Search results for: essential quality tools

Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath

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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.

Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics

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Authors: Dararat Tongdee, Surapong Chirarattananon, Somchai Maneewan, Chantana Punlek

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Recently, the Internet of Things (IoT) is the important technology that connects devices to the network and people can access real-time communication. This technology is used to report, collect, and analyze the big data for achieving a purpose. For a smart building, there are many IoT technologies that enable management and building operators to improve occupant thermal comfort, indoor air quality, and building energy efficiency. In this research, we propose monitoring and controlling performance of a smart dedicated outdoor air system (SDOAS) based on IoT platform. The SDOAS was specifically designed with the desiccant unit and thermoelectric module. The designed system was intended to monitor, notify, and control indoor environmental factors such as temperature, humidity, and carbon dioxide (CO₂) level. The SDOAS was tested under the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE 62.2) and indoor air quality standard. The system will notify the user by Blynk notification when the status of the building is uncomfortable or tolerable limits are reached according to the conditions that were set. The user can then control the system via a Blynk application on a smartphone. The experimental result indicates that the temperature and humidity of indoor fresh air in the comfort zone are approximately 26 degree Celsius and 58% respectively. Furthermore, the CO₂ level was controlled lower than 1000 ppm by indoor air quality standard condition. Therefore, the proposed system can efficiently work and be easy to use for buildings.

Keywords: internet of things, indoor air quality, smart dedicated outdoor air system, thermal comfort

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Authors: Alexey Abilov

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Sociological research in the form of a questionnaire survey of the population in the last decade has become an essential part of a comprehensive assessment of the territory in the practice of urban planning in Kazakhstan. This method was successfully used for developing master plans of settlements, urban agglomerations, and projects of detailed planning of individual sections of the urban environment. Also, it greatly contributes to the objectification of design solutions, since in addition to the traditional expert multifactorial assessment of urban development territories by professional designers, they provide an opportunity to consider existing urban development problems at the local level from the inside, through the eyes of the living population. A comparison of two areas of assessment of the territory -expert and social- allows us to give a more balanced final assessment, which can serve as a strong basis for making correct design decisions. The author of the article shows this by the example of the social assessment of the territory of the Almaty urban agglomeration in the form of a questionnaire survey of the population conducted in order to assess the quality of the living environment of the population, preferences in place and forms of recreation, as well as to delimitation the boundaries of the agglomeration. At the same time, the author's methodology of qualitative and quantitative assessment of the territory divided into polling stations is used, based on a comparison of the percentage of respondents' responses to various questionnaire questions with the total number of respondents.

Keywords: social assessment of territory, comprehensive assessment, urban agglomeration, correct design decisions

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Authors: Aabha Chaubey, Bani Bhattacharya

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Evaluation of the quality of teaching in engineering education in India needs to be conducted on a continuous basis to achieve the best teaching quality in technical education. Quality teaching is an influential factor in technical education which impacts largely on learning outcomes of the students. Present study is not exclusively theory-driven, but it draws on various specific concepts and constructs in the domain of technical education. These include teaching and learning in higher education, teacher effectiveness, and teacher evaluation and performance management in higher education. Student Evaluation of Education Quality (SEEQ) was proposed as one of the evaluation instruments of the quality teaching in engineering education. SEEQ is one of the popular and standard instrument widely utilized all over the world and bears the validity and reliability in educational world. The present study was designed to evaluate the teaching quality through SEEQ in the context of technical education in India, including its validity and reliability based on the collected data. The multiple dimensionality of SEEQ that is present in every teaching and learning process made it quite suitable to collect the feedback of students regarding the quality of instructions and instructor. The SEEQ comprises of 9 original constructs i.e.; learning value, teacher enthusiasm, organization, group interaction, and individual rapport, breadth of coverage, assessment, assignments and overall rating of particular course and instructor with total of 33 items. In the present study, a total of 350 samples comprising first year undergraduate students from Indian Institute of Technology, Kharagpur (IIT, Kharagpur, India) were included for the evaluation of the importance of SEEQ. They belonged to four different courses of different streams of engineering studies. The above studies depicted the validity and reliability of SEEQ was based upon the collected data. This further needs Confirmatory Factor Analysis (CFA) and Analysis of Moment structure (AMOS) for various scaled instrument like SEEQ Cronbach’s alpha which are associated with SPSS for the examination of the internal consistency. The evaluation of the effectiveness of SEEQ in CFA is implemented on the basis of fit indices such as CMIN/df, CFI, GFI, AGFI and RMSEA readings. The major findings of this study showed the fitness indices such as ChiSq = 993.664,df = 390,ChiSq/df = 2.548,GFI = 0.782,AGFI = 0.736,CFI = 0.848,RMSEA = 0.062,TLI = 0.945,RMR = 0.029,PCLOSE = 0.006. The final analysis of the fit indices presented positive construct validity and stability, on the other hand a higher reliability was also depicted which indicated towards internal consistency. Thus, the study suggests the effectivity of SEEQ as the indicator of the quality evaluation instrument in teaching-learning process in engineering education in India. Therefore, it is expected that with the continuation of this research in engineering education there remains a possibility towards the betterment of the quality of the technical education in India. It is also expected that this study will provide an empirical and theoretical logic towards locating a construct or factor related to teaching, which has the greatest impact on teaching and learning process in a particular course or stream in engineering education.

