Search results for: maternity care model

Authors: Ching-Ling Lin, Li-Chi Huang, Yao-Tsung Chang, Ruey-Yu Chen, Shwu-Huey Yang

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Introduction & Purpose: Diabetes and its related complications always been a major part of medical cost in Taiwan. To patient with diabetes, self-management blood sugar, improving a healthy lifestyle are the most important thing to avoid getting worse. The aim of this study was to explore the trend of the changing in blood glucose within intervention and followed-up periods of patients who participated in the health coaching program between 2017 and 2020. Design & Methods: The data was combined from two diabetes health coaching program. The intervention group had health coaching and usual care for 6 months, whereas the control had usual care only. The main outcome variables were HbA1c level at baseline, 3, 6, 9, and 12 months. Results: In total, the data were available for 99 patients in the coaching intervention group and for 88 patients in the control group, the dropout rate during the follow-up period is about 18%. Of 187 participants, 54% were female, mean age was 61.5 years (SD=10.19), only 32.1% had a bachelor’s degree or higher, and the mean duration of diabetes treatment at Cathay General Hospital was 9.9 years. Within 12 months, the intervention group had a significant decrease of 0.65% (SD=1.05) in HbA1c level, and a non-significant decrease of 0.13%(SD=0.96) was observed in the control group. The figure showed the effect was the most significant in the first three months of the intervention and can be maintained for up to six months after the intervention was over. The HbA1c values of the two groups at each follow-up point are significantly different. In addition, there were non-significant correlation between HbA1c and gender, age, and educational level. Conclusion: Health coaching might be an effective way to enhance self-management for patients with diabetes and improving their blood sugar control in Taiwan.

Keywords: diabetes, health coaching, HbA1c, self-management

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Authors: Chongyang Ye, Rong Liu

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Elastic compression stockings (ECSs) have been widely applied in prophylaxis and treatment of chronic venous insufficiency of lower extremities. The medical function of ECS is to improve venous return and increase muscular pumping action to facilitate blood circulation, which is largely determined by the complex interaction between the ECS and lower limb tissues. Understanding the mechanical transmission of ECS along the skin surface, deeper tissues, and vascular system is essential to assess the effectiveness of the ECSs. In this study, a three-dimensional (3D) finite element (FE) model of the leg-ECS system integrated with a 3D fluid-solid interaction (FSI) model of the leg-vein system was constructed to analyze the biomechanical properties of veins and soft tissues under different ECS compression. The Magnetic Resonance Imaging (MRI) of the human leg was divided into three regions, including soft tissues, bones (tibia and fibula) and veins (peroneal vein, great saphenous vein, and small saphenous vein). The ECSs with pressure ranges from 15 to 26 mmHg (Classes I and II) were adopted in the developed FE-FSI model. The soft tissue was assumed as a Neo-Hookean hyperelastic model with the fixed bones, and the ECSs were regarded as an orthotropic elastic shell. The interfacial pressure and stress transmission were simulated by the FE model, and venous hemodynamics properties were simulated by the FSI model. The experimental validation indicated that the simulated interfacial pressure distributions were in accordance with the pressure measurement results. The developed model can be used to predict interfacial pressure, stress transmission, and venous hemodynamics exerted by ECSs and optimize the structure and materials properties of ECSs design, thus improving the efficiency of compression therapy.

Keywords: elastic compression stockings, fluid-solid interaction, tissue and vein properties, prediction

Procedia PDF Downloads 107

Authors: Marica Pidor-Quingco, Francis Cabatingan

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Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

Procedia PDF Downloads 125

Authors: Sung Hyun You, Jeong Hoon Kim, Dae Ki Kim, Choon Ki Ahn

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In this paper, we proposed a new strategy for estimating indoor temperature based on the modified resistance capacitance (R–C) network thermal dynamic model. Using minimum variance finite impulse response (FIR) filter, accurate indoor temperature estimation can be achieved. Our study is clarified by the experimental validation of the proposed indoor temperature estimation method. This experiment scenario environment is composed of a demand response (DR) server and home energy management system (HEMS) in a test bed.

