. In Indonesia, unfortunately, Ministry of Finance (MoF) is the only public sector organization that has already formally established procedure to assess its information security adequacy by performing information security audits (November 2017). We assess the implementation of information security audits in the MoF using qualitative data obtained by interviewing IT auditors and by analysis of related documents. For this reason, information security audit practice in the MoF could become the acceptable benchmark for all other public sector organizations in Indonesia. This study is important because, to the best of the author’s knowledge, our research into information security audits practice in Indonesia’s public sector have not been found yet. Results showed that information security audits performed mostly by doing pentest (penetration testing) to MoF’s critical applications.

Keywords: information security audit, information technology, Ministry of Finance of Indonesia, public sector organization

Procedia PDF Downloads 207

Authors: Ahmad Zahran, Ahmed Herzallah, Ahmad Ahmad, Mahran Quraan

Abstract:

Generation of high DC voltages is necessary for testing the insulation material of high voltage AC transmission lines with long lengths. The harmonic and ripple contents of the output DC voltage supplied by high voltage DC circuits require the use of costly capacitors to smooth the output voltage after rectification. This paper proposes a new modular multiplier high voltage DC generator with embedded Cockcroft-Walton circuits that achieve a negligible harmonic and ripple contents of the output DC voltage without the need for costly filters to produce a nearly constant output voltage. In this new topology, Cockcroft-Walton modules are connected in series to produce a high DC output voltage. The modules are supplied by low input AC voltage sources that have the same magnitude and frequency and shifted from each other by a certain angle to eliminate the harmonics from the output voltage. The small ripple factor is provided by the smoothing column capacitors and the phase shifted input voltages of the cascaded modules. The constituent harmonics within each module are determined using Fourier analysis. The viability of the proposed DC generator for testing purposes and the effectiveness of the cascaded connection are confirmed by numerical simulations using MATLAB/Simulink.

Keywords: Cockcroft-Walton circuit, harmonics, ripple factor, HVDC generator

Procedia PDF Downloads 345

Authors: Guozhen Li, Philip Hall, Nick Miles, Tao Wu, Jie Dong

Abstract:

This paper presents a Euler-Lagrange model of the water-particles multiphase flows in a Vorsyl separator where particles with different densities are separated. A series of particles with their densities ranging from 760 kg/m³ to 1380 kg/m³ were fed into the Vorsyl separator with water by means of tangential inlet. The simulation showed that the feed materials acquired centrifugal force which allows most portion of the particles with a density less than water to move to the center of the separator, enter the vortex finder and leave the separator through the bottom outlet. While the particles heavier than water move to the wall, reach the throat area and leave the separator through the side outlet. The particles were thus separated and particles collected at the bottom outlet are pure and clean. The influence of particle density on separation efficiency was investigated which demonstrated a positive correlation of the separation efficiency with increasing density difference between medium liquid and the particle. In addition, the influence of the split ratio on the performance was studied which showed that the separation efficiency of the Vorsyl separator can be improved by the increase of split ratio. The simulation also suggested that the Vorsyl separator may not function when the feeding velocity is smaller than a certain critical feeding in velocity. In addition, an increasing feeding velocity gives rise to increased pressure drop, however does not necessarily increase the separation efficiency.

Keywords: Vorsyl separator, separation efficiency, CFD, split ratio

Procedia PDF Downloads 318

Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

Abstract:

Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

Procedia PDF Downloads 135

Authors: Shreya Saxena

Abstract:

Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

Procedia PDF Downloads 81

Authors: Asmaa Abazaid, Maram Al-Ostah, Nadeen Abu-Zahra, Ruba Bawab, Refaat Abdel-Razek

Abstract:

Innovation audit is defined as a tool that can be used to reflect on how the innovation is managed in an organization. The aim of this study is to audit innovation in the second top Engineering Firms in the world, and one of the Small Medium Enterprises (SMEs) companies that are working in United Arab Emirates (UAE). The obtained results are then compared with four international companies from China and Brazil. The Diamond model has been used for auditing innovation in the two companies in UAE to evaluate their innovation management and to identify each company’s strengths and weaknesses from an innovation perspective. The results of the comparison between the two companies (Jacobs and Hyper General Contracting) revealed that Jacobs has support for innovation, its innovation processes are well managed, the company is committed to the development of its employees worldwide and the innovation system is flexible. Jacobs was doing best in all innovation management dimensions: strategy, process, organization, linkages and learning, while Hyper General Contracting did not score as Jacobs in any of the innovation dimensions. Furthermore, the audit results of both companies were compared with international companies to examine how well the two construction companies in UAE manage innovation relative to SABIC (Saudi company), Poly Easy and Arnious (Brazilian companies), Huagong tools and Guizohou Yibai (Chinese companies). The results revealed that Jacobs is doing best in learning and organization dimensions, while PolyEasy and Jacobs are equal in the linkage dimension. Huagong Tools scored the highest score in process dimension among all the compared companies. However, the highest score of strategy dimension was given to PolyEasy. On the other hand, Hyper General Contracting scored the lowest in all of the innovation management dimensions. It needs to improve its management of all the innovation management dimensions with special attention to be given to strategy, process, and linkage as they got scores below 4 out of 7 comparing with other dimensions. Jacobs scored the highest in three innovation management dimensions related to the six companies. However, the strategy dimension is considered low, and special attention is needed in this dimension.