Keywords: confirmatory factor analysis, engineering education, SEEQ, teaching and learning process

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Authors: Hiroaki Nasu, Ryota Miyamoto, Yuta Kodera, Yasuyuki Nogami

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To promote Industry 4.0 and Society 5.0 and so on, it is important to connect and share data so that every member can trust it. Blockchain (BC) technology is currently attracting attention as the most advanced tool and has been used in the financial field and so on. However, the data collaboration using BC has not progressed sufficiently among companies on the supply chain of manufacturing industry that handle sensitive data such as product quality, manufacturing conditions, etc. There are two main reasons why data utilization is not sufficiently advanced in the industrial supply chain. The first reason is that manufacturing information is top secret and a source for companies to generate profits. It is difficult to disclose data even between companies with transactions in the supply chain. In the blockchain mechanism such as Bitcoin using PKI (Public Key Infrastructure), in order to confirm the identity of the company that has sent the data, the plaintext must be shared between the companies. Another reason is that the merits (scenarios) of collaboration data between companies are not specifically specified in the industrial supply chain. For these problems this paper proposes a Business to Business (B2B) collaboration system using homomorphic encryption and BC technique. Using the proposed system, each company on the supply chain can exchange confidential information on encrypted data and utilize the data for their own business. In addition, this paper considers a scenario focusing on quality data, which was difficult to collaborate because it is a top secret. In this scenario, we show a implementation scheme and a benefit of concrete data collaboration by proposing a comparison protocol that can grasp the change in quality while hiding the numerical value of quality data.

Keywords: business to business data collaboration, industrial supply chain, blockchain, homomorphic encryption

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Authors: Andrew Enaifoghe

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Municipalities are the most fundamental units of governance, and they are responsible for providing basic services and supporting growth in the areas they rule. South African local government is primarily understood in terms of service delivery, and the South African constitution provides municipalities with the responsibility of mobilizing economic resources, to better the lives of all people. Essential public services are the primary pillars of enhanced quality of life, and appropriate supplies of safe water and sanitation are required for life, well-being, and human dignity. Therefore, having access to basic services is directly tied to social inclusion and social capital, and towns' inability to offer services can have a negative influence on social and economic growth. The problem of service delivery is seen as one of the biggest challenges facing South African municipalities today. This study attempts to assess South African municipal service delivery. Focusing on the main causes of service delivery challenges, the study also looks at the impact of these challenges to identify ways to minimize such challenges by introducing legal instruments such as municipal budgeting and annual reports. A qualitative design was adopted, and data were collected using a desktop technique and analyzed based on content. While public engagement in municipal affairs is required by law, considerable work has to be done to ensure successful participation. Finally, municipalities were deemed to need to do more to improve human capacity to offer services.

