Search results for: usability guidelines
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1661

Search results for: usability guidelines

1541 Suicide Intervention Experiences and Practices of School Counselors: Basis for Development of Practice Guidelines

Authors: Joel C. Navarez

Abstract:

The current study investigated the Filipino school counselor’s knowledge, attitudes, and competencies in suicide intervention as well as their experiences and practices in suicide intervention. The study also aimed to develop and standardize suicide intervention guidelines. The study has two (2) phases. Phase 1 utilized the descriptive and generic qualitative inquiry methods of research. Purposive and convenience sampling was applied, and participants were college counselors from the National Capital Region (NCR), Luzon, Visayas, and Mindanao. Results revealed that counselors do not have high level of knowledge on suicidal behaviors, have some negative attitudes toward suicidal behavior, and need to acquire better intervention skills. The findings also showed that the trainings received by counselors are not enough to advance their suicide intervention skills, which would help enhance positive attitudes towards suicide risk assessment and management. Some common experiences of the counselors in suicide intervention were focused on the areas of accountability, stigmatizing attitudes of parents, and confidentiality issues. Phase 2 of the study was the development of suicide intervention practice guidelines using the Delphi process. The tentative guideline was based on the content analysis of interventions taken from literature and from the actual intervention practices of counselors, as seen from the findings of the qualitative study of Phase 1. After three (3) Delphi rounds and the consensus from sixteen (16) mental health experts, 145 recommended actions can be implemented by school counselors in suicide.

Keywords: counselor competencies, counselor development, suicide, suicide intervention

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1540 A Cost Effective Approach to Develop Mid-Size Enterprise Software Adopted the Waterfall Model

Authors: Mohammad Nehal Hasnine, Md Kamrul Hasan Chayon, Md Mobasswer Rahman

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Organizational tendencies towards computer-based information processing have been observed noticeably in the third-world countries. Many enterprises are taking major initiatives towards computerized working environment because of massive benefits of computer-based information processing. However, designing and developing information resource management software for small and mid-size enterprises under budget costs and strict deadline is always challenging for software engineers. Therefore, we introduced an approach to design mid-size enterprise software by using the Waterfall model, which is one of the SDLC (Software Development Life Cycles), in a cost effective way. To fulfill research objectives, in this study, we developed mid-sized enterprise software named “BSK Management System” that assists enterprise software clients with information resource management and perform complex organizational tasks. Waterfall model phases have been applied to ensure that all functions, user requirements, strategic goals, and objectives are met. In addition, Rich Picture, Structured English, and Data Dictionary have been implemented and investigated properly in engineering manner. Furthermore, an assessment survey with 20 participants has been conducted to investigate the usability and performance of the proposed software. The survey results indicated that our system featured simple interfaces, easy operation and maintenance, quick processing, and reliable and accurate transactions.

Keywords: end-user application development, enterprise software design, information resource management, usability

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1539 Guidelines to Designing Generic Protocol for Responding to Chemical, Biological, Radiological and Nuclear Incidents

Authors: Mohammad H. Yarmohammadian, Mehdi Nasr Isfahani, Elham Anbari

Abstract:

Introduction: The awareness of using chemical, biological, and nuclear agents in everyday industrial and non-industrial incidents has increased recently; release of these materials can be accidental or intentional. Since hospitals are the forefronts of confronting Chemical, Biological, Radiological and Nuclear( CBRN) incidents, the goal of the present research was to provide a generic protocol for CBRN incidents through a comparative review of CBRN protocols and guidelines of different countries and reviewing various books, handbooks and papers. Method: The integrative approach or research synthesis was adopted in this study. First a simple narrative review of programs, books, handbooks, and papers about response to CBRN incidents in different countries was carried out. Then the most important and functional information was discussed in the form of a generic protocol in focus group sessions and subsequently confirmed. Results: Findings indicated that most of the countries had various protocols, guidelines, and handbooks for hazardous materials or CBRN incidents. The final outcome of the research synthesis was a 50 page generic protocol whose main topics included introduction, definition and classification of CBRN agents, four major phases of incident and disaster management cycle, hospital response management plan, equipment, and recommended supplies and antidotes for decontamination (radiological/nuclear, chemical, biological); each of these also had subtopics. Conclusion: In the majority of international protocols, guidelines, handbooks and also international and Iranian books and papers, there is an emphasis on the importance of incident command system, determining the safety degree of decontamination zones, maps of decontamination zones, decontamination process, triage classifications, personal protective equipment, and supplies and antidotes for decontamination; these are the least requirements for such incidents and also consistent with the provided generic protocol.

