Search results for: medical decision
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7113

Search results for: medical decision

4263 A Report on the Elearning Programme of the Irish College of General Practitioners Which Can Address Continuing Education Needs of Primary Care Physicians

Authors: Nicholas P. Fenlon, Aisling Lavelle, David Mclean, Margaret O'riordan

Abstract:

Background: The case for continuing professional development has been well made, and was formalized in Ireland in recent years through the enactment of the Medical Practitioner’s Act, which requires registered medical practitioners to complete a minimum of 50 hours CPD each year. The ICGP, who have been providing CPD opportunities to its members for many years, have responded to this need by developing a series of evidence-based, high-quality, multimedia modules across a range of clinical and non-clinical areas. (More traditional education opportunities are still being provided by the college also). Overview of Programme: The first module was released in September 2011, since when the eLearning program has grown steadily, and there are currently almost 20 modules available, with a further 5 in production. Each module contains three to six 10-minute video lessons, which use a combination of graphics, images, text, voice-over and clinical clips. These are supported by supplementary videos of expert pieces-to-camera, Q&As with content experts, clinical scenarios, external links and relevant documentation and other resources. Successful completion of MCQs will result in a Certificate of Completion, which can be printed or stored in Professional Competence portfolio. The Medical Practitioner’s Act requires doctors to gather CPD credits across 8 domains of practice, and various eLearning modules have been developed to address each. For instance, modules with a strong clinical content would include Management of Hypertension, Management of COPD, and Management of Asthma. Other modules focus on health promotion such as Promoting Smoking Cessation, Promoting Physical Activity, and Addressing Childhood Obesity. Modules where communication skills are keys include modules on Suicide Prevention and Management of Depression. Other modules, currently in development include non-clinical topics around risk management, including Confidentiality, Consent etc. Each module is developed by a core group, which includes where possible, a GP with a special interest in the area, and a content expert(s). The college works closely with a medical education consultant and a production company in developing and producing the modules. Modules can be accessed (with password) through the ICGP website and are available free to all ICGP members. Summary of Evaluation: There are over 1700 registered users to date (over 55% of College membership). The program was evaluated using an online survey in 2013 (N = 144/950 – 12%) and results were very positive overall but provided material for the further improvement of the program also. Future Plans: While knowledge can be imparted well through eLearning, skills and attitudes are more difficult to influence through an online environment. The college is now developing a series of linked workshops, which will lead to ICGP Professional Competence Awards. The first pilot workshop is scheduled for February 2015 and is Cardiology-themed. Participants will be required to complete the following 4 modules in advance of attending – Management of Hypertension, Management of Heart Failure, Promoting Smoking Cessation, and Promoting Physical Activity. The workshop will be case-based and interactive, addressing ECG Interpretation in General Practice. Conclusions: The ICGP have responded to members needs for high-quality evidence-based education delivered in a way that suits GPs.

Keywords: CPD opportunities, evidence-based, high quality, multimedia modules across a range of clinical and non-clinical areas, medical practitioner’s act

Procedia PDF Downloads 597
4262 Motivations, Perceptions, and Aspirations concerning Teaching as a Career for High School Students from Racially/Ethnically Diverse Backgrounds

Authors: Mi Ok Kang

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This study explores the factors that motivate urban high school students from racially/ethnically diverse backgrounds to choose teaching as a future career. It draws on in-depth interviews with high school students of color living in an urban downtown located in an intermountain area in the U.S. Using the factors influencing teaching choice (FIT-Choice) model, this study examines the motivations, mobility experiences, and aspirations of participating high school students who self-identified as Latino/a, Tongan, and Chinese. The study identifies influential factors -both challenges and strengthening effects- that high school students of color experience in their career decision making. The study concludes that self-perceptions of teaching abilities, parental support, social connections, job security, and prior work with children during the internship in K-12 classroom motivated them to be a teacher. Limitations such as financial struggles of parents, the low social status of teaching career, and the low salary and benefit packages in the U.S. are among the factors that cause students to waver in or doubt their career choice.