Keywords: municipalities, service delivery, corruption, monitoring, South Africa

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Authors: Gulay Aras, Isil Kutluturk Karagoz, Z. Candan Algun

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Background: Hypermetropia in school-age is a pathology that responds to treatment. In the literature, there has been no study of exercise practice in hypermetropia treatment. Objective: The purpose of this study was to investigate the effects of eye exercises and convergence exercise on visual acuity in school-age children with hypermetropia. Methods: Forty volunteer school-age children with hypermetropia (30 girls, 30 boys, between 7-17 years of age) were included in the study. Sociodemographic information and clinical characteristics were evaluated. 40 participants were randomly divided into two groups: eye exercises and convergence exercises. Home exercise protocols were given to all groups for six weeks, and regular phone calls were made once a week. Individuals performed eye exercises 10 times, convergence exercises 5 min. for two sessions per day for six weeks. The right and left eyes of all the subjects participating in the study were assessed separately by the eye doctor with a Snellen chart. The participants' quality of life was assessed using Pediatric Quality of Life Inventory Version 4.0. Physical health total score (PHTS) and scale total score (STS), which were obtained by evaluating Psychosocial health total score (PSHTS) school, emotional and social functioning, were calculated separately in the scores. At the end of the exercise program, the assessment tests applied at the beginning of the study were reapplied to all individuals. Results: There was no statistically significant difference between the pre- and post-Snellen chart measurements and quality of life in the eye exercises group (p > 0,05). There was a statistically significant difference in visual acuity of right and left eyes (p=0,004, p=0,014) and quality of life in PHTS, PSHTS and STS in the convergence exercise group (p=0,001, p=0,017, p=0,001). Conclusions: In school-age children, convergence exercises were found to be effective on visual acuity and health-related quality of life. Convergence exercises are recommended for the treatment of school-aged children with hypermetropia.

Keywords: convergence exercise, eye exercises, hypermetropia, school-age children

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Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

Procedia PDF Downloads 361

Authors: Kinneret Segal

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Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life

Procedia PDF Downloads 114

Authors: Armando Cartenì

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Within the design of sustainable transportation engineering, the problem of reducing particulate matter (PM) concentrations in railways metro system was not much discussed. It is well known that PM levels in railways metro system are mainly produced by mechanical friction at the rail-wheel-brake interactions and by the PM re-suspension caused by the turbulence generated by the train passage, which causes dangerous problems for passenger health. Starting from these considerations, the aim of this research was twofold: i) to investigate the particulate matter concentrations in a ‘traditional’ railways metro system; ii) to investigate the particulate matter concentrations of a ‘high quality’ metro system equipped with design devices useful for reducing PM concentrations: platform screen doors, rubber-tyred and an advanced ventilation system. Two measurement surveys were performed: one in the ‘traditional’ metro system of Naples (Italy) and onother in the ‘high quality’ rubber-tyred metro system of Turin (Italy). Experimental results regarding the ‘traditional’ metro system of Naples, show that the average PM10 concentrations measured in the underground station platforms are very high and range between 172 and 262 µg/m3 whilst the average PM2,5 concentrations range between 45 and 60 µg/m3, with dangerous problems for passenger health. By contrast the measurements results regarding the ‘high quality’ metro system of Turin show that: i) the average PM10 (PM2.5) concentrations measured in the underground station platform is 22.7 µg/m3 (16.0 µg/m3) with a standard deviation of 9.6 µg/m3 (7.6 µg/m3); ii) the indoor concentrations (both for PM10 and for PM2.5) are statistically lower from those measured in outdoors (with a ratio equal to 0.9-0.8), meaning that the indoor air quality is greater than those in urban ambient; iii) that PM concentrations in underground stations are correlated to the trains passage; iv) the inside trains concentrations (both for PM10 and for PM2.5) are statistically lower from those measured at station platform (with a ratio equal to 0.7-0.8), meaning that inside trains the use of air conditioning system could promote a greater circulation that clean the air. The comparison among the two case studies allow to conclude that the metro system designed with PM reduction devices allow to reduce PM concentration up to 11 times against a ‘traditional’ one. From these results, it is possible to conclude that PM concentrations measured in a ‘high quality’ metro system are significantly lower than the ones measured in a ‘traditional’ railway metro systems. This result allows possessing the bases for the design of useful devices for retrofitting metro systems all around the world.

