A Qualitative Method for Assessing the Impact of ICT on the Architectural Design Process

During the last thirty years or so, we have witnessed tremendous developments in information and communication technology (ICT). Computer processing power doubles each 18 months, as Gordon Moore predicted during the mid-1960s. The computer and communications world has been revolutionised by the invention of the Internet. It has changed the way of exchanging, viewing, sharing, manipulating and storing the information. Other technologies such as smartphones, wearable computers, tablets, wireless communications and satellite communications have made the adoption of ICT easier and beneficial to all its users. ICT affects the productivity, performance and the competitive advantage of a business. It also impacts on the shape of the business process and its product. In architectural design, ICT is widely used throughout the design process and its final product. The aim of this research, therefore, is to explore the key implication of using ICT in architectural design and what new changes and forms have occurred on buildings as a result of ICT developments and use by architecture practitioners. To achieve this aim, a qualitative research approach was adopted using a narrative review of ICT usage in the design of buildings. The literature found was subjected to a thematic analysis of how ICT adoption affected the architectural design process. The findings of this research indicate that there is a continuous change in the design process and its final products (buildings) as the technology evolves. The framework proposed provides a foundation for gathering evidence from case studies of the impact of ICT adoption by architectural designers. The research proposes that future empirical work has to be conducted to test and refine the relevance, importance and applicability of each of the components of the framework, in order to detect the impact of ICT on the building design process and its final product

Filming Trauma Simulations for Medical Education: A Comparison of First-Person View vs. Remotely Shot Video

With advancements in video technology, first-person view places observers in the vantage point of the camera operator. Lightweight wearable products, such as GoPro cameras, are capable of capturing high-resolution footage. In a 3-phase project, first-person view (FPV) footage was compared to remotely-shot video (RSV) of identical trauma scenarios viewed by medical students and residents at PCOM. Students responded to a trauma simulation by assessing the patient, obtaining a history and stabilizing the patient. This scenario was run once using RSV and again using FPV to capture the encounter. Both formats were screened for medical students in Phase I and Phase II and for surgery residents in Phase III. Participants in all phases responded to a survey to determine which video format was most educational. Over the three project phases, 301 medical students and 20 surgical residents viewed the trauma scenarios captured in FPV and RSV. Survey results for Phase I and Phase II demonstrated a majority of respondents preferred FPV over RSV content. Additionally, a majority of respondents thought FPV would be a useful adjunct in medical education. Phase III results also showed that most residents preferred FPV content. Residents similarly found FPV to have an educational value. Based on the feedback obtained in all three project phases, medical students and surgical residents demonstrated a preference for FPV. With this input, PCOM will expand its use of FPV in medical education

Prototype system for knowledge problem definition

Attitudes to knowledge management (KM) have changed considerably as organizations are now realizing its benefits. Implementation, however, has been facing serious difficulties attributed to either not being able to anticipate the barriers when planning KM strategies or to using inappropriate methods and tools for implementation. These difficulties are more critical in construction due to the fragmented nature of the industry. This paper suggests that proper definition of a KM problem at the early stages of developing the KM initiatives will result in better control over the KM barriers. A methodology for identifying KM problems within a business context is then introduced. The methodology is encapsulated into a prototype software system, which facilitates its deployment in organizations and provides online help facilities. The methodology, development, operation, and evaluation of the prototype are described. The paper concludes that the prototype offers considerable potential for delivering a clarified KM problem and a distilled set of issues for an organization to address. This represents a significant first step in any KM initiative

Impact of the Mass Drug Administration for malaria in response to the Ebola outbreak in Sierra Leone

