Search results for: disaster risk management

Authors: Magdalena Korytowska, Gunnar Lengstrand, Cecilia Larsson Wexell

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Background: Breast cancer (BC) is the most common cancer among women worldwide, and cases are continuing to increase in Sweden. Bone is the most common metastatic site in breast cancer patients, where > 65-75% of women with advanced breast cancer develop bone metastases during their disease. To prevent the skeletal-related events of metastases (e.g., pathological fractures, bone loss, cancer-induced bone pain, and hypercalcemia bone), two different classes of antiresorptive medications (AR), bisphosphonate and denosumab are typically administered every 3 to 4 weeks. Since 2015, adjuvant bisphosphonate treatment has been used every six months for three to five years in postmenopausal women for the prevention of skeletal metastases and improved survival. Methods: A case-control study was conducted to test the hypotheses that patients treated with high-dose AR are at higher risk of developing MRONJ than breast cancer patients with adjuvant bisphosphonate treatment at a lower dose. Medical and odontological data was collected between 2015-2020. Assessment of oral health and dental care before and during oncological treatment took place at the specialist clinic for Orofacial medicine linked to the specific hospital. Results: In total, 220 patients were included, 101 patients in the high-dose group and 119 patients in the adjuvant BP-treatment group. MRONJ was diagnosed in 13 patients (14%) in the high-dose group. The mandible was affected in most of the cases (84.6%), with a mean duration of high-dose treatment of 19.7 months. In 46.2% of cases, no dental cause of MRONJ could be identified. Overall, estrogen receptor-positive (ER+) BC was the most representative type in 172 patients (78.2%). However, this was 83.9% in the high-dose cases group. The most used drug was denosumab. Twenty-five patients (26.9%) switched their medication from ZOL to denosumab during their oncological treatment. Patients with ER+ breast cancer were reported in 88 patients (87.8%) in the adjuvant group that was treated with ZOL. Conclusions: MRONJ was diagnosed only in the high-dose AR group. Dental assessment and care of patients in the adjuvant group should be considered, with a recommendation to potentially prolong ZOL treatment from 3 to 5 years, with concomitant use of hormonal therapy in patients diagnosed with ER+ breast cancer to prevent bone loss induced by oncological treatment. A new referral for dental assessment is very important in the case of bone metastases when treatment with high dose AR will be required since it is associated with a higher risk of MRONJ.

Keywords: antiresorptive therapy, breast cancer, dental care, MRONJ

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Authors: Moon-Tak Oh, Kyung-Min Park, Tae-Eun Yoon, Hoon Choi, Chil-Woo Lee

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This paper is about middle-ware which enables group-user applications on mobile devices in physical proximity to interact with other devices without intervention of a central server. Requirements of the middle-ware are identified from service usage scenarios, and the functional architecture of the middle-ware is specified. These requirements include group management, synchronization, and resource management. Group Management needs to provide various capabilities to such applications with respect to managing multiple users (e.g., creation of groups, discovery of group or individual users, member join/leave, election of a group manager and service-group association) using D2D communication technology. We designed the middle-ware for the above requirements on the Android platform.

Keywords: group user, middleware, mobile service, physical proximity

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Authors: Jaroslav Masek, Juraj Camaj, Eva Nedeliakova

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The aim of optimization of store management is not only designing the situation of store management itself including its equipment, technology and operation. In optimization of store management we need to consider also synchronizing of technological, transport, store and service operations throughout the whole process of logistic chain in such a way that a natural flow of material from provider to consumer will be achieved the shortest possible way, in the shortest possible time in requested quality and quantity and with minimum costs. The paper deals with the application of the queuing theory for optimization of warehouse processes. The first part refers to common information about the problematic of warehousing and using mathematical methods for logistics chains optimization. The second part refers to preparing a model of a warehouse within queuing theory. The conclusion of the paper includes two examples of using queuing theory in praxis.

Keywords: queuing theory, logistics system, mathematical methods, warehouse optimization

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Authors: Henry Kiptum Yatich, Ronald Chepkilot, Aquilars Mutuku Kalio

