Search results for: BS assignment

Authors: Michael Johnson, Vincenzo Oliveri

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This work considers an interdisciplinary Problem-Based Learning (PBL) project developed by lecturers from the Aeronautical and Electronic and Computer Engineering departments at the University of Limerick. This “CANSAT” project utilises the CanSat can-sized satellite platform in order to allow students from aeronautical and electronic engineering to engage in a mixed format (online/face-to-face), interdisciplinary PBL assignment using a real-world platform and application. The project introduces students to the design, development, and construction of the CanSat system over the course of a single semester, enabling student(s) to apply their aeronautical and technical skills/capabilities to the realisation of a working CanSat system. In this case study, the CanSat kits are used to pivot the real-world, discipline-relevant PBL goal of designing, building, and testing the CanSat system with payload(s) from a traditional module-based setting to an online PBL setting. Feedback, impressions, benefits, and challenges identified through the semester are presented. Students found the project to be interesting and rewarding, with the interdisciplinary nature of the project appealing to them. Challenges and difficulties encountered are also addressed, with solutions developed between the students and facilitators to overcoming these discussed.

Keywords: Problem-Based Learning, Online PBL, Electronic Engineering, Aeronautical Engineering, Interdisciplinary Project, CanSat.

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Authors: A. Kulprasutidilok

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In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.

Keywords: Community-based participatory research, elderly health care, Thailand.

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Authors: Mohamad K. Hasan, Hameed Al-Qaheri

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Optimization plays an important role in most real world applications that support decision makers to take the right decision regarding the strategic directions and operations of the system they manage. Solutions for traffic management and traffic congestion problems are considered major problems that most decision making authorities for cities around the world are looking for. This review paper gives a full description of the traffic problem as part of the transportation planning process and present a view as a framework of urban transportation system analysis where the core of the system is a transportation network equilibrium model that is based on optimization techniques and that can also be used for evaluating an alternative solution or a combination of alternative solutions for the traffic congestion. Different transportation network equilibrium models are reviewed from the sequential approach to the multiclass combining trip generation, trip distribution, modal split, trip assignment and departure time model. A GIS-Based intelligent decision support system framework for urban transportation system analysis is suggested for implementation where the selection of optimized alternative solutions, single or packages, will be based on an intelligent agent rather than human being which would lead to reduction in time, cost and the elimination of the difficulty, by human being, for finding the best solution to the traffic congestion problem.

Keywords: Multiclass simultaneous transportation equilibrium models, transportation planning, urban transportation systems analysis, intelligent decision support system.

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Authors: Ebrahim Panah, Muhammad Yasir Babar

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Thanks to the development of online technology and social networks, people are able to communicate as well as learn. WhatsApp is a popular social network which is growingly gaining popularity. This app can be used for communication as well as education. It can be used for instructor-learner, learner-learner, and learner-content interactions; however, very little knowledge is available on these potentials of WhatsApp. The current study was undertaken to investigate university students’ perceptions of WhatsApp used as a tool for instructor-learner dialogue, learner-content dialogue, and learner-learner dialogue. The study adopted a survey approach and distributed the questionnaire developed by Google Forms to 54 (11 males and 43 females) university students. The obtained data were analyzed using SPSS version 20. The result of data analysis indicates that students have positive attitudes towards WhatsApp as a tool for Instructor-Learner Dialogue: it easy to reach the lecturer (4.07), the instructor gives me valuable feedback on my assignment (4.02), the instructor is supportive during course discussion and offers continuous support with the class (4.00). Learner-Content Dialogue: WhatsApp allows me to academically engage with lecturers anytime, anywhere (4.00), it helps to send graphics such as pictures or charts directly to the students (3.98), it also provides out of class, extra learning materials and homework (3.96), and Learner-Learner Dialogue: WhatsApp is a good tool for sharing knowledge with others (4.09), WhatsApp allows me to academically engage with peers anytime, anywhere (4.07), and we can interact with others through the use of group discussion (4.02). It was also found that there are significant positive correlations between students’ perceptions of Instructor-Learner Dialogue (ILD), Learner-Content Dialogue (LCD), Learner-Learner Dialogue (LLD) and WhatsApp Application in classroom. The findings of the study have implications for lectures, policy makers and curriculum developers.

Keywords: Instructor-learner dialogue, learners-contents dialogue, learner-learner dialogue, WhatsApp.

