Search results for: electronic clinical decision support systems

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Mohammad Abdullah-Al-Wadud

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In the current era of automation and artificial intelligence, different systems have been increasingly keeping on depending on decision-making capabilities of machines. Such systems/applications may range from simple classifiers to sophisticated surveillance systems based on traditional sensors and related equipment which are becoming more common in the internet of things (IoT) paradigm. However, the available data for such problems are usually imprecise and incomplete, which leads to uncertainty in decisions made based on traditional probability-based classifiers. This requires a robust fusion framework to combine the available information sources with some degree of certainty. The theory of evidence can provide with such a method for combining evidence from different (may be unreliable) sources/observers. This talk will address the employment of the Dempster-Shafer Theory of evidence in some practical applications.

Keywords: decision making, dempster-shafer theory, evidence fusion, incomplete data, uncertainty

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Authors: O. Bendermel, C. Seladji, M. Khaouani

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In this work, we made a numerical study of the thermal and dynamic behaviour of air in a horizontal channel with electronic components. The influence to use baffles on the profiles of velocity and temperature is discussed. The finite volume method and the algorithm Simple are used for solving the equations of conservation of mass, momentum and energy. The results found show that baffles improve heat transfer between the cooling air and electronic components. The velocity will increase from 3 times per rapport of the initial velocity.

Keywords: electronic components, baffles, cooling, fluids engineering

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Authors: Anli Du Preez, James Bekker

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Data is currently one of the most critical and influential emerging technologies. However, the true potential of data is yet to be exploited since, currently, about 1% of generated data are ever actually analyzed for value creation. There is a data gap where data is not explored due to the lack of data analytics infrastructure and the required data analytics skills. This study developed a decision support framework for data analytics by following Jabareen’s framework development methodology. The study focused on machine learning algorithms, which is a subset of data analytics. The developed framework is designed to assist data analysts with little experience, in choosing the appropriate machine learning algorithm given the purpose of their application.

Keywords: Data analytics, Industrial engineering, Machine learning, Value creation

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Authors: Ange Weinrabe, James Tran, Ian B. Hickie

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Risk-taking behaviour is common during youth. In the time between adolescence and early adulthood, young people (aged 15-25 years) are more vulnerable to mood disorders, such as anxiety and depression. What impact does an emerging mood disorder have on decision-making in youth at critical decision points in their lives? In this article, we explore the impact of risk and ambiguity on youth decision-making in a clinical setting using a well-known economic experiment. At two time points, separated by six to eight weeks, we measured risky and ambiguous choices concurrently with findings from three psychological questionnaires, the 10-item Kessler Psychological Distress Scale (K10), the 17-item Quick Inventory of Depressive Symptomatology Adolescent Version (QIDS-A17), and the 12-item Somatic and Psychological Health Report (SPHERE-12), for young help seekers aged 16-25 (n=30, mean age 19.22 years, 19 males). When first arriving for care, we found that 50% (n=15) of participants experienced severe anxiety (K10 ≥ 30) and were severely depressed (QIDS-A17 ≥ 16). In Session 2, taking attrition rates into account (n=5), we found that 44% (n=11) remained severe across the full battery of questionnaires. When applying multiple regression analyses of the pooled sample of observations (N=55), across both sessions, we found that participants who rated severely anxious avoided making risky decisions. We suggest there is some statistically significant (although weak) (p=0.09) relation between risk and severe anxiety scores as measured by K10. Our findings may support working with novel tools with which to evaluate youth experiencing an emerging mood disorder and their cognitive capacities influencing decision-making.

Keywords: anxiety, decision-making, risk, adolescence

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Authors: Ben Clapperton, Daniel Stahl, Kimberley Goldsmith, Trudie Chalder

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Chronic fatigue syndrome (CFS) is a condition characterised by chronic disabling fatigue and other symptoms that currently can't be explained by any underlying medical condition. Although clinical trials support the effectiveness of cognitive behaviour therapy (CBT), the success rate for individual patients is modest. Patients vary in their response and little is known which factors predict or moderate treatment outcomes. The aim of the project is to develop a prediction model from baseline characteristics of patients, such as demographics, clinical and psychological variables, which may predict likely treatment outcome and provide guidance for clinical decision making and help clinicians to recommend the best treatment. The project is aimed at identifying subgroups of patients with similar baseline characteristics that are predictive of treatment effects using modern cluster analyses and data mining machine learning algorithms. The characteristics of these groups will then be used to inform the types of individuals who benefit from a specific treatment. In addition, results will provide a better understanding of for whom the treatment works. The suitability of different clustering methods to identify subgroups and their response to different treatments of CFS patients is compared.