Keywords: career development, diversifying teaching force, FIT-Choice, high school students of color

Procedia PDF Downloads 278
4261 Polarity Classification of Social Media Comments in Turkish

Authors: Migena Ceyhan, Zeynep Orhan, Dimitrios Karras

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People in modern societies are continuously sharing their experiences, emotions, and thoughts in different areas of life. The information reaches almost everyone in real-time and can have an important impact in shaping people’s way of living. This phenomenon is very well recognized and advantageously used by the market representatives, trying to earn the most from this means. Given the abundance of information, people and organizations are looking for efficient tools that filter the countless data into important information, ready to analyze. This paper is a modest contribution in this field, describing the process of automatically classifying social media comments in the Turkish language into positive or negative. Once data is gathered and preprocessed, feature sets of selected single words or groups of words are build according to the characteristics of language used in the texts. These features are used later to train, and test a system according to different machine learning algorithms (Naïve Bayes, Sequential Minimal Optimization, J48, and Bayesian Linear Regression). The resultant high accuracies can be important feedback for decision-makers to improve the business strategies accordingly.

Keywords: feature selection, machine learning, natural language processing, sentiment analysis, social media reviews

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4260 Intelligent Wireless Patient Monitoring and Tracking System

Authors: Ch. Sandeep Kumar Subudhi, S. Sivanandam

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Our system is to monitor the human body temperature, blood pressure (BP), Pulse Rate and ECG and tracking the patient location. In our system the body temperature is detected by using LM35 temperature sensor, blood pressure is detected by the BP sensor, pulse rate is detected by the ear plug pulse sensor and the ECG is detected by the three lead ECG sensor in the working environment of the patient. The sensed information is sent to the PIC16F877 microcontroller through signal conditioning circuit. A desired amount of sensor value is set and if it is exceeded preliminary steps should be taken by indication by buzzer. The sensor information will be transmitted from the patient unit to the main controller unit with the help of Zigbee communication medium which is connected with the microcontrollers in the both units. The main controller unit will send those sensor data as well as the location of that patient by the help of GPS module to the observer/doctor. The observer/doctor can receive the SMS sent by GSM module and further decision can be taken. The message is sent to a cell phone using global system mobile (GSM) Modem. MAX232 acts as a driver between microcontroller and modem.

Keywords: LM35, heart beat sensor, ECG Sensor, BP Sensor, Zigbee module, GSM module, GPS module, PIC16F877A microcontroller

Procedia PDF Downloads 377
4259 The Role of Uncertainty in the Integration of Environmental Parameters in Energy System Modeling

Authors: Alexander de Tomás, Miquel Sierra, Stefan Pfenninger, Francesco Lombardi, Ines Campos, Cristina Madrid

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Environmental parameters are key in the definition of sustainable energy systems yet excluded from most energy system optimization models. Still, decision-making may be misleading without considering them. Environmental analyses of the energy transition are a key part of industrial ecology but often are performed without any input from the users of the information. This work assesses the systemic impacts of energy transition pathways in Portugal. Using the Calliope energy modeling framework, 250+ optimized energy system pathways are generated. A Delphi study helps to identify the relevant criteria for the stakeholders as regards the environmental assessment, which is performed with ENBIOS, a python package that integrates life cycle assessment (LCA) with a metabolic analysis based on complex relations. Furthermore, this study focuses on how the uncertainty propagates through the model’s consortium. With the aim of doing so, a soft link between the Calliope/ENBIOS cascade and Brightway’s data capabilities is built to perform Monte Carlo simulations. These findings highlight the relevance of including uncertainty analysis as a range of values rather than informing energy transition results with a single value.

Keywords: energy transition, energy modeling, uncertainty, sustainability

Procedia PDF Downloads 77
4258 Land Suitability Analysis for Maize Production in Egbeda Local Government Area of Oyo State Using GIS Techniques

Authors: Abegunde Linda, Adedeji Oluwatayo, Tope-Ajayi Opeyemi

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Maize constitutes a major agrarian production for use by the vast population but despite its economic importance, it has not been produced to meet the economic needs of the country. Achieving optimum yield in maize can meaningfully be supported by land suitability analysis in order to guarantee self-sufficiency for future production optimization. This study examines land suitability for maize production through the analysis of the physic-chemical variations in soil properties over space using a Geographic Information System (GIS) framework. Physic-chemical parameters of importance selected include slope, landuse, and physical and chemical properties of the soil. Landsat imagery was used to categorize the landuse, Shuttle Radar Topographic Mapping (SRTM) generated the slope and soil samples were analyzed for its physical and chemical components. Suitability was categorized into highly, moderately and marginally suitable based on Food and Agricultural Organisation (FAO) classification using the Analytical Hierarchy Process (AHP) technique of GIS. This result can be used by small scale farmers for efficient decision making in the allocation of land for maize production.

