Search results for: surgical ambulatory assessment unit

Authors: Laura Brennan, Ram Balakumar

Abstract:

ChatGPT has been developed by Open AI (Nov 2022) as a powerful artificial intelligence (AI) language model which has been designed to produce human-like text from user written prompts. To gain the most from the system, user written prompts must give context specific information. This article aims to give guidance on how to optimise the ChatGPT system in the context of education for otolaryngology. Otolaryngology is a specialist field which sees little time dedicated to providing education to both medical students and doctors. Additionally, otolaryngology trainees have seen a reduction in learning opportunities since the COVID-19 pandemic. In this article we look at these various barriers to medical education in Otolaryngology training and suggest ways that ChatGPT can overcome them and assist in simulation-based training. Examples provide how this can be achieved using the Authors’ experience to further highlight the practicalities. What this article has found is that while ChatGPT cannot replace traditional mentorship and practical surgical experience, it can serve as an invaluable supplementary resource to simulation based medical education in Otolaryngology.

Keywords: artificial intelligence, otolaryngology, surgical training, medical education

Procedia PDF Downloads 121

Authors: Talbi Mohammed, Oustous Aziz, Ben Messaoud Mounir, Sebihi Rajaa, Khalis Mohammed

Abstract:

Background: Breast cancer is the leading cause of death for women around the world. Screening mammography is the reference examination, due to its sensitivity for detecting small lesions and micro-calcifications. Therefore, it is essential to ensure quality mammographic examinations with the most optimal dose. These conditions depend on the choice of exposure parameters. Clinically, practices must be evaluated in order to determine the most appropriate exposure parameters. Material and Methods: We performed our measurements on a mobile mammography unit (PLANMED Sofie-classic.) in Morocco. A solid dosimeter (AGMS Radcal) and a MTM 100 phantom allow to quantify the delivered dose and the image quality. For image quality assessment, scores are defined by the rate of visible inserts (MTM 100 phantom), obtained and compared for each acquisition. Results: The results show that the parameters of the mammography unit on which we have made our measurements can be improved in order to offer a better compromise between image quality and breast dose. The last one can be reduced up from 13.27% to 22.16%, while preserving comparable image quality.

Keywords: Mammography, Breast Dose, Image Quality, Phantom

Procedia PDF Downloads 139

Authors: J. Yan, B. Pieper, B. Bucsky, H. H. Sievers, B. Nasseri, S. A. Mohamed

Abstract:

In order to optimize the efficacy of medications, the regular follow-up with long-term continuous monitoring of heart rhythmic patterns has been facilitated since clinical introduction of cardiac implantable electronic monitoring devices (CIMD). Extensive analysis of rhythmic circadian properties is capable to disclose the distributions of arrhythmic events, which may support appropriate medication according rate-/rhythm-control strategy and minimize consequent afflictions. 348 patients (69 ± 0.5ys, male 61.8%) with predisposed atrial fibrillation (AF), undergoing primary ablating therapies combined to coronary or valve operations and secondary implantation of CIMDs, were involved and divided into 3 groups such as PAAF (paroxysmal AF) (n=99, male 68.7%), PEAF (persistent AF) (n=94, male 62.8%), and LSPEAF (long-standing persistent AF) (n=155, male 56.8%). All patients participated in three-year ambulant follow-up (3, 6, 9, 12, 18, 24, 30 and 36 months). Burdens of atrial fibrillation recurrence were assessed using cardiac monitor devices, whereby attacks frequencies and their circadian patterns were systemically analyzed. Anticoagulants and regular anti-arrhythmic medications were evaluated and the last were listed in terms of anti-rate and anti-rhythm regimens. Patients in the PEAF-group showed the least AF-burden after surgical ablating procedures compared to both of the other subtypes (p < 0.05). The AF-recurrences predominantly performed such attacks’ property as shorter than one hour, namely within 10 minutes (p < 0.05), regardless of AF-subtypes. Concerning circadian distribution of the recurrence attacks, frequent AF-attacks were mostly recorded in the morning in the PAAF-group (p < 0.05), while the patients with predisposed PEAF complained less attack-induced discomforts in the latter half of the night and the ones with LSPEAF only if they were not physically active after primary surgical ablations. Different AF-subtypes presented distinct therapeutic efficacies after appropriate surgical ablating procedures and recurrence properties in sense of circadian distribution. An optimization of medical regimen and drug dosages to maintain the therapeutic success needs more attention to detailed assessment of the long-term follow-up. Rate-control strategy plays a much more important role than rhythm-control in the ongoing follow-up examinations.