Keywords: energy consumption, resistance-capacitance network model, demand response, finite impulse response filter

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Authors: Settapong Malisuwan, Jesada Sivaraks, Peerawat Promkladpanao, Nattakit Suriyakrai, Navneet Madan

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In this paper, a compact microstrip patch antenna is designed for mobile LTE applications by applying the frequency-dependent Smith-Chart (FDSC) model. The FDSC model is adopted in this research to reduce the error on the frequency-dependent characteristics. The Ansoft HFSS and various techniques is applied to meet frequency and size requirements. The proposed method within this research is suitable for use in computer-aided microstrip antenna design and RF integrated circuit (RFIC) design.

Keywords: frequency-dependent, smith-chart, microstrip, antenna, LTE, CAD

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Authors: Ugoh Kelechi Melford, Anene O.

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Introduction: Evidence has shown that there are increasing rates of new HIV and other STI infections occurring among Men who have Sex with Men (MSM) in Nigeria, with the prevalence 3 times higher than the general population as reported by the 2011 National Integrated Bio Behavioral Surveillance Survey. The poor state of health care and support services hinders our effort to control the high rates of these new infections among MSM. Methods: The Initiative for Improved Male Health (IMH-Initiative) works to provide a safe space for young MSM living with HIV to access comprehensive palliative care and support, as well as referrals for other services through drama and dance competitions. An STI assessment was conducted in IMH-Initiative’s Community Center in Calabar, for gay men and other MSM. An STI history was conducted for all clients who visited the community clinic specifically for HCT and STI counseling and referrals within a 5 month period, and their data were collated. Results: 61 MSM were diagnosed, and reported the following in the last 6 months. 49 where living with HIV. 46 had previous histories of untreated anal warts. 20 had previous histories of treated Gonorrhea by self-medication and herbs. 21 had untreated boils and rashes around the genitals. 10 clients where living with HIV, and reported untreated penile and rectal gonorrhea. All clients indicated that there were not comfortable discussing STI infections with staff of public hospitals. Conclusion: It is evident that a reasonable number of STI infections among MSM are not completely treated or ignored. This thereby increases the individual’s risk of HIV infection, and cripples HIV prevention programming in Nigeria. HIV programs targeting MSM must incorporate STI syndromic management, so as to increase access to non-stigmatized diagnosis and treatment of STIs. Also, access to STI drugs for clients cannot be overemphasized.

Keywords: MSM, IBBSS, STI, IMH

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Authors: Nanyombi Lubimbi, Josette Niyokindi

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Background: As in many other developing countries in Africa, Rwanda suffers from a chronic shortage of skilled Health Care professionals including Clinical Instructors. This shortage negatively affects the clinical instruction quality therefore impacting student-learning outcomes. Due to poor clinical supervision, it is often noted that students have no structure or consistent guidance in their learning process. The Clinical Educators and the Rwandan counterparts identified the need to create a favorable environment for learning. Description: During orientation the expectations of the student learning process, collaboration of the clinical instructors with the nurses and Clinical Educators is outlined. The ward managers facilitate structured learning by helping the students identify a maximum of two patients using the school’s objectives to guide the appropriate selection of patients. Throughout the day, Clinical Educators with collaboration of Clinical Instructors when present conduct an ongoing assessment of learning and provide feedback to the students. Post-conference is provided once or twice a week to practice critical thinking skills of patient cases that they have been taking care of during the day. Lessons Learned: The students are found to be more confident with knowledge and skills gained during rotations. Clinical facility evaluations completed by students at the end of their rotations highlight the student’s satisfaction and recommendation for continuation of structured learning. Conclusion: Based on the satisfaction of both students and Clinical Instructors, we have identified need for structured learning during clinical rotations. We acknowledge that more evidence-based practice is necessary to effectively address the needs of nursing and midwifery students throughout the country.

Keywords: Rwanda, clinical rotation, structured learning, critical thinking skills, post-conference

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Authors: Rumeysa Terzioglu

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Social entrepreneurship is not only a new concept but also an engaging factor of development that utilizes opportunities in economic and social areas for women. Social entrepreneurs have experience in determining and solving social problems with community participation. Social entrepreneurship is a consequence of individual social and economic initiatives contributing to women’s social and economic development against poverty. Women’s empowerment is an essential point for development. Türkiye has been developing an alternative empowerment model for women affected by the national development plan. Social entrepreneurship is an alternative model of social and economic empowerment of women’s status in Türkiye.