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Studies on energy management have focused on environmental conservation, reduction in production and operation expenses. However, transferring gains of energy management practices to competitive advantage is importance to manufacturers in Kenya. Success in managing competitive advantage arises out of a firm’s ability in identifying and implementing actions that can give the company an edge over its rivals. Manufacturing firms in Kenya are the highest consumers of both electricity and petroleum products. In this regard, the study posits that transfer of the gains of energy management practices to competitive advantage is imperative. The study was carried in Nairobi and its environs, which hosts the largest number of manufacturers. The study objectives were; to determine the level of implementing energy management regulations on sustaining competitive advantage, to determine the level of implementing company energy management policy on competitive advantage, to examine the level of implementing energy efficient technology on sustaining competitive advantage, and to assess the percentage energy expenditure on sustaining competitive advantage among manufacturing firms. The study adopted a survey research design, with a study population of 145,987. A sample of 384 respondents was selected randomly from 21 proportionately selected firms. Structured questionnaires were used to collect data. Data analysis was done using descriptive statistics (mean and standard deviations) and inferential statistics (correlation, regression, and T-test). Data is presented using tables and diagrams. The study found that Energy Management Regulations, Company Energy Management Policies, and Energy Expenses are significant predictors of Competitive Advantage (CA). However, Energy Efficient Technology as a component of Energy Management Practices did not have a significant relationship with Competitive Advantage. The study revealed that the level of awareness in the sector stood at 49.3%. Energy Expenses in the sector stood at an average of 10.53% of the firm’s total revenue. The study showed that gains from energy efficiency practices can be transferred to competitive strategies so as to improve firm competitiveness. The study recommends that manufacturing firms should consider energy management practices as part of its strategic agenda in assessing and reviewing their energy management practices as possible strategies for sustaining competitiveness. The government agencies such as Energy Regulatory Commission, the Ministry of Energy and Petroleum, and Kenya Association of Manufacturers should enforce the energy management regulations 2012, and with enhanced stakeholder involvement and sensitization so as promote sustenance of firm competitiveness. Government support in providing incentives and rebates for acquisition of energy efficient technologies should be pursued. From the study limitation, future experimental and longitudinal studies need to be carried out. It should be noted that energy management practices yield enormous benefits to all stakeholders and that the practice should not be considered a competitive tool but rather as a universal practice.

Keywords: energy, efficiency, management, guidelines, policy, technology, competitive advantage

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Authors: Mwenya Mubanga, Sula Mazimba

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Background: In Zambia, much of the focus on nutrition and health has been on reducing micronutrient deficiencies, wasting and underweight malnutrition and not on the rising global projections of trends in obesity and type 2 diabetes. The aim of this review was to identify and collate studies on the prevalence of obesity, diabetes and diabetes-related cardiovascular disease conducted in Zambia, to summarize their findings and to identify areas that need further research. Methods: The Medical Literature Analysis and Retrieval System (MEDLINE) database was searched for peer-reviewed articles on the prevalence of, and factors associated with obesity, type 2 diabetes, and diabetes-related cardiovascular disease amongst Zambian residents using a combination of search terms. The period of search was from 1 January 2000 to 31 December 2016. We expanded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of peer-reviewed articles. Results: In Zambia, the current prevalence of Obesity and Type 2 diabetes is estimated at 13%-16% and 2.0 – 3.0% respectively. Risk factors such as the adoption of western dietary habits, the social stigmatization associated with rapid weight loss due to Tuberculosis and/ or the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and rapid urbanization have all been blamed for fueling the increased risk of obesity and type 2 diabetes. However, unlike traditional Western populations, those with no formal education were less likely to be obese than those who attained secondary or tertiary level education. Approximately 30% of those surveyed were unaware of their diabetes diagnosis and more than 60% were not on treatment despite a known diabetic status. Socio-demographic factors such as older age, female sex, urban dwelling, lack of tobacco use and marital status were associated with an increased risk of obesity, impaired glucose tolerance and type 2 diabetes. We were unable to identify studies that specifically looked at diabetes-related cardiovascular disease. Conclusion: Although the prevalence of Obesity and Type 2 diabetes in Zambia appears low, more representative studies focusing on parts of the country outside of the main industrial zone need to be conducted. There also needs to be research on diabetes-related cardiovascular disease. National surveillance, monitoring and evaluation on all non-communicable diseases need to be prioritized and policies that address underweight, obesity and type 2 diabetes developed.

Keywords: type 2 diabetes, Zambia, obesity, cardiovascular disease

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Authors: Won Man Park, Dae Kyung Choi, Kyungsoo Kim, Yoon Hyuk Kim

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Traction therapy has been used in the treatment of spinal pain for decades. However, a case study reported the occurrence of large disc protrusion during motorized traction therapy. In this study, we hypothesized that additional local decompression with a global axial traction could be helpful for risk reduction of intervertebral disc damage. A validated three dimensional finite element model of the lumbar spine was used. Two-step traction therapy using the axial global traction (the first step) with 1/3 body weight and the additional local decompression (the second step) with 7 mm translation of L4 spinal bone was determined for the traction therapy. During two-step traction therapy, the sacrum was constrained in all translational directions. Reduced lordosis angle by the global axial traction recovered with the additional local decompression. Stress on fibers of the annulus fibrosus by the axial global traction decreased with the local decompression by 17%~96% in the posterior region of intervertebral disc. Stresses on ligaments except anterior longitudinal ligaments in all motion segments decreased till 4.9 mm~5.6 mm translation of L4 spinal bone. The results of this study showed that the additional local decompression is very useful for reducing risk of damage in the intervertebral disc and ligaments caused by the global axial traction force. Moreover, the local decompression could be used to enhance reduction of intradiscal pressure.

