Search results for: virtual healthcare facilities

Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

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Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

Procedia PDF Downloads 148

Authors: Atucungwiire Rwebiita

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Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

Procedia PDF Downloads 179

Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

Procedia PDF Downloads 177

Authors: Marco F. Benaglia, Mei H. Chen, Kune M. Tsai, Chia H. Hung

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As societal and family structures, consumer dietary habits, and awareness about food safety and quality continue to evolve in most developed countries, the demand for refrigerated and frozen foods has been growing, and the issues related to their preservation have gained increasing attention. A well-established cold chain logistics system is essential to avoid any temperature abuse; therefore, assessing potential disruptions in the operational processes of cold chain logistics centers becomes pivotal. This study preliminarily employs HACCP to find disruption factors in cold chain logistics centers that may cause temperature abuse. Then, concept mapping is applied: selected experts engage in brainstorming sessions to identify any further factors. The panel consists of ten experts, including four from logistics and home delivery, two from retail distribution, one from the food industry, two from low-temperature logistics centers, and one from the freight industry. Disruptions include equipment-related aspects, human factors, management aspects, and process-related considerations. The areas of observation encompass freezer rooms, refrigerated storage areas, loading docks, sorting areas, and vehicle parking zones. The experts also categorize the disruption factors based on perceived similarities and build a similarity matrix. Each factor is evaluated for its impact, frequency, and investment importance. Next, multiple scale analysis, cluster analysis, and other methods are used to analyze these factors. Simultaneously, key disruption factors are identified based on their impact and frequency, and, subsequently, the factors that companies prioritize and are willing to invest in are determined by assessing investors’ risk aversion behavior. Finally, Cumulative Prospect Theory (CPT) is applied to verify the risk patterns. 66 disruption factors are found and categorized into six clusters: (1) "Inappropriate Use and Maintenance of Hardware and Software Facilities", (2) "Inadequate Management and Operational Negligence", (3) "Product Characteristics Affecting Quality and Inappropriate Packaging", (4) "Poor Control of Operation Timing and Missing Distribution Processing", (5) "Inadequate Planning for Peak Periods and Poor Process Planning", and (6) "Insufficient Cold Chain Awareness and Inadequate Training of Personnel". This study also identifies five critical factors in the operational processes of cold chain logistics centers: "Lack of Personnel’s Awareness Regarding Cold Chain Quality", "Personnel Not Following Standard Operating Procedures", "Personnel’s Operational Negligence", "Management’s Inadequacy", and "Lack of Personnel’s Knowledge About Cold Chain". The findings show that cold chain operators prioritize prevention and improvement efforts in the "Inappropriate Use and Maintenance of Hardware and Software Facilities" cluster, particularly focusing on the factors of "Temperature Setting Errors" and "Management’s Inadequacy". However, through the application of CPT theory, this study reveals that companies are not usually willing to invest in the improvement of factors related to the "Inappropriate Use and Maintenance of Hardware and Software Facilities" cluster due to its low occurrence likelihood, but they acknowledge the severity of the consequences if it does occur. Hence, the main implication is that the key disruption factors in cold chain logistics centers’ processes are associated with personnel issues; therefore, comprehensive training, periodic audits, and the establishment of reasonable incentives and penalties for both new employees and managers may significantly reduce disruption issues.

Keywords: concept mapping, cold chain, HACCP, cumulative prospect theory

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Authors: Mikhail Zimin, Svetlana Zimina, Maxim Zimin

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Without question, the basic method of prevention of human and material losses is the provision for adequate strength of constructions. At the same time, seismic load has a stochastic character. So, at all times, there is little danger of earthquake forces exceeding the selected design load. This risk is very low, but the consequences of such events may be extremely serious. Very dangerous are also occasional mistakes in seismic zoning, soil conditions changing before temblors, and failure to take into account hazardous natural phenomena caused by earthquakes. Besides, it is known that temblors detrimentally affect the environmental situation in regions where they occur, resulting in panic and worsening various disease courses. It may lead to mistakes of personnel of hazardous production facilities like the production and distribution of gas and oil, which may provoke severe accidents. In addition, gas and oil pipelines often have long mileage and cross many perilous zones by contrast with buildings. This situation increases the risk of heavy accidents. In such cases, complex monitoring of potential earthquake localities would be relevant. Even though the number of successful real-time forecasts of earthquakes is not great, it is well in excess, such as may be under random guessing. Experimental performed time-lapse study and analysis consist of searching seismic, biological, meteorological, and light earthquake precursors, processing such data with the help of fuzzy sets, collecting weather information, utilizing a database of terrain, and computing risk of slope processes under the temblor in a given setting. Works were done in a real-time environment and broadly acceptable results took place. Observations from already in-place seismic recording systems are used. Furthermore, a look back study of precursors of known earthquakes is done. Situations before Ashkhabad, Tashkent, and Haicheng seismic events are analyzed. Fairish findings are obtained. Results of earthquake forecasts can be used for predicting dangerous natural phenomena caused by temblors such as avalanches and mudslides. They may also be utilized for prophylaxis of some diseases and their complications. Relevant software is worked out too. It should be emphasized that such control does not require serious financial expenses and can be performed by a small group of professionals. Thus, complex monitoring of potential earthquake localities, including short-term earthquake forecasts and analysis of possible hazardous consequences of temblors, may further the safety of pipeline facilities.

