Search results for: integrated care delivery

Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

Abstract:

Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

Procedia PDF Downloads 185

Authors: Thomas A. Fuller

Abstract:

Over the past fifteen years, virtual schooling has been introduced and implemented in varying degrees throughout the public education system in the United States. It is possible in some states for students to voluntarily take all of their course load online, without ever having to step in a classroom. Experts foresee a dramatic rise in the number of courses taken online by public school students in the United States, with some predicting that by 2019 as many as 50% of public high school courses will be delivered online. This electronic delivery of public education offers tremendous potential to the scientific community because it calls for innovation and is funded by public school revenue. Public accountability provides a ready supply of statistical data for measuring the progress of virtual schools as they are implemented into the public school arena. This allows for a survey of the current use of virtual schooling through examination of past statistical data, as well as forecasting forward for future years based upon this past data. Virtual schooling is on the rise in the United States, but its growth has been tempered by practical problems of implementation. The greatest and best use of virtual schooling thus far has been to supplement the courses offered by public schools (e.g., offering unique language courses, elective courses, and games-based math and science courses). The weaknesses of virtual schooling lay in the problematic accountability in allowing students to take courses online at home and the lack of supportive infrastructure in the public school arena. Virtual schooling holds great promise for the public school education system in the United States, as well as the scientific community. Online courses allow students access to a much greater catalog of courses than is offered through classroom instruction in their local public school. This promising sector needs assistance from the scientific community in implementing new pedagogical methodologies.

Keywords: virtual schools, online classroom, electronic delivery, technological innovation

Procedia PDF Downloads 383

Authors: Tien-Li Chang, Huang-Chi Huang, Zhao-Chi Chen, Wun-Yi Chen

Abstract:

The droplet-based microfluidic are used as micro-reactors for chemical and biological assays. Hence, the precise addition of reagents into the droplets is essential for this function in the scope of lab-on-a-chip applications. To obtain the characteristics (size, velocity, pressure, and frequency of production) of droplets, this study describes an integrated on-chip method of real-time signal detection. By controlling and manipulating the fluids, the flow behavior can be obtained in the droplet-based microfluidics. The detection method is used a type of infrared sensor. Through the varieties of droplets in the microfluidic devices, the real-time conditions of velocity and pressure are gained from the sensors. Here the microfluidic devices are fabricated by polydimethylsiloxane (PDMS). To measure the droplets, the signal acquisition of sensor and LabVIEW program control must be established in the microchannel devices. The devices can generate the different size droplets where the flow rate of oil phase is fixed 30 μl/hr and the flow rates of water phase range are from 20 μl/hr to 80 μl/hr. The experimental results demonstrate that the sensors are able to measure the time difference of droplets under the different velocity at the voltage from 0 V to 2 V. Consequently, the droplets are measured the fastest speed of 1.6 mm/s and related flow behaviors that can be helpful to develop and integrate the practical microfluidic applications.

Keywords: microfluidic, droplets, sensors, single detection

Procedia PDF Downloads 493

Authors: Sisay Tiroro Salato

Abstract:

Background: Ethiopia has been implementing the maternal death surveillance and response system to provide real-time actionable information, including causes of death and contributing factors. Analysis of maternal mortality surveillance data was conducted to identify the causes and underlying factors in Addis Ababa, Ethiopia. Methods: We carried out a retrospective surveillance data analysis of 324 maternal deaths reported in Addis Ababa, Ethiopia, from 2017 to 2021. The data were extracted from the national maternal death surveillance and response database, including information from case investigation, verbal autopsy, and facility extraction forms. The data were analyzed by computing frequency and presented in numbers, proportions, and ratios. Results: Of 324 maternal deaths, 92% died in the health facilities, 6.2% in transit, and 1.5% at home. The mean age at death was 28 years, ranging from 17 to 45. The maternal mortality ratio per 100,000 live births was 77for the five years, ranging from 126 in 2017 to 21 in 2021. The direct and indirect causes of death were responsible for 87% and 13%, respectively. The direct causes included obstetric haemorrhage, hypertensive disorders in pregnancy, puerperal sepsis, embolism, obstructed labour, and abortion. The third delay (delay in receiving care after reaching health facilities) accounted for 57% of deaths, while the first delay (delay in deciding to seek health care) and the second delay (delay in reaching health facilities) and accounted for 34% and 24%, respectively. Late arrival to the referral facility, delayed management after admission, andnon-recognition of danger signs were underlying factors. Conclusion: Over 86% of maternal deaths were attributed by avoidable direct causes. The majority of women do try to reach health services when an emergency occurs, but the third delays present a major problem. Improving the quality of care at the healthcare facility level will help to reduce maternal death.