Keywords: lumbar spine, traction-therapy, biomechanics, finite element analysis

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Authors: Ted Gournelos

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Marketing approaches in practice and academic literature usually foreground the importance of product and brand awareness in strategy. Decisions emphasize justifications and promotions of existing projects, which has the unintended consequence of pushing marketing, public relations, and other communications to secondary strategies and tactics rather than as inherent pieces of organizational development. In other words, marketers implement what others have already decided. This is a challenge not only for the communications field, but also for the organizations themselves, since integrated communications employees are often the primary, if not the only, touchpoints for client/customer/user research and interaction. Organizations thus become increasingly out of touch, raising the risk of public or human resources crisis and decreasing the focus on opportunities for development and growth. This paper will discuss the potential for social entrepreneurship to refocus marketing and communications professionals on primary strategy, and suggest best practices for developing initiatives not only to impact marketing efforts themselves, but also the guiding organizational approaches to project management, human resources, corporate social responsibility, and research. It will provide a comparative analysis of social media marketing efforts conducted by food security non-governmental organizations from several countries, pointing out both flaws and areas of opportunity for integration with for-profit organizational strategy, and discuss the implications of descriptive, proactive, and interactive messaging.

Keywords: social enterprise, strategy, innovation, social media

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Authors: Elisabetta Ceretti, Silvia Bonizzoni, Alberto Bonetti, Milena Villarini, Marco Verani, Maria Antonella De Donno, Sara Bonetta, Umberto Gelatti

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Introduction: Air pollution is a global problem. In 2013, the International Agency for Research on Cancer (IARC) classified air pollution and particulate matter as carcinogenic to human. The study of the health effects of air pollution in children is very important because they are a high-risk group in terms of the health effects of air pollution and early exposure during childhood can increase the risk of developing chronic diseases in adulthood. The MAPEC_LIFE (Monitoring Air Pollution Effects on Children for supporting public health policy) is a project founded by EU Life+ Programme which intends to evaluate the associations between air pollution and early biological effects in children and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. Methods: The study was carried out on 6-8-year-old children living in five Italian towns in two different seasons. Two biomarkers of early biological effects, primary DNA damage detected with the comet assay and frequency of micronuclei, were investigated in buccal cells of children. Details of children diseases, socio-economic status, exposures to other pollutants and life-style were collected using a questionnaire administered to children’s parents. Child exposure to urban air pollution was assessed by analysing PM0.5 samples collected in the school areas for PAHs and nitro-PAHs concentration, lung toxicity and in vitro genotoxicity on bacterial and human cells. Data on the chemical features of the urban air during the study period were obtained from the Regional Agency for Environmental Protection. The project created also the opportunity to approach the issue of air pollution with the children, trying to raise their awareness on air quality, its health effects and some healthy behaviors by means of an educational intervention in the schools. Results: 1315 children were recruited for the study and participate in the first sampling campaign in the five towns. The second campaign, on the same children, is still ongoing. The preliminary results of the tests on buccal mucosa cells of children will be presented during the conference as well as the preliminary data about the chemical composition and the toxicity and genotoxicity features of PM0.5 samples. The educational package was tested on 250 children of the primary school and showed to be very useful, improving children knowledge about air pollution and its effects and stimulating their interest. Conclusions: The associations between levels of air pollutants, air mutagenicity and biomarkers of early effects will be investigated. A tentative model to calculate the global absolute risk of having early biological effects for air pollution and other variables together will be proposed and may be useful to support policy-making and community interventions to protect children from possible health effects of air pollutants.

Keywords: air pollution exposure, biomarkers of early effects, children, public health policy

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Authors: Mehtab Alam, Mudiarasan Kuppusamy, Puvaneswaran Kunaserkaran

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The purpose of this paper is to bridge the gap and complete the relationship between tourism destinations and image branding as a choice of edifice foreign policy. Such options became a crucial component for individuals interested in leisure and travel activities. The destination management factors have been evaluated and analyzed using the primary and secondary data in a mixed-methods approach (quantitative sample of 384 and qualitative 8 semi-structured interviews at saturated point). The study chose the Environmental Management Accounting (EMA) and Image Restoration (IR) theories, along with a schematic diagram and an analytical framework supported by NVivo software 12, for two locations in Abbottabad, KPK, Pakistan: Shimla Hill and Thandiani. This incorporates the use of PLS-SEM model for assessing validity of data while SPSS for data screening of descriptive statistics. The results show that destination management's promotion of tourism has significantly improved Pakistan's state image. The use of institutional setup, environmental drivers, immigration, security, and hospitality as well as recreational initiatives on destination management is encouraged. The practical ramifications direct the heads of tourism projects, diplomats, directors, and policymakers to complete destination projects before inviting people to Pakistan. The paper provides the extent of knowledge for academic tourism circles to use tourism destinations as brand ambassadors.

