Search results for: integrated clinical environment

Authors: Charléa M. Smith, Raiden L. Schodowski, Arletty Pinel

Abstract:

Due to the COVID-19 pandemic, the Faculty of Medical Sciences of The University of the West Indies (UWI) Mona in Kingston, Jamaica, had to rapidly migrate to digital and blended learning. Students in the preclinical stage of the program transitioned to full-time online learning, while students in the clinical stage experienced decreased daily patient contact and the implementation of a blend of online lectures and virtual clinical practice. Such sudden changes were coupled with the institutional pressure of the need to introduce a novel approach to education without much time for preparation, as well as additional strain endured by the faculty, who were overwhelmed by serving as frontline workers. During the period July 20 to August 23, 2021, this study surveyed preclinical and clinical students to capture their experiences with these changes and their recommendations for future use of digital modalities of learning to enhance medical education. It was conducted with a fellow student of the 2021 cohort of the MultiPod mentoring program. A questionnaire was developed and distributed digitally via WhatsApp to all medical students of the UWI Mona campus to assess students’ experiences and perceptions of the advantages, challenges, and impact on individual knowledge proficiencies brought about by the transition to predominantly digital learning environments. 108 students replied, 53.7% preclinical and 46.3% clinical. 67.6% of the total were female and 30.6 % were male; 1.8% did not identify themselves by gender. 67.2% of preclinical students preferred blended learning and 60.3% considered that the content presented did not prepare them for clinical work. Only 31% considered that the online classes were interactive and encouraged student participation. 84.5% missed socialization with classmates and friends and 79.3% missed a focused environment for learning. 80% of the clinical students felt that they had not learned all that they expected and only 34% had virtual interaction with patients, mostly by telephone and video calls. Observing direct consultations was considered the most useful, yet this was the least-used modality. 96% of the preclinical students and 100% of the clinical ones supplemented their learning with additional online tools. The main recommendations from the survey are the use of interactive teaching strategies, more discussion time with lecturers, and increased virtual interactions with patients. Universities are returning to face-to-face learning, yet it is unlikely that blended education will disappear. This study demonstrates that students’ perceptions of their experience during mobility restrictions must be taken into consideration in creating more effective, inclusive, and efficient blended learning opportunities.

Keywords: blended learning, digital learning, medical education, student perceptions

Procedia PDF Downloads 129

Authors: Ratri Werdiningtyas, Yongping Wei, Andrew Western

Abstract:

This paper contributes to on-going attempts at bringing together land, water and environmental policy in catchment management. A tension remains in defining the boundaries of policy integration. Most of Integrated Water Resource Management is valued as rhetoric policy. It is far from being achieved on the ground because the socio-ecological system has not been understood and developed into complete and coherent problem representation. To clarify the feature of integration, this article draws on institutional fit for public policy integration and uses these insights in an empirical setting to identify the mechanism that can facilitate effective public integration for catchment management. This research is based on the journey of Victoria’s government from 1890-2016. A total of 274 Victorian Acts related to land, water, environment management published in those periods has been investigated. Four conditions of integration have been identified in their co-evolution: (1) the integration policy based on reserves, (2) the integration policy based on authority interest, (3) policy based on integrated information and, (4) policy based coordinated resource, authority and information. Results suggest that policy coordination among their policy instrument is superior rather than policy integration in the case of catchment management.

Keywords: catchment management, co-evolution, policy integration, phase

Procedia PDF Downloads 201

Authors: Joy Cao, Min Zhou

Abstract:

Purpose: Acute Type A aortic dissection is a well-known cause of extremely high mortality rate. A highly accurate and cost-effective non-invasive predictor is critically needed so that the patient can be treated at earlier stage. Although various CFD approaches have been tried to establish some prediction frameworks, they are sensitive to uncertainty in both image segmentation and boundary conditions. Tedious pre-processing and demanding calibration procedures requirement further compound the issue, thus hampering their clinical applicability. Using the latest physics informed deep learning methods to establish an accurate and cost-effective predictor framework are amongst the main goals for a better Type A aortic dissection treatment. Methods: Via training a novel physics-informed deep residual network, with non-invasive 4D MRI displacement vectors as inputs, the trained model can cost-effectively calculate all these biomarkers: aortic blood pressure, WSS, and OSI, which are used to predict potential type A aortic dissection to avoid the high mortality events down the road. Results: The proposed deep learning method has been successfully trained and tested with both synthetic 3D aneurysm dataset and a clinical dataset in the aortic dissection context using Google colab environment. In both cases, the model has generated aortic blood pressure, WSS, and OSI results matching the expected patient’s health status. Conclusion: The proposed novel physics-informed deep residual network shows great potential to create a cost-effective, non-invasive predictor framework. Additional physics-based de-noising algorithm will be added to make the model more robust to clinical data noises. Further studies will be conducted in collaboration with big institutions such as Cleveland Clinic with more clinical samples to further improve the model’s clinical applicability.

Keywords: type-a aortic dissection, deep residual networks, blood flow modeling, data-driven modeling, non-invasive diagnostics, deep learning, artificial intelligence.