Keywords: Brazil, China, innovation audit, innovation evaluation, innovation management, Saudi Arabia, United Arab Emirates

Procedia PDF Downloads 265

Authors: Rachel Ashwell, Sally Millett

Abstract:

Introduction: Adequate post-operative pain relief is a key priority in the delivery of caesarean sections. This improves patient experience, reduces morbidity and enables optimal mother-infant interaction. Recommendations outlined in the NICE guidelines for caesarean section (CS) include offering peri-operative intrathecal/epidural diamorphine and post-operative opioid analgesics; offering non-steroidal anti-inflammatory drugs (NSAIDs) unless contraindicated and taking hourly observations for 12 hours following intrathecal diamorphine. Method: This audit assessed the provision of post-CS analgesia in 29 women over a two-week period. Indicators used were the use of intrathecal/epidural opioids, use of post-operative opioids and NSAIDs, frequency of observations and patient satisfaction with pain management on post-operative days 1 and 2. Results: All women received intrathecal/epidural diamorphine, 97% were prescribed post-operative opioids and all were prescribed NSAIDs unless contraindicated. Hourly observations were not maintained for 12 hours following intrathecal diamorphine. 97% of women were satisfied with their pain management on post-operative day 1 whereas only 75% were satisfied on day 2. Discussion: This service meets the proposed standards for the provision of post-operative analgesia, achieving high levels of patient satisfaction 1 day after CS. However, patient satisfaction levels are significantly lower on post-operative day 2, which may be due to reduced frequency of observations. The lack of an official audit standard for patient satisfaction on postoperative day 2 may result in reduced incentive to prioritise pain management at this stage.

Keywords: Caesarean section, analgesia, postoperative care, patient satisfaction

Procedia PDF Downloads 368

Authors: Andrei Contan, Richard Torkar

Abstract:

Aim: The process of test automation and its practices in industry have to be better understood, both for the industry itself and for the research community. Method: We conducted a quantitative industry survey by asking IT professionals to answer questions related to the area of test automation. Results: Test automation needs and practices vary greatly between organizations at different stages of the software development life cycle. Conclusions: Most of the findings are general test automation challenges and are specific to small- to medium-sized companies, developing software applications in the web, desktop or mobile domain.

Keywords: survey, testing, test automation, status of test automation

Procedia PDF Downloads 623

Authors: Daud Muhammad

Abstract:

Introduction: Ankle radiographs are frequently requested in Emergency Departments (ED) for patients presenting with traumatic ankle pain. The Ottawa Ankle Rules (OAR) serve as a clinical guideline to determine the necessity of these radiographs, aiming to reduce unnecessary imaging. This audit was conducted to evaluate the adequacy of clinical information provided in radiograph requests in relation to the OAR. Methods: A retrospective analysis was performed on 50 consecutive ankle radiograph requests under ED clinicians' names for patients aged above 5 years, specifically excluding follow-up radiographs for known fractures. The study assessed whether the provided clinical information met the criteria outlined by the OAR. Results: The audit revealed that none of the 50 radiograph requests contained sufficient information to satisfy the Ottawa Ankle Rules. Furthermore, 10 out of the 50 radiographs (20%) identified fractures. Discussion: The findings indicate a significant lack of adherence to the OAR, suggesting potential overuse of radiography and unnecessary patient exposure to radiation. This non-compliance may also contribute to increased healthcare costs and resource utilization, as well as possible delays in diagnosis and treatment. Recommendations: To address these issues, the following recommendations are proposed: (1) Education and Training: Enhance awareness and training among ED clinicians regarding the OAR. (2) Standardised Request Forms: Implement changes to imaging request forms to mandate relevant information according to the OAR. (3) Scan Vetting: Promote awareness among radiographers to discuss the appropriateness of scan requests with clinicians. (4) Regular re-audits should be conducted to monitor improvements in compliance.