Keywords: chronic fatigue syndrome, latent class analysis, prediction modelling, self-organizing maps

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Authors: Ghada S. Moussa

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Vehicle classification is an important task in traffic surveillance and intelligent transportation systems. Classification of vehicle images is facing several problems such as: high intra-class vehicle variations, occlusion, shadow, illumination. These problems and others must be considered to develop a reliable vehicle classification system. In this study, a reliable multi-type vehicle classification system based on Bag-of-Words (BoW) paradigm is developed. Our proposed system used and compared four well-known classifiers; Linear Discriminant Analysis (LDA), Support Vector Machine (SVM), k-Nearest Neighbour (KNN), and Decision Tree to classify vehicles into four categories: motorcycles, small, medium and large. Experiments on a large dataset show that our approach is efficient and reliable in classifying vehicles with accuracy of 95.7%. The SVM outperforms other classification algorithms in terms of both accuracy and robustness alongside considerable reduction in execution time. The innovativeness of developed system is it can serve as a framework for many vehicle classification systems.

Keywords: vehicle classification, bag-of-words technique, SVM classifier, LDA classifier, KNN classifier, decision tree classifier, SIFT algorithm

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Authors: Andrés I. Ávila, Patricia Aros, César San Martín, Elizabeth Kehr, Yovana Leal

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We consider a linear programming model to help farmers to decide if it is convinient to choose among three kinds of export fruits for their future investment. We consider area, investment, water, productivitiy minimal unit, and harvest restrictions and a monthly based model to compute the average income in five years. Also, conditions on the field as area, water availability and initia investment are required. Using the Chilean costs and dollar-peso exchange rate, we can simulate several scenarios to understand the possible risks associated to this market.

Keywords: mixed integer problem, fruit production, support decision model, fruit tree farms

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Authors: Aliaksei Patsekha, Michael Hohenberger, Harald Raupenstrauch

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An effective emergency response to accidents with chemical, biological, radiological, nuclear, or explosive materials (CBRNE) that represent highly dynamic situations needs immediate actions within limited time, information and resources. The aim of the study is to provide the foundation for division of unsafe area into risk zones according to the impact of hazardous parameters (heat radiation, thermal dose, overpressure, chemical concentrations). A decision on the boundary values for three risk zones is based on the vulnerability analysis that covered a variety of accident scenarios containing the release of a toxic or flammable substance which either evaporates, ignites and/or explodes. Critical values are selected for the boundary definition of the Red, Orange and Yellow risk zones upon the examination of harmful effects that are likely to cause injuries of varying severity to people and different levels of damage to structures. The obtained results provide the basis for creating a comprehensive real-time risk map for a decision support at CBRNE operations.

Keywords: boundary values, CBRNE threats, decision making process, hazardous effects, vulnerability analysis, risk zones

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Authors: Nika GorgoShadze, Anri Shainidze, Bachuki Katamadze

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In parallel to the development of the digital economy in the world, electronic commerce is also widely developing. Internet and ICT (information and communication technology) have created new business models as well as promoted to market consolidation, sustainability of the business environment, creation of digital economy, facilitation of business and trade, business dynamism, higher competitiveness, etc. Electronic commerce involves internet technology which is sold via the internet. Nowadays electronic commerce is a field of business which is used by leading world brands very effectively. After the research of internet market in Georgia, it was found out that quality of internet is high in Tbilisi and is low in the regions. The internet market of Tbilisi can be evaluated as high-speed internet service, competitive and cost effective internet market. Development of electronic commerce in Georgia is connected with organizational and methodological as well as legal problems. First of all, a legal framework should be developed which will regulate responsibilities of organizations. The Ministry of Economy and Sustainable Development will play a crucial role in creating legal framework. Ministry of Justice will also be involved in this process as well as agency for data exchange. Measures should be taken in order to make electronic commerce in Georgia easier. Business companies may be offered some model to get low-cost and complex service. A service centre should be created which will provide all kinds of online-shopping. This will be a rather interesting innovation which will facilitate online-shopping in Georgia. Development of electronic business in Georgia requires modernized infrastructure of telecommunications (especially in the regions) as well as solution of institutional and socio-economic problems. Issues concerning internet availability and computer skills are also important.

