Search results for: medication therapy management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11203

Search results for: medication therapy management

7123 Global Supply Chain Tuning: Role of National Culture

Authors: Aleksandr S. Demin, Anastasiia V. Ivanova

Abstract:

Purpose: The current economy tends to increase the influence of digital technologies and diminish the human role in management. However, it is impossible to deny that a person still leads a business with its own set of values and priorities. The article presented aims to incorporate the peculiarities of the national culture and the characteristics of the supply chain using the quantitative values of the national culture obtained by the scholars of comparative management (Hofstede, House, and others). Design/Methodology/Approach: The conducted research is based on the secondary data in the field of cross-country comparison achieved by Prof. Hofstede and received in the GLOBE project. The data mentioned are used to design different aspects of the supply chain both on the cross-functional and inter-organizational levels. The connection between a range of principles in general (roles assignment, customer service prioritization, coordination of supply chain partners) and in comparative management (acknowledgment of the national peculiarities of the country in which the company operates) is shown over economic and mathematical models, mainly linear programming models. Findings: The combination of the team management wheel concept, the business processes of the global supply chain, and the national culture characteristics let a transnational corporation to form a supply chain crew balanced in costs, functions, and personality. To elaborate on an effective customer service policy and logistics strategy in goods and services distribution in the country under review, two approaches are offered. The first approach relies exceptionally on the customer’s interest in the place of operation, while the second one takes into account the position of the transnational corporation and its previous experience in order to accord both organizational and national cultures. The effect of integration practice on the achievement of a specific supply chain goal in a specific location is advised to assess via types of correlation (positive, negative, non) and the value of national culture indices. Research Limitations: The models developed are intended to be used by transnational companies and business forms located in several nationally different areas. Some of the inputs to illustrate the application of the methods offered are simulated. That is why the numerical measurements should be used with caution. Practical Implications: The research can be of great interest for the supply chain managers who are responsible for the engineering of global supply chains in a transnational corporation and the further activities in doing business on the international area. As well, the methods, tools, and approaches suggested can be used by top managers searching for new ways of competitiveness and can be suitable for all staff members who are keen on the national culture traits topic. Originality/Value: The elaborated methods of decision-making with regard to the national environment suggest the mathematical and economic base to find a comprehensive solution.

Keywords: logistics integration, logistics services, multinational corporation, national culture, team management, service policy, supply chain management

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7122 Postural Orthostatic Tachycardia Syndrome: A Case Study and Discussion of Its Epidemiology, Pathophysiology, Diagnosis, and Management

Authors: Zayd Parekh, Amish Prasad, Baraa Souman

Abstract:

Postural orthostatic tachycardia syndrome (POTS) is characterized by orthostatic intolerance due to an exaggerated tachycardia in response to standing upright. This exaggerated orthostatic tachycardia is defined as the heart rate (HR) rising 30 beats above a baseline value while supine or seated within ten minutes. The tachycardia can lead to symptoms of orthostatic intolerance such as palpitations, lightheadedness, exercise intolerance, fatigue, and anxiety. POTS can go undiagnosed for many years due to its similarities with other cardiac and psychiatric conditions and nonspecific presentation, making it crucial to raise awareness for it in the medical field. The following case study discusses a 30-year-old female who was evaluated in the emergency room several times before being referred to the clinic for POTS. An overview of what tests are performed with this patient is also provided, highlighting the diagnostic work-up for POTS and the process of ruling out other differentials being considered. Finally, the epidemiology, the various theories regarding its pathophysiology, the diagnostic process, and pharmacological and non-pharmacological management for POTS are reviewed.

Keywords: orthostatic intolerance, postural orthostatic tachycardia syndrome, syncope, tachycardia

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7121 ISO 9001:2008 Effectiveness on the Performance of Public Organizations in Oman

Authors: Said Rashid Aal Abdulsallam

Abstract:

The purpose of this paper is to measure ISO 9001:2008 effectiveness and determines its impact on the performance dimensions in terms of service quality, operational performance and customer satisfaction from the perspectives of both service providers and receivers. The paper is based on an empirical study carried out on all the ISO 9001:2008 certified departments in the Ministry of Education in the Sultanate of Oman. Data were obtained from the certified departments and their equivalent clients through two structured online questionnaires. Exploratory factor analyses are applied to extract the underlying factors of the indicators of ISO 9001 objectives and performance dimensions. Multiple linear regression analyses are also applied in order to determine the impact of ISO 9001 effectiveness on the performance dimensions of the certified departments. The study sample includes all the ISO 9001 certified departments in the Ministry of Education. The study instruments used target both the service providers as well as the service receivers with the purpose of alleviating the subjective nature of the data collected from the service providers who may be biased in favour of ISO 9001 quality management system or their performance. The findings of the study verify the effectiveness of the application of ISO 9001:2008 quality management system. Additionally, the study reveals that the ISO 9001 certified departments have achieved the ISO 9001 the standard's objectives including prevention of nonconformities, continuous improvement and customer satisfaction focus at different rates. The study also proves that there is a significant relation between the achievement of the ISO 9001 standard objectives and the operational performance of the departments. Even though the operational performance service quality of the ISO 9001 certified departments has substantially improved from the perspective of the departments, the customer satisfaction has not notably increased from the perspective of the service receivers.