Keywords: social entrepreneurship, women, women empowerment, development

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Authors: Zhuang Guo

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In the field of GaN-based resonant tunneling diodes (RTDs) simulations, the traditional Tsu-Esaki formalism failed to predict the values of peak currents and peak voltages in the simulated current-voltage(J-V) characteristics. The main reason is that due to the strong internal polarization fields, two-dimensional electron gas(2DEG) accumulates at emitters, resulting in 2D-2D resonant tunneling currents, which become the dominant parts of the total J-V characteristics. By comparison, based on the 3D-2D resonant tunneling mechanism, the traditional Tsu-Esaki formalism cannot predict the J-V characteristics correctly. To overcome this shortcoming, we develop a new analytical model for the 2D-2D resonant tunneling currents generated in GaN-based RTDs. Compared with Tsu-Esaki formalism, the new model has made the following modifications: Firstly, considering the Heisenberg uncertainty, the new model corrects the expression of the density of states around the 2DEG eigenenergy levels at emitters so that it could predict the half width at half-maximum(HWHM) of resonant tunneling currents; Secondly, taking into account the effect of bias on wave vectors on the collectors, the new model modifies the expression of the transmission coefficients which could help to get the values of peak currents closer to the experiment data compared with Tsu-Esaki formalism. The new analytical model successfully predicts the J-V characteristics of GaN-based RTDs, and it also reveals more detailed mechanisms of resonant tunneling happened in GaN-based RTDs, which helps to design and fabricate high-performance GaN RTDs.

Keywords: GaN-based resonant tunneling diodes, tsu-esaki formalism, 2D-2D resonant tunneling, heisenberg uncertainty

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Authors: Hyun Joon Chang, Jae In Kim, Sungsoo Na

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Kinesin-1 (hereafter called kinesin) is a molecular motor protein that moves cargos toward the end of microtubules using the energy of adenosine triphosphate (ATP) hydrolysis. When kinesin is inactive, its tail autoinhibits the motor chain in order to prevent from reacting with the ATP by cross-linking of the tail domain to the motor domains at two positions. However, the morphological study of kinesin during autoinhibition is yet remained obscured. In this study, we report the effect of the binding site of the tail domain using the normal mode analysis of the elastic network model on kinesin in the tail-free form and tail-bind form. Considering the relationship between the connectivity of conventional network model with respect to the cutoff length and the functionality of the binding site of the tail, we revaluated the network model to observe the key role of the tail domain in its structural aspect. Contingent on the existence of the tail domain, the results suggest the morphological stability of the motor domain. Furthermore, employing the results from normal mode analysis, we have determined the strain energy of the neck linker, an essential portion of the motor domain for ATP hydrolysis. The results of the neck linker also converge to the same indication, i.e. the morphological analysis of the motor domain.

Keywords: elastic network model, Kinesin-1, autoinhibition

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Authors: Slim Amami

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A model is developed to prevent the risks related to climate conditions in the agricultural sector. It will determine the yearly optimum premium to be paid by a farmer in order to reach his required turnover. The model is mainly based on both climatic stability and 'soft' responses of usually grown species to average climate variations at the same place and inside a safety ball which can be determined from past meteorological data. This allows the use of linear regression expression for dependence of production result in terms of driving meteorological parameters, main ones of which are daily average sunlight, rainfall and temperature. By a simple best parameter fit from the expert table drawn with professionals, optimal representation of yearly production is deduced from records of previous years, and yearly payback is evaluated from minimum yearly produced turnover. Optimal premium is then deduced, and gives the producer a useful bound for negotiating an offer by insurance companies to effectively protect their harvest. The application to wheat production in the French Oise department illustrates the reliability of the present model with as low as 6% difference between predicted and real data. The model can be adapted to almost every agricultural field by changing state parameters and calibrating their associated coefficients.

