Search results for: Ariane Plaisance

Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault

Abstract:

Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.

Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design

Procedia PDF Downloads 355

Authors: Daphne Ashley Sze, Kenneth Santos, Ariane Gabrielle Lim

Abstract:

As women are now given more freedom and choice to pursue employment, the world’s over-all fertility has been decreasing mainly due to the shift in time allocation between working and child rearing. As such, we study the case of the Philippines, where there exists a decreasing fertility rate and increasing openness for women labor participation. We focused on the distinction between fertility and fecundity, the former being the manifestation of the latter and aim to trace and compare the effects of both fecundity and fertility to women’s employment status through the estimation of the reproduction function and multinomial logistic function. Findings suggest that the perception of women regarding employment opportunities in the Philippines links the negative relationship observed between fertility, fecundity and women’s employment status. Today, there has been a convergence in the traditional family roles of men and women, as both genders now have identical employment opportunities that continue to shape their preferences.

Keywords: multinomial logistic function, tobit, fertility, women employment status, fecundity

Procedia PDF Downloads 611

Authors: Ariane C. Lim, Daphne Ashley L. Sze, Kenneth S. Santos

Abstract:

As women are now given more freedom and choice to pursue employment, the world’s over-all fertility has been decreasing mainly due to the shift in time allocation between working and child-rearing. As such, we study the case of the Philippines, where there exists a decreasing fertility rate and increasing openness for women labor participation. We focused on the distinction between fertility and fecundity, the former being the manifestation of the latter and aim to trace and compare the effects of both fecundity and fertility to women’s employment status through the estimation of the reproduction function and multinomial logistic function. Findings suggest that the perception of women regarding employment opportunities in the Philippines links the negative relationship observed between fertility, fecundity and women’s employment status. Today, there has been a convergence in the traditional family roles of men and women, as both genders now have identical employment opportunities that continue to shape their preferences.

Keywords: multinomial logistic function, tobit, fertility, women employment status, fecundity

Procedia PDF Downloads 634

Authors: R. Haoui

Abstract:

The purpose of this work is to simulate the flow at the exit of Vulcan 1 engine of European launcher Ariane 5. The geometry of the propellant nozzle is already determined using the characteristics method. The pressure in the outlet section of the nozzle is less than atmospheric pressure on the ground, causing the existence of oblique and normal shock waves at the exit. During the rise of the launcher, the atmospheric pressure decreases and the shock wave disappears. The code allows the capture of shock wave at exit of nozzle. The numerical technique uses the Flux Vector Splitting method of Van Leer to ensure convergence and avoid the calculation instabilities. The Courant, Friedrichs and Lewy coefficient (CFL) and mesh size level are selected to ensure the numerical convergence. The nonlinear partial derivative equations system which governs this flow is solved by an explicit unsteady numerical scheme by the finite volume method. The accuracy of the solution depends on the size of the mesh and also the step of time used in the discretized equations. We have chosen in this study the mesh that gives us a stationary solution with good accuracy.

Keywords: finite volume, lunchers, nozzles, shock wave

Procedia PDF Downloads 289

Authors: Utsamani Cintyamena, Sandra Frans Olivia, Shita Lisyadewi, Ariane Utomo

Abstract:

Family planning is one of fundamental aspects in preventing maternal morbidity and mortality. However, the prevalence rate of Indonesia’s married women in choosing contraception is low. This study purpose to assess opportunities and challenges in family planning. Methodology: We conducted a qualitative study in Banyumas District which has huge reduction of maternal mortality rate from 2013 to 2015. Four focus group discussions and four small group discussions were conducted to assess knowledge and attitude of women in using contraceptive and their method of choice, as well as in-depth interview to four health workers and two family planning field officers as triangulation. Thematic content analysis was done manually. Results: Key themes emerge across interviews including (1) first choice of contraception is the one that they previously had, provided that they did not encountered problems with it, (2) rumor and fear of side effect affected their method of choice, (3) selection of contraceptive method was influenced by approval of husband, believes, and role model in community. Conclusion: Collaboration of health worker, family planning field officers, community, as well as support from stakeholder, must be increased to socializing family planning.

Keywords: attitude, challenge, chance, family planning, knowledge

Procedia PDF Downloads 149

Authors: Fofie Kokea Ariane Darolle, Gouet Daniel Hervé, Koumetio Fidèle, Yemele David

Abstract:

The electrical resistivity method is successfully used in this paper in order to have a clearer picture of the subsurface of the North-East ofFiguil in northern Cameroon. It is worth noting that this method is most often used when the objective of the study is to image the shallow subsoils by considering them as a set of stratified ground layers. The problem to be solved is very often environmental, and in this case, it is necessary to perform an inversion of the data in order to have a complete and accurate picture of the parameters of the said layers. In the case of this work, thirty-three (33) Schlumberger VES have been carried out on an irregular grid to investigate the subsurface of the study area. The 1D inversion applied as a preliminary modeling tool and in correlation with the mechanical drillings results indicates a complex subsurface lithology distribution mainly consisting of marbles and schists. Moreover, the quasi-3D inversion with lateral constraint shows that the misfit between the observed field data and the model response is quite good and acceptable with a value low than 10%. The method also reveals existence of two water bearing in the considered area. The first is the schist or weathering aquifer (unsuitable), and the other is the marble or the fracturing aquifer (suitable). The final quasi 3D inversion results and geological models indicate proper sites for groundwaters prospecting and for mining exploitation, thus allowing the economic development of the study area.

Keywords: electrical resistivity method, 1D inversion, quasi 3D inversion, groundwaters, mining

Procedia PDF Downloads 157