Keywords: AHP, GIS, MCE, suitability, Zea mays

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4257 Risk Factors for Postoperative Fever in Patients Undergoing Lumbar Fusion

Authors: Bang Haeyong

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Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

Procedia PDF Downloads 245
4256 Validation Pulmonary Embolus Severity Index Score Early Mortality Rate at 1, 3, 7 Days in Patients with a Diagnosis of Pulmonary Embolism

Authors: Nicholas Marinus Batt, Angus Radford, Khaled Saraya

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Pulmonary Embolus Severity Index (PESI) score is a well-validated decision-making score grading mortality rates (MR) in patients with a suspected or confirmed diagnosis of pulmonary embolism (PE) into 5 classes. Thirty and 90 days MR in class I and II are lower allowing the treatment of these patients as outpatients. In a London District General Hospital (DGH) with mixed ethnicity and high disease burden, we looked at MR at 1, 3, and 7 days of all PESI score classes. Our pilot study of 112 patients showed MR of 0% in class I, II, and III. The current study includes positive Computed Tomographic Scans (CT scans) for PE over the following three years (total of 555). MR was calculated for all PESI score classes at 1, 3 & 7 days. Thirty days MR was additionally calculated to validate the study. Our initial results so far are in line with our pilot studies. Further subgroup analysis accounting for the local co-morbidities and disease burden and its impact on the MR will be undertaken.

Keywords: Pulmonary Embolism (PE), Pulmonary Embolism Severity Index (PESI) score, mortality rate (MR), CT pulmonary artery

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4255 Worst-Case Load Shedding in Electric Power Networks

Authors: Fu Lin

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We consider the worst-case load-shedding problem in electric power networks where a number of transmission lines are to be taken out of service. The objective is to identify a prespecified number of line outages that lead to the maximum interruption of power generation and load at the transmission level, subject to the active power-flow model, the load and generation capacity of the buses, and the phase-angle limit across the transmission lines. For this nonlinear model with binary constraints, we show that all decision variables are separable except for the nonlinear power-flow equations. We develop an iterative decomposition algorithm, which converts the worst-case load shedding problem into a sequence of small subproblems. We show that the subproblems are either convex problems that can be solved efficiently or nonconvex problems that have closed-form solutions. Consequently, our approach is scalable for large networks. Furthermore, we prove the convergence of our algorithm to a critical point, and the objective value is guaranteed to decrease throughout the iterations. Numerical experiments with IEEE test cases demonstrate the effectiveness of the developed approach.

Keywords: load shedding, power system, proximal alternating linearization method, vulnerability analysis

Procedia PDF Downloads 137
4254 Analysis of Drought Flood Abrupt Alternation Events and there Impacts in Kenya

Authors: Betty Makena, Tsegaye Tadesse, Mark Svoboda

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Global warming has intensified the frequency and intensity of extreme climate disasters and led to unpredictable weather conditions. Consequently, rapid shifts between drought and floods, known as Drought-Flood Abrupt Alteration (DFAA), have become increasingly common. DFAA results in superimposed impacts of drought and floods within a short period, exacerbating the effects of the floods or drought event. Current disaster management plans often overlook DFAA events, as they primarily focus on either floods or drought. Therefore, effectively identifying DFAA events is crucial for developing effective mitigation strategies. This study aims to identify historical DFAA events in Kenya using the Long Cycle Drought-Flood Abrupt Alteration Index (LDFAI). The research will analyze the spatial distribution, temporal variation, and intensity of DFAA events from 1990 to 2023, as well as their socio-economic impacts. Understanding these events is important to develop more effective strategies to address the impacts of DFAA events. Findings from this study will inform decision making to develop coping strategies to mitigate the adverse effects of DFAA in Kenya.

Keywords: abrupt, alteration, drought, floods

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4253 Informal Governance as Response to Institutional Paralysis

Authors: Stefanie Kasparek

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The United Nations Security Council (UNSC) is probably the most recognized international security organization. It is also profoundly misunderstood and undervalued in its effort to promote peace and security. With the rising involvement of non-state actors and the way states fight wars, international governance has become increasingly complex. However, the formal UNSC agenda has long remained static, reflecting states' unwillingness to entertain more conflicts. Nevertheless, resolutions remain the scholarly measure of states' interests and policies, neglecting the significant share of issues the Council entertains informally. This project builds on a rational institutionalism framework. It provides a systematic analysis of how and under what conditions states use informal governance instead of, or in combination with, formal rules at the agenda-setting stage of the policy process. Data for this project comes from elite interviews and a newly created dataset on governance choices. The results show that counter existing arguments, weaker states successfully circumvent formal institutional roadblocks and use informal governance mechanisms to pursue vital interests, thereby countering institutional restrictions and power asymmetries present informal governance settings.