Keywords: tourism, management, state image, foreign policy, image branding

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Authors: Oumayma Tajouri

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The relationship between total quality management (TQM) practices and innovation is conflictual. Some scholars suggest that TQM has an effect on incremental improvement and would not lead to innovation and creativity. The purpose of this paper is to analyse the association between TQM and different types of innovation. Our goal is to examine to what extent the implementation of TQM practices is indeed supporting innovation in the Tunisian ISO 9001 certified industries. Using a self-administered survey to sample ISO9001 certified industry companies, this study examines five hypotheses and tests the relation between TQM practices and innovation. The principal finding of this study is that TQM has significant and positive effects on innovation in the Tunisian context. The results support that TQM has an influence on incremental, radical, and administrative innovation.

Keywords: total quality management, incremental innovation product and/service, radical innovation product/service, incremental innovation process, radical innovation process, administrative innovation

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Authors: Pushkar Lal Sharma, Sanjana Singh, Umesh Kumar Sahu

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This paper helps to understand the need of Customer Relationship Management in Libraries and why Librarians should implement the marketing concept of Customer Relationship Management in their libraries. As like any industry, libraries too face growing challenges to continuously meet customer expectations, and attract and retain users in light of overflowing competition. The ability to understand customers, build relationships and market diverse services is essential when considering ways to expand service offerings and improve Return on Investment. Since Library is service oriented Enterprise, hence the Customer/User/ Reader/Patron are the most important element of Library & Information System to whom and for whom library offers various services. How to provide better and most efficient services to its users is the main concern of every Library & Information centre in the present era. The basic difference between Business Enterprise and Library Information System is that ‘in Business System ‘the efficiency is measured in terms of ’profit’ or ‘monetary gains’; whereas in a Library & Information System, the efficiency is measured in terms of ‘services’ and therefore the goals that are set in Business Enterprise are’ profit oriented’ whereas goals set in the Library & Information Centre are ‘Service-oriented’. With the explosion of information and advancement of technology readers have so many choices to get information rather than visiting a library. Everything is available at the click of a mouse, library customers have become more knowledgeable and demanding in an era marked by abundance of information resources and services. With this explosion of information in every field of knowledge and choice in selection of service, satisfying user has become a challenge now a day for libraries. Accordingly, Libraries have to build good relationship with its users by adopting Customer relationship Management. CRM refers to the methods and tools which help an organization to manage its relationship with its customers in an organized way. The Customer Relationship Management (CRM) combines business strategy and technology to identify, acquire and retain good customer relationship. The goal of CRM is to optimize management of customer information needs & interests and increase customer satisfaction and loyalty. Implementing CRM in Libraries can improve customer data and process management, customer loyalty, retention and satisfaction.

Keywords: customer relationship management, CRM, CRM tools, customer satisfaction

Procedia PDF Downloads 51

Authors: Hadeer Hegazy, Wael Ewieda, Ranin Soliman, Samah Elway, Asmaa Tawfik, Ragaa Sayed, Sahar Mousa

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The current healthcare system is facing major challenges in terms of cost, quality of care, and access to services. In response, the concept of value-based healthcare has emerged as a new approach to healthcare delivery. This concept puts the focus on patient values rather than on the traditional medical model of care. To achieve this, healthcare organizations must be agile and able to anticipate and respond quickly to changing needs. Agile management is essential for healthcare organizations to achieve value-based care, as it allows them to rapidly adjust their strategies to changing circumstances. Additionally, it is argued that agile management can help healthcare organizations gain a better understanding of the needs of their patients and develop better care delivery models. Besides, it can help healthcare organizations develop new services, innovate, and become more efficient. The authors provide evidence to support their argument, drawing on examples from successful value-based healthcare initiatives at children’s cancer hospital Egypt-57357. The paper offers insight into how agile management can be used to facilitate the shift towards value-based healthcare and how it can be used to maximize value in the healthcare system.