Keywords: maternal death, surveillance, delays, factors

Procedia PDF Downloads 113

Authors: Surajit Bhattacharya, Daniel Veltri, Atit A. Patel, Daniel N. Cox

Abstract:

miRNAs have emerged as key post-transcriptional regulators of gene expression, however identification of biologically-relevant target genes for this epigenetic regulatory mechanism remains a significant challenge. To address this knowledge gap, we have developed a novel tool in R, Intra-miR-ExploreR, that facilitates integrated discovery of miRNA targets by incorporating target databases and novel target prediction algorithms, using statistical methods including Pearson and Distance Correlation on microarray data, to arrive at high confidence intragenic miRNA target predictions. We have explored the efficacy of this tool using Drosophila melanogaster as a model organism for bioinformatics analyses and functional validation. A number of putative targets were obtained which were also validated using qRT-PCR analysis. Additional features of the tool include downloadable text files containing GO analysis from DAVID and Pubmed links of literature related to gene sets. Moreover, we are constructing interaction maps of intragenic miRNAs, using both micro array and RNA-seq data, focusing on neural tissues to uncover regulatory codes via which these molecules regulate gene expression to direct cellular development.

Keywords: miRNA, miRNA:mRNA target prediction, statistical methods, miRNA:mRNA interaction network

Procedia PDF Downloads 511

Authors: Maha Salah Abdullah Ismail, Manal S. Ismail, Amir M. Saleh

Abstract:

Reflexology treatment is a method for enhancing body relaxation. It is a widely recognized as an alternative therapy, effective for many health conditions. This study aimed to evaluate the effect of reflexology treatment on arterial blood gases among mechanically ventilated patients. A quasi-experimental (pre and post-test) research design was used. Research hypothesis was mechanically ventilated patients who will receive the reflexology treatment will have improvement in their arterial blood gases than those who will not. The current study was carried out in different Intensive Care Units at the Cairo University Hospitals. A purposeful sample of 100 adults’ mechanically ventilated patients was recruited over a period of three months of data collection. The participants were divided into two equally matched groups; (1) The study group who has received the routine care, in addition, two reflexology sessions on the feet, (2) The control group who has received only the routine care. One tool was utilized to collect data pertinent to the study; mechanically ventilated patients' data sheet that consists of demographic and medical data. Result: Majority (58% of the study group and 82% of the control group) were males, with mean age of 50.9 years in both groups. Patients who received the reflexology treatment significantly increase in the oxygen saturation pre second session (t=5.15, p=.000), immediate post sessions (t=4.4, p=.000) and post two hours (t= 4.7, p= .000). The study group was more likely to have lower PaO2 (F=5.025, p=.015), PaCo2 (F=4.952, p=.025) and higher HCo3 (F=15.211, p=.000) than the control group. Conclusion: This study results support the positive effect of reflexology treatment in improving some arterial blood gases among mechanically ventilated patients’ with the conventional therapy as in the study group there was increase in the oxygen saturation. In differences between groups there decrease PaO2, PaCo2 and increase HCo3 in the study group. Recommendation: Nurses should be trained how to demonstrate the foot reflexology among mechanically ventilated patients.

Keywords: arterial blood gases, foot, mechanical ventilated patient, reflexology

Procedia PDF Downloads 209

Authors: Najade Sheriff, Malaz Elsaddig, Kevin Jones

Abstract:

Background: Death in the first month of life accounts for an increasing proportion of under-five mortality. Advancement to reduce this number is being made across the globe; however, progress is slowest in sub-Saharan Africa. Objectives: The study aims to identify differences between neonatal deaths of inpatient babies born in a hospital facility in rural Uganda to those of neonates admitted from the community and to explore whether they can be used to risk stratify neonatal admissions. Results: A retrospective chart review was conducted on records for neonates admitted to the Special Care Baby Unit (SCBU) Kitovu Hospital from 1st July 2016 to 21st July 2017. A total of 442 babies were admitted and the overall neonatal mortality was 24.8% (40% inpatient, 37% community, 23% hospital referrals). 40% of deaths occurred within 24 hours of admission and the majority were male (63%). 43% of babies were hypothermic upon admission, a significantly greater proportion of which were inpatient babies born in labour ward (P=0.0025). Intrapartum related death accounted for ½ of all inpatient babies whereas complications of prematurity were the predominant cause of death in the community group (37%). Severe infection does not seem like a significant factor of mortality for inpatients (2%) as it does for community admissions (29%). Furthermore, with 52.5% of community admissions weighing < 1500g, very low birth weight (VLBW) may be a significant risk factor for community neonatal death. Conclusion: The neonatal mortality rate in this study is high, and the leading causes of death are all largely preventable. A high rate of inpatient birth asphyxiation indicates the need for good quality facility-based perinatal care as well as a greater focus on the management of hypothermia, such as Kangaroo care. Moreover, a reduction in preterm deliveries is necessary to reduce associated comorbidities, and monitoring for signs of infection is especially important for community admissions.