Keywords: electronic commerce, internet market, electronic business, information technology, information society, electronic systems

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Authors: Golyasamin Khanehzaei, Mohd. Bakri Ishak, Ahmad Makmom Hj Abdullah, Latifah Abd Manaf

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Abstract—Management of clinical waste is a critical problem worldwide. Immediate attention is required to manage the clinical waste in an appropriate way in newly developing economy country such as Malaysia. The increasing amount of clinical waste generated is resulted from rapid urbanization and growing number of private health care facilities in developing countries such as Malaysia. In order to develop a sensible clinical waste management system and improvement of the management, information on factors affecting clinical waste generation has the crucial role. This paper is the study of management characteristics of clinical waste and the level of efficiency of clinical waste management systems operating in private clinics located in Selangor, Malaysia. Are they following the proper international standards? By taking all of this in consideration the aim of this paper is to identify and discuss the current trend, current challenges and also the present opportunities among the challenges of clinical waste management in private clinics of Selangor, Malaysia. The SWOT analysis was characterized for the evaluation of strengths, weaknesses, opportunities and threats. The methodology for this study was constituted of direct observation, Informal interviews, Conducting SWOT analysis, conduction of one sustainability dimensions analysis and application. The results show that clinical waste management in private clinics is far from an ideal model.

Keywords: clinical waste, SWOT analysis, Selangor, Malaysia

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Authors: A. Hol

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Nowadays, within quickly changing business environments, companies are often faced with specific problems where knowledge required to make timely decisions is often available however is not always readily accessible by the decision makers, in a required form. To identify if in any way via innovative system development companies could be assisted so that they can make quicker industry specific decisions in a given time and space, researchers conducted in depth case study investigation during which they studied company’s e-transformation recommendations, company’s current issues and problems as well as the nature of company’s pressing decisions. This study utilizes Scenario Based Analysis with the aim to help identify parameters crucial for the development of the system that could support decision making in a given time and space. Based on the findings, Context Specific e-transformation decision making framework is proposed.

Keywords: e-transformation, business context, decision making, e-T Guide, ICT

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Authors: Kamalendu Pal

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This paper describes the main features of a knowledge-based system evaluation method. System evaluation is placed in the context of a hybrid legal decision-support system, Advisory Support for Home Settlement in Divorce (ASHSD). Legal knowledge for ASHSD is represented in two forms, as rules and previously decided cases. Besides distinguishing the two different forms of knowledge representation, the paper outlines the actual use of these forms in a computational framework that is designed to generate a plausible solution for a given case, by using rule-based reasoning (RBR) and case-based reasoning (CBR) in an integrated environment. The nature of suitability assessment of a solution has been considered as a multiple criteria decision making process in ASHAD evaluation. The evaluation was performed by a combination of discussions and questionnaires with different user groups. The answers to questionnaires used in this evaluations method have been measured as a combination of linguistic variables, fuzzy numbers, and by using defuzzification process. The results show that the designed evaluation method creates suitable mechanism in order to improve the performance of the knowledge-based system.

Keywords: case-based reasoning, fuzzy number, legal decision-support system, linguistic variable, rule-based reasoning, system evaluation

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Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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Authors: Lara Dutil-Fafard, Caroline Rhéaume, Patrick Archambault, Daniel Lafond, Neal W. Pollock

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Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

Keywords: decision support system, event-sequence diagram, exploration mission, medical autonomy, scenario-based queries, space medicine

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Authors: Norshakirah Ab.Aziz, Nurul Atiqah Jamaluddin

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Consequently, electronic word-of-mouth (e-WoM) becomes one of the resources in the decision making process and considered a valuable marketing channel for consumers and organizations. Admittedly, there is increasing concern on the accuracy and genuine of e-WoM content because consumers prefer to look out product or service information available online. Thus, the focus of this study is to propose a model and guidelines how to select trusted online review content according to domain chosen –undergrad students smartphone online review. Undeniable, mobile devices like smartphone has now become a necessity in today are daily life to complete our daily chores. The model and guideline focused on product competency review and the message integrity. In other words, this study aims to enable consumers to identify trusted online review content, which helps them in buying decisions.