Keywords: hospital, CBRN, decontamination, generic protocol, CBRN Incidents

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1538 A Cloud-Based Mobile Auditing Tools for Muslim-Friendly Hospitality Services

Authors: Mohd Iskandar Illyas Tan, Zuhra Junaida Mohamad Husny, Farawahida Mohd Yusof

Abstract:

The potentials of Muslim-friendly hospitality services bring huge opportunities to operators (hoteliers, tourist guides, and travel agents), especially among the Muslim countries. In order to provide guidelines that facilitate the operations among these operators, standards and manuals have been developing by the authorities. Among the challenges is the applicability and complexity of the standard to be adopted in the real world. Mobile digital technology can be implemented to overcome those challenges. A prototype has been developed to help operators and authorities to assess their readiness in complying with MS2610:2015. This study analyzes the of mobile digital technology characteristics that are suitable for the user in conducting sharia’ compliant hospitality audit. A focus group study was conducted in the state of Penang, Malaysia that involves operators (hoteliers, tourist guide, and travel agents) as well as agencies (Islamic Tourism Center, Penang Islamic Affairs Department, Malaysian Standard) that involved directly in the implementation of the certification. Both groups were given the 3 weeks to test and provide feedback on the usability of the mobile applications in order to conduct an audit on their readiness towards the Muslim-friendly hospitality services standard developed by the Malaysian Standard. The feedbacks were analyzed and the overall results show that three criteria (ease of use, completeness and fast to complete) show the highest responses among both groups for the mobile application. This study provides the evidence that the mobile application development has huge potentials to be implemented by the Muslim-friendly hospitality services operator and agencies.

Keywords: hospitality, innovation, audit, compliance, mobile application

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1537 Implementation and Challenges of Assessment Methods in the Case of Physical Education Class in Some Selected Preparatory Schools of Kirkos Sub-City

Authors: Kibreab Alene Fenite

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The purpose of this study is to investigate the implementation and challenges of different assessment methods for physical education class in some selected preparatory schools of kirkos sub city. The participants in this study are teachers, students, department heads and school principals from 4 selected schools. Of the total 8 schools offering in kirkos sub city 4 schools (Dandi Boru, Abiyot Kirse, Assay, and Adey Ababa) are selected by using simple random sampling techniques and from these schools all (100%) of teachers, 100% of department heads and school principals are taken as a sample as their number is manageable. From the total 2520 students, 252 (10%) of students are selected using simple random sampling. Accordingly, 13 teachers, 252 students, 4 department heads and 4 school principals are taken as a sample from the 4 selected schools purposefully. As a method of data gathering tools; questionnaire and interview are employed. To analyze the collected data, both quantitative and qualitative methods are used. The result of the study revealed that assessment in physical education does not implement properly: lack of sufficient materials, inadequate time allotment, large class size, and lack of collaboration and working together of teachers towards assessing the performance of students, absence of guidelines to assess the physical education subject, no different assessment method that is implementing on students with disabilities in line with their special need are found as major challenges in implementing the current assessment method of physical education. To overcome these problems the following recommendations have been forwarded. These are: the necessary facilities and equipment should be available; In order to make reliable, accurate, objective and relevant assessment, teachers of physical education should be familiarized with different assessment techniques; Physical education assessment guidelines should be prepared, and guidelines should include different types of assessment methods; qualified teachers should be employed, and different teaching room must be build.

Keywords: assessment, challenges, equipment, guidelines, implementation, performance

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1536 Cost Based Analysis of Risk Stratification Tool for Prediction and Management of High Risk Choledocholithiasis Patients

Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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1535 Good Practices for Model Structure Development and Managing Structural Uncertainty in Decision Making

Authors: Hossein Afzali

Abstract:

Increasingly, decision analytic models are used to inform decisions about whether or not to publicly fund new health technologies. It is well noted that the accuracy of model predictions is strongly influenced by the appropriateness of model structuring. However, there is relatively inadequate methodological guidance surrounding this issue in guidelines developed by national funding bodies such as the Australian Pharmaceutical Benefits Advisory Committee (PBAC) and The National Institute for Health and Care Excellence (NICE) in the UK. This presentation aims to discuss issues around model structuring within decision making with a focus on (1) the need for a transparent and evidence-based model structuring process to inform the most appropriate set of structural aspects as the base case analysis; (2) the need to characterise structural uncertainty (If there exist alternative plausible structural assumptions (or judgements), there is a need to appropriately characterise the related structural uncertainty). The presentation will provide an opportunity to share ideas and experiences on how the guidelines developed by national funding bodies address the above issues and identify areas for further improvements. First, a review and analysis of the literature and guidelines developed by PBAC and NICE will be provided. Then, it will be discussed how the issues around model structuring (including structural uncertainty) are not handled and justified in a systematic way within the decision-making process, its potential impact on the quality of public funding decisions, and how it should be presented in submissions to national funding bodies. This presentation represents a contribution to the good modelling practice within the decision-making process. Although the presentation focuses on the PBAC and NICE guidelines, the discussion can be applied more widely to many other national funding bodies that use economic evaluation to inform funding decisions but do not transparently address model structuring issues e.g. the Medical Services Advisory Committee (MSAC) in Australia or the Canadian Agency for Drugs and Technologies in Health.

