Search results for: omissions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 22

Search results for: omissions

22 Improving Compliance in Prescribing Regular Medications for Surgical Patients: A Quality Improvement Project in the Surgical Assessment Unit

Authors: Abdullah Tahir

Abstract:

The omission of regular medications in surgical patients poses a significant challenge in healthcare settings and is associated with increased morbidity during hospital stays. Human factors such as high workload, poor communication, and emotional stress are known to contribute to these omissions, particularly evident in the surgical assessment unit (SAU) due to its high patient burden and long wait times. This study aimed to quantify and address the issue by implementing targeted interventions to enhance compliance in prescribing regular medications for surgical patients at Stoke Mandeville Hospital, United Kingdom. Data were collected on 14 spontaneous days between April and May 2023, and the frequency of prescription omissions was recorded using a tally chart. Subsequently, informative posters were introduced in the SAU, and presentations were given to the surgical team to emphasize the importance of compliance in this area. The interventions were assessed using a second data collection cycle, again over 14 spontaneous days in May 2023. Results demonstrated an improvement from 40% (60 out of 150) to 74% (93 out of 126) of patients having regular medications prescribed at the point of clerking. These findings highlight the efficacy of frequent prompts and awareness-raising interventions in increasing workforce compliance and addressing the issue of prescription omissions in the SAU.

Keywords: prescription omissions, quality improvement, regular medication, surgical assessment unit

Procedia PDF Downloads 42
21 User-Awareness from Eye Line Tracing During Specification Writing to Improve Specification Quality

Authors: Yoshinori Wakatake

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Many defects after the release of software packages are caused due to omissions of sufficient test items in test specifications. Poor test specifications are detected by manual review, which imposes a high human load. The prevention of omissions depends on the end-user awareness of test specification writers. If test specifications were written while envisioning the behavior of end-users, the number of omissions in test items would be greatly reduced. The paper pays attention to the point that writers who can achieve it differ from those who cannot in not only the description richness but also their gaze information. It proposes a method to estimate the degree of user-awareness of writers through the analysis of their gaze information when writing test specifications. We conduct an experiment to obtain the gaze information of a writer of the test specifications. Test specifications are automatically classified using gaze information. In this method, a Random Forest model is constructed for the classification. The classification is highly accurate. By looking at the explanatory variables which turn out to be important variables, we know behavioral features to distinguish test specifications of high quality from others. It is confirmed they are pupil diameter size and the number and the duration of blinks. The paper also investigates test specifications automatically classified with gaze information to discuss features in their writing ways in each quality level. The proposed method enables us to automatically classify test specifications. It also prevents test item omissions, because it reveals writing features that test specifications of high quality should satisfy.

Keywords: blink, eye tracking, gaze information, pupil diameter, quality improvement, specification document, user-awareness

Procedia PDF Downloads 32
20 Making Good Samaritans: An Exploration of Criminal Liability for Failure to Rescue in England and Wales

Authors: Usmaan Siddiqui

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In England and Wales, there is no duty to rescue strangers. We will be investigating whether this is correct, and whether we should introduce a Good Samaritan law. In order to explore this, firstly, we will be exploring the nature of our moral duties. How far do our moral duties extend? Do they extend only to our family and friends, or do they also extend to strangers? Secondly, even if there does exist a moral duty, should this duty be enforced by criminal law? To what extent should the criminal law reflect morality? Under English criminal law, the consensus is, that it is not the job of the English criminal law to perfect human behaviour, and whilst the law should prevent us from causing harm, it should not force us to be good. This approach is radically different from many other European countries that actually do have a Good Samaritan law. If there are compelling in principle reasons to introduce a Good Samaritan law how would we deal with the pragmatic institutional constraints? Such a law has been stated as being unworkable in practice and difficult in defining its limits. In order to verify this, we shall carry out a comparative analysis between England and selected states in the US to gauge how successful the Good Samaritan law has been in dealing with these institutional constraints. In terms of methodology, as well as a comparative analysis, we shall also be carrying out a doctrinal analysis exploring what the English criminal law’s position is regarding Omissions. In conclusion, the findings so far are, whilst it is not the job of the law to perfect human behaviour, both respect for the law and the level of social co-operation will be greatly improved if the law encourages morally desirable conduct. Whilst it is possible for society to exist without a duty to assist the distressed, a society which ignores the vulnerable is cold, callous, and uncaring. After all, we all need to face up to the possibility that we may be one day be vulnerable and in need of urgent aid, and it is about time English criminal law, catches up with the majority of Europe and protects the vulnerable.

