Search results for: research guidelines
25629 A New Proposed Framework for the Development of Interface Design for Malaysian Interactive Courseware
Authors: Norfadilah Kamaruddin
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This paper introduces a new proposed framework for the development process of interface design for Malaysian interactive courseware by exploring four established model in the recent research literature, existing Malaysian government guidelines and Malaysian developers practices. In particular, the study looks at the stages and practices throughout the development process. Significant effects of each of the stages are explored and documented, and significant interrelationships among them suggested. The results of analysis are proposed as potential model that helps in establishing and designing a new version of Malaysian interactive courseware.Keywords: development processes, interaction with interface, interface design, social sciences
Procedia PDF Downloads 37925628 Non-Linear Static Analysis of Screwed Moment Connections in Cold-Formed Steel Frames
Authors: Jikhil Joseph, Satish Kumar S R.
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Cold-formed steel frames are preferable for framed constructions due to its low seismic weights and results into low seismic forces, but on the contrary, significant lateral deflections are expected under seismic/wind loading. The various factors affecting the lateral stiffness of steel frames are the stiffness of connections, beams and columns. So, by increasing the stiffness of beam, column and making the connections rigid will enhance the lateral stiffness. The present study focused on Structural elements made of rectangular hollow sections and fastened with screwed in-plane moment connections for the building frames. The self-drilling screws can be easily drilled on either side of the connection area with the help of gusset plates. The strength of screwed connections can be made 1.2 times the connecting elements. However, achieving high stiffness in connections is also a challenging job. Hence in addition to beam and column stiffness’s the connection stiffness are also going to be a governing parameter in the lateral deflections of the frames. SAP 2000 Non-linear static analysis has been planned to study the seismic behavior of steel frames. The SAP model will be consisting of nonlinear spring model for the connection to account the semi-rigid connections and the nonlinear hinges will be assigned for beam and column sections according to FEMA 273 guidelines. The reliable spring and hinge parameters will be assigned based on an experimental and analytical database. The non-linear static analysis is mainly focused on the identification of various hinge formations and the estimation of lateral deflection and these will contribute as an inputs for the direct displacement-based Seismic design. The research output from this study are the modelling techniques and suitable design guidelines for the performance-based seismic design of cold-formed steel frames.Keywords: buckling, cold formed steel, nonlinear static analysis, screwed connections
Procedia PDF Downloads 17925627 Exploring the Situational Approach to Decision Making: User eConsent on a Health Social Network
Authors: W. Rowan, Y. O’Connor, L. Lynch, C. Heavin
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Situation Awareness can offer the potential for conscious dynamic reflection. In an era of online health data sharing, it is becoming increasingly important that users of health social networks (HSNs) have the information necessary to make informed decisions as part of the registration process and in the provision of eConsent. This research aims to leverage an adapted Situation Awareness (SA) model to explore users’ decision making processes in the provision of eConsent. A HSN platform was used to investigate these behaviours. A mixed methods approach was taken. This involved the observation of registration behaviours followed by a questionnaire and focus group/s. Early results suggest that users are apt to automatically accept eConsent, and only later consider the long-term implications of sharing their personal health information. Further steps are required to continue developing knowledge and understanding of this important eConsent process. The next step in this research will be to develop a set of guidelines for the improved presentation of eConsent on the HSN platform.Keywords: eConsent, health social network, mixed methods, situation awareness
Procedia PDF Downloads 29525626 The Impact of Nutritional Education for Peritoneal Dialysis Patients in Mongolia
Authors: Sanchir Erdenebayar, Namuuntsetseg Oyunbaatar