Procedia PDF Downloads 51

Authors: Rashida Suleiman, Asamoah Jnr. Boakye, Suleiman Ahmed Ibn Ahmed

Abstract:

In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. MYCIN is a groundbreaking illustration of a clinical decision support system (CDSS), which was developed to assist physicians in the diagnosis and treatment of bacterial infections by providing suggestions for antibiotic regimens. MYCIN was one of the earliest expert systems to demonstrate how CDSSs may assist human decision-making in complicated areas. Relevant databases were searched using google scholar, PubMed and general Google search, which were peculiar to clinical decision support systems. The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of MYCIN, a clinical decision support system. Inferences drawn from the articles showed some usage of MYCIN for problem-based learning among clinicians and students in some countries. Furthermore, the data demonstrated that MYCIN had completed clinical testing at Stanford University Hospital following years of research. The system (MYCIN) was shown to be extremely accurate and effective in diagnosing and treating bacterial infections, and it demonstrated how CDSSs might enhance clinical decision-making in difficult circumstances. Despite the challenges MYCIN presents, the benefits of its usage to clinicians, students and software developers are enormous.

Keywords: clinical decision support system, MYCIN, diagnosis, bacterial infections, support systems

Procedia PDF Downloads 93

Authors: Bhavani Veasuvalingam

Abstract:

Case-based learning (CBL) is a popular instructional method aimed to bridge theory to clinical practice. This study aims to explore CBL mixed modality curriculum in influencing students’ learning styles and strategies that support learning. An explanatory sequential mixed method study was employed with initial phase, 44-itemed Felderman’s Index of Learning Style (ILS) questionnaire employed across year one medical students (n=142) using convenience sampling to describe the preferred learning styles. The qualitative phase utilised three focus group discussions (FGD) to explore in depth on the multimodal learning style exhibited by the students. Most students preferred combination of learning stylesthat is reflective, sensing, visual and sequential i.e.: RSVISeq style (24.64%) from the ILS analysis. The frequency of learning preference from processing to understanding were well balanced, with sequential-global domain (66.2%); sensing-intuitive (59.86%), active- reflective (57%), and visual-verbal (51.41%). The qualitative data reported three major themes, namely Theme 1: CBL mixed modalities navigates learners’ learning style; Theme 2: Multimodal learners active learning strategies supports learning. Theme 3: CBL modalities facilitating theory into clinical knowledge. Both quantitative and qualitative study strongly reports the multimodal learning style of the year one medical students. Medical students utilise multimodal learning styles to attain the clinical knowledge when learning with CBL mixed modalities. Educators’ awareness of the multimodal learning style is crucial in delivering the CBL mixed modalities effectively, considering strategic pedagogical support students to engage and learn CBL in bridging the theoretical knowledge into clinical practice.

Keywords: case-based learning, learnign style, medical students, learning

Procedia PDF Downloads 63

Authors: Nizamuddin Khan

Abstract:

Integrated livestock and cropping system is very old agricultural practice since antiquity. It is an eco-friendly and sustainable farming system in which both the resources are optimally and rationally utilized through the recycling and re-utilization of their by-products. Indian farmers follow in- farm integrated farming system unlike in developed countries where both farm and off-farm system prevailed. The data on different components of the integrated farming system is very limited and that too is not widely available in published form. The primary source is the only option for understanding the mechanism, process, evaluation and performance of integrated livestock cropping system. Researcher generated data through the field survey of sampled respondents from sampled villages from Bulandshahr district of Uttar Pradesh. The present paper aims to understand the component group of system, degree, and level of integration, level of generation of employment, income, improvement in farm ecology, the economic viability of farmers and check in rural-urban migration. The study revealed that area witnessed intra farm integration in which both livestock and cultivation of crops take place on the same farm. Buffalo, goat, and poultry are common components of integration. Wheat, paddy, sugarcane and horticulture are among the crops. The farmers are getting 25% benefit more than those who do not follow the integrated system. Livestock husbandry provides employment and income through the year, especially during agriculture offseason. 80% of farmers viewed that approximately 35% of the total expenditure incurred is met from the livestock sector. Landless, marginal and small farmers are highly benefited from agricultural integration. About 70% of farmers acknowledged that using wastes of animals and crops the soil ecology is significantly maintained. Further, the integrated farming system is helpful in reducing rural to urban migration. An incentive with credit facilities, assured marketing, technological aid and government support is urgently needed for sustainable development of agriculture and farmers.

Keywords: integrated, recycle, employment, soil ecology, sustainability

Procedia PDF Downloads 140

Authors: J. Hajri, H. Hrizi, N. Sboui, H. Baudrand

Abstract:

This paper presents a study of SIW circuits (Substrate Integrated Waveguide) with a rigorous and fast original approach based on Iterative process (WCIP). The theoretical suggested study is validated by the simulation of two different examples of SIW circuits. The obtained results are in good agreement with those of measurement and with software HFSS.

Keywords: convergence study, HFSS, modal decomposition, SIW circuits, WCIP method

Procedia PDF Downloads 463

Authors: Raveendranath Veeramani, Parkash Chand, H. Y. Suma, A. Umamageswari

Abstract:

Background and Aims: The aim of this study was to evaluate students’ perception of Integrated Learning Program[ILP]. Settings and Design: A questionnaire was used to survey and evaluate the perceptions of 1styear MBBS students at the Department of Anatomy at our medical college in India. Materials and Methods: The first MBBS Students of Anatomy were involved in the ILP on the Liver and extra hepatic biliary apparatus integrating the Departments of Anatomy, Biochemistry and Hepato-biliary Surgery. The evaluation of the ILP was done by two sets of short questionnaire that had ten items using the Likert five-point grading scale. The data involved both the students’ responses and their grading. Results: A majority of students felt that the ILP was better in as compared to the traditional lecture method of teaching.The integrated teaching method was better at fulfilling learning objectives (128 students, 83%), enabled better understanding (students, 94%), were more interesting (140 students, 90%), ensured that they could score better in exams (115 students, 77%) and involved greater interaction (100 students, 66%), as compared to traditional teaching methods. Most of the students (142 students, 95%) opined that more such sessions should be organized in the future. Conclusions: Responses from students show that the integrated learning session should be incorporated even at first phase of MBBS for selected topics so as to create interest in the medical sciences at the entry level and to make them understand the importance of basic science.