Keywords: criminal, law, omissions, philosophy

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19 The Study on the Overall Protection of the Ancient Villages

Authors: Zhang Yu, Ding Yi

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The discussion about elements of cultural heritage and their relevance among the ancient villages is comparably insufficient. The protection work is strongly influenced by touristic development and cultural gimmick, resulting in low protection efficiency and many omissions. Historical villages as the cultural settlement patterns bear a large number of heritage relics. They were regionally scattered with a clear characteristic of gathering. First of all, this study proposes the association and similarities of the forming mechanism between four historic cultural villages in Mian Mountain. Secondly, the study reveals that these villages own the strategic pass, underground passage, and the mountain barrier. Thirdly, based on the differentiated characteristics of villages’ space, the study discusses about the integrated conservation from three levels: the regional heritage conservation, the cultural line shaping, and the featured brand building.

Keywords: conservation, fortress, historical villages, Mian Moutain

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18 The Evaluation of Child Maltreatment Severity and the Decision-Making Processes in the Child Protection System

Authors: Maria M. Calheiros, Carla Silva, Eunice Magalhães

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Professionals working in child protection services (CPS) need to have common and clear criteria to identify cases of maltreatment and to differentiate levels of severity in order to determine when CPS intervention is required, its nature and urgency, and, in most countries, the service that will be in charge of the case (community or specialized CPS). Actually, decision-making process is complex in CPS, and, for that reason, such criteria are particularly important for who significantly contribute to that decision-making in child maltreatment cases. The main objective of this presentation is to describe the Maltreatment Severity Assessment Questionnaire (MSQ), specifically designed to be used by professionals in the CPS, which adopts a multidimensional approach and uses a scale of severity within subtypes. Specifically, we aim to provide evidence of validity and reliability of this tool, in order to improve the quality and validity of assessment processes and, consequently, the decision making in CPS. The total sample was composed of 1000 children and/or adolescents (51.1% boys), aged between 0 and 18 years old (M = 9.47; DP = 4.51). All the participants were referred to official institutions of the children and youth protective system. Children and adolescents maltreatment (abuse, neglect experiences and sexual abuse) were assessed with 21 items of the Maltreatment Severity Questionnaire (MSQ), by professionals of CPS. Each item (sub-type) was composed of four descriptors of increasing severity. Professionals rated the level of severity, using a 4-point scale (1= minimally severe; 2= moderately severe; 3= highly severe; 4= extremely severe). The construct validity of the Maltreatment Severity Questionnaire was assessed with a holdout method, performing an Exploratory Factor Analysis (EFA) followed by a Confirmatory Factor Analysis (CFA). The final solution comprised 18 items organized in three factors 47.3% of variance explained. ‘Physical neglect’ (eight items) was defined by parental omissions concerning the insurance and monitoring of the child’s physical well-being and health, namely in terms of clothing, hygiene, housing conditions and contextual environmental security. ‘Physical and Psychological Abuse’ (four items) described abusive physical and psychological actions, namely, coercive/punitive disciplinary methods, physically violent methods or verbal interactions that offend and denigrate the child, with the potential to disrupt psychological attributes (e.g., self-esteem). ‘Psychological neglect’ (six items) involved omissions related to children emotional development, mental health monitoring, school attendance, development needs, as well as inappropriate relationship patterns with attachment figures. Results indicated a good reliability of all the factors. The assessment of child maltreatment cases with MSQ could have a set of practical and research implications: a) It is a valid and reliable multidimensional instrument to measure child maltreatment, b) It is an instrument integrating the co-occurrence of various types of maltreatment and a within-subtypes scale of severity; c) Specifically designed for professionals, it may assist them in decision-making processes; d) More than using case file reports to evaluate maltreatment experiences, researchers could guide more appropriately their research about determinants and consequences of maltreatment.