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Authors: Agah Tuğrul Korucu, Handan Atun

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Diversity and usefulness of information that used in education are have increased due to development of technology. Web technologies have made enormous contributions to the distance learning system especially. Mobile systems, one of the most widely used technology in distance education, made much easier to access web technologies. Not bounding by space and time, individuals have had the opportunity to access the information on web. In addition to this, the storage of educational information and resources and accessing these information and resources is crucial for both students and teachers. Because of this importance, development and dissemination of web technologies supply ease of access to information and resources are provided by web technologies. Dynamic web technologies introduced as new technologies that enable sharing and reuse of information, resource or applications via the Internet and bring websites into expandable platforms are commonly known as Web 2.0 technologies. Cloud systems are one of the dynamic web technologies that defined as a model provides approaching the demanded information independent from time and space in appropriate circumstances and developed by NIST. One of the most important advantages of cloud systems is meeting the requirements of users directly on the web regardless of hardware, software, and dealing with install. Hence, this study aims at using cloud services in education and investigating the services provided by the cloud computing. Survey method has been used as research method. In the findings of this research the fact that cloud systems are used such studies as resource sharing, collaborative work, assignment submission and feedback, developing project in the field of education, and also, it is revealed that cloud systems have plenty of significant advantages in terms of facilitating teaching activities and the interaction between teacher, student and environment.

Keywords: Cloud systems, cloud systems in education, distance learning, e-learning, integration of information technologies, online learning environment.

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Authors: Abdulkareem Hussein Bibire

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Job satisfaction and motivation have been given an important attention in psychology because they are seen as main instruments in maintaining organizational growth and development; they are also used to accomplish organizational aims and objectives. However, it has been observed that some institutions failed in motivating and stimulating their workers; in contrast, workers may be motivated but not satisfied with the job and failed to perform efficiently and effectively. It is hoped that the study of this nature would be of significance value to all stakeholders in education specifically, lecturers in higher institutions in Nigeria. Also, it is hoped that the findings of this study will enhance lecturers’ effectiveness and performance in discharging their duties. In the light of the above statements, this study investigated whether job satisfaction and motivation predict lecturers’ effectiveness in Nigeria Police Academy, Wudil, Kano State. Correlational research method was adopted for the study, while purposive sampling technique was used to choose the institution and the sampled lectures (70). Simple random sampling technique was used to select one hundred cadets across the academy. Two instruments were used to elicit information from both lecturers and cadets. These were job satisfaction and motivation; and lecturers’ effectiveness Questionnaires. The instruments were subjected to pilot testing and found to have reliability coefficient of 0.69 and 0.71 respectively. The results of the study revealed that there was a significance relationship among job satisfaction, motivation and lecturers effectiveness in Nigeria Police Academy. There was a significance relationship between job satisfaction and lecturers’ effectiveness in Nigeria Police Academy the cal r is 0.21 while the crt r is 0.19. at p<0.05 and; there was a significance relationship between job motivation and lecturers effectiveness in Nigeria Police Academy the cal r is 0.20 while the crt r is 0.19 at p<0.05This study therefore concluded that there was a significance relationship among job satisfaction, motivation and lecturers effectiveness in Nigeria Police Academy. Based on the data collected, collated and analyzed Recommendations were made for both the lecturers and the Academy management. It is also suggested that lecturers should be industrious in their primary assignment in other to make values to cadets lives and career. And management should also try to enhance lecturers performance by more motivational needs for the lecturers.

Keywords: Satisfaction, motivation, lecturer effectiveness, academy.

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Authors: К. R. Aida–Zade, C. Ardil, S. S. Rustamov

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Statement of the automatic speech recognition problem, the assignment of speech recognition and the application fields are shown in the paper. At the same time as Azerbaijan speech, the establishment principles of speech recognition system and the problems arising in the system are investigated. The computing algorithms of speech features, being the main part of speech recognition system, are analyzed. From this point of view, the determination algorithms of Mel Frequency Cepstral Coefficients (MFCC) and Linear Predictive Coding (LPC) coefficients expressing the basic speech features are developed. Combined use of cepstrals of MFCC and LPC in speech recognition system is suggested to improve the reliability of speech recognition system. To this end, the recognition system is divided into MFCC and LPC-based recognition subsystems. The training and recognition processes are realized in both subsystems separately, and recognition system gets the decision being the same results of each subsystems. This results in decrease of error rate during recognition. The training and recognition processes are realized by artificial neural networks in the automatic speech recognition system. The neural networks are trained by the conjugate gradient method. In the paper the problems observed by the number of speech features at training the neural networks of MFCC and LPC-based speech recognition subsystems are investigated. The variety of results of neural networks trained from different initial points in training process is analyzed. Methodology of combined use of neural networks trained from different initial points in speech recognition system is suggested to improve the reliability of recognition system and increase the recognition quality, and obtained practical results are shown.