Keywords: community, mortality, newborn, Uganda

Procedia PDF Downloads 187

Authors: Prem K. Mony, Bharadwaj Amrutur, Prashanth Thankachan, Swarnarekha Bhat, Suman Rao, Maryann Washington, Annamma Thomas, N. Sheela, Hiteshwar Rao, Sumi Antony

Abstract:

The disease burden among mothers and newborns is caused mostly by a handful of avoidable conditions occurring around the time of childbirth and within the first month following delivery. Real-time monitoring of vital parameters of mothers and neonates offers a potential opportunity to impact access as well as the quality of care in vulnerable populations. We describe the design, development and testing of an innovative wearable device for remote biomonitoring (RBM) of body temperatures in mothers and neonates in a hospital in southern India. The architecture consists of: [1] a low-cost, wearable sensor tag; [2] a gateway device for ‘real-time’ communication link; [3] piggy-backing on a commercial GSM communication network; and [4] an algorithm-based data analytics system. Requirements for the device were: long battery-life upto 28 days (with sampling frequency 5/hr); robustness; IP 68 hermetic sealing; and human-centric design. We undertook pre-clinical laboratory testing followed by clinical trial phases I & IIa for evaluation of safety and efficacy in the following sequence: seven healthy adult volunteers; 18 healthy mothers; and three sets of babies – 3 healthy babies; 10 stable babies in the Neonatal Intensive Care Unit (NICU) and 1 baby with hypoxic ischaemic encephalopathy (HIE). The 3-coin thickness, pebble-design sensor weighing about 8 gms was secured onto the abdomen for the baby and over the upper arm for adults. In the laboratory setting, the response-time of the sensor device to attain thermal equilibrium with the surroundings was 4 minutes vis-a-vis 3 minutes observed with a precision-grade digital thermometer used as a reference standard. The accuracy was ±0.1°C of the reference standard within the temperature range of 25-40°C. The adult volunteers, aged 20 to 45 years, contributed a total of 345 hours of readings over a 7-day period and the postnatal mothers provided a total of 403 paired readings. The mean skin temperatures measured in the adults by the sensor were about 2°C lower than the axillary temperature readings (sensor =34.1 vs digital = 36.1); this difference was statistically significant (t-test=13.8; p<0.001). The healthy neonates provided a total of 39 paired readings; the mean difference in temperature was 0.13°C (sensor =36.9 vs digital = 36.7; p=0.2). The neonates in the NICU provided a total of 130 paired readings. Their mean skin temperature measured by the sensor was 0.6°C lower than that measured by the radiant warmer probe (sensor =35.9 vs warmer probe = 36.5; p < 0.001). The neonate with HIE provided a total of 25 paired readings with the mean sensor reading being not different from the radian warmer probe reading (sensor =33.5 vs warmer probe = 33.5; p=0.8). No major adverse events were noted in both the adults and neonates; four adult volunteers reported mild sweating under the device/arm band and one volunteer developed mild skin allergy. This proof-of-concept study shows that real-time monitoring of temperatures is technically feasible and that this innovation appears to be promising in terms of both safety and accuracy (with appropriate calibration) for improved maternal and neonatal health.

Keywords: public health, remote biomonitoring, temperature surveillance, wearable sensors, mothers and newborns

Procedia PDF Downloads 208

Authors: Masoud Swalehe, Semra Günay

Abstract:

Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.

Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest

Procedia PDF Downloads 300

Authors: Sebastián Olivares Lizana, Marianna Oyanedel González

Abstract:

This study takes part of a major project based on implementing a CLIL program (Content and Language Integrated Learning) at Universidad Técnica Federico Santa María, a leading Chilean tertiary Institution. It aims at examining the relationship between the development of Reflective Processes (RP) and Cognitive Academic Language Proficiency (CALP) in weekly learning logs written by faculty members, participants of an initial professional development online course on English for Academic Purposes (EAP). Such course was designed with a genre-based approach, and consists of multiple tasks directed to academic writing proficiency. The results of this analysis will be described and classified in a scale of key indicators that represent both the Reflective Processes and the advances in CALP, and that also consider linguistic proficiency and task progression. Such indicators will evidence affordances and constrains of using a genre-based approach in an EFL Engineering CLIL program implementation at tertiary level in Chile, and will serve as the starting point to the design of a professional development course directed to teaching methodologies in a CLIL EFL environment in Engineering education at Universidad Técnica Federico Santa María.

