Search results for: Standard Paediatric Observation Chart

Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

Procedia PDF Downloads 221

Authors: L. A. Toro, N. Prieto, J. J. Vargas

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There are many control charts for monitoring mean and variance. Among these, the X y R, X y S, S2 Hotteling and Shewhart control charts, for mentioning some, are widely used for monitoring mean a variance in industrial processes. In particular, the Shewhart charts are based on the information about the process contained in the current observation only and ignore any information given by the entire sequence of points. Moreover, that the Shewhart chart is a control chart without memory. Consequently, Shewhart control charts are found to be less sensitive in detecting smaller shifts, particularly smaller than 1.5 times of the standard deviation. These kind of small shifts are important in many industrial applications. In this study and effective alternative to Shewhart control chart was implemented. In case of univariate process an Exponentially Moving Average (EWMA) control chart was developed and Multivariate Exponentially Moving Average (MEWMA) control chart in case of multivariate process. Both of these charts were based on memory and perform better that Shewhart chart while detecting smaller shifts. In these charts, information the past sample is cumulated up the current sample and then the decision about the process control is taken. The mentioned characteristic of EWMA and MEWMA charts, are of the paramount importance when it is necessary to control industrial process, because it is possible to correct or predict problems in the processes before they come to a dangerous limit.

Keywords: control charts, multivariate exponentially moving average (MEWMA), exponentially moving average (EWMA), industrial control process

Procedia PDF Downloads 324

Authors: Salehah Tahkin, Norlaila Mustafa, Dayang Anita Abdul Aziz

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Knowledge of medical ethics is important to all practitioners so the best care can be delivered to all patients through safe practice. Surgeons are not exceptions to this. Knowledge, attitude, and practice (KAP) of medical ethics among paediatric surgeons and trainees in Malaysia has not been evaluated before. This study aims to determine the level of KAP regarding medical ethics among these groups. This was a cross-sectional study involving three groups of samples, i.e., paediatric surgeons (PS), paediatric surgical trainees (PST), and medical officers with a special interest in paediatric surgery (MO). A validated KAP questionnaire was used. Standard formulas were used to calculate objective indexes for measuring KAP, which were then compared for statistical significance across different sample groups; p less than 0.05 is taken as significant. The index is rated into 5 classes using a score of 0 to 10, i.e., poor (1-2.99), fair (3-4.99), good (5-6.99), very good (7-8.99), and excellent (9-10). There were 117 samples, i.e., PS n=45 (38.5%), PST n=25 (21.3%), and MO n=47 (40.2%). For knowledge, all three groups display a good index score (mean score of 5.44). For attitude, PS and MO also display an index score of good (mean score of 5.81), while the PST index score was fair (4.82). For practice, our study shows a highest score of 7.14 (very good) among PST. However, these differences were not statistically significant (p> 0.05). Conclusion: Training in paediatric surgery must continue to emphasize professionalism and medical ethics education to deliver the best health care services.

Keywords: KAP, medical ethics, paediatric, surgeons, trainees

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Authors: Vildan Cırık, Emine Efe

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Complementary health approaches are growing in popularity worldwide and play a substantial role in health care. It is very important for paediatric nurses to have knowledge of practices affecting the medical conditions of patients and to communicate with them through integrative nursing care. The purpose of this study was to determine paediatric nurses’ knowledge and experiences of complementary health approaches (CHA) and their personal and professional attitudes to the use of complementary health approaches. This multicentre study was conducted with 1450 paediatric nurses in 18 hospitals in Turkey. Paediatric nurses included in the study were working in the following clinics: Paediatric Service, Paediatric Intensive Care, Paediatric Haematology/Oncology. Data collection focused on the paediatric nurses’ knowledge and experiences of CHA. A high proportion of our sample of paediatric nurses reported that they had used some form of CHA themselves; the most popular choices of CHA were prayer, massage, and vitamins techniques. Paediatric nurses reported positive experiences (drawing/music/art/dance therapies, prayer, herbs, thermal springs, massage, and reflexology) and negative experiences (herbs, thermal springs, prayer, and massage). This study may contribute to increased awareness of the potentially important role of paediatric nurses in the delivery of CHA. Paediatric nurses play important roles in helping patients to use complementary health approaches safely and accurately. Trainings on CHA should be organised, data collection forms including CHA should be created, and evidence-based studies should be focused towards improving the clinical practice of paediatric nurses.

