Search results for: interval-valued hesitant fuzzy setting
Commenced in January 2007
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Edition: International
Paper Count: 2517

Search results for: interval-valued hesitant fuzzy setting

657 Report of a Realistic Simulation Training in Using Bougie Guide for Endotracheal Intubation

Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Dóris F. Rabelo

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Some patients with COVID-19 disease and difficult airway characteristics undergo to endotracheal intubation (ETI) procedure. The tracheal introducer, known as the bougie guide, can aid ETI in patients with difficult airway pattern. Realistic simulation (RS) is a methodology utilized for healthcare professionals training. To improve skills in using the bougie guide of physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was carried out. Simulated scenario included the Nasco Lifeform realistic simulator for ETI and a bougie guide introducer. Training was a capacitation program organized by the Health Department of Bahia State. Objective: To report effects in participants´ self-confidence perception for using bougie guide after a RS based training. Methods: Descriptive study, secondary data extracted from questionnaires. Priority workplace and previous knowledge about bougie were reported on a preparticipation formulary. Participants also completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding to self-confidence in using bougie guide. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's exact test. Results: From May to June 2020 a total of 36 physicians participated of training, 25 (69%) from primary care setting, 32 (89%) with no previous knowledge about the bougie guide utilization. For those who had previous knowledge about bougie pre-training self-confidence median was 6,5, and 2 for participants who had not. In overall there was an increase in self-confidence median for bougie utilization. Median (variation) before and after training was 2.5 (1-7) vs. 8 (4-10) (p <0.0001). Among those who had no previous knowledge about bougie (n = 32) an increase in self-confidence greater than 3 points for bougie utilization was reported by 31 vs. 1 participants (p = 0.71). Conclusions: Most of participants had no previous knowledge about using the bougie guide. RS training contributed to self-confidence increase for using bougie for ETI procedure. RS methodology can contribute for training in using the bougie guide for ETI procedure during COVID-19 outbreak.

Keywords: bougie, confidence, COVID-19, endotracheal intubation, realistic simulation

Procedia PDF Downloads 110
656 Nutrition and Physical Activity Intervention on Health Screening Outcomes for Singaporean Employees: A Worksite Based Randomised Controlled Trial

Authors: Elaine Wong

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This research protocol aims to explore and justify the need for nutrition and physical activity intervention to improve health outcomes among SME (Small Medium Enterprise) employees. It was found that the worksite is an ideal and convenient setting for employees to take charge of their health thru active participation in health programmes since they spent a great deal of time at their workplace. This study will examine the impact of both general or/and targeted health interventions in both SME and non-SME companies utilizing the Workplace Health Promotion (WHP) grant over a 12 months period and assessed the improvement in chronic health disease outcomes in Singapore. Random sampling of both non-SME and SME companies will be conducted to undergo health intervention and statistical packages such as Statistical Package for Social Science (SPSS) 25 will be used to examine the impact of both general and targeted interventions on employees who participate and those who do not participate in the intervention and their effects on blood glucose (BG), blood lipid, blood pressure (BP), body mass index (BMI), and body fat percentage. Using focus groups and interviews, the data results will be transcribed to investigate enablers and barriers to workplace health intervention revealed by employees and WHP coordinators that could explain the variation in the health screening results across the organisations. Dietary habits and physical activity levels of the employees participating and not participating in the intervention will be collected before and after intervention to assess any changes in their lifestyle practices. It makes economic sense to study the impact of these interventions on health screening outcomes across various organizations that are existing grant recipients to justify the sustainability of these programmes by the local government. Healthcare policy makers and employers can then tailor appropriate and relevant programmes to manage these escalating chronic health disease conditions which is integral to the competitiveness and productivity of the nation’s workforce.

Keywords: chronic diseases, health screening, nutrition and fitness intervention , workplace health

Procedia PDF Downloads 126
655 Liquefaction Potential Assessment Using Screw Driving Testing and Microtremor Data: A Case Study in the Philippines

Authors: Arturo Daag

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The Philippine Institute of Volcanology and Seismology (PHIVOLCS) is enhancing its liquefaction hazard map towards a detailed probabilistic approach using SDS and geophysical data. Target sites for liquefaction assessment are public schools in Metro Manila. Since target sites are in highly urbanized-setting, the objective of the project is to conduct both non-destructive geotechnical studies using Screw Driving Testing (SDFS) combined with geophysical data such as refraction microtremor array (ReMi), 3 component microtremor Horizontal to Vertical Spectral Ratio (HVSR), and ground penetrating RADAR (GPR). Initial test data was conducted in liquefaction impacted areas from the Mw 6.1 earthquake in Central Luzon last April 22, 2019 Province of Pampanga. Numerous accounts of liquefaction events were documented areas underlain by quaternary alluvium and mostly covered by recent lahar deposits. SDS estimated values showed a good correlation to actual SPT values obtained from available borehole data. Thus, confirming that SDS can be an alternative tool for liquefaction assessment and more efficient in terms of cost and time compared to SPT and CPT. Conducting borehole may limit its access in highly urbanized areas. In order to extend or extrapolate the SPT borehole data, non-destructive geophysical equipment was used. A 3-component microtremor obtains a subsurface velocity model in 1-D seismic shear wave velocity of the upper 30 meters of the profile (Vs30). For the ReMi, 12 geophone array with 6 to 8-meter spacing surveys were conducted. Microtremor data were computed through the Factor of Safety, which is the quotient of Cyclic Resistance Ratio (CRR) and Cyclic Stress Ratio (CSR). Complementary GPR was used to study the subsurface structure and used to inferred subsurface structures and groundwater conditions.