Keywords: iso 9001, customer satisfaction, operational performance, public organization, quality management

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7120 Status of Hazardous Waste Generation and Its Impacts on Environment and Human Health: A Study in West Bengal

Authors: Sk Ajim Ali

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The present study is an attempt to overview on the major environmental and health impacts due to hazardous waste generation and poor management. In present scenario, not only hazardous waste, but as a common term ‘Waste’ is one of the acceptable and thinkable environmental issues. With excessive increasing population, industrialization and standardization of human’s life style heap in extra waste generation which is directly or indirectly related with hazardous waste generation. Urbanization and population growth are solely responsible for establishing industrial sector and generating various Hazardous Waste (HW) and concomitantly poor management practice arising adverse effect on environment and human health. As compare to other Indian state, West Bengal is not too much former in HW generation. West Bengal makes a rank of 7th in HW generation followed by Maharashtra, Gujarat, Tamil Nadu, U.P, Punjab and Andhra Pradesh. During the last 30 years, the industrial sectors in W.B have quadrupled in size, during 1995 there were only 440 HW generating Units in West Bengal which produced 129826 MTA hazardous waste but in 2011, it rose up into 609 units and it produced about 259777 MTA hazardous waste. So, the notable thing is that during a 15 year interval there increased 169 waste generating units but it produced about 129951 MTA of hazardous waste. Major chemical industries are the main sources of HW and causes of adverse effect on the environment and human health. HW from industrial sectors contains heavy metals, cyanides, pesticides, complex aromatic compounds (i.e. PCB) and other chemical which are toxic, flammable, reactive, and corrosive and have explosive properties which highly affect the surrounding environment and human health in and around he disposal sites. The main objective of present study is to highlight on the sources and components of hazardous waste in West Bengal and impacts of improper HW management on health and environment. This study is carried out based on a secondary source of data and qualitative method of research. The secondary data has been collected annual report of WBPCB, WHO’s report, research paper, article, books and so on. It has been found that excessive HW generation from various sources and communities has serious health hazards that lead to the spreading of infectious disease and environmental change.

Keywords: environmental impacts, existing HW generation and management practice, hazardous waste (HW), health impacts, recommendation and planning

Procedia PDF Downloads 268
7119 Effect of a Mindfulness Application on Graduate Nursing Student’s Stress and Anxiety

Authors: Susan K. Steele-Moses, Aimee Badeaux

Abstract:

Background Literature: Nurse anesthesia education placed high demands on students both personally and professionally. High levels of anxiety affect student’s mental, emotional, and physical well-being, which impacts their student success. Whereas more research has focused on the health and well-being of graduate students, far less has focused specifically on nurse anesthesia students (SNRAs), who may experience higher levels of anxiety due to the rigor of their academic program. Current literature describes stressors experienced by SRNAs that cause anxiety and affect their performance, including personal, academic, clinical, interpersonal, emotional, and financial. Sample: DNP-NA 2025 and DNP-NA 2024 cohorts (N = 36). Eighteen (66.7%) students participated in the study. Instrumentation: The DASS-21 was used to measure stress (7 items; α = .87) and anxiety (7 items; α = .74) from the participants. Intervention: The mind-shift meditation app, based on cognitive behavioral therapy, is being used daily before clinical and exams to decrease nurse anesthesia students’ stress and anxiety over time. Results: At baseline, the students exhibited a moderate level of stress, but their anxiety levels were low. The range of scores was 4-21 (out of 28) for stress (M = 12.88; SD = 5.40) and 0-16 (out of 28) for anxiety (M = 6.81; SD = 5.04). Both stress and anxiety were normally distributed [SW = .242 (stress); SW = .210 (anxiety)] without any outliers. There was a significant difference between their stress and anxiety levels (t = 5.55; p < .001) at baseline. Stress and anxiety will be measured over time, with the change analyzed using repeated measures ANOVA. Implications for Practice: The use of purposeful mindfulness meditation has been shown to decrease stress and anxiety in nursing students.

Keywords: mindfulness, meditation, graduate nursing education, nursing education

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7118 Ways for University to Conduct Research Evaluation: Based on National Research University Higher School of Economics Example

Authors: Svetlana Petrikova, Alexander Yu Kostinskiy

Abstract:

Management of research evaluation in the Higher School of Economics (HSE) originates from the HSE Academic Fund created in 2004 to facilitate and support academic research and presents its results to international academic community. As the means to inspire the applicants, science projects went through competitive selection process evaluated by the group of experts. Drastic development of HSE, quantity of applied projects for each Academic Fund competition and the need to coordinate the conduct of expert evaluation resulted in founding of the Office for Research Evaluation in 2013. The Office’s primary objective is management of research evaluation of science projects. The standards to conduct the evaluation are defined as follows: - The exercise of the process approach, the unification of the functioning of department. - The uniformity of regulatory, organizational and methodological framework. - The development of proper on-line evaluation system. - The broad involvement of external Russian and international experts, the renouncement of the usage of own employees. - The development of an algorithm to make a correspondence between experts and science projects. - The methodical usage of opened/closed international and Russian databases to extend the expert database. - The transparency of evaluation results – free access to assessment while keeping experts confidentiality. The management of research evaluation of projects is based on the sole standard, organization and financing. The standard way of conducting research evaluation at HSE is based upon Regulations on basic principles for research evaluation at HSE. These Regulations have been developed from the moment of establishment of the Office for Research Evaluation and are based on conventional corporate standards for regulatory document management. The management system of research evaluation is implemented on the process approach basis. Process approach means deployment of work as a process, which is the aggregation of interrelated and interacting activities processing inputs into outputs. Inputs are firstly client asking for the assessment to be conducted, defining the conditions for organizing and carrying of the assessment and secondly the applicant with proper for the competition application; output is assessment given to the client. While exercising process approach to clarify interrelation and interacting main parties or subjects of the assessment are determined and the way for interaction between them forms up. Parties to expert assessment are: - Ordering Party – The department of the university taking the decision to subject a project to expert assessment; - Providing Party – The department of the university authorized to provide such assessment by the Ordering Party; - Performing Party – The legal and natural entities that have expertise in the area of research evaluation. Experts assess projects in accordance with criteria and states of expert opinions approved by the Ordering Party. Objects of assessment generally are applications or HSE competition project reports. Mainly assessments are deployed for internal needs, i.e. the most ordering parties are HSE branches and departments, but assessment can also be conducted for external clients. The financing of research evaluation at HSE is based on the established corporate culture and traditions of HSE.

Keywords: expert assessment, management of research evaluation, process approach, research evaluation

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7117 Accelerating Mobile Innovation, Adoption, and Translational Science within a Large Research Enterprise and Healthcare System

Authors: Stephen Wheat

Abstract:

Institutional mobile application governance and distribution processes are essential to mobile app innovation. The absence of effective processes poses a significant barrier to the development and adoption of mobile apps for use within a research enterprise and also impedes the translational science of applying research apps in clinical and engineering settings. To accelerate mobile app innovation and adoption, Emory University and Emory Healthcare implemented a three-pronged strategy including. I) Mobile app review and distribution policies and processes. II) Mobile app management infrastructure and mobile app foundation components. III) A strategic sourcing strategy based on preferred mobile app development firms. The results have been an increase from five to 56 mobile apps in the pipeline over three years; increased engagement from technology transfer, legal counsel, compliance, and information security; articulation of a coordinated mobile app strategy; and allocation of more institutional resources toward specific mobile technology and mobile application goals.

Keywords: mobile app management, governance, distribution, information security

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7116 Effects of Progressive Resistive Exercise on Isometric Strength of Shoulder Extensor and Abductor Muscles in Adult Hemiplegic

Authors: S. Abbasi, M. R. Hadian, M. Abdolvahab, M. Jalili, S. H. Jalaei

Abstract:

Background: Rehabilitation treatments have significant role in reducing the disabilities of Cerebro Vascular Accident (CVA). Due to great role of upper limb in the function of individuals particularly in Activity of Daily Living and the effect of stability of shoulder girdle on hand function, the aim of this study was to study the effects of Progressive Resistive Exercise on shoulder extensor and abductor muscles isometric strengths in adult hemiplegic. Methods: 17 adult hemiplegics patients (50-70 yrs., mean 60/52, SD7/22); with RT side dominancy and 6 months after stroke, participated in this study. All procedures were approved by ethical committee of TUMS and written consents were also taken. Patients were familiarized with the procedure and shoulder extensor and abductor muscles isometric strengths were measured by dynamometer. Results: according to result to our study, shoulder extensor and abductor muscles isometric strengths showed Significant differences between mean scores of pre and post intervention (P<0/05). Progressive Resistive Exercise improved 34% shoulder extensor muscles isometric strength and 27% shoulder abductor muscle isometric strength. Conclusion: Results of our research showed that progressive resistive exercise approach is a useful method for increasing the isometric strength of shoulder extensor and abductor muscles. Therefore, it might be concluded that improvement of strength of shoulder muscles could result in stability in shoulder girdle and consequently might effect on hand function in hemiplegic patients.

Keywords: shoulder extensor muscles isometric strength, shoulder abductor muscles isometric strength, hemiplegic, physical therapy

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7115 The Mediterranean Migration Crisis: The North East Hotspot Policy

Authors: Loizos A. Hadjivasiliou, May Chehab

Abstract:

Confronted with the human tragedy unfolding in the Mediterranean during the 2011-2016 period, the European Union introduced for the first time the “hotspot approach”, the establishment of facilities for initial reception, identification registration, and fingerprinting of asylum seekers and migrants arriving in the EU by sea, at the frontline Member States. However, the lack of a comprehensive collective policy on migration management and border security left the Mediterranean Member States, mainly Italy, Greece, and Cyprus, struggling to overcome these challenges. The current study sheds light on the implementation of the hotspot approach as the frontispiece of the European response to the migration challenges, which, limited to the operational and financial support of the hosting member states, leads to heterogeneous burden-sharing. Within this framework, it highlights the fact that the implementation of the hotspots as a panacea carries the risk of transforming the Mediterranean member states into giant hotspots with unpredictable consequences for the future of the Schengen area.