Keywords: complementary health approaches, paediatric nurses, knowledge, experience, attitude, Turkey

Procedia PDF Downloads 168

Authors: Jasper Kevin C. Dionisio, Denise Mae M. Unsay

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In a manufacturing firm, controlling the process ensures that optimum efficiency, productivity, and quality in an organization are achieved. An operation with no standardized procedure yields a poor productivity, inefficiency, and an out of control process. This study focuses on controlling the small intestine processing of a chicken dressing plant through the use of Statistical Process Control (SPC). Since the operation does not employ a standard procedure and does not have an established standard time, the process through the assessment of the observed time of the overall operation of small intestine processing, through the use of X-Bar R Control Chart, is found to be out of control. In the solution of this problem, the researchers conduct a motion and time study aiming to establish a standard procedure for the operation. The normal operator was picked through the use of Westinghouse Rating System. Instead of utilizing the traditional motion and time study, the researchers used the X-Bar R Control Chart in determining the process average of the process that is used for establishing the standard time. The observed time of the normal operator was noted and plotted to the X-Bar R Control Chart. Out of control points that are due to assignable cause were removed and the process average, or the average time the normal operator conducted the process, which was already in control and free form any outliers, was obtained. The process average was then used in determining the standard time of small intestine processing. As a recommendation, the researchers suggest the implementation of the standard time established which is with consonance to the standard procedure which was adopted from the normal operator. With that recommendation, the whole operation will induce a 45.54 % increase in their productivity.

Keywords: motion and time study, process controlling, statistical process control, X-Bar R Control chart

Procedia PDF Downloads 178

Authors: Mai Ali

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The abstract underscores the critical importance of junior paediatricians acquiring expertise in handling paediatric emergencies, with a particular focus on Diabetic Ketoacidosis (DKA). Existing literature reveals a wealth of research on healthcare professionals' knowledge regarding DKA, encompassing diverse cultural backgrounds and medical specialties. Consistently, challenges such as the absence of standardized protocols and inadequacies in training emerge as common issues across healthcare centres. This research proposal seeks to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom in managing DKA within various clinical contexts. The primary objective is to assess their level of competence and propose effective strategies to enhance DKA training comprehensively.

Keywords: DKA, knowledge, Junior paediatricians, local protocols

Procedia PDF Downloads 43

Authors: Michael B. C. Khoo, J. L. Khoo, W. C. Yeong, W. L. Teoh

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The Shewhart Xbar control chart is a useful process monitoring tool in manufacturing industries to detect the presence of assignable causes. However, it is insensitive in detecting small process shifts. To circumvent this problem, adaptive control charts are suggested. An adaptive chart enables at least one of the chart’s parameters to be adjusted to increase the chart’s sensitivity. Two common adaptive charts that exist in the literature are the double sampling (DS) Xbar and variable sampling interval (VSI) Xbar charts. This paper compares the performances of the DS and VSI Xbar charts, based on the average time to signal (ATS) criterion. The ATS profiles of the DS Xbar and VSI Xbar charts are obtained using the Mathematica and Statistical Analysis System (SAS) programs, respectively. The results show that the VSI Xbar chart is generally superior to the DS Xbar chart.

Keywords: adaptive charts, average time to signal, double sampling, charts, variable sampling interval

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Authors: Derya Karagöz

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A Shewhart chart based on normality assumption is not appropriate for skewed distributions since its Type-I error rate is inflated. This study presents X̄ and S control charts for monitoring the process variability for skewed distributions. We propose Weighted Standard Deviation (WSD) X̄ and S control charts. Standard deviation estimator is applied to monitor the process variability for estimating the process standard deviation, in the case of the W SD X̄ and S control charts as this estimator is simple and easy to compute. Unlike the Shewhart control chart, the proposed charts provide asymmetric limits in accordance with the direction and degree of skewness to construct the upper and lower limits. The performances of the proposed charts are compared with other heuristic charts for skewed distributions by using Simulation study. The Simulation studies show that the proposed control charts have good properties for skewed distributions and large sample sizes.