Keywords: agenda-setting, decision-making, international governance, UNSC

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4252 Human Immunodeficiency Virus Infection/AIDS Abandoned Children in Kenya

Authors: Ruth Muturi Wanjiku

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HIV/AIDS in Kenya for unborn and young kids. HIV/AIDS is a significant health concern in Kenya, with an estimated 1.5 million people living with the disease. Unfortunately, many of these individuals are unaware of their HIV status, and the disease continues to spread among the population or unborn kids. HIV/AIDS can be transmitted from an infected mother during pregnancy, childbirth, or breastfeeding. However, with early testing and treatment, the risk of mother-to-child transmission can be significantly reduced. Therefore, it is crucial for pregnant women to get tested and receive appropriate medical care. For young kids, HIV/AIDS education is critical to preventing the spread of the disease. It is essential to teach children about the importance of safe sex practices, avoiding risky behaviors such as sharing needles and getting tested regularly. Additionally, children should be taught about the stigma surrounding HIV/AIDS and encouraged to treat individuals living with the disease with compassion and respect. In conclusion, HIV/AIDS is a significant health concern in Kenya that affects individuals of all ages. For unborn kids, early testing and treatment are critical to reducing the risk of mother-to-child transmission. For young kids, education about HIV/AIDS and safe sex practices is essential to preventing the spread of the disease and reducing stigma. It is essential to promote awareness and encourage individuals to get tested and seek medical care if they believe they may be infected with HIV/AIDS.

Keywords: AIDS, HIV, children, pregnant

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4251 Evaluation of the Enablers of Industry 4.0 in the Ready-Made Garments Sector of Bangladesh: A Fuzzy Analytical Hierarchy Process Approach

Authors: Shihab-Uz-Zaman Shah, Sanjeeb Roy, Habiba Akter

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Keeping the high impact of the Ready-Made Garments (RMG) on the country’s economic growth in mind, this research paves a way for the implementation of Industry 4.0 in the garments industry of Bangladesh. At present, Industry 4.0 is a common buzzword representing the adoption of digital technologies in the production process to transform the existing industries into smart factories and create a great change in the global value chain. The RMG industry is the largest industrial sector of Bangladesh which provides 12.26% to its National GDP (Gross Domestic Product). The work starts with identifying possible enablers of Industry 4.0. To evaluate the enablers, a Multiple-Criteria Decision-Making (MCDM) procedure named Fuzzy Analytical Hierarchy Process (FAHP) was used. A questionnaire was developed as a part of a survey for collecting and analyzing expert opinions from relevant academicians and industrialists. The responses were eventually used as the input for the FAHP which helped to assign weight matrices to the enablers. This weight matrix indicated the level of importance of these enablers. The full paper will discuss the way of a successful evaluation of the enablers and implementation of Industry 4.0 by using these enablers.

Keywords: enablers, fuzzy AHP, industry 4.0, RMG sector

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4250 Evaluating the Radiation Dose Involved in Interventional Radiology Procedures

Authors: Kholood Baron

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Radiologic interventional studies use fluoroscopy imaging guidance to perform both diagnostic and therapeutic procedures. These could result in high radiation doses being delivered to the patients and also to the radiology team. This is due to the prolonged fluoroscopy time and the large number of images taken, even when dose-minimizing techniques and modern fluoroscopic tools are applied. Hence, these procedures are part of the everyday routine of interventional radiology doctors, assistant nurses, and radiographers. Thus, it is important to estimate the radiation exposure dose they received in order to give objective advice and reduce both patient and radiology team radiation exposure dose. The aim of this study was to find out the total radiation dose reaching the radiologist and the patient during an interventional procedure and to determine the impact of certain parameters on the patient dose. Method: The radiation dose was measured by TLD devices (thermoluminescent dosimeter; radiation dosimeter device). Physicians, patients, nurses, and radiographers wore TLDs during 12 interventional radiology procedures performed in two hospitals, Mubarak and Chest Hospital. This study highlights the need for interventional radiologists to be mindful of the radiation doses received by both patients and medical staff during interventional radiology procedures. The findings emphasize the impact of factors such as fluoroscopy duration and the number of images taken on the patient dose. By raising awareness and providing insights into optimizing techniques and protective measures, this research contributes to the overall goal of reducing radiation doses and ensuring the safety of patients and medical staff.