Keywords: agriculture, database, meteorological factors, production model, optimal price

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Authors: Lailial Muhtifah, Sirtul Marhamah

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This article forwards the conceptual framework of continuous academic lecturer model in Islamic higher education (IHE). It is intended to make a contribution to the broader issue of how the concept of excellence can promote adherence to standards in higher education and drive quality enhancement. This model reveals a process and steps to increase performance and achievement of excellence regular lecturer gradually. Studies in this model are very significant to realize excellence academic culture in IHE. Several steps were identified from previous studies through literature study and empirical findings. A qualitative study was conducted at institute. Administrators and lecturers were interviewed, and lecturers learning communities observed to explore institute culture policies, and procedures. The original in this study presents and called Continuous Academic Lecturer Model (CALM) with its components, namely Standard, Quality, and Excellent as the basis for this framework (SQE). Innovation Excellence Framework requires Leaders to Support (LS) lecturers to achieve a excellence culture. So, the model named CALM-SQE+LS. Several components of performance and achievement of CALM-SQE+LS Model should be disseminated and cultivated to all lecturers in university excellence in terms of innovation. The purpose of this article is to define the concept of “CALM-SQE+LS”. Originally, there were three components in the Continuous Academic Lecturer Model i.e. standard, quality, and excellence plus leader support. This study is important to the community as specific cases that may inform educational leaders on mechanisms that may be leveraged to ensure successful implementation of policies and procedures outline of CALM with its components (SQE+LS) in institutional culture and professional leader literature. The findings of this study learn how continuous academic lecturer is part of a group's culture, how it benefits in university. This article blends the available criteria into several sub-component to give new insights towards empowering lecturer the innovation excellence at the IHE. The proposed conceptual framework is also presented.

Keywords: continuous academic lecturer model, excellence, quality, standard

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Authors: Douglas J. Kube

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At the beginning of the COVID-19 pandemic, the Canadian Red Cross deployed workers into long-term care homes across Canada to support our most vulnerable citizens. It began by recruiting and training small teams of workers to provide non-clinical services for facilities in outbreak. Deployed workers were trained on an approach based on successful Red Cross deployments used with Ebola in which zones were established, levels of protection used, and strict protocols followed to prevent exposure. This paper addresses aspects of human performance through a safety culture lens. The Red Cross deployments highlight valuable insights and are an excellent case study in the principles of human performance and organizational culture. This paper looks at human performance principles, including human fallibility, predictability of error-likely situations, avoiding events by understanding reasons mistakes occur, and the influence on behaviour by organizational factors. This study demonstrates how the Red Cross’s organizational culture and work design positively influenced performance to protect workers and residents/clients. Lastly, this paper shares lessons that can be applied in many workplaces to improve worker health and safety and safety culture. This critical examination is based on the author’s experience as a Senior Occupational Health and Safety Advisor with the Red Cross during the pandemic as part of the team responsible for developing and implementing biological safety practices in long-term care deployments.

Keywords: COVID, human performance, organizational culture, work design

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Authors: Oktofa Y. Sudrajad, Didier V. Caillie

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Association of Southeast Asian Countries Nations (ASEAN) is moving forward to the next level of regional integration by the initiation of ASEAN Economic Community (AEC) which is already started in 2015, 8 years after its declaration for the creation of AEC in 2007. This commitment imposes financial integration in the region is one of the main agenda which will be achieved until 2025. Therefore, the commitment to financial integration including banking integration will bring new landscape in the competition and business model in this region. This study investigates the effect of competition on bank business model using a sample of 324 banks from seven members of Association of Southeast Asian Nations (ASEAN) countries (Cambodia, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam). We use market power approach and Boone indicator as competition measures, while income diversification and bank funding strategies are employed as bank business model representation. Moreover, we also evaluate bank business model based by grouping the banks based on the main banking characteristics. We use unbalanced bank-specific annual panel data over the period of 2003 – 2015. Our empirical analysis shows that the banking industries in ASEAN countries adapt their business model by increasing non-interest income proportion due to the level of competition increase in the sector.

Keywords: bank business model, banking competition, Boone indicator, market power

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Authors: Lingyu Ding, Hongxia Hua, Hanfei Zhu, Jinling Lu, Qin Xu