Keywords: asylum, burden sharing, hotspots, migration management policy, Schengen area

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7114 Career Development for Benjarong Porcelain Handicraft Communities in Central Thailand

Authors: Chutikarn Sriwiboon, Suwaree Yordchim

Abstract:

Benjarong handicraft product is one of the most important handicraft products from Thailand. It involves the management of traditional wisdom of arts and Thai culture. This paper drew upon data collection from local communities by using an in-depth interview technique which was conducted in Thailand during summer of 2014. The survey was structured primarily to obtain local wisdom and concerns toward their career development. This research paper was a qualitative research conducted by focus groups with a total of 51 cooperative women and occupational groups around Thailand which produced the Benjarong products. The data were significantly collected from many sources and many communities, which totaled 24,430 handicraft products, in which the 668 different patterns of Benjarong products were produced by 51 local community network groups in Thailand. The findings revealed that after applying the Philosophy of Sufficiency Economy, there was a significantly positive change in their career development and the process of knowledge management enables local community to enhance their personal development and career.

Keywords: Benjarong, career development, community, handicraft

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7113 Measuring Banks’ Antifragility via Fuzzy Logic

Authors: Danielle Sandler dos Passos, Helder Coelho, Flávia Mori Sarti

Abstract:

Analysing the world banking sector, we realize that traditional risk measurement methodologies no longer reflect the actual scenario with uncertainty and leave out events that can change the dynamics of markets. Considering this, regulators and financial institutions began to search more realistic models. The aim is to include external influences and interdependencies between agents, to describe and measure the operationalization of these complex systems and their risks in a more coherent and credible way. Within this context, X-Events are more frequent than assumed and, with uncertainties and constant changes, the concept of antifragility starts to gain great prominence in comparison to others methodologies of risk management. It is very useful to analyse whether a system succumbs (fragile), resists (robust) or gets benefits (antifragile) from disorder and stress. Thus, this work proposes the creation of the Banking Antifragility Index (BAI), which is based on the calculation of a triangular fuzzy number – to "quantify" qualitative criteria linked to antifragility.

Keywords: adaptive complex systems, X-Events, risk management, antifragility, banking antifragility index, triangular fuzzy number

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7112 Analyze Needs for Training on Academic Procrastination Behavior on Students in Indonesia

Authors: Iman Dwi Almunandar, Nellawaty A. Tewu, Anshari Al Ghaniyy

Abstract:

The emergence of academic procrastination behavior among students in Indonesian, especially the students of Faculty of Psychology at YARSI University becomes a habit to be underestimated, so often interfere with the effectiveness of learning process. The lecturers at the Faculty of Psychology YARSI University have very often warned students to be able to do and collect assignments accordance to predetermined deadline. However, they are still violated it. According to researchers, this problem needs to do a proper training for the solution to minimize academic procrastination behavior on students. In this study, researchers conducted analyze needs for deciding whether need the training or not. Number of sample is 30 respondents which being choose with a simple random sampling. Measurement of academic procrastination behavior is using the theory by McCloskey (2011), there are six dimensions: Psychological Belief about Abilities, Distractions, Social Factor of Procrastination, Time Management, Personal Initiative, Laziness. Methods of analyze needs are using Questioner, Interview, Observations, Focus Group Discussion (FGD), Intelligence Tests. The result of analyze needs shows that psychology students generation of 2015 at the Faculty of Psychology YARSI University need for training on Time Management.

Keywords: procrastination, psychology, analyze needs, behavior

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7111 COVID-19: The Cause or the Confounder

Authors: Praveenkumar Natarajan

Abstract:

A 59-year-old male with no known co-morbidities was admitted to a private hospital for complaints of fever and cough and was diagnosed to haveCOVID-19. CT of the thorax revealed the involvement of 50% of the lungs. Screening ECG and ECHO were normal. The patient was treated with oxygen therapy and drugs and was discharged after 12 days of admission. Post-discharge, the patient remained symptom-free and continued his work. After one month, the patient developed a fever for three days, for which he took antipyretics. Subsequently, the patient developed sudden onset breathlessness, which rapidly progressed to grade 4 NYHA, and developed a cough as well. Suspecting COVID-19 reinfection, the patient visited a nearby hospital, where COVID–19 rt-PCR swabs turned out to be positive, and was referred to our hospital. On receiving, the patient had diffuse lung crepitations and a diastolic murmur in the neo-aortic area. CT thorax revealed pulmonary edema with areas of consolidation. ECHO revealed vegetation on the aortic valve with severe aortic regurgitation. Blood cultures were taken, which revealed the growth of Enterococcus faecalis. The diagnosis of infective endocarditis was made, and the patient was started on appropriate treatment. COVID–19 has effects on various systems, including the cardiovascular system. Even though infective endocarditis is common in the elderly with valvular heart disease, this patient had developed infective endocarditis in an apparently normal aortic valve. Infective endocarditis and COVID–19 can have similar presentations leading to diagnostic difficulties. COVID–19, affecting the heart valves causing valvulitis and predisposing them to the development of infective endocarditis, is also an area to be explored.