Keywords: weighted standard deviation, MAD, skewed distributions, S control charts

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Authors: Saowanit Sukparungsee

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Generally, the traditional Shewhart p chart has been developed by for charting the binomial data. This chart has been developed using the normal approximation with condition as low defect level and the small to moderate sample size. In real applications, however, are away from these assumptions due to skewness in the exact distribution. In this paper, a modified Exponentially Weighted Moving Average (EWMA) control chat for detecting a change in binomial data by improving square root transformations, namely ISRT p EWMA control chart. The numerical results show that ISRT p EWMA chart is superior to ISRT p chart for small to moderate shifts, otherwise, the latter is better for large shifts.

Keywords: number of defects, exponentially weighted moving average, average run length, square root transformations

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Authors: Umar Farouk Abbas, Danjuma Mustapha, Hamisu Idi

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It is now a known fact that quality is an important issue in manufacturing industries. A control chart is an integrated and powerful tool in statistical process control (SPC). The mean µ and standard deviation σ parameters are estimated. In general, the multivariate exponentially weighted moving average (MEWMA) and multivariate cumulative sum (MCUSUM) are used in the detection of small shifts in joint monitoring of several correlated variables; the charts used information from past data which makes them sensitive to small shifts. The aim of the paper is to compare the performance of Shewhart xbar, MEWMA, and MCUSUM control charts in terms of their false rates when parameters are estimated with autocorrelation. A simulation was conducted in R software to generate the average run length (ARL) values of each of the charts. After the analysis, the results show that a comparison of the false alarm rates of the charts shows that MEWMA chart has lower false alarm rates than the MCUSUM chart at various levels of parameter estimated to the number of ARL0 (in control) values. Also noticed was that the sample size has an advert effect on the false alarm of the control charts.

Keywords: average run length, MCUSUM chart, MEWMA chart, false alarm rate, parameter estimation, simulation

Procedia PDF Downloads 175

Authors: O. Ikpotokin

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In any production process, every product is aimed to attain a certain standard, but the presence of assignable cause of variability affects our process, thereby leading to low quality of product. The ability to identify and remove this type of variability reduces its overall effect, thereby improving the quality of the product. In case of a univariate control chart signal, it is easy to detect the problem and give a solution since it is related to a single quality characteristic. However, the problems involved in the use of multivariate control chart are the violation of multivariate normal assumption and the difficulty in identifying the quality characteristic(s) that resulted in the out of control signals. The purpose of this paper is to examine the use of non-parametric control chart (the bootstrap approach) for obtaining control limit to overcome the problem of multivariate distributional assumption and the p-value method for detecting out of control signals. Results from a performance study show that the proposed bootstrap method enables the setting of control limit that can enhance the detection of out of control signals when compared, while the p-value method also enhanced in identifying out of control variables.

Keywords: bootstrap control limit, p-value method, out-of-control signals, p-value, quality characteristics

Procedia PDF Downloads 317

Authors: Ali Akbar Heydari

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Control charts are an important tool of statistical quality control. Thesecharts are used to detect and eliminate unwanted special causes of variation that occurred during aperiod of time. The design and operation of control charts require the determination of three design parameters: the sample size (n), the sampling interval (h), and the width coefficient of control limits (k). Thevariable parameters (VP) x-bar controlchart is the x-barchart in which all the design parameters vary between twovalues. These values are a function of the most recent process information. In fact, in the VP x-bar chart, the position of each sample point on the chart establishes the size of the next sample and the timeof its sampling. The synthetic x-barcontrol chartwhich integrates the x-bar chart and the conforming run length (CRL) chart, provides significant improvement in terms of detection power over the basic x-bar chart for all levels of mean shifts. In this paper, we introduce the syntheticVP x-bar control chart for monitoring changes in the process mean. To determine the design parameters, we used a statistical design based on the minimum out of control average run length (ARL) criteria. The optimal chart parameters of the proposed chart are obtained using the Markov chain approach. A numerical example is also done to show the performance of the proposed chart and comparing it with the other control charts. The results show that our proposed syntheticVP x-bar controlchart perform better than the synthetic x-bar controlchart for all shift parameter values. Also, the syntheticVP x-bar controlchart perform better than the VP x-bar control chart for the moderate or large shift parameter values.