Keywords: integrated learning, students response, vertical integration, horizontal integration

Procedia PDF Downloads 167

Authors: Yong Cang

Abstract:

RJV001 is a subcutaneous injection containing mutated recombinant Collagenase H (ColH), leading to disruption of collagen matrix in adipose tissue and programmed cell death of adipocytes. Here we reported our clinical investigation of the safety, tolerance and pharmacodynamics of localized RJV001 injection into healthy human abdominal fat tissues (NCT04821648, Arizona Research Center). Investigate the safety, tolerance and clinical pharmacodynamics of subcutaneous RJV001 in humans. In the dose-escalating study, 18 subjects completed the study, 100% female, 78% white, with a mean age of 42[±9.9]. All three tested dose (0.05, 0.075 and 0.15 mg/injection), up to 30 injections, were safe and well-tolerated. Bruising and tenderness to palpation, mild to moderate, were the most frequent local skin reactions but nearly all resolved within 30 days. Additionally, physician-monitored ultrasound measurement showed that a reduction in abdominal fat tissue thickness was consistently observed in Cohort C (0.075, 0.15 mg/injection, 30injections), with a mean reduction of 7.37 [± 2.020] mm. Based on this clinical study, RJV001 has been advanced to phase II clinical studies. In the dose-escalating study, subcutaneously administered RJV001 was safe and well-tolerated in healthy adults up to 0.15 mg/injection, 30 injections. Fat reduction and adipocytolysis were observed by ultrasound measurements and histological analysis for exploratory purposes.

Keywords: fat reduction, mutant collagenase, clinical trial, subcutaneous injection

Procedia PDF Downloads 75

Authors: Deborah Asibu Abu

Abstract:

Motivation is the process that initiates, guides, and maintains goal-oriented behaviors. It is one of the most important ingredients in teaching and learning yet it does not come by chance; it involves necessary strategies appropriate to achieve a common goal. In learning, the psychological attention of the student is very important. This helps them to imagine whatever is being taught for a simple understanding, nonetheless, many students will be able to imagine how the environment is in social studies or how the bones or plant is, in integrated Science but will find it difficult to imagine what subject-verb agreement or phrases and clauses actually looks like until they are motivated or with the use of TLM’s to stir their interest to learn and forever remember. For students to be able to receive the motivation they need, there must be an effective relationship between the teacher and the student as well as the use of strategies for effectual execution of achievable goals. Every teacher must understand the importance of motivation by applying various kinds of teaching methodology, especially in the English Language as a subject. Hence this paper suggests some important factors necessary for student’s motivation in teaching and learning English Language, it handles what teaching method is, types of motivation, educational curriculum structure of many, what suitable teaching methods can achieve, appropriate teachers’ disposition, learning environment as tool for motivation and some other domestic factors that can also influence student motivation.

Keywords: english language, teacher-student relationship, curriculum structure, learning environment

Procedia PDF Downloads 14

Authors: Teerapong Chaisen, Pornpan Puttaraksa, Chayanit Chitchai, Peeraya Somsak, Rinyaphat Kecharananta

Abstract:

This paper aims to study integrated marketing communication (IMC) of department store in Chiang Mai with the object to understand how department stores manage communication in order to inform customer and how customers react to the received information. We study the example of 300 customers both Thai and foreigners who received the given information from the department stores and the reactions of these customers. This paper shows Central festival is the top destination to visit for Thai customers. On the other hand, Central Plaza is favored by foreign customers. However, all department stores need to use more IMC to make awareness for customer.

Keywords: integrated marketing communication, satisfaction, department store, consumer

Procedia PDF Downloads 286

Authors: Robby Y. Tallar, Nikodemus L., Yuri S., Jian P. Suen

Abstract:

Research in the subject of ecological water resources management is full of trivial questions addressed and it seems, today to be one branch of science that can strongly contribute to the study of complexity (physical, biological, ecological, socio-economic, environmental, and other aspects). Existing literature available on different facets of these studies, much of it is technical and targeted for specific users. This study offered the combination all aspects in evaluation methodology for aquaculture lakes with its paradigm refer to hierarchical theory and to the effects of spatial specific arrangement of an object into a space or local area. Therefore, the process in developing a conceptual framework represents the more integrated and related applicable concept from the grounded theory. A design of integrated evaluation methodology for aquaculture lakes is presented. The method is based on the identification of a series of attributes which can be used to describe status of aquaculture lakes using certain indicators from aquaculture water quality index (AWQI), aesthetic aquaculture lake index (AALI) and rapid appraisal for fisheries index (RAPFISH). The preliminary preparation could be accomplished as follows: first, the characterization of study area was undertaken at different spatial scales. Second, an inventory data as a core resource such as city master plan, water quality reports from environmental agency, and related government regulations. Third, ground-checking survey should be completed to validate the on-site condition of study area. In order to design an integrated evaluation methodology for aquaculture lakes, finally we integrated and developed rating scores system which called Integrated Aquaculture Lake Index (IALI).The development of IALI are reflecting a compromise all aspects and it responds the needs of concise information about the current status of aquaculture lakes by the comprehensive approach. IALI was elaborated as a decision aid tool for stakeholders to evaluate the impact and contribution of anthropogenic activities on the aquaculture lake’s environment. The conclusion was while there is no denying the fact that the aquaculture lakes are under great threat from the pressure of the increasing human activities, one must realize that no evaluation methodology for aquaculture lakes can succeed by keeping the pristine condition. The IALI developed in this work can be used as an effective, low-cost evaluation methodology of aquaculture lakes for developing countries. Because IALI emphasizes the simplicity and understandability as it must communicate to decision makers and the experts. Moreover, stakeholders need to be helped to perceive their lakes so that sites can be accepted and valued by local people. For this site of lake development, accessibility and planning designation of the site is of decisive importance: the local people want to know whether the lake condition is safe or whether it can be used.