Keywords: assessment, maltreatment, children and youth, decision-making

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17 Cognitive Approach at the Epicenter of Creative Accounting in Cameroonian Companies: The Relevance of the Psycho-Sociological Approach and the Theory of Cognitive Dissonance

Authors: Romuald Temomo Wamba, Robert Wanda

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The issue of creative accounting in the psychological and sociological framework has been a mixed subject for over 60 years. The objective of this article is to ensure the existence of creative accounting in Cameroonian entities on the one hand and to understand the strategies used by audit agents to detect errors, omissions, irregularities, or inadequacies in the financial state; optimization techniques used by account preparers to strategically bypass texts on the other hand. To achieve this, we conducted an exploratory study using a cognitive approach, and the data analysis was performed by the software 'decision explorer'. The results obtained challenge the authors' cognition (manifest latent and deceptive behavior). The tax inspectors stress that the entities in Cameroon do not derogate from the rules of piloting in the financial statements. Likewise, they claim a change in current income and net income through depreciation, provisions, inventories, and the spreading of charges over long periods. This suggests the suspicion or intention of manipulating the financial statements. As for the techniques, the account preparers manage the accruals at the end of the year as the basis of the practice of creative accounting. Likewise, management accounts are more favorable to results management.

Keywords: creative accounting, sociocognitive approach, psychological and sociological approach, cognitive dissonance theory, cognitive mapping

Procedia PDF Downloads 162
16 Militating Factors Against Building Information Modeling Adoption in Quantity Surveying Practice in South Africa

Authors: Kenneth O. Otasowie, Matthew Ikuabe, Clinton Aigbavboa, Ayodeji Oke

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The quantity surveying (QS) profession is one of the professions in the construction industry, and it is saddled with the responsibility of measuring the number of materials as well as the workmanship required to get work done in the industry. This responsibility is vital to the success of a construction project as it determines if a project will be completed on time, within budget, and up to the required standard. However, the practice has been criticised severally for failure to accurately execute her responsibility. The need to reduce errors, inaccuracies and omissions has made the adoption of modern technologies such as building information modeling (BIM) inevitable in its practice. Nevertheless, there are barriers to the adoption of BIM in QS practice in South Africa (SA). Thus, this study aims to investigate these barriers. A survey design was adopted. A total number of one hundred and fifteen (115) questionnaires were administered to quantity surveyors in Guateng Province, SA, and ninety (90) were returned and found suitable for analysis. Collected data were analysed using percentage, mean item score, standard deviation, one-sample t-test, and Kruskal-Wallis. The findings show that lack of BIM expertise, lack of government enforcement, resistance to change, and no client demand for BIM are the most significant barriers to the adoption of BIM in QS practice. As a result, this study recommends that trainings on BIM technology be prioritised, and government must take the lead in BIM adoption in the country, particularly in public projects.

Keywords: barriers, BIM, quantity surveying practice, South Africa

Procedia PDF Downloads 63
15 Using Multiple Strategies to Improve the Nursing Staff Edwards Lifesciences Hemodynamic Monitoring Correctness of Operation

Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

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Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

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14 Recontextualisation of Political Discourse: A Case Study of Translation of News Stories

Authors: Hossein Sabouri

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News stories as one of the branches of political discourse has always been regarded a sensitive and challenging area. Political translators often encounter some struggles that are vitally important when it comes to deal with the political tension between the source culture and the target one. Translating news stories is of prime importance since it has widespread availability and power of defining or even changing the facts. News translation is usually more than straight transfer of source text. Like original text endeavoring to manipulate the readers’ minds with imposing their ideologies, translated text seeking to change these ideologies influenced by ideological power. In other words, translation product is not considered more than a recontextualisation of the source text. The present study examines possible criteria for occurring changes in the translation process of news stories based on the ideological and political stance of translator using theories of ‘critical discourse analysis’and ‘translation and power. Fairclough investigates the ideological issues in (political) discourse and Tymoczko studies the political and power-related engagement of the translator in the process of translation. Incorporation of Fairclough and Gentzler and Tymoczko’s theories paves the way for the researcher to looks at the ideological power position of the translator. Data collection and analysis have been accomplished using 17 political-text samples taken from online news agencies which are related to the ‘Iran’s Nuclear Program’. Based on the findings, recontextualisation is mainly observed in terms of the strategies of ‘substitution, omissions, and addition’ in the translation process. The results of the study suggest that there is a significant relationship between the translation of political texts and ideologies of target culture.