Keywords: EFL, EAL, genre, CLIL, engineering

Procedia PDF Downloads 395

Authors: Gevher Sayar, Dicle Aydın

Abstract:

The need for shelter which is one of the essential requirement of humanity has emerged for different type of dwelling needs depend on upon different culture and location. Almost all dwellings as an element of the public improvements effect the physical appearance of the city. Dwelling zones create part of whole in terms of urban area use. Whereas in traditional texture merger of parcels create city blocks, in new settlement area city blocks become a part, so the property of each part differs. The perspective of this study is part-to-whole relationship of residential areas and diversified residential areas are illustrated. The purpose of this study is that dwelling applications which have constructed quickly as gated community in the last 20 years in new settlement area of Konya (Turkey) have compared traditional texture in terms of part-to-whole relationship. According to the perception of traditional neighborhood in Konya, the relationship of houses between street pattern and each other are suited for city culture and location. In contrast, new settlement areas cannot become integrated another part of city, they have become restricted areas, so new settlement areas have not integrated, they have separated. The perception of part forms whole has changed, roads provide the relationship of growing parts with one another and walls of gated communities has disjunctive feature. In this study, by using visual analysis photographs and technical drawings are used. Traditional texture and current dwelling have compared.

Keywords: dwelling, residential area, urban part, urban whole

Procedia PDF Downloads 256

Authors: Akanksha Dicholkar, Celin Jacob, Omkar More

Abstract:

Work force instability, as demonstrated by high rates of staff turnover and lingering vacancy rates, continues to be a major challenge faced by health care organizations. The impact is manifested in workflow inefficiencies, delays in delivering patient care, and dissatisfaction among patients and staff, all of which can have significant negative effects on quality of care and patient safety. In addition, the staggering administrative costs created by a transient work force threaten health care organizations financial viability. One nurse retention strategy is to have newly hired nurses partake in Preceptorship. Precepting is a way to enculturate new employees into their role. Also good professional, collegial relationship between an experienced nurse and a newly hired nurse relations was evidenced. This study demonstrates impact of preceptor program on absconding rate, employee satisfaction & Patient satisfaction. Purpose of study: To decrease absconding rate. Objective: 1. To reduce the high absconding rate among nurses in Aster Medcity (AMC). 2. To facilitate the acclimatization of the newly hired nurse into their role, focusing on professional growth, inter-professional relationships and clinical skills required for the job. Methodology: Descriptive study by Convenience sampling method and collect data by direct observation, questionnaire, interviews. Sample size as per Sample size statistical table at 95 % CI. We conducted a pre and post intervention analysis to assess the impact of Preceptorship at AMC, with a daily occupancy of approx. 300 patients. Result: Preceptor program has had a significant improvement positive impact on all measured parameters. Absconding rate came down from 20% to 0% (P= 0.001). Patient satisfaction scores rose from 85% to 95%. Employee satisfaction rose form 65% to 85%. Conclusion: The project proved that Preceptor Development Programme and the steps taken in hand holding of the new joinees were effective in reducing the absconding rate among nurses and improved the overall satisfaction of new nurses. Preceptee satisfaction with the preceptorship experience was correlated with favorable evaluation of the relationship between the preceptee and preceptor. These findings indicate that when preceptors and preceptees have the benefit of formal preceptorship programs that are well supported, and when the preceptors’ efforts are rewarded, satisfaction is enhanced for both participants, preceptor commitment to the role is reinforced.

Keywords: absconding rate, preceptor, employee satisfaction index, satisfaction index

Procedia PDF Downloads 308

Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

Abstract:

Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

Procedia PDF Downloads 263

Authors: Gabriella Fardhiyanti, Victor Wee

Abstract:

Air connectivity is the crucial factors to boost a region economics growth. It will open the accessibility to support regional competitiveness and helps to achieve ASEAN (Association of Southeast Asian Nations) integration in term of economic integration, business investment, promote intra-regional trade, and creates the sense of belongingness among ASEAN people in the region. An increasing number of air connectivity and transportation will be benefiting the region because air transportation is a vital hub for ASEAN. The aim of this paper is to address the importance of air connectivity in promoting ASEAN Integration, by focusing on the ASEAN vision for a more integrated region. The assessment uses based on the Netscan Air connectivity model based on the flight destination and airport connectivity index, further analysis present that air connectivity significantly influence ASEAN tourism sector. Follow by the implications of open skies policy for the liberation of the aviation industry and the growth of low cost-carriers (LCCs) in the region. This paper provides recommendation and strategy for overcoming the challenges faced by ASEAN to boost ASEAN tourism integration successfully. The findings can assist in guiding policy and industry stakeholders in the future decision relating to air liberalization and more integrated system in the region.