Keywords: aesthetic value, AHP, aquaculture lakes, integrated lakes, RAPFISH

Procedia PDF Downloads 202

Authors: Natan C. G. Silva, Carlos A. C. Girao Neto, Marcele M. S. Vasconcelos, Luciana R. B. Goncalves, Maria Valderez P. Rocha

Abstract:

Galactooligosaccharides (GOS) are sugars with prebiotic function that can be synthesized chemically or enzymatically, and this last one can be promoted by the action of β-galactosidases. In addition to favoring the transgalactosylation reaction to form GOS, these enzymes can also catalyze the hydrolysis of lactose. A highly studied type of GOS is lactulose because it presents therapeutic properties and is a health promoter. Among the different raw materials that can be used to produce lactulose, whey stands out as the main by-product of cheese manufacturing, and its discarded is harmful to the environment due to the residual lactose present. Therefore, its use is a promising alternative to solve this environmental problem. Thus, lactose from whey is hydrolyzed into glucose and galactose by β-galactosidases. However, in order to favor the transgalactosylation reaction, the medium must contain fructose, due this sugar reacts with galactose to produce lactulose. Then, the glucose-isomerase enzyme can be used for this purpose, since it promotes the isomerization of glucose into fructose. In this scenario, the aim of the present work was first to develop β-galactosidase biocatalysts of Kluyveromyces lactis and to apply it in the integrated reactions of hydrolysis, isomerization (with the glucose-isomerase from Streptomyces murinus) and transgalactosylation reaction, using whey as a substrate. The immobilization of β-galactosidase in chitosan previously functionalized with 0.8% glutaraldehyde was evaluated using different enzymatic loads (2, 5, 7, 10, and 12 mg/g). Subsequently, the hydrolysis and transgalactosylation reactions were studied and conducted at 50°C, 120 RPM for 20 minutes. In parallel, the isomerization of glucose into fructose was evaluated under conditions of 70°C, 750 RPM for 90 min. After, the integration of the three processes for the production of lactulose was investigated. Among the evaluated loads, 7 mg/g was chosen because the best activity of the derivative (44.3 U/g) was obtained, being this parameter determinant for the reaction stages. The other parameters of immobilization yield (87.58%) and recovered activity (46.47%) were also satisfactory compared to the other conditions. Regarding the integrated process, 94.96% of lactose was converted, achieving 37.56 g/L and 37.97 g/L of glucose and galactose, respectively. In the isomerization step, conversion of 38.40% of glucose was observed, obtaining a concentration of 12.47 g/L fructose. In the transgalactosylation reaction was produced 13.15 g/L lactulose after 5 min. However, in the integrated process, there was no formation of lactulose, but it was produced other GOS at the same time. The high galactose concentration in the medium probably favored the reaction of synthesis of these other GOS. Therefore, the integrated process proved feasible for possible production of prebiotics. In addition, this process can be economically viable due to the use of an industrial residue as a substrate, but it is necessary a more detailed investigation of the transgalactosilation reaction.

Keywords: beta-galactosidase, glucose-isomerase, galactooligosaccharides, lactulose, whey

Procedia PDF Downloads 106

Authors: Mohammad H. Yarmohammadian, Fatemeh Rezaei

Abstract:

Introduction: Improving patient safety in health systems is one of the main priorities in healthcare systems, so clinical risk management in organizations has become increasingly significant. Although several tools have been developed for clinical risk management, each has its own limitations. Aims: This study aims to develop a comprehensive tool that can complete the limitations of each risk assessment and management tools with the advantage of other tools. Methods: Procedure was determined in two main stages included development of an initial model during meetings with the professors and literature review, then implementation and verification of final model. Subjects and Methods: This study is a quantitative − qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment of the two parts of the fourth phase and seven phases of the research was conducted. Purposive and stratification sampling of various responsible teams for the selected process was conducted in the operating room. Final model verified in eight phases through application of activity breakdown structure, failure mode and effects analysis (FMEA), healthcare risk priority number (RPN), root cause analysis (RCA), FT, and Eindhoven Classification model (ECM) tools. This model has been conducted typically on patients admitted in a day-clinic ward of a public hospital for surgery in October 2012 to June. Statistical Analysis Used: Qualitative data analysis was done through content analysis and quantitative analysis done through checklist and edited RPN tables. Results: After verification the final model in eight-step, patient's admission process for surgery was developed by focus discussion group (FDG) members in five main phases. Then with adopted methodology of FMEA, 85 failure modes along with its causes, effects, and preventive capabilities was set in the tables. Developed tables to calculate RPN index contain three criteria for severity, two criteria for probability, and two criteria for preventability. Tree failure modes were above determined significant risk limitation (RPN > 250). After a 3-month period, patient's misidentification incidents were the most frequent reported events. Each RPN criterion of misidentification events compared and found that various RPN number for tree misidentification reported events could be determine against predicted score in previous phase. Identified root causes through fault tree categorized with ECM. Wrong side surgery event was selected by focus discussion group to purpose improvement action. The most important causes were lack of planning for number and priority of surgical procedures. After prioritization of the suggested interventions, computerized registration system in health information system (HIS) was adopted to prepare the action plan in the final phase. Conclusion: Complexity of health care industry requires risk managers to have a multifaceted vision. Therefore, applying only one of retrospective or prospective tools for risk management does not work and each organization must provide conditions for potential application of these methods in its organization. The results of this study showed that the integrated clinical risk management model can be used in hospitals as an efficient tool in order to improve clinical governance.