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Background: Postoperative pain is a prevalent problem leading to many adverse outcomes in surgical patients. Virtual reality (VR) is an emerging non-pharmacological method of postoperative pain relief, but the effects of it are not clear. This review aimed to explore the effects of VR on relieving postoperative pain. Methods: We searched PubMed, Embase, Web of Science, and other databases from inception to November 2019 to get the eligible studies. Meta-analyses were conducted to compare VR and usual care for relieving postoperative pain. Subgroup analyses and sensitivity analyses were performed to explain the heterogeneity. Results: Overall, 8 randomized control trials (RCTs) enrolling 723 participants were included. Our results demonstrated that the patients receiving the VR intervention had lower postoperative pain scores than those receiving the usual care. One subgroup analysis revealed that VR could relieve postoperative pain both in minor surgery and major surgery. Another subgroup analysis demonstrated a significant reduction in postoperative pain among patients receiving VR during the intraoperative and the postoperative periods. However, there was no significant postoperative pain relief when receiving VR during the preoperative period. Additionally, significant improvements in postoperative satisfaction were reported in two studies. However, another two studies included found that VR could not affect physiological parameters related to pain. Conclusion: Applying VR can relieve postoperative pain effectively. The type of surgery and timing of using VR are the main sources of heterogeneity. More rigorous studies about the relationship between VR and postoperative pain relief will be needed.

Keywords: meta-analysis, postoperative pain, systematic review, virtual reality

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Authors: Martín Pratto Burgos

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The Engineering School of the University of the Republic in Uruguay offers an Introductory Mathematical Course from the second semester of 2019. This course has been designed to assist students in preparing themselves for math courses that are essential for Engineering Degrees, namely Math1, Math2, and Math3 in this research. The research proposes to build a model that can accurately predict the student's activity and academic progress based on their performance in the three essential Mathematical courses. Additionally, there is a need for a model that can forecast the incidence of the Introductory Mathematical Course in the three essential courses approval during the first academic year. The techniques used are Principal Component Analysis and predictive modelling using the Generalised Linear Model. The dataset includes information from 5135 engineering students and 12 different characteristics based on activity and course performance. Two models are created for a type of data that follows a binomial distribution using the R programming language. Model 1 is based on a variable's p-value being less than 0.05, and Model 2 uses the stepAIC function to remove variables and get the lowest AIC score. After using Principal Component Analysis, the main components represented in the y-axis are the approval of the Introductory Mathematical Course, and the x-axis is the approval of Math1 and Math2 courses as well as student activity three years after taking the Introductory Mathematical Course. Model 2, which considered student’s activity, performed the best with an AUC of 0.81 and an accuracy of 84%. According to Model 2, the student's engagement in school activities will continue for three years after the approval of the Introductory Mathematical Course. This is because they have successfully completed the Math1 and Math2 courses. Passing the Math3 course does not have any effect on the student’s activity. Concerning academic progress, the best fit is Model 1. It has an AUC of 0.56 and an accuracy rate of 91%. The model says that if the student passes the three first-year courses, they will progress according to the timeline set by the curriculum. Both models show that the Introductory Mathematical Course does not directly affect the student’s activity and academic progress. The best model to explain the impact of the Introductory Mathematical Course on the three first-year courses was Model 1. It has an AUC of 0.76 and 98% accuracy. The model shows that if students pass the Introductory Mathematical Course, it will help them to pass Math1 and Math2 courses without affecting their performance on the Math3 course. Matching the three predictive models, if students pass Math1 and Math2 courses, they will stay active for three years after taking the Introductory Mathematical Course, and also, they will continue following the recommended engineering curriculum. Additionally, the Introductory Mathematical Course helps students to pass Math1 and Math2 when they start Engineering School. Models obtained in the research don't consider the time students took to pass the three Math courses, but they can successfully assess courses in the university curriculum.

Keywords: machine-learning, engineering, university, education, computational models

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Authors: Victoria Goodall, Paul Fatti, Norman Owen-Smith

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Hidden Markov Models have become popular for the analysis of animal tracking data. These models are being used to model the movements of a variety of species in many areas around the world. A common assumption of the model is that the observations need to have regular time steps. In many ecological studies, this will not be the case. The objective of the research is to modify the movement model to allow for irregularly spaced locations and investigate the effect on the inferences which can be made about the latent states. A modification of the likelihood function to allow for these irregular spaced locations is investigated, without using interpolation or averaging the movement rate. The suitability of the modification is investigated using GPS tracking data for lion (Panthera leo) in South Africa, with many observations obtained during the night, and few observations during the day. Many nocturnal predator tracking studies are set up in this way, to obtain many locations at night when the animal is most active and is difficult to observe. Few observations are obtained during the day, when the animal is expected to rest and is potentially easier to observe. Modifying the likelihood function allows the popular Hidden Markov Model framework to be used to model these irregular spaced locations, making use of all the observed data.