Keywords: electronic word of mouth, e-WoM, WoM, online review

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Authors: Maziyar Nouraee

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Electronic markets in recent decades contribute remarkably in business transactions. Many organizations consider traditional ways of trade non-economical and therefore they do trade only through electronic markets. There are different categorizations of electronic markets functions. In one classification, functions of electronic markets are categorized into classes as information, transactions, and value added. In the present paper, effects of the three classes on the two major elements of the supply chain management are measured. The two elements are decrease in the product unit cost and reduction in response time to the customer. The results of the current research show that among nine minor elements related to the three classes of electronic markets functions, six factors and three factors influence on reduction of the product unit cost and reduction of response time to the customer, respectively.

Keywords: electronic commerce, electronic market, B2B trade, supply chain management

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Authors: Ahmad Mohsin, Syda Fatima, Falak Nawaz, Aman Ullah Khan

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Selection of an appropriate architectural style is vital to the success of target web service under development. The nature of architecture design and selection for service-oriented computing applications is quite different as compared to traditional software. Web Services have complex and rigorous architectural styles to choose. Due to this, selection for accurate architectural style for web services development has become a more complex decision to be made by architects. Architectural style selection is a multi-criteria decision and demands lots of experience in service oriented computing. Decision support systems are good solutions to simplify the selection process of a particular architectural style. Our research suggests a new approach using DSS for selection of architectural styles while developing a web service to cater FRs and NFRs. Our proposed DSS helps architects to select right web service architectural pattern according to the domain and non-functional requirements. In this paper, a rule base DSS has been developed using CLIPS (C Language Integrated Production System) to support decisions using multi-criteria requirements. This DSS takes architectural characteristics, domain requirements and software architect preferences for NFRs as input for different architectural styles in use today in service-oriented computing. Weighted sum model has been applied to prioritize quality attributes and domain requirements. Scores are calculated using multiple criterions to choose the final architecture style.

Keywords: software architecture, web-service, rule-based, DSS, multi-criteria requirements, quality attributes

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Authors: Jacquelyn Burkell, Jane Bailey

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Artificial intelligence (AI) solutions deployed within the justice system face the critical task of providing acceptable explanations for decisions or actions. These explanations must satisfy the joint criteria of public and professional accountability, taking into account the perspectives and requirements of multiple stakeholders, including judges, lawyers, parties, witnesses, and the general public. This research project analyzes and integrates two existing literature on explanations in order to propose guidelines for explainable AI in the justice system. Specifically, we review three bodies of literature: (i) explanations of the purpose and function of 'explainable AI'; (ii) the relevant case law, judicial commentary and legal literature focused on the form and function of reasons for judicial decisions; and (iii) the literature focused on the psychological and sociological functions of these reasons for judicial decisions from the perspective of the public. Our research suggests that while judicial ‘reasons’ (arguably accurate descriptions of the decision-making process and factors) do serve similar explanatory functions as those identified in the literature on 'explainable AI', they also serve an important ‘justification’ function (post hoc constructions that justify the decision that was reached). Further, members of the public are also looking for both justification and explanation in reasons for judicial decisions, and that the absence of either feature is likely to contribute to diminished public confidence in the legal system. Therefore, artificially automated judicial decision-making systems that simply attempt to document the process of decision-making are unlikely in many cases to be useful to and accepted within the justice system. Instead, these systems should focus on the post-hoc articulation of principles and precedents that support the decision or action, especially in cases where legal subjects’ fundamental rights and liberties are at stake.

Keywords: explainable AI, judicial reasons, public accountability, explanation, justification

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Authors: Arturo J. Anci Alméstar, Jose D. Fernandez Huapaya, David Mauricio

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Companies make erroneous decisions by not evaluating the inherent difficulties of entering electronic commerce without a prior review of current digital and alternate means of payment. For this reason, it is very important for businesses to have reliable, complete and integrated information on the means of current digital and alternate payments that allow decisions to be made about which of these to use. However, there is no such consolidated information or criteria that companies use to make decisions about the means of payment according to their needs. In this paper, we propose a decision tree model based on a taxonomy that presents us with a categorization of digital and alternative means of payment, as well as the visualization of the flow of information at a high level from the company to obtain a recommendation. This will allow the company to make the most appropriate decision about the implementation of the digital means of payment or alternative ideal for their needs, which allows a reduction in costs and complexity of the payment process. Likewise, the efficiency of the proposed model was evaluated through a satisfaction survey presented to company personnel, confirming the satisfactory quality level of the recommendations obtained by the model.