Keywords: air connectivity, ASEAN integration, low-cost carries, NetScan connectivity model, open skies policy

Procedia PDF Downloads 215

Authors: Farzaneh Yazdani, Nastaran Yazdani, Laya Nobakht

Abstract:

The aim of this study was to explore the changes that may happen in students attitudes regarding disability after attending the module ‘Disability: theories, nature and experiences’ designed around reflective self-awareness exercises. Literature indicates enhanced knowledge does not automatically lead to changes in attitude. Health care professionals are the most significant people to instil hope in their clients to pursue a happy life. As an advocate for people with disability, health care professionals need to believe themselves in people with disability being able to pursue a happy life as an abled body does. Researchers aimed to explore the impact of the ‘Disability’ module using discussion and reflective exercises, on students’ way of thinking and possible changes in attitude towards disability. Students were asked to write stories from the beginning and after completing the module. A thematic analysis was applied to identify the students’ way of communicating their thoughts and feelings about disable-bodied /disability before and after the module. Three major themes were identified to represent the differences before and after attending the module as: problem /solution oriented approach towards perceived problems, separating/ integrating disable/able-bodied, passive/ active role of disable-bodied and society.

Keywords: qualitative study, reflection, rehabilitation, thematic analysis

Procedia PDF Downloads 299

Authors: Sau Kam Adeline Chan

Abstract:

World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.

Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error

Procedia PDF Downloads 148

Authors: Barış Ozluoymak, Emin Guzel, Ahmet İnce

Abstract:

Since chemical fertilizers are used for meeting the deficiency of plant nutrients, its many harmful effects are not taken into consideration for the structure of the earth. These fertilizers are hampering the work of the organisms in the soil immediately after thrown to the ground. This interference is first started with a change of the soil pH and micro organismic balance is disrupted by reaction in the soil. Since there can be no fragmentation of plant residues, organic matter in the soil will be increasingly impoverished in the absence of micro organismic living. Biological activity reduction brings about a deterioration of the soil structure. If the chemical fertilization continues intensively, soils will get worse every year; plant growth will slow down and stop due to the intensity of chemical fertilizers, yield decline will be experienced and farmer will not receive an adequate return on his investment. In this research, a prototype of automatic farm manure spreading machine for orange orchards that not just manufactured in Turkey was designed, constructed, tested and eliminate the human drudgery involved in spreading of farm manure in the field. The machine comprised several components as a 5 m3 volume hopper, automatic controlled hydraulically driven chain conveyor device and side delivery conveyor belts. To spread the solid farm manure automatically, the machine was equipped with an electronic control system. The hopper and side delivery conveyor designs fitted between orange orchard tree row spacing. Test results showed that the control system has significant effects on reduction in the amount of unnecessary solid farm manure use and avoiding inefficient manual labor.

Keywords: automatic control system, conveyor belt application, orchard, solid farm manure

Procedia PDF Downloads 285

Authors: Reem Al-Garni

Abstract:

Malnutrition is a global epidemic, but the under-weight or Failure-To-Thrive risk is increasing in rehabilitation setting and considered one of the contribution factor for developmental delay. Beside the consequences of malnutrition on children growth and development, there are other side-effects that might delay or hold the progress of rehabilitation. The awareness for malnutrition must be raised and discussed by the rehabilitation team, to promote the treatment and to optimize the client care. The solution can start from food supplements intake and / or Enteral Nutrition plan, depending on the malnutrition level and to reach the goal, the medical team should to work together in order to provide comprehensive treatment and to help the family to be able to manage their child condition. We have explore the outcomes of rehabilitation between the children with CP whose diagnosed with malnutrition and children with normal body Wight Over a period of 4 months who received 4-6 weeks of rehabilitation two hours daily by using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings reported that children with normal body Wight has better outcomes and improvement comparing with children with malnutrition for the entire study sample.

Keywords: Cerebral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, malnutrition

Procedia PDF Downloads 318

Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

Abstract:

Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

Procedia PDF Downloads 76

Authors: Polycarp Igbojekwe

Abstract:

The main objective of this study was to determine if emotional labour has become a criterion in performance appraisal, job description, selection, and training schemes in the hotel industry in Nigeria. Our main assumption was that majority of hotel organizations have not built emotional labour into their human resources management schemes. Data were gathered by the use of structured questionnaires designed in Likert format, and interviews. The focus group was managers of the selected hotels. Analyses revealed that majority of the hotels have not built emotional labour into their human resources schemes particularly in the 1, 2, and 3-star hotels. It was observed that service employees of 1, 2, and 3-star hotels have not been adequately trained to perform emotional labour; a critical factor in quality service delivery. Managers of 1, 2, and 3-star hotels have not given serious thought to emotional labour as a critical factor in quality service delivery. The study revealed that suitability of an individual’s characteristics is not being considered as a criterion for selection and performance appraisal for service employees. The implication of this is that, person-job-fit is not seriously considered. It was observed that there has been a disconnect between required emotional competency, its recognition, evaluation, and training. Based on the findings of this study, it is concluded that selection, training, job description and performance appraisal instruments in use in hotels in Nigeria are inadequate. Human resource implications of the findings in this study are presented. It is recommended that hotel organizations should re-design and plan the emotional content and context of their human resources practices to reflect the emotional demands of front line jobs in the hotel industry and the crucial role emotional labour plays during service encounters.

