Search results for: Aggrey Daniel Maina Thuo
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 512

Search results for: Aggrey Daniel Maina Thuo

212 Effect of Distance to Health Facilities on Maternal Service Use and Neonatal Mortality in Ethiopia

Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

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Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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211 Assistive Kitchenware Design for Hemiparetics

Authors: Daniel F. Madrinan-Chiquito

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Hemiparesis affects about eight out of ten stroke survivors, causing weakness or the inability to move one side of the body. One-sided weakness can affect arms, hands, legs, or facial muscles. People with one-sided weakness may have trouble performing everyday activities such as eating, cooking, dressing, and using the bathroom. Rehabilitation treatments, exercises at home, and assistive devices can help with mobility and recovery. Historically, such treatments and devices were developed within the fields of medicine and biomedical engineering. However, innovators outside of the traditional medical device community, such as Industrial Designers, have recently brought their knowledge and expertise to assistive technologies. Primary and secondary research was done in three parts. The primary research collected data by talking with several occupational therapists currently attending to stroke patients, and surveys were given to patients with hemiparesis and hemiplegia. The secondary research collected data through observation and testing of products currently marketed for single-handed people. Modern kitchenware available in the market for people with an acquired brain injury has deficiencies in both aesthetic and functional values. Object design for people with hemiparesis or hemiplegia has not been meaningfully explored. Most cookware is designed for use with two hands and possesses little room for adaptation to the needs of one-handed individuals. This project focuses on the design and development of two kitchenware devices. These devices assist hemiparetics with different cooking-related tasks such as holding, grasping, cutting, slicing, chopping, grating, and other essential activities. These intentionally designed objects will improve the quality of life of hemiparetics by enabling greater independence and providing an enhanced ability for precision tasks in a cooking environment.

Keywords: assistive technologies, hemiparetics, industrial design, kitchenware

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210 Optimal Design of Tuned Inerter Damper-Based System for the Control of Wind-Induced Vibration in Tall Buildings through Cultural Algorithm

Authors: Luis Lara-Valencia, Mateo Ramirez-Acevedo, Daniel Caicedo, Jose Brito, Yosef Farbiarz

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Controlling wind-induced vibrations as well as aerodynamic forces, is an essential part of the structural design of tall buildings in order to guarantee the serviceability limit state of the structure. This paper presents a numerical investigation on the optimal design parameters of a Tuned Inerter Damper (TID) based system for the control of wind-induced vibration in tall buildings. The control system is based on the conventional TID, with the main difference that its location is changed from the ground level to the last two story-levels of the structural system. The TID tuning procedure is based on an evolutionary cultural algorithm in which the optimum design variables defined as the frequency and damping ratios were searched according to the optimization criteria of minimizing the root mean square (RMS) response of displacements at the nth story of the structure. A Monte Carlo simulation was used to represent the dynamic action of the wind in the time domain in which a time-series derived from the Davenport spectrum using eleven harmonic functions with randomly chosen phase angles was reproduced. The above-mentioned methodology was applied on a case-study derived from a 37-story prestressed concrete building with 144 m height, in which the wind action overcomes the seismic action. The results showed that the optimally tuned TID is effective to reduce the RMS response of displacements up to 25%, which demonstrates the feasibility of the system for the control of wind-induced vibrations in tall buildings.

Keywords: evolutionary cultural algorithm, Monte Carlo simulation, tuned inerter damper, wind-induced vibrations

Procedia PDF Downloads 135
209 Knowledge Management Strategies within a Corporate Environment of Papers

Authors: Daniel J. Glauber

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Knowledge transfer between personnel could benefit an organization’s improved competitive advantage in the marketplace from a strategic approach to knowledge management. The lack of information sharing between personnel could create knowledge transfer gaps while restricting the decision-making processes. Knowledge transfer between personnel can potentially improve information sharing based on an implemented knowledge management strategy. An organization’s capacity to gain more knowledge is aligned with the organization’s prior or existing captured knowledge. This case study attempted to understand the overall influence of a KMS within the corporate environment and knowledge exchange between personnel. The significance of this study was to help understand how organizations can improve the Return on Investment (ROI) of a knowledge management strategy within a knowledge-centric organization. A qualitative descriptive case study was the research design selected for this study. The lack of information sharing between personnel may create knowledge transfer gaps while restricting the decision-making processes. Developing a knowledge management strategy acceptable at all levels of the organization requires cooperation in support of a common organizational goal. Working with management and executive members to develop a protocol where knowledge transfer becomes a standard practice in multiple tiers of the organization. The knowledge transfer process could be measurable when focusing on specific elements of the organizational process, including personnel transition to help reduce time required understanding the job. The organization studied in this research acknowledged the need for improved knowledge management activities within the organization to help organize, retain, and distribute information throughout the workforce. Data produced from the study indicate three main themes including information management, organizational culture, and knowledge sharing within the workforce by the participants. These themes indicate a possible connection between an organizations KMS, the organizations culture, knowledge sharing, and knowledge transfer.