Keywords: risk, earthquake, monitoring, forecast, precursor

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Authors: Eyob Seife, Molla Alemayaehu, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew

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Globally, immunization averts between 2 and 3 million deaths yearly, but Vaccine-Preventable Diseases still account for more in Sub-Saharan African countries and takes the majority of under-five deaths yearly, which indicates the need for consistent and on-time information to have evidence-based decision so as to save lives of these vulnerable groups. However, ensuring data of sufficient quality and promoting an information-use culture at the point of collection remains critical and challenging, especially in remote areas where the Ararso district is selected based on a hypothesis of there is a difference in reported and recounted immunization data consistency. Data quality is dependent on different factors where organizational, behavioral, technical and contextual factors are the mentioned ones. A cross-sectional quantitative study was conducted on September 2022 in the Ararso district. The study used the world health organization (WHO) recommended data quality self-assessment (DQS) tools. Immunization tally sheets, registers and reporting documents were reviewed at 4 health facilities (1 health center and 3 health posts) of primary health care units for one fiscal year (12 months) to determine the accuracy ratio, availability and timeliness of reports. The data was collected by trained DQS assessors to explore the quality of monitoring systems at health posts, health centers, and at the district health office. A quality index (QI), availability and timeliness of reports were assessed. Accuracy ratios formulated were: the first and third doses of pentavalent vaccines, fully immunized (FI), TT2+ and the first dose of measles-containing vaccines (MCV). In this study, facility-level results showed poor timeliness at all levels and both over-reporting and under-reporting were observed at all levels when computing the accuracy ratio of registration to health post reports found at health centers for almost all antigens verified. A quality index (QI) of all facilities also showed poor results. Most of the verified immunization data accuracy ratios were found to be relatively better than that of quality index and timeliness of reports. So attention should be given to improving the capacity of staff, timeliness of reports and quality of monitoring system components, namely recording, reporting, archiving, data analysis and using information for decisions at all levels, especially in remote and areas.

Keywords: accuracy ratio, ararso district, quality of monitoring system, regular immunization program, timeliness of reports, Somali region-Ethiopia

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Authors: German Ricci, Horacio Divito

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This article analyses the ethical dimension of the IMF in its relationship with Argentina from the Standby Agreement sanctioned in 2018 to the Extended Fund Facilities of 2023. From the analysis of the statements of the IMF, the appeal of the Agency to an ethic is evidenced and supposedly shared with the borrowing country, in addition to the well-known technical-economic evaluations. The Fund "vindicates" and "punishes" the borrowing country through moral judgment. In the Fund's narratives, the "effort," "commitment," and "work" of the local elite are rewarded. On the other hand, there is a repeated discursive emphasis of the IMF on its permanent intention to "help" Argentina through its collaborative nature. Finally, the emergence of moral prescriptions that question the very being of the debtor country and its representatives is detected when the relationship between local authorities and the IMF is tense.

Keywords: IMF, Argentina, ethics, moral, dependency routine, symbolic power

Procedia PDF Downloads 85

Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

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Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