Keywords: decision-making process, economic evaluation, good modelling practice, structural uncertainty

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1534 Development of Visual Element Design Guidelines for Consumer Products Based on User Characteristics

Authors: Taezoon Park, Wonil Hwang

Abstract:

This study aims to build a design guideline for the effective visual display used for consumer products considering user characteristics; gender and age. Although a number of basic experiments identified the limits of human visual perception, the findings remain fragmented and many times in an unfriendly form. This study compiled a design cases along with tables aggregated from the experimental result of visual perception; brightness/contrast, useful field of view, color sensitivity. Visual design elements commonly used for consumer product, were selected and appropriate guidelines were developed based on the experimental result. Since the provided data with case example suggests a feasible design space, it will save time for a product designer to find appropriate design alternatives.

Keywords: design guideline, consumer product, visual design element, visual perception, emotional design

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1533 Streamlining the Fuzzy Front-End and Improving the Usability of the Tools Involved

Authors: Michael N. O'Sullivan, Con Sheahan

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Researchers have spent decades developing tools and techniques to aid teams in the new product development (NPD) process. Despite this, it is evident that there is a huge gap between their academic prevalence and their industry adoption. For the fuzzy front-end, in particular, there is a wide range of tools to choose from, including the Kano Model, the House of Quality, and many others. In fact, there are so many tools that it can often be difficult for teams to know which ones to use and how they interact with one another. Moreover, while the benefits of using these tools are obvious to industrialists, they are rarely used as they carry a learning curve that is too steep and they become too complex to manage over time. In essence, it is commonly believed that they are simply not worth the effort required to learn and use them. This research explores a streamlined process for the fuzzy front-end, assembling the most effective tools and making them accessible to everyone. The process was developed iteratively over the course of 3 years, following over 80 final year NPD teams from engineering, design, technology, and construction as they carried a product from concept through to production specification. Questionnaires, focus groups, and observations were used to understand the usability issues with the tools involved, and a human-centred design approach was adopted to produce a solution to these issues. The solution takes the form of physical toolkit, similar to a board game, which allows the team to play through an example of a new product development in order to understand the process and the tools, before using it for their own product development efforts. A complimentary website is used to enhance the physical toolkit, and it provides more examples of the tools being used, as well as deeper discussions on each of the topics, allowing teams to adapt the process to their skills, preferences and product type. Teams found the solution very useful and intuitive and experienced significantly less confusion and mistakes with the process than teams who did not use it. Those with a design background found it especially useful for the engineering principles like Quality Function Deployment, while those with an engineering or technology background found it especially useful for design and customer requirements acquisition principles, like Voice of the Customer. Products developed using the toolkit are added to the website as more examples of how it can be used, creating a loop which helps future teams understand how the toolkit can be adapted to their project, whether it be a small consumer product or a large B2B service. The toolkit unlocks the potential of these beneficial tools to those in industry, both for large, experienced teams and for inexperienced start-ups. It allows users to assess the market potential of their product concept faster and more effectively, arriving at the product design stage with technical requirements prioritized according to their customers’ needs and wants.

Keywords: new product development, fuzzy front-end, usability, Kano model, quality function deployment, voice of customer

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1532 Dynamic Stability Assessment of Different Wheel Sized Bicycles Based on Current Frame Design Practice with ISO Requirement for Bicycle Safety

Authors: Milan Paudel, Fook Fah Yap, Anil K. Bastola

Abstract:

The difficulties in riding small wheel bicycles and their lesser stability have been perceived for a long time. Although small wheel bicycles are designed using the similar approach and guidelines that have worked well for big wheel bicycles, the performance of the big wheelers and the smaller wheelers are markedly different. Since both the big wheelers and small wheelers have same fundamental geometry, most blame the small wheel for this discrepancy in the performance. This paper reviews existing guidelines for bicycle design, especially the front steering geometry for the bicycle, and provides a systematic and quantitative analysis of different wheel sized bicycles. A validated mathematical model has been used as a tool to assess the dynamic performance of the bicycles in term of their self-stability. The results obtained were found to corroborate the subjective perception of cyclists for small wheel bicycles. The current approach for small wheel bicycle design requires higher speed to be self-stable. However, it was found that increasing the headtube angle and selecting a proper trail could improve the dynamic performance of small wheel bicycles. A range of parameters for front steering geometry has been identified for small wheel bicycles that have comparable stability as big wheel bicycles. Interestingly, most of the identified geometries are found to be beyond the ISO recommended range and seem to counter the current approach of small wheel bicycle design. Therefore, it was successfully shown that the guidelines for big wheelers do not translate directly to small wheelers, but careful selection of the front geometry could make small wheel bicycles as stable as big wheel bicycles.