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Objectives: Peritoneal dialysis treatment is one of the important forms of kidney replacement therapy, and it has recently developed instantly in Mongolia for the past five years. Currently, more than 120 patients undergo peritoneal dialysis nationwide. These patients lack nutritional education, which predisposes them to protein deficiency and further impairs their quality of life. However, there is no study which is conducted among those about their dietary in Mongolia. Therefore, integrated nutrition information and educating them about dietary patterns to follow are urgently needed for PD patients. Methods: A cross-sectional study was carried out on 45 patients aged between 18 and 60 years who were undergoing CAPD at the biggest Medvic dialysis center in Ulaanbaatar. The knowledge of nutrition and food intake is assessed by interview based on a validated questionnaire prepared from KDIGO guidelines, semi-FFQ and a 24-hour dietary recall method. In addition, a biochemical blood test that includes total protein, albumin, calcium, phosphorus, potassium, and hemoglobin is used for an assessment of the patient’s current nutritional status. Results: Knowledge of nutritional status for CAPD was great, with 21.4% of patients and 78.65% having poor nutrition knowledge. The rate of mild to moderate malnutrition was 48.8% among research participants. Serum albumin was 38.4 ± 4.7 g/L, and total protein was 67.3±7.5g/l. Patients met 62.5± 26.5% of their daily intake nutritional requirement for calories and 72±40% of their nutritional requirement for protein. All patients’ energy intake was significantly /1328±304kcal/ lower than the energy requirement (2124±378kcal). Only 14.2% met the recommended dietary protein intake recommended to them of greater than 1.2 g/kg. Conclusions: As was established before, nutritional education has a vital positive impact on the health and nutritional status of peritoneal dialysis patients. The results of this study show that nutritional education programs are not enough adequate in peritoneal dialysis patients. There is a crucial priority to establish nutritional educational programs and guidelines for PD patients in Mongolia.Keywords: renal diet, peritoneal dialysis, nutrition education, CKD diet
Procedia PDF Downloads 6325625 Cryogenic Separation of CO2 from Molten Carbonate Fuel Cell Anode Outlet—Experimental Guidelines
Authors: Jarosław Milewski, Rafał Bernat
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This paper presents an analysis of using cryogenic separation unit for recovering fuel from anode off gas of molten carbonate fuel cells (MCFCs) in order to upgrade the efficiently of the unit. In the proposed solution, the CSU is used for condensing water and carbon dioxide from anode off gas, and re-cycling the rest of the stream to the anode, saving certain amount of fuel (at least 30%). The resulting system efficiency is increased considerably. CSU, virtually consumes power, thus this solution has energy penalty as well, on the other hand, MCFC generates large amount of heat at elevated temperature, thus part of the CSU can be based on absorption chiller. In all cases, a high amount of fuel is obtained after condensation of water and carbon dioxide and re-cycled to the anode inlet. Based on mathematical modeling done previously, the concept and guidelines for forthcoming experimental investigations are presented in this paper. During planned experiments, an existing single cell laboratory stand will be equipped with re-cycle device (a fan, a peristaltic pump, etc.). Parallel, a mixture of anode off gas will be cooled down for determining the proper temperature for the separation of water and carbon dioxide.Keywords: cryogenic separation, experiments, fuel cells, molten carbonate fuel cells
Procedia PDF Downloads 24725624 The Created of Interpretation to Promote Cultural Tourism for Sai Temple’ Local Boat Museum in Bangkhontee District, Samut Songkhram Province, Thailand
Authors: Teera Intararuang
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This research aims to study guidelines to developed Sai Temple’ local boat museum to be as cultural tourism attraction and explored villagers requirement in term of type and format of interpretation which they want to promote their cultural tourism for Sai Temple, Kradangnga sub-district, Bang Khon Tee district, Samut Songkhram province. However, this article will explores only the requirement of type and format of interpretation which 40 villagers of Ruam Sai Pattana 789 purposed to promote Sai temple. The procedures are In-depth Interview, Observation, Focus Group by discussing ideas. After that the information received is synthesized and analyzed. From research result, it is revealed that the local community’ requirement on types and format of interpretation as brochure with up to date, faithfully and formally content to present Sai Temple which got the most demand score (3.82) considered as most wanted demand.Keywords: museum, boat museum, cultural tourism, interpretation, brochure, Bangkhontee district, Samut Songkhram province
Procedia PDF Downloads 44325623 Downstream Supply Chain Collaboration: The Cornerstone of the Global Supply Chain
Authors: Fatiha Naaoui-Outini
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Purpose – The purpose of this paper is to shed light on how a Downstream Supply Chain facilitated the Customer Service Performance (BTB) by more collaborative practices between the different stakeholders in the chain. Methodology/approach – The paper developed a theoretical framework and conducted a qualitative exploratory study approach based on six semi-structured interviews with two international groups in the distribution sector with the aim of understanding and analyzing how companies have changed their supply chains to ensure optimal customer service. Findings/Implications – The study contributes to the Global Supply Chain Management and Collaboration literature by integrating the role of the downstream supply chain into research that may actually influence customer service performance on BTB. Our findings also provide firms with some guidelines on building successful downstream supply chain collaboration and a significant influence on customer service performance in BTB. Because of the exploratory nature of the study approach, the research results are limited to the data collected, and these preliminary findings require further confirmation.Keywords: customer service performance (B2B), global supply chain, downstream supply collaboration, qualitative case study