Keywords: screw drive testing, microtremor, ground penetrating RADAR, liquefaction

Procedia PDF Downloads 169
654 Study on Optimization of Air Infiltration at Entrance of a Commercial Complex in Zhejiang Province

Authors: Yujie Zhao, Jiantao Weng

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In the past decade, with the rapid development of China's economy, the purchasing power and physical demand of residents have been improved, which results in the vast emergence of public buildings like large shopping malls. However, the architects usually focus on the internal functions and streamlines of these buildings, ignoring the impact of the environment on the subjective feelings of building users. Only in Zhejiang province, the infiltration of cold air in winter frequently occurs at the entrance of sizeable commercial complex buildings that have been in operation, which will affect the environmental comfort of the building lobby and internal public spaces. At present, to reduce these adverse effects, it is usually adopted to add active equipment, such as setting air curtains to block air exchange or adding heating air conditioners. From the perspective of energy consumption, the infiltration of cold air into the entrance will increase the heat consumption of indoor heating equipment, which will indirectly cause considerable economic losses during the whole winter heating stage. Therefore, it is of considerable significance to explore the suitable entrance forms for improving the environmental comfort of commercial buildings and saving energy. In this paper, a commercial complex with apparent cold air infiltration problem in Hangzhou is selected as the research object to establish a model. The environmental parameters of the building entrance, including temperature, wind speed, and infiltration air volume, are obtained by Computational Fluid Dynamics (CFD) simulation, from which the heat consumption caused by the natural air infiltration in the winter and its potential economic loss is estimated as the objective metric. This study finally obtains the optimization direction of the building entrance form of the commercial complex by comparing the simulation results of other local commercial complex projects with different entrance forms. The conclusions will guide the entrance design of the same type of commercial complex in this area.

Keywords: air infiltration, commercial complex, heat consumption, CFD simulation

Procedia PDF Downloads 107
653 A Comparative, Epidemiological Study of Acute Renal Colic Presentations to Major Academic Emergency Departments in Doha, Qatar and Melbourne, Australia

Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron

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Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.

Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology

Procedia PDF Downloads 204
652 Feedback of an Automated Hospital about the Performance of an Automated Drug Dispensing System’s Implementation

Authors: Bouami Hind, Millot Patrick

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The implementation of automated devices in life-critical systems such as hospitals can bring a new set of challenges related to automation malfunctions. While automation has been identified as great leverage for the medication dispensing system’s security and efficiency, it also increases the complexity of the organization. In particular, the installation and operation stage of automated devices can be complex when malfunctions related to automated systems occur. This paper aims to document operators’ situation awareness about the malfunctions of automated drug delivery systems (ADCs) during their implementation through Saint Brieuc hospital’s feedback. Our evaluation approach has been deployed in Saint Brieuc hospital center’s pharmacy, which has been equipped with automated nominative drug dispensing systems since January of 2021. The analysis of Saint Brieuc hospital center pharmacy’s automation revealed numerous malfunctions related to the implementation of Automated Delivery Cabinets. It appears that the targeted performance is not reached in the first year of implementation in this case study. Also, errors have been collected in patients' automated treatments’ production such as lack of drugs in pill boxes or nominative carnets, excess of drugs, wrong location of the drug, drug blister damaged, non-compliant sachet, or ticket errors. Saint Brieuc hospital center’s pharmacy is doing a tremendous job of setting up and monitoring performance indicators from the beginning of automation and throughout ADC’s operation to control ADC’s malfunctions and meet the performance targeted by the hospital. Health professionals, including pharmacists, biomedical engineers and directors of work, technical services and safety, are heavily involved in an automation project. This study highlights the importance of the evaluation of ADCs’ performance throughout the implementation process and the hospital’s team involvement in automation supervision and management.

Keywords: life-critical systems, situation awareness, automated delivery cabinets, implementation, risks and malfunctions

Procedia PDF Downloads 73
651 Exploring Help Seeking Attitude among Muslim Students in a School with a Dual Education System in Brunei Darussalam

Authors: Aziz Zulazmi Samsudin, Siti Norhedayah Abdul Latif

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The lack of normalization of mental health as a conversational topic is becoming increasingly evident in certain cultures. The fact that students underutilize mental health services in schools can be attributed to the presence of various barriers that impede their willingness to seek for help. Stigma surrounding mental health services continue to be the most prevalent barrier for help seeking behavior. Alternative barriers have emerged that are both personal and public in nature that can have a substantial impact on students’ preference to seek for help in schools. A sequential explanatory study was carried out among 256 Muslim students in a school with dual education system in exploring both their Self-Stigma of Seeking Help (SSOSH) and Mental Health Help-Seeking Attitude (MHSA). In addition, 12 students were interviewed in a focus group setting to explore further the phenomena of help seeking approach by students to understand the initial quantitative analysis. Preliminary findings indicated that the students’ level of self-stigma was only moderate, but they had a favorable attitude towards counselling help. There was no significant difference on gender for both variables; however, the lower the self-stigma, the higher the mental help-seeking attitude for this current study, which is a common trend of relationship between the two variables. The interview revealed that, apart from public stigma, the absence of a qualified counsellor, a lack of ethical principles of counselling, a confidentiality issue, and the emotional openness of the students were identified as other barriers to their help-seeking attitudes. This paper also discussed the recommendation made by students in addressing barriers to counselling and facilitating their counselling needs for the improvement of students' mental and academic well-being. Additionally, this research offers the most recent data about mental health in the context of schools with a dual education system in Brunei Darussalam. It is hoped to serve as a guide for policy makers to consider the provision of mental health services that is more appealing to the students’ mental and academic well-being.

Keywords: mental health help-seeking attitude (MHSA), public stigma, school counselling, self-stigma, self-stigma of seeking help (SSOSH), well-being.