Keywords: emotional labour, employee selection, job description, performance appraisal, person-job-fit, employee compensation

Procedia PDF Downloads 192

Authors: Anders Schou Simonsen, Thomas Condra, Kim Sørensen

Abstract:

Various processes are modelled using a discrete phase, where particles are seeded from a source. Such particles can represent liquid water droplets, which are affecting the continuous phase by exchanging thermal energy, momentum, species etc. Discrete phases are typically modelled using parcel, which represents a collection of particles, which share properties such as temperature, velocity etc. When coupling the phases, the exchange rates are integrated over the cell, in which the parcel is located. This can cause spikes and fluctuating exchange rates. This paper presents an alternative method of coupling a discrete and a continuous plug flow phase. This is done using triangular parcels, which span between nodes following the dynamics of single droplets. Thus, the triangular parcels are propagated using the corner nodes. At each time step, the exchange rates are spatially integrated over the surface of the triangular parcels, which yields a smooth continuous exchange rate to the continuous phase. The results shows that the method is more stable, converges slightly faster and yields smooth exchange rates compared with the steam tube approach. However, the computational requirements are about five times greater, so the applicability of the alternative method should be limited to processes, where the exchange rates are important. The overall balances of the exchanged properties did not change significantly using the new approach.

Keywords: CFD, coupling, discrete phase, parcel

Procedia PDF Downloads 267

Authors: Bunakiye R. Japheth, Ogude U. Cyril

Abstract:

Since the process of transforming user requirements to modeling constructs are not very well supported by domain-specific frameworks, it became necessary to integrate domain requirements with the specific architectures to achieve an integrated customizable solutions space via artifact orientation. Domain-specific modeling language specifications of model-driven engineering technologies focus more on requirements within a particular domain, which can be tailored to aid the domain expert in expressing domain concepts effectively. Modeling processes through domain-specific language formalisms are highly volatile due to dependencies on domain concepts or used process models. A capable solution is given by artifact orientation that stresses on the results rather than expressing a strict dependence on complicated platforms for model creation and development. Based on this premise, domain-specific methods for producing artifacts without having to take into account the complexity and variability of platforms for model definitions can be integrated to support customizable development. In this paper, we discuss methods for the integration capabilities and necessities within a common structure and semantics that contribute a metamodel for artifact-orientation, which leads to a reusable software layer with concrete syntax capable of determining design intents from domain expert. These concepts forming the language formalism are established from models explained within the oil and gas pipelines industry.

Keywords: control process, metrics of engineering, structured abstraction, semantic model

Procedia PDF Downloads 142

Authors: Dusanee Suwankhong, Pranee Liamputtong

Abstract:

Mothers living with HIV tend to experience stigma and discrimination which has an impact on their psychological and social well-being and their human rights. This paper explores the lived experience of Thai mothers with HIV in their family. In-depth interviewing and drawing methods were employed to gain a deep understanding on the experience of 30 HIV-positive mothers in the southern community of Thailand. The data was analyzed using thematic analysis method. We found that the majority of HIV-positive mothers learned about their HIV status through blood test services during their antenatal care, but some decided to visit a doctor when their partner became chronically frail and showed some signs indicating HIV/AIDS. Learning about their HIV gave them a great shock, and they could not believe that they were infected with HIV/AIDS. They feared that their illness would be disclosed and hence attempted to keep their HIV secret. This was due to the fact that people in their community would blame and labeled them as a ‘disgusting person’. Besides, they would be separated from social contacts and networks, their individual rights would be disregarded, and their potential roles would be restricted. Although participants suggested that people had more positive view on HIV-infected person nowadays, all still wanted to keep it secret because of fear of stigma and discrimination. Thai health care has provided various kinds of support programs, but many mothers chose not to participate due to the fear of disclosure. However, the women attempted to seek some strategies to live a life which would be more acceptable by the community. We conclude that HIV is still seen as a stigmatised disease in rural community of southern Thailand. Local health care providers and relevant sectors in the locality should create suitable programs to enhance self-worth among those HIV-positive mothers because this could increase a quality of life of this vulnerable mothers. Providing sufficient and appropriate supports for better emotional wellbeing is an essential role of health professionals so that the feeling of isolation among these women could be eliminated and positive social justice can be achieved.