Procedia PDF Downloads 14825622 Reliability Based Performance Evaluation of Stone Column Improved Soft Ground
Authors: A. GuhaRay, C. V. S. P. Kiranmayi, S. Rudraraju
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The present study considers the effect of variation of different geotechnical random variables in the design of stone column-foundation systems for assessing the bearing capacity and consolidation settlement of highly compressible soil. The soil and stone column properties, spacing, diameter and arrangement of stone columns are considered as the random variables. Probability of failure (Pf) is computed for a target degree of consolidation and a target safe load by Monte Carlo Simulation (MCS). The study shows that the variation in coefficient of radial consolidation (cr) and cohesion of soil (cs) are two most important factors influencing Pf. If the coefficient of variation (COV) of cr exceeds 20%, Pf exceeds 0.001, which is unsafe following the guidelines of US Army Corps of Engineers. The bearing capacity also exceeds its safe value for COV of cs > 30%. It is also observed that as the spacing between the stone column increases, the probability of reaching a target degree of consolidation decreases. Accordingly, design guidelines, considering both consolidation and bearing capacity of improved ground, are proposed for different spacing and diameter of stone columns and geotechnical random variables.Keywords: bearing capacity, consolidation, geotechnical random variables, probability of failure, stone columns
Procedia PDF Downloads 35925621 Design Guidelines for URM Infills and Effect of Construction Sequence on Seismic Performance of Code Compliant RC Frame Buildings
Authors: Putul Haldar, Yogendra Singh, D. K. Paul
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Un-Reinforced Masonry (URM) infilled RC framed buildings are the most common construction practice for modern multi-storey buildings in India like many other parts of the world. Although the behavior and failure pattern of the global structure changes significantly due to infill-frame interaction, the general design practice is to treat them as non-structural elements and their stiffness, strength and interaction with frame is often ignored, as it is difficult to simulate. Indian Standard, like many other major national codes, does not provide any explicit guideline for modeling of infills. This paper takes a stock of controlling design provisions in some of the major national seismic design codes (BIS 2002; CEN 2004; NZS-4230 2004; ASCE-41 2007) to ensure the desired seismic performance of infilled frame. Most of the national codes on seismic design of buildings still lack in adequate guidelines on modeling and design of URM infilled frames results in variable assumption in analysis and design. This paper, using nonlinear pushover analysis, also presents the effect of one of such assumptions of conventional ‘simultaneous’ analysis procedure of infilled frame on the seismic performance of URM infilled RC frame buildings.Keywords: URM infills, RC frame, seismic design codes, construction sequence of infilled frame
Procedia PDF Downloads 38925620 An Aesthetic Spatial Turn - AI and Aesthetics in the Physical, Psychological, and Symbolic Spaces of Brand Advertising
Authors: Yu Chen
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In line with existing philosophical approaches, this research proposes a conceptual model with an innovative spatial vision and aesthetic principles for Artificial Intelligence (AI) application in brand advertising. The model first identifies the major constituencies in contemporary advertising on three spatial levels—physical, psychological, and symbolic. The model further incorporates the relationships among AI, aesthetics, branding, and advertising and their interactions with the major actors in all spaces. It illustrates that AI may follow the aesthetic principles-- beauty, elegance, and simplicity-- to reinforce brand identity and consistency in advertising, to collaborate with stakeholders, and to satisfy different advertising objectives on each level. It proposes that, with aesthetic guidelines, AI may assist consumers to emerge into the physical, psychological, and symbolic advertising spaces and helps transcend the tangible advertising messages to meaningful brand symbols. Conceptually, the research illustrates that even though consumers’ engagement with brand mostly begins with physical advertising and later moves to psychological-symbolic, AI-assisted advertising should start with the understanding of brand symbolic-psychological and consumer aesthetic preferences before the physical design to better resonate. Limits of AI and future AI functions in advertising are discussed.Keywords: AI, spatial, aesthetic, brand advertising