Procedia PDF Downloads 101

Authors: A. Basu, A. A. Purohit, M. M. Vaidya, M. D. Kudale

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Mumbai, being traditionally the epicenter of India's trade and commerce, the existing major ports such as Mumbai and Jawaharlal Nehru Ports (JN) situated in Thane estuary are also developing its waterfront facilities. Various developments over the passage of decades in this region have changed the tidal flux entering/leaving the estuary. The intake at Pir-Pau is facing the problem of shortage of water in view of advancement of shoreline, while jetty near Ulwe faces the problem of ship scheduling due to existence of shallower depths between JN Port and Ulwe Bunder. In order to solve these problems, it is inevitable to have information about tide levels over a long duration by field measurements. However, field measurement is a tedious and costly affair; application of artificial intelligence was used to predict water levels by training the network for the measured tide data for one lunar tidal cycle. The application of two layered feed forward Artificial Neural Network (ANN) with back-propagation training algorithms such as Gradient Descent (GD) and Levenberg-Marquardt (LM) was used to predict the yearly tide levels at waterfront structures namely at Ulwe Bunder and Pir-Pau. The tide data collected at Apollo Bunder, Ulwe, and Vashi for a period of lunar tidal cycle (2013) was used to train, validate and test the neural networks. These trained networks having high co-relation coefficients (R= 0.998) were used to predict the tide at Ulwe, and Vashi for its verification with the measured tide for the year 2000 & 2013. The results indicate that the predicted tide levels by ANN give reasonably accurate estimation of tide. Hence, the trained network is used to predict the yearly tide data (2015) for Ulwe. Subsequently, the yearly tide data (2015) at Pir-Pau was predicted by using the neural network which was trained with the help of measured tide data (2000) of Apollo and Pir-Pau. The analysis of measured data and study reveals that: The measured tidal data at Pir-Pau, Vashi and Ulwe indicate that there is maximum amplification of tide by about 10-20 cm with a phase lag of 10-20 minutes with reference to the tide at Apollo Bunder (Mumbai). LM training algorithm is faster than GD and with increase in number of neurons in hidden layer and the performance of the network increases. The predicted tide levels by ANN at Pir-Pau and Ulwe provides valuable information about the occurrence of high and low water levels to plan the operation of pumping at Pir-Pau and improve ship schedule at Ulwe.

Keywords: artificial neural network, back-propagation, tide data, training algorithm

Procedia PDF Downloads 487

Authors: Y. Alqaheem, A. Alomair, F. Altarkait, F. Alswaileh, Nusrat Tanoli

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Helium market is continuously growing due to its essential uses in the electronic and healthcare sectors. Currently, helium is produced by cryogenic distillation but the process is uneconomical especially for low production volumes. On the other hand, polymeric membranes can provide a cost-effective solution for helium purification due to their low operating energy. However, the preparation of membranes involves the use of very toxic solvents such as chloroform. In this work, polyetherimide membranes were prepared using a less toxic solvent, n-methylpyrrolidone with a polymer-to-solvent ratio of 27 wt%. The developed membrane showed a superior helium permeability of 15.9 Barrer that surpassed the permeability of membranes made by chloroform.

Keywords: helium separation, polyetherimide, dense membrane, gas permeability

Procedia PDF Downloads 175

Authors: Anusha Vaddiraj Pallapu

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Across the globe, there is a steady increase in people residing in urban areas. Due to this increase in urban population, urban health is affecting. The major issues identified like overcrowding, air pollution, unhealthy diet, inadequate infrastructure, poor solid waste management systems and insufficient access to health facilities, these issues are gradually clearly observed in health statistics of diseases and deaths rapidly increase in urban areas. Therefore, the present study aims to assess the health statistics and infrastructure services at urban areas to know the cause and effect between Infrastructure, its management and diseases (water borne). Most of the Indian cities have the municipal boundaries, which authorized by their respective municipal corporations and development authorities. Generally, cities have various zones under which municipal wards exist. The paper focuses on the city Ahmedabad, at Gujarat state. Ahmedabad Municipal Corporation (AMC) is divided into six zones namely Central zone, West zone, New-West zone, East zone, North zone, and South zone. Each zone includes various wards within it. Incidence of diseases in Ahmadabad which are linked to infrastructure was identified such as water-borne diseases. Later on, the occurrence of water-borne diseases at urban area was examined at each zone level. The study methodology follows four steps i.e. 1) Pre-Field literature study: Study on Sewerage system in urban areas and its best practices and public health status globally and Indian scenario; 2) Field study: Data collection and interviews of stakeholders regarding heal status and issues at each zone and ward level; 3) Post field: Data analysis with qualitative description of each ward of zones, followed by correlation coefficient analysis between sewerage coverage, diseases and density of each ward using geographic information system mapping (GIS); 4) Identification of reasons: Affected health on each of zone and wards followed by correlation analysis on each reason. The results reveal that the health conditions in Ahmedabad municipal zones or boundaries are effected due to the slums created by the migrated people from various rural and urban areas. It is also observed that due to increase in population water supply and sewerage management is affecting. The overall effect on infrastructure is creating the health diseases which detailed in the paper using geographical information system in Indian city.

Keywords: infrastructure, municipal wards, GIS, water supply, sewerage, medical facilities, water borne diseases

Procedia PDF Downloads 219

Authors: Jonali Baruah, Keesha Green

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This experimental study examines the effects of anonymity in video meeting groups across the stages of innovation (idea generation, selection, and refinement) on various measures of creativity. A sample of 92 undergraduate students participated in small groups of three to four members to complete creativity, decision-making, and idea-refinement task in either anonymous or identified conditions. The study followed two anonymity (anonymous and identified) X 3 stages of innovation (idea generation, idea selection, and idea refinement) in a mixed factorial design. Results revealed that the anonymous groups produced ideas of the highest average quality in the refinement phase of innovation. The results of this study enhanced our understanding of the productivity and creativity of groups in computer-mediated communication.