Keywords: air quality, pollutant emission, quality in public transport, underground railway, external cost reduction, transportation planning

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Authors: Rafik Balti, Mohamed Ben Mansour, Abdellah Arhaliass, Anthony Masse

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Unfortunately, shrimps are highly perishable and they start deteriorating immediately after death owing to their high water content and nutritional components. Currently, there has been an increasing interest in bioactive edible films and coatings to preserve the freshness and quality of foods. In this study, active edible coatings from microalgal exopolysaccharides (EPS) enriched with different concentrations of Red Seaweed Extract (RSE) (0.5, 1 and 1.5 % (w/v)) were developed and their effects on the quality changes of white shrimp during refrigerated storage (4 ± 1 °C) were examined over a period of 8 days. The control and the coated shrimp samples were analyzed periodically for microbiological (total viable bacteria, psychrotrophic bacteria, and enterobacteriaceae counts), chemical (pH, TVB-N, TMA-N, PV, TBARS), textural and sensory characteristics. The results indicated that the coating with a mixture of EPS and RSE could significantly decrease the total volatile basic nitrogen (TVB-N), trimethylamine (TMA) and thiobarbituric acid reactive substances (TBARS) (p < 0.05). With storage, EPS coatings containing RSE at both levels (1 and 1.5 %) were more effective in inhibiting the microbial species studied, specially psychrotrophic bacteria. Also, EPS + RSE coated samples had lower polyphenol oxidase (PPO) activity and lipid oxidation (p < 0.05) toward the end of storage. Textural and color properties of coated shrimp were generally more acceptable. Sensory scores indicated no significant changes in all samples during storage. The obtained results indicate that the edible EPS coating solutions enriched with RSE have noticeable effects on the quality and shelf life of shrimps when compared to control group. Finally, the present work demonstrates the effectiveness of EPS enriched coatings, offering a promising alternative to preserve more better the quality characteristics and to extend the shelf life of shrimp during the refrigerated storage

Keywords: active coating, exopolysaccharides, red seaweed, refrigerated storage, white shrimp

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Authors: Réka Sárközi, Péter Iványi, Attila B. Széll

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The aim of this paper is to present the adaptation of the dome construction tool for formex algebra to the parametric design software Grasshopper. Formex algebra is a mathematical system, primarily used for planning structural systems such like truss-grid domes and vaults, together with the programming language Formian. The goal of the research is to allow architects to plan truss-grid structures easily with parametric design tools based on the versatile formex algebra mathematical system. To produce regular structures, coordinate system transformations are used and the dome structures are defined in spherical coordinate system. Owing to the abilities of the parametric design software, it is possible to apply further modifications on the structures and gain special forms. The paper covers the basic dome types, and also additional dome-based structures using special coordinate-system solutions based on spherical coordinate systems. It also contains additional structural possibilities like making double layer grids in all geometry forms. The adaptation of formex algebra and the parametric workflow of Grasshopper together give the possibility of quick and easy design and optimization of special truss-grid domes.

Keywords: parametric design, structural morphology, space structures, spherical coordinate system

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Authors: S. A. Gayvoronsky, T. A. Ezangina

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The robust control system objects with interval-undermined parameters is considers in this paper. Initial information about the system is its characteristic polynomial with interval coefficients. On the basis of coefficient estimations of quality indices and criterion of the maximum stability degree, the methods of synthesis of a robust regulator parametric is developed. The example of the robust stabilization system synthesis of the rope tension is given in this article.