Keywords: knowledge transfer, management, knowledge management strategies, organizational learning, codification

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208 Metabolic Profiling of Populus trichocarpa Family 1 UDP-Glycosyltransferases

Authors: Patricia M. B. Saint-Vincent, Anna Furches, Stephanie Galanie, Erica Teixeira Prates, Piet Jones, Nancy Engle, David Kainer, Wellington Muchero, Daniel Jacobson, Timothy J. Tschaplinski

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Uridine diphosphate-glycosyltransferases (UGTs) are enzymes that catalyze sugar transfer to a variety of plant metabolites. UGT substrates, which include plant secondary metabolites involved in lignification, demonstrate new activities and incorporation when glycosylated. Knowledge of UGT function, substrate specificity, and enzyme products is important for plant engineering efforts, especially related to increasing plant biomass through lignification. UGTs in Populus trichocarpa, a biofuel feedstock, and model woody plant, were selected from a pool of gene candidates using rapid prioritization strategies. A functional genomics workflow, consisting of a metabolite genome-wide association study (mGWAS), expression of synthetic codon-optimized genes, and high-throughput biochemical assays with mass spectrometry-based analysis, was developed for determining the substrates and products of previously-uncharacterized enzymes. A total of 40 UGTs from P. trichocarpa were profiled, and the biochemical assay results were compared to predicted mGWAS connections. Assay results confirmed seven of 11 leaf mGWAS associations and demonstrated varying levels of substrate specificity among candidate UGTs. P. trichocarpa UGT substrate processing confirms the role of these newly-characterized enzymes in lignan, flavonoid, and phytohormone metabolism, with potential implications for cell wall biosynthesis, nitrogen uptake, and biotic and abiotic stress responses.

Keywords: Populus, metabolite-gene associations, GWAS, bio feedstocks, glycosyltransferase

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207 Enhancing Higher Education Teaching and Learning Processes: Examining How Lecturer Evaluation Make a Difference

Authors: Daniel Asiamah Ameyaw

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This research attempts to investigate how lecturer evaluation makes a difference in enhancing higher education teaching and learning processes. The research questions to guide this research work states first as, “What are the perspectives on the difference made by evaluating academic teachers in order to enhance higher education teaching and learning processes?” and second, “What are the implications of the findings for Policy and Practice?” Data for this research was collected mainly through interviewing and partly documents review. Data analysis was conducted under the framework of grounded theory. The findings showed that for individual lecturer level, lecturer evaluation provides a continuous improvement of teaching strategies, and serves as source of data for research on teaching. At the individual student level, it enhances students learning process; serving as source of information for course selection by students; and by making students feel recognised in the educational process. At the institutional level, it noted that lecturer evaluation is useful in personnel and management decision making; it assures stakeholders of quality teaching and learning by setting up standards for lecturers; and it enables institutions to identify skill requirement and needs as a basis for organising workshops. Lecturer evaluation is useful at national level in terms of guaranteeing the competencies of graduates who then provide the needed manpower requirement of the nation. Besides, it mentioned that resource allocation to higher educational institution is based largely on quality of the programmes being run by the institution. The researcher concluded, that the findings have implications for policy and practice, therefore, higher education managers are expected to ensure that policy is implemented as planned by policy-makers so that the objectives can successfully be achieved.

Keywords: academic quality, higher education, lecturer evaluation, teaching and learning processes

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206 Effective Strategies Migrants Adopted to Improve Food Security in a Regional Area of Australia

Authors: Joanne Sin Wei Yeoh, Quynh Lê, Daniel R. Terry, Rosa Mc Manamey

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Food security is a global issue and one of the concerns in Australia, particularly in regional and rural areas. Despite Australia’s current ability to produce enough food to feed more than its current population, evidence has been accumulating over the last decade to demonstrate many Australians struggle to feed themselves, including immigrants from cultural and linguistically diverse (CALD) backgrounds. This study aims to identify the acculturation strategies used by migrants to enhance their approach to food security in Tasmania. The study employed a mixed methods approach that used both questionnaires and semi-structured interviews with migrants living in Tasmania. Descriptive and inferential statistics was used to analyse data collected from questionnaire, whereas, thematic analysis was employed to analyse the interview data. Migrants (n=301) completed the questionnaire with a response rate of 50.2% and 33 follow-up interviews were conducted. We found that majority of the migrants (70.0%) replaced food ingredients and went without the food they could not buy from shops with similar ingredients. Support and advice from friends were effective ways to improve their food access. Additionally, length of stays in Tasmania and region of origin were significantly associated with the ways migrants dealing with food security. The interview results revealed that migrants managed to adapt to the new food culture by using different acculturation strategies, including access food ingredients from other country; adjusting or adapting; home gardening and access to technology. In addition, social and cultural capitals were also treated as vital roles in improving migrants’ food security. To summarize, migrants employed different strategies for food security while acculturating into the new environment. Our findings could become the guidelines for migrants and relevant government or private sectors that address food security.

Keywords: food security, migrants, strategies, inferential statistics

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205 The Effect of Metal Transfer Modes on Mechanical Properties of 3CR12 Stainless Steel

Authors: Abdullah Kaymakci, Daniel M. Madyira, Ntokozo Nkwanyana

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The effect of metal transfer modes on mechanical properties of welded 3CR12 stainless steel were investigated. This was achieved by butt welding 10 mm thick plates of 3CR12 in different positions while varying the welding positions for different metal transfer modes. The ASME IX: 2010 (Welding and Brazing Qualifications) code was used as a basis for welding variables. The material and the thickness of the base metal were kept constant together with the filler metal, shielding gas and joint types. The effect of the metal transfer modes on the microstructure and the mechanical properties of the 3CR12 steel was then investigated as it was hypothesized that the change in welding positions will affect the transfer modes partly due to the effect of gravity. The microscopic examination revealed that the substrate was characterized by dual phase microstructure, that is, alpha phase and beta phase grain structures. Using the spectroscopic examination results and the ferritic factor calculation had shown that the microstructure was expected to be ferritic-martensitic during air cooling process. The tested tensile strength and Charpy impact energy were measured to be 498 MPa and 102 J which were in line with mechanical properties given in the material certificate. The heat input in the material was observed to be greater than 1 kJ/mm which is the limiting factor for grain growth during the welding process. Grain growths were observed in the heat affected zone of the welded materials. Ferritic-martensitic microstructure was observed in the microstructure during the microscopic examination. The grain growth altered the mechanical properties of the test material. Globular down hand had higher mechanical properties than spray down hand. Globular vertical up had better mechanical properties than globular vertical down.