Keywords: creativity, anonymity, idea-generation, idea-refinement, innovation

Procedia PDF Downloads 144

Authors: Haiu-Lan Chin, Yu-Fen Hsiao, Hua-Ying Chuang, Wei Lee

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An adult with intellectual disability generally has insufficient physical activity which is an important factor leading to premature weakness. Studies in recent years on frailty syndrome have accumulated substantial data about indicators of human aging, including unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity. Of these indicators, hand-grip strength can be seen as a predictor of mortality, disability, complications, and increased length of hospital stay. Hand-grip strength in fact provides a comprehensive overview of one’s vitality. The research is about the investigation on hand-grip strength of adults with intellectual disabilities in facilities, institutions and workshops. The participants are 197 male adults (M=39.09±12.85 years old), and 114 female ones (M=35.80±8.2 years old) so far. The aim of the study is to figure out the performance of their hand-grip strength, and initiate the setting of training on hand-grip strength in their daily life which will decrease the weakening on their physical condition. Test items include weight, bone density, basal metabolic rate (BMR), static body balance except hand-grip strength. Hand-grip strength was measured by a hand dynamometer and classified as normal group ( ≧ 30 kg for male and ≧ 20 kg for female) and weak group ( < 30 kg for male, < 20 kg for female)The analysis includes descriptive statistics, and the indicators of grip strength fo the adults with intellectual disability. Though the research is still ongoing and the participants are increasing, the data indicates: (1) The correlation between hand-grip strength and degree of the intellectual disability (p ≦. 001), basal metabolic rate (p ≦ .001), and static body balance (p ≦ .01) as well. Nevertheless, there is no significant correlation between grip strength and basal metabolic rate which had been having significant correlation with hand-grip strength. (2) The difference between male and female subjects in hand-grip strength is significant, the hand-grip strength of male subjects (25.70±12.81 Kg) is much higher than female ones (16.30±8.89 Kg). Compared to the female counterparts, male participants indicate greater individual differences. And the proportion of weakness between male and female subjects is also different. (3) The regression indicates the main factors related to grip strength performance include degree of the intellectual disability, height, static body balance, training and weight sequentially. (4) There is significant difference on both hand-grip and static body balance between participants in facilities and workshops. The study supports the truth about the sex and gender differences in health. Nevertheless, the average hand-grip strength of left hand is higher than right hand in both male and female subjects. Moreover, 71.3% of male subjects and 64.2% of female subjects have better performance in their left hand-grip which is distinctive features especially in low degree of the intellectual disability.

Keywords: adult with intellectual disability, frailty syndrome, grip strength, physical condition

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Authors: Rofaida Ashour

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This study discusses the implementation of quality improvement initiatives aimed at reducing contamination rates in cultured karyotyping samples. The primary objective was to enhance patient outcomes through systematic audits and targeted staff engagement. Recognizing the critical impact of sample integrity on diagnostic accuracy, a thorough analysis was conducted to identify the root causes of contamination. The project involved two audit cycles, which facilitated a comprehensive assessment of adherence to local protocols. Key issues identified included lapses in the use of personal protective equipment (PPE) and inadequate awareness of proper sample handling procedures among staff. To address these challenges, a multi-faceted approach was adopted. Firstly, a presentation was delivered to the laboratory team emphasizing the significance of strict adherence to PPE guidelines during the collection and handling of samples. This session aimed to raise awareness and foster a culture of safety within the unit. Additionally, informative posters illustrating the correct procedures were strategically placed around the laboratory to serve as ongoing visual reminders for staff. Recognizing the heightened risk associated with patients exhibiting fever or signs of infection, special measures were introduced to manage their sample collection. These proactive strategies were designed to minimize the likelihood of introducing contaminated samples into the culture process. The results of the audits demonstrated a significant reduction in contamination rates, underscoring the effectiveness of the interventions. This experience reinforced the importance of continuous quality improvement in healthcare settings, particularly in ensuring the delivery of high-quality, safe, and efficient services. Conducting regular audits not only provided valuable insights into operational practices but also highlighted the critical role of active team engagement and a data-driven approach in decision-making. Effective communication and collaboration among team members emerged as essential components for the success of quality improvement initiatives.