Keywords: interval polynomial, controller synthesis, analysis of quality factors, maximum degree of stability, robust degree of stability, robust oscillation, system accuracy

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Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

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Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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Authors: Chaca Nugraha Zaid, Hikmat Ronaldo, Emerald Falah Brayoga, Azizah Eddy Setiawati, Soviandini Dwiki Kartika Putri, Novita Wijayanti

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In the tofu stick production, the manual cutting process takes a half of working day or 4 hours for 21 kg of tofu. This issue has hampered the small and medium enterprises (SMEs) to increase the capacity of production to fulfill the market demand. In order to address the issue, the cutting process should be automized to create fast, efficient, and effective tools. This innovation to tackle this problem is an automatic cutter tool that is able to move continuously to cut the tofu into stick size. The tool uses the 78,5-watt electric motor and automatic sensors to drive the cutting tool automatically, resulting faster process time with more uniform size compared to the manual cutter. The component of this tool, i.e., cutting knife and the driver, electric motor, limit switch sensors, riley, Arduino nano, and power supply. The cutting speed cutting speed of this tool is 101,25 mm/s producing 64 tofu sticks. Benefits that can be obtained from the use of automatic tofu stick cutter, i.e. (1) Faster process (2) More uniform cutting result; (3) The quality of the tofu stick is maintained due to minimal contact with humans so that contamination can be suppressed; (4) The cutting knife can be modified to the desired size of the owner.

Keywords: automatic, cutter, small and medium enterprise, tofu stick

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Authors: A. T. Kassem

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Fires areconsidered a common hazardous action that any building may face. Most buildings’ structural elements are designed, taking into consideration precautions for fire safety, using deterministic design approaches. Public and highly important buildings are commonly designed considering standard fire rating and, in many cases, contain large compartments with central domes. Real fire scenarios are not commonly brought into action in structural design of buildings because of complexities in both scenarios and analysis tools. This paper presents a modern approach towards analysis of spherical domes in real fire condition via implementation of building information modelling, and adopting a probabilistic approach. BIMhas been implemented to bridge the gap between various software packages enabling them to function interactively to model both real fire and corresponding structural response. Ventilation controlled fires scenarios have been modeled using both “Revit” and “Pyrosim”. Monte Carlo simulation has been adopted to engage the probabilistic analysis approach in dealing with various parameters. Conclusions regarding failure probability and fire endurance, in addition to the effects of various parameters, have been extracted.

Keywords: concrete, spherical domes, ventilation controlled fires, BIM, monte carlo simulation, pyrosim, revit

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Authors: Wesam Rababa, Jamal Al-Qawasmi

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The global climate is negatively impacted by CO2 emissions, which are mostly produced by buildings. Several green building rating systems (GBRS) have been proposed to impose low-carbon criteria in order to address this problem. The Green Globes certification is one such system that evaluates a building's sustainability level by assessing different categories of environmental impact and emerging concepts aimed at reducing environmental harm. Therefore, assessment tools at the national level are crucial in the developing world, where specific local conditions require a more precise evaluation. This study analyzed eight sustainable building assessment systems from different regions of the world, comparing a comprehensive list of CO2-related indicators with a various assessment system for conducting coverage analysis. The results show that GBRS includes both direct and indirect indicators in this regard. It reveals deep variation between examined practices, and a lack of consensus not only on the type and the optimal number of indicators used in a system, but also on the depth and breadth of coverage of various sustainable building SB attributes. Generally, the results show that most of the examined systems reflect a low comprehensive coverage, the highest of which is found in materials category. On the other hand, the most of the examined systems reveal a very low representative coverage.

Keywords: Assessment tools, CO2-related indicators, Comparative study, Green Building Rating Systems

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Authors: Cassey Younghans

Abstract:

Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

Procedia PDF Downloads 155

Authors: Yosef Ferede Bogale

Abstract:

The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality service risk, banks

Procedia PDF Downloads 139

Authors: Rashmi Malik, Videep Mishra

Abstract:

The practice of generative design has become a transformative approach for an efficient way of generating multiple iterations for any design project. The conventional way of modeling the game elements is very time-consuming and requires skilled artists to design. A 3D modeling tool like 3D S Max, Blender, etc., is used traditionally to create the game library, which will take its stipulated time to model. The study is focused on using the generative design tool to increase the efficiency in game development at the stage of prop and environment generation. This will involve procedural level and customized regulated or randomized assets generation. The paper will present the system design approach using generative tools like Grasshopper (visual scripting) and other scripting tools to automate the process of game library modeling. The script will enable the generation of multiple products from the single script, thus creating a system that lets designers /artists customize props and environments. The main goal is to measure the efficacy of the automated system generated to create a wide variety of game elements, further reducing the need for manual content creation and integrating it into the workflow of AAA and Indie Games.