Keywords: big wheel bicycle, design approach, ISO requirements, small wheel bicycle, stability and performance

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1531 Mechanisms and Process of an Effective Public Policy Formulation in Islamic Economic System

Authors: Md Abu Saieed

Abstract:

Crafting and implementing public policy is one of the indispensable works in any form of state and government. But the policy objectives, methods of formulation and tools of implementation might be different based on the ideological nature, historical legacy, structure and capacity of administration and management and other push and factors. Public policy in Islamic economic system needs to be based on the key guidelines of divine scriptures along with other sources of sharia’h. As a representative of Allah (SWT), the governor and other apparatus of the state will formulate and implement public policies which will enable to establish a true welfare state based on justice, equity and equality. The whole life of Prophet Muhammad (pbuh) and his policy in operating state of affairs in Madina is the practical guidelines for the policy actors and professionals in Islamic system of economics. Moreover, policy makers need to be more meticulous in formulating Islamic public policy which meets the needs and demands of contemporary worlds as well.

Keywords: formulation, Islam, public policy, policy factors, Sharia’h

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1530 Female Frontline Health Workers in High-Risk Workplaces: Legal Protection in Bangladesh amid the Covid-19 Pandemic

Authors: Nabila Farhin, Israt Jahan

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Despite the feminisation of the global health force, women mostly engage in nursing, midwifery and community health workers (HWs), and the posts like surgeons, doctors, and specialists are generally male-dominated. It is also prominent in Bangladesh, where female HWs witness systematic workplace inequalities, discrimination, and underpayment. The Covid-19 pandemic put unsurmountable pressure on HWs as they had to serve in high-risk workplaces as frontliners. The already disadvantaged female HWs shouldered the same burden, were overworked without adequate occupational health and safety measures (OSH) and risked their lives. Acknowledging their vulnerable workplace conditions, the World Health Organization (WHO) and International Labour Organization (ILO) circulated a few specialised guidelines amid the peril. Bangladesh tried to adhere to international guidelines while formulating pandemic management strategies. In reality, the already weak and understaffed health sector collapsed with the patient influx and many HWs got infected and died in the line of duty, exposing the high-risk nature of the work. Unfortunately, the gender-segregated data of infected HWs are absent. This qualitative research investigates whether the existing laws of Bangladesh are adequate in protecting female HWs as frontliners in high-risk workplaces during the Covid-19 pandemic. The paper first examines international labour laws safeguarding female frontline HWs. It also analyses the specialised Covid-19 pandemic guidelines protecting their interests. Finally, the research investigates the compliance of Bangladesh as per international legal guidance during the pandemic. In doing so, it explores the domestic laws, professional guidelines for HWs and pandemic response strategies. The paper critically examines the primary sources like international and national statutes, rules, regulations and guidelines. Secondary sources like authoritative journal articles, books and newspaper reports are contextually analysed in line with the objective of the paper. The definition of HW is ambiguous in the labour laws of Bangladesh. It leads to confusion regarding the extent of legal protection rendered to female HWs at private hospitals in high-risk situations. The labour laws are not applicable in Public hospitals, as the employees follow the public service rules. Unfortunately, the country has no specialised law to protect HWs in high-risk workplaces, and the professional guidelines for HWs also remain inadequate in this regard. Even though the pandemic management strategies highlight some protective measures in high-risk situations, they only deal with HWs who are pregnant or have underlying health issues. No specialised protective guidelines can be found for female HWs as frontliners. Therefore, the laws are insufficient and failed to render adequate legal protection to female frontline HWs during the pandemic. The country also lacks comprehensive health legislation and uniform institutional and professional guidelines, preventing them from accessing grievance mechanisms. Hence, the female HWs felt victimised while duty-bound to serve in high-risk workplaces without adequate safeguards. Bangladesh should clarify the definition of HWs and standardise the service rules for providing medical care in high-risk workplaces. The research also recommends adequate health legislation and specialised legal protection to safeguard female HWs in future emergencies.

Keywords: female health workers (HWs), high-risk workplaces, Covid-19 pandemic, Bangladesh

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1529 Nation Branding: Guidelines for Identity Development and Image Perception of Thailand Brand in Health and Wellness Tourism

Authors: Jiraporn Prommaha

Abstract:

The purpose of this research is to study the development of Thailand Brand Identity and the perception of its image in order to find any guidelines for the identity development and the image perception of Thailand Brand in Health and Wellness Tourism. The paper is conducted through mixed methods research, both the qualitative and quantitative researches. The qualitative focuses on the in-depth interview of executive administrations from public and private sectors involved scholars and experts in identity and image issue, main 11 people. The quantitative research was done by the questionnaires to collect data from foreign tourists 800; Chinese tourists 400 and UK tourists 400. The technique used for this was the Exploratory Factor Analysis (EFA), this was to determine the relation between the structures of the variables by categorizing the variables into group by applying the Varimax rotation technique. This technique showed recognition the Thailand brand image related to the 2 countries, China and UK. The results found that guidelines for brand identity development and image perception of health and wellness tourism in Thailand; as following (1) Develop communication in order to understanding of the meaning of the word 'Health and beauty tourism' throughout the country, (2) Develop human resources as a national agenda, (3) Develop awareness rising in the conservation and preservation of natural resources of the country, (4) Develop the cooperation of all stakeholders in Health and Wellness Businesses, (5) Develop digital communication throughout the country and (6) Develop safety in Tourism.