Procedia PDF Downloads 8025619 The Reflection Framework to Enhance the User Experience for Cultural Heritage Spaces’ Websites in Post-Pandemic Times
Authors: Duyen Lam, Thuong Hoang, Atul Sajjanhar, Feifei Chen
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With the emerging interactive technology applications helping users connect progressively with cultural artefacts in new approaches, the cultural heritage sector gains significantly. The interactive apps’ issues can be tested via several techniques, including usability surveys and usability evaluations. The severe usability problems for museums’ interactive technologies commonly involve interactions, control, and navigation processes. This study confirms the low quality of being immersive for audio guides in navigating the exhibition and involving experience in the virtual environment, which are the most vital features of new interactive technologies such as AR and VR. In addition, our usability surveys and heuristic evaluations disclosed many usability issues of these interactive technologies relating to interaction functions. Additionally, we use the Wayback Machine to examine what interactive apps/technologies were deployed on these websites during the physical visits limited due to the COVID-19 pandemic lockdown. Based on those inputs, we propose the reflection framework to enhance the UX in the cultural heritage domain with detailed guidelines.Keywords: framework, user experience, cultural heritage, interactive technology, museum, COVID-19 pandemic, usability survey, heuristic evaluation, guidelines
Procedia PDF Downloads 6925618 Outcomes of Pain Management for Patients in Srinagarind Hospital: Acute Pain Indicator
Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt
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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.Keywords: outcome, pain management, acute pain, Srinagarind Hospital
Procedia PDF Downloads 23225617 Technological Enhancements in Supply Chain Management Post COVID-19
Authors: Miran Ismail
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COVID-19 has caused widespread disruption in all economical sectors and industries around the world. The COVID-19 lockdown measures have resulted in production halts, restrictions on persons and goods movement, border closures, logistical constraints, and a slowdown in trade and economic activity. The main subject of this paper is to leverage technology to manage the supply chain effectively and efficiently through the usage of artificial intelligence. The research methodology is based on empirical data collected through a questionnaire survey. One of the approaches utilized is a case study of industrial organizations that face obstacles such as high operational costs, large inventory levels, a lack of well-established supplier relationships, human behavior, and system issues. The main contribution of this research to the body of knowledge is the empirical insights and on supply chain sustainability performance measurement. The results provide guidelines for the selection of advanced technologies to support supply chain processes and for the design of sustainable performance measurement systems.Keywords: information technology, artificial intelligence, supply chain management, industrial organizations
Procedia PDF Downloads 12525616 Sleep Health Management in Residential Aged Care Facilities
Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini
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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.Keywords: registered nurses, residential aged care facilities, sedative use, sleep
Procedia PDF Downloads 10725615 Evaluation Model in the Branch of Virtual Education of “Universidad Manuela Beltrán” Bogotá-Colombia
Authors: Javier López
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This Paper presents the evaluation model designed for the virtual education branch of The “Universidad Manuela Beltrán, Bogotá-Colombia”. This was the result of a research, developed as a case study, which had three stages: Document review, observation, and a perception survey for teachers. In the present model, the evaluation is a cross-cutting issue to the educational process. Therefore, it consists in a group of actions and guidelines which lead to analyze the student’s learning process from the admission, during the academic training, and to the graduation. This model contributes to the evaluation components which might interest other educational institutions or might offer methodological guidance to consolidate an own modelKeywords: model, evaluation, virtual education, learning process
Procedia PDF Downloads 45225614 The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital
Authors: Salma Ainine, Colin Ritchie, Tracey McFee
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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in the incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently cross-checked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014–September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification, and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, an introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.Keywords: antibiotic resistance, antibiotic stewardship, dental infection, hygiene standards