Keywords: iterative game design, generative design, gaming asset automation, generative game design

Procedia PDF Downloads 75

Authors: S. Apprich, F. Wulle, A. Lechler, A. Pott, A. Verl

Abstract:

Large-scale machine tools for the manufacturing of large work pieces, e.g. blades, casings or gears for wind turbines, feature pose-dependent dynamic behavior. Small structural damping coefficients lead to long decay times for structural vibrations that have negative impacts on the production process. Typically, these vibrations are handled by increasing the stiffness of the structure by adding mass. That is counterproductive to the needs of sustainable manufacturing as it leads to higher resource consumption both in material and in energy. Recent research activities have led to higher resource efficiency by radical mass reduction that rely on control-integrated active vibration avoidance and damping methods. These control methods depend on information describing the dynamic behavior of the controlled machine tools in order to tune the avoidance or reduction method parameters according to the current state of the machine. The paper presents the appearance, consequences and challenges of the pose-dependent dynamic behavior of lightweight large-scale machine tool structures in production. The paper starts with the theoretical introduction of the challenges of lightweight machine tool structures resulting from reduced stiffness. The statement of the pose-dependent dynamic behavior is corroborated by the results of the experimental modal analysis of a lightweight test structure. Afterwards, the consequences of the pose-dependent dynamic behavior of lightweight machine tool structures for the use of active control and vibration reduction methods are explained. Based on the state of the art on pose-dependent dynamic machine tool models and the modal investigation of an FE-model of the lightweight test structure, the criteria for a pose-dependent model for use in vibration reduction are derived. The description of the approach for a general pose-dependent model of the dynamic behavior of large lightweight machine tools that provides the necessary input to the aforementioned vibration avoidance and reduction methods to properly tackle machine vibrations is the outlook of the paper.

Keywords: dynamic behavior, lightweight, machine tool, pose-dependency

Procedia PDF Downloads 460

Authors: Željka Rogač, Dejan Stevanović, Sara Bečanović, Ljubica Božić, Aleksandar Dimitrijević, Dragana Bogićević, Dimitrije Nikolić

Abstract:

Children with epilepsy face changes in cognitive functioning, the appearance of symptoms of psychopathology and a decline in their quality of life. Factors related to epileptic seizures and the side effects of AEDs are considered to be potential causes of these changes.These changes can be prevented by prompt action, replacement of AEDs, psychological and psychiatric treatment, and social support. However, a review of literature has not yielded a conclusion as to when it is best to react, i.e., when changes in the functioning of children with newly-diagnosed epilepsy appears. The primary goal of this study was to investigate the impact of the most commonly used AEDs on cognitive status, behavior, anxiety and depression, as well as quality of life of children with newly-diagnosed epilepsy, during the first six months of treatment. This is a non-interventional, prospective study involving six-month monitoring of cognitive status, internalizing and externalizing symptoms, as well as quality of life of children with newly-diagnosed epilepsy, and the impact of antiepileptic drugs on these domains. Children with new-onset epilepsy and their parents, immediately after the introduction of antiepileptic drugs as well as six months later, filled out appropriate questionnaires (RCADS, NCBRF, CHEQOL-25, KIDSCREEN-10, AEP). At the same time, a psychologist performed the psychological testing of the child (REVISK). At the very beginning of REVISK treatment, a reduced VIQ was established, while after six months there was a significant decrease in IQ, VIQ and especially PIQ, under the influence of primary cognitive potentials and the development of depressive symptoms. All scores of the RCADS and NCBFR questionnaires were significantly elevated after six months while internalizing and externalizing symptoms affected each other. The development of depressive symptoms was significantly influenced by AED. The scores of the CHEQOL25 and KIDSCREEN10 questionnaires were significantly reduced, influenced by the adverse effects of AED and quality of life at the start of treatment. Side effects of AEDs, were significantly associated with depressive symptoms and reduced quality of life and did not significantly affect cognitive decline, anxiety, ADHD, and behavioral disorders during the first six months.