Keywords: value-based healthcare, agility in healthcare, nursing department, patients outcomes

Procedia PDF Downloads 752

Authors: T. Al-Alawi, N. Shorbaji, E. Rashaidi, M.Alidrisi

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Purpose/Objective(s): The main purpose of this study is to analyze the planning of SBRT treatments for localized prostate cancer with 6FFF and 10FFF energies to see if there is a dosimetric difference between the two energies and how we can increase the plan efficiency and reduce its complexity. Also, to introduce a planning method in our department to treat prostate cancer by utilizing high energy photons without increasing patient toxicity and fulfilled all dosimetric constraints for OAR (an organ at risk). Then toevaluate the target 95% coverage PTV95, V5%, V2%, V1%, low dose volume for OAR (V1Gy, V2Gy, V5Gy), monitor unit (beam-on time), and estimate the values of homogeneity index HI, conformity index CI a Gradient index GI for each treatment plan.Materials/Methods: Two treatment plans were generated for15 patients with localized prostate cancer retrospectively using the CT planning image acquired for radiotherapy purposes. Each plan contains two/three complete arcs with two/three different collimator angle sets. The maximum dose rate available is 1400MU/min for the energy 6FFF and 2400MU/min for 10FFF. So in case, we need to avoid changing the gantry speed during the rotation, we tend to use the third arc in the plan with 6FFF to accommodate the high dose per fraction. The clinical target volume (CTV) consists of the entire prostate for organ-confined disease. The planning target volume (PTV) involves a margin of 5 mm. A 3-mm margin is favored posteriorly. Organs at risk identified and contoured include the rectum, bladder, penile bulb, femoral heads, and small bowel. The prescription dose is to deliver 35Gyin five fractions to the PTV and apply constraints for organ at risk (OAR) derived from those reported in references. Results: In terms of CI=0.99, HI=0.7, and GI= 4.1, it was observed that they are all thesame for both energies 6FFF and 10FFF with no differences, but the total delivered MUs are much less for the 10FFF plans (2907 for 6FFF vs.2468 for 10FFF) and the total delivery time is 124Sc for 6FFF vs. 61Sc for 10FFF beams. There were no dosimetric differences between 6FFF and 10FFF in terms of PTV coverage and mean doses; the mean doses for the bladder, rectum, femoral heads, penile bulb, and small bowel were collected, and they were in favor of the 10FFF. Also, we got lower V1Gy, V2Gy, and V5Gy doses for all OAR with 10FFF plans. Integral dosesID in (Gy. L) were recorded for all OAR, and they were lower with the 10FFF plans. Conclusion: High energy 10FFF has lower treatment time and lower delivered MUs; also, 10FFF showed lower integral and meant doses to organs at risk. In this study, we suggest usinga 10FFF beam for SBRTprostate treatment, which has the advantage of lowering the treatment time and that lead to lessplan complexity with respect to 6FFF beams.

Keywords: FFF beam, SBRT prostate, VMAT, prostate cancer

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Authors: Shadab Shishegar, Sophie Duchesne, Genevieve Pelletier

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Sustainability as one of the key elements of Smart cities, can be realized by employing Real Time Control Strategies for city’s infrastructures. Nowadays Stormwater management systems play an important role in mitigating the impacts of urbanization on natural hydrological cycle. These systems can be managed in such a way that they meet the smart cities standards. In fact, there is a huge potential for sustainable management of urban stormwater and also its adaptability to global challenges like climate change. Hence, a dynamically managed system that can adapt itself to instability of the environmental conditions is desirable. A Global Predictive Real Time Control approach is proposed in this paper to optimize the performance of stormwater management basins in terms of flooding prevention. To do so, a mathematical optimization model is developed then solved using Genetic Algorithm (GA). Results show an improved performance at system-level for the stormwater basins in comparison to static strategy.

Keywords: environmental sustainability, optimization, real time control, storm water management

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Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

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HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

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Authors: Vallence Ngabo M., Leonard Atuhaire, Peter Clever Rutayisire

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The main aim of this study was to establish the differences in both the determinants of stunting and the causal mechanism through which the identified determinants influence stunting amongst male and female under-fives in Uganda. Literature shows that male children below the age of five years are at a higher risk of being stunted than their female counterparts. Specifically, studies in Uganda indicate that being a male child is positively associated with stunting, while being a female is negatively associated with stunting. Data for 904 males and 829 females under-fives was extracted form UDHS-2016 survey dataset. Key variables for this study were identified and used in generating relevant models and paths. Structural equation modeling techniques were used in their generalized form (GSEM). The generalized nature necessitated specifying both the family and link functions for each response variable in the system of the model. The sex of the child (b4) was used as a grouping factor and the height for age (HAZ) scores were used to construct the status for stunting of under-fives. The estimated models and path clearly indicated that the set of underlying factors that influence male and female under-fives respectively was different and the path through which they influence stunting was different. However, some of the determinants that influenced stunting amongst male under-fives also influenced stunting amongst the female under-fives. To reduce the stunting problem to the desirable state, it is important to consider the multifaceted and complex nature of the risk factors that influence stunting amongst the under-fives but, more importantly, consider the different sex-specific factors and their causal mechanism or paths through which they influence stunting.