Procedia PDF Downloads 22725613 The Exploration of Sustainable Landscape in Iran: From Persian Garden to Modern Park
Authors: Honey Fadaie, Vahid Parhoodeh
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This paper concentrates on the result of research based on studies on parameters of sustainability in Persian Garden design as a traditional Iranian landscape and in a contemporary park, Jamshidieh in Iran as a new experience of re-creation of Persian Gardens’ sustainable design. Since, sustainable development has three parts: social, economic and environmental. The complexities of each part are too great to discuss in a paper of this length, thus the authors decided to analyze the design of Persian garden by considering their environmental sustainability. By the analysis of sustainable features and characteristics of traditional gardens, and exploration of parameters of sustainability in Iranian modern landscape, Such as Jamshideh Park, the main objective of this research is to identify the strategies for sustainable landscaping and parameters of creating sustainable green spaces for contemporary cities. The results demonstrate that in Persian Gardens, sustainable parameters such as productive networks and local renewable materials have been used to achieve sustainable development. At the conclusion, guidelines and recommendations for sustainable landscaping are presented.Keywords: Jamshidieh park, Persian garden, sustainable landscape, urban green space
Procedia PDF Downloads 47725612 The Positive Impact of Wheelchair Service Provision on the Health and Overall Satisfaction of Wheelchair Users with the Devices
Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward
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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production
Procedia PDF Downloads 10625611 Evaluating and Improving the Management of Tonsilitis in an a+E Department
Authors: Nicolas Koslover, Tamara Levene
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Aims: Tonsilitis is one of the most common presentations to the A+E department. We aimed to assess whether patients presenting with tonsilitis are being managed in-line with current guidance. We then set out to educate A+E staff about tonsilitis management and then assessed for improvement in management. Methods: All patients presenting to A+E in one fortnight with a documented diagnosis of tonsilitis were included. We reviewed the notes to assess the choice of treatment in each case and whether a clinical score (CENTOR or FEVERPain score) was used to guide choice of treatment (in accordance with NICE guideline [NG84]). We designed and delivered an educational intervention for A+E staff covering tonsilitis guidelines. The audit was repeated two weeks later. Results: Over the study period, 49 patients were included; only 35% (n=17) had either a clinical score documented or had all components of a score recorded. In total, 39% (n=19) were treated with antibiotics. Of these, 63% (n=12) should not have been prescribed an antibiotic and 37% (n=7) were prescribed an inappropriate antibiotic. At re-audit, (n=50 cases), 58% (n=29) had a clinical score documented and 28% (n=14) were treated with antibiotics. Of these, 29% (n=4) should not have been prescribed antibiotics and 21% (n=3) were prescribed an inappropriate antibiotic. Thus, after this teaching session, there was a significant improvement in antibiotic prescribing practices (63% vs. 29%, p=0.026). Conclusions: A+E assessment and management of tonsilitis frequently deviated from guidelines, but a single teaching session vastly improved clinical scoring and antibiotic prescribing practices.Keywords: tonsilitis, education, emergency medicine, ENT
Procedia PDF Downloads 16725610 Clinically-Based Improvement Project Focused on Reducing Risks Associated with Diabetes Insipidus, Syndrome of Inappropriate ADH, and Cerebral Salt Wasting in Paediatric Post-Neurosurgical and Traumatic Brain Injury Patients
Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen
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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric
Procedia PDF Downloads 9325609 A Case Study on the Collapse Assessment of the Steel Moment-Frame Setback High-Rise Tower
Authors: Marzie Shahini, Rasoul Mirghaderi
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This paper describes collapse assessments of a steel moment-frame high-rise tower with setback irregularity, designed per the 2010 ASCE7 code, under spectral-matched ground motion records. To estimate a safety margin against life-threatening collapse, an analytical model of the tower is subjected to a suite of ground motions with incremental intensities from maximum considered earthquake hazard level to the incipient collapse level. Capability of the structural system to collapse prevention is evaluated based on the similar methodology reported in FEMA P695. Structural performance parameters in terms of maximum/mean inter-story drift ratios, residual drift ratios, and maximum plastic hinge rotations are also compared to the acceptance criteria recommended by the TBI Guidelines. The results demonstrate that the structural system satisfactorily safeguards the building against collapse. Moreover, for this tower, the code-specified requirements in ASCE7-10 are reasonably adequate to satisfy seismic performance criteria developed in the TBI Guidelines for the maximum considered earthquake hazard level.Keywords: high-rise buildings, set back, residual drift, seismic performance