Keywords: atrial fibrillation, CIMD, MAZE, rate-control, rhythm-control, rhythm patterns

Procedia PDF Downloads 123

Authors: Imam Asrowardi, Septafiansyah Dwi Putra, Eko Subyantoro

Abstract:

Process assessments can improve IT service management system (IT SMS) processes but the assessment method is not always transparent. This paper outlines a project to develop a solution- mediated process assessment tool to enable transparent and objective SMS process assessment. Using the international standards for SMS and process assessment, the tool is being developed following the International standard approach in collaboration and evaluate by expert judgment from committee members and ITSM practitioners.

Keywords: SMS, tools evaluation, ITIL, ISO service

Procedia PDF Downloads 451

Authors: Jeong-Moh John Yahng, Angelika Na

Abstract:

Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

Procedia PDF Downloads 111

Authors: Hsiao-Lin Fang

Abstract:

The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

Procedia PDF Downloads 150

Authors: Alison Ryan, Himani Chhabra, Mohammed Dungarwalla, Judith Jones

Abstract:

Background: Impacted and ectopic teeth present in 1-2% of orthodontic patients and often require joint surgical and orthodontic management. The authors present two patients undergoing orthodontic treatment, where the impacted teeth, in a hopeless position, spontaneously erupted during the period of cessation of general anaesthetic lists during the COVID-19 pandemic. Patient information: A healthy 11-year-old boy was referred to the Department of Oral and Maxillofacial Surgery for the management of a mesioangular impacted LR7. The patient was seen by the joint oral surgery/orthodontic team, who planned for the removal of the LR7 under general anaesthetic. A healthy 13-year-old boy was referred to the same Department and team for surgical extraction of unerupted and buccally impacted UL3 and UR3 under general anaesthetic. Management and outcome: The majority of elective dental-alveolar work ceased as a result of the global pandemic. On resumption of activity, the first patient was reviewed in July 2021. The LR7 had spontaneously erupted in a favourable position, and following MDT review, a decision was made to forgo any further surgical intervention. The second patient was reviewed in July 2021. The UL3 had clinically erupted, and there was radiographic evidence of favourable movement of UR3. Due to the nature of the patient’s malocclusion, the decision was made to proceed with the extractions as previously planned. Key Learning Points: Severely impacted teeth do have a prospect of spontaneous eruption or alignment without clinical intervention, and current literature states the initial location, axial inclination, degree of root formation, and relation of the impacted tooth to adjacent teeth roots may influence spontaneous eruption. There is potential to introduce a period of observation to account for this possibility in the developing dentition, with the aim of reducing the unnecessary need for surgical intervention. This could help prevent episodes of general anaesthetic and allocate theatre space more appropriately.

Keywords: spontaneous eruption, impaction, observation, hopeless position, surgical, orthodontic, change in treatment plan

Procedia PDF Downloads 50

Authors: Alaa Alateeqi, Sara Aldhulaiee, Sara Alibraheem, Noura Alsaleh

Abstract:

For the past few decades or so, Kuwait's local food industry has grown remarkably due to increase in demand for processed or semi processed food products in the market. It is important that the ever increasing food manufacturing/processing units maintain the required quality standards as per regional and to some extent international quality requirements. It has been realized that all Kuwait food manufacturing units should understand and follow the international standard practices, and moreover a set of guidelines must be set for quality assurance such that any new business in this area is aware of the minimum requirements. The current study has been undertaken to identify the gaps in Kuwait food industries in following the Good Manufacturing Practices (GMP) in terms of quality planning, control and quality assurance. GMP refers to Good Manufacturing Practices, which are a set of rules, laws or regulations that certify producing products within quality standards and ensuring that it is safe, pure and effective. The present study therefore reports about a ‘case study’ in a reputed food manufacturing unit in Kuwait; starting from assessment of the current practices followed by diagnosis, report of the diagnosis and road map and corrective measures for GMP implementation in the unit. The case study has also been able to identify the best practices and establish a benchmarking data for other companies to follow, through measuring the selected company's quality, policies, products and strategies and compare it with the established benchmarking data. A set of questionnaires and assessment mechanism has been established for companies to identify their ‘benchmarking score’ in relation to the number of non-conformities and conformities with the GMP standard requirements.

Keywords: good manufacturing practices, GMP, benchmarking, Kuwait Food Industries, food quality

Procedia PDF Downloads 438

Authors: Suvorov Vasyl, Filipchuk Viktor

Abstract:

Background: If non-surgical treatment of developmental dysplasia of the hip (DDH) fails or if DDH is late-detected, surgery is necessary. Salter pelvic osteotomy (SPO) is an effective surgical option for such cases. The objectives of this study were to assess the results after SPO, evaluate risk factors, and reveal those radiological parameters that may correlate with the results. Mid- and long-term postoperative results after SPO in 17 patients (22 hip joints) were analyzed. Risk factors included those that do not depend on the surgeon (patient's age, value of the acetabular index (AI) preoperatively, DDH Tonnis grade) and those that depend on the surgeon (amount of AI correction). To radiological parameters which may correlate with the amount of AI correction, we referred distance "d" and the lateral rotation angle. Results: SPO allows performing AI correction in ranges 24.1 ± 6.5°. Excellent and good clinical results were obtained in 95.5% of patients; excellent and good radiological results in 86.4% of patients. Risk factors that do not depend on the surgeon were older patient’s age and higher preoperative AI values (p < 0.05). The risk factor that depends on the surgeon was the amount of AI correction (p < 0.05). The distance "d" was recognized as a radiological parameter that may indicate sufficient AI correction (p < 0.05). Conclusion: In older patients with a higher preoperative AI value, the results will be predictably worse. The surgeon may influence the result with a greater amount of AI correction (which may also be indicated radiologically by the distance "d" values).

Keywords: developmental dysplasia of the hip, results, risk factor, pelvic osteotomy, salter osteotomy

Procedia PDF Downloads 100

Authors: Shannon Hearney, Jeffrey Hoch

Abstract:

While all cancers are costly to treat, pancreatic cancer is a notoriously costly and deadly form of cancer. Across the world there are a variety of treatment centers ranging from small clinics to large, high-volume hospitals as well as differing structures of payment and access. It has been noted that centers that treat a high volume of pancreatic cancer patients have higher quality of care, it is unclear if that care is cost-effective. In the US there is no clear consensus on the cost-effectiveness of high-volume centers for the surgical care of pancreatic cancer. Other European countries, like Finland and Italy have shown that high-volume centers have lower mortality rates and can have lower costs, there however, is still a gap in knowledge about these centers cost-effectiveness globally. This paper seeks to review the current literature in Europe and the US to gain a better understanding of the state of high-volume pancreatic surgical centers cost-effectiveness while considering the contextual differences in health system structure. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, “Europe” “socialized medicine”, “privatized medicine”, “for-profit”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

Procedia PDF Downloads 64

Authors: Ayesha Asif, Muhammad Zeeshan

Abstract:

The sensitivity of hospital-microenvironments for all types of pollutants, due to the presence of patients with immune deficiencies, makes them complex indoor spaces. Keeping in view, this study investigated indoor air quality (IAQ) of two most sensitive places, i.e., operation theater (OT) and intensive care unit (ICU), of a publically managed hospital. Taking CO₂ concentration as air quality indicator and temperature (T) and relative humidity (RH) as thermal comfort parameters, continuous monitoring of the three variables was carried out. Measurements were recorded at an interval of 1 min for weekdays and weekends, including occupational and non-occupational hours. Outdoor T and RH measurements were also used in the analysis. Results show significant variation (p < 0.05) in CO₂, T and RH values over the day during weekdays while no significant variation (p > 0.05) have been observed during weekends of both the monitored sites. Maximum observed values of CO₂ in OT and ICU were found to be 2430 and 624 ppm, T as 24.7ºC and 28.9ºC and RH as 29.6% and 32.2% respectively.