Keywords: HIV-positive mothers, lived experience, southern Thailand, stigma and discrimination

Procedia PDF Downloads 187

Authors: Carlo Gozzelino

Abstract:

Since the early 2000s, the phenomenon of the two-sided markets has been of growing interest in academic literature as such kind of markets differs by having cross-side network effects and same-side network effects characterizing the transactions, which make the analysis different when compared to traditional seller-buyer concept. Due to such externalities, pricing strategies can be based on subsidizing the participation of one side (i.e. considered key for the platform to attract the other side) while recovering the loss on the other side. In recent years, several players of the Italian financial intermediation industry moved from an integrated landscape (i.e. selling their own products) to an open one (i.e. intermediating third party products). According to academic literature such behavior can be interpreted as a merchant move towards a platform, operating in a two-sided market environment. While several application of two-sided market framework are available in academic literature, purpose of this paper is to use a two-sided market concept to suggest a new framework applied to financial intermediation. To this extent, a model is developed to show how competitors behave when vertically integrated and how the peculiarities of a two-sided market act as an incentive to disintegrate. Additionally, we show that when all players act as a platform, the dynamics of a two-sided markets can allow at least a Nash equilibrium to exist, in which platform of different sizes enjoy positive profit. Finally, empirical evidences from Italian market are given to sustain – and to challenge – this interpretation.

Keywords: financial intermediation, network externalities, two-sided markets, vertical differentiation

Procedia PDF Downloads 160

Authors: Karl Bryant Buan, Owaida Macadadaya Jr., Mon Eleazar Nonato, Zeke Andrew Palabrica, Charistabelle Mae Santiago

Abstract:

This study explored the occupational health risks faced by employees in the Business Process Outsourcing (BPO) industry, particularly in the Telco Account department of Alorica. The study used a stratified sampling method and a diagnostic tool called Workplace Integrated Safety and Health (WISH) Assessment to measure and evaluate the employees' perception of workplace health and safety. The results showed that more than 50% of call center workers reported feeling emotionally drained, sleep deprived, burnt out, and in need of anxiety or stress medication due to their work. Additionally, there was a significant difference in the perception of employee diversity, specifically in terms of leadership commitment, participation, policies, programs, and practices. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) results revealed that most employees complained of discomfort in their lower back, shoulder, upper back, neck, and hip. The researchers recommended an implementation plan for alternative work set-up, a satisfaction survey for employees, team-building activities or programs, and motivational approaches through benefits, incentives, and rewards.

Keywords: WISH assessment, CMDQ, ANOVA, diverse SOGIESC

Procedia PDF Downloads 70

Authors: Raymond Chi Fai Si Tou, Jacey Ja Young Choe, Amy Siu Ian So

Abstract:

Smart hotels can be defined as the hotel which has an intelligent system, through digitalization and networking which achieve hotel management and service information. In addition, smart hotels include high-end designs that integrate information and communication technology with hotel management fulfilling the guests’ needs and improving the quality, efficiency and satisfaction of hotel management. The purpose of this study is to identify appropriate factors that may influence guests’ satisfaction and intention to revisit Smart Hotels based on service quality measurement of lodging quality index and extended UTAUT theory. Unified Theory of Acceptance and Use of Technology (UTAUT) is adopted as a framework to explain technology acceptance and use. Since smart hotels are technology-based infrastructure hotels, UTATU theory could be as the theoretical background to examine the guests’ acceptance and use after staying in smart hotels. The UTAUT identifies four key drivers of the adoption of information systems: performance expectancy, effort expectancy, social influence, and facilitating conditions. The extended UTAUT modifies the definitions of the seven constructs for consideration; the four previously cited constructs of the UTAUT model together with three new additional constructs, which including hedonic motivation, price value and habit. Thus, the seven constructs from the extended UTAUT theory could be adopted to understand their intention to revisit smart hotels. The service quality model will also be adopted and integrated into the framework to understand the guests’ intention of smart hotels. There are rare studies to examine the service quality on guests’ satisfaction and intention to revisit in smart hotels. In this study, Lodging Quality Index (LQI) will be adopted to measure the service quality in smart hotels. Using integrated UTAUT theory and service quality model because technological applications and services require using more than one model to understand the complicated situation for customers’ acceptance of new technology. Moreover, an integrated model could provide more perspective insights to explain the relationships of the constructs that could not be obtained from only one model. For this research, ten in-depth interviews are planned to recruit this study. In order to confirm the applicability of the proposed framework and gain an overview of the guest experience of smart hotels from the hospitality industry, in-depth interviews with the hotel guests and industry practitioners will be accomplished. In terms of the theoretical contribution, it predicts that the integrated models from the UTAUT theory and the service quality will provide new insights to understand factors that influence the guests’ satisfaction and intention to revisit smart hotels. After this study identifies influential factors, smart hotel practitioners could understand which factors may significantly influence smart hotel guests’ satisfaction and intention to revisit. In addition, smart hotel practitioners could also provide outstanding guests experience by improving their service quality based on the identified dimensions from the service quality measurement. Thus, it will be beneficial to the sustainability of the smart hotels business.