Keywords: hidden Markov Models, irregular observations, animal movement modelling, nocturnal predator

Procedia PDF Downloads 239

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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Authors: Bita Mashayekhi, Azadeh Maddahi, Arash Tahriri

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The purpose of this paper is developing a model for audit quality, with regard to the contextual and environmental attributes of the audit profession in Iran. For this purpose, using an exploratory approach, and because of the special attributes of the auditing profession in Iran in terms of the legal environment, regulatory and supervisory mechanisms, audit firms size, and etc., we used grounded theory approach as a qualitative research method. Therefore, we got the opinions of the experts in the auditing and capital market areas through unstructured interviews. As a result, the authors revealed the determinants of audit quality, and by using these determinants, developed an Integrated Audit Quality Model, including causal conditions, intervening conditions, context, as well as action strategies related to AQ and their consequences. In this research, audit quality is studied using a systemic approach. According to this approach, the quality of inputs, processes, and outputs of auditing determines the quality of auditing, therefore, the quality of all different parts of this system is considered.

Keywords: audit quality, integrated audit quality model, demand for audit service, supply of audit, grounded theory

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Authors: Aedah Abd Rahman

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Software organisations may implement single or multiple frameworks in order to remain competitive. There are wide selection of generic Software Process Improvement (SPI) frameworks, best practices and standards implemented with different focuses and goals. Issues and difficulties emerge in the SPI practices from the context of software development and IT Service Management (ITSM). This research looks into the integration of multiple frameworks from the perspective of software development and ITSM. The research question of this study is how to define steps of methodology to solve the multi model software process improvement problem. The objective of this study is to define the research approach and methodologies to produce a more integrated and efficient Multi Model Process Improvement (MMPI) solution. A multi-step methodology is used which contains the case study, framework mapping and Delphi study. The research outcome has proven the usefulness and appropriateness of the proposed framework in SPI and quality practice in Malaysian software industries. This mixed method research approach is used to tackle problems from every angle in the context of software development and services. This methodology is used to facilitate the implementation and management of multi model environment of SPI frameworks in multiple domains.

Keywords: Delphi study, methodology, multi model software process improvement, service management

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Authors: Vinko Vidučić, Tanja Brešan Ančić, Marijana Tomelić Ćurlin

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Prior to quantifying the variables of the information model for using school terminology in Croatia's region of Dalmatia from 1884 to 2014, the most relevant model variables had to be determined: historical circumstances, standard of living, education system, linguistic situation, and media. The research findings show that there was no significant transfer of the 1884 school terms into 1949 usage; likewise, the 1949 school terms were not widely used in 2014. On the other hand, the research revealed that the meaning of school terms changed over the decades. The quantification of the variables will serve as the groundwork for creating an information model for using school terminology in Dalmatia from 1884 to 2014 and for defining direct growth rates in further research.

Keywords: education system, historical circumstances, linguistic situation, media, school terminology, standard of living

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Authors: Prathuang Usaborisut, Dithaporn Thungsotanon

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Soil compaction induced by a tractor towing trailer becomes a major problem associated to sugarcane productivity. Soil beneath the tractor’s tire is not only under compressing stress but also shearing stress. Therefore, in order to help to understand such effects on soil, this research aimed to determine stress state in soil and predict compaction of soil under a tractive tire. The octahedral stress ratios under the tires were higher than one and much higher under higher draft forces. Moreover, the ratio was increasing with increase of number of tire’s passage. Soil compaction model was developed using data acquired from triaxial tests. The model was then used to predict soil bulk density under tractive tire. The maximum error was about 4% at 15 cm depth under lower draft force and tended to increase with depth and draft force. At depth of 30 cm and under higher draft force, the maximum error was about 16%.