Keywords: aortic regurgitation, COVID-19, infective endocarditis, valvulitis

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7110 Estimated Human Absorbed Dose of 111 In-BPAMD as a New Bone-Seeking Spect-Imaging Agent

Authors: H. Yousefnia, S. Zolghadri

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An early diagnosis of bone metastases is very important for providing a profound decision on a subsequent therapy. A prerequisite for the clinical application of new diagnostic radiopharmaceutical is the measurement of organ radiation exposure dose from biodistribution data in animals. In this study, the dosimetric studies of a novel agent for SPECT-imaging of bone methastases, 111In-(4-{[(bis(phosphonomethyl))carbamoyl]methyl}-7,10-bis(carboxymethyl)-1,4,7,10-tetraazacyclododec-1-yl) acetic acid (111In-BPAMD) complex, have been estimated in human organs based on mice data. The radiolabeled complex was prepared with high radiochemical purity at the optimal conditions. Biodistribution studies of the complex were investigated in male Syrian mice at selected times after injection (2, 4, 24 and 48 h). The human absorbed dose estimation of the complex was performed based on mice data by the radiation absorbed dose assessment resource (RADAR) method. 111In-BPAMD complex was prepared with high radiochemical purity >95% (ITLC) and specific activities of 2.85 TBq/mmol. Total body effective absorbed dose for 111In-BPAMD was 0.205 mSv/MBq. This value is comparable to the other 111In clinically used complexes. The results show that the dose to critical organs the complex is well within the acceptable considered range for diagnostic nuclear medicine procedures. Generally, 111In-BPAMD has interesting characteristics and can be considered as a viable agent for SPECT-imaging of the bone metastases in the near future.

Keywords: In-111, BPAMD, absorbed dose, RADAR

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7109 Treatment Outcome of Cutaneous Leishmaniasis and Its Associated Factors among Admitted Patients in All Africa Leprosy Rehabilitation and Training Center Hospital, Ethiopia

Authors: Kebede Mairie, Getahun Belete, Mitike Abeba

Abstract:

Background: Leishmania aethiopica is a peculiar parasite causing cutaneous leishmaniasis in Ethiopia and its mainstay treatment is Sodium Stibogluconate. However, its treatment outcome in Ethiopia is not well documented. Objectives: To determine the treatment outcome of admitted cutaneous leishmaniasis patients and its associated factors in Addis Ababa, Ethiopia. Methods: A retrospective study was conducted from 1st November 2021 to 30th March 2022. Medical records of all cutaneous leishmaniasis-diagnosed and admitted patients who received parenteral sodium stibogluconate at All Africa Leprosy Rehabilitation and Training Center (ALERT) hospital, the main Leishmania treatment center in Ethiopia from July 2011 to September 2021 were reviewed. Results: A total of 827 charts of admitted cases from July 2011 to September 2021 were retrieved, but 667 (80.65%) were reviewed. Improvement in the treatment outcome was recorded in 93.36 % in the first course of SSG treatment and 96.23%, 94.62%, and 96.97% subsequently in the second, third and fourth treatment courses, respectively. Female gender and diffuse cutaneous leishmaniasis were the two predictive determinants in the treatment of cutaneous leishmaniasis. Conclusion: The study shows that parenteral sodium stibogluconate therapy treats hospitalized cutaneous leishmaniasis patients well, with female gender and diffuse cutaneous leishmaniasis having poor outcomes suggesting the need for a different approach for diffuse cutaneous leishmaniasis patients.

Keywords: cutaneous leishmaniasis, leishmania aethiopica, sodium stibogluconate, diffuse cutaneous leishmaniasis, pentostam

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7108 Outcome Analysis of Various Management Strategies for Ileal Perforation

Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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7107 Resistin Mediates Tomato and Broccoli Extracts Effects on Glucose Homeostasis in High Fat Diet Induced Obesity in Rats

Authors: N. M. Aborehab, M. Helmy, N. E. Waly

Abstract:

Resistin was identified as an adipocyte hormone that participates in regulation of glucose metabolism. Elevated levels of Resistin are postulated to cause insulin resistance. This may link obesity, and increased fat mass to type II diabetes and insulin resistance. We hypothesized that tomato and broccoli extract treatment regulates glucose homeostasis via modulation of resistin levels in high fat diet induced obesity rats (HFD). 63 male albino rats were divided into 8 groups as follows: control, HFD, stop fat diet (SD), Tomato 200 mg/kg (T200), Tomato 400mg/kg (T400), Broccoli 200 mg/kg (B200), Broccoli 400 mg/kg (B400), Chromax (CX). Treatment continued for 1 month. Serum levels of resistin, leptin, adiponectin, glucose and insulin were measured using ELISA, and spectrophotometry. Serum level of resistin was significantly reduced in T 200, T 400, B 200, B 400 and CX groups to: 4.13 ± 0.22 ng/ml, 1.51 ± 0.04 ng/ml, 4.13 ± 0.22 ng/ml, 2.32 ± 0.15 ng/ml and 1.37 ± 0.03 ng/ml respectively compared to HFD group and SD group (P value < 0.0001). Non-significant difference was found between T 400, B 400 and CX groups. Mean serum level of leptin was significantly reduced in T 400 (22.7 ± 0.84 Pg/ml) group compared to B 400 (41 ± 2.45 Pg/ml) and CX groups (45.7 ± 2.91 Pg/ml), P value < 0.001.The mean serum level of adiponectin was significantly increased in T 400 group (131 ± 3.84 Pg/ml) compared to CX group (112 ± 4.77 Pg/ml), P value was < 0.01. Our results demonstrate that tomato and broccoli extract treatment regulates glucose homeostasis via reduction of serum resistin and may be a useful non-pharmacological therapy for obesity. Further studies are required to assess the potential use of these extract as a treatment for type II diabetes and obesity.