Keywords: failure modes and effective analysis, risk management, root cause analysis, model

Procedia PDF Downloads 215

Authors: Achim Kampker, Heiner Hans Heimes, Mathias Ordung, Jan-Philip Ganser

Abstract:

In the past years, the automotive industry has changed significantly. Innovative mobility concepts have become more important, and electric vehicles see a chance of replacing vehicles with combustion engines in the long term. However, the coming years will be characterized by coexistence. In this context, there are two possible production scenarios: One the one hand, electric vehicles could be manufactured in bespoke assembly lines. Concerning the uncertainty regarding sales figures development, this alternative boasts a high investment risk. Therefore, an integrated assembly building upon existing structures also seems a feasible solution. This empirical study aims at validating hypotheses concerning theoretical and practical challenges of the integrated production in the final assembly. In order to take a test of approaches of the research by analyzing censored feedback of professionals, these hypotheses are validated in the framework of an expert study. For this purpose, hypotheses have been generated on the basis of a requirements analysis and a concept specification. Thereupon, a list of question has been implemented and deduced from the hypotheses to execute an online- and written-survey and interviews with professionals. The interpretation and evaluation of the findings includes an inter-component comparison for the electric drivetrain. Furthermore, key drivers for a sufficient integrated product and process design are presented.

Keywords: automotive industry, final assembly, integrated manufacturing, product and process development

Procedia PDF Downloads 304

Authors: Gyoomi Kim, Jiyoung Bae

Abstract:

In the field of language education research, there are not many tries to empirically examine learners’ acceptance behavior and related factors of mobile-assisted language learning (MALL). This study is one of the few attempts to propose an integrated theoretical framework that explains MALL users’ acceptance behavior and potential factors. Constructs from technology acceptance model (TAM) and MALL research are tested in the integrated framework. Based on previous studies, a hypothetical model was developed. Four external variables related to the MALL user’s acceptance behavior were selected: subjective norm, content reliability, interactivity, self-regulation. The model was also composed of four other constructs: two latent variables, perceived ease of use and perceived usefulness, were considered as cognitive constructs; attitude toward MALL as an affective construct; behavioral intention to use MALL as a behavioral construct. The participants were 438 undergraduate students who enrolled in an intensive English program at one university in Korea. This particular program was held in January 2018 using the vacation period. The students were given eight hours of English classes each day from Monday to Friday for four weeks and asked to complete MALL courses for practice outside the classroom. Therefore, all participants experienced blended MALL environment. The instrument was a self-response questionnaire, and each construct was measured by five questions. Once the questionnaire was developed, it was distributed to the participants at the final ceremony of the intensive program in order to collect the data from a large number of the participants at a time. The data showed significant evidence to support the hypothetical model. The results confirmed through structural equation modeling analysis are as follows: First, four external variables such as subjective norm, content reliability, interactivity, and self-regulation significantly affected perceived ease of use. Second, subjective norm, content reliability, self-regulation, perceived ease of use significantly affected perceived usefulness. Third, perceived usefulness and perceived ease of use significantly affected attitude toward MALL. Fourth, attitude toward MALL and perceived usefulness significantly affected behavioral intention to use MALL. These results implied that the integrated framework from TAM and MALL could be useful when adopting MALL environment to university students or adult English learners. Key constructs except interactivity showed significant relationships with one another and had direct and indirect impacts on MALL user’s acceptance behavior. Therefore, the constructs and validated metrics is valuable for language researchers and educators who are interested in MALL.

Keywords: blended MALL, learner factors/variables, mobile-assisted language learning, MALL, technology acceptance model, TAM, theoretical framework

Procedia PDF Downloads 196

Authors: Chun-Chuan Yang, Jeng-Yueng Chen, Yi-Ting Mai, Chen-Ming Yang

Abstract:

In this paper, the design of integrated sleep scheduling for relay nodes and user equipments under a Donor eNB (DeNB) in the mode of Time Division Duplex (TDD) in LTE-A is presented. The idea of virtual time is proposed to deal with the discontinuous pattern of the available radio resource in TDD, and based on the estimation of the traffic load, three power saving schemes in the top-down strategy are presented. Associated mechanisms in each scheme including calculation of the virtual subframe capacity, the algorithm of integrated sleep scheduling, and the mapping mechanisms for the backhaul link and the access link are presented in the paper. Simulation study shows the advantage of the proposed schemes in energy saving over the standard DRX scheme.

Keywords: LTE-A, relay, TDD, power saving

Procedia PDF Downloads 479

Authors: Angen May T. Fabro

Abstract:

This study analyzed how the form and content in Adonis Durado’s select poems revealed universal realities for a proposed integrated teaching guide. The study employed discourse analysis that generates verbal interpretation of data to answer the variables under study in order to satisfy the main problem. This method used analyses and interpretations of discourse texts of the literary work under study. This research made use of studies and research investigations relevant to the present investigation. Findings of the study showed that form and content play a significant role in identifying the universal realities found in the select poems of Adonis Durado.