Keywords: brand identity, image perception, nation branding, health and wellness tourism, mixed methods research

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1528 A Numerical Computational Method of MRI Static Magnetic Field for an Ergonomic Facility Design Guidelines

Authors: Sherine Farrag

Abstract:

Magnetic resonance imaging (MRI) presents safety hazards, with the general physical environment. The principal hazard of the MRI is the presence of static magnetic fields. Proper architectural design of MRI’s room ensure environment and health care staff safety. This research paper presents an easy approach for numerical computation of fringe static magnetic fields. Iso-gauss line of different MR intensities (0.3, 0.5, 1, 1.5 Tesla) was mapped and a polynomial function of the 7th degree was generated and tested. Matlab script was successfully applied for MRI SMF mapping. This method can be valid for any kind of commercial scanner because it requires only the knowledge of the MR scanner room map with iso-gauss lines. Results help to develop guidelines to guide healthcare architects to design of a safer Magnetic resonance imaging suite.

Keywords: designing MRI suite, MRI safety, radiology occupational exposure, static magnetic fields

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1527 An Audit of Local Guidance Compliance For Stereotactic Core Biopsy For DCIS In The Breast Screening Programme

Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

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1526 Quality Assurance in Translation Crowdsourcing: The TED Open Translation Project

Authors: Ya-Mei Chen

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The participatory culture enabled by Web 2.0 technologies has led to the emergence of online translation crowdsourcing, which mainly relies on the collective intelligence of volunteer translators. Due to the fact that many volunteer translators do not have formal translator training, concerns have been raised about the quality of crowdsourced translations. Some empirical research has been done to examine the translation quality of for-profit crowdsourcing initiatives. However, quality assurance of non-profit translation crowdsourcing has rarely been explored in detail. Using the TED Open Translation Project as a case study, this paper investigates how the translation-review-approval method adopted by TED can (1) direct the volunteer translators’ use of translation strategies as well as the reviewers’ adoption of revising strategies and (2) shape the final translation products. To well examine the actual effect of TED’s translation-review-approval method, this paper will focus on its two major quality assurance mechanisms, that is, TED’s style guidelines and quality review. Based on an anonymous questionnaire, this research will first explore whether the volunteer translators and reviewers are aware of the style guidelines and whether their use of translation strategies is similar to that advised in the guidelines. The questionnaire, which will be posted online, will consist of two parts: demographic information and translation strategies. The invitations to complete it will then be distributed through TED Translator Facebook groups. With an aim to investigate if the style guidelines have any substantial impacts on actual subtitling practices, a comparison will be made between the original English subtitles of 20 TED talks (each around 5 to 7 minutes) and their Chinese subtitle translations to identify regularly adopted strategies. Concerning the function of the reviewing stage, a comparative study will be conducted between the drafts of Chinese subtitles for 10 short English talks and the revised versions of these drafts so as to examine the actual revising strategies and their effect on translation quality. According to the results obtained from the questionnaire and textual comparisons, this paper will provide in-depth analysis of quality assurance of the TED Open Translation Project. It is hoped that this research, through a detailed investigation of non-profit translation crowdsourcing, can enable translation researchers and practitioners to have a better understanding of quality control in translation crowdsourcing in the digital age.

Keywords: quality assurance, TED, translation crowdsourcing, volunteer translators

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1525 Association between Healthy Eating Index-2015 Scores and the Probability of Sarcopenia in Community-Dwelling Iranian Elderly

Authors: Zahra Esmaeily, Zahra Tajari, Shahrzad Daei, Mahshid Rezaei, Atefeh Eyvazkhani, Marjan Mansouri Dara, Ahmad Reza Dorosty Motlagh, Andriko Palmowski

Abstract:

Objective: Sarcopenia (SPA) is associated with frailty and disability in the elderly. Adherence to current dietary guidelines in addition to physical activity could play a role in the prevention of muscle wasting and weakness. The Healthy Eating Index-2015 (HEI) is a tool to assess diet quality as recommended in the U.S. Dietary Guidelines for Americans. This study aimed to investigate whether there is a relationship between HEI scores and the probability of SPA (PS) among the Tehran elderly. Method: A previously validated semi-quantitative food frequency questionnaire was used to assess HEI and the dietary intake of randomly selected elderly people living in Tehran, Iran. Handgrip strength (HGS) was measured to evaluate the PS. Statistical evaluation included descriptive analysis and standard test procedures. Result: 201 subjects were included. Those probably suffering from SPA (as determined by HGS) had significantly lower HEI scores (p = 0.02). After adjusting for confounders, HEI scores and HGS were still significantly associated (adjusted R2 = 0.56, slope β = 0.03, P = 0.09). Elderly people with a low probability of SPA consumed more monounsaturated and polyunsaturated fatty acids (P = 0.06) and ingested less added sugars and saturated fats (P = 0.01 and P = 0.02, respectively). Conclusion: In this cross-sectional study, HEI scores are associated with the probability of SPA. Adhering to current dietary guidelines might contribute to ameliorating muscle strength and mass in aging individuals.