Keywords: Speech recognition, cepstral analysis, Voice activation detection algorithm, Mel Frequency Cepstral Coefficients, features of speech, Cepstral Mean Subtraction, neural networks, Linear Predictive Coding.

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Authors: Amit Chhabra, Gurvinder Singh, Sandeep Singh Waraich, Bhavneet Sidhu, Gaurav Kumar

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Decrease in hardware costs and advances in computer networking technologies have led to increased interest in the use of large-scale parallel and distributed computing systems. One of the biggest issues in such systems is the development of effective techniques/algorithms for the distribution of the processes/load of a parallel program on multiple hosts to achieve goal(s) such as minimizing execution time, minimizing communication delays, maximizing resource utilization and maximizing throughput. Substantive research using queuing analysis and assuming job arrivals following a Poisson pattern, have shown that in a multi-host system the probability of one of the hosts being idle while other host has multiple jobs queued up can be very high. Such imbalances in system load suggest that performance can be improved by either transferring jobs from the currently heavily loaded hosts to the lightly loaded ones or distributing load evenly/fairly among the hosts .The algorithms known as load balancing algorithms, helps to achieve the above said goal(s). These algorithms come into two basic categories - static and dynamic. Whereas static load balancing algorithms (SLB) take decisions regarding assignment of tasks to processors based on the average estimated values of process execution times and communication delays at compile time, Dynamic load balancing algorithms (DLB) are adaptive to changing situations and take decisions at run time. The objective of this paper work is to identify qualitative parameters for the comparison of above said algorithms. In future this work can be extended to develop an experimental environment to study these Load balancing algorithms based on comparative parameters quantitatively.

Keywords: SLB, DLB, Host, Algorithm and Load.

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Authors: F. O. Maphiri-Makananise

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This paper explores and provides substantiated evidence on the usage patterns of Information and Communication Technologies (ICTs) by female users at Vhembe District in Limpopo- Province, South Africa. The study presents a comprehensive picture on the usage of ICTs from female users’ perspective. The significance of this study stems from the need to assess the role, relevance and usage patterns of ICTs such as smartphones, computers, laptops, and iPods, the internet and social networking sites among females following the developments of new media technologies in society. The objective of the study is to investigate the usability and accessibility of ICTs to empower female users in South Africa. The study used quantitative and qualitative research methods to determine the major ideas, perceptions and usage patterns of ICTs by users. Data collection involved the use of structured selfadministered questionnaire from two groups of respondents who participated in this study. Thus, (n=50) female students at the University of Venda provided their ideas and perceptions about the usefulness and usage patterns of ICTs such as smartphones, the Internet and computers at the university level, whereas, the second group were (n=50) learners from Makhado Comprehensive School who provided their perceptions and ideas about the use of ICTs at the high school level. The researcher also noted that the findings of the study were useful as a guideline and model for ICT intervention that could work as an empowerment to women in South Africa. It was observed that the central purpose of ICTs among female users was to search for information regarding assignment writing, conducting research, dating, exchanging ideas and networking with friends and relatives. This was demonstrated by a high number of females who used ICTs for e-learning (62%) and social purposes (85%). Therefore, the study revealed that most females used ICTs for social purposes and accessing the internet rather than for entertainment, a gesture that provides an opportune space to empower rural women in South Africa.

Keywords: Female users, Information and Communication Technologies, Internet, Usage patterns.

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Authors: Barbara Vojvodikova, Katerina Jupova, Iva Ticha

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Cities in their historical evolution have always adapted their internal structure to the needs of society (for example protective city walls during classicism era lost their defense function, became unnecessary, were demolished and gave space for new features such as roads, museums or parks). Today it is necessary to modify the internal structure of the city in order to minimize the impact of climate changes on the environment of the population. This article discusses the results of the Urban Climate model owned by VITO, which was carried out as part of a project from the European Union's Horizon grant agreement No 730004 Pan-European Urban Climate Services Climate-Fit city. The use of the model was aimed at changes in land use and land cover in cities related to urban heat islands (UHI). The task of the application was to evaluate possible land use change scenarios in connection with city requirements and ideas. Two pilot areas in the Czech Republic were selected. One is Ostrava and the other Hodonín. The paper provides a demonstration of the application of the model for various possible future development scenarios. It contains an assessment of the suitability or inappropriateness of scenarios of future development depending on the temperature increase. Cities that are preparing to reconstruct the public space are interested in eliminating proposals that would lead to an increase in temperature stress as early as in the assignment phase. If they have evaluation on the unsuitability of some type of design, they can limit it into the proposal phases. Therefore, especially in the application of models on Local level - in 1 m spatial resolution, it was necessary to show which type of proposals would create a significant temperature island in its implementation. Such a type of proposal is considered unsuitable. The model shows that the building itself can create a shady place and thus contribute to the reduction of the UHI. If it sensitively approaches the protection of existing greenery, this new construction may not pose a significant problem. More massive interventions leading to the reduction of existing greenery create a new heat island space.