Procedia PDF Downloads 26125608 New Media and Social Media Laws and Ethics in United Arab Emirates
Authors: Ahmed Farouk Radwan, Sheren Mousa
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There are many laws and regulations governing the use of new and social media in the United Arab Emirates. During the past few years, the importance of using these platforms in the fields of media and government communication has increased, as well as at the level of individual use. In 2016, the National Media Council Law was issued to regulate traditional and new media field, and gave the council the power to oversee and undertake the media affairs in the state. NMC is mandated to: Develop the UAE’s media policy, Draft media legislation and ensure its execution and Prohibited media content ,Co-ordinate the media policy between the emirates in line with the UAE’s domestic and foreign policy, Ensure support for the federation and project national unity. All media organizations in the UAE must comply with the regulations and rules issued by council. Social media influencers have to be licensed by NMC if they accept paid ads to be published on their accounts. The study explores other laws concerning of new media and social media regulations and ethics including Combatting Cybercrimes law, Combating Discrimination and Hatred law, The Government Guidelines for social media users in the UAE, The Guidelines for the practices of electronic participation and social networking, Copyright Law, and Child Rights Law. The study clarifies the legal articles, items and standards in all these laws which related with the new media and social platforms and also determines the prohibited digital practices and the cultural norms governing it.Keywords: media laws, media ethics, new media , UAE
Procedia PDF Downloads 16925607 Genetic Counseling for Severe Mental Disorders. Integrating Innovative Services and Prophylactic Interventions in an Online Platform - MENTALICA
Authors: Ramona Moldovan, Doina Cosman, Sebastian Moldovan, Radu Popp, Victor Pop
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MENTALICA is a project aimed at developing and evaluating a platform that can assist individuals diagnosed with severe mental disorders and their families in managing the consequences associated with severe mental disorders, recurrence risks, prevention strategies and treatment options. MENTALICA is a platform based on guidance issued by some of the most prominent scientific organizations in the world. In order to personalize the information provided, the program explores details about the personal and family history of mental disorders. MENTALICA summarizes the answers and gives respondents a personal assessment. This includes personalized information and support about schizophrenia, bipolar disorder and schizoaffective disorder. MENTALICA includes several modules: Family history tools, Risk assessment tools and Risk factor sheets, Practical guides for patients, Practical guides for families, Guidelines for clinicians. Currently, there are no available guidelines for genetic counselling for mental disorders. Respondents can print out their reports and discuss them with family members or their doctors. We will briefly present the current status of MENTALICA and its implications for patients, professionals and the community.Keywords: genetic counseling, mental disorders, platform
Procedia PDF Downloads 49125606 Demographic Assessment and Evaluation of Degree of Lipid Control in High Risk Indian Dyslipidemia Patients
Authors: Abhijit Trailokya
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Background: Cardiovascular diseases (CVD’s) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient’s profile being treated, and factors that determine treatment success or failure in achieving desired goals. Purpose: The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India. Methods: This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed. Results: 3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician’s lack of awareness about recent treatment guidelines also might contribute to patients’ poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient’s life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients. Conclusion: As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70%. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.Keywords: cardiovascular disease, diabetes mellitus, dyslipidemia, LDL-C, lipid lowering drug, statins
Procedia PDF Downloads 20125605 From Theory to Practice: An Iterative Design Process in Implementing English Medium Instruction in Higher Education
Authors: Linda Weinberg, Miriam Symon