Keywords: aging, HEI-2015, Iranian, sarcopenic

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1524 Heavy Metal Concentrations in Sediments of Sta. Maria River, Laguna

Authors: Francis Angelo A. Sta. Ana

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Heavy metal pollutants are a major environmental concern in built-up areas in the Philippines. It causes negative effects on aquatic organisms and human health. Heavy metals concentrations of chromium, mercury, lead, copper, arsenic, zinc, cadmium, and nickel were investigated in Sta. Maria river, in Laguna. A total of 16 sediment samples were collected from the river at four stations. Atomic absorption spectroscopy (AAS) was used for element detection. It is found that copper is associated with chromium based on statistical analysis using principal component analysis (PCA). Conduct of Sediment Quality Guideline (SQG) revealed that chromium has high toxicity due to values higher than Sediment Quality Guidelines Probable Effect Level (SQG’s PEL). Copper, Nickel, and Pb fall on average toxicity while others are below PEL and effect range low (ERL).

Keywords: heavy metals, pollutants, sediment quality guidelines, atomic absorption spectroscopy

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1523 Evaluation of Public Library Adult Programs: Use of Servqual and Nippa Assessment Standards

Authors: Anna Ching-Yu Wong

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This study aims to identify the quality and effectiveness of the adult programs provided by the public library using the ServQUAL Method and the National Library Public Programs Assessment guidelines (NIPPA, June 2019). ServQUAl covers several variables, namely: tangible, reliability, responsiveness, assurance, and empathy. NIPPA guidelines focus on program characteristics, particularly on the outcomes – the level of satisfaction from program participants. The reached populations were adults who participated in library adult programs at a small-town public library in Kansas. This study was designed as quantitative evaluative research which analyzed the quality and effectiveness of the library adult programs by analyzing the role of each factor based on ServQUAL and the NIPPA's library program assessment guidelines. Data were collected from November 2019 to January 2020 using a questionnaire with a Likert Scale. The data obtained were analyzed in a descriptive quantitative manner. The impact of this research can provide information about the quality and effectiveness of existing programs and can be used as input to develop strategies for developing future adult programs. Overall the result of ServQUAL measurement is in very good quality, but still, areas need improvement and emphasis in each variable: Tangible Variables still need improvement in indicators of the temperature and space of the meeting room. Reliability Variable still needs improvement in the timely delivery of the programs. Responsiveness Variable still needs improvement in terms of the ability of the presenters to convey trust and confidence from participants. Assurance Variables still need improvement in the indicator of knowledge and skills of program presenters. Empathy Variable still needs improvement in terms of the presenters' willingness to provide extra assistance. The result of program outcomes measurement based on NIPPA guidelines is very positive. Over 96% of participants indicated that the programs were informative and fun. They learned new knowledge and new skills and would recommend the programs to their friends and families. They believed that together, the library and participants build stronger and healthier communities.

Keywords: ServQual model, ServQual in public libraries, library program assessment, NIPPA library programs assessment

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1522 Service Blueprint for Improving Clinical Guideline Adherence via Mobile Health Technology

Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

Abstract:

Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint

Procedia PDF Downloads 385
1521 Comparing the Educational Effectiveness of eHealth to Deliver Health Knowledge between Higher Literacy Users and Lower Literacy Users

Authors: Yah-Ling Hung

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eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.

Keywords: eHealth, health intervention, health literacy, usability evaluation

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1520 Investigation of the Usability of Biochars Obtained from Olive Pomace and Smashed Olive Seeds as Additives for Bituminous Binders