Keywords: poems, poesy, integrated teaching guide, Adonis Durado’s poesy

Procedia PDF Downloads 273

Authors: S. H. Iranmanesh, L. Aliabadi, A. Mollajan

Abstract:

Integrated resilience engineering (IRE) is capable of returning banking systems to the normal state in extensive economic circumstances. In this study, information system of a large bank (with several branches) is assessed and optimized under severe economic conditions. Data envelopment analysis (DEA) models are employed to achieve the objective of this study. Nine IRE factors are considered to be the outputs, and a dummy variable is defined as the input of the DEA models. A standard questionnaire is designed and distributed among executive managers to be considered as the decision-making units (DMUs). Reliability and validity of the questionnaire is examined based on Cronbach's alpha and t-test. The most appropriate DEA model is determined based on average efficiency and normality test. It is shown that the proposed integrated design provides higher efficiency than the conventional RE design. Results of sensitivity and perturbation analysis indicate that self-organization, fault tolerance, and reporting culture respectively compose about 50 percent of total weight.

Keywords: banking system, Data Envelopment Analysis (DEA), Integrated Resilience Engineering (IRE), performance evaluation, perturbation analysis

Procedia PDF Downloads 138

Authors: Geraldine O’Neill

Abstract:

Work-integrated learning is a valuable learning experience for students in higher education. However, the fairness of the assessment process has been identified as a challenge. This study explored solutions to this challenge through interviews with expert authors in the field and workshops across nine different disciplines in Ireland. In keeping with the use of a participatory and action research methodology, the key stakeholders in the process, the students, educators, and practitioners, identified some solutions. The solutions included the need to: clarify the assessments’ expectations; enhance the flexibility of the competencies, reduce the number of competencies; use grading scales with lower specificity; support practitioner training, and empower students in the assessment process. The results are discussed as they relate to interactional, procedural, and distributive fairness.

Keywords: competencies, fairness, grading scales, work-integrated learning

Procedia PDF Downloads 92

Authors: F. Gallop, C. Ward, M. Zaky, M. Vaghela, R. Sabaratnam

Abstract:

Nitrous oxide (N₂O) has been used in anaesthesia for over 150 years owing to advantageous physical and pharmacological properties. However, with a global warming potential of 310, we have an urgent responsibility to reduce its usage and emission. Anecdotal evidence in our hospital trust suggests minimal N₂O usage, yet our theatres receive a staggering supply. This warranted further investigation. We used a data collection tool to prospectively capture quantitative and qualitative data regarding N₂O cases during one week: this recorded demographics, N₂O indications, clinical management, and total N₂O consumption in litres. In addition, N₂O usage in dental sedation suites and paediatric theatres was separately quantified. Pipeline supply data was acquired from British Oxygen Company accounts. We captured 490 cases. 4% (n=19) used N₂O, 63% (n=12) of these in dental theatres. Common N₂0 indications were induction speed (37%) and rapidly increasing anaesthesia depth (32%). In adult cases, N₂O was always used intraoperatively rather than solely at induction. 74% (n=14) of anaesthetists reported environmental concern over using N₂O. The week’s total N₂O usage was 8109 litres, amounting to 421,668 litres annually. However, the annual N₂O pipeline supply is 2,997,000 litres; an enormous 1.8 million Kg of CO₂. Our results supportively demonstrate that the N₂O pipeline supply greatly exceeds its clinical use. Acknowledging clinical areas not audited, the discrepancy between supply and usage suggests approximately 2.5 million litres of yearly wastage. We consequently recommend terminating the N₂O pipeline supply in minimally used areas, eliminating 1.5 million Kg of CO₂ emissions. High usage clinical areas could consider portable N₂O cylinders as an alternative. In Sweden, N₂O destruction technology is routinely used to minimise CO₂ emissions. Our results support National Health System investment in similar infrastructure.

Keywords: anaesthesia, environment, medical gases, nitrous oxide, sustainability

Procedia PDF Downloads 102

Authors: Hossein Ghaedamini, Salman Farahbakhsh, Alireza Amirbeigi, Zahra Saghafi, Salman Daneshi, Alireza Ghaedamini

Abstract:

Background: Assessing the challenges of clinical education of medical students is one of the most important and sensitive parts of medical education. The aim of this study was to investigate the views and experiences of Kerman medical students on the factors that facilitate and inhibit the quality of clinical education. Materials and Methods: This research was qualitative and used a phenomenological approach. The study population included medical interns of Kerman University of Medical Sciences in 1400. The method of data collection was in-depth interviews with participants. Data were encoded and analyzed by Claizey stepwise model. Results: First, about 540 primary codes were extracted in the form of two main themes (facilitators and inhibitors) and 10 sub-themes including providing motivational models and creating interest in interns, high scientific level of professors and the appropriate quality of their teaching, the use of technology in the clinical education process, delegating authority and freedom of action and more responsibilities to interns, inappropriate treatment of some officials, professors, assistants and department staff with their interns, inadequate educational programming, lack of necessary cooperation and providing inappropriate treatment by clinical training experts for interns, inadequate evaluation method in clinical training for interns, poor quality mornings, the unefficiency of grand rounds, the inappropriate way of evaluating clinical training for interns, the lack of suitable facilities and conditions with the position of a medical intern, and the hardwork of some departments were categorized. Conclusion: Clinical education is always mixed with special principles and subtleties, and special attention to facilitators and inhibitors in this process has an important role in improving its quality.