Keywords: quality improvement, contamination rates, karyotyping samples, healthcare protocols, staff engagement

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Authors: Sayedramin Hashemianesfehani, Seyed Hossein Hosseinilargani

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In this study, we attempt to realize that to what extent the increase in selected commodities in Iran Market is originated from the implementation of the targeted subsidies law. Hence, an econometric model based on existing theories of increasing and transferring prices in order to transferring inflation is developed. In other words, world price index and virtual variables defined for targeted subsidies has significant and positive impact on the producer price index. The obtained results indicated that the targeted subsidies act in Iran has influential long and short-term impacts on producer price indexes. Finally, world prices of dairy products and dairy price with respect to major parameters is carried out to obtain some managerial ‎results.

Keywords: econometric models, targeted subsidies, consumer price index (CPI), producer price index (PPI)

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Authors: Hira Jabbar, Tanzeel-Ur Rehman

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Urban parks and open spaces play a significant role in improving physical and mental health of the citizens, strengthen the societies and make the cities more attractive places to live and work. As the world’s cities continue to grow, continuing to value green space in cities is vital but is also a challenge, particularly in developing countries where there is pressure for space, resources, and development. Offering equal opportunity of accessibility to parks is one of the important issues of park distribution. The distribution of parks should allow all inhabitants to have close proximity to their residence. Remote sensing and Geographic information systems (GIS) can provide decision makers with enormous opportunities to improve the planning and management of Park facilities. This study exhibits the capability of GIS and RS techniques to provide baseline knowledge about the distribution of parks, level of accessibility and to help in identification of potential areas for such facilities. For this purpose Landsat OLI imagery for year 2016 was acquired from USGS Earth Explorer. Preprocessing models were applied using Erdas Imagine 2014v for the atmospheric correction and NDVI model was developed and applied to quantify the land use/land cover classes including built up, barren land, water, and vegetation. The parks amongst total public green spaces were selected based on their signature in remote sensing image and distribution. Percentages of total green and parks green were calculated for each town of Lahore City and results were then synchronized with the recommended standards. ANGSt model was applied to calculate the accessibility from parks. Service area analysis was performed using Network Analyst tool. Serviceability of these parks has been evaluated by employing statistical indices like service area, service population and park area per capita. Findings of the study may contribute in helping the town planners for understanding the distribution of parks, demands for new parks and potential areas which are deprived of parks. The purpose of present study is to provide necessary information to planners, policy makers and scientific researchers in the process of decision making for the management and improvement of urban parks.

Keywords: accessible natural green space standards (ANGSt), geographic information systems (GIS), remote sensing (RS), United States geological survey (USGS)

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Authors: Sh. Minapoor, S. Ajeli, M. Javadi Toghchi

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Non-crimp 3D orthogonal fabric composite is one of the textile-based composite materials that are rapidly developing light-weight engineering materials. The present paper focuses on geometric and micro mechanical modeling of non-crimp 3D orthogonal carbon fabric and composites reinforced with it for aerospace applications. In this research meso-finite element (FE) modeling employs for stress analysis in different load conditions. Since mechanical testing of expensive textile carbon composites with specific application isn't affordable, simulation composite in a virtual environment is a helpful way to investigate its mechanical properties in different conditions.

Keywords: woven composite, aerospace applications, finite element method, mechanical properties

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Authors: Sara Namdarian, Hafez Salleh

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This paper scrutinizes the circumstances of the application of Augmented Reality (AR) technology to enhance the adaptability of architecture classrooms in private Malaysian university classrooms. This study aims to indicate the constraints of mono-functional classrooms in comparison to the potentials of multi-functional classrooms derived from AR application through an exploratory mixed method strategy. This paper expects to contribute towards recognition of suitable AR techniques which can be applied in the development of Adaptive-AR-Classroom-Systems (AARCS) in architecture classrooms. The findings, derived from the analysis, show current classrooms have limited functional spaces, and concludes that AR application can be used in design classrooms to provide a variety of visuals and virtual objects that are required in conducting architecture projects in higher educational centers.

Keywords: design activity, space enhancement, design education, architectural design augmented reality

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Authors: N. S. A. Rahim, N. N. Abu Mansor, M. I. Saidi, N. R. A. Rahim, K. F. Adrutdin

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The use of coaching as one of organizational culture with the contribution of the involvement of line manager roles is an important to update employees’ knowledge and skills continuously. In healthcare sector, it is dynamic that nurse must update their knowledge and skills to keep pace with change. This paper attempts to discuss the involvement of line manager roles towards creating a coaching culture who give their support and innovation towards motivate nurses to give their best performance either in public or private hospitals.