Keywords: digital payment medium, decision tree, decision making, digital payments taxonomy

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Authors: Saurav Dhawan, Sanchit Bansal

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Background T-MACS is a computer-based decision aid that ‘rules in’ and ‘rules out’ ACS using a combination of the presence or absence of six clinical features with only one biomarker measured on arrival: hs-cTnT. T-MACS had 99.3% negative predictive value and 98.7% sensitivity for ACS, ‘ruling out’ ACS in 40% of patients while ‘ruling in’ 5% at the highest risk. We aim at benchmarking the use of T-MACS which could help to conserve healthcare resources, facilitate early discharges, and ensure safe practice. Methodology Randomized retrospective data collection (n=300) was done from ED electronic records across 3 hospital sites within MFT over a period of 2 months. Data was analysed and compared by percentage for the usage of T-MACS, number of admissions/discharges, and in days for length of stay in hospital. Results MRI A&E had the maximum compliance with the use of T-MACS in the trust at 66%, with minimum admissions (44%) and an average length of stay of 1.825 days. NMG A&E had an extremely low compliance rate (8 %), with 75% admission and 3.387 days as the average length of stay. WYT A&E had no TMACS recorded, with a maximum of 79% admissions and the longest average length of stay at 5.07 days. Conclusion All three hospital sites had a RAG rating of ‘RED’ as per the compliance levels. The assurance level was calculated as ‘Very Limited’ across all sites. There was a positive correlation observed between compliance with TMACS and direct discharges from ED, thereby reducing the average length of stay for patients in the hospital.

Keywords: ACS, discharges, ED, T-MACS

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Authors: Ankur Kapur, Moosath Vasudevan

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This movie review looks at the depiction of mental illness in popular cinema, using the movie A Beautiful Mind as a case study. It tries to understand cinema and media from a clinical psychology perspective in terms of the portrayal of symptoms and caregiver support. The review aims to analyze the portrayal of schizophrenia in the book and the movie ‘A Beautiful Mind’ on Professor John Nash. It will analyze the differences in portrayal of schizophrenia, under different media and the creative applications of the author, directors and actors in depicting the disorder as closely as it is understood in Clinical Psychology. The differences would be studied for romanticisation of symptoms in the book and the movie. Even within a medium (only the movie), verbal and non-verbal cues of the disorder will be compared for the depiction of schizophrenia. The study will dwell on the comparative description of how the caregivers coped with the patient and his illness. For this, the study will understand it through the lens of Bowen’s Family Systems Theory.

Keywords: caregiver, communication, media, systems theory

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Authors: Marta Fernández Batalla, José María Santamaría García, Maria Lourdes Jiménez Rodríguez, Roberto Barchino Plata, Adriana Cercas Duque, Enrique Monsalvo San Macario

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Background: Primary Care Nursing is taking more autonomy in clinical decisions. One of the most frequent therapies to solve is related to the problems of maintaining a sufficient supply of food. Nursing diagnoses related to food are addressed by the nurse-family and community as the first responsible. Objectives and interventions are set according to each patient. To improve the goal setting and the treatment of these care problems, a technological tool is developed to help nurses. Objective: To evaluate the computational tool developed to support the clinical decision in feeding problems. Material and methods: A cross-sectional descriptive study was carried out at the Meco Health Center, Madrid, Spain. The study population consisted of four specialist nurses in primary care. These nurses tested the tool on 30 people with ‘need for nutritional therapy’. Subsequently, the usability of the tool and the satisfaction of the professional were sought. Results: A simple and convenient computational tool is designed for use. It has 3 main entrance fields: age, size, sex. The tool returns the following information: BMI (Body Mass Index) and caloric consumed by the person. The next step is the caloric calculation depending on the activity. It is possible to propose a goal of BMI or weight to achieve. With this, the amount of calories to be consumed is proposed. After using the tool, it was determined that the tool calculated the BMI and calories correctly (in 100% of clinical cases). satisfaction on nutritional assessment was ‘satisfactory’ or ‘very satisfactory’, linked to the speed of operations. As a point of improvement, the options of ‘stress factor’ linked to weekly physical activity. Conclusion: Based on the results, it is clear that the computational tools of decision support are useful in the clinic. Nurses are not only consumers of computational tools, but can develop their own tools. These technological solutions improve the effectiveness of nutrition assessment and intervention. We are currently working on improvements such as the calculation of protein percentages as a function of protein percentages as a function of stress parameters.