Keywords: control chart, markov chain approach, statistical design, synthetic, variable parameter

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Authors: Zayed Alsulami, Asma Aldosseri, Ahmed Ezziden, Abdulrahman Alonazi

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Children are more susceptible to medication errors than adults. Medication administration process is the last stage in the medication treatment process and most of the errors detected in this stage. Little research has been undertaken about medication errors in children in the Middle East countries. This study was aimed to evaluate how the paediatric nurses adhere to the medication administration policy and also to identify any medication preparation and administration errors or any risk factors. An observational, prospective study of medication administration process from when the nurses preparing patient medication until administration stage (May to August 2014) was conducted in Saudi Arabia. Twelve paediatric nurses serving 90 paediatric patients were observed. 456 drug administered doses were evaluated. Adherence rate was variable in 7 steps out of 16 steps. Patient allergy information, dose calculation, drug expiry date were the steps in medication administration with lowest adherence rates. 63 medication preparation and administration errors were identified with error rate 13.8% of medication administrations. No potentially life-threating errors were witnessed. Few logistic and administrative factors were reported. The results showed that the medication administration policy and procedure need an urgent revision to be more sensible for nurses in practice. Nurses’ knowledge and skills regarding the medication administration process should be improved.

Keywords: medication sasfety, paediatric, medication errors, paediatric ward

Procedia PDF Downloads 359

Authors: Yupaporn Areepong

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The main goal of this paper is to study Statistical Process Control (SPC) with Exponentially Weighted Moving Average (EWMA) control chart when observations are serially-correlated. The characteristic of control chart is Average Run Length (ARL) which is the average number of samples taken before an action signal is given. Ideally, an acceptable ARL of in-control process should be enough large, so-called (ARL0). Otherwise it should be small when the process is out-of-control, so-called Average of Delay Time (ARL1) or a mean of true alarm. We find explicit formulas of ARL for EWMA control chart for Seasonal Autoregressive and Moving Average processes (SARMA) with Exponential white noise. The results of ARL obtained from explicit formula and Integral equation are in good agreement. In particular, this formulas for evaluating (ARL0) and (ARL1) be able to get a set of optimal parameters which depend on smoothing parameter (λ) and width of control limit (H) for designing EWMA chart with minimum of (ARL1).

Keywords: average run length, optimal parameters, exponentially weighted moving average (EWMA), control chart

Procedia PDF Downloads 527

Authors: Devatha Kalyan Kumar, R. Poovarasan

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In this paper, we have taken certain important factors and health parameters of diabetes patients especially among children by birth (pediatric congenital) where using the above three metrics methods we are going to assess the importance of each attributes in the dataset and thereby determining the most highly responsible and co-related attribute causing diabetics among young patients. We use cost optimization, control chart and Spearmen methodologies for the real-time application of finding the data efficiency in this diabetes dataset. The Spearmen methodology is the correlation methodologies used in software development process to identify the complexity between the various modules of the software. Identifying the complexity is important because if the complexity is higher, then there is a higher chance of occurrence of the risk in the software. With the use of control; chart mean, variance and standard deviation of data are calculated. With the use of Cost optimization model, we find to optimize the variables. Hence we choose the Spearmen, control chart and cost optimization methods to assess the data efficiency in diabetes datasets.