Keywords: nursing, line managers’ roles, coaching, coaching culture

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Authors: M. Zaïgouche, A. Kouvahe, F. Stefanelli

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IMPERTIO is a high technology based project aiming at offering efficient assistance help in communication for persons affected by Cerebral Palsy. The systems currently available are hardly used by these patients who are not satisfied by ergonomics and response time. The project rests upon the concept that, opposite to usual master-slave communication giving power to the entity with larger range of possibilities, providing conversely the mastery to the entity with smaller range of possibilities will allow a better understanding ground for both parties. Entirely customizable, the application developed from this idea gives full freedom to the user. Through pictograms (one button linked to a word or a sentence) and adapted keyboard, noticeable improvements are brought to the response time and ease to use ergonomics.

Keywords: cerebral palsy, master-slave relation, communication interface, virtual keyboard, word construction algorithm

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Authors: Yue Huang, Yiheng Feng

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Due to the global pressure on climate and energy, many countries are vigorously promoting electric vehicles and building charging (public) charging facilities. Faced with the supply-demand gap of existing electric vehicle charging stations and unreasonable space usage in China, this paper takes the central city of Nanjing as an example, establishes a site selection model through multivariate data integration, conducts multiple linear regression SPSS analysis, gives quantitative site selection results, and provides optimization models and suggestions for charging station layout planning.

Keywords: electric vehicle, charging station, allocation optimization, urban mobility, urban infrastructure, nanjing

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Authors: Slimane Souag, Amel Graa, Farid Benhamida

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In this paper we present a new method for solving the secured power flow problem by the economic dispatch using DC power flow method and Generation Shift Distribution Factor (GSDF), in this work we create a graphical interface in LabVIEW as a virtual instrument. Hence the dc power flow reduces the power flow problem to a set of linear equations, which make the iterative calculation very fast and the GSFD matrix present the effects of single and multiple generator MW change on the transmission line. The effectiveness of the method developed is identified through its application to an IEEE-14 bus test system. The calculation results show excellent performance of the proposed method, in regard to computation time and quality of results.

Keywords: electrical power system security, economic dispatch, sensitivity matrix, labview

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Authors: Zi Wang, Xinlei He, Jianghua Lv, Yuqing Lan

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Kernel though widely used, is complicated. Errors caused by some bugs are often costly. Statically, more than half of the mistakes occur in the design phase. Thus, we introduce a modeling method, KMVM (Linux Kernel Modeling and verification Method), based on type theory for proper designation and correct exploitation of the Kernel. In the model, the Kernel is separated into six levels: subsystem, dentry, file, struct, func, and base. Each level is treated as a type. The types are specified in the structure and relationship. At the same time, we use a demanding path to express the function to be implemented. The correctness of the design is verified by recursively checking the type relationship and type existence. The method has been applied to verify the OPEN business of VFS (virtual file system) in Linux Kernel. Also, we have designed and developed a set of security communication mechanisms in the Kernel with verification.

Keywords: formal approach, type theory, Linux Kernel, software program

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Authors: Nema M. Salem, Hanan A. Altukhaifi, Amal Mukhtar, Reemaz K. Hetaimish

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Recently, BCI field of research has gained a lot of interest. Apart from motor neuroprosthetics, many studies showed the possibility of controlling a virtual environment of a videogame using the acquired electroencephalogram signals (EEG) from the gamer. In addition, another study had successfully moved a farm tractor using the human’s EEG signals. This article utilizes the use of EEG signals, as a source of technology, in controlling a Parallax Boe-Bot robot. The commercial Emotive Epoc headset has been used in acquiring the EEG signals from rested subjects. Because the human's visual cortex can successfully differentiate between different colors, the red and green colors are used as visual stimuli for generating EEG signals using the Epoc. Arduino and Labview are used to translate the virtually pressed keys into instructions controlling the motion and rotation of the robot. Optimistic results have been achieved except for minor delay and accuracy in the robot’s response.

Keywords: BCI, Emotiv Epoc headset, EEG, Labview, Arduino applications, robot

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Authors: Premvadee Na Nakornpanom

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Language mixing in spontaneous speech has been widely discussed, but not in virtual situations; especially in context of the third language learning students. Thus, this study was an attempt to explore the characteristics of the mixing of Japanese, English and Thai in a mobile chat room by students with their background of Japanese, English, and Thai. The result found that Insertion of Thai and English content words was a very common linguistic phenomenon embedded in the utterances. As chatting is to be ‘relational’ or ‘interactional’, it affected the style of lexical choices to be speech-like, more personal and emotional-related. A Japanese sentence-final question particle“か”(ka) was added to the end of the sentence based on Thai grammar rule. Moreover, some unique characteristics were created. The non-verbal cues were represented in personal, Thai styles by inserting textual representations of images or feelings available on the websites into streams of conversations.