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650 Integration of Educational Data Mining Models to a Web-Based Support System for Predicting High School Student Performance

Authors: Sokkhey Phauk, Takeo Okazaki

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The challenging task in educational institutions is to maximize the high performance of students and minimize the failure rate of poor-performing students. An effective method to leverage this task is to know student learning patterns with highly influencing factors and get an early prediction of student learning outcomes at the timely stage for setting up policies for improvement. Educational data mining (EDM) is an emerging disciplinary field of data mining, statistics, and machine learning concerned with extracting useful knowledge and information for the sake of improvement and development in the education environment. The study is of this work is to propose techniques in EDM and integrate it into a web-based system for predicting poor-performing students. A comparative study of prediction models is conducted. Subsequently, high performing models are developed to get higher performance. The hybrid random forest (Hybrid RF) produces the most successful classification. For the context of intervention and improving the learning outcomes, a feature selection method MICHI, which is the combination of mutual information (MI) and chi-square (CHI) algorithms based on the ranked feature scores, is introduced to select a dominant feature set that improves the performance of prediction and uses the obtained dominant set as information for intervention. By using the proposed techniques of EDM, an academic performance prediction system (APPS) is subsequently developed for educational stockholders to get an early prediction of student learning outcomes for timely intervention. Experimental outcomes and evaluation surveys report the effectiveness and usefulness of the developed system. The system is used to help educational stakeholders and related individuals for intervening and improving student performance.

Keywords: academic performance prediction system, educational data mining, dominant factors, feature selection method, prediction model, student performance

Procedia PDF Downloads 85
649 Outcomes of Pain Management for Patients in Srinagarind Hospital: Acute Pain Indicator

Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

Procedia PDF Downloads 201
648 3d Property Modelling of the Lower Acacus Reservoir, Ghadames Basin, Libya

Authors: Aimen Saleh

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The Silurian Lower Acacus sandstone is one of the main reservoirs in North West Libya. Our aim in this study is to grasp a robust understanding of the hydrocarbon potential and distribution in the area. To date, the depositional environment of the Lower Acacus reservoir still open to discussion and contradiction. Henceforth, building three dimensional (3D) property modelling is one way to support the analysis and description of the reservoir, its properties and characterizations, so this will be of great value in this project. The 3D model integrates different data set, these incorporates well logs data, petrophysical reservoir properties and seismic data as well. The finalized depositional environment model of the Lower Acacus concludes that the area is located in a deltaic transitional depositional setting, which ranges from a wave dominated delta into tide dominated delta type. This interpretation carried out through a series of steps of model generation, core description and Formation Microresistivity Image tool (FMI) interpretation. After the analysis of the core data, the Lower Acacus layers shows a strong effect of tidal energy. Whereas these traces found imprinted in different types of sedimentary structures, for examples; presence of some crossbedding, such as herringbones structures, wavy and flaser cross beddings. In spite of recognition of some minor marine transgression events in the area, on the contrary, the coarsening upward cycles of sand and shale layers in the Lower Acacus demonstrate presence of a major regressive phase of the sea level. However, consequently, we produced a final package of this model in a complemented set of facies distribution, porosity and oil presence. And also it shows the record of the petroleum system, and the procedure of Hydrocarbon migration and accumulation. Finally, this model suggests that the area can be outlined into three main segments of hydrocarbon potential, which can be a textbook guide for future exploration and production strategies in the area.

Keywords: Acacus, Ghadames , Libya, Silurian

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647 Promoting Students' Worldview Through Integrative Education in the Process of Teaching Biology in Grades 11 and 12 of High School

Authors: Saule Shazhanbayeva, Denise van der Merwe

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Study hypothesis: Nazarbayev Intellectual School of Kyzylorda’s Biology teachers can use STEM-integrated learning to improve students' problem-solving ability and responsibility as global citizens. The significance of this study is to indicate how the use of STEM integrative learning during Biology lessons could contribute to forming globally-minded students who are responsible community members. For the purposes of this study, worldview is defined as a view that is broader than the country of Kazakhstan, allowing students to see the significance of their scientific contributions to the world as global citizens. The context of worldview specifically indicates that most students have never traveled outside of their city or region within Kazakhstan. In order to broaden student understanding, it is imperative that students are exposed to different world views and contrasting ideas within the educational setting of Biology as the science being used for the research. This exposure promulgates students understanding of the significance they have as global citizens alongside the obligations which would rest on them as scientifically minded global citizens. Integrative learning should be Biological Science - with Technology and engineering in the form of problem-solving, and Mathematics to allow improved problem-solving skills to develop within the students of Nazarbayev Intellectual School (NIS) of Kyzylorda. The school's vision is to allow students to realise their role as global citizens and become responsible community members. STEM allows integrations by combining four subject skills to solve topical problems designed by educators. The methods used are based on qualitative analysis: for students’ performance during a problem-solution scenario; and Biology teacher interviews to ascertain their understanding of STEM implementation and willingness to integrate it into current lessons. The research indicated that NIS is ready for a shift into STEM lessons to promote globally responsible students. The only additional need is for proper STEM integrative lesson method training for teachers.

Keywords: global citizen, STEM, Biology, high-school

Procedia PDF Downloads 36
646 A Retrospective Analysis of the Impact of the Choosing Wisely Canada Campaign on Emergency Department Imaging Utilization for Head Injuries

Authors: Sameer Masood, Lucas Chartier

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Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.