Keywords: welding, metal transfer modes, stainless steel, microstructure, hardness, tensile strength

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204 Countering Radicalization to Violent Extremism: A Comparative Study of Canada, the UK and South East Asia

Authors: Daniel Alati

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Recent high-profile terrorist events in Canada, the United Kingdom and Europe – the London Bridge attacks, the terrorist attacks in Nice, France and Barcelona, Spain, the 2014 Ottawa Parliament attacks and the 2017 attacks in Edmonton – have all raised levels of public and academic concern with so-called “lone-wolf” and “radicalized” terrorism. Similarly, several countries outside of the “Western” world have been dealing with radicalization to violent extremism for several years. Many South East Asian countries, including Indonesia, Malaysia, Singapore and the Philippines have all had experience with what might be described as ISIS or extremist-inspired acts of terrorism. Indeed, it appears the greatest strength of groups such as ISIS has been their ability to spread a global message of violent extremism that has led to radicalization in markedly different jurisdictions throughout the world. These markedly different jurisdictions have responded with counter-radicalization strategies that warrant further comparative analysis. This paper utilizes an inter-disciplinary legal methodology. In doing so, it compares legal, political, cultural and historical aspects of the counter-radicalization strategies employed by Canada, the United Kingdom and several South East Asian countries (Indonesia, Malaysia, Singapore and the Philippines). Whilst acknowledging significant legal and political differences between these jurisdictions, the paper engages in these analyses with an eye towards understanding which best practices might be shared between the jurisdictions. In doing so, it presents valuable findings of a comparative nature that are useful to both academic and practitioner audiences in several jurisdictions.

Keywords: Canada, United Kingdom and South East Asia, comparative law and politics, radicalization to violent extremism, terrorism

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203 Modelling of Damage as Hinges in Segmented Tunnels

Authors: Gelacio JuáRez-Luna, Daniel Enrique GonzáLez-RamíRez, Enrique Tenorio-Montero

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Frame elements coupled with springs elements are used for modelling the development of hinges in segmented tunnels, the spring elements modelled the rotational, transversal and axial failure. These spring elements are equipped with constitutive models to include independently the moment, shear force and axial force, respectively. These constitutive models are formulated based on damage mechanics and experimental test reported in the literature review. The mesh of the segmented tunnels was discretized in the software GID, and the nonlinear analyses were carried out in the finite element software ANSYS. These analyses provide the capacity curve of the primary and secondary lining of a segmented tunnel. Two numerical examples of segmented tunnels show the capability of the spring elements to release energy by the development of hinges. The first example is a segmental concrete lining discretized with frame elements loaded until hinges occurred in the lining. The second example is a tunnel with primary and secondary lining, discretized with a double ring frame model. The outer ring simulates the segmental concrete lining and the inner ring simulates the secondary cast-in-place concrete lining. Spring elements also modelled the joints between the segments in the circumferential direction and the ring joints, which connect parallel adjacent rings. The computed load vs displacement curves are congruent with numerical and experimental results reported in the literature review. It is shown that the modelling of a tunnel with primary and secondary lining with frame elements and springs provides reasonable results and save computational cost, comparing with 2D or 3D models equipped with smeared crack models.

Keywords: damage, hinges, lining, tunnel

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202 Balanced Scorecard (BSC) Project : A Methodological Proposal for Decision Support in a Corporate Scenario

Authors: David de Oliveira Costa, Miguel Ângelo Lellis Moreira, Carlos Francisco Simões Gomes, Daniel Augusto de Moura Pereira, Marcos dos Santos

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Strategic management is a fundamental process for global companies that intend to remain competitive in an increasingly dynamic and complex market. To do so, it is necessary to maintain alignment with their principles and values. The Balanced Scorecard (BSC) proposes to ensure that the overall business performance is based on different perspectives (financial, customer, internal processes, and learning and growth). However, relying solely on the BSC may not be enough to ensure the success of strategic management. It is essential that companies also evaluate and prioritize strategic projects that need to be implemented to ensure they are aligned with the business vision and contribute to achieving established goals and objectives. In this context, the proposition involves the incorporation of the SAPEVO-M multicriteria method to indicate the degree of relevance between different perspectives. Thus, the strategic objectives linked to these perspectives have greater weight in the classification of structural projects. Additionally, it is proposed to apply the concept of the Impact & Probability Matrix (I&PM) to structure and ensure that strategic projects are evaluated according to their relevance and impact on the business. By structuring the business's strategic management in this way, alignment and prioritization of projects and actions related to strategic planning are ensured. This ensures that resources are directed towards the most relevant and impactful initiatives. Therefore, the objective of this article is to present the proposal for integrating the BSC methodology, the SAPEVO-M multicriteria method, and the prioritization matrix to establish a concrete weighting of strategic planning and obtain coherence in defining strategic projects aligned with the business vision. This ensures a robust decision-making support process.

Keywords: MCDA process, prioritization problematic, corporate strategy, multicriteria method

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201 Advanced Lithium Recovery from Brine: 2D-Based Ion Selectivity Membranes

Authors: Nour S. Abdelrahman, Seunghyun Hong, Hassan A. Arafat, Daniel Choi, Faisal Al Marzooqi