Keywords: broccoli, obesity, resistin, tomato

Procedia PDF Downloads 287
7106 Preventable Stress and Trauma, and Menstrual Health Management: Experiences of Adolescent Girls from India

Authors: Daisy Dutta, Chhanda Chakraborti

Abstract:

Background and significance of the study: Menstrual Hygiene Management (MHM) is poor in many Lower and Middle-Income Countries (LMIC) such as India. Poor and inadequate menstrual hygiene has an adverse effect on the health and social life of adolescent girls and women. There are many well-known barriers to adequate Menstrual Hygiene Management (MHM); e.g., lack of awareness, lack of WASH (Water, Sanitation and Hygiene) facilities, lack of affordable menstrual absorbents, etc. But, there is a unique barrier which is very much avoidable; i.e., lack of proper guidance and counseling about menstruation. Menstruation is associated with various social and cultural restrictions and taboos and being a taboo topic; often there is no discussion in the society on this topic. Thus, many adolescent girls encounter the menarche with a lot of unnecessary and avoidable trauma, stress and awkwardness. This trauma, stress, and anxiety are even more prevalent among adolescent girls residing in rural areas. This study argues that this unnecessary stress and anxiety of the adolescent girls can be alleviated by reinforcing social support and adequate information and guidance about MHM and eliminating the futile socio-cultural restrictions during menstruation. Methodology: A qualitative study was conducted in a North-eastern State of India where 45 adolescent girls were interviewed both from rural and urban areas. The adolescent girls were asked about their experiences of stress and anxiety on their first menstruation, their preparedness for menarche, their source of information and guidance, their hygiene-practices, and the various restrictions they follow. Findings: Maximum number of girls did not receive any information about menstruation before menarche. Most of them reported that they were terrified about their first menstruation as they were unprepared. Among those who were aware before menarche, reported that they did not receive proper guidance to manage their menstruation in a hygienic manner. Hygiene-related practices are also influenced by their knowledge about MHM. In maximum cases, girls are bound to follow certain cultural and religious restrictions even if they don’t want to follow which created additional stress in managing their menstruation with dignity. Conclusion: Lack of proper guidance and counseling about menstruation and MHM along with an array of socio-cultural restrictions can enhance a negative attitude in adolescent girls towards menstruation due to which they have to go through an extra and unnecessary burden of stress and trauma. This stress and trauma is preventable by improving the provisions of proper guidance and counseling about menstruation in a supportive environment.

Keywords: adolescent girls, menstrual hygiene management, socio-cultural restrictions, stress, trauma

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7105 Regulating Nanocarrier and Mononuclear Phagocyte System Interactions through Esomeprazole-Based Preconditioning Strategy

Authors: Zakia Belhadj, Bing He, Hua Zhang, Xueqing Wang, Wenbing Dai, Qiang Zhang

Abstract:

Mononuclear phagocyte system (MPS) forms an abominable obstacle hampering the tumor delivery efficiency of nanoparticles. Passively targeted nanocarriers have received clinical approval over the past 20 years. However, none of the actively targeted nanocarriers have entered clinical trials. Thus it is important to endue effective targeting ability to actively targeted approaches by overcoming biological barriers to nanoparticle drug delivery. Here, it presents that an Esomeprazole-based preconditioning strategy for regulating nanocarrier-MPS interaction to substantially prolong circulation time and enhance tumor targeting of nanoparticles. In vitro, the clinically approved proton pump inhibitor Esomeprazole “ESO” was demonstrated to reduce interactions between macrophages and subsequently injected targeted vesicles by interfering with their lysosomal trafficking. Of note, in vivo studies demonstrated that ESO pretreatment greatly decreased the liver and spleen uptake of c(RGDm7)-modified vesicles, highly enhanced their tumor accumulation, thereby provided superior therapeutic efficacy of c(RGDm7)-modified vesicles co-loaded with Doxorubicin (DOX) and Gefitinib (GE). This MPS-preconditioning strategy using ESO provides deeper insights into regulating nanoparticles interaction with the phagocytic system and enhancing their cancer cells' accessibility for anticancer therapy.