Keywords: Ottawa ankle rules, ankle radiographs, emergency department, traumatic pain

Procedia PDF Downloads 12

Authors: Sammy Xiaoyan Ying

Abstract:

Professional skepticism remains one of the most important and controversial topics in auditing. This study examines the influence of client cooperativeness and fraud risk on judgments of professional skepticism among Chinese entry-level auditors in the context of evaluation of client-provided audit evidence. Given that the essence of auditors’ PS rests on distrust of clients, this study invokes trust-related theories from psychological and cultural perspectives. Specifically, invoking psychology theories of trust concerning positive relationship between risk and distrust, this study hypothesizes that professional skepticism is likely to be positively associated with client fraud risk. The results support the hypothesis and show that lower (higher) levels of client fraud risk lead to lower (higher) levels of professional skepticism. Furthermore, drawing on analysis of relationship between cooperation and trust, with particular reference to guanxi dynamics in the Chinese culture, this study hypothesizes that professional skepticism is likely to be negatively associated with client cooperativeness. The results support the hypothesis and show that higher (lower) levels of client cooperativeness lead to lower (higher) levels of professional skepticism. The findings may assist audit firms and auditing educators in improving training and education programs and enhancing entry-level auditors’ abilities to maintain professional skepticism. Also, practitioners and regulators may benefit from increasing awareness of psychological factors in influencing professional skepticism.

Keywords: audit judgment, Chinese culture, entry-level auditor, professional skepticism

Procedia PDF Downloads 273

Authors: Dammak Saida, Mbarek Sonia

Abstract:

This paper aims to examine the impact of public interest commitment, the attitude towards independence enforcement, and organizational ethical culture on auditors' ethical behavior. It also tests the moderating effect of gender diversity on these relationships. The sample consisted of 100 Tunisian chartered accountants. An online survey was used to collect the data. Data analysis techniques used to test hypotheses The findings of this study provide practical implications for accounting professionals, regulators, and audit firms as they help understand auditors' beliefs and behaviors, which implies more effective mechanisms for improving their ethical values.

Keywords: public interest, independence, organizational culture, professional behavior, Tunisian auditors

Procedia PDF Downloads 52

Authors: Khadidja Mebarki, Naceur Boussouar, Nabila Ihaddadene, M. Akermi

Abstract:

Food products are particularly sensitive, since they concern the health of the consumer, whether it’s be from the health point of view or commercial, this kind of product must be subjected to rigorous controls, in order to prevent any fraud. Quality and safety are essential for food security, public health and economic development. The strengthening of food security is essential to increase food security which is considered reached when all individuals can at any time access safe and nutritious food they need to lead healthy and active lives. The objective of this project is to initiate a quality approach in the laboratories of the quality control and the repression of fraud. It will be directed towards the application of good laboratory practices, traceability, management of quality documents (quality, procedures and specification manual) and quality audits. And to prepare the ground for a possible accreditation by ISO 17025 standard of BECHAR laboratory’s. The project will take place in four main stages: 1- Preparation of an audit grid; 2- Realization of a quality audit according to the method of 5 M completed by a section on quality documentation; 3- Drafting of an audit report and proposal for recommendations; 4- Implementation of corrective actions on the ground. This last step consisted in the formalization of the cleaning disinfection plan; work on good hygiene practices, establishment of a mapping of processes and flow charts of the different processes of the laboratory, classifying quality documents and formalizing the process of document management. During the period of the study within the laboratory, all facets of the work were almost appreciated, as we participated in the expertise performed in within it.

Keywords: quality, management, ISO 17025 accreditation, GLP

Procedia PDF Downloads 492

Authors: Alexandra Roy

Abstract:

Building on literature on cognitive matching and social categorization and using the correspondence testing method, we test the interaction effect of person characteristics (Gender with physical attractiveness) and job context (client contact, industry status, coworker contact). As expected, while findings show a strong impact of gender with beauty on hiring chances, job context characteristics have also a significant overall effect of this hiring outcome. Moreover, the rate of positive responses varies according some of the recruiter’s characteristics. Results are robust to various sensitivity checks. Implications of the results, limitations of the study, and directions for future research are discussed.