Keywords: epilepsy, children, AEDs, cognition, behavior, ADHD, anxiety, depression, QOL

Procedia PDF Downloads 105

Authors: Mas Rahmah

Abstract:

Indonesia is the most populous Southeast Asian nations, as Indonesia`s population is constantly growing, food security has become a crucial trending issue. Although Indonesia has more than enough natural resources and agricultural products to ensure food security for all, Indonesia is still facing the problem of food security because of adverse weather conditions, increasing population, political instability, economic factors (unemployment, rising food prices), and the dependent system of agriculture. This paper will analyze that Geographical Indication (GI) can aid in transforming Indonesian agricultural-dependent system by tapping the unique product attributes of their quality products since Indonesia has a lot of agricultural products with unique quality and special characteristic associated with geographical factors such as Toraja Coffee, Alor Vanili, Banda Nutmeg, Java Tea, Deli Tobacco, Cianjur Rise etc. This paper argues that the reputation and agricultural products and their intrinsic quality should be protected under GI because GI will provide benefit supporting the food security program. Therefore, this paper will expose the benefit of GI protection such as increasing productivity, improving the exports of GI products, creating employment, adding economic value to products, and increasing the diversity of supply of natural and unique quality products, etc. that can contribute to food security. The analysis will finally conclude that the scenario of promoting GI may indirectly contribute to food security through adding value by incorporating territory specific cultural, environmental and social qualities into production, processing and developing of unique local, niche and special agricultural products.

Keywords: geographical indication, food security, agricultural product, Indonesia

Procedia PDF Downloads 372

Authors: Nosheen Fatima Warraich

Abstract:

One of the most often used models in information system (IS) research is the technology acceptance model (TAM). This meta-analysis aims to measure the relationship between TAM variables, Perceived Ease of Use (PEOU), and Perceived Usefulness (PU) with users’ attitudes and behavioral intention (BI) in mobile and digital libraries context. It also examines the relationship of external variables (information quality and system quality) with TAM variables (PEOU and PU) in digital libraries settings. This meta-analysis was performed through PRISMA-P guidelines. Four databases (Google Scholar, Web of Science, Scopus, and LISTA) were utilized for searching, and the search was conducted according to defined criteria. The findings of this study revealed a large effect size of PU and PEOU with BI. There was also a large effect size of PU and PEOU with attitude. A medium effect size was found between SysQ -> PU, InfoQ-> PU, and SysQ -> PEOU. However, there was a small effect size between InfoQ and PEOU. It fills the literature gap and also confirms that TAM is a valid model for the acceptance and use of technology in mobile and digital libraries context. Thus, its findings would be helpful for developers and designers in designing and developing mobile library apps. It will also be beneficial for library authorities and system librarians in designing and developing digital libraries in academic settings.

Keywords: technology acceptance model (tam), perceived ease of use, perceived usefulness, information quality, system quality, meta-analysis, systematic review, digital libraries, and mobile library apps.

Procedia PDF Downloads 80

Authors: T. Miková

Abstract:

This paper analyzes the effect of a single uniform accounting rule on reporting quality by investigating the influence of IFRS on earnings management. This paper examines whether earnings management is reduced after IFRS adoption through the use of “loss avoidance thresholds”, a method that has been verified in earlier studies. This paper concentrates on two European countries: one that represents the continental code law tradition with weak protection of investors (France) and one that represents the Anglo-American common law tradition, which typically implies a strong enforcement system (the United Kingdom). The research investigates a sample of 526 companies (6822 firm-year observations) during the years 2000 – 2013. The results are different for the two jurisdictions. This study demonstrates that a single set of accounting standards contributes to better reporting quality and reduces the pervasiveness of earnings management in France. In contrast, there is no evidence that a reduction in earnings management followed the implementation of IFRS in the United Kingdom. Due to the fact that IFRS benefit France but not the United Kingdom, other political and economic factors, such legal system or capital market strength, must play a significant role in influencing the comparability and transparency cross-border companies’ financial statements. Overall, the result suggests that IFRS moderately contribute to the accounting quality of reported financial statements and bring benefit for stakeholders, though the role played by other economic factors cannot be discounted.