Keywords: Heat islands, land use, urban climate model.

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Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

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High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: Acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education.

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Authors: S. Jamshidi, E. Feizi Ashtiani, M. Ardestani

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Waste Load Allocation (WLA) strategies usually intend to find economic policies for water resource management. Water quality trading (WQT) is an approach that uses discharge permit market to reduce total environmental protection costs. This primarily requires assigning discharge limits known as total maximum daily loads (TMDLs). These are determined by monitoring organizations with respect to the receiving water quality and remediation capabilities. The purpose of this study is to compare two approaches of TMDL assignment for WQT policy in small catchment area of Haraz River, in north of Iran. At first, TMDLs are assigned uniformly for the whole point sources to keep the concentrations of BOD and dissolved oxygen (DO) at the standard level at checkpoint (terminus point). This was simply simulated and controlled by Qual2kw software. In the second scenario, TMDLs are assigned using multi objective particle swarm optimization (MOPSO) method in which the environmental violation at river basin and total treatment costs are minimized simultaneously. In both scenarios, the equity index and the WLA based on trading discharge permits (TDP) are calculated. The comparative results showed that using economically optimized TMDLs (2nd scenario) has slightly more cost savings rather than uniform TMDL approach (1st scenario). The former annually costs about 1 M$ while the latter is 1.15 M$. WQT can decrease these annual costs to 0.9 and 1.1 M$, respectively. In other word, these approaches may save 35 and 45% economically in comparison with command and control policy. It means that using multi objective decision support systems (DSS) may find more economical WLA, however its outcome is not necessarily significant in comparison with uniform TMDLs. This may be due to the similar impact factors of dischargers in small catchments. Conversely, using uniform TMDLs for WQT brings more equity that makes stakeholders not feel that much envious of difference between TMDL and WQT allocation. In addition, for this case, determination of TMDLs uniformly would be much easier for monitoring. Consequently, uniform TMDL for TDP market is recommended as a sustainable approach. However, economical TMDLs can be used for larger watersheds.

Keywords: Waste load allocation (WLA), Water quality trading (WQT), Total maximum daily loads (TMDLs), Haraz River, Multi objective particle swarm optimization (MOPSO), Equity.

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Authors: Siddhartha Bhattacharyya, Paramartha Dutta, Ujjwal Maulik, Prashanta Kumar Nandi

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A multilayer self organizing neural neural network (MLSONN) architecture for binary object extraction, guided by a beta activation function and characterized by backpropagation of errors estimated from the linear indices of fuzziness of the network output states, is discussed. Since the MLSONN architecture is designed to operate in a single point fixed/uniform thresholding scenario, it does not take into cognizance the heterogeneity of image information in the extraction process. The performance of the MLSONN architecture with representative values of the threshold parameters of the beta activation function employed is also studied. A three layer bidirectional self organizing neural network (BDSONN) architecture comprising fully connected neurons, for the extraction of objects from a noisy background and capable of incorporating the underlying image context heterogeneity through variable and adaptive thresholding, is proposed in this article. The input layer of the network architecture represents the fuzzy membership information of the image scene to be extracted. The second layer (the intermediate layer) and the final layer (the output layer) of the network architecture deal with the self supervised object extraction task by bi-directional propagation of the network states. Each layer except the output layer is connected to the next layer following a neighborhood based topology. The output layer neurons are in turn, connected to the intermediate layer following similar topology, thus forming a counter-propagating architecture with the intermediate layer. The novelty of the proposed architecture is that the assignment/updating of the inter-layer connection weights are done using the relative fuzzy membership values at the constituent neurons in the different network layers. Another interesting feature of the network lies in the fact that the processing capabilities of the intermediate and the output layer neurons are guided by a beta activation function, which uses image context sensitive adaptive thresholding arising out of the fuzzy cardinality estimates of the different network neighborhood fuzzy subsets, rather than resorting to fixed and single point thresholding. An application of the proposed architecture for object extraction is demonstrated using a synthetic and a real life image. The extraction efficiency of the proposed network architecture is evaluated by a proposed system transfer index characteristic of the network.