Keywords: correlation, congenital diabetics, linear relationship, monotonic function, ranking samples, pediatric

Procedia PDF Downloads 228

Authors: Shourav Ahmed, M. Gulam Kibria, Kais Zaman

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Control charts graphically verify variation in quality parameters. Attribute type control charts deal with quality parameters that can only hold two states, e.g., good or bad, yes or no, etc. At present, p-control chart is most commonly used to deal with attribute type data. In construction of p-control chart using binomial distribution, the value of proportion non-conforming must be known or estimated from limited sample information. As the probability distribution of fraction non-conforming (p) is considered in hyperbinomial distribution unlike a constant value in case of binomial distribution, it reduces the risk of false detection. In this study, a statistical control chart is proposed based on hyperbinomial distribution when prior estimate of proportion non-conforming is unavailable and is estimated from limited sample information. We developed the control limits of the proposed modified p-chart using the mean and variance of hyperbinomial distribution. The proposed modified p-chart can also utilize additional sample information when they are available. The study also validates the use of modified p-chart by comparing with the result obtained using cumulative distribution function of hyperbinomial distribution. The study clearly indicates that the use of hyperbinomial distribution in construction of p-control chart yields much accurate estimate of quality parameters than using binomial distribution.

Keywords: binomial distribution, control charts, cumulative distribution function, hyper binomial distribution

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Authors: Victoria Siriaki Jorry, I. S. Mbalawata, Hayong Shin

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The main objective in a change detection problem is to develop algorithms for efficient detection of gradual and/or abrupt changes in the parameter distribution of a process or time series data. In this paper, we present a modified cumulative (MCUSUM) algorithm to detect the start and end of a time-varying linear drift in mean value of a time series data based on likelihood ratio test procedure. The design, implementation and performance of the proposed algorithm for a linear drift detection is evaluated and compared to the existing CUSUM algorithm using different performance measures. An approach to accurately approximate the threshold of the MCUSUM is also provided. Performance of the MCUSUM for gradual change-point detection is compared to that of standard cumulative sum (CUSUM) control chart designed for abrupt shift detection using Monte Carlo Simulations. In terms of the expected time for detection, the MCUSUM procedure is found to have a better performance than a standard CUSUM chart for detection of the gradual change in mean. The algorithm is then applied and tested to a randomly generated time series data with a gradual linear trend in mean to demonstrate its usefulness.

Keywords: average run length, CUSUM control chart, gradual change detection, likelihood ratio test

Procedia PDF Downloads 261

Authors: Maya Agarwala

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Objectives: Audit the quality of clinical photographs taken for Orthodontic patients at Queen’s hospital, Romford. Design and setting: All Orthodontic photographs are taken in the Medical Photography Department at Queen’s Hospital. Retrospective audit with data collected between January - March 2023. Gold standard: Institute of Medical Illustrators (IMI) standard 12 photographs: 6 extraoral and 6 intraoral. 100% of patients to have the standard 12 photographs meeting a satisfactory diagnostic quality. Materials and methods: 30 patients randomly selected. All photographs analysed against the IMI gold standard. Results: A total of 360 photographs were analysed. 100% of the photographs had the 12 photographic views. Of which, 93.1% met the gold standard. Of the extraoral photos: 99.4% met the gold standard, 0.6% had incorrect head positioning. Of the intraoral photographs: 87.2% met the gold standard. The most common intraoral errors were: the presence of saliva pooling (7.2%), insufficient soft tissue retraction (3.3%), incomplete occlusal surface visibility (2.2%) and mirror fogging (1.1%). Conclusion: The gold standard was not met, however the overall standard of Orthodontic photographs is high. Further training of the Medical Photography team is needed to improve the quality of photographs. Following the training, the audit will be repeated. High-quality clinical photographs are an important part of clinical record keeping.

Keywords: orthodontics, paediatric, photography, audit

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Authors: Khaled R. Khater

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The weight of the SPT hammer is standard (0.623kN). The locally manufacturer drilling rigs use hammers, sometimes deviating off the standard weight. This affects the field measured blow counts (Nf) consequentially, affecting most of correlations previously obtained, as they were obtained based on standard hammer weight. The literature presents energy corrections factor (η2) to be applied to the SPT total input energy. This research investigates the effect of the hammer weight variation, as a single parameter, on the field measured blow counts (Nf). The outcome is a correction factor (ηk), equation, and correction chart. They are recommended to adjust back the measured misleading (Nf) to the standard one as if the standard hammer is used. This correction is very important to be done in such cases where a non-standard hammer is being used because the bore logs in any geotechnical report should contain true and representative values (Nf), let alone the long records of correlations, already in hand. The study here-in is achieved by using laboratory physical model to simulate the SPT dripping hammer mechanism. It is designed to allow different hammer weights to be used. Also, it is manufactured to avoid and eliminate the energy loss sources. This produces a transmitted efficiency up to 100%.