Keywords: dosimetry, radiation dose, interventional radiology procedures, patient radiation dose

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4249 A Robust Optimization Model for Multi-Objective Closed-Loop Supply Chain

Authors: Mohammad Y. Badiee, Saeed Golestani, Mir Saman Pishvaee

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In recent years consumers and governments have been pushing companies to design their activities in such a way as to reduce negative environmental impacts by producing renewable product or threat free disposal policy more and more. It is therefore important to focus more accurate to the optimization of various aspect of total supply chain. Modeling a supply chain can be a challenging process due to the fact that there are a large number of factors that need to be considered in the model. The use of multi-objective optimization can lead to overcome those problems since more information is used when designing the model. Uncertainty is inevitable in real world. Considering uncertainty on parameters in addition to use multi-objectives are ways to give more flexibility to the decision making process since the process can take into account much more constraints and requirements. In this paper we demonstrate a stochastic scenario based robust model to cope with uncertainty in a closed-loop multi-objective supply chain. By applying the proposed model in a real world case, the power of proposed model in handling data uncertainty is shown.

Keywords: supply chain management, closed-loop supply chain, multi-objective optimization, goal programming, uncertainty, robust optimization

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4248 Movement of the Viscous Elastic Fixed Vertically Located Cylinder in Liquid with the Free Surface Under the Influence of Waves

Authors: T. J. Hasanova, C. N. Imamalieva

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The problem about the movement of the rigid cylinder keeping the vertical position under the influence of running superficial waves in a liquid is considered. The indignation of a falling wave caused by the presence of the cylinder which moves is thus considered. Special decomposition on a falling harmonious wave is used. The problem dares an operational method. For a finding of the original decision, Considering that the image denominator represents a tabular function, Voltaire's integrated equation of the first sort which dares a numerical method is used. Cylinder movement in the continuous environment under the influence of waves is considered in work. Problems are solved by an operational method, thus originals of required functions are looked for by the numerical definition of poles of combinations of transcendental functions and calculation of not own integrals. Using specificity of a task below, Decisions are under construction the numerical solution of the integrated equation of Volter of the first sort that does not create computing problems of the complex roots of transcendental functions connected with search.

Keywords: rigid cylinder, linear interpolation, fluctuations, Voltaire's integrated equation, harmonious wave

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4247 A Digital Twin Approach for Sustainable Territories Planning: A Case Study on District Heating

Authors: Ahmed Amrani, Oussama Allali, Amira Ben Hamida, Felix Defrance, Stephanie Morland, Eva Pineau, Thomas Lacroix

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The energy planning process is a very complex task that involves several stakeholders and requires the consideration of several local and global factors and constraints. In order to optimize and simplify this process, we propose a tool-based iterative approach applied to district heating planning. We build our tool with the collaboration of a French territory using actual district data and implementing the European incentives. We set up an iterative process including data visualization and analysis, identification and extraction of information related to the area concerned by the operation, design of sustainable planning scenarios leveraging local renewable and recoverable energy sources, and finally, the evaluation of scenarios. The last step is performed by a dynamic digital twin replica of the city. Territory’s energy experts confirm that the tool provides them with valuable support towards sustainable energy planning.

Keywords: climate change, data management, decision support, digital twin, district heating, energy planning, renewables, smart city

Procedia PDF Downloads 168
4246 Innovative Small and Medium Sized Firms: Intangible Investment and Financial Constraints - a Literature Review.

Authors: Eliane Abdo

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Small and medium sized firms “SMEs” play essential role in the countries’ economic development mainly in terms of production, employment and equitable distribution of income. For innovative SMEs, the investment in the human capital and in research and development are crucial to survive in a competitive environment. In this paper we perform a literature review to underline the financing difficulties and constraints which innovative SMEs face while investing in intangible assets: not only when defining amount of the investments but also while choosing its financing methods. Literature review revealed that in order to finance their intangible assets, SMEs rely in first on their internal financing: the availability of internal cash flows can then determine their investment’s decision. Moreover SMEs face difficulties to finance their intangibles by financial debts due to the uncertainty of future cash flow and the absence of physical guarantees; they will therefore go for the issuance of new shares as a second choice, since innovative companies have high opportunity of growth that attract new shareholders.