Keywords: news translation, recontextualisation, ideological power, political discourse

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13 Causes and Impacts of Rework Costs in Construction Projects

Authors: Muhammad Ejaz1

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Rework has been defined as: "The unnecessary effort of re-doing a process or activity that was incorrectly implemented the first time." A great threat to the construction industry is rework. By and large due attention has not been given to avoid the causes of reworks, resulting time and cost over runs, in civil engineering projects. Besides these direct consequences, there might also be indirect consequences, such as stress, de-motivation or loss of future clients. When delivered products do not meet the requirements or expectations, work often has to be redone. Rework occurs in various phases of the construction process or in various divisions of a company. Rework can occur on the construction site or in a management department due to for example bad materials management. Rework can also have internal or external origins. Changes in clients’ expectations are an example of an external factor that might lead to rework. Rework can cause many costs to be higher than calculated at the start of the project. Rework events can have many different origins and for this research they have been categorized into four categories; changes, errors, omissions, and damages. The research showed that the major source of reworks were non professional attitude from technical hands and ignorance of total quality management principals by stakeholders. It also revealed that sources of reworks have not major differences among project categories. The causes were further analyzed by interviewing employees. Based on existing literature an extensive list of rework causes was made and during the interviews the interviewees were asked to confirm or deny statements regarding rework causes. The causes that were most frequently confirmed can be grouped into the understanding categories. 56% (max) of the causes are change-related, 30% (max) is error-related and 18% (max) falls into another category. Therefore, by recognizing above mentioned factors, reworks can be reduced to a great extent.

Keywords: total quality management, construction industry, cost overruns, rework, material management, client’s expectations

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12 Improving Efficiency and Effectiveness of FMEA Studies

Authors: Joshua Loiselle

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This paper discusses the challenges engineering teams face in conducting Failure Modes and Effects Analysis (FMEA) studies. This paper focuses on the specific topic of improving the efficiency and effectiveness of FMEA studies. Modern economic needs and increased business competition require engineers to constantly develop newer and better solutions within shorter timeframes and tighter margins. In addition, documentation requirements for meeting standards/regulatory compliance and customer needs are becoming increasingly complex and verbose. Managing open actions and continuous improvement activities across all projects, product variations, and processes in addition to daily engineering tasks is cumbersome, time consuming, and is susceptible to errors, omissions, and non-conformances. FMEA studies are proven methods for improving products and processes while subsequently reducing engineering workload and improving machine and resource availability through a pre-emptive, systematic approach of identifying, analyzing, and improving high-risk components. If implemented correctly, FMEA studies significantly reduce costs and improve productivity. However, the value of an effective FMEA is often shrouded by a lack of clarity and structure, misconceptions, and previous experiences and, as such, FMEA studies are frequently grouped with the other required information and documented retrospectively in preparation of customer requirements or audits. Performing studies in this way only adds cost to a project and perpetuates the misnomer that FMEA studies are not value-added activities. This paper discusses the benefits of effective FMEA studies, the challenges related to conducting FMEA studies, best practices for efficiently overcoming challenges via structure and automation, and the benefits of implementing those practices.

Keywords: FMEA, quality, APQP, PPAP

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11 Residential High-Rises and Meaningful Places: Missing Actions in the Isle of Dogs Regeneration

Authors: Elena Kalcheva, Ahmad Taki, Yuri Hadi

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Urban regeneration often includes residential high-rises as a way of optimum use of land. However, high-rises are in many cases connected to placelessness, this is not due to some intrinsic characteristic of the typology, but more to a failure to provide meaningful places in connection to them. The reason to study the Isle of the Dogs regeneration is the successful process that led to vibrant area with strong identity and social sustainability. Therefore, the purpose of this research is to identify the gaps into the sound strategy for the development of the area and in its implementation which will make the place more sustainable. The paper addresses four research questions: are the residential high-rises supporting a proper physical form; is there deployed properly scaled mix of land uses and functions in connection with residential high-rises; are there possible quality activities in quality places near the residential high-rises; and is there a strong sense of place created with the residential high-rise buildings and their surroundings. The methodology relies on observational survey of the researched area together with structured questions, to evaluate the external qualities of the residential high-rises and their surroundings. Visual information can help identify the mistakes and the omissions of the provided project examples. It can provide insight on how can be improved imageability, legibility and human scale. In this connection, the paper argues that although the quality of the architecture of the high-rises is superb, there is a failure to create meaningful, high quality public realm in connection with them. As such, it does not function as well as the designers intended to do: the functional quality of the public realm is quite low. The implications of the study suggest that actions need to take place in order to improve and foster further regeneration of the area.