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While few institutions of higher education in Israel offer international programs taught entirely in English, many Israeli students today can study at least one content course taught in English during their degree program. In particular, with the growth of international partnerships and opportunities for student mobility, English medium instruction is a growing phenomenon. There are however no official guidelines in Israel for how to develop and implement content courses in English and no training to help lecturers prepare for teaching their materials in a foreign language. Furthermore, the implications for the students and the nature of the courses themselves have not been sufficiently considered. In addition, the institution must have lecturers who are able to teach these courses effectively in English. An international project funded by the European Union addresses these issues and a set of guidelines which provide guidance for lecturers in adapting their courses for delivery in English have been developed. A train-the-trainer approach is adopted in order to cascade knowledge and experience in English medium instruction from experts to language teachers and on to content teachers thus maximizing the scope of professional development. To accompany training, a model English medium course has been created which serves the dual purpose of highlighting alternatives to the frontal lecture while integrating language learning objectives with content goals. This course can also be used as a standalone content course. The development of the guidelines and of the course utilized backwards, forwards and central design in an iterative process. The goals for combined language and content outcomes were identified first after which a suitable framework for achieving these goals was constructed. The assessment procedures evolved through collaboration between content and language specialists and subsequently were put into action during a piloting phase. Feedback from the piloting teachers and from the students highlight the need for clear channels of communication to encourage frank and honest discussion of expectations versus reality. While much of what goes on in the English medium classroom requires no better teaching skills than are required in any classroom, the understanding of students' abilities in achieving reasonable learning outcomes in a foreign language must be rationalized and accommodated within the course design. Concomitantly, preparatory language classes for students must be able to adapt to prepare students for specific language and cognitive skills and activities that courses conducted in English require. This paper presents findings from the implementation of a purpose-designed English medium instruction course arrived at through an iterative backwards, forwards and central design process utilizing feedback from students and lecturers alike leading to suggested guidelines for English medium instruction in higher education.Keywords: English medium instruction, higher education, iterative design process, train-the-trainer
Procedia PDF Downloads 30125604 Some Metal Levels in Muscle Tissue of Seven Fish Species from the Suğla and Beyşehir Lakes, Turkey
Authors: Haluk Özparlak, Murad Aydın Şanda, Gülşin Arslan
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Phoxinellus anatolicus, Carassius gibelio, Sander lucioperca, Vimba vimba tenella, Capoeta capoeta, Tinca tinca from Suğla Lake (Turkey) and Phoxinellus anatolicus, Scardinius erythrophthalmus, Tinca tinca from Beyşehir Lake (Turkey) are economically important fish species and these fish have been consumed as food by local people. P. anatolicus is also endangered and endemic species from Turkey. In this study, concentrations of Cd, Co, Cr, Fe, Mn, Ni, Pb and Zn were determined in muscle tissue of these fish by using atomic absorption spectrophotometer. Levels of metals in the muscle tissue of all the fish specimens were compared with results of previous studies, the tolerance levels of national and international guidelines and the levels of Provisional Tolerable Weekly Intake (PTWI) limits set by FAO/WHO. Concentrations of Cd, Cr, Ni and Pb in the muscle tissue of all the fish specimens from Suğla and Beyşehir Lakes exceeded the tolerance levels of national and international guidelines. However, concentrations of Cd, Fe, Pb and Zn were below PTWI limits. Therefore, in terms of these metal levels, consumption of fresh filet of examined seven fish species (weekly up to about 300 g/person) doesn’t seem to be objectionable for human health.Keywords: Beyşehir Lake, fish, metal levels, Suğla Lake
Procedia PDF Downloads 33525603 Childhood Apraxia of Speech and Autism: Interaction Influences and Treatment
Authors: Elad Vashdi
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It is common to find speech deficit among children diagnosed with Autism. It can be found in the clinical field and recently in research. One of the DSM-V criteria suggests a speech delay (Delay in, or total lack of, the development of spoken language), but doesn't explain the cause of it. A common perception among professionals and families is that the inability to talk results from the autism. Autism is a name for a syndrome which just describes a phenomenon and is defined behaviorally. Since it is not based yet on a physiological gold standard, one can not conclude the nature of a deficit based on the name of the syndrome. A wide retrospective research (n=270) which included children with motor speech difficulties was conducted in Israel. The study analyzed entry evaluations in a private clinic during the years 2006-2013. The data was extracted from the reports. High percentage of children diagnosed with Autism (60%) was found. This result demonstrates the high relationship between Autism and motor speech problem. It also supports recent findings in research of Childhood apraxia