Keywords: stunting, underfives, sex of the child, GSEM, causal mechanism

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Authors: Nipun Agarwal, David Paul, Fareed Un Din

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Strategy development and implementation is the key to an organization’s success in today’s competitive marketplace. Many organizations develop excellent strategy but are unable to implement this strategy in order to succeed. The difference between strategic goals and its implementation is called strategic error. Strategic error occurs when an organization does not have structures in place to implement their strategy. Strategy implementation happens through projects and having a project management method that provides certainty and agility will help an organization become more competitive in implementing strategy. Numerous project management methods exist in theory and practice. However, projects mainly used the Waterfall method in the past that provides certainty in terms of budget, delivery date and resourcing. It is common practice now to utilise Agile based methods. However, Agile based methods do not provide specific deadlines and budgets. But provide agility in product design and project delivery, which is useful to companies. Both Waterfall and Agile methods in some forms are the opposites of each other. Executive management prefer agility in delivery projects as the competitive landscape changes frequently. However, they also appreciate certainty in the projects being able to quantify budgets, deadlines and resources that is harder for an Agile based method to provide. This paper attempts to develop a hybrid project management method that attempts to merge these Waterfall and Agile methods to provide the positives from both these approaches.

Keywords: strategy, project management, strategy implementation, agile

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Authors: Yusri Yusof, Chen Wong Keong

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This paper presents the implementation details of a Relational Database Management System of a STEP-technology product model repository. It is able support the implementation of any EXPRESS language schema, although it has been primarily implemented to support mechanical product life cycle applications. This database support the input of STEP part 21 file format from CAD in geometrical and topological data format and support a range of queries for mechanical product life cycle applications. This proposed relational database management system uses entity-to-table method (R1) rather than type-to-table method (R4). The two mapping methods have their own strengths and drawbacks.

Keywords: RDBMS, CAD, ISO 10303, part-21 file

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Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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Authors: Diana Bardhi

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Road safety is an essential part of the economic and social development of any industrialized country. Decisions to maintain and improve the reliability, functionality of infrastructure structures can only be achieved through integrated road life cycle planning and management. There has always been a tendency to review road maintenance strategies, but there is still no serious and reliable administration due to not only insufficient funds but also problems in the proper reorganization of this system. The safety and performance of the road system depend on the ongoing activity of road maintenance management. For it to be effective, it is necessary to intervene before the degradation has caused irreparable damage or damage with a high economic cost of repairs. Investments in road infrastructure during 2006-2014 show that the life of these projects presents problems related to the maintenance and management of life cycle performance in a wide range of constituent elements. Maintenance planning includes various problems that depend on the degree of degradation of asphalt layers, the degree of damage to road structures (bridges, tunnels, culverts, and the economic planning of resources for their repair). The purpose of this study is first to provide a brief overview of the problems in the field of maintenance and life cycle management of road infrastructure investments, proposing ways to reorganize the sector of administration and maintenance of ongoing roads and secondly testing and evaluating the work and nature of standards of different types of road infrastructure projects, through a methodology consisting of a) development, b) data collection, and c) analysis.

Keywords: infrastructure, maintenance, depreciation, efficiency

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Authors: Linda O. N. Nwabunike

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The role of internal and external efforts in the management of exploration and exploitation has been highlighted in literature. External ties support ambidexterity at different levels with, for instance: business unit ambidexterity, individual ambidexterity, organizational ambidexterity, and alliance ambidexterity. Recently studies have highlighted the combination of organization, alliance, and acquisition strategies for ambidexterity by conceptualizing ambidexterity across modes of operation. Literature still lacks detailed understanding of how these different processes are combined in the management of ambidexterity across modes of operation. This study plans to propose a conceptual model that illustrates the social processes involved in the management of ambidexterity across modes of operation. Main arguments are integrated from social structures, organizational design, and ambidexterity literature. The framework illustrates that how social capital is promoted by hierarchical relations within the organization and business relations across the boundaries of the organization. Whereby such social relations within and outside the organization are supported by the dual structures of the organization in the coordination of multiple efforts. This paper has potential to contribute to the understanding about how ambidexterity is attained.

Keywords: ambidexterity, coordination, external-ties, social-capital

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Authors: Ming Lu, Xiaojun Li, Bodi Lu, Juehui Xing

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Earthquake damage phenomenon of each large earthquake gives comprehensive and profound real test to the dynamic performance and failure mechanism of different engineering structures. Cognitive engineering structure characteristics through seismic damage phenomenon are often far superior to expensive shaking table experiments. After the earthquake, people will record a variety of different types of engineering damage photos. However, a large number of earthquake damage photographs lack sufficient information and reduce their using value. To improve the research value and the use efficiency of engineering seismic damage photographs, this paper objects to explore and show seismic damage background information, which includes the earthquake magnitude, earthquake intensity, and the damaged structure characteristics. From the research requirement in earthquake engineering field, the authors use the 2008 China Wenchuan M8.0 earthquake photographs, and provide four kinds of attribute indexes and classification, which are seismic information, structure types, earthquake damage parts and disaster causation factors. The final object is to set up an engineering structural seismic damage database based on these four attribute indicators and classification, and eventually build a website providing seismic damage photographs.