Keywords: small and medium sized firms, capital structure, intangible investment, financial constraints

Procedia PDF Downloads 118
4245 The Implementation of a Nurse-Driven Palliative Care Trigger Tool

Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

Procedia PDF Downloads 190
4244 New Employee on-Boarding Program: Effective Tool for Reducing the Prevalence of Workplace Injuries/Accidents

Authors: U. Ugochukwu, J. Lee, P. Conley

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According to a recent survey by the UT Southwestern Workplace Safety Committee, the three most common on-the-job injuries reported by workers at the medical center are musculoskeletal injuries, slip-and-fall injuries and repetitive motion injuries. Last year alone, of the 650 documented workplace injuries and accidents, 45% were seen in employees in their first-two years of employment. UT Southwestern New Employee On-Boarding program was created and modeled to follows OSHA’s model that consist of: determining if training is needed, identifying training needs, identifying goals and objectives, developing learning activities, conducting the training, evaluating program effectiveness, and improving the program. The hospital’s management best practices were recreated to limit and control workplace injuries and accidents. Regular trainings and workshops on workplace safety and compliance were initiated for new employees. Various computer workstations were evaluated and recommendations were made to reduce musculoskeletal disorders. Post exposure protocols and workers protection programs were remodeled for infectious agents and chemicals used in the hospital, and medical surveillance programs were updated, for every emerging threat, to ensure they are in compliance with the US policy, regulatory and standard setting organizations. If ignorance of specific job hazards and of proper work practices is to blame for this higher injury rate, then training will help to provide a solution. Use of this program in training activities is just one of many ways UT Southwestern complied with the OSHA standards that relate to training while enhancing the safety and health of their employees.

Keywords: ergonomics, hazard, on-boarding, surveillance, workplace

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4243 Coastal Flood Mapping of Vulnerability Due to Sea Level Rise and Extreme Weather Events: A Case Study of St. Ives, UK

Authors: S. Vavias, T. R. Brewer, T. S. Farewell

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Coastal floods have been identified as an important natural hazard that can cause significant damage to the populated built-up areas, related infrastructure and also ecosystems and habitats. This study attempts to fill the gap associated with the development of preliminary assessments of coastal flood vulnerability for compliance with the EU Directive on the Assessment and Management of Flood Risks (2007/60/EC). In this context, a methodology has been created by taking into account three major parameters; the maximum wave run-up modelled from historical weather observations, the highest tide according to historic time series, and the sea level rise projections due to climate change. A high resolution digital terrain model (DTM) derived from LIDAR data has been used to integrate the estimated flood events in a GIS environment. The flood vulnerability map created shows potential risk areas and can play a crucial role in the coastal zone planning process. The proposed method has the potential to be a powerful tool for policy and decision makers for spatial planning and strategic management.

Keywords: coastal floods, vulnerability mapping, climate change, extreme weather events

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4242 Atmospheric Fluid Bed Gasification of Different Biomass Fuels

Authors: Martin Lisý, Marek Baláš, Michal Špiláček, Zdeněk Skála

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This paper shortly describes biomass types and growing amount in the Czech Republic. The considerable part of this paper deals with energy parameters of the most frequent utilizing biomass types and results of their gasification testing. There was chosen sixteen the most exploited "Czech" woody plants and grasses. There were determinated raw, element and biochemical analysis, basic calorimetric values, ash composition and ash characteristic temperatures. After that, each biofuel was tested by fluid bed gasification. The essential part of this paper yields results of chosen biomass types gasification experiments. Partly, there are described an operating conditions in detail with accentuation of individual fuels particularities partly, there is summarized gas composition and impurities content. The essential difference was determined mainly between woody plants and grasses both from point of view of the operating conditions and gas quality. The woody plants was evaluated as more suitable fuels for fluid bed gasifiers. This results will be able to significantly help with decision which energy plants are suitable for growing or with optimal biomass-treatment technology selection.