Keywords: correction factors, hammer weight, physical model, standard penetration test

Procedia PDF Downloads 347

Authors: Khaliun Nyambayar, Nomindari Azzaya, Batkhuyag Purevjav

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Pharmacovigilance was officially introduced in Mongolia in 2003, in accordance with the Health Minister Order 183 for the registry of adverse drug reactions (ADR), approved in 2006 and was reviewed in 2010. This study was designed to evaluate the incidence and common types of adverse drug reactions among hospitalized children, the frequency of adverse drug reaction reported by health care providers, and the follow-up processes resulting from adverse drug reactions. A retrospective study of paediatric patients who experienced an adverse drug reaction from 2015 to 2019, extracted from the “yellow” card at the State Research Center for Maternal and Child Health, (city). A total of 417 adverse drug reactions were reported with an overall incidence was 80 (21.5%). Adverse reactions resulting from the use of antibiotics (particularly gentamycin, cephalosporins, and vancomycin) were usually mild. ADR’s were reported by physicians and nurses (93.8%), pharmacists (6.25%). Although documentation of physician notification occurred for 93% of adverse drug reactions, only 29% of cases were documented in the patient's medical chart, 13% included follow-up education for individuals involved, and 10% were updated in the allergy profile of the hospital computer system. Measures to improve the detection and reporting of adverse drug reactions by all health care professionals should be improved, to enhance our understanding of the nature and impact of these reactions in children.

Keywords: adverse drug reaction, pediatric, yellow card, Mongolia

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Authors: V. Makis, L. Jafari

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In this paper, we develop an optimal Bayesian chart to control the expected number of defects per inspection unit in production processes with long production runs. We formulate this control problem in the optimal stopping framework. The objective is to determine the optimal stopping rule minimizing the long-run expected average cost per unit time considering partial information obtained from the process sampling at regular epochs. We prove the optimality of the control limit policy, i.e., the process is stopped and the search for assignable causes is initiated when the posterior probability that the process is out of control exceeds a control limit. An algorithm in the semi-Markov decision process framework is developed to calculate the optimal control limit and the corresponding average cost. Numerical examples are presented to illustrate the developed optimal control chart and to compare it with the traditional u-chart.

Keywords: Bayesian u-chart, economic design, optimal stopping, semi-Markov decision process, statistical process control

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Authors: Hoda Abugharsa

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In this paper we propose to design a sorter circuit using insertion sorting algorithm. The circuit will be designed using Algorithmic State Machines (ASM) method. That means converting the insertion sorting flowchart into an ASM chart. Then the ASM chart will be used to design the sorter circuit and the control unit.

Keywords: insert sorting algorithm, ASM chart, sorter circuit, state machine, control unit

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Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: average run length (ARL), bernoulli cusum (BC) chart, beta binomial posterior predictive (BBPP) distribution, clinical indicator (CI), healthcare organization (HCO), highest posterior density (HPD) interval

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Authors: Young Jae Choung, Seoung Bum Kim

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Statistical Process Control (SPC) is a popular technique for process monitoring. A widely used tool in SPC is a control chart, which is used to detect the abnormal status of a process and maintain the controlled status of the process. Traditional control charts, such as Hotelling’s T2 control chart, are effective techniques to detect abnormal observations and monitor processes. However, many complicated manufacturing systems exhibit nonlinearity because of the different demands of the market. In this case, the unregulated use of a traditional linear modeling approach may not be effective. In reality, many industrial processes contain the nonlinear and time-varying properties because of the fluctuation of process raw materials, slowing shift of the set points, aging of the main process components, seasoning effects, and catalyst deactivation. The use of traditional SPC techniques with time-varying data will degrade the performance of the monitoring scheme. To address these issues, in the present study, we propose a parameterless self-organizing map (PLSOM)-based control chart. The PLSOM-based control chart not only can manage a situation where the distribution or parameter of the target observations changes, but also address the nonlinearity of modern manufacturing systems. The control limits of the proposed PLSOM chart are established by estimating the empirical level of significance on the percentile using a bootstrap method. Experimental results with simulated data and actual process data from a thin-film transistor-liquid crystal display process demonstrated the effectiveness and usefulness of the proposed chart.