of speech (CAS) occurrence among children with ASD. Only small percentage of the participants in this research (10%) were diagnosed with CAS even though their verbal deficits well fitted the guidelines for CAS diagnosis set by ASHA in 2007. This fact raises questions regarding the diagnostic procedure in Israel. The understanding that CAS might highly exist within Autism and can have a remarkable influence on the course of early development should be a guiding tool within the diagnosis procedure. CAS can explain the nature of the speech problem among some of the autistic children and guide the treatment in a more accurate way. Calculating the prevalence of CAS which includes the comorbidity with ASD reveals new numbers and suggests treating differently the CAS population.Keywords: childhood apraxia of speech, Autism, treatment, speech
Procedia PDF Downloads 27525602 Legal Regulation of Personal Information Data Transmission Risk Assessment: A Case Study of the EU’s DPIA
Authors: Cai Qianyi
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In the midst of global digital revolution, the flow of data poses security threats that call China's existing legislative framework for protecting personal information into question. As a preliminary procedure for risk analysis and prevention, the risk assessment of personal data transmission lacks detailed guidelines for support. Existing provisions reveal unclear responsibilities for network operators and weakened rights for data subjects. Furthermore, the regulatory system's weak operability and a lack of industry self-regulation heighten data transmission hazards. This paper aims to compare the regulatory pathways for data information transmission risks between China and Europe from a legal framework and content perspective. It draws on the “Data Protection Impact Assessment Guidelines” to empower multiple stakeholders, including data processors, controllers, and subjects, while also defining obligations. In conclusion, this paper intends to solve China's digital security shortcomings by developing a more mature regulatory framework and industry self-regulation mechanisms, resulting in a win-win situation for personal data protection and the development of the digital economy.Keywords: personal information data transmission, risk assessment, DPIA, internet service provider, personal information data transimission, risk assessment
Procedia PDF Downloads 6125601 Environmental, Social and Corporate Governance Reporting With Regard to Best Practices of Companies Listed on the Warsaw Stock Exchange - Selected Problems
Authors: Katarzyna Olejko
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The need to redefine the goals and adapt the operational activities carried out in accordance with the concept of sustainable management to these goals results in the increasing importance of information on the company's activities perceived from the perspective of the effectiveness and efficiency of environmental goals implementation. The narrow scope of reporting data on a company's impact on the environment is not adequate to meet the information needs of modern investors. Reporting obligations are therefore imposed on companies in order to increase the effectiveness of corporate governance and to improve the process of assessing the achievement of environmental goals. The non-financial reporting obligations introduced in Polish legislation increased the scope of reported information. However, the lack of detailed guidelines on the method of reporting resulted in a large diversification of the scope of non-financial information, making it impossible to compare the data presented by companies. The source of information regarding the level of the implementation of standards in Environmental, social and corporate governance (ESG) is the report on compliance with best practices published by the Warsaw Stock Exchange. The document Best Practices of Warsaw Stock Exchange (WSE) Listed Companies (2021), amended by the WSE in 2021, includes the rules applicable to this area (ESG). The aim of this article is to present the level of compliance with good practices in the area of ESG by selected companies listed on the Warsaw Stock Exchange The research carried out as part of this study, which was based on information from reports on the compliance with good practices of companies listed on the Warsaw Stock Exchange that was made available in the good practice scanner, have revealed that good practices in the ESG area are implemented by companies to a limited extent. The level of their application in comparison with other rules is definitely lower. The lack of experience and clear guidelines on ESG reporting may cause some confusion, which is why conscious investors and reporting companies themselves are pinning their hopes on the Corporate Sustainability Reporting Directive (CSRD) adopted by European Parliament.Keywords: reporting, ESG, corporate governance, best practices
Procedia PDF Downloads 7525600 Prescription of Lubricating Eye Drops in the Emergency Eye Department: A Quality Improvement Project
Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley
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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.Keywords: lubrication, dry eye disease, guideline, prescription
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