Keywords: correspondence testing, discrimination, hiring, physical attractiveness

Procedia PDF Downloads 183

Authors: Supachai Supmak, Yachai Limpiyakorn

Abstract:

Mutation testing can be applied for the quality assessment of test cases. Prioritization of mutation test generation has been a critical element of the industry practice that would contribute to the evaluation of test cases. The industry generally delivers the product under the condition of time to the market and thus, inevitably sacrifices software testing tasks, even though many test cases are required for software verification. This paper presents an approach of applying a social network centrality measure, PageRank, to prioritize mutation test generation. The source code with the highest values of PageRank will be focused first when developing their test cases as these modules are vulnerable to defects or anomalies which may cause the consequent defects in many other associated modules. Moreover, the approach would help identify the reducible test cases in the test suite, still maintaining the same criteria as the original number of test cases.

Keywords: software testing, mutation test, network centrality measure, test case prioritization

Procedia PDF Downloads 84

Authors: Rungrawee Samawathdana, Aim-Utcha Wattanaburanon

Abstract:

Test specifications for open book or notes exams provide the essential information to identify the types of the test items with validity of the evaluations process. This article explains the purpose of test specifications and illustrates how to use it to help construct the approach of open book or notes exams. The complication of the course objectives is challenging for the test designing.

Keywords: course curriculum, environment for health, internationalization, test specifications

Procedia PDF Downloads 549

Authors: Andreas Latz, Daniela Heinz, Fatima Hashemi, Melek Baygül

Abstract:

Introduction: Feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), and feline coronavirus (FCoV) are serious infectious diseases affecting cats worldwide. Transmission of these viruses occurs primarily through close contact with infected cats (via saliva, nasal secretions, faeces, etc.). FeLV, FIV, and FCoV infections can occur in combination and are expressed in similar clinical symptoms. Diagnosis can therefore be challenging: Symptoms are variable and often non-specific. Sick cats show very similar clinical symptoms: apathy, anorexia, fever, immunodeficiency syndrome, anemia, etc. Sample volume for small companion animals for diagnostic purposes can be challenging to collect. In addition, multiplex diagnosis of diseases can contribute to an easier, cheaper, and faster workflow in the lab as well as to the better differential diagnosis of diseases. For this reason, we wanted to develop a new diagnostic tool that utilizes less sample volume, reagents, and consumables than multiplesingleplex ELISA assays Methods: The Multiplier from Dynextechonogies (USA) has been used as platform to develop a Multiplex diagnostic tool for the detection of antibodies against FIV and FCoV/FIP and antigens for FeLV. Multiplex diagnostics. The Dynex®Multiplier®is a fully automated chemiluminescence immunoassay analyzer that significantly simplifies laboratory workflow. The Multiplier®ease-of-use reduces pre-analytical steps by combining the power of efficiently multiplexing multiple assays with the simplicity of automated microplate processing. Plastic beads have been coated with antigens for FIV and FCoV/FIP, as well as antibodies for FeLV. Feline blood samples are incubated with the beads. Read out of results is performed via chemiluminescence Results: Bead coating was optimized for each individual antigen or capture antibody and then combined in the multiplex diagnostic tool. HRP: Antibody conjugates for FIV and FCoV antibodies, as well as detection antibodies for FeLV antigen, have been adjusted and mixed. 3 individual prototyple batches of the assay have been produced. We analyzed for each disease 50 well defined positive and negative samples. Results show an excellent diagnostic performance of the simultaneous detection of antibodies or antigens against these feline diseases in a fully automated system. A 100% concordance with singleplex methods like ELISA or IFA can be observed. Intra- and Inter-Assays showed a high precision of the test with CV values below 10% for each individual bead. Accelerated stability testing indicate a shelf life of at least 1 year. Conclusion: The new tool can be used for multiplex diagnostics of the most important feline infectious diseases. Only a very small sample volume is required. Fully automation results in a very convenient and fast method for diagnosing animal diseases.With its large specimen capacity to process over 576 samples per 8-hours shift and provide up to 3,456 results, very high laboratory productivity and reagent savings can be achieved.

Keywords: Multiplex, FIV, FeLV, FCoV, FIP

Procedia PDF Downloads 78

Authors: Ziyan Zhang

Abstract:

Although the Synthetic Control Method (SCM) is now widely applied, its most commonly- used inference method, placebo test, is often problematic, especially when the treatment is not uniquely assigned. This paper discusses the problems with the placebo test under the multivariate treatment case. And, to improve the power of inferences, I further propose an Andrews-type procedure as it potentially solves some drawbacks of the placebo test. Simulations are conducted to show the Andrews’ test is often valid and powerful, compared with the placebo test.

Keywords: Synthetic Control Method, Multiple treatments, Andrews' test, placebo test

Procedia PDF Downloads 141

Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

Abstract:

Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

Procedia PDF Downloads 86

Authors: Peri Harish Kumar, Rafique Umer Harvitkar

Abstract:

Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

Procedia PDF Downloads 88