Keywords: control chart, parameter-less self-organizing map, self-organizing map, time-varying property

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Authors: Viliam Makis, Farnoosh Naderkhani, Leila Jafari

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In this paper, we present a model and an algorithm for the calculation of the optimal control limit, average cost, sample size, and the sampling interval for an optimal Bayesian chart to control the proportion of defective items produced using a semi-Markov decision process approach. Traditional p-chart has been widely used for controlling the proportion of defectives in various kinds of production processes for many years. It is well known that traditional non-Bayesian charts are not optimal, but very few optimal Bayesian control charts have been developed in the literature, mostly considering finite horizon. The objective of this paper is to develop a fast computational algorithm to obtain the optimal parameters of a Bayesian p-chart. The decision problem is formulated in the partially observable framework and the developed algorithm is illustrated by a numerical example.

Keywords: Bayesian control chart, semi-Markov decision process, quality control, partially observable process

Procedia PDF Downloads 289

Authors: Encarnación Álvarez-Verdejo, Raúl Amor-Pulido, Pablo J. Moya-Fernández, Juan F. Muñoz-Rosas, Francisco J. Blanco-Encomienda

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Many companies use the statistical tool named as statistical quality control, and which can have a high cost for the companies interested on these statistical tools. The evaluation of the quality of products and services is an important topic, but the reduction of the cost of the implantation of the statistical quality control also has important benefits for the companies. For this reason, it is important to implement a economic design for the various steps included into the statistical quality control. In this paper, we describe some relevant aspects related to the economic design of a quality control chart for the proportion of defective items. They are very important because the suggested issues can reduce the cost of implementing a quality control chart for the proportion of defective items. Note that the main purpose of this chart is to evaluate and control the proportion of defective items of a production process.

Keywords: proportion, type I error, economic plan, distribution function

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Authors: Alexandra Shipley

Abstract:

Background: Undergraduate paediatric teaching must overcome two major challenges: 1) balancing patient safety with active student engagement and 2) exposing students to a comprehensive range of pathologies within a relatively short clinical placement. Whilst lectures and shadowing on paediatric wards constitute the mainstay of learning, Simulation and Virtual Reality (VR) are emerging as effective teaching tools, which - immune to the unpredictability and seasonal variation of hospital presentations - could expose students to the entire syllabus more reliably, efficiently, and independently. We aim to evaluate the potential utility of Simulation and VR in addressing gaps within the traditional paediatric curriculum from the perspective of medical students. Summary of Work: Exposure to and perceived utility of various learning opportunities within the Paediatric and Emergency Medicine courses were assessed through a questionnaire completed by 5th year medical students (n=23). Summary of Results: Students reported limited exposure to several common acute paediatric presentations, such as bronchiolitis (41%), croup (32%) or pneumonia (14%), and to clinical emergencies, including cardiac/respiratory arrests or trauma calls (27%). Across all conditions, average self-reported confidence in assessment and management to the level expected of an FY1 is greater amongst those who observed at least one case (e.g. 7.6/10 compared with 3.6/10 for croup). Students rated exposure through Simulation or VR to be of similar utility to witnessing a clinical scenario on the ward. In free text responses, students unanimously favoured being ‘challenged’ through ‘hands-on’ patient interaction over passive shadowing, where it is ‘easy to zone out.’ In recognition of the fact that such independence is only appropriate in certain clinical situations, many students reported wanting more Simulation and VR teaching. Importantly, students raised the necessity of ‘proper debriefs’ after these sessions to maximise educational value. Discussion and Conclusion: Our questionnaire elicited several student-perceived challenges in paediatric education, including incomplete exposure to common pathologies and limited opportunities for active involvement in patient care. Indeed, these experiences seem to be important predictors of confidence. Quantitative and qualitative feedback suggests that VR and Simulation satisfy students’ self-reported appetite for independent engagement with authentic clinical scenarios. Take-aways: Our findings endorse further development of VR and Simulation as high-yield adjuncts to paediatric education.