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Abstract—The advancement of lithium extraction methods from water sources, particularly saltwater brine, is gaining prominence in the lithium recovery industry due to its cost-effectiveness. Traditional techniques like recrystallization, chemical precipitation, and solvent extraction for metal recovery from seawater or brine are energy-intensive and exhibit low efficiency. Moreover, the extensive use of organic solvents poses environmental concerns. As a result, there's a growing demand for environmentally friendly lithium recovery methods. Membrane-based separation technology has emerged as a promising alternative, offering high energy efficiency and ease of continuous operation. In our study, we explored the potential of lithium-selective sieve channels constructed from layers of 2D graphene oxide and MXene (transition metal carbides and nitrides), integrated with surface – SO₃₋ groups. The arrangement of these 2D sheets creates interplanar spacing ranging from 0.3 to 0.8 nm, which forms a barrier against multivalent ions while facilitating lithium-ion movement through nano capillaries. The introduction of the sulfonate group provides an effective pathway for Li⁺ ions, with a calculated binding energy of Li⁺ – SO³⁻ at – 0.77 eV, the lowest among monovalent species. These modified membranes demonstrated remarkably rapid transport of Li⁺ ions, efficiently distinguishing them from other monovalent and divalent species. This selectivity is achieved through a combination of size exclusion and varying binding affinities. The graphene oxide channels in these membranes showed exceptional inter-cation selectivity, with a Li⁺/Mg²⁺ selectivity ratio exceeding 104, surpassing commercial membranes. Additionally, these membranes achieved over 94% rejection of MgCl₂.

Keywords: ion permeation, lithium extraction, membrane-based separation, nanotechnology

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200 Exploring Individual Decision Making Processes and the Role of Information Structure in Promoting Uptake of Energy Efficient Technologies

Authors: Rebecca J. Hafner, Daniel Read, David Elmes

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The current research applies decision making theory in order to address the problem of increasing uptake of energy-efficient technologies in the market place, where uptake is currently slower than one might predict following rational choice models. Specifically, in two studies we apply the alignable/non-alignable features effect and explore the impact of varying information structure on the consumers’ preference for standard versus energy efficient technologies. As researchers in the Interdisciplinary centre for Storage, Transformation and Upgrading of Thermal Energy (i-STUTE) are currently developing energy efficient heating systems for homes and businesses, we focus on the context of home heating choice, and compare preference for a standard condensing boiler versus an energy efficient heat pump, according to experimental manipulations in the structure of prior information. In Study 1, we find that people prefer stronger alignable features when options are similar; an effect which is mediated by an increased tendency to infer missing information is the same. Yet, in contrast to previous research, we find no effects of alignability on option preference when options differ. The advanced methodological approach used here, which is the first study of its kind to randomly allocate features as either alignable or non-alignable, highlights potential design effects in previous work. Study 2 is designed to explore the interaction between alignability and construal level as an explanation for the shift in attentional focus when options differ. Theoretical and applied implications for promoting energy efficient technologies are discussed.

Keywords: energy-efficient technologies, decision-making, alignability effects, construal level theory, CO2 reduction

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199 Exploring Gender-Base Salary Disparities and Equities Among University Presidents

Authors: Daniel Barkley, Jianyi Zhu

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This study investigates base salary differentials and gender equity among university presidents across 427 U.S. colleges and universities. While endowments typically do not directly determine university presidents' base salaries, our analysis reveals a noteworthy pattern: endowments explain more than half of the variance in female university presidents' base salaries, compared to a mere 0.69 percent for males. Moreover, female presidents' base salaries tend to rise much faster than male base salaries with increasing university endowments. This disparate impact of endowments on base salaries implies an endowment threshold for achieving gender pay equity. We develop an analytical model predicting an endowment threshold for achieving gender equality and empirically estimate this equity threshold using data from over 427 institutions. Surprisingly, the fields of science and athletics have emerged as sources of gender-neutral base pay. Both male and female university presidents with STEM backgrounds command higher base salaries than those without such qualifications. Additionally, presidents of universities affiliated with Power 5 conferences consistently receive higher base salaries regardless of gender. Consistent with the theory of human capital accumulation, the duration of the university presidency incrementally raises base salaries for both genders but at a diminishing rate. Curiously, prior administrative leadership experience as a vice president, provost, dean, or department chair does not significantly influence base salaries for either gender. By providing empirical evidence and analytical models predicting an endowment threshold for achieving gender equality in base salaries, the study offers valuable insights for policymakers, university administrators, and other stakeholders. These findings hold crucial policy implications, informing strategies to promote gender equality in executive compensation within higher education institutions.

Keywords: higher education, endowments, base salaries, university presidents

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198 Managing Physiological and Nutritional Needs of Rugby Players in Kenya

Authors: Masita Mokeira, Kimani Rita, Obonyo Brian, Kwenda Kennedy, Mugambi Purity, Kirui Joan, Chomba Eric, Orwa Daniel, Waiganjo Peter

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Rugby is a highly intense and physical game requiring speed and strength. The need for physical fitness therefore cannot be over-emphasized. Sports are no longer about lifting weights so as to build muscle. Most professional teams are investing much more in the sport in terms of time, equipment and other resources. To play competitively, Kenyan players may therefore need to complement their ‘home-grown’ and sometimes ad-hoc training and nutrition regimes with carefully measured strength and conditioning, diet, nutrition, and supplementation. Nokia Research Center and University of Nairobi conducted an exploratory study on needs and behaviours surrounding sports in Africa. Rugby being one sport that is gaining ground in Kenya was selected as the main focus. The end goal of the research was to identify areas where mobile technology could be used to address gaps, challenges and/or unmet needs. Themes such as information gap, social culture, growth, and development, revenue flow, and technology adoption among others emerged about the sport. From the growth and development theme, it was clear that as rugby continues to grow in the country, teams, coaches, and players are employing interesting techniques both in training and playing. Though some of these techniques are indeed scientific, those employing them are sometimes not fully aware of their scientific basis. A further case study on sports science in rugby in Kenya focusing on physical fitness and nutrition revealed interesting findings. This paper discusses findings on emerging adoption of techniques in managing physiological and nutritional needs of rugby players across different levels of rugby in Kenya namely high school, club and national levels.