Keywords: Beta activation function, fuzzy cardinality, multilayer self organizing neural network, object extraction,

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Authors: Peter Clutterbuck, Terry Rowlands, Owen Seamons

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In this paper we describe one critical research program within a complex, ongoing multi-year project (2010 to 2014 inclusive) with the overall goal to improve the learning outcomes for first year undergraduate commerce/business students within an Information Systems (IS) subject with very large enrolment. The single research program described in this paper is the analysis of student attitudes and decision making in relation to the availability of formative assessment feedback via Web-based real time conferencing and document exchange software (Adobe Connect). The formative assessment feedback between teaching staff and students is in respect of an authentic problem-based, team-completed assignment. The analysis of student attitudes and decision making is investigated via both qualitative (firstly) and quantitative (secondly) application of the Theory of Planned Behavior (TPB) with a two statistically-significant and separate trial samples of the enrolled students. The initial qualitative TPB investigation revealed that perceived self-efficacy, improved time-management, and lecturer-student relationship building were the major factors in shaping an overall favorable student attitude to online feedback, whilst some students expressed valid concerns with perceived control limitations identified within the online feedback protocols. The subsequent quantitative TPB investigation then confirmed that attitude towards usage, subjective norms surrounding usage, and perceived behavioral control of usage were all significant in shaping student intention to use the online feedback protocol, with these three variables explaining 63 percent of the variance in the behavioral intention to use the online feedback protocol. The identification in this research of perceived behavioral control as a significant determinant in student usage of a specific technology component within a virtual learning environment (VLE) suggests that VLEs could now be viewed not as a single, atomic entity, but as a spectrum of technology offerings ranging from the mature and simple (e.g., email, Web downloads) to the cutting-edge and challenging (e.g., Web conferencing and real-time document exchange). That is, that all VLEs should not be considered the same. The results of this research suggest that tertiary students have the technological sophistication to assess a VLE in this more selective manner.

Keywords: Formative assessment feedback, virtual learning environment, theory of planned behavior, perceived behavioral control.

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Authors: Suraiya Jabin, Kamal K. Bharadwaj

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In the recent past Learning Classifier Systems have been successfully used for data mining. Learning Classifier System (LCS) is basically a machine learning technique which combines evolutionary computing, reinforcement learning, supervised or unsupervised learning and heuristics to produce adaptive systems. A LCS learns by interacting with an environment from which it receives feedback in the form of numerical reward. Learning is achieved by trying to maximize the amount of reward received. All LCSs models more or less, comprise four main components; a finite population of condition–action rules, called classifiers; the performance component, which governs the interaction with the environment; the credit assignment component, which distributes the reward received from the environment to the classifiers accountable for the rewards obtained; the discovery component, which is responsible for discovering better rules and improving existing ones through a genetic algorithm. The concatenate of the production rules in the LCS form the genotype, and therefore the GA should operate on a population of classifier systems. This approach is known as the 'Pittsburgh' Classifier Systems. Other LCS that perform their GA at the rule level within a population are known as 'Mitchigan' Classifier Systems. The most predominant representation of the discovered knowledge is the standard production rules (PRs) in the form of IF P THEN D. The PRs, however, are unable to handle exceptions and do not exhibit variable precision. The Censored Production Rules (CPRs), an extension of PRs, were proposed by Michalski and Winston that exhibit variable precision and supports an efficient mechanism for handling exceptions. A CPR is an augmented production rule of the form: IF P THEN D UNLESS C, where Censor C is an exception to the rule. Such rules are employed in situations, in which conditional statement IF P THEN D holds frequently and the assertion C holds rarely. By using a rule of this type we are free to ignore the exception conditions, when the resources needed to establish its presence are tight or there is simply no information available as to whether it holds or not. Thus, the IF P THEN D part of CPR expresses important information, while the UNLESS C part acts only as a switch and changes the polarity of D to ~D. In this paper Pittsburgh style LCSs approach is used for automated discovery of CPRs. An appropriate encoding scheme is suggested to represent a chromosome consisting of fixed size set of CPRs. Suitable genetic operators are designed for the set of CPRs and individual CPRs and also appropriate fitness function is proposed that incorporates basic constraints on CPR. Experimental results are presented to demonstrate the performance of the proposed learning classifier system.

Keywords: Censored Production Rule, Data Mining, GeneticAlgorithm, Learning Classifier System, Machine Learning, PittsburgApproach, , Reinforcement learning.

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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Authors: G. Feletti, D. Tedesco, P. Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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