Keywords: intention to revisit, guest satisfaction, qualitative interviews, smart hotels

Procedia PDF Downloads 208

Authors: Shawna Staud, Mary Kaye Scaramucci

Abstract:

Objective: Rubber cup polishing has been a traditional method of preventative therapy in dental hygiene treatment. Newer methods such as air polishing have changed the way dental hygiene care is provided, yet this technique has not been embraced by students in the program nor by practitioners in the workforce. Students entering the workforce tend to follow office protocol and are limited in confidence to introduce technologies learned in the curriculum. This project was designed to help students gain confidence in newer skills and encourage private practice settings to adopt newer technologies for patient care. Our program recently introduced air polishing earlier in the program before the rubber cup technique to determine if students would embrace the technology to become leading-edge professionals when they enter the marketplace. Methods: The class of 2022 was taught the traditional method of polishing in the first-year curriculum and air polishing in the second-year curriculum. The class of 2023 will be taught the air polishing method in the first-year curriculum and the traditional method of polishing in the second-year curriculum. Pre- and post-graduation survey data will be collected from both cohorts. Descriptive statistics and pre and post-paired t-tests with alpha set at .05 to compare pre and post-survey results will be used to assess data. Results: This study is currently in progress, with a completion date of October 2023. The class of 2022 completed the pre-graduation survey in the spring of 2022. The post-gradation survey will be sent out in October 2022. The class of 2023 cohort will be surveyed in the spring of 2023 and October 2023. Conclusion: Our hypothesis is students who are taught air polishing first will be more inclined to adopt that skill in private practice, thereby embracing newer technology and improving oral health care.

Keywords: luggage handling system at world’s largest pilgrimage center

Procedia PDF Downloads 103

Authors: Ching-Feng Chen, Ching-Chih Tsai

Abstract:

With the size of the transistor gradually approaching the physical limit, it challenges the persistence of Moore’s Law due to the development of the high numerical aperture (high-NA) lithography equipment and other issues such as short channel effects. In the context of the ever-increasing technical requirements of portable devices and high-performance computing, relying on the law continuation to enhance the chip density will no longer support the prospects of the electronics industry. Weighing the chip’s power consumption-performance-area-cost-cycle time to market (PPACC) is an updated benchmark to drive the evolution of the advanced wafer nanometer (nm). The advent of two and half- and three-dimensional (2.5 and 3D)- Very-Large-Scale Integration (VLSI) packaging based on Through Silicon Via (TSV) technology has updated the traditional die assembly methods and provided the solution. This overview investigates the up-to-date and cutting-edge packaging technologies for 2.5D and 3D integrated circuits (ICs) based on the updated transistor structure and technology nodes. The author concludes that multi-chip solutions for 2.5D and 3D IC packagings are feasible to prolong Moore’s Law.

Keywords: moore’s law, high numerical aperture, power consumption-performance-area-cost-cycle time to market, 2.5 and 3D- very-large-scale integration, packaging, through silicon via

Procedia PDF Downloads 114

Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

Abstract:

Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

Procedia PDF Downloads 369

Authors: Siti N. I. Mat Kamal, Othman Ibrahim, Mehrbakhsh Nilashi, Jafalizan M. Jali

Abstract:

The use of digital forensics (DF) is nowadays essential for law enforcement agencies to identify analysis and interpret the digital information derived from digital sources. In Malaysia, the engagement of Malaysian Law Enforcement Agencies (MLEA) with this new technology is not evenly distributed. To investigate the factors influencing the adoption of DF in Malaysia law enforcement agencies’ operational environment, this study proposed the initial theoretical framework based on the integration of technology organization environment (TOE), institutional theory, and human organization technology (HOT) fit model. A questionnaire survey was conducted on selected law enforcement agencies in Malaysia to verify the validity of the initial integrated framework. Relative advantage, compatibility, coercive pressure, normative pressure, vendor support and perceived technical competence of technical staff were found as the influential factors on digital forensics adoption. In addition to the only moderator of this study (agency size), any significant moderating effect on the perceived technical competence and the decision to adopt digital forensics by Malaysian law enforcement agencies was found insignificant. Thus, these results indicated that the developed integrated framework provides an effective prediction of the digital forensics adoption by Malaysian law enforcement agencies.

Keywords: digital forensics, digital forensics adoption, digital information, law enforcement agency

Procedia PDF Downloads 151