Keywords: rugby, nutrition, physiological needs, sports science

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197 Design and Implementation of 3kVA Grid-Tied Transformerless Power Inverter for Solar Photovoltaic Application

Authors: Daniel O. Johnson, Abiodun A. Ogunseye, Aaron Aransiola, Majors Samuel

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Power Inverter is a very important device in renewable energy use particularly for solar photovoltaic power application because it is the effective interface between the DC power generator and the load or the grid. Transformerless inverter is getting more and more preferred to the power converter with galvanic isolation transformer and may eventually supplant it. Transformerless inverter offers advantages of improved DC to AC conversion and power delivery efficiency; and reduced system cost, weight and complexity. This work presents thorough analysis of the design and prototyping of 3KVA grid-tie transformerless inverter. The inverter employs electronic switching method with minimised heat generation in the system and operates based on the principle of pulse-width modulation (PWM). The design is such that it can take two inputs, one from PV arrays and the other from Battery Energy Storage BES and addresses the safety challenge of leakage current. The inverter system was designed around microcontroller system, modeled with Proteus® software for simulation and testing of the viability of the designed inverter circuit. The firmware governing the operation of the grid-tied inverter is written in C language and was developed using MicroC software by Mikroelectronica® for writing sine wave signal code for synchronization to the grid. The simulation results show that the designed inverter circuit performs excellently with very high efficiency, good quality sinusoidal output waveform, negligible harmonics and gives very stable performance under voltage variation from 36VDC to 60VDC input. The prototype confirmed the simulated results and was successfully synchronized with the utility supply. The comprehensive analyses of the circuit design, the prototype and explanation on overall performance will be presented.

Keywords: grid-tied inverter, leakage current, photovoltaic system, power electronic, transformerless inverter

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196 Effect of Different Temperatures and Cold Storage on Pupaes Apanteles gelechiidivoris Marsh (Hymenoptera: Braconidae) Parasitoid of Tuta absoluta Meyrick (Lepidoptera: Gelechiidae)

Authors: Jessica Morales Perdomo, Daniel Rodriguez Caicedo, Fernando Cantor Rincon

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Tuta absoluta known as the tomato leaf miner, is one of the main pests in tomato crops in South America and the main pest in many European countries. Apanteles gelechiidivoris is a parasitoid of third instar Tuta absoluta larvae. Our studies have demonstrated that this parasitoid can cause up to 80% mortality of T. absoluta larvae in the field. We investigated cold storage of A. gelechiidivoris pupae as a method of mass production of this parasitoid. This storage method does not interfere with biological characteristics of the parasitoid. In this study, we evaluated the effect of different temperatures (4, 8 and 12°C) and different time duration (7, 14, 21 or 28 days) of cold storage on biological parameters of A. gelechiidivoris pupae and adults. The biological parameters of the parasitoid evaluated were: adult emergence time, lifespan, parasitism percentage and sex ratio. We found that the adult emergence time was delayed when the parasitoid pupae were stored at 4°C and 8°C. The shortest adult emergence was recorded when pupae were stored for seven days. The lowest adult emergence was found for pupae stored at 4°C and decreased significantly as the days of storage increased. We found high percentages of adult emergence when pupae were stored at 8°C and 12°C for seven days. Adult lifespan decreased with increasing days of cold storage. Adults emerging from pupae stored at 8°C during seven and 14 days showed the longest lifespan (nine days). The lowest parasitism rate was recorded at 4°C at every time point. The highest percentage of parasitism (80%) was found at 8°C during seven days of storage. The treatments had no effect on adults the sex ratio. The results suggest that A. gelechiidivoris pupae can be stored for up to 14 days at 8°C without affecting the efficacy of the parasitoid in the field.

Keywords: biological control, cold storage, massive rearing, quality control

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195 Findings from an Access Improvement Project for Antiretroviral Therapy Uptake through Traditional Birth Attendants at Mother Theresa Hospital, Lagos, Nigeria

Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

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In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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194 Clinical and Epidemiological Profile in Patients with Preeclampsia in a Private Institution in Medellin, Colombia 2015

Authors: Camilo Andrés Agudelo Vélez, Lina María Martínez Sánchez, Isabel Cristina Ortiz Trujillo, Evert Armando Jiménez Cotes, Natalia Perilla Hernández, María de los Ángeles Rodríguez Gázquez, Daniel Duque Restrepo, Felipe Hernández Restrepo, Dayana Andrea Quintero Moreno, Juan José Builes Gómez, Camilo Ruiz Mejía, Ana Lucia Arango Gómez

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Preeclampsia is a clinical complication during pregnancy with high incidence in Colombia; therefore, it is important to evaluate the influence of external conditions and medical interventions, in order to promote measures that encourage improvements in the quality of life. Objective: Determine clinical and sociodemographic variables in women with preeclampsia. Methods: This cross-sectional study enrolled 50 patients with the diagnosis of preeclampsia, from a private institution in Medellin, during 2015. We used the software SPSS ver.20 for statistical analysis. For the qualitative variables, we calculated the mean and standard deviation, while, for ordinal and nominal levels of quantitative variables, ratios were estimated. Results: The average age was 26.8±5.9 years. The predominant characteristics were socioeconomic stratum 2 (48%), students (55%), mixed race (46%) and middle school as level of education (38%). As for clinical features, 72% of the cases were mild preeclampsia, and 22% were severe forms. The most common clinical manifestations were edema (46%), headache (62%), and proteinuria (55%). As for the Gyneco-obstetric history, 8% reported previous episodes of this disease and it was the first pregnancy for 60% of the patients. Conclusions: Preeclampsia is a frequent condition in young women; on the other hand, headache and edema were the most common reasons for consultation, therefore, doctors need to be aware of these symptoms in pregnant women.