Keywords: draft force, soil compaction model, stress state, tractive tire

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Authors: M. Gerasimou, S. Mantzoukis, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

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Purpose: Microbial infection of the blood is a serious condition where bacteria invade the bloodstream and cause systemic disease. In such cases, blood cultures are performed. Blood cultures are a key diagnostic test for intensive care unit (ICU) patients. Material and method: The BacT/Alert system, which measures the production of carbon dioxide with metabolic organisms, is used. The positive result in the BacT/Alert system is followed by culture in the following selective media: Blood, Mac Conkey No 2, Chocolate, Mueller Hinton, Chapman and Sabaureaud agar. Gram staining method was used to differentiate bacterial species. The microorganisms were identified by biochemical techniques in the automated Microscan (Siemens) system and followed by a sensitivity test on the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer-based test. Results: In 2017 the Laboratory of Microbiology received 3347 blood cultures. Of these, 170 came from the ICU. 116 found positive. Of these S. epidermidis was identified in 42, A. baumannii in 27, K. pneumoniae in 12 (4 of these KPC ‘Klebsiella pneumoniae carbapenemase’), S. hominis in 8, E. faecium in 7, E. faecalis in 5, P. aeruginosa in 3, C. albicans in 3, S. capitis in 2, K. oxytoca in 2, P. mirabilis in 2, E. coli in 1, S. intermidius in 1 and S. lugdunensis in 1. Conclusions: The study of epidemiological data and microbial resistance phenotypes is essential for the choice of therapeutic regimen for the early treatment and limitation of multivalent strains, while it is a crucial factor to solve diagnostic problems.

Keywords: blood culture, bloodstream, infection, intensive care unit

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Authors: M. Karimpour, N. Elkhoury, L. Hitihamillage, S. Moridpour, R. Hesami

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There is a necessity among rail transportation authorities for a superior understanding of the rail track degradation overtime and the factors influencing rail degradation. They need an accurate technique to identify the time when rail tracks fail or need maintenance. In turn, this will help to increase the level of safety and comfort of the passengers and the vehicles as well as improve the cost effectiveness of maintenance activities. An accurate model can play a key role in prediction of the long-term behaviour of railroad tracks. An accurate model can decrease the cost of maintenance. In this research, the rail track degradation is predicted using an autoregressive moving average with exogenous input (ARMAX). An ARMAX has been implemented on Melbourne tram data to estimate the values for the tram track degradation. Gauge values and rail usage in Million Gross Tone (MGT) are the main parameters used in the model. The developed model can accurately predict the future status of the tram tracks.

Keywords: ARMAX, dynamic systems, MGT, prediction, rail degradation

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Authors: Peyman Aela, Lu Zong, Guoqing Jing

Abstract:

Recently, there has been growing interest in numerical modeling of ballast railway tracks. A commonly used mechanistic modeling approach for ballast is the discrete element method (DEM). Up to now, the effects of the contact model on ballast particle behavior have not been precisely examined. In this regard, selecting the appropriate contact model is mainly associated with the particle characteristics and the loading condition. Since ballast is cohesionless material, different contact models, including the linear spring, Hertz-Mindlin, and Hysteretic models, could be used to calculate particle-particle or wall-particle contact forces. Moreover, the simulation of a dynamic test is vital to investigate the effect of damping parameters on the ballast deformation. In this study, ballast box tests were simulated by DEM to examine the influence of different contact models on the mechanical behavior of the ballast layer under cyclic loading. This paper shows how the contact model can affect the deformation and damping of a ballast layer subjected to cyclic loading in a ballast box.

Keywords: ballast, contact model, cyclic loading, DEM

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Authors: Abeer Amayri, Akif A. Bulgak

Abstract:

Due to today’s globalization as well as outsourcing practices of the companies, the Supply Chain (SC) performances have become more dependent on the efficient movement of material among places that are geographically dispersed, where there is more chance for disruptions. One such disruption is the quality and delivery uncertainties of outsourcing. These uncertainties could lead the products to be unsafe and, as is the case in a number of recent examples, companies may have to end up in recalling their products. As a result of these problems, there is a need to develop a methodology for selecting suppliers globally in view of risks associated with low quality and late delivery. Accordingly, we developed a two-stage stochastic model that captures the risks associated with uncertainty in quality and delivery as well as a solution procedure for the model. The stochastic model developed simultaneously optimizes supplier selection and purchase quantities under price discounts over a time horizon. In particular, our target is the study of global organizations with multiple sites and multiple overseas suppliers, where the pricing is offered in suppliers’ local currencies. Our proposed methodology is applied to a case study for a US automotive company having two assembly plants and four potential global suppliers to illustrate how the proposed model works in practice.