Keywords: choosing wisely, emergency department, head injury, quality improvement

Procedia PDF Downloads 198
645 Developing a Self-Healing Concrete Filler Using Poly(Methyl Methacrylate) Based Two-Part Adhesive

Authors: Shima Taheri, Simon Clark

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Concrete is an essential building material used in the majority of structures. Degradation of concrete over time increases the life-cycle cost of an asset with an estimated annual cost of billions of dollars to national economies. Most of the concrete failure occurs due to cracks, which propagate through a structure and cause weakening leading to failure. Stopping crack propagation is thus the key to protecting concrete structures from failure and is the best way to prevent inconveniences and catastrophes. Furthermore, the majority of cracks occur deep within the concrete in inaccessible areas and are invisible to normal inspection. Few materials intrinsically possess self-healing ability, but one that does is concrete. However, self-healing in concrete is limited to small dormant cracks in a moist environment and is difficult to control. In this project, we developed a method for self-healing of nascent fractures in concrete components through the automatic release of self-curing healing agents encapsulated in breakable nano- and micro-structures. The Poly(methyl methacrylate) (PMMA) based two-part adhesive is encapsulated in core-shell structures with brittle/weak inert shell, synthesized via miniemulsion/solvent evaporation polymerization. Stress fields associated with propagating cracks can break these capsules releasing the healing agents at the point where they are needed. The shell thickness is playing an important role in preserving the content until the final setting of concrete. The capsules can also be surface functionalized with carboxyl groups to overcome the homogenous mixing issues. Currently, this formulated self-healing system can replace up to 1% of cement in a concrete formulation. Increasing this amount to 5-7% in the concrete formulation without compromising compression strength and shrinkage properties, is still under investigation. This self-healing system will not only increase the durability of structures by stopping crack propagation but also allow the use of less cement in concrete construction, thereby adding to the global effort for CO2 emission reduction.

Keywords: self-healing concrete, concrete crack, concrete deterioration, durability

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644 Non-Conformance Clearance through an Intensified Mentorship towards ISO 15189 Accreditation: The Case of Jimma and Hawassa Hospital Microbiology Laboratories, Ethiopia

Authors: Dawit Assefa, Kassaye Tekie, Gebrie Alebachew, Degefu Beyene, Bikila Alemu, Naji Mohammed, Asnakech Agegnehu, Seble Tsehay, Geremew Tasew

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Background: Implementation of a Laboratory Quality Management System (LQMS) is critical to ensure accurate, reliable, and efficient laboratory testing of antimicrobial resistance (AMR). However, limited LQMS implementation and progress toward accreditation in the AMR surveillance laboratory testing setting exist in Ethiopia. By addressing non-conformances (NCs) and working towards accreditation, microbiology laboratories can improve the quality of their services, increase staff competence, and contribute to mitigate the spread of AMR. Methods: Using standard ISO 15189 horizontal and vertical assessment checklists, certified assessors identified NCs at Hawassa and Jimma Hospital microbiology laboratories. The Ethiopian Public Health Institute AMR mentors and IDDS staff prioritized closing the NCs through the implementation of an intensified mentorship program that included ISO 15189 orientation training, resource allocation, and action plan development. Results: For the two facilities to clear their NCs, an intensified mentorship approach was adopted by providing ISO 15189 orientation training, provision of buffer reagents, controls, standards, and axillary equipment, and facilitating equipment maintenance and calibration. Method verification and competency assessment were also conducted along with the implementation of standard operating procedures and recommended corrective actions. This approach enhanced the laboratory's readiness for accreditation. After addressing their NCs, the two laboratories applied to Ethiopian Accreditation Services for ISO 15189 accreditation. Conclusions: Clearing NCs through the implementation of intensified mentorship was crucial in preparing the two laboratories for accreditation and improving quality laboratory test results. This approach can guide other microbiology laboratories’ accreditation attainment efforts.

Keywords: non-conformance clearance, intensified mentorship, accreditation, ISO 15189

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643 Beliefs about the Use of Extemporaneous Compounding for Paediatric Outpatients among Physicians in Yogyakarta, Indonesia

Authors: Chairun Wiedyaningsih, Sri Suryawati, Yati Soenarto, Muhammad Hakimi

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Background: Many drugs used in paediatrics are not commercially available in suitable dosage forms. Therefore, the drugs often prescribed in extemporaneous compounding dosage form. Compounding can pose health risks include poor quality and unsafe products. Studies of compounding dosage form have primarily focused on prescription profiles, reasons of prescribing never be explored. Objectives: The study was conducted to identify factors influencing physicians’ decision to prescribe extemporaneous compounding dosage form for paediatric outpatients. Setting: Daerah Istimewa Yogyakarta (DIY) province, Indonesia. Method: Qualitative semi-structured interviews were conducted with 15 general physicians and 7 paediatricians to identify the reason of prescribing extemporaneous compounding dosage form. The interviews were transcribed and analysed using thematic analysis. Results: Factors underlying prescribing of compounding could be categorized to therapy, healthcare system, patient and past experience. The primary reasons of therapy factors were limited availability of drug compositions, dosages or formulas specific for children. Beliefs in efficacy of the compounding forms were higher when the drugs used primarily to overcome complex cases. Physicians did not concern about compounding form containing several active substances because manufactured syrups may also contain several active substances. Although medicines were available in manufactured syrups, limited institutional budget was healthcare system factor of compounding prescribing. The prescribing factors related to patients include easy to use, efficient and lower price. The prescribing factors related to past experience were physicians’ beliefs to the progress of patient's health status. Conclusions: Compounding was prescribed based on therapy-related factors, healthcare system factors, patient factors and past experience.

Keywords: compounding dosage form, interview, physician, prescription

Procedia PDF Downloads 397
642 Long-Term Results of Coronary Bifurcation Stenting with Drug Eluting Stents

Authors: Piotr Muzyk, Beata Morawiec, Mariusz Opara, Andrzej Tomasik, Brygida Przywara-Chowaniec, Wojciech Jachec, Ewa Nowalany-Kozielska, Damian Kawecki