Keywords: pre-eclampsia, hypertension, pregnancy complications, pregnancy, abdominal, edema

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193 Performance and Structural Evaluation of the Torrefaction of Bamboo under a High Gravity (Higee) Environment Using a Rotating Packed Bed

Authors: Mark Daniel De Luna, Ma. Katreena Pillejera, Wei-Hsin Chen

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The raw bamboo (Phyllostachys mankinoi), with a moisture content of 13.54 % and a higher heating value (HHV) of 17.657 MJ/kg, was subjected to torrefaction under a high gravity (higee) environment using a rotating packed bed. The performance of the higee torrefaction was explored in two parts: (1) effect of rotation and temperature and (2) effect of duration on the solid yield, HHV and energy yield. By statistical analyses, the results indicated that the rotation, temperature and their interaction has a significant effect on the three responses. Same remarks on the effect of duration where when the duration (temperature and rotation) increases, the HHV increases, while the solid yield and energy yield decreases. Graphical interpretations showed that at 300 °C, the rotating speed has no evident effect on the responses. At 30-min holding time, the highest HHV reached (28.389 MJ/kg) was obtained in the most severe torrefaction condition (the rotating speed at 1800 rpm and temperature at 300 °C) with an enhancement factor of HHV corresponding to 1.61 and an energy yield of 63.51%. Upon inspection, the recommended operating condition under a 30-min holding time is at 255 °C-1800 rpm since the enhancement factor of HHV (1.53), HHV (26.988 MJ/kg), and energy yield (65.21%) values are relatively close to that of the aforementioned torrefaction condition. The Van Krevelen diagram of the torrefied biomass showed that the ratios decrease as the torrefaction intensifies, hence improving the hydrophobicity of the product. The spreads of the results of the solid yield, enhancement factor (EF) of HHV, energy yield, and H/C and O/C ratios were in accordance with the trends of the responses. Overall, from the results presented, it can be concluded that the quality of the product from the process is at par to that of coal (i.e. HHV of coal is 21-35 MJ/kg). The Fourier transform infrared (FTIR) spectroscopy results indicated that cellulose and lignin may have been degraded at a lower temperature accompanied with a high rotating speed. The results suggested that torrefaction under higee environment indicates promising process for the utilization of bamboo.

Keywords: heat transfer, high gravity environment, FTIR, rotation, rotating speed, torrefaction

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192 Enhancing Self-Assessment and Management Potentials by Modifying Option Selections on Hartman’s Personality Test

Authors: Daniel L. Clinciu, IkromAbdulaev, Brian D. Oscar

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Various personality profile tests are used to identify personality strengths and limits in individuals, helping both individuals and managers to optimize work and team effort in organizations. One such test, Hartman’s personality profile emphasizes four driving "core motives" influenced or affected by both strengths and limitations. The driving core motives are classified into four colors: Red-motivated by power; Blue-discipline and loyalty; White-peace; and Yellow–fun loving. Two shortcomings of Hartman’s personality test are noted; 1) only one choice for every item/situation allowed and 2) selection of a choice even if not applicable. A test taker may be as much nurturing as he is opinionated but since “opinionated” seems less attractive the individual would likely select nurturing, causing a misidentification in personality strengths and limits. Since few individuals have a "strong" personality, it is difficult to assess their true personality strengths and limits allowing either only one choice or requiring unwanted choices, undermining the potential of the test. We modified Hartman’s personality profile allowing test takers to make either multiple choices for any item/situation or leave them blank when not applying. Sixty-eight participants (38 males and 30 females), 17-49 years old, from countries in Asia, Europe, N. America, CIS, Africa, Latin America, and Oceania were included. 58 participants (85.3%) reported the modified test, allowing either multiple or no choices better identified their personality strengths and limits, while 10 participants (14.7%) expressed the original (one choice version) is sufficient. The overall results show our modified test enhanced the identification and balance of personality strengths and limits, aiding test takers, managers, and firms to better understand personality strengths and limits, particularly useful in making task-related, teamwork, and management decisions.

Keywords: organizational behavior, personality tests, personality limitations, personality strengths, task management, team work

Procedia PDF Downloads 362
191 A Bicycle Based Model of Prehospital Care Implanted in Northeast of the Brazil: Initial Experience

Authors: Odaleia de O. Farias, Suzelene C. Marinho, Ecleidson B. Fragoso, Daniel S. Lima, Francisco R. S. Lira, Lara S. Araújo, Gabriel dos S. D. Soares

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In populous cities, prehospital care services that use vehicles alternative to ambulances are needed in order to reduce costs and improve response time to occurrences in areas with large concentration of people, such as leisure and tourism spaces. In this context, it was implanted a program called BIKE VIDA, that is innovative quick access and assistance program. The aim of this study is to describe the implantation and initial profile of occurrences performed by an urgency/emergency pre-hospital care service through paramedics on bicycles. It is a cross-sectional, descriptive study carried out in the city of Fortaleza, Ceara, Brazil. The data included service records from July to August 2017. Ethical aspects were respected. The service covers a perimeter of 4.5 km, divided into three areas with perimeter of 1.5 km for each paramedic, attending from 5 am to 9 pm. Materials transported by bicycles include External Automated Defibrillator - DEA, portable oxygen, oximeter, cervical collar, stethoscope, sphygmomanometer, dressing and immobilization materials and personal protective equipment. Occurrences are requested directly by calling the emergency number 192 or through direct approach to the professional. In the first month of the program, there were 93 emergencies/urgencies, mainly in the daytime period (71,0%), in males (59,7%), in the age range of 26 to 45 years (46,2%). The main nature was traumatic incidents (53.3%). Most of the cases (88,2%) did not require ambulance transport to the hospital, and there were two deaths. Pre-hospital service through bicycles is an innovative strategy in Brazil and has shown to be promising in terms of reducing costs and improving the quality of the services offered.