Keywords: high-rises, isle of the dogs, public realm, regeneration

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10 Spatial Interpolation of Intermediate Soil Properties to Enhance Geotechnical Surveying for Foundation Design

Authors: Yelbek B. Utepov, Assel T. Mukhamejanova, Aliya K. Aldungarova, Aida G. Nazarova, Sabit A. Karaulov, Nurgul T. Alibekova, Aigul K. Kozhas, Dias Kazhimkanuly, Akmaral K. Tleubayeva

Abstract:

This research focuses on enhancing geotechnical surveying for foundation design through the spatial interpolation of intermediate soil properties. Traditional geotechnical practices rely on discrete data from borehole drilling, soil sampling, and laboratory analyses, often neglecting the continuous nature of soil properties and disregarding values in intermediate locations. This study challenges these omissions by emphasizing interpolation techniques such as Kriging, Inverse Distance Weighting, and Spline interpolation to capture the nuanced spatial variations in soil properties. The methodology is applied to geotechnical survey data from two construction sites in Astana, Kazakhstan, revealing continuous representations of Young's Modulus, Cohesion, and Friction Angle. The spatial heatmaps generated through interpolation offered valuable insights into the subsurface environment, highlighting heterogeneity and aiding in more informed foundation design decisions for considered cites. Moreover, intriguing patterns of heterogeneity, as well as visual clusters and transitions between soil classes, were explored within seemingly uniform layers. The study bridges the gap between discrete borehole samples and the continuous subsurface, contributing to the evolution of geotechnical engineering practices. The proposed approach, utilizing open-source software geographic information systems, provides a practical tool for visualizing soil characteristics and may pave the way for future advancements in geotechnical surveying and foundation design.

Keywords: soil mechanical properties, spatial interpolation, inverse distance weighting, heatmaps

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9 An Experiment Research on the Effect of Brain-Break in the Classroom on Elementary School Students’ Selective Attention

Authors: Hui Liu, Xiaozan Wang, Jiarong Zhong, Ziming Shao

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Introduction: Related research shows that students don’t concentrate on teacher’s speaking in the classroom. The d2 attention test is a time-limited test about selective attention. The d2 attention test can be used to evaluate individual selective attention. Purpose: To use the d2 attention test tool to measure the difference between the attention level of the experimental class and the control class before and after Brain-Break and to explore the effect of Brain-Break in the classroom on students' selective attention. Methods: According to the principle of no difference in pre-test data, two classes in the fourth- grade of Shenzhen Longhua Central Primary School were selected. After 20 minutes of class in the third class in the morning and the third class in the afternoon, about 3-minute Brain-Break intervention was performed in the experimental class for 10 weeks. The normal class in the control class did not intervene. Before and after the experiment, the d2 attention test tool was used to test the attention level of the two-class students. The paired sample t-test and independent sample t-test in SPSS 23.0 was used to test the change in the attention level of the two-class classes around 10 weeks. This article only presents results with significant differences. Results: The independent sample t-test results showed that after ten-week of Brain-Break, the missed errors (E1 t = -2.165 p = 0.042), concentration performance (CP t = 1.866 p = 0.05), and the degree of omissions (Epercent t = -2.375 p = 0.029) in experimental class showed significant differences compared with control class. The students’ error level decreased and the concentration increased. Conclusions: Adding Brain-Break interventions in the classroom can effectively improve the attention level of fourth-grade primary school students to a certain extent, especially can improve the concentration of attention and decrease the error rate in the tasks. The new sport's learning model is worth promoting

Keywords: cultural class, micromotor, attention, D2 test

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8 Procedures and Strategies in Translation: Two Marathi Translations of Train to Pakistan by Khushwant Singh