Keywords: clinical education, medical students, qualitative study, education

Procedia PDF Downloads 38

Authors: Lu-Chiu Huang, Pei-Pei Chen, Li-Chin Yu, Chiao-Wen Kuo, Tsui-Tao Liu, Rung-Chuang Feng

Abstract:

Purpose: People put increasing emphasis on demands of medical quality and protecting their interests. Patients' or family's dissatisfaction with medical care may easily lead to medical dispute. Physician-family communication plays an essential role in medical care. A sound communication cannot only strengthen patients' belief in the medical team but make patient have definite insight into treatment course of the disease. A family meeting provides an effective platform for communication between clinical staff, patients and family. Decisions and consensuses formed in family meetings can promote patients' or family's satisfaction with medical care. Clinical staff's attitudes toward family meeting may determine behavioral intentions to hold family meeting. This study aims to explore clinical staff's difficulties in holding family meeting and evaluate how their attitudes and behavior influence the effect of family meetings. Methods: This was a cross-sectional study. It was conducted at a regional teaching hospital in Taipei city. The research team developed its own structural questionnaires, whose expert validity was checked by the nursing experts. Participants filled in the questionnaires online. Data were collected by convenience sampling. A total of 568 participants were invited. They included doctors, nurses, social workers, and so on. Results: 1) The average score of ‘clinical staff’s attitudes to family meetings’ was 5.15 (SD=0.898). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It indicated that clinical staff had positive attitudes toward family meetings, 2) The average score of ‘clinical staff’s behavior to family meetings’ was 5.61 (SD=0.937). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It meant clinical staff tended to have positive behavior at the family meeting, and 3) The average score of ‘Difficulty in conducting family meetings’ was 5.15 (SD=0.897). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. The higher the score was, the less difficulty the clinical staff felt. It demonstrated clinical staff felt less difficulty in conducting family meetings. Clinical staff's identification with family meetings brought favored effects. Persistent and active promotion for family meetings can bring patients and family more benefits. Implications for practice: Understanding clinical staff's difficulty in participating family meeting and exploring their attitudes or behavior toward physician-family communication are helpful to develop modes of interaction. Consequently, quality and satisfaction of physician-family communication can be increased.

Keywords: clinical staff, communication, family meeting, physician-family

Procedia PDF Downloads 302

Authors: Phawida Wattanasoonthorn

Abstract:

Ventilator-associated pneumonia is a serious infection found to be among the top three infections in the hospital. To investigate the effects of clinical practice guideline on knowledge and preventive practices of nursing personnel, and incidences of ventilator-associated pneumonia. A pre-post quasi-experimental study on 17 professional nurses, and 123 ventilator-associated pneumonia patients admitted to the surgical intensive care unit, and the accident and surgical ward of Songkhla Hospital from October 2013 to January 2014. The study found that after using the clinical practice guideline, the subjects’ median score increased from 16.00 to 19.00. The increase in practicing correctly was from 66.01 percent to 79.03 percent with the statistical significance level of .05, and the incidences of ventilator-associated pneumonia decreased by 5.00 percent. The results of this study revealed that the use of the clinical practice guideline helped increase knowledge and practice skill of nursing personnel, and decrease incidences of ventilator-associated pneumonia. Thus, nursing personnel should be encouraged, reminded and promoted to continue using the practice guideline through various means including training, providing knowledge, giving feedback, and putting up posters to remind them of practicing correctly and sustainably.

Keywords: Clinical Practice Guideline, knowledge, Preventive Ventilator, Pneumonia

Procedia PDF Downloads 367

Authors: Haftu Hailu Berhe, Hailekiros Sibhato Gebremichael, Kinfe Tsegay Beyene, Haileselassie Mehari

Abstract:

The purpose of the study is to develop and validate integrated literature-based JIT, TQM, TPM, SCM and LSS framework through a combination of the PDCA cycle and DMAIC methodology. The study adopted a mixed research approach. Accordingly, the qualitative study employed to develop the framework is based on identifying the uniqueness and common practices of JIT, TQM, TPM, SCM and LSS initiatives, the existing practice of the integration, identifying the existing gaps in the framework and practices, developing new integrated JIT, TQM, TPM, SCM and LSS practice framework. Previous very few studies of the uniqueness and common practices of the five initiatives are preserved. Whereas the quantitative study working to validate the framework is based on empirical analysis of the self-administered questionnaire using a statistical package for social science. A combination of the PDCA cycle and DMAIC methodology stand integrated CI framework is developed. The proposed framework is constructed as a project-based framework with five detailed implementation phases. Besides, the empirical analysis demonstrated that the proposed framework is valuable if adopted and implemented correctly. So far, there is no study proposed & validated the integrated CI framework within the scope of the study. Therefore, this is the earliest study that proposed and validated the framework for manufacturing industries. The proposed framework is applicable to manufacturing industries and can assist in achieving competitive advantages when the manufacturing industries, institutions and government offer unconditional efforts in implementing the full contents of the framework.

Keywords: integrated continuous improvement framework, just in time, total quality management, total productive maintenance, supply chain management, lean six sigma

Procedia PDF Downloads 83

Authors: Roghieh Eskandari, Ali Motamedi

Abstract:

There is a significant demand for renovation as-built assets are aging. To plan for a desirable and comfortable indoor environment, stakeholders use simulation technics to assess potential renovation scenarios with the innovative designs. Diminished Reality (DR), which is a technique of visually removing unwanted objects from the real-world scene in real-time, can contribute to the renovation design visualization for stakeholders by removing existing structures and assets from the scene. Using DR, the objects to be demolished or changed will be visually removed from the scene for a better understanding of the intended design scenarios for stakeholders. This research proposes an integrated system for renovation plan visualization using Building Information Modelling (BIM) data and mixed reality (MR) technologies. It presents a BIM-based DR method that utilizes a textured BIM model of the environment to accurately register the virtual model of the occluded background to the physical world in real-time. This system can facilitate the simulation of the renovation plan by visually diminishing building elements in an indoor environment.