Keywords: accounting standards, earnings management, international financial reporting standards, loss avoidance, reporting quality

Procedia PDF Downloads 202

Authors: Yasaman Sanayei, Alireza Bahiraie

Abstract:

This paper presents a systematic methodology based on the application of artificial neural networks for sequencing batch reactor (SBR). The SBR is a fill-and-draw biological wastewater technology, which is specially suited for nutrient removal. Employing reactive dye by Sphingomonas paucimobilis bacteria at sequence batch reactor is a novel approach of dye removal. The influent COD, MLVSS, and reaction time were selected as the process inputs and the effluent COD and BOD as the process outputs. The best possible result for the discrete pole parameter was a= 0.44. In orderto adjust the parameters of ANN, the Levenberg-Marquardt (LM) algorithm was employed. The results predicted by the model were compared to the experimental data and showed a high correlation with R2> 0.99 and a low mean absolute error (MAE). The results from this study reveal that the developed model is accurate and efficacious in predicting COD and BOD parameters of the dye-containing wastewater treated by SBR. The proposed modeling approach can be applied to other industrial wastewater treatment systems to predict effluent characteristics. Note that SBR are normally operated with constant predefined duration of the stages, thus, resulting in low efficient operation. Data obtained from the on-line electronic sensors installed in the SBR and from the control quality laboratory analysis have been used to develop the optimal architecture of two different ANN. The results have shown that the developed models can be used as efficient and cost-effective predictive tools for the system analysed.

Keywords: artificial neural network, COD removal, SBR, Sphingomonas paucimobilis

Procedia PDF Downloads 417

Authors: Varda Gil, Ella Shoval, Tussia Mira

Abstract:

Teacher mentoring is a complex practical profession whose unique characteristic is the teacher-mentors' commitment to helping teachers link theory with teaching practice in the process of decision-making and in their reflections on teaching. The aim of this research is to examine the way practicing teacher-mentors participating in a teacher mentoring course made the connection between theory and practice. The researchers analyzed 20 final papers submitted by participants in a course to train teacher mentors. The participants were all veteran high-school teachers. The course comprised 112 in-class hours in addition to mentoring novices in the field. The course covered the following topics: The teacher-mentors' perception of their role; formative and summative evaluation of the novices; tutoring strategies and tools; types of learners; and ways of communicating and dealing with novice teachers' resistance to counseling. The course participants were required to write a 4-5 page reflective summary of their field mentoring practice. In addition, they were required to link theories explicitly learned in the course to their practice in the field. A qualitative analysis of the papers led to the creation of the taxonomy of the link between theory and practice relating to four topics: The kinds of links made between theory and practice, the quality of these links, the links made between private teaching theories and official teaching theory, and the qualities of these links. This taxonomy may prove to be a useful tool in the teacher-mentor training processes.

Keywords: taxonomy, teacher-mentors, theory, practice, teacher-mentor training

Procedia PDF Downloads 359

Authors: Mohamed Bin Alhaj, Hexu Liu, Mohammed Sulaiman, Osama Abudayyeh

Abstract:

An effective facility maintenance management (FMM) system plays a crucial role in improving the quality of services and maintaining the facility in good condition. Current FMM heavily relies on the quality of the data collection function of the FMM systems, at times resulting in inefficient FMM decision-making. The new technology-based crowdsourcing provides great potential to improve the current FMM practices, especially in terms of timeliness and quality of data. This research aims to investigate the feasibility of using new technology-driven crowdsourcing for FMM and highlight its opportunities and challenges. A survey was carried out to understand the human, data, system, geospatial, and automation characteristics of crowdsourcing for an educational campus FMM via social networks. The survey results were analyzed to reveal the challenges and recommendations for the implementation of crowdsourcing for FMM. This research contributes to the body of knowledge by synthesizing the challenges and opportunities of using crowdsourcing for facility maintenance and providing a road map for applying crowdsourcing technology in FMM. In future work, a conceptual framework will be proposed to support data-driven FMM using social networks.

Keywords: crowdsourcing, facility maintenance management, social networks

Procedia PDF Downloads 180

Authors: Yosef Ferede Bogale

Abstract:

The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality services risk, bank

Procedia PDF Downloads 71