Keywords: feeding behavior health, nutrition therapy, primary care nursing, technology assessment

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Authors: Rachel Falconer

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Background: The United Nations Convention on the Rights of the Child sets out the duties placed on signatory nations to take measures to protect children from all forms of violence, abuse, neglect and maltreatment. The systems for ensuring this protection vary globally, shaped by national welfare policies. In England and Finland, past research has highlighted differences in how child protection issues are framed and how state agencies respond. However, less is known about how such differences impact processes of social work judgment and decision making in practice. Method: Data was collected as part of a wider PhD project in three stages. First, social workers in sites across England and Finland were asked to complete a short questionnaire. Participants were then asked to comment on two constructed case vignettes, and were interviewed about their experiences of child protection decision making at the point of referral. Interviews were analyzed using NVivo to draw out key themes. Findings: There were similarities in how the English and Finnish social workers responded to the case vignettes; for example, participants in both countries expressed concerns about similar risk factors and all felt further assessment was needed. Differences were observed, in particular, in regard to the sources of support and guidance participants referred to, with the English social workers appearing to rely more upon managerial input for their decisions than the Finnish social workers. These findings suggest evidence for two distinct decision making approaches: ‘supervised’ and ‘supported’ judgement. Implications for practice: The findings have relevance to the conference theme of research and evaluation of social work practice, and support the findings of previous studies that have emphasized the significance of organizational factors in child protection decision making. The comparative methodology has also helped to demonstrate how organizational factors can influence practice in different child protection system ‘orientations’. The presentation will discuss the potential practice implications of ‘supervised’, manager-led approaches to decision making as contrasted with ‘supported’, team-led approaches, inviting discussion about the relevance of these findings for social work in other countries.

Keywords: child protection, comparative research, decision making, social work, vignettes

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Authors: J. Magerman, P. Martin

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Nursing students' clinical abilities is highly dependent on the quality of the clinical experience obtained while placed in the clinical environment. The clinical environment has amongst other, key role players which include the clinical supervisor. The primary role of the clinical supervisor is to guide nursing students to become the best practice nursing professionals. However, globally literature alludes to the failure of educating institutions to deliver competent nursing professionals to meet the needs of patients and deliver quality patient care. At the participating university, this may be due to various factors such as large student numbers and social and environmental challenges experienced by clinical supervisors. The aim of this study was to explore and describe the lived experiences of clinical supervisors who supervise nursing students at a higher education institution. The study employed a qualitative research approach utilizing a descriptive phenomenological design. Purposive sampling was used to select participants, who supervised first and second year nursing studnets at the higher education institution under study. TH esample comprised of eight clinical supervisors who supervise first and secon year nursing studnets at teh institution under study. Data was collected by means of in-depht interviews. Data was analysed using Collaizzi's seven steps method of qualitative analysis. Five major themes identified , focussed on the experiences regarding time a sa constraint to job productivity, the impact of teh organisational culture on the fluidity of support, interpersonal relationships a sa dynamic communication process, impact on the self, and limited resources. Trustworthiness of the data was ensured by means of applying Guba's model of truth value, applicability, consistency and neutrality. Reflexivity was also used by the researcher to further enhance trustworthiness.

Keywords: clinical supervision, clinical supervisors, nursing students, clinical placements

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Authors: Ünal Kızıl, Levent Genç, Sefa Aksu, Ahmet Tapınç

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The Figaro AM-1 sensor module which employs TGS 2600 model gas sensor in air quality assessment was used. The system was coupled with a microprocessor that enables sensor module to create warning message via telephone. This low cot sensor system’s performance was compared with a Diagnose II commercial electronic nose system. Both air quality sensor and electronic nose system employ metal oxide chemical gas sensors. In the study experimental setup, data acquisition methods for electronic nose system, and performance of the low cost air quality system were evaluated and explained.