Keywords: esomeprazole (ESO), mononuclear phagocyte system (MPS), preconditioning strategy, targeted lipid vesicles

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7104 Metabolome-based Profiling of African Baobab Fruit (Adansonia Digitata L.) Using a Multiplex Approach of MS and NMR Techniques in Relation to Its Biological Activity

Authors: Marwa T. Badawy, Alaa F. Bakr, Nesrine Hegazi, Mohamed A. Farag, Ahmed Abdellatif

Abstract:

Diabetes Mellitus (DM) is a chronic disease affecting a large population worldwide. Africa is rich in native medicinal plants with myriad health benefits, though less explored towards the development of specific drug therapy as in diabetes. This study aims to determine the in vivo antidiabetic potential of the well-reported and traditionally used fruits of Baobab (Adansonia digitata L.) using STZ induced diabetic model. The in-vitro cytotoxic and antioxidant properties were examined using MTT assay on L-929 fibroblast cells and DPPH antioxidant assays, respectively. The extract showed minimal cytotoxicity with an IC50 value of 105.7 µg/mL. Histopathological and immunohistochemical investigations showed the hepatoprotective and the renoprotective effects of A. digitata fruits’ extract, implying its protective effects against diabetes complications. These findings were further supported by biochemical assays, which showed that i.p., injection of a low dose (150 mg/kg) of A. digitata twice a week lowered the fasting blood glucose levels, lipid profile, hepatic and renal markers. For a comprehensive overview of extract metabolites composition, ultrahigh performance (UHPLC) analysis coupled to high-resolution tandem mass spectrometry (HRMS/MS) in synchronization with molecular networks led to the annotation of 77 metabolites, among which 50% are reported for the first time in A. digitata fruits.

Keywords: adansonia digital, diabetes mellitus, metabolomics, streptozotocin, Sprague, dawley rats

Procedia PDF Downloads 143
7103 Financial Instruments Disclosure: A Review of the Literature

Authors: Y. Tahat, T. Dunne, S. Fifield, D. Power

Abstract:

Information about a firm’s usage of Financial Instruments (FIs) plays a very important role in determining its financial position and performance. Yet accounting standard-setters have encountered problems when deciding on the FI-related disclosures which firms must make. The primary objective of this paper is to review the extant literature on FI disclosure. This objective is achieved by surveying the literature on: the corporate usage of FIs; the different accounting standards adopted concerning FIs; and empirical studies on FI disclosure. This review concludes that the current research on FI disclosure has generated a number of useful insights. In particular, the paper reports that: FIs are a very important risk management mechanism in ensuring that companies have the cash available to make value-enhancing investments, however, without a clear set of risk management objectives, using such instruments can be dangerous; accounting standards concerning FIs have resulted in enhanced transparency about the usage of these instruments; and FI-related information is a key input into investors’ decision-making processes. Finally, the paper provides a number of suggestions for future research in the area.

Keywords: financial instruments, financial reporting, accounting standards, value relevance, corporate disclosure

Procedia PDF Downloads 396
7102 Low Carbon Tourism Management: Strategies for Climate-Friendly Tourism of Koh Mak, Thailand

Authors: Panwad Wongthong, Thanan Apivantanaporn, Sutthiwan Amattayakul

Abstract:

Nature-based tourism is one of the fastest growing industries that can bring in economic benefits, improve quality of life and promote conservation of biodiversity and habitats. As tourism develops, substantial socio-economic and environmental costs become more explicit. Particularly in island destinations, the dynamic system and geographical limitations makes the intensity of tourism development and severity of the negative environmental impacts greater. The current contribution of the tourism sector to global climate change is established at approximately 5% of global anthropogenic CO2 emissions. In all scenarios, tourism is anticipated to grow substantially and to account for an increasingly large share of global greenhouse gas emissions. This has prompted an urgent call for more sustainable alternatives. This study selected a small island of Koh Mak in Thailand as a case study because of its reputation of being laid back, family oriented and rich in biodiversity. Importantly, it is a test platform for low carbon tourism development project supported by the Designated Areas for Sustainable Tourism Administration (DASTA) in collaboration with the Institute for Small and Medium Enterprises Development (ISMED). The study explores strategies for low carbon tourism management and assesses challenges and opportunities for Koh Mak to become a low carbon tourism destination. The goal is to identify suitable management approaches applicable for Koh Mak which may then be adapted to other small islands in Thailand and the region. Interventions/initiatives to increase energy efficiency in hotels and resorts; cut carbon emissions; reduce impacts on the environment; and promote conservation will be analyzed. Ways toward long-term sustainability of climate-friendly tourism will be recommended. Recognizing the importance of multi-stakeholder involvement in the tourism sector, findings from this study can reward Koh Mak tourism industry with a triple-win: cost savings and compliance with higher standards/markets; less waste, air emissions and effluents; and better capabilities of change, motivation of business owners, staff, tourists as well as residents. The consideration of climate change issues in the planning and implementation of tourism development is of great significance to protect the tourism sector from negative impacts.