Keywords: indoor air quality, CO₂ concentration, hospital building, comfort assessment

Procedia PDF Downloads 108

Authors: Hussain A. Alkharusi, Said S. Aldhafri, Hilal Z. Alnabhani, Muna Alkalbani

Abstract:

Analysing classroom assessments is one of the responsibilities of the teacher. It aims improving teacher’s instruction and assessment as well as student learning. The present study investigated factors that might explain variation in teachers’ practices regarding analysis of classroom assessments. The factors considered in the investigation included gender, in-service assessment training, teaching load, teaching experience, knowledge in assessment, attitude towards quantitative aspects of assessment, and self-perceived competence in analysing assessments. Participants were 246 in-service teachers in Oman. Results of a stepwise multiple linear regression analysis revealed that self-perceived competence was the only significant factor explaining the variance in teachers’ analysis of assessments. Implications for research and practice are discussed.

Keywords: analysis of assessment, classroom assessment, in-service teachers, self-competence

Procedia PDF Downloads 302

Authors: Hsin-Yi Lo, Chia-Yu Hsu

Abstract:

This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

Procedia PDF Downloads 40

Authors: Eftah Bte Moh, Hj Abdullah Izazol Binti Idris, Abd. Aziz Bin Abd. Shukor

Abstract:

This study aimed to identify the alignment of understanding and assessment practices among secondary school teachers. The study was carried out using quantitative descriptive study. The sample consisted of 164 teachers who taught Form 1 and 2 from 11 secondary schools in the district of North Kinta, Perak, Malaysia. Data were obtained from 164 respondents who answered Expectation Alignment Understanding and Practices of School Assessment (PEKDAPS) questionnaire. The data were analysed using SPSS 17.0 +. The Cronbach alpha value obtained through PEKDAPS questionnaire pilot study was 0.86. The results showed that teachers' performance in PEKDAPS based on the mean value was less than 3, which means that perfect alignment does not occur between the understanding and practices of school assessment. Two major PEKDAPS sub-constructs of articulation across grade and age and usability of the system were higher than the moderate alignment of the understanding and practices of school assessment (Min=2.0). The content was focused on PEKDAPs sub-constructs which showed lower than the moderate alignment of the understanding and practices of school assessment (Min=2.0). Another two PEKDAPS sub-constructs of transparency and fairness and the pedagogical implications showed moderate alignment (2.0). The implications of the study is that teachers need to fully understand the importance of alignment among components of assessment, learning and teaching and learning objectives as strategies to achieve quality assessment process.

Keywords: school based assessment, alignment, understanding, assessment practices

Procedia PDF Downloads 432

Authors: Serge Lacroix

Abstract:

The proposed study looks at the psychoeducational assessment of bilingual students, in English and French in this case. It will be the opportunity to look at language of assessment and specifically how certain tests can be administered in one language and others in another language. It is also a look into the questioning of the validity of the test scores that are obtained as well as the quality and generalizability of the conclusions that can be drawn. Bilingualism and multiculturalism, although in constant expansion, is not considered in norms development and remains a poorly understood factor when it is at play in the context of a psychoeducational assessment. Student placement, diagnoses, accurate measures of intelligence and achievement are all impacted by the quality of the assessment procedure. The same is true for questionnaires administered to parents and self-reports completed by bilingual students who, more often than not, are assessed in a language that is not their primary one or are compared to monolinguals not dealing with the same challenges or the same skills. Results show that students, when offered to work in a bilingual fashion, chooses to do so in a significant proportion. Recommendations will be offered to support educators aiming at expanding their skills when confronted with multilingual students in an assessment context.