Keywords: emergency, response time, prehospital care, urgency

Procedia PDF Downloads 197
190 Appraisal of the Impact Strength on Mild Steel Cladding Weld Metal Geometry

Authors: Chukwuemeka Daniel Ezeliora, Chukwuebuka Lawrence Ezeliora

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The research focused on the appraisal of impact strength on mild steel cladding weld metal geometry. Over the years, poor welding has resulted in failures in engineering components, poor material quality, the collapse of welded materials, and failures in material strength. This is as a result of poor selection and combination of welding input process parameters. The application of the Tungsten Inert Gas (TIG) welding method with weld specimen of length 60; width 40, and thickness of 10 was used for the experiment. A butt joint method was prepared for the welding, and tungsten inert gas welding process was used to perform the twenty (20) experimental runs. A response surface methodology was used to model and to analyze the system. For an adequate polynomial approximation, the experimental design was used to collect the data. The key parameters considered in this work are welding current, gas flow rate, welding speed, and voltage. The range of the input process parameters was selected from the literature and the design. The steps followed to achieve the experimental design and results is the use of response surface method (RSM) implemented in central composite design (CCD) to generate the design matrix, to obtain quadratic model, and evaluate the interactions in the factors as well as optimizing the factors and the response. The result expresses that the best impact strength of the mild steel cladding weld metal geometry is 115.419 Joules. However, it was observed that the result of the input factors is; current 180.4 amp, voltage 23.99 volt, welding speed 142.7 mm.s and gas flow rate 10.8 lit/min as the optimum of the input process parameters. The optimal solution gives a guide for optimal impact strength of the weldment when welding with tungsten inert gas (TIG) under study.

Keywords: mild steel, impact strength, response surface, bead geometry, welding

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189 Spatial Variation of WRF Model Rainfall Prediction over Uganda

Authors: Isaac Mugume, Charles Basalirwa, Daniel Waiswa, Triphonia Ngailo

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Rainfall is a major climatic parameter affecting many sectors such as health, agriculture and water resources. Its quantitative prediction remains a challenge to weather forecasters although numerical weather prediction models are increasingly being used for rainfall prediction. The performance of six convective parameterization schemes, namely the Kain-Fritsch scheme, the Betts-Miller-Janjic scheme, the Grell-Deveny scheme, the Grell-3D scheme, the Grell-Fretas scheme, the New Tiedke scheme of the weather research and forecast (WRF) model regarding quantitative rainfall prediction over Uganda is investigated using the root mean square error for the March-May (MAM) 2013 season. The MAM 2013 seasonal rainfall amount ranged from 200 mm to 900 mm over Uganda with northern region receiving comparatively lower rainfall amount (200–500 mm); western Uganda (270–550 mm); eastern Uganda (400–900 mm) and the lake Victoria basin (400–650 mm). A spatial variation in simulated rainfall amount by different convective parameterization schemes was noted with the Kain-Fritsch scheme over estimating the rainfall amount over northern Uganda (300–750 mm) but also presented comparable rainfall amounts over the eastern Uganda (400–900 mm). The Betts-Miller-Janjic, the Grell-Deveny, and the Grell-3D underestimated the rainfall amount over most parts of the country especially the eastern region (300–600 mm). The Grell-Fretas captured rainfall amount over the northern region (250–450 mm) but also underestimated rainfall over the lake Victoria Basin (150–300 mm) while the New Tiedke generally underestimated rainfall amount over many areas of Uganda. For deterministic rainfall prediction, the Grell-Fretas is recommended for rainfall prediction over northern Uganda while the Kain-Fritsch scheme is recommended over eastern region.

Keywords: convective parameterization schemes, March-May 2013 rainfall season, spatial variation of parameterization schemes over Uganda, WRF model

Procedia PDF Downloads 311
188 Construction Innovation: Support for 3D Printing House

Authors: Andrea Palazzo, Daniel Macek, Veronika Malinova

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Contour processing is the new technology challenge for architects and construction companies. The many advantages it promises make it one of the most interesting solutions for construction in terms of automation of building processes. The technology for 3D printing houses offers many application possibilities, from low-cost construction, to being considered by NASA for visionary projects as a good solution for building settlements on other planets. Another very important point is that clients, as architects, will no longer have many limits in design concerning ideas and creativity. The prices for real estate are constantly increasing and the lack of availability of construction materials as well as the speculation that has been created around it in 2021 is bringing prices to such a level that in the future real estate developers risk not being able to find customers for these ultra-expensive homes. Hence, this paper starts with the introduction of 3D printing, which now has the potential to gain an important position in the market, becoming a valid alternative to the classic construction process. This technology is not only beneficial from an economic point of view but it is also a great opportunity to have an impact on the environment by reducing CO2 emissions. Further on in the article we will also understand if, after the COP 26 (2021 United Nations Climate Change Conference), world governments could also push towards building technologies that reduce the waste materials that are needed to be disposed of and at the same time reduce emissions with the contribution of governmental funds. This paper will give us insight on the multiple benefits of 3D printing and emphasise the importance of finding new solutions for materials that can be used by the printer. Therefore, based on the type of material, it will be possible to understand the compatibility with current regulations and how the authorities will be inclined to support this technology. This will help to enable the rise and development of this technology in Europe and in the rest of the world on actual housing projects and not only on prototypes.