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Background: Coronary bifurcation is one of the most complex lesion in patients with coronary ar-tery disease. Provisional T-stenting is currently one of the recommended techniques. The aim was to assess optimal methods of treatment in the era of drug-eluting stents (DES). Methods: The regis-try consisted of data from 1916 patients treated with coronary percutaneous interventions (PCI) using either first- or second-generation DES. Patients with bifurcation lesion entered the analysis. Major adverse cardiac and cardiovascular events (MACCE) were assessed at one year of follow-up and comprised of death, acute myocardial infarction (AMI), repeated PCI (re-PCI) of target ves-sel and stroke. Results: Of 1916 registry patients, 204 patients (11%) were diagnosed with bifurcation lesion >50% and entered the analysis. The most commonly used technique was provi-sional T-stenting (141 patients, 69%). Optimization with kissing-balloons technique was performed in 45 patients (22%). In 59 patients (29%) second-generation DES was implanted, while in 112 pa-tients (55%), first-generation DES was used. In 33 patients (16%) both types of DES were used. The procedure success rate (TIMI 3 flow) was achieved in 98% of patients. In one-year follow-up, there were 39 MACCE (19%) (9 deaths, 17 AMI, 16 re-PCI and 5 strokes). Provisional T-stenting resulted in similar rate of MACCE to other techniques (16% vs. 5%, p=0.27) and similar occurrence of re-PCI (6% vs. 2%, p=0.78). The results of post-PCI kissing-balloon technique gave equal out-comes with 3% vs. 16% of MACCE in patients in whom no optimization technique was used (p=0.39). The type of implanted DES (second- vs. first-generation) had no influence on MACCE (4% vs 14%, respectively, p=0.12) and re-PCI (1.7% vs. 51% patients, respectively, p=0.28). Con-clusions: The treatment of bifurcation lesions with PCI represent high-risk procedures with high rate of MACCE. Stenting technique, optimization of PCI and the generation of implanted stent should be personalized for each case to balance risk of the procedure. In this setting, the operator experience might be the factor of better outcome, which should be further investigated.

Keywords: coronary bifurcation, drug eluting stents, long-term follow-up, percutaneous coronary interventions

Procedia PDF Downloads 176
641 Magnitude of Visual Impairment and Associated Factors among Adult Glaucoma Patients Attending University of Gondar, Comprehensive Specialized Hospital, Tertiary Eye Care and Training Center, Northwest Ethiopia, 2022

Authors: Getenet Shumet Birhan, Biruk Lelisa Eticha, Gizachew Tilahun Belete, Fisseha Admassu Ayele

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Context: Glaucoma is a significant public health concern globally, being the second leading cause of blindness. This study focuses on adult glaucoma patients in Ethiopia, specifically at the University of Gondar. Research Aim: The main objective is to assess the prevalence of visual impairment and identify associated factors among adult glaucoma patients at the University of Gondar. Methodology: The study used an institution-based cross-sectional design, collecting data from 423 glaucoma patients through interviews and medical chart reviews. Descriptive statistics and logistic regression were employed for analysis. Findings: The study found a high prevalence of visual impairment (77.6%) among adult glaucoma patients, with factors such as female sex, rural residence, glaucoma type, disease stage, and duration of diagnosis significantly associated with visual impairment. Theoretical Importance: This research adds valuable insights into the prevalence and determinants of visual impairment among glaucoma patients in Ethiopia, contributing to the existing literature on eye health in low-resource settings. Data Collection: Data were collected through face-to-face interviews and medical chart reviews at the University of Gondar, utilizing a structured questionnaire. Analysis Procedures: Descriptive statistics, frequency analysis, and binary logistic regression were employed to analyze the data and identify factors associated with visual impairment in adult glaucoma patients. Question Addressed: The study sought to answer the question of the prevalence of visual impairment and its associated factors among adult glaucoma patients at the University of Gondar in Northwest Ethiopia. Conclusion: The research concludes that visual impairment is significantly high among adult glaucoma patients in this setting, with several factors playing a role in its occurrence.

Keywords: visual impairment, glaucoma, Ethiopia, Gondar

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640 Epidemiology of Private Prehospital Calls over the Last Decade in South Africa

Authors: Rhodine Hickman, Craig Wylie, Michael G. McCaul

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Introduction: The World Health Organisation has called on governments around the world to recognise emergency conditions as a global public health problem and respond with appropriate steps for effective preventative strategies. However, to understand the magnitude of the problem, good quality epidemiological data is required. This is especially challenging in low and middle-income countries, where routine data is scarce, specifically within the prehospital setting. Methods: We conducted a retrospective cross-sectional study of a national prehospital private sector EMS database. The database being the property of ER24 (private Emergency Medical Services (EMS) company in South Africa) contains claims submitted by the majority of ambulance services in South Africa during the period between 1 January 2008 to 28 March 2017. We used descriptive statistics and control charts to describe the data using STATA 14. Results: 299,257 calls were included in the analysis. The top clinical conditions requiring ambulance transport were transport accidents (10% of total call volume) and ischaemic heart disease (4.4%). The number of transport accidents consistently increased between 2009 and 2014 and reached beyond the limit for normal variation in 2015. Victims of transport accidents required basic life support services 60% of the time with 80% of injuries being minor to moderate. The frequency of ischaemic heart disease had a steady incline from 2011 to 2016. Advanced life support services were required about 50% of the time, with 60% of patients needing urgent care. Conclusion: Transport accidents, followed by ischaemic heart disease, are the most prevalent conditions in South African private EMS. There is a potential to address these conditions by developing the capacity of low and mid-level providers in trauma and advanced EMS providers in ischaemic heart disease.

Keywords: emergency care, emergency medicine, prehospital providers, South Africa

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639 Knowledge Sharing Practices in the Healthcare Sector: Evidences from Primary Health Care Organizations in Indonesia