Keywords: psychoeducational assessment, bilingualism, multiculturalism, intelligence, achievement

Procedia PDF Downloads 427

Authors: Amit Kumar Baghel, Sisir Kumar Nayak

Abstract:

The proposed metamaterial design help to increase the radiation efficiency at 2.9 GHz by reducing the side and back lobes by making the phase difference of the waves emerging from the phase center of the horn antenna same after passing through metamaterial array. The unit cell of the metamaterial is having concentric ring structure made of copper of 0.035 mm thickness on both sides of FR4 sheet. The inner ring diameter is kept as 3 mm, and the outer ring diameters are changed according to the path and tramission phase difference of the unit cell from the phase center of the antenna in both the horizontal and vertical direction, i.e., in x- and y-axis. In this case, the ring radius varies from 3.19 mm to 6.99 mm with the respective S21 phase difference of -62.25° to -124.64°. The total phase difference can be calculated by adding the path difference of the respective unit cell in the array to the phase difference of S21. Taking one of the unit cell as the reference, the total phase difference between the reference unit cell and other cells must be integer multiple of 360°. The variation of transmission coefficient S21 with the ring radius is greater than -6 dB. The array having 5 x 5 unit cell is kept inside the pyramidal horn antenna (L X B X H = 295.451 x 384.233 x 298.66 mm3) at a distance of 36.68 mm from the waveguide throat. There is an improvement in side lobe level in E-plane by 14.6 dB when the array is used. The front to back lobe ration is increased by 1 dB by using the array. The proposed antenna with metamaterial array can be used in beam shaping for wireless power transfer applications.

Keywords: metamaterial, side lobe level, front to back ratio, beam forming

Procedia PDF Downloads 218

Authors: Babu Shersad, Partha Banerjee

Abstract:

Reduction in haemoglobin levels has been implicated to be a cause for reduced exercise tolerance and cardiovascular complications of chronic renal diseases. Trends of hemoglobin levels in patients on haemodialysis could be an indicator of efficacy of hemodialysis and an indicator of quality of life in haemodialysis patients. In the UAE, the rate of growth (of patients on dialysis) is 10 to 15 per cent per year. The primary mode of haemodialysis in the region is based on in-patient hospital-based hemodialysis units. The increase in risk of cardiovascular and cerebrovascular morbidity as well as mortality in pre-dialysis Chronic Renal Disease has been reported. However, data on the health burden on haemodialysis in standalone dialysis facilities is very scarce. This is mainly due to the paucity of ambulatory centres for haemodialysis in the region. AMSA is the first center to offer standalone dialysis in the UAE and a study over a one year period was performed. Patient data was analyzed using a questionnaire for 45 patients with an average of 2.5 dialysis sessions per week. All patients were on chronic haemodialysis as outpatients. The trends of haemoglobin levels as an independent variable were evaluated. These trends were interpreted in comparison with other parameters of renal function (creatinine, uric acid, blood pressure and ferritin). Trends indicate an increase in hemoglobin levels with increased supplementation of iron and erythropoietin over time. The adequacy of hemodialysis shows improvement concomitantly. This, in turn, correlates with better patient outcomes and has a direct impact on morbidity and mortality. This study is a pilot study and further studies are indicated so that objective parameters can be studied and validated for hemodialysis in the region.

Keywords: haemodialysis, haemoglobin in haemodialysis, haemodialysis parameters, erythropoietic agents in haemodialysis

Procedia PDF Downloads 251

Authors: Filomena Lopes, Sandra Fernandes

Abstract:

Active learning strategies are at the center of any change process aimed to improve the development of student skills. This paper aims to analyse the impact of teaching strategies, including problem-based learning (PBL), in the curricular unit of information system for management, based on students’ perceptions of how they contribute to develop the desired learning outcomes of the curricular unit. This course is part of the 1st semester and 3rd year of the graduate degree program in management at a private higher education institution in Portugal. The methodology included an online questionnaire to students (n=40). Findings from students reveal a positive impact of the teaching strategies used. In general, 35% considered that the strategies implemented in the course contributed to the development of courses’ learning objectives. Students considered PBL as the learning strategy that better contributed to enhance the courses’ learning outcomes. This conclusion brings forward the need for further reflection and discussion on the impact of student feedback on teaching and learning processes.