Authors: Muhammed Ertugrul Celoglu, Beyza Furtana, Mehmet Yilmaz, Baha Vural Kok

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Biomass, which is considered to be one of the largest renewable energy sources in the world, has a potential to be utilized as a bitumen additive after it is processed by a wide variety of thermochemical methods. Furthermore, biomasses are renewable in short amounts of time, and they possess a hydrocarbon structure. These characteristics of biomass promote their usability as additives. One of the most common ways to create materials with significant economic values from biomasses is the processes of pyrolysis. Pyrolysis is defined as the process of an organic matter’s thermochemical degradation (carbonization) at a high temperature and in an anaerobic environment. The resultant liquid substance at the end of the pyrolysis is defined as bio-oil, whereas the resultant solid substance is defined as biochar. Olive pomace is the resultant mildly oily pulp with seeds after olive is pressed and its oil is extracted. It is a significant source of biomass as the waste of olive oil factories. Because olive pomace is waste material, it could create problems just as other waste unless there are appropriate and acceptable areas of utilization. The waste material, which is generated in large amounts, is generally used as fuel and fertilizer. Generally, additive materials are used in order to improve the properties of bituminous binders, and these are usually expensive materials, which are produced chemically. The aim of this study is to investigate the usability of biochars obtained after subjecting olive pomace and smashed olive seeds, which are considered as waste materials, to pyrolysis as additives in bitumen modification. In this way, various ways of use will be provided for waste material, providing both economic and environmental benefits. In this study, olive pomace and smashed olive seeds were used as sources of biomass. Initially, both materials were ground and processed through a No.50 sieve. Both of the sieved materials were subjected to pyrolysis (carbonization) at 400 ℃. Following the process of pyrolysis, bio-oil and biochar were obtained. The obtained biochars were added to B160/220 grade pure bitumen at 10% and 15% rates and modified bitumens were obtained by mixing them in high shear mixtures at 180 ℃ for 1 hour at 2000 rpm. Pure bitumen and four different types of bitumen obtained as a result of the modifications were tested with penetration, softening point, rotational viscometer, and dynamic shear rheometer, evaluating the effects of additives and the ratios of additives. According to the test results obtained, both biochar modifications at both ratios provided improvements in the performance of pure bitumen. In the comparison of the test results of the binders modified with the biochars of olive pomace and smashed olive seed, it was revealed that there was no notable difference in their performances.

Keywords: bituminous binders, biochar, biomass, olive pomace, pomace, pyrolysis

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1519 Factors That Contribute to Noise Induced Hearing Loss Amongst Employees at the Platinum Mine in Limpopo Province, South Africa

Authors: Livhuwani Muthelo, R. N. Malema, T. M. Mothiba

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Long term exposure to excessive noise in the mining industry increases the risk of noise induced hearing loss, with consequences for employee’s health, productivity and the overall quality of life. Objective: The objective of this study was to investigate the factors that contribute to Noise Induced Hearing Loss amongst employees at the Platinum mine in the Limpopo Province, South Africa. Study method: A qualitative, phenomenological, exploratory, descriptive, contextual design was applied in order to explore and describe the contributory factors. Purposive non-probability sampling was used to select 10 male employees who were diagnosed with NIHL in the year 2014 in four mine shafts, and 10 managers who were involved in a Hearing Conservation Programme. The data were collected using semi-structured one-on-one interviews. A qualitative data analysis of Tesch’s approach was followed. Results: The following themes emerged: Experiences and challenges faced by employees in the work environment, hearing protective device factors and management and leadership factors. Hearing loss was caused by partial application of guidelines, policies, and procedures from the Department of Minerals and Energy. Conclusion: The study results indicate that although there are guidelines, policies, and procedures available, failure in the implementation of one element will affect the development and maintenance of employees hearing mechanism. It is recommended that the mine management should apply the guidelines, policies, and procedures and promptly repair the broken hearing protective devices.

Keywords: employees, factors, noise induced hearing loss, noise exposure

Procedia PDF Downloads 92
1518 Medication Errors in Neonatal Intensive Care Unit

Authors: Ramzi Shawahna

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Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

Procedia PDF Downloads 49
1517 Gaming Mouse Redesign Based on Evaluation of Pragmatic and Hedonic Aspects of User Experience

Authors: Thedy Yogasara, Fredy Agus

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In designing a product, it is currently crucial to focus not only on the product’s usability based on performance measures, but also on user experience (UX) that includes pragmatic and hedonic aspects of product use. These aspects play a significant role in fulfillment of user needs, both functionally and psychologically. Pragmatic quality refers to as product’s perceived ability to support the fulfillment of behavioral goals. It is closely linked to functionality and usability of the product. In contrast, hedonic quality is product’s perceived ability to support the fulfillment of psychological needs. Hedonic quality relates to the pleasure of ownership and use of the product, including stimulation for personal development and communication of user’s identity to others through the product. This study evaluates the pragmatic and hedonic aspects of gaming mice G600 and Razer Krait using AttrakDiff tool to create an improved design that is able to generate positive UX. AttrakDiff is a method that measures pragmatic and hedonic scores of a product with a scale between -3 to +3 through four attributes (i.e. Pragmatic Quality, Hedonic Quality-Identification, Hedonic Quality-Stimulation, and Attractiveness), represented by 28 pairs of opposite words. Based on data gathered from 15 participants, it is identified that gaming mouse G600 needs to be redesigned because of its low grades (pragmatic score: -0.838, hedonic score: 1, attractiveness score: 0.771). The redesign process focuses on the attributes with poor scores and takes into account improvement suggestions collected from interview with the participants. The redesigned mouse G600 is evaluated using the previous method. The result shows higher scores in pragmatic quality (1.929), hedonic quality (1.703), and attractiveness (1.667), indicating that the redesigned mouse is more capable of creating pleasurable experience of product use.