Authors: Galih Imaduddin

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Knowledge has been viewed as one of the most important resources in organizations, including those that operate in the healthcare sector. On that basis, Knowledge Management (KM) is crucial for healthcare organizations to improve their productivity and ensure effective utilization of their resources. Despite the growing interests to understand how KM might work for healthcare organizations, there is only a modest amount of empirical inquiries which have specifically focused on the tools and initiatives to share knowledge. Hence, the main purpose of this paper is to investigate the way healthcare organizations, particularly public sector ones, utilize knowledge sharing tools and initiatives for the benefit of patient-care. Employing a qualitative method, 13 (thirteen) Community Health Centers (CHCs) from a high-performing district health setting in Indonesia were observed. Data collection and analysis involved a repetition of document retrievals and interviews (n=41) with multidisciplinary health professionals who work in these CHCs. A single case study was cultivated reflecting on the means that were used to share knowledge, along with the factors that inhibited the exchange of knowledge among those health professionals. The study discovers that all of the thirteen CHCs exhibited and applied knowledge sharing means which included knowledge documents, virtual communication channels (i.e. emails and chatting applications), and social learning forums such as staff meetings, morning briefings, and communities of practices. However, the intensity of utilization was different among these CHCs, in which organizational culture, leadership, professional boundaries, and employees’ technological aptitude were presumed to be the factors that inhibit knowledge sharing processes. Making a distance with the KM literature of other sectors, this study denounces the primacy of technology-based tools, suggesting that socially-based initiatives could be more reliable for sharing knowledge. This suggestion is largely due to the nature of healthcare work which is still predominantly based on the tacit form of knowledge.

Keywords: knowledge management, knowledge sharing, knowledge sharing tools and initiatives, knowledge sharing inhibitors, primary health care organizations

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638 Entrepreneurial Leadership in a Startup Context: A Comparative Study on Two Egyptian Startup Businesses

Authors: Nada Basset

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Problem Statement: The study examines the important role of leading change inside start-ups and highlights the challenges faced by an entrepreneur during the startup phase of the business. Research Methods/Procedures/Approaches: A qualitative research approach is taken, using the case study analysis method. A comparative study was made between two day care nurseries in Greater Cairo. Non-probability purposive sampling was used and a triangulation of semi-structured interviews, document analysis and participant-observation were applied simultaneously. The in-depth case study analysis took place over a longitudinal study of four calendar months. Results/Findings: Findings demonstrated that leading change in an entrepreneurial setup must be initiated by the entrepreneur, who must also be the owner of the change process. Another important finding showed that the culture of change, although created by the entrepreneur, needs the support and engagement of followers, who should be sharing the same value system and vision of the entrepreneur. Conclusions and Implications: An important implication suggests that during the first year of a start-up lifecycle, special emphasis must be made to the recruitment and selection of personnel, who should play a role into setting the new start-up culture and help it grow or shrink. Another drawn conclusion is that the success of the change must be measured in both quantitative and qualitative terms. Increasing revenues and customer attrition rates -as quantitative KPIs- must be aligned with other qualitative KPIs like customer satisfaction, employee satisfaction, and organizational commitment and business reputation. Originality of Paper: The paper addresses change management in an entrepreneurial concept, with an empirical application on an Egyptian start-up model providing a service to both adults and children. This privileges the research as the constructs measured merged together the level of satisfaction of employees, decision-makers (parents of children), and the users (children).

Keywords: leadership, change management, entrepreneurship, startup business

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637 Effect of Rehabilitative Nursing Program on Pain Intensity and Functional Status among Patients with Discectomy

Authors: Amal Shehata

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Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

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636 Facies Analysis and Depositional Environment of Late Cretaceous (Cenomanian) Lidam Formation, South East Sirt Basin, Libya

Authors: Miloud M. Abugares

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This study concentrates on the facies analysis, cyclicity and depositional environment of the Upper Cretaceous (Cenomanian) carbonate ramp deposits of the Lidam Formation. Core description, petrographic analysis data from five wells in Hamid and 3V areas in the SE Sirt Basin, Libya were studied in detail. The Lidam Formation is one of the main oil producing carbonate reservoirs in Southeast Sirt Basin and this study represents one of the key detailed studies of this Formation. In this study, ten main facies have been identified. These facies are; Chicken-Wire Anhydrite Facies, Fine Replacive Dolomite Facies, Bioclastic Sandstone Facies, Laminated Shale Facies, Stromatolitic Laminated Mudstone Facies, Ostracod Bioturbated Wackestone Facies, Bioturbated Mollusc Packstone Facies, Foraminifera Bioclastic Packstone/Grainstone Facies Peloidal Ooidal Packstone/Grainstone Facies and Squamariacean/Coralline Algae Bindstone Facies. These deposits are inferred to have formed in supratidal sabkha, intertidal, semi-open restricted shallow lagoon and higher energy shallow shoal environments. The overall depositional setting is interpreted as have been deposited in inner carbonate ramp deposits. The best reservoir quality is encountered in Peloidal- Ooidal Packstone/Grainstone facies, these facies represents storm - dominated shoal to back shoal deposits and constitute the inner part of carbonate ramp deposits. The succession shows a conspicuous hierarchical cyclicity. Porous shoal and backshoal deposits form during maximum transgression system and early regression hemi-cycle of the Lidam Fm. However; oil producing from shoal and backshoal deposits which only occur in the upper intervals 15 - 20 feet, which forms the large scale transgressive cycle of the Upper Lidam Formation.

Keywords: Lidam Fm. Sirt Basin, Wackestone Facies, petrographic, intertidal

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635 GIS Data Governance: GIS Data Submission Process for Build-in Project, Replacement Project at Oman electricity Transmission Company

Authors: Rahma Saleh Hussein Al Balushi

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Oman Electricity Transmission Company's (OETC) vision is to be a renowned world-class transmission grid by 2025, and one of the indications of achieving the vision is obtaining Asset Management ISO55001 certification, which required setting out a documented Standard Operating Procedures (SOP). Hence, documented SOP for the Geographical information system data process has been established. Also, to effectively manage and improve OETC power transmission, asset data and information need to be governed as such by Asset Information & GIS department. This paper will describe in detail the current GIS data submission process and the journey for developing it. The methodology used to develop the process is based on three main pillars, which are system and end-user requirements, Risk evaluation, data availability, and accuracy. The output of this paper shows the dramatic change in the used process, which results subsequently in more efficient, accurate, and updated data. Furthermore, due to this process, GIS has been and is ready to be integrated with other systems as well as the source of data for all OETC users. Some decisions related to issuing No objection certificates (NOC) for excavation permits and scheduling asset maintenance plans in Computerized Maintenance Management System (CMMS) have been made consequently upon GIS data availability. On the Other hand, defining agreed and documented procedures for data collection, data systems update, data release/reporting and data alterations has also contributed to reducing the missing attributes and enhance data quality index of GIS transmission data. A considerable difference in Geodatabase (GDB) completeness percentage was observed between the years 2017 and year 2022. Overall, concluding that by governance, asset information & GIS department can control the GIS data process; collect, properly record, and manage asset data and information within the OETC network. This control extends to other applications and systems integrated with/related to GIS systems.