Keywords: higher education, active learning strategies, skills development, student assessment

Procedia PDF Downloads 29

Authors: Merle Bischoff, Thomas Gries, Gunnar Seide

Abstract:

Nanocomposites have become more and more important as the implementation of nanoparticles in polymer allows additional functions in common industrial parts. Especially in the fabrication of filaments or fibres nanomodification is important, as only very small fillers can be added to the very fine fibres (common diameter is 20 µm, fine filament are 1 µm). Discharging fibres, conductive fibres, and many other functional fibres raise in their importance nowadays. Especially the dispersion quality is essential for the final enhancement of the filament propertied. In this paper, the dispersion of carbon nanoparticles in polymer melt is enhanced by a newly developed sonication unit of ITA and BANDELIN electronic GmbH & Co. KG. The first development steps of the unit fabrication, as well as the first experimental results of the modification of the dispersion, are shown. Special focus will be laid on the sealing of the new sonication unit as well as the positioning and equipment size when being implemented in an existing melt spinning unit. Furthermore, the influence on the thereby manufactured nano-modified filaments will be shown.

Keywords: dispersion, sonication, carbon nanoparticles, filaments

Procedia PDF Downloads 272

Authors: Chia-Chi Chang, Chuan-Bi Lin, Chia-Min Chan

Abstract:

Most ZigBee sensor networks to date make use of nodes with limited processing, communication, and energy capabilities. Energy consumption is of great importance in wireless sensor applications as their nodes are commonly battery-driven. Once ZigBee nodes are deployed outdoors, limited power may make a sensor network useless before its purpose is complete. At present, there are two strategies for long node and network lifetime. The first strategy is saving energy as much as possible. The energy consumption will be minimized through switching the node from active mode to sleep mode and routing protocol with ultra-low energy consumption. The second strategy is to evaluate the energy consumption of sensor applications as accurately as possible. Erroneous energy model may render a ZigBee sensor network useless before changing batteries. In this paper, we present a ZigBee wireless sensor node with four key modules: a processing and radio unit, an energy harvesting unit, an energy storage unit, and a sensor unit. The processing unit uses CC2530 for controlling the sensor, carrying out routing protocol, and performing wireless communication with other nodes. The harvesting unit uses a 2W solar panel to provide lasting energy for the node. The storage unit consists of a rechargeable 1200 mAh Li-ion battery and a battery charger using a constant-current/constant-voltage algorithm. Our solution to extend node lifetime is implemented. Finally, a long-term sensor network test is used to exhibit the functionality of the solar powered system.

Keywords: ZigBee, Li-ion battery, solar panel, CC2530

Procedia PDF Downloads 347

Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

Abstract:

Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

Procedia PDF Downloads 320

Authors: Youn-Sung Kim, Hye-Mi Kim, Sang-Hoon Seo, Jaden Cha

Abstract:

This International standard IEC 61508 sets out a generic approach for all safety lifecycle activities for systems comprised of electrical/electronic/programmable electronic (E/E/PE) elements that are used to perform safety functions. The control unit in stage control system is safety related facilities to control state and speed for stage system running, and it performs safety-critical function by stage control system. The controller unit is part of safety loops corresponding to the IEC 61508 and classified as logic part in the safety loop. In this paper, we analyze using FMEDA (Failure Mode Effect and Diagnostic Analysis) to verification for fault tolerance methods and functional safety of control unit. Moreover, we determined SIL (Safety Integrity Level) for control unit according to the safety requirements defined in IEC 61508-2 based on an analyzed functional safety.