Keywords: global supply chains, quality, stochastic programming, supplier selection

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Authors: Adil Rasheed, Mandar Tabib

Abstract:

The paper describes the ability of a high-resolution Computational Fluid Dynamics model to predict terrain-induced turbulence and wind shear close to the ground. Various sensitivity studies to choose the optimal simulation setup for modeling the flow characteristics in a complex terrain are presented. The capabilities of the model are demonstrated by applying it to the Sandnessjøen Airport, Stokka in Norway, an airport that is located in a mountainous area. The model is able to forecast turbulence in real time and trigger an alert when atmospheric conditions might result in high wind shear and turbulence.

Keywords: aviation safety, terrain-induced turbulence, atmospheric flow, alert system

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Authors: Valentina Futoryanova, Hugh Hunt

Abstract:

One of the common failure modes of the diesel engine turbochargers is high cycle fatigue of the turbine wheel blades. Mistuning of the blades due to the casting process is believed to contribute to the failure mode. Laser vibrometer is used to characterize mistuning for a population of turbine wheels through the analysis of the blade response to piezo speaker induced noise. The turbine wheel design under investigation is radial and is typically used in 6-12 L diesel engine applications. Amplitudes and resonance frequencies are reviewed and summarized. The study also includes test results for a paddle wheel that represents a perfectly tuned system and acts as a reference. Mass spring model is developed for the paddle wheel and the model suitability is tested against the actual data. Randomization is applied to the stiffness matrix to model the mistuning effect in the turbine wheels. Experimental data is shown to have good agreement with the model.

Keywords: vibration, radial turbines, mistuning, turbine blades, modal analysis, periodic structures, finite element

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Authors: Nini Johana Marín Rodríguez, William Fernando Oquendo Patino

Abstract:

In this work, we model a coupled system where we explore the effects of steady and random behavior on a linear system like an extension of the classic Strogatz model. This is exemplified by modeling a couple love dynamics as a linear system of two coupled differential equations and studying its stability for four types of lovers chosen as CC='Cautious- Cautious', OO='Only other feelings', OP='Opposites' and RR='Romeo the Robot'. We explore the effects of, first, introducing saturation, and second, adding a random variation to one of the CC-type lover, which will shape his character by trying to model how its variability influences the dynamics between love and hate in couple in a long run relationship. This work could also be useful to model other kind of systems where interactions can be modeled as linear systems with external or internal random influence. We found the final results are not easy to predict and a strong dependence on initial conditions appear, which a signature of chaos.

Keywords: differential equations, dynamical systems, linear system, love dynamics

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Authors: Samantha Meyerholz

Abstract:

MSKCC offers patients cutting edge cancer care with the highest quality standards. However, many patients and industry members do not realize that the operations of the Immunology Histology Lab (IHC) are the backbone for carrying out this mission. The IHC lab manufactures blocks and slides containing critical tissue samples that will be read by a Pathologist to diagnose and dictate a patient’s treatment course. The lab processes 200 requests daily, leading to the generation of approximately 2,000 slides and 1,100 blocks each day. Lab material is transported through labeling, cutting, staining and sorting manufacturing stations, while being managed by multiple techs throughout the space. The quality of the stain as well as wait times associated with processing requests, is directly associated with patients receiving rapid treatments and having a wider range of care options. This project aims to improve slide request turnaround time for rush and non-rush cases, while increasing the quality of each request filled (no missing slides or poorly stained items). Rush cases are to be filled in less than 24 hours, while standard cases are allotted a 48 hour time period. Reducing turnaround times enable patients to communicate sooner with their clinical team regarding their diagnosis, ultimately leading faster treatments and potentially better outcomes. Additional project goals included streamlining tech and material workflow, while reducing waste and increasing efficiency. This project followed a DMAIC structure with emphasis on lean and ergonomic principles that could be integrated into an evolving lab culture. Load times and batching processes were analyzed using process mapping, FMEA analysis, waste analysis, engineering observation, 5S and spaghetti diagramming. Reduction of lab technician movement as well as their body position at each workstation was of top concern to pathology leadership. With new equipment being brought into the lab to carry out workflow improvements, screen and tool placement was discussed with the techs in focus groups, to reduce variation and increase comfort throughout the workspace. 5S analysis was completed in two phases in the IHC lab, helping to drive solutions that reduced rework and tech motion. The IHC lab plans to continue utilizing these techniques to further reduce the time gap between tissue analysis and cancer care.

Keywords: engineering, ergonomics, healthcare, lean

Procedia PDF Downloads 218