Keywords: biomass growing, biomass types, gasification, biomass fuels

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4241 The Impact of Internal Dynamics of Standing Committees on Legislative Productivity in the Korean National Assembly

Authors: Lee Da Hyun

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The purpose of this study is to explore the relation between the internal dynamics of standing committees and legislative productivity of the Korean National Assembly using statistical methods. Studies on legislation in South Korea have been largely revolved around political parties due to the uniqueness of its political context including strong party cohesion and party’s nomination right. However, as standing committees have been at the center of legislatures since the 6th National Assembly, there is a growing need for studying the operation and effectiveness of standing committees in legislation process. Thus, through panel data analysis for the sixteen standing committees across the four terms of the Korean National Assembly-from the 16th to the 19th-this article attempts to reveal that legislators’ bill passing rate is not a sole function of factors pertaining to political party as the existing studies have believed. By measuring the ideological distribution within a committee and the bill passing rate, this article provides differentiated interpretation from established theories of standing committees and presents compelling evidence describing complex interactions and independent operation of the standing committees with the subsequent legislative results.

Keywords: collective decision-making, lawmaking, legislation, political polarization, standing committees

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4240 Exploring Consumers' Intention to Adopt Mobile Payment System in Ghana

Authors: Y. Kong, I. Masud, M. H. Nyaso

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This paper seeks to examine consumers’ intention to adopt and use mobile payment method in Ghana. A conceptual framework was adopted from the extant literature using the Technology Acceptance Model (TAM) and the Theory of Reasoned Action (TRA) as the theoretical bases. Data for the study was obtained from a sample of 425 respondents through online and direct surveys using structured questionnaire. Structural Equation Modeling was used to analyse the data through SPSS v.22 and SmartPLS v.3. Findings with regards to the determinants of mobile payment system adoption indicate that subjective norm, perceived ease of use, attitude, and perceived usefulness play active roles in consumers’ decision to adopt mobile payment system in Ghana. Also, perceived usefulness and perceived ease of use have a significant and positive influence on consumers’ attitude towards mobile payment adoption in Ghana. Further, subjective norm was found to influence perceived usefulness and perceived ease of use of mobile payment adoption in Ghana. The study contributes to literature on mobile payment system from developing country context. The study proffered some recommendations.

Keywords: consumer behaviour, mobile payment, subjective norm, theory of planned behavior

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4239 Investigating Non-suicidal Self-Injury Discussions on Twitter

Authors: Muhammad Abubakar Alhassan, Diane Pennington

Abstract:

Social networking sites have become a space for people to discuss public health issues such as non-suicidal self-injury (NSSI). There are thousands of tweets containing self-harm and self-injury hashtags on Twitter. It is difficult to distinguish between different users who participate in self-injury discussions on Twitter and how their opinions change over time. Also, it is challenging to understand the topics surrounding NSSI discussions on Twitter. We retrieved tweets using #selfham and #selfinjury hashtags and investigated those from the United kingdom. We applied inductive coding and grouped tweeters into different categories. This study used the Latent Dirichlet Allocation (LDA) algorithm to infer the optimum number of topics that describes our corpus. Our findings revealed that many of those participating in NSSI discussions are non-professional users as opposed to medical experts and academics. Support organisations, medical teams, and academics were campaigning positively on rais-ing self-injury awareness and recovery. Using LDAvis visualisation technique, we selected the top 20 most relevant terms from each topic and interpreted the topics as; children and youth well-being, self-harm misjudgement, mental health awareness, school and mental health support and, suicide and mental-health issues. More than 50% of these topics were discussed in England compared to Scotland, Wales, Ireland and Northern Ireland. Our findings highlight the advantages of using the Twitter social network in tackling the problem of self-injury through awareness. There is a need to study the potential risks associated with the use of social networks among self-injurers.

Keywords: self-harm, non-suicidal self-injury, Twitter, social networks

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4238 Case Report: A Case of Confusion with Review of Sedative-Hypnotic Alprazolam Use

Authors: Agnes Simone

Abstract:

A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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4237 A Constructivist Approach and Tool for Autonomous Agent Bottom-up Sequential Learning

Authors: Jianyong Xue, Olivier L. Georgeon, Salima Hassas

Abstract:

During the initial phase of cognitive development, infants exhibit amazing abilities to generate novel behaviors in unfamiliar situations, and explore actively to learn the best while lacking extrinsic rewards from the environment. These abilities set them apart from even the most advanced autonomous robots. This work seeks to contribute to understand and replicate some of these abilities. We propose the Bottom-up hiErarchical sequential Learning algorithm with Constructivist pAradigm (BEL-CA) to design agents capable of learning autonomously and continuously through interactions. The algorithm implements no assumption about the semantics of input and output data. It does not rely upon a model of the world given a priori in the form of a set of states and transitions as well. Besides, we propose a toolkit to analyze the learning process at run time called GAIT (Generating and Analyzing Interaction Traces). We use GAIT to report and explain the detailed learning process and the structured behaviors that the agent has learned on each decision making. We report an experiment in which the agent learned to successfully interact with its environment and to avoid unfavorable interactions using regularities discovered through interaction.