Keywords: safety function, failure mode effect, IEC 61508-2, diagnostic analysis, stage control system

Procedia PDF Downloads 246

Authors: Rose Virginy S. Bautista, Ida Marie Tabangay-Lim, Helen Bongalon-Amo, Jose Modesto B. Abellera

Abstract:

Chordomas, particularly those of the spine and the head and neck region, represent a rare and locally aggressive group of malignancies. The complexity of these tumors -given the rarity, location, and involvement of neurovascular structures- imposes a challenge in the diagnosis and management. We herein report a case of spinal cord compression due to a prevertebral cervical chordoma. The patient presented with a gradually enlarging lateral neck mass, with progressive bilateral extremity weakness and urinary incontinence; preoperative biopsy showed chordoma. A multidisciplinary approach for the management of this case was made, involving neurosurgery, head and neck surgery, and radiation oncology services. Surgical collaboration between the two cutting services was done to have a radical excision of the tumor and spinal cord decompression. The patient was then referred for adjuvant radiation therapy. With this collaborative treatment strategy, more comprehensive and quality care could be provided to our patients.

Keywords: chordoma, surgical collaboration, spinal cord compression, neurosurgery, head and neck surgery

Procedia PDF Downloads 35

Authors: Lucie Litvack, Malaz Elsaddig, Kevin Jones

Abstract:

There is strong evidence to support the efficacy of the World Health Organization (WHO) Surgical Safety Checklist in improving patient safety; however, its use can be associated with difficulties. This study uses qualitative data collected in Kitovu Healthcare Complex, a rural Ugandan hospital, to identify factors that may influence the use of the checklist in a low-income setting. Potential barriers to and motivators for the hospital’s use of this checklist are identified and explored through observations of current patient safety practices; semi-structured interviews with theatre staff; a focus group with doctors; and trial implementation of the checklist. Barriers identified include the institutional context; knowledge and understanding; patient safety culture; resources and checklist contents. Motivators for correct use include prior knowledge; team attitudes; and a hospital advocate. Challenges are complex and unique to this socioeconomic context. Stepwise change to improve patient safety practices, local champions, whole team training, and checklist modification may assist the implementation and sustainable use of the checklist in an effective way.

Keywords: anaesthesia, patient safety, Uganda, WHO surgical safety checklist

Procedia PDF Downloads 330

Authors: Uttam Neupane, Narendra Budha, Subash Kumar Bhattarai

Abstract:

Material management is an essential part in construction project management. There are a number of material management problems in the Nepalese construction industry, which contribute to an inefficient material management system. Ineffective material management can cause waste of time and money thus increasing the problem of time and cost overrun. An assessment of material management system with gap and solution was carried out on 20 construction projects implemented by the Federal Level Project Implementation Unit (FPIU); Kaski district of Nepal. To improve the material management process, the respondents have provided possible solutions to overcome the gaps seen in the current material management process. The possible solutions are preparation of material schedule in line with the construction schedule for material requirement planning, verifications of material and locating of source, purchasing of the required material in advance before commencement of work, classifying the materials, and managing the inventory based on their usage value and eliminating and reduction in wastages during the overall material management process.

Keywords: material management, construction site, inventory, construction project

Procedia PDF Downloads 29

Authors: A. C. Khor, M. R. Mohamed, M. H. Sulaiman, M. R. Daud

Abstract:

Packaging for vanadium redox flow battery is one of the key elements for successful implementation of flow battery in the electrical energy storage system. Usually the bulky battery size and low energy densities make this technology not available for mobility application. Therefore RFB with improved packaging size and energy capacity are highly desirable. This paper focuses on the study of packaging improvement for unit cell V-RFB to the application on Series Hybrid Electric Vehicle. Two different designs of 25 cm2 and 100 cm2 unit cell V-RFB at same current density are used for the sample in this investigation. Further suggestions on packaging improvement are highlighted.

Keywords: electric vehicle, redox flow battery, packaging, vanadium

Procedia PDF Downloads 399

Authors: N. Dumitru, S. Dumitru, C. Copilusi, N. Ploscaru

Abstract:

On this research, experimental analyses have been performed in order to determine the oil pump mechanism dynamics and stability from an oil unit mechanical structure. The experimental tests were focused on the vibrations which occur inside of the rod element during functionality of the oil pump unit. The oil pump mechanism dynamic parameters were measured and also determined through numerical computations. Entire research is based on the oil pump unit mechanical system virtual prototyping. For a complete analysis of the mechanism, the frequency dynamic response was identified, mainly for the mechanism driven element, based on two methods: processing and virtual simulations with MSC Adams aid and experimental analysis. In fact, through this research, a complete methodology is presented where numerical simulations of a mechanism with deformed elements are developed on a dynamic mode and these can be correlated with experimental tests.