Keywords: additive manufacturing, contour crafting, development, new regulation, printing material

Procedia PDF Downloads 198
187 Legal Pluralism and Efficiency in International Marriage Law: Implications of Regulatory Competition on an Analysis of Conflict of Law Rules

Authors: Rorick Daniel Tovar Galvan

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The existence of different legal systems represents an important barrier for married couples that attempt to reside in another country. Each movement can cause important changes in the rights and obligations derived from the marriage since a different law could be used by the courts to solve legal disputes arising from their relationship. In a context in which it is increasingly common to move from one country to another, people cannot be certain about the outcomes of proceedings dealing with i.e., the dissolution of property regime, maintenance payments or time to wait to initiate divorce because a foreign – and in most cases unknown – law could apply every time they move. At first glance, the answer to this issue seems to be the harmonization of the legal systems: the greater the mobility of individuals inside a group of countries, the higher the similarities of their laws should be. Such a solution could be positive for spouses because a higher degree of legal certainty would be reached in case the same legal rules applied regardless of the place where the couple lives. However, the legal pluralism brings with it also advantages that could be appreciated when one looks closely at the economic rationale behind the legal institution of marriage. This contribution carries out an economic analysis of the existence of different legal systems in the area of marriage law and proposes another strategy to cope with the problems arising from legal pluralism. Far from eliminating the diversity of legal systems, one wishes to foster it, since significant advantages could arise from such diversity in case couples are permitted to choose the applicable law themselves. Based on the idea that the law could be seem as a product offered in the market as well as states and spouses as suppliers and consumers of this product, the paper shows the advantages of designing a legal framework that allows spouses to determine freely the law governing the legal effects of their marriage. Instead of promoting the harmonization of the substantive law, one explores the benefits of encouraging the regulatory competition at international level in the area of marriage law.

Keywords: conflict of laws, harmonization, international marriage law, law and economics, regulatory competition

Procedia PDF Downloads 193
186 Use of Alternative and Complementary Therapies in Patients with Chronic Pain in a Medical Institution in Medellin, Colombia, 2014

Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez

Abstract:

Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.

Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia

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185 Comparison of Effects over the Autonomic Nervous System When Using Force Training and Interval Training in Indoor Cycling with University Students

Authors: Daniel Botero, Oscar Rubiano, Pedro P. Barragan, Jaime Baron, Leonardo Rodriguez Perdomo, Jaime Rodriguez

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In the last decade interval training (IT) has gained importance when is compare with strength training (ST). However, there are few studies analyzing the impact of these training over the autonomic nervous system (ANS). This work has aimed to compare the activity of the autonomic nervous system, when is expose to an IT or ST indoor cycling mode. After approval by the ethics committee, a cross-over clinical trial with 22 healthy participants (age 21 ± 3 years) was implemented. The selection of participants for the groups with sequence force-interval (F-I) and interval-force (I-F) was made randomly with assignation of 11 participants for each group. The temporal series of heart rate was obtained before and after each training using the POLAR TEAM® heart monitor. The evaluation of the ANS was performed with spectral analysis of the heart rate variability (HRV) using the fast Fourier transform (Kubios software). A training of 8 weeks in each sequence (4 weeks with each training) with an intermediate period of two weeks of washout was implemented for each group. The power parameter of the HRV in the low frequency band (LF = 0.04-0.15Hz related to the sympathetic nervous system), high frequency (HF = 0.15-0.4Hz, related to the parasympathetic) and LF/HF (with reference to a modulation of parasympathetic over the sympathetic), were calculated. Afterward, the difference between the parameters before and after was realized. Then, to evaluate statistical differences between each training was implemented the method of Wellek (Wellek and Blettner, 2012, Medicine, 109 (15), 276-81). To determine the difference of effect over parasympathetic when FT and IT are used, the T test is implemented obtaining a T value of 0.73 with p-value ≤ 0.1. For the sympathetic was obtained a T of 0.33 with p ≤ 0.1 and for LF/HF the T was 1.44 with a p ≥ 0.1. Then, the carry over effect was evaluated and was not present. Significant changes over autonomic activity with strength or interval training were not observed. However, a modulation of the parasympathetic over the sympathetic can be observed. Probably, these findings should be explained because the sample is little and/or the time of training was insufficient to generate changes.

Keywords: autonomic nervous, force training, indoor cycling, interval training

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184 Need of Trained Clinical Research Professionals Globally to Conduct Clinical Trials

Authors: Tambe Daniel Atem

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Background: Clinical Research is an organized research on human beings intended to provide adequate information on the drug use as a therapeutic agent on its safety and efficacy. The significance of the study is to educate the global health and life science graduates in Clinical Research in depth to perform better as it involves testing drugs on human beings. Objectives: to provide an overall understanding of the scientific approach to the evaluation of new and existing medical interventions and to apply ethical and regulatory principles appropriate to any individual research. Methodology: It is based on – Primary data analysis and Secondary data analysis. Primary data analysis: means the collection of data from journals, the internet, and other online sources. Secondary data analysis: a survey was conducted with a questionnaire to interview the Clinical Research Professionals to understand the need of training to perform clinical trials globally. The questionnaire consisted details of the professionals working with the expertise. It also included the areas of clinical research which needed intense training before entering into hardcore clinical research domain. Results: The Clinical Trials market worldwide worth over USD 26 billion and the industry has employed an estimated 2,10,000 people in the US and over 70,000 in the U.K, and they form one-third of the total research and development staff. There are more than 2,50,000 vacant positions globally with salary variations in the regions for a Clinical Research Coordinator. R&D cost on new drug development is estimated at US$ 70-85 billion. The cost of doing clinical trials for a new drug is US$ 200-250 million. Due to an increase trained Clinical Research Professionals India has emerged as a global hub for clinical research. The Global Clinical Trial outsourcing opportunity in India in the pharmaceutical industry increased to more than $2 billion in 2014 due to increased outsourcing from U.S and Europe to India. Conclusion: Assessment of training need is recommended for newer Clinical Research Professionals and trial sites, especially prior the conduct of larger confirmatory clinical trials.

Keywords: clinical research, clinical trials, clinical research professionals

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183 Return to Bowel Function after Right versus Extended Right Hemicolectomy: A Retrospective Review

Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

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Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

Procedia PDF Downloads 88