Keywords: air quality, electronic nose, environmental quality, gas sensor

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Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki, Anastasia Kalamakidou

Abstract:

Transport infrastructure assets are key components of the national asset portfolio. The decision to invest in a new infrastructure in transports could take from a few years to some decades. This is mainly because of the need to reserve and spent many capitals, the long payback period, the number of the stakeholders involved in the decision process and –many times- the investment and business risks are high. Decision makers and stakeholders need to define the framework and the outputs of the decision process taking into account the project characteristics, the business uncertainties, and the different expectations. Therefore, the decision assessment framework is an essential challenge linked with the key decision factors meet the stakeholder expectations highlighting project trade-offs, financial risks, business uncertainties and market limitations. This paper examines the decision process for new transport infrastructure projects in cross-border regions, where a wide range of stakeholders with different expectation is involved. According to a consequences analysis systemic approach, the relationship of transport infrastructure development, economic system development and stakeholder expectation is analysed. Adopting the on system of system methodological approach, the decision making the framework, variables, inputs and outputs are defined, highlighting the key shareholder’s role and expectations. The application provides the methodology outputs presenting the proposed decision framework for a strategic railway project in north Greece deals with the upgrade of the existing railway corridor connecting Greece, Turkey, and Bulgaria.

Keywords: system of system decision making, managing decisions for transport projects, decision support framework, defining decision process

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Authors: Jacqueline M. Dias, Amina A Khowaja

Abstract:

Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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Authors: Manita Ale, Ganesh P. Shivakoti, Ram C. Bastakoti

Abstract:

Irrigation system, a system for enhancing agricultural productivity, requires regular maintenance in order to avoid irregular allocation of water. For maintenance of the system in long run, farmers’ participation plays a key role increasing the performance of system. The performance of any irrigation system mainly relies on various factors which affect collective action plus decision making, as well as their shared impacts. The paper consists of system level information that were collected from 12 Irrigation Systems (IS) from three-sampled districts of Nepal and the household information that were collected from 160 irrigation water users. The results reveal that, out of 12 sampled irrigation systems, only 4 systems shows high performance levels. The high performance level of those systems was characterized on the basis of adequate availability of water, good maintenance of system infrastructure, and conformance to existing rules followed. In addition, the paper compares different irrigation systems based on trust, reciprocity, cropping intensity, command area and yield as tools to indicate the importance of collective action in performance of irrigation system.

Keywords: collective action, decision-making, farmers’ participation, performance

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Authors: Girija Madhavanprabhakaran, Frincy Franacis, Sheeba Elizabeth John

Abstract:

Introduction: A wide range of prenatal genetic screening is introduced with increasing incidences of congenital anomalies even in low-risk pregnancies and is an emerging standard of care. Being frontline caretakers, the role and responsibilities of nurses and midwives are critical as they are working along with couples to provide evidence-based supportive educative care. The increasing genetic disorders and advances in prenatal genetic screening with limited genetic counselling facilities urge nurses and midwifery nurses with essential competencies to help couples to take informed decision. Objective: This integrative literature review aimed to explore nurse midwives’ knowledge and role in prenatal screening and genetic counselling competency and the challenges faced by them to cater to all pregnant women to empower their autonomy in decision making and ensuring psychological comfort. Method: An electronic search using keywords prenatal screening, genetic counselling, prenatal counselling, nurse midwife, nursing education, genetics, and genomics were done in the PUBMED, SCOPUS and Medline, Google Scholar. Finally, based on inclusion criteria, 8 relevant articles were included. Results: The main review results suggest that nurses and midwives lack essential support, knowledge, or confidence to be able to provide genetic counselling and help the couples ethically to ensure client autonomy and decision making. The majority of nurses and midwives reported inadequate levels of knowledge on genetic screening and their roles in obtaining family history, pedigrees, and providing genetic information for an affected client or high-risk families. The deficiency of well-recognized and influential clinical academic midwives in midwifery practice is also reported. Evidence recommended to update and provide sound educational training to improve nurse-midwife competence and confidence. Conclusion: Overcoming the challenges to achieving informed choices about fetal anomaly screening globally is a major concern. Lack of adequate knowledge and counselling competency, communication insufficiency, need for education and policy are major areas to address. Prenatal nurses' and midwives’ knowledge on prenatal genetic screening and essential counselling competencies can ensure services to the majority of pregnant women around the globe to be better-informed decision-makers and enhances their autonomy, and reduces ethical dilemmas.

Keywords: challenges, genetic counselling, prenatal screening, prenatal counselling

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