Background: As emergency response to the Ebola epidemic, the Government of Sierra Leone and its partners implemented a large-scale Mass Drug Administration (MDA) with artesunate–amodiaquine (ASAQ) covering >2.7 million people in the districts hardest hit by Ebola during December 2014–January 2015. The World Health Organization (WHO) and the National Malaria Control Programme (NMCP) evaluated the impact of the MDA on malaria morbidity at health facilities and the number of Ebola alerts received at District Ebola Command Centres. Methods: The coverage of the two rounds of MDA with ASAQ was estimated by relating the number anti-malarial medicines distributed to the estimated resident population. Segmented time-series analysis was applied to weekly data collected from 49 primary health units (PHUs) and 11 hospitals performing malaria parasitological testing during the study period, to evaluate trends of malaria cases and Ebola alerts during the post-MDA weeks compared to the pre-MDA weeks in MDA- and non-MDA-cheifdoms. Results: After two rounds of the MDA, the number of suspected cases tested with rapid diagnostic test (RDT) decreased significantly by 43 % (95 % CI 38–48 %) at week 1 and remained low at week 2 and 3 post-first MDA and at week 1 and 3 post-second MDA; RDT positive cases decreased significantly by 47 % (41–52 %) at week 1 post-first and remained lower throughout all post-MDA weeks; and the RDT test positivity rate (TPR) declined by 35 % (32–38 %) at week 2 and stayed low throughout all post-MDA weeks. The total malaria (clinical + confirmed) cases decreased significantly by 45 % (39–52 %) at week 1 and were lower at week 2 and 3 post-first MDA; and week 1 post-second MDA. The proportion of confirmed malaria cases (out of all-outpatients) fell by 33 % (29–38 %) at week 1 post-first MDA and were lower during all post-MDA weeks. On the contrary, the non-malaria outpatient cases (cases due to other health conditions) either remained unchanged or fluctuated insignificantly. The Ebola alerts decreased by 30 % (13–46 %) at week 1 post-first MDA and much lower during all the weeks post–second MDA. Conclusions: The MDA achieved its goals of reducing malaria morbidity and febrile cases that would have been potentially diagnosed as suspected Ebola cases with increased risk of nosocomial infections. The intervention also helped reduce patient case-load to the severely strained health services at the peak of the Ebola outbreak and malaria transmission. As expected, the effect of the MDA waned in a matter of few weeks and malaria intensity returned to the pre-MDA levels. Nevertheless, the approach was an appropriate public health intervention in the context of the Ebola epidemic even in high malaria transmission areas of Sierra Leone

Live capture and reuse of project knowledge

It is important that the knowledge generated on construction projects is captured and shared between project team members for continuous improvement, to prevent the ‘reinvention of the wheel’ and to avoid repetition of previous mistakes. However, this is undermined mainly by the loss of important insights and knowledge due to time lapse in capturing the knowledge, staff turnover and people’s reluctance to share knowledge. To address this, it is crucial for knowledge to be captured ‘live’ in a collaborative environment while the project is being executed and presented in a format that will facilitate its reuse during and after the project. This paper uses a case study approach to investigate the end-users’ requirements for the ‘live’ capture and reuse of knowledge methodology, and shortcomings of current practice in meeting these requirements. A framework for the ‘live’ methodology that satisfies the requirements is then presented and discussed

Developing a social mobilisation intervention for salt reduction: participatory action research in Bombali district, Sierra Leone

From Springer Nature via Jisc Publications RouterHistory: received 2023-01-08, accepted 2023-09-01, registration 2023-09-04, epub 2023-09-12, online 2023-09-12, collection 2023-12Acknowledgements: Thanks to all the stakeholders in the social mobilisation teams and focus group discussion members from the communities of Binkolo, Maforay, Makarie and Masongbo.Publication status: PublishedFunder: UK National Institute for Health Research; Grant(s): 16/136/100Sophie Witter - ORCID: 0000-0002-7656-6188 https://orcid.org/0000-0002-7656-6188Background: High salt intake is a major risk factor for hypertension, which in turn contributes to cardiovascular diseases, the major cause of death from non communicable diseases (NCDs). Research is limited on social mobilisation interventions to tackle NCDs, including in fragile health settings such as Sierra Leone. Methods: Participatory action research methods were used to develop a social mobilisation intervention for salt reduction in Bombali District, Sierra Leone. A team of 20 local stakeholders were recruited to develop and deliver the intervention. Stakeholder workshop reports and interviews were used to record outcomes, enablers, and barriers to the intervention. Focus group discussions were used to observe knowledge, attitudes, and behaviours of community members pre- and post- the intervention. Results: Stakeholders showed enthusiasm and were well engaged in the social mobilisation process around salt reduction. They developed radio jingles, radio show talks, organised community awareness raising meetings, school sensitisation outreaches, and door to door engagements. Stakeholders reported benefiting personally through developing their own skills and confidence in communication and felt positive about their role in educating their community. The interventions led to reported increased awareness of risks of high salt intake and NCDs, resulting in a reduction of salt use in the community, leading to perceived health gains. However, salt reduction was also met with some resistance due to social factors. Local community structures were also reactivated to work on the interventions and connect the community to the local health facility, which saw an increase in patients having their blood pressure checked. The comparison villages also experienced an increase in awareness and perceived reductions in salt intake behaviours. This was as messages had cascaded via the radio and initial focus group discussions. The social mobilisation stakeholders also agreed on future activities that could continue at no or low cost. Conclusion: Social mobilisation interventions can provide low-cost strategies to tackle NCDs in fragile settings such as Sierra Leone through the utilisation of community structures. However, more research is required to ascertain the key enablers for replicability and if such successes can be sustained over a longer follow up period.This study/project is funded by the UK National Institute for Health Research (NIHR) [NIHR Global Health Research programme (project reference 16/136/100)/NIHR Research Unit on Health in Situations of Fragility]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funder played no role in the study design, data collection, analysis, interpretation, or in writing the manuscript.pubpu

A rating system for building resilience

Measuring and rating resilience of assets is a key enabler for asset and portfolio management. This paper presents a resilience rating system for buildings by utilising a Building Information Modelling approach. The assessment is carried out through a calculation following the Analytical Hierarchy Process. This methodology can be applied to different types of buildings, without a loss of precision or reliability. This resilience rating forms an integral part of more comprehensive array of Key Performance Indicators frameworks for asset and portfolio management, and therefore can significantly influence strategic investment choices for designers, engineers and building owners

Community Event-Based Surveillance for Ebola Virus Disease in Sierra Leone: Implementation of a National-Level System During a Crisis.