Keywords: code-mixing, Japanese, English, Thai, line chat

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Authors: Sophia El Ouazzani, Amer M. Burhan, Mary Wickenden

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Background: Despite improvements in recent years, the Moroccan mental healthcare system still face disparity between available resources and the current population’sneeds. The societal stigma, and limited economic, political, and human resources are all factors in shaping the psychiatric system, exacerbating the discontinuity of services for users after discharged from the hospital. As a result, limited opportunities for social inclusion and meaningful community engagement undermines human rights and recovery potential for people with mental health problems, especially those with psychiatric disabilities from serious mental illness (SMI). Recovery-oriented practice, such as mental health rehabilitation, addresses the complex needs of patients with SMI and support their community inclusion. The cultural acceptability of recovery-oriented practice is an important notion to consider for a successful implementation. Exploring the extent to which recovery-oriented practices are used in Morocco is a necessary first step to assess the cultural relevance of such a practice model. Aims: This study aims to explore understanding and knowledge, perception, and perspective about core concepts in mental health rehabilitation, including psychiatric disability, recovery, and engagement in meaningful occupations for people with SMI in Morocco. Methods: A pilot qualitative study was undertaken. Data was collected via semi-structured interviews and focusgroup discussions with healthcare professional students. Questions were organised around the following themes: 1) students’ perceptions, understanding, and expectations around concepts such as SMI, mental health disability, and recovery, and 2) changes in their views and expectations after starting their professional training. Further analysis of students’ perspectives on the concept of ‘meaningful occupation’ and how is this viewed within the context of the research questions was done. The data was extracted using an inductive thematic analysis approach. This is a pilot stage of a doctoral project, further data will be collected and analysed until saturation is reached. Results: A total of eight students were included in this study which included occupational therapy and mental health nursing students receiving training in Morocco. The following themes emerged as influencing students’ perceptions and views around the main concepts: 1) Stigma and discrimination, 2) Fatalism and low expectations, 3) Gendered perceptions, 4) Religious causation, 5) Family involvement, 6) Professional background, 7) Inaccessibility of services and treatment. Discussion/Contribution: Preliminary analysis of the data suggests that students’ perceptions changed after gaining more clinical experiences and being exposed to people with psychiatric disabilities. Prior to their training, stigma shaped greatly how they viewed people with SMI. The fear, misunderstanding, and shame around SMI and their functional capacities may contribute to people with SMI being stigmatizedand marginalised from their family and their community. Religious causations associated to SMIsare understood as further deepening the social stigma around psychiatric disability. Perceptions are influenced by gender, with women being doubly discriminated against in relation to recovery opportunities. Therapeutic pessimism seems to persist amongst students and within the mental healthcare system in general and regarding the recovery potential and opportunities for people with SMI. The limited resources, fatalism, and stigma all contribute to the low expectations for recovery and community inclusion. Implications and future directions will be discussed.

Keywords: disability, mental health rehabilitation, recovery, serious mental illness, transcultural psychiatry

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Authors: Lan Cheng, Harry Qin, Yang Wang

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Background: COVID-19 has induced the largest digital learning experiment in history. There is also emerging research evidence that students have paid a high cost of learning loss from virtual learning. University-wide survey results demonstrate that digital learning remains difficult for students who struggle with learning challenges, isolation, or a lack of resources. Large-scale efforts are therefore increasingly utilized for digital education. To better prepare students in higher education for this grand scientific and technological transformation, STEM education has been prioritized and promoted as a strategic imperative in the ongoing curriculum reform essential for unfinished learning needs and whole-person development. Building upon five key elements identified in the STEM education literature: Problem-based Learning, Community and Belonging, Technology Skills, Personalization of Learning, Connection to the External Community, this case study explores the potential of pedagogical innovation that integrates computational and experimental methodologies to support, enrich, and navigate STEM education. Objectives: The goal of this case study is to create a high-fidelity prototype design for STEM education with knowledge transfer technology that contains a Cooperative Multi-Agent System (CMAS), which has the objectives of (1) conduct assessment to reveal a virtual learning mechanism and establish strategies to facilitate scientific learning engagement, accessibility, and connection within and beyond university setting, (2) explore and validate an interactional co-creation approach embedded in project-based learning activities under the STEM learning context, which is being transformed by both digital technology and student behavior change,(3) formulate and implement the STEM-oriented campaign to guide learning network mapping, mitigate the loss of learning, enhance the learning experience, scale-up inclusive participation. Methods: This study applied a case study strategy and a methodology informed by Social Network Analysis Theory within a cross-disciplinary communication paradigm (students, peers, educators). Knowledge transfer technology is introduced to address learning challenges and to increase the efficiency of Reinforcement Learning (RL) algorithms. A co-creation learning framework was identified and investigated in a context-specific way with a learning analytic tool designed in this study. Findings: The result shows that (1) CMAS-empowered learning support reduced students’ confusion, difficulties, and gaps during problem-solving scenarios while increasing learner capacity empowerment, (2) The co-creation learning phenomenon have examined through the lens of the campaign and reveals that an interactive virtual learning environment fosters students to navigate scientific challenge independently and collaboratively, (3) The deliverables brought from the STEM educational campaign provide a methodological framework both within the context of the curriculum design and external community engagement application. Conclusion: This study brings a holistic and coherent pedagogy to cultivates students’ interest in STEM and develop them a knowledge base to integrate and apply knowledge across different STEM disciplines. Through the co-designing and cross-disciplinary educational content and campaign promotion, findings suggest factors to empower evidence-based learning practice while also piloting and tracking the impact of the scholastic value of co-creation under the dynamic learning environment. The data nested under the knowledge transfer technology situates learners’ scientific journey and could pave the way for theoretical advancement and broader scientific enervators within larger datasets, projects, and communities.