Keywords: attribute index, classification method, earthquake damage picture, engineering structure

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Authors: Umang Varshney, Amit Karamchandani, Rohit Kapoor

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Practitioners and researchers have realized that Blockchain is not limited to currency. Blockchain as a distributed ledger can ensure a transparent and traceable supply chain. Due to Blockchain-enabled IoTs, a firm’s information management system can now take inputs from other supply chain partners in real-time. This study aims to provide empirical evidence of dimensions responsible for blockchain implemented firm’s growth and highlight how sector (manufacturing or service), state's regulatory environment, and choice of blockchain network affect the blockchain's usefulness. This post-adoption study seeks to validate the findings of pre-adoption studies done on the blockchain. Data will be collected through a survey of managers working in blockchain implemented firms and analyzed through PLS-SEM.

Keywords: blockchain, information management system, PLS-SEM, firm's growth

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Authors: Yongjian Du, Jinhua Sun, Kim M. Liew, Huahua Xiao

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Optimal allocation of emergency resources before a disaster is of great importance for emergency response. In reality, the pre-protection for a single critical node where accidents may occur is common. In this study, a model is developed to determine location and inventory decisions of multiple emergency resources among a set of candidate stations to minimize the total cost based on the constraints of budgetary and capacity. The total cost includes the economic accident loss which is accorded with probability distribution of time and the warehousing cost of resources which is increasing over time. A ratio is set to measure the degree of a storage station only serving the target node that becomes larger with the decrease of the distance between them. For the application of linear program, it is assumed that the length of travel time to the accident scene of emergency resources has a linear relationship with the economic accident loss. A computational experiment is conducted to illustrate how the proposed model works, and the results indicate its effectiveness and practicability.

Keywords: emergency response, integer linear program, multiple emergency resources, pre-allocation decisions, single potential accident node

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Authors: Thanduxolo Elford Fana

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Rationale and Purpose: Performance management and development system are central to effective and efficient service delivery, especially in highly labour intensive sectors such as South African public health. Performance management and development systems seek to ensure that good employee performance is rewarded accordingly, while those who underperform are developed so that they can reach their full potential. An effective and efficiently implemented performance management system motivates and improves employee engagement. The purpose of this study is to examine the implementation of the performance management and development system and the challenges that are encountered during its implementation in the Eastern Cape Provincial Department of Health. Methods: A qualitative research approach and a case study design was adopted in this study. The primary data were collected through observations, focus group discussions with employees, a group interview with shop stewards, and in-depth interviews with supervisors and managers, from April 2019 to September 2019. There were 45 study participants. In-depth interviews were held with 10 managers at facility level, which included chief executive officer, chief medical officer, assistant director’s in human resources management, patient admin, operations, finance, and two area manager and two operation managers nursing. A group interview was conducted with five shop stewards and an in-depth interview with one shop steward from the group. Five focus group discussions were conducted with clinical and non-clinical staff. The focus group discussions were supplemented with an in-depth interview with one person from each group in order to counter the group effect. Observations included moderation committee, contracting, and assessment meetings. Findings: The study shows that the performance management and development system was not properly implemented. There was non-compliance to performance management and development system policy guidelines in terms of time lines for contracting, evaluation, payment of incentives to good performers, and management of poor performance. The study revealed that the system is ineffective in raising the performance of employees and unable to assist employees to grow. The performance bonuses were no longer paid to qualifying employees. The study also revealed that lack of capacity and commitment, poor communication, constant policy changes, financial constraints, weak and highly bureaucratic management structures, union interference were challenges that were encountered during the implementation of the performance management and development system. Lastly, employees and supervisors were rating themselves three irrespective of how well or bad they performed. Conclusion: Performance management is regarded as vital to improved performance of the health workforce and healthcare service delivery among populations. Effective implementation of performance management and development system depends on well-capacitated and unbiased management at facility levels. Therefore, there is an urgent need to improve communication, link performance management to rewards, and capacitate staff on performance management and development system, as it is key to improved public health sector outcomes or performance.

Keywords: challenges, implementation, performance management and development system, public hospital

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Authors: Kristina De Milt, Nicole Huang, Jihye Park

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Opioids have been a mainstay of the treatment of chronic pain, but their overprescription and misuse have led to an opioid epidemic. Recently, as an attempt to decrease the number of opioids prescribed, the use of cannabinoid therapy has become an increasingly popular adjunctive chronic pain management choice among providers. This review of literature investigates the effects of adjunctive cannabinoids to opioids in the management of chronic pain. The nine articles are included in the literature review range from observational studies to meta-analyses published in the year 2016 and after. A majority of the studies showed a decrease in the need for opioids after adjunctive cannabinoids were introduced and, in some instances, the cessation of opioid consumption. More high-quality evidence is needed to further support this stance and providers should weigh the benefits and risks of adjunctive cannabinoids according to the clinical picture.