Authors: Manoj Gujar

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The present paper is an attempt to interpret two Marathi translations of Khushwant Singh’s (1915-2014) novel Train to Pakistan (1956). The 20th century was branded as an era of Liberalization, Privatization and Globalization. Different countries and cultures have enunciated interaction with one another in an unprecedented manner. The world is becoming multilingual and multicultural. The democratic countries such as the U.S.A., the U.K., and India have become pivotal centers of interlingual and cross-cultural exchange. People belonging to different nationalities showed keen interest in knowing the characteristic features of different languages and of their cultures. Here, ‘Translation’ plays an important role in such multilingual and multicultural contexts. Translation is not only translation of a language but a translation of a culture. However, in the act of translation a translator makes use of such procedures as borrowing, definition, literal translation, substitution, lexical creation, omission, addition as well as their various combinations. To him, a text produced in one linguistic and cultural context can reach other linguistic and cultural contexts through these processes of translation. A worthy work of art appeals many readers. India, being a multilingual country we find that there goes multiple translations of the same text in different Indian languages. But sometimes, if can be found that a same text appeals to different ages and the same text gets translated into the same language by the two or more authors. In this reference, the present paper is an attempt to study how different translations of the same text differ in terms of procedures and strategies during the process of the translation of culture. The source text is Khushwant Singh’s historical novel Train to Pakistan (1956). The novel was widely appreciated and so translated into different regional languages in India. The novel has two Marathi translations: Agniratha (1972) by Hidayatkhan and Train to Pakistan (1980) by Anil Kinikar. This paper is an attempt to evaluate the strategies and procedures in translation to analyze these two Marathi translations. Hidayat Khan made a lot of omissions of the significant details and distorted the original text to a large extent, whereas, Anil Kinikar has done justice to the Source Text by rendering it in Marathi as faithfully as possible.

Keywords: culture, multilingual, procedures and strategies, translation

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7 Identification of Architectural Design Error Risk Factors in Construction Projects Using IDEF0 Technique

Authors: Sahar Tabarroki, Ahad Nazari

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The design process is one of the most key project processes in the construction industry. Although architects have the responsibility to produce complete, accurate, and coordinated documents, architectural design is accompanied by many errors. A design error occurs when the constraints and requirements of the design are not satisfied. Errors are potentially costly and time-consuming to correct if not caught early during the design phase, and they become expensive in either construction documents or in the construction phase. The aim of this research is to identify the risk factors of architectural design errors, so identification of risks is necessary. First, a literature review in the design process was conducted and then a questionnaire was designed to identify the risks and risk factors. The questions in the form of the questionnaire were based on the “similar service description of study and supervision of architectural works” published by “Vice Presidency of Strategic Planning & Supervision of I.R. Iran” as the base of architects’ tasks. Second, the top 10 risks of architectural activities were identified. To determine the positions of possible causes of risks with respect to architectural activities, these activities were located in a design process modeled by the IDEF0 technique. The research was carried out by choosing a case study, checking the design drawings, interviewing its architect and client, and providing a checklist in order to identify the concrete examples of architectural design errors. The results revealed that activities such as “defining the current and future requirements of the project”, “studies and space planning,” and “time and cost estimation of suggested solution” has a higher error risk than others. Moreover, the most important causes include “unclear goals of a client”, “time force by a client”, and “lack of knowledge of architects about the requirements of end-users”. For error detecting in the case study, lack of criteria, standards and design criteria, and lack of coordination among them, was a barrier, anyway, “lack of coordination between architectural design and electrical and mechanical facility”, “violation of the standard dimensions and sizes in space designing”, “design omissions” were identified as the most important design errors.

Keywords: architectural design, design error, risk management, risk factor

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6 Inappropriate Prescribing Defined by START and STOPP Criteria and Its Association with Adverse Drug Events among Older Hospitalized Patients

Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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5 Visual Representation and the De-Racialization of Public Spaces