Keywords: AttrakDiff, hedonic aspect, pragmatic aspect, product design, user experience

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1516 Compliance Of Dialysis patients With Nutrition Guidelines: Insights From A Questionnaire

Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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1515 'Antibody Exception' under Dispute and Waning Usage: Potential Influence on Patenting Antibodies

Authors: Xiangjun Kong, Dongning Yao, Yuanjia Hu

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Therapeutic antibodies have become the most valuable and successful class of biopharmaceutical drugs, with a huge market potential and therapeutic advantages. Antibody patents are, accordingly, extremely important. As the technological limitation of the early stage of this field, the U. S. Patent and Trademark Offices (USPTO) have issued guidelines that suggest an exception for patents claiming a genus of antibodies that bind to a novel antigen, even in the absence of any experimental antibody production. This 'antibody exception' allowed for a broad scope on antibody claims, and led a global trend to patent antibodies without antibodies. Disputes around the pertinent patentability and written description issues remain particularly intense. Yet the validity of such patents had not been overtly challenged until Centocor v. Abbott, which restricted the broad scope of antibody patents and hit the brakes on the 'antibody exception'. The courts tend to uphold the requirement for adequate description of antibodies in the patent specifications, to avoid overreaching antibody claims. Patents following the 'antibody exception' are at risk of being found invalid for inadequately describing what they have claimed. However, the relation between the court and USPTO guidelines remains obscure, and the waning of the 'antibody exception' has led to further disputes around antibody patents. This uncertainty clearly affects patent applications, antibody innovations, and even relevant business performance. This study will give an overview of the emergence, debate, and waning usage of the 'antibody exception' in a number of enlightening cases, attempting to understand the specific concerns and the potential influence of antibody patents. We will then provide some possible strategies for antibody patenting, under the current considerations on the 'antibody exception'.

Keywords: antibody exception, antibody patent, USPTO (U. S. Patent and Trademark Offices) guidelines, written description requirement

Procedia PDF Downloads 127
1514 Investigating the Accessibility of Physically Disabled Individuals in Corporate Offices: A Case of Dhaka City

Authors: Ishrar Tabassum, Jay Andrew Saptok, Khalid Raihan Kabir, Elmee Tabassum

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The purpose of this study is to bring light to the current state of the working environments in the corporate environment and other such institutions with a particular focus on the Bangladesh National Building Code (BNBC) and its guidelines for accommodating the physically disabled. Data were collected via semi-formal interviews, site visits and focus groups conducted using a preset questionnaire as the guidelines. After conducting surveys at corporate offices of 20 organizations from major commercial sectors in Dhaka city, the auditing showed many inadequacies, as aside from the larger corporate offices, the offices have little to no accessibility for the physically disabled. This study hopes to shed light on the fact that the existing BNBCs lack of emphasis on ensuring the accessibility of the handicapped in corporate buildings in the hope that, in the future, the physically disabled will have greater opportunities at being productive members of the workforce.

Keywords: person with disability, PWD, corporate buildings, Dhaka City

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1513 A Wearable Device to Overcome Post–Stroke Learned Non-Use; The Rehabilitation Gaming System for wearables: Methodology, Design and Usability

Authors: Javier De La Torre Costa, Belen Rubio Ballester, Martina Maier, Paul F. M. J. Verschure

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After a stroke, a great number of patients experience persistent motor impairments such as hemiparesis or weakness in one entire side of the body. As a result, the lack of use of the paretic limb might be one of the main contributors to functional loss after clinical discharge. We aim to reverse this cycle by promoting the use of the paretic limb during activities of daily living (ADLs). To do so, we describe the key components of a system that is composed of a wearable bracelet (i.e., a smartwatch) and a mobile phone, designed to bring a set of neurorehabilitation principles that promote acquisition, retention and generalization of skills to the home of the patient. A fundamental question is whether the loss in motor function derived from learned–non–use may emerge as a consequence of decision–making processes for motor optimization. Our system is based on well-established rehabilitation strategies that aim to reverse this behaviour by increasing the reward associated with action execution as well as implicitly reducing the expected cost associated with the use of the paretic limb, following the notion of the reinforcement–induced movement therapy (RIMT). Here we validate an accelerometer–based measure of arm use, and its capacity to discriminate different activities that require increasing movement of the arm. We also show how the system can act as a personalized assistant by providing specific goals and adjusting them depending on the performance of the patients. The usability and acceptance of the device as a rehabilitation tool is tested using a battery of self–reported and objective measurements obtained from acute/subacute patients and healthy controls. We believe that an extension of these technologies will allow for the deployment of unsupervised rehabilitation paradigms during and beyond the hospitalization time.

Keywords: stroke, wearables, learned non use, hemiparesis, ADLs

Procedia PDF Downloads 179
1512 Comparing the ‘Urgent Community Care Team’ Clinical Referrals in the Community with Suggestions from the Clinical Decision Support Software Dem DX

Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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