Keywords: asset management ISO55001, standard procedures process, governance, CMMS

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634 Investigating the Effect of Using Amorphous Silica Ash Obtained from Rice Husk as a Partial Replacement of Ordinary Portland Cement on the Mechanical and Microstructure Properties of Cement Paste and Mortar

Authors: Aliyu Usman, Muhaammed Bello Ibrahim, Yusuf D. Amartey, Jibrin M. Kaura

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This research is aimed at investigating the effect of using amorphous silica ash (ASA) obtained from rice husk as a partial replacement of ordinary Portland cement (OPC) on the mechanical and microstructure properties of cement paste and mortar. ASA was used in partial replacement of ordinary Portland cement in the following percentages 3 percent, 5 percent, 8 percent and 10 percent. These partial replacements were used to produce Cement-ASA paste and Cement-ASA mortar. ASA was found to contain all the major chemical compounds found in cement with the exception of alumina, which are SiO2 (91.5%), CaO (2.84%), Fe2O3 (1.96%), and loss on ignition (LOI) was found to be 9.18%. It also contains other minor oxides found in cement. Consistency of Cement-ASA paste was found to increase with increase in ASA replacement. Likewise, the setting time and soundness of the Cement-ASA paste also increases with increase in ASA replacements. The test on hardened mortar were destructive in nature which include flexural strength test on prismatic beam (40mm x 40mm x 160mm) at 2, 7, 14 and 28 days curing and compressive strength test on the cube size (40mm x 40mm, by using the auxiliary steel platens) at 2,7,14 and 28 days curing. The Cement-ASA mortar flexural and compressive strengths were found to be increasing with curing time and decreases with cement replacement by ASA. It was observed that 5 percent replacement of cement with ASA attained the highest strength for all the curing ages and all the percentage replacements attained the targeted compressive strength of 6N/mm2 for 28 days. There is an increase in the drying shrinkage of Cement-ASA mortar with curing time, it was also observed that the drying shrinkages for all the curing ages were greater than the control specimen all of which were greater than the code recommendation of less than 0.03%. The scanning electron microscope (SEM) was used to study the Cement-ASA mortar microstructure and to also look for hydration product and morphology.

Keywords: amorphous silica ash, cement mortar, cement paste, scanning electron microscope

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633 Modified Norhaya Upper Limp Elevation Sling-Quick Approach Ensuring Timely Limb Elevation

Authors: Prem, Norhaya, Vwrene C., Mohammad Harris A., Amarjit, Fazir M.

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Upper limb surgery is a common orthopedic procedure. After surgery, it is necessary to raise the patient's arm to reduce limb swelling and promote recovery. After an injury or surgery, swelling (edema) in the limbs is common. This swelling can be painful, cause stiffness, and affect movement and ability to do daily activities. One of the easiest ways to manage swelling is to elevate the swollen limb. The goal is to elevate the swollen limb slightly above the level of the heart. This helps the extra fluid move back towards the heart for circulation to the rest of the body. Conventional arm sling or pillows are usually placed under the arm to raise it, but in this way the arm cannot be fixed well and easily slide down, without ideal raising effect. Conventional arm sling need experience to tie the sling and this delay in the application process. To reduce the waiting time and cost, modified Norhaya upper limb elevation sling was designed and made readily available. The sling is made from calico fabric, readily available in the ward. Measurements of patients’ arm lengths are obtained, and fabric sizes are cut into the average arm lengths, as well as 1 size above and below. The cut calico fabric is then sewn together with thick sewing threads. Its application is easy and junior most staff or doctor will be able to apply it on patient. The time taken to set up the sling is also reduced. Feedback gathered from ground staff regarding ease of setting up the sling was tremendous and patient also feel comfort in the modified Norhaya sling. The device can freely adjust the raising height of the affected limb and effectively fix the affected limb to reduce its swelling, thus promoting recovery. This device is worthy to be clinically popularized and applied. The Modified Norhaya upper limb elevation sling is the quickest to set up and the delay in elevating the patient’s hand is significantly reduced. Moreover, it is reproducible and there is also significant cost savings.

Keywords: elevate, effective, sling, timely

Procedia PDF Downloads 164
632 Perception of Mass Media Usage in Educational Development of Rural Communities in Nigeria

Authors: Aniekan James Akpan, Inemesit Akpan Umoren, Uduak Iwok

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From prehistoric and primitive cultures, education was seen as a process of culture transmission by way of guiding children into becoming good members of their local communities. Even in modern cultures, education is seen as a systematic discipline aimed at cultivating genuine values to improve oneself and society. Without education, the chances of realizing the desired vision are marred as it is believed that nations that invest much in education are able to reap the desired benefits technologically, economically, socially, politically, and otherwise. In this sense, the moulding of character is considered the primary purpose of education, and until the audience of mass media through its various vehicles is seen as tools for improving the overall development of society. It is believed that a media-friendly person is likely to perform better than someone who is less friendly. This work, therefore, examines the role media play in educational development. As highlighted by the study, a summary of the functions of media shows that they widen horizon by acting as a liberating force, breaking distance, bonds, and transforming a traditional society into a modern one. With the use of technological development theory, agenda-setting theory as well as uses and gratification theory and multiple intelligence theory, the work identifies different ways in which mass media help in educational development and draws attention to the audience’s perception of media functions in terms of educational development. With a survey method and a population of 6,903,321 people, the work sampled 220 respondents using purposive technique drawn from rural communities in the South-South region of Nigeria. The work concludes that mass media are potent vehicles for teaching and learning and therefore recommends that government should provide basic infrastructures to the rural communities to aid full utilization of media potentials in educational development and equally urge media owners and practitioners to as a matter of urgency increase coverage time on issues bordering on education as it is done for political and other issues.