Keywords: cognitive development, constructivist learning, hierarchical sequential learning, self-adaptation

Procedia PDF Downloads 176
4236 Development of a Digital Healthcare Intervention to Reduce Digital and Healthcare Inequality in Rural Communities with a Focus on Hypertensive Management

Authors: Festus Adedoyin, Nana Mbeah Otoo, Sofia Meacham

Abstract:

Hypertension is one of the main health issues in Ghana, where prevalence is higher in rural than in urban areas. This is due to the challenges rural areas have in accessing technology and healthcare services for hypertension control. This study's goal is to create a digital healthcare solution to alleviate this inequality. Through an analysis of current technology and problems, using the ring onion methodology, the study determined the needs for the intervention and evaluated healthcare disparities. An online application with teleconsultation capabilities, reminder mechanisms, and clinical decision support is part of the suggested solution. In outlying areas, mobile clinics in containers with the required equipment will be established. Heuristic evaluation and think-aloud sessions were used to assess the prototype's usability and navigational problems. This study highlights the need to develop digital health interventions to help manage hypertension in rural locations and decrease healthcare disparities. To develop and improve digital healthcare solutions for rural areas worldwide and in Ghana, this study might be used as a tool for future research.

Keywords: digital health, health inequalities, hypertension management, rural areas

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4235 Identification of Knee Dynamic Profiles in High Performance Athletes with the Use of Motion Tracking

Authors: G. Espriú-Pérez, F. A. Vargas-Oviedo, I. Zenteno-Aguirrezábal, M. D. Moya-Bencomo

Abstract:

One of the injuries with a higher incidence among university-level athletes in the North of Mexico is presented in the knee. This injury generates absenteeism in training and competitions for at least 8 weeks. There is no active quantitative methodology, or protocol, that directly contributes to the clinical evaluation performed by the medical personnel at the prevalence of knee injuries. The main objective is to contribute with a quantitative tool that allows further development of preventive and corrective measures to these injuries. The study analyzed 55 athletes for 6 weeks, belonging to the disciplines of basketball, volleyball, soccer and swimming. Using a motion capture system (Nexus®, Vicon®), a three-dimensional analysis was developed that allows the measurement of the range of movement of the joint. To focus on the performance of the lower limb, eleven different movements were chosen from the Functional Performance Test, Functional Movement Screen, and the Cincinnati Jump Test. The research identifies the profile of the natural movement of a healthy knee, with the use of medical guidance, and its differences between each sport. The data recovered by the single-leg crossover hop managed to differentiate the type of knee movement among athletes. A maximum difference of 60° of offset was found in the adduction movement between male and female athletes of the same discipline. The research also seeks to serve as a guideline for the implementation of protocols that help identify the recovery level of such injuries.

Keywords: Cincinnati jump test, functional movement screen, functional performance test, knee, motion capture system

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4234 A Multi-Objective Methodology for Selecting Lean Initiatives in Modular Construction Companies

Authors: Saba Shams Bidhendi, Steven Goh, Andrew Wandel

Abstract:

The implementation of lean manufacturing initiatives has produced significant impacts in improving operational performance and reducing manufacturing wastes in the production process. However, selecting an appropriate set of lean strategies is critical to avoid misapplication of the lean manufacturing techniques and consequential increase in non-value-adding activities. To the author’s best knowledge, there is currently no methodology to select lean strategies that considers their impacts on manufacturing wastes and performance metrics simultaneously. In this research, a multi-objective methodology is proposed that suggests an appropriate set of lean initiatives based on their impacts on performance metrics and manufacturing wastes and within manufacturers’ resource limitation. The proposed methodology in this research suggests the best set of lean initiatives for implementation that have highest impacts on identified critical performance metrics and manufacturing wastes. Therefore, manufacturers can assure that implementing suggested lean tools improves their production performance and reduces manufacturing wastes at the same time. A case study was conducted to show the effectiveness and validate the proposed model and methodologies.

Keywords: lean manufacturing, lean strategies, manufacturing wastes, manufacturing performance, optimisation, decision making

Procedia PDF Downloads 187