Keywords: co-creation, cross-disciplinary, knowledge transfer, STEM education, social network analysis

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Authors: Kumar Satyam Das, Murali Raghunathan

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This note discusses the feasibility of field development of a challenging shallow offshore field in South East Asia and how its learnings can be applied to marginal field development across the world especially developing marginal fields in this low oil price world. The field was found to be economically challenging even during high oil prices and the project was put on hold. Shell started development study with the aim to significantly reduce cost through competitively scoping and revive stranded projects. The proposed strategy to achieve this involved Improve Per platform recovery and Reduction in CAPEX. Methodology: Based on various Benchmarking Tool such as Woodmac for similar projects in the region and economic affordability, a challenging target of 50% reduction in unit development cost (UDC) was set for the project. Technical scope was defined to the minimum as to be a wellhead platform with minimum functionality to ensure production. The evaluation of key project decisions like Well location and number, well design, Artificial lift methods and wellhead platform type under different development concept was carried out through integrated multi-discipline approach. Key elements influencing per platform recovery were Wellhead Platform (WHP) location, Well count, well reach and well productivity. Major Findings: Reservoir being shallow posed challenges in well design (dog-leg severity, casing size and the achievable step-out), choice of artificial lift and sand-control method. Integrated approach amongst relevant disciplines with challenging mind-set enabled to achieve optimized set of development decisions. This led to significant improvement in per platform recovery. It was concluded that platform recovery largely depended on the reach of the well. Choice of slim well design enabled designing of high inclination and better productivity wells. However, there is trade-off between high inclination Gas Lift (GL) wells and low inclination wells in terms of long term value, operational complexity, well reach, recovery and uptime. Well design element like casing size, well completion, artificial lift and sand control were added successively over the minimum technical scope design leading to a value and risk staircase. Logical combinations of options (slim well, GL) were competitively screened to achieve 25% reduction in well cost. Facility cost reduction was achieved through sourcing standardized Low Cost Facilities platform in combination with portfolio execution to maximizing execution efficiency; this approach is expected to reduce facilities cost by ~23% with respect to the development costs. Further cost reductions were achieved by maximizing use of existing facilities nearby; changing reliance on existing water injection wells and utilizing existing water injector (W.I.) platform for new injectors. Conclusion: The study provides a spectrum of technically feasible options. It also made clear that different drivers lead to different development concepts and the cost value trade off staircase made this very visible. Scoping of the project through competitive way has proven to be valuable for decision makers by creating a transparent view of value and associated risks/uncertainty/trade-offs for difficult choices: elements of the projects can be competitive, whilst other parts will struggle, even though contributing to significant volumes. Reduction in UDC through proper scoping of present projects and its benchmarking paves as a learning for the development of marginal fields across the world, especially in this low oil price scenario. This way of developing a field has on average a reduction of 40% of cost for the Shell projects.

Keywords: benchmarking, full field development, CAPEX, feasibility

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Authors: Carolina Senabre, Sergio Valero, Emilio Velasco

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This research objective is to compare the differences of brake measurements obtained with the same vehicle when braking on VTEQ Ministry of Transport (MOT) brake testers versus others such as Maha, Ryme and a dynamometric platform. These different types of brake testers have been used and analyzed by the mechanical engineering staffs at the mechanical laboratory at the Miguel Hernández University. Parameters of the vehicle have been controlled to be the same in all tests. Therefore, brake measurements variability will be due to the tester used. Advances and disadvantages of each brake tester have been analyzed.

Keywords: brake tester, Ministry of transport, longitudinal braking, Bank of Rollers

Procedia PDF Downloads 350