Keywords: educational, development, media usage, perception

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631 Special Education in the South African Context: A Bio-Ecological Perspective

Authors: Suegnet Smit

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Prior to 1994, special education in South Africa was marginalized and fragmented. Moving away from a Medical model approach to special education, the Government, after 1994, promoted an Inclusive approach, as a means to transform education in general, and special education in particular. This transformation, however, is moving at too a slow pace for learners with barriers to learning and development to benefit fully from their education. The goal of the Department of Basic Education is to minimize, remove, and prevent barriers to learning and development in the educational setting, by attending to the unique needs of the individual learner. However, the implementation of Inclusive education is problematic, and general education remains poor. This paper highlights the historical development of special education in South Africa, underpinned by a bio-ecological perspective. Problematic areas within the systemic levels of the education system are highlighted in order to indicate how the interactive processes within the systemic levels affect special needs learners on the personal dimension of the bio-ecological approach. As part of the methodology, thorough document analysis was conducted on information collected from a large body of research literature, which included academic articles, reports, policies, and policy reviews. Through a qualitative analysis, data were grouped and categorized according to the bio-ecological model systems, which revealed various successes and challenges within the education system. The challenges inhibit change, growth, and development for the child, who experience barriers to learning. From these findings, it is established that special education in South Africa has been, and still is, on a bumpy road. Sadly, the transformation process of change, envisaged by implementing Inclusive education, is still yet a dream, not fully realized. Special education seems to be stuck at what is, and the education system has not moved forward significantly enough to reach what special education should and could be. The gap that exists between a vision of Inclusive quality education for all, and the current reality, is still too wide. Problems encountered in all the education system levels, causes a funnel-effect downward to learners with special educational needs, with negative effects for the development of these learners.

Keywords: bio-ecological perspective, education systems, inclusive education, special education

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630 A Posterior Predictive Model-Based Control Chart for Monitoring Healthcare

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

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

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

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629 The Fabric of Culture: Deciphering the Discourse of Permitted and Prohibited Raw Materials for Clothing in Hadith Literature

Authors: Hadas Hirsch

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Clothing is aimed at concealing and revealing the body, protecting it, and manifesting religious, political, and social declarations. The material and symbolic meanings of clothing and its raw materials are evaluated through the context of their social, cultural, and religious systems. The raw materials for clothing that were frequent and familiar in the 7th century Arab Peninsula were wool, leather, cotton, and some kinds of silk. The spread of the Muslim empire and the intersections with other religions and cultures enable the trickling of new raw materials that were unknown to Muslims or unaccepted. The sources for this research are hadith collections that discuss in details various kinds of textiles and their origin, together with a legal explanation that permits or prohibits its use. The paper will describe and analyze this discussion by contextualizing it in social, religious, and cultural reality that creates a structure of socio-religious dependency. The aim is not to identify, catalogue, and technically analyze fabrics but to reveal their role in Muslims’ life as a means of creating dependency for the community and setting borders inside and outside. The analysis is built upon a scale that starts with the most recommended raw materials, then comes the permitted ones and, in the end, the prohibited raw materials. This mapping will provide an insight into the ways textiles, as a cultural medium, help to shape and redefine identities and, at the same time, enable a sphere for creative expression within socio-cultural and religious limits and context. To sum up, hadith literature has the main role is characterizing Muslim clothing, from garments to textiles and colors, including multiple variations and contradicting aspects. The Muslim style of clothing and, in particular, textiles is a manifestation of the socio-religious structure of dependency that creates differentiated Muslim identity together with subdivision of gendered groups. Some other aspects are the tension between authenticity and imitation and the jurists’ pragmatic and practice attitude that enables an individual sphere of expression within the limits of jurisprudence.

Keywords: Hadith, jurisprudence, medieval Islam, material culture

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628 Developing Family-Based Eco-Citizenship with Social Media: A Mixed Methods Collective Case Study of Families Looking to Adopt Ecologically Responsible Actions Using Facebook

Authors: Michel T. Leger, Shawn Martin

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Leading an ecologically responsible lifestyle represents a difficult challenge. Though research in environmental education does point to an increase in the intention to act more responsibly towards the environment, this intent does not seem to translate to concrete ecological action. This mixed methods collective case study explores the adoption of ecological actions in the family, a context of socio-ecological transformation rarely examined in the scientific literature. More specifically, it takes into account the popular use of social media today to explore the potential role social media, namely Facebook, in promoting environmental action. In other words, for families who are intent on adopting an ecologically friendly lifestyle, could the use of Facebook positively affect the way family members relate to the environment and bring about real change in their daily household actions? To answer this question, twenty-one families living in an urban setting were recruited and then divided them into two distinct groups. The first group of families attempted to lower their household electrical bill as part of a private Facebook group, while the other aimed to do the same, but without the directed use of social media. For both groups, we recorded the amount of kilowatt-hours used during the project as well as the amount used for the same months the previous year, adjusting for temperature variations. Exit interviews were also conducted with each family in order to try to understand the processes of eco-citizenship development in the context of family. Results seem to suggest that both virtual social networks and one-on-one support can help to increase environmental awareness in participating family. Interestingly, families from the Facebook group seemed to demonstrate a higher degree of environmental engagement, and younger family members in this group were more active in the processes of collective behavioral change.

Keywords: environmental education, family-based eco-citizenship, social media, case study

Procedia PDF Downloads 119