Keywords: cannabis, chronic pain, opioids, pain management

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Authors: Neeti Nayak, Khalid Duri

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Despite the many advances made in transportation planning, the number of injuries and fatalities in the United States which involve motorized vehicles near intersections remain largely unchanged year over year. Data from the National Highway Traffic Safety Administration for 2018 indicates accidents involving motorized vehicles at traffic intersections accounted for 8,245 deaths and 914,811 injuries. Furthermore, collisions involving pedal cyclists killed 861 people (38% at intersections) and injured 46,295 (68% at intersections), while accidents involving pedestrians claimed 6,247 lives (25% at intersections) and injured 71,887 (56% at intersections)- the highest tallies registered in nearly 20 years. Some of the causes attributed to the rising number of accidents relate to increasing populations and the associated changes in land and traffic usage patterns, insufficient visibility conditions, and inadequate applications of traffic controls. Intersections that were initially designed with a particular land use pattern in mind may be rendered obsolete by subsequent developments. Many accidents involving pedestrians are accounted for by locations which should have been designed for safe crosswalks. Conventional solutions for evaluating intersection safety often require costly deployment of engineering surveys and analysis, which limit the capacity of resource-constrained administrations to satisfy their community’s needs for safe roadways adequately, effectively relegating mitigation efforts for high-risk areas to post-incident responses. This paper demonstrates how geospatial technology can identify high-risk locations and evaluate the viability of specific intersection management techniques. GIS is used to simulate relevant real-world conditions- the presence of traffic controls, zoning records, locations of interest for human activity, design speed of roadways, topographic details and immovable structures. The proposed methodology provides a low-cost mechanism for empowering urban planners to reduce the risks of accidents using 2-dimensional data representing multi-modal street networks, parcels, crosswalks and demographic information alongside 3-dimensional models of buildings, elevation, slope and aspect surfaces to evaluate visibility and lighting conditions and estimate probabilities for jaywalking and risks posed by blind or uncontrolled intersections. The proposed tools were developed using sample areas of Southern California, but the model will scale to other cities which conform to similar transportation standards given the availability of relevant GIS data.

Keywords: crosswalks, cyclist safety, geotechnology, GIS, intersection safety, pedestrian safety, roadway safety, transportation planning, urban design

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Authors: Amer Alsari, Hassan Alhalal, Tahar Ayadat, Andi Asiz, Omar KM Ouda

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Al Khaldiyah is a regional road situated in west-south of Al Khobar, precisely in the area of Half Moon Bay. It is characterized by four lines, which become six lines in some places, in both directions extending over about 10 km length. The road extends between the bridge near the Air Force Base and Half Moon Bay Road. Many accidents have been observed in this road notably over the last two years. Many injuries and deaths were recorded, some of the victims were PMU students. Consequently, management of the road to eliminate or reduce accidents to a large extend becomes imperative. The main goal of this project are to propose sustainable solutions for the purpose optimizing safety and improving its sight view by designing some appropriate junctions including bridge and tunnel in the critical locations.

Keywords: management, road, accident, traffic, safety, sustainable, solutions

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Authors: Raghunandan Gurumurthy, Aricson Pereira, Sandeep Patil

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The escalating adoption of electric vehicles (EVs) across the globe has underscored the critical importance of advancing battery system technologies. This has catalyzed a shift towards the design and development of battery systems that not only exhibit higher energy efficiency but also boast enhanced thermal performance and sophisticated multi-material enclosures. A significant leap in this domain has been the incorporation of simulation-based design optimization for battery packs and Battery Management Systems (BMS), a move further enriched by integrating artificial intelligence/machine learning (AI/ML) approaches. These strategies are pivotal in refining the design, manufacturing, and operational processes for electric vehicles and energy storage systems. By leveraging AI/ML, stakeholders can now predict battery performance metrics—such as State of Health, State of Charge, and State of Power—with unprecedented accuracy. Furthermore, as Li-ion batteries (LIBs) become more prevalent in urban settings, the imperative for bolstering thermal and fire resilience has intensified. This has propelled Battery Thermal Management Systems (BTMs) to the forefront of energy storage research, highlighting the role of machine learning and AI not just as tools for enhanced safety management through accurate temperature forecasts and diagnostics but also as indispensable allies in the early detection and warning of potential battery fires.

Keywords: electric vehicles, battery thermal management, industrial engineering, machine learning, artificial intelligence, manufacturing

Procedia PDF Downloads 65