INTRODUCTION:  There are few documented examples of community networks that have used unstructured information to support surveillance during a health emergency. In January 2015, the Ebola Response Consortium rapidly implemented community event-based surveillance for Ebola virus disease at a national scale in Sierra Leone. METHODS: Community event based surveillance uses community health monitors in each community to provide an early warning system of events that are suggestive of Ebola virus disease transmission. The Ebola Response Consortium, a consortium of 15 nongovernmental organizations, applied a standardized procedure to implement community event-based surveillance across nine of the 14 districts. To evaluate system performance during the first six months of operation (March to August 2015), we conducted a process evaluation. We analyzed the production of alerts, conducted interviews with surveillance stakeholders and performed rapid evaluations of community health monitors to assess their knowledge and reported challenges. RESULTS: The training and procurement of supplies was expected to begin in January 2015 and attain full scale by March 2015. We found several logistical challenges that delayed full implementation until June 2015 when the epidemic was past its peak. Community health monitors reported 9,131 alerts during this period. On average, 82% of community health monitors reported to their supervisor at least once per week. Most alerts (87%) reported by community health monitors were deaths unrelated to Ebola. During the rapid evaluations, the mean recall by community health monitors was three of the six trigger events. Implementation of the national system achieved scale, but three months later than anticipated. DISCUSSION: Community event based surveillance generated consistent surveillance information during periods of no- to low-levels of transmission across districts. We interpret this to mean that community health monitors are an effective tool for generating useful, unstructured information at the village level. However, to maximize validity, the triggers require more training, may be too many in number, and need increased relevance to the context of the tail end of the epidemic

Incidence and risk factors of surgical site infections and related antibiotic resistance in Freetown, Sierra Leone: a prospective cohort study

BACKGROUND: There is limited information on surgical site infections (SSI) and the related antibiotic resistance needed to guide their management and prevention in Sierra Leone. In this study, we aimed to establish the incidence and risk factors of SSI and the related antibiotic resistance among adults attending a tertiary hospital, and a secondary health facility in Freetown, Sierra Leone. METHODS: This is a prospective cohort study designed to collect data from adult (18 years or older) patients who attended elective and emergency surgeries at two hospitals in Freetown between February and July, 2021. Data analysis was done using STATA version 16. RESULTS: Of 338 patients, 245 (72.5%) and 93 (27.5%) had their surgeries at the tertiary and secondary hospitals, respectively. Many were males 192 (56.8%), less than 35 years 164 (48.5%), and 39 (11.5%) developed an SSI. Of the 39 patients who acquired an SSI, 7 (17.9%) and 32 (82.1%) had their surgeries at the secondary and tertiary hospitals, respectively. The incidence of SSI is higher in contaminated 17 (43.6%) than in clean-contaminated 12 (30.8%) and clean 10 (25.6%) wounds. Wound swabs were collected in 29 (74.4%) patients, of which 18 (62.1%) had bacterial growth. In total, 49 isolates of 14 different bacteria including gram-negative 41 (83.7%) and gram-positive 8 (16.3%) isolates were identified. Of these, 32 (65.3%) were Enterobacteriaceae, 9 (18.4%) were Non-fermenting gram-negative bacilli and 10 (12.2%) were Enterococci. The most common isolates were Escherichia coli (12, 24.5%), Klebsiella pneumoniae (10, 20.4%), Acinetobacter baumannii (5, 10.2%), Klebsiella oxytoca (4, 8.2%) and Enterococcus faecalis (4, 8.2%). The Enterobacteriaceae were either resistance to carbapenems (4, 8.2%) or were extended-spectrum beta-lactamase (ESBL) producing organisms (29, 59.2%). Male sex [p = 0.031], an ASA score >/= 2 [p = 0.020), administration of general anaesthesia [p = 0.018] and elevated fasting glucose [p = 0.033] were predictive of SSI. CONCLUSION: The incidence of SSI in this study is comparable to other low- and middle-income countries, but a substantial proportion of these postoperative wounds have an ESBL-producing Enterobacteriaceae. Therefore, routine surveillance of SSI and related antibiotic resistance is required in resource-limited settings