Keywords: paediatric emergency education, simulation, virtual reality, medical education

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Authors: Maria Janet, Anita David, P. Vijayasamundeeswarimaria

Abstract:

Introduction: The main purpose of this study is to compare the effectiveness of web-based and blended learning on Paediatric Basic Life Support on competency among undergraduate nursing students in selected nursing colleges in Chennai. Materials and methods: A descriptive pre-test and post-test study design were used for this study. Samples of 100 Fourth year B.Sc., nursing students at Sri Ramachandra Faculty of Nursing SRIHER, Chennai, 100 Fourth year B.Sc., nursing students at Apollo College of Nursing, Chennai, were selected by purposive sampling technique. The instrument used for data collection was Knowledge Questionnaire on Paediatric Basic Life Support (PBLS). It consists of 29 questions on the general expansion of Basic Life Support and Cardiopulmonary Resuscitation, Prerequisites of Basic Life Support, and Knowledge on Paediatric Basic Life Support in which each question has four multiple choices answers, each right answer carrying one mark and no negative scoring. This questionnaire was formed with reference to AHA 2020 (American Heart Association) revised guidelines. Results: After the post-test, in the web-based learning group, 58.8% of the students had an inadequate level of objective performance score, while 41.1% of them had an adequate level of objective performance score. In the blended learning group, 26.5% of the students had an inadequate level of an objective performance score, and 73.4% of the students had an adequate level of an objective performance score. There was an association between the post-test level of knowledge and the demographic variables of undergraduate nursing students undergoing blended learning. The age was significant at a p-value of 0.01, and the performance of BLS before was significant at a p-value of 0.05. The results show that there was a significant positive correlation between knowledge and objective performance score of undergraduate nursing students undergoing web-based learning on paediatric basic life support.

Keywords: basic life support, paediatric basic life support, web-based learning, blended learning

Procedia PDF Downloads 37

Authors: Abubakar Sulaiman

Abstract:

The paper examines how election observation influences electoral reforms in Nigeria. Over the years, election observation continues to play critical role in the electoral process specifically in Nigeria and Africa at large. Election observation keeps an eye on the electoral process and all the stakeholders during elections, to ensure that the process is fair to all contestants. While literature abound on this role of election observation on electoral process in Nigeria, scanty scholarly efforts have been made to appraise how election observation influences electoral reforms in Nigeria. Also, while election observation may play a role in ensuring that the electoral process is credible, specifically, its role in prvoking and eliciting various electoral reforms in the country has not been explored. The paper adopts the explanatory research design using secondary data and document analysis. Preliminary findings show that election observation has influenced electoral reforms in Nigeria in no small measure. The paper concludes that election observation is critical for result oriented electoral reforms in Nigeria, albeit, such reforms have to be implemented to the latter.

Keywords: electoral reforms, election observation, electoral process, developing country

Procedia PDF Downloads 125

Authors: Rominkumar Busa, Shahira K. C., Lijiya A.

Abstract:

Text recognition is an important area in computer vision which deals with detecting and recognising text from an image. The Optical Character Recognition (OCR) is a saturated area these days and with very good text recognition accuracy. However the same OCR methods when applied on text with small font sizes like the text data of chart images, the recognition rate is less than 30%. In this work, aims to extract small text in images using the deep learning model, CRNN with CTC loss. The text recognition accuracy is found to improve by applying image enhancement by super resolution prior to CRNN model. We also observe the text recognition rate further increases by 18% by applying the proposed method, which involves super resolution and character segmentation followed by CRNN with CTC loss. The efficiency of the proposed method shows that further pre-processing on chart image text and other small text images will improve the accuracy further, thereby helping text extraction from chart images.

Keywords: small text extraction, OCR, scene text recognition, CRNN

Procedia PDF Downloads 93