Authors: Donna Banks

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In 1998 Winston James called for more research on the Caribbean diaspora and this ethnographic study, incorporating participant observation, interviews, and archival research, adds to the scholarship in this area. The research is grounded in the discipline of cultural studies but is cross-disciplinary in nature, engaging anthropology, psychology, and urban planning. This paper centers on community murals and their contribution to a more culturally diverse and representative community. While many museums are in the process of reassessing their collection, acquiring works, and developing programming to be more inclusive, and public art programs are investing millions of dollars in trying to fashion an identity in which all residents can feel included, local artists in neighborhoods in many countries have been using community murals to tell their stories. Community murals serve a historical, political, and social purpose and are an instrumental strategy in creative placemaking projects. Community murals add to the livability of an area. Even though official measurements of livability do not include race, ethnicity, and gender - which are egregious omissions - murals are a way to integrate historically underrepresented people into the wider history of a country. This paper draws attention to a creative placemaking project in the port city of Bristol, England. A city, like many others, with a history of spacializing race and racializing space. For this reason, Bristol’s Seven Saints of St. Pauls® Art & Heritage Trail, which memorializes seven Caribbean-born social and political change agents, is examined. The Seven Saints of St. Pauls® Art & Heritage Trail is crucial to the city, as well as the country, in its contribution to the de-racialization of public spaces. Within British art history, with few exceptions, portraits of non-White people who are not depicted in a subordinate role have been absent. The artist of the mural project, Michelle Curtis, has changed this long-lasting racist and hegemonic narrative. By creating seven large-scale portraits of individuals not typically represented visually, the artist has added them into Britain’s story. In these murals, however, we see more than just the likeness of a person; we are presented with a visual commentary that reflects each Saint’s hybrid identity of being both Black Caribbean and British, as well as their social and political involvement. Additionally, because the mural project is part of a heritage trail, the murals' are therapeutic and contribute to improving the well-being of residents and strengthening their sense of belonging.

Keywords: belonging, murals, placemaking, representation

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4 Integrating Computer-Aided Manufacturing and Computer-Aided Design for Streamlined Carpentry Production in Ghana

Authors: Benson Tette, Thomas Mensah

Abstract:

As a developing country, Ghana has a high potential to harness the economic value of every industry. Two of the industries that produce below capacity are handicrafts (for instance, carpentry) and information technology (i.e., computer science). To boost production and maintain competitiveness, the carpentry sector in Ghana needs more effective manufacturing procedures that are also more affordable. This issue can be resolved using computer-aided manufacturing (CAM) technology, which automates the fabrication process and decreases the amount of time and labor needed to make wood goods. Yet, the integration of CAM in carpentry-related production is rarely explored. To streamline the manufacturing process, this research investigates the equipment and technology that are currently used in the Ghanaian carpentry sector for automated fabrication. The research looks at the various CAM technologies, such as Computer Numerical Control routers, laser cutters, and plasma cutters, that are accessible to Ghanaian carpenters yet unexplored. We also investigate their potential to enhance the production process. To achieve the objective, 150 carpenters, 15 software engineers, and 10 policymakers were interviewed using structured questionnaires. The responses provided by the 175 respondents were processed to eliminate outliers and omissions were corrected using multiple imputations techniques. The processed responses were analyzed through thematic analysis. The findings showed that adaptation and integration of CAD software with CAM technologies would speed up the design-to-manufacturing process for carpenters. It must be noted that achieving such results entails first; examining the capabilities of current CAD software, then determining what new functions and resources are required to improve the software's suitability for carpentry tasks. Responses from both carpenters and computer scientists showed that it is highly practical and achievable to streamline the design-to-manufacturing process through processes such as modifying and combining CAD software with CAM technology. Making the carpentry-software integration program more useful for carpentry projects would necessitate investigating the capabilities of the current CAD software and identifying additional features in the Ghanaian ecosystem and tools that are required. In conclusion, the Ghanaian carpentry sector has a chance to increase productivity and competitiveness through the integration of CAM technology with CAD software. Carpentry companies may lower labor costs and boost production capacity by automating the fabrication process, giving them a competitive advantage. This study offers implementation-ready and representative recommendations for successful implementation as well as important insights into the equipment and technologies available for automated fabrication in the Ghanaian carpentry sector.

Keywords: carpentry, computer-aided manufacturing (CAM), Ghana, information technology(IT)

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3 Managing Type 1 Diabetes in College: A Thematic Analysis of Online Narratives Posted on YouTube

Authors: Ekaterina Malova

Abstract:

Type 1 diabetes (T1D) is a chronic illness requiring immense lifestyle changes to reduce the chance of life-threatening complications. Moving to a college may be the first time for a young adult with T1D to take responsibility for all the aspects of their diabetes care. In addition, people with T1D constantly face stigmatization and discrimination as a result of their health condition, which puts additional pressure on young adults with T1D. Hence, omissions in diabetes self-care often occur during the time of transition to college when both the social and physical environment of young adults changes drastically and contribute to the fact that emerging young adults remain one of the age groups with the highest hemoglobin levels and poorest diabetes control. However, despite potential severe health risks caused by a lack of proper diabetes self-care, little is known about the experiences of emerging adults embarking on a higher education journey as this population. Thus, young adults with type 1 diabetes are a 'forgotten group,' meaning that their experiences are rarely addressed by researchers. Given that self-disclosure and information-seeking can be challenging for individuals with stigmatized illnesses, online platforms like YouTube have become a popular medium of self-disclosure and information-seeking for people living with T1D. Thus, this study aims to provide an analysis of experiences that college students with T1D choose to share with the general public online and explore the nature of information being communicated by college students with T1D to the online community in personal narratives posted on YouTube. A systematic approach was used to retrieve a video sample by searching YouTube with keywords 'type 1 diabetes' and 'college,' with results ordered by relevance. A total of 18 videos were saved. Video lengths ranged from 2 to 28 minutes. The data were coded using NVivo. Video transcripts were coded and analyzed utilizing the thematic analysis method. Three key themes emerged from thematic analysis: 1) Advice, 2) Personal experience, and 3) Things I wish everyone knew about T1D. In addition, Theme 1 was divided into subtopics to differentiate between the most common types of advice: 1) Overcoming stigma and b) Seeking social support. The identified themes indicate that two groups of the population can potentially benefit from watching students’ video testimonies: 1) lay public and 2) other students with T1D. Given that students in the videos reported a lack of T1D education in the lay public, such video narratives can serve important educational purposes and reduce health stigma, while perceived similarity and identification with students in the videos may facilitate the transition of health information to other individuals with T1D and positively affect their diabetes routine. Thus, online video narratives can potentially serve both educational and persuasive purposes, empowering students with T1D to stay in control of T1D while succeeding academically.

Keywords: type 1 diabetes, college students, health communication, transition period

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2 Information and Communication Technology (ICT) Education Improvement for Enhancing Learning Performance and Social Equality

Authors: Heichia Wang, Yalan Chao

Abstract:

Social inequality is a persistent problem. One of the ways to solve this problem is through education. At present, vulnerable groups are often less geographically accessible to educational resources. However, compared with educational resources, communication equipment is easier for vulnerable groups. Now that information and communication technology (ICT) has entered the field of education, today we can accept the convenience that ICT provides in education, and the mobility that it brings makes learning independent of time and place. With mobile learning, teachers and students can start discussions in an online chat room without the limitations of time or place. However, because liquidity learning is quite convenient, people tend to solve problems in short online texts with lack of detailed information in a lack of convenient online environment to express ideas. Therefore, the ICT education environment may cause misunderstanding between teachers and students. Therefore, in order to better understand each other's views between teachers and students, this study aims to clarify the essays of the analysts and classify the students into several types of learning questions to clarify the views of teachers and students. In addition, this study attempts to extend the description of possible omissions in short texts by using external resources prior to classification. In short, by applying a short text classification, this study can point out each student's learning problems and inform the instructor where the main focus of the future course is, thus improving the ICT education environment. In order to achieve the goals, this research uses convolutional neural network (CNN) method to analyze short discussion content between teachers and students in an ICT education environment. Divide students into several main types of learning problem groups to facilitate answering student problems. In addition, this study will further cluster sub-categories of each major learning type to indicate specific problems for each student. Unlike most neural network programs, this study attempts to extend short texts with external resources before classifying them to improve classification performance. In short, by applying the classification of short texts, we can point out the learning problems of each student and inform the instructors where the main focus of future courses will improve the ICT education environment. The data of the empirical process will be used to pre-process the chat records between teachers and students and the course materials. An action system will be set up to compare the most similar parts of the teaching material with each student's chat history to improve future classification performance. Later, the function of short text classification uses CNN to classify rich chat records into several major learning problems based on theory-driven titles. By applying these modules, this research hopes to clarify the main learning problems of students and inform teachers that they should focus on future teaching.

Keywords: ICT education improvement, social equality, short text analysis, convolutional neural network

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1 Reducing Diagnostic Error in Australian Emergency Departments Using a Behavioural Approach

Authors: Breanna Wright, Peter Bragge

Abstract:

Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.

Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error

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