Keywords: diminished reality, building information modelling, mixed reality, stock renovation

Procedia PDF Downloads 76

Authors: Chang Liu, Hanwen Zhang, Vikash Sharma, Don Eliseo Lucerno-Prisno III, Emmanuel Yujuico, Maulik Chokshi, Prashanthi Krishnakumar, Bach Xuan Tran, Giang Thu Vu, Kamilla Anna Pinter, Shenglan Tang

Abstract:

Background and Aims: Globally, many health systems focus on hospital-based healthcare models targeting acute care and disease treatment, which are not effective in addressing the challenges of ageing populations, chronic conditions, multi-morbidities, and increasingly unhealthy lifestyles. Recently, integrated care programs on chronic diseases have been developed, piloted, and implemented to meet such challenges. However, integrated care programs in the Asia-Pacific region vary in the levels of integration from linkage to coordination to full integration. This study aims to identify and analyze existing cases of integrated care in the Asia-Pacific region and identify the facilitators and barriers in order to improve existing cases and inform future cases. Methods: The study is a comparative study, with a combination approach of desk-based research and key informant interviews. The selected countries included in this study represent a good mix of lower-middle income countries (the Philippines, India, Vietnam, and Fiji), upper-middle income country (China), and high-income country (Singapore) in the Asia-Pacific region. Existing integrated care programs were identified through the scoping review approach. Trigger, history, general design, beneficiaries, and objectors were summarized with barriers and facilitators of integrated care based on key informant interviews. Representative case(s) in each country were selected and comprehensively analyzed through deep-dive case studies. Results: A total of 87 existing integrated care programs on chronic diseases were found in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines, and 1 in Fiji. 9 representative cases of integrated care were selected for in-depth description and analysis, with 2 in China, the Philippines, and Vietnam, and 1 in Singapore, India, and Fiji. Population aging and the rising chronic disease burden have been identified as key drivers for almost all the six countries. Among the six countries, Singapore has the longest history of integrated care, followed by Fiji, the Philippines, and China, while India and Vietnam have a shorter history of integrated care. Incentives, technologies, education, and performance evaluation would be crucial for developing strategies for implementing future programs and improve already existing programs. Conclusion: Integrated care is important for addressing challenges surrounding the delivery of long-term care. To date, there is an increasing trend of integrated care programs on chronic diseases in the Asia-Pacific region, and all six countries in our study set integrated care as a direction for their health systems transformation.

Keywords: integrated healthcare, integrated care delivery, chronic diseases, Asia-Pacific region

Procedia PDF Downloads 96

Authors: Alimohammad

Abstract:

Man's entry into space is one of the most important results of developments and advances made in information technology. But this human step, like many of his other actions, is not free of danger, as space pollution today has become a major problem for the global community. Paying attention to the issue of preserving the space environment is in the interest of all governments and mankind, and ignoring it can increase the possibility of conflict between countries. What many space powers still do not pay attention to is the freedom to explore and exploit space should be limited by banning pollution of the space environment. Therefore, freedom and prohibition are complementary and should not be considered conflicting concepts. The legal system created by the current space treaties for the effective preservation of the space environment has failed. Customary international law also does not have an effective provision and guarantee of sufficient executions in order to prevent damage to the environment. Considering the responsibility of each generation in the healthy transfer of the environment to the next generation and considering the sustainable development concept, the space environment must also be passed on to future generations in a healthy and undamaged manner. As a result, many environmental policies related to Earth should also be applied to the space environment..

Keywords: law, space, environment, responsibility

Procedia PDF Downloads 48

Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

Abstract:

Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

Procedia PDF Downloads 116

Authors: Getachew Belay Kassahun

Abstract:

Background: Locally established clinical laboratory reference intervals (RIs) are required to interpret laboratory test results for screening, diagnosis, and prognosis. The objective of this study was to establish a reference interval of clinical chemistry parameters among apparently healthy adolescents aged between 12 and 17 years in Mekelle, Tigrai, in the northern part of Ethiopia. Methods: Community-based cross-sectional study was employed from December 2018 to March 2019 in Mekelle City among 172 males and 172 females based on a Multi-stage sampling technique. Blood samples were tested for Fasting blood sugar (FBS), alanine amino transferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), Creatinine, urea, total protein, albumin (ALB), direct and indirect bilirubin (BIL.D and BIL.T) using 25 Bio system clinical chemistry analyzer. Results were analyzed using SPSS version 23 software and based on the Clinical Laboratory Standard Institute (CLSI)/ International Federation of Clinical Chemistry (IFCC) C 28-A3 Guideline which defines the reference interval as the 95% central range of 2.5th and 97.5th percentiles. Mann Whitney U test, descriptive statistics and box and whisker were statistical tools used for analysis. Results: This study observed statistically significant differences between males and females in ALP, ALT, AST, Urea and Creatinine Reference intervals. The established reference intervals for males and females, respectively, were: ALP (U/L) 79.48-492.12 versus 63.56-253.34, ALT (U/L) 4.54-23.69 versus 5.1-20.03, AST 15.7- 39.1 versus 13.3- 28.5, Urea (mg/dL) 9.33-24.99 versus 7.43-23.11, and Creatinine (mg/dL) 0.393-0.957 versus 0.301-0.846. The combined RIs for Total Protein (g/dL) were 6.08-7.85, ALB (g/dL) 4.42-5.46, FBS(mg/dL) 65-110, BIL.D (mg/dL) 0.033-0.532, and BIL.T (mg/dL) 0.106-0.812. Conclusions: The result showed a marked difference between sex and company-derived values for selected clinical chemistry parameters. Thus, the use of age and sex-specific locally established reference intervals for clinical chemistry parameters is recommended.

Keywords: reference interval, adolescent, clinical chemistry, Ethiopia

Procedia PDF Downloads 42