Keywords: modal dynamic analysis, oil pump, vibrations, flexible elements, frequency response

Procedia PDF Downloads 287

Authors: P. Junpeng, A. Tungkasamit

Abstract:

Research-based learning is the key for the national research universities of Thailand. The indicator reflects the success of the study in assessing the learning outcomes of students. The development of the lecturers is the most important mechanism in driving. Nowadays the lecturers lack the knowledge and skills of assessment for learning. Therefore, this study aims to develop the knowledge and skills for lecturer’s assessment through research-based learning in higher education. The target group were lecturers who teach in higher education from Khon Kaen University of Thailand. This study was a research and development involved the concept of continuing professional development. Research was conducted in 3 phases: 1) to inspire one’s thought, to accomplish both knowledge and skill, 2) to focus on changes, and 3) to reflect the changes as well as suggest the guidelines for development. The results showed that the lecturers enhanced their knowledge and skill in assessment and emphasized on assessment for learning rather than assessment of learning.

Keywords: research-based nexus, professional development, assessment for learning, higher education

Procedia PDF Downloads 331

Authors: Vijayan Narayananayar

Abstract:

Identifying learning gaps is crucial in ensuring learners have the necessary knowledge and skills to succeed. The Learning and Teaching (L&T) approach requires tutors to identify gaps in knowledge and improvise learning activities to close them. One approach to identifying learning gaps is through diagnostic assessment, which uses well-structured questions and answer options. The paper focuses on the use of diagnostic assessment as a learning and teaching approach in a foundational module at a polytechnic. The study used diagnostic assessment over two semesters, including the COVID and post-COVID semesters, to identify gaps in learning. The design of the diagnostic activity, pedagogical intervention, and survey responses completed by learners were analyzed. Results showed that diagnostic assessment can be an effective tool for identifying learning gaps and designing interventions to address them. Additionally, the use of diagnostic assessment provides an opportunity for tutors to engage with learners on a one-to-one basis, tailoring teaching to individual needs. The paper also discusses the design of diagnostic questions and answer options, including characteristics that need to be considered in achieving the target of identifying learning gaps. The implications of using diagnostic assessment as a learning and teaching approach include bridging the gap between theory and practice, and ensuring learners are equipped with skills necessary for their future careers. This paper can be useful in helping educators and practitioners to incorporate diagnostic assessment into their L&T approach.

Keywords: assessment, learning & teaching, diagnostic assessment, analytics

Procedia PDF Downloads 62

Authors: Romeo A. Botes, Imelda Smit

Abstract:

The demands of an ever changing and complex higher education environment, along with the profile of modern learners challenge current approaches to assessment and feedback. More learners enter the education system every year. The younger generation expects immediate feedback. At the same time, feedback should be meaningful. The assessment of practical activities in programming poses a particular problem, since both lecturers and learners in the information and computer science discipline acknowledge that paper-based assessment for programming subjects lacks meaningful real-life testing. At the same time, feedback lacks promptness, consistency, comprehensiveness and individualisation. Most of these aspects may be addressed by modern, technology-assisted assessment. The focus of this paper is the continuous development of an artefact that is used to assist the lecturer in the assessment and feedback of practical programming activities in a senior database programming class. The artefact was developed using three Design Science Research cycles. The first implementation allowed one programming activity submission per assessment intervention. This pilot provided valuable insight into the obstacles regarding the implementation of this type of assessment tool. A second implementation improved the initial version to allow multiple programming activity submissions per assessment. The focus of this version is on providing scaffold feedback to the learner – allowing improvement with each subsequent submission. It also has a built-in capability to provide the lecturer with information regarding the key problem areas of each assessment intervention.

Keywords: programming, computer-aided assessment, technology-assisted assessment, programming assessment software, design science research, mixed-method

Procedia PDF Downloads 275