Keywords: climate change, CO2 emissions, low carbon tourism, sustainable tourism management

Procedia PDF Downloads 271
7101 Unlocking Tourism Value through a Tourist Experience Management Paradigm

Authors: Siphiwe P. Mandina, Tinashe Shamuyashe

Abstract:

Tourism has become a topical issue amongst academics and practitioners due to its potential to contribute significantly towards an economy’s GDP. The problem underpinning this research is the fact that the major attraction, Victoria Falls, is being marketed in neighboring countries like South Africa, Botswana and Zambia with tour operators providing just day trips to the Victoria Falls. This has deprived Zimbabwe of income from tourism with tourists making day trips and actually not spending nights in Zimbabwe. This therefore calls for cutting edge marketing strategies that are superior to or inimitable by competing nations such as South Africa and Zambia. This study proposes a shift towards an experience management paradigm in the tourism sector. A qualitative research was adopted for this study, and findings of this study were generalized across different tourism contexts, therefore making the survey based research design more appropriate. The target population for this study is tourists visiting Zimbabwe over the period 2016 and ZTA visitor database acquired from the Department of Immigration will form the sampling frame for the purposes of this study.

Keywords: tourist experiences, Zimbabwe, tourist arrivals, competitiveness

Procedia PDF Downloads 240
7100 Communities’ Attitudes and Perceptions of Protected Areas in South Africa: Insights from the Somkhanda Game Reserve

Authors: Sakhile Nsukwini, Urmilla Bob

Abstract:

Meaningful community participation is essential to the long-term success of protected areas. Hence, it is important to understand what drives neighbouring communities’ attitudes and perceptions towards protected areas. This study sought to determine local community attitudes towards conservation and protected areas, as well as their perceptions of benefits and participation at Somkhanda Game Reserve. Semi-structured interviews were held with experienced park officials, while a structured household survey and focus group discussions were conducted across two surrounding villages. The results highlighted a number of interesting findings, including support for biodiversity conservation and protected areas balanced by considerable negativity towards the Somkhanda Game Reserve itself. It was also determined that despite stated co-management policies, community residents perceived there was little meaningful participation, and benefits were poorly communicated and unfairly distributed. Practical suggestions were made for cooperatively developing more effective participation with the communities, despite limited available resources.

Keywords: communities, protected areas, perceptions, co-management, land restitution

Procedia PDF Downloads 97
7099 Water Demand Modelling Using Artificial Neural Network in Ramallah

Authors: F. Massri, M. Shkarneh, B. Almassri

Abstract:

Water scarcity and increasing water demand especially for residential use are major challenges facing Palestine. The need to accurately forecast water consumption is useful for the planning and management of this natural resource. The main objective of this paper is to (i) study the major factors influencing the water consumption in Palestine, (ii) understand the general pattern of Household water consumption, (iii) assess the possible changes in household water consumption and suggest appropriate remedies and (iv) develop prediction model based on the Artificial Neural Network to the water consumption in Palestinian cities. The paper is organized in four parts. The first part includes literature review of household water consumption studies. The second part concerns data collection methodology, conceptual frame work for the household water consumption surveys, survey descriptions and data processing methods. The third part presents descriptive statistics, multiple regression and analysis of the water consumption in the two Palestinian cities. The final part develops the use of Artificial Neural Network for modeling the water consumption in Palestinian cities.

Keywords: water management, demand forecasting, consumption, ANN, Ramallah

Procedia PDF Downloads 199
7098 A Multicriteria Model for Sustainable Management in Agriculture

Authors: Basil Manos, Thomas Bournaris, Christina Moulogianni

Abstract:

The European agricultural policy supports all member states to apply agricultural development plans for the development of their agricultural sectors. A specific measure of the agricultural development plans refers to young people in order to enter into the agricultural sector. This measure helps the participating young farmers in achieving maximum efficiency, using methods and environmentally friendly practices, by altering their farm plans. This study applies a Multicriteria Mathematical Programming (MCDA) model for the young farmers to find farm plans that achieve the maximum gross margin and the minimum environmental impacts (less use of fertilizers and irrigation water). The analysis was made in the region of Central Macedonia, Greece, among young farmers who have participated in the “Setting up Young Farmers” measure during 2007-2010. The analysis includes the implementation of the MCDA model for the farm plans optimization and the comparison of selected environmental indicators with those of the existent situation.

Keywords: multicriteria, optimum farm plans, environmental impacts, sustainable management

Procedia PDF Downloads 325
7097 Storm-water Management for Greenfield Area Using Low Impact Development Concept for Town Planning Scheme Mechanism

Authors: Sahil Patel

Abstract:

Increasing urbanization leads to a concrete forest. The effects of new development practices occur in the natural hydrologic cycle. Here the concerns have been raised about the groundwater recharge in sufficient quantity. With further development, porous surfaces reduce rapidly. A city like Ahmedabad, with a non-perennial river, is 100% dependent on groundwater. The Ahmedabad city receives its domestic use water from the Narmada river, located about 200 km away. The expenses to bring water is much higher. Ahmedabad city receives annually 800 mm rainfall, and mostly this water increases the local level waterlogging problems; after that, water goes to the Sabarmati river and merges into the sea. The existing developed area of Ahmedabad city is very dense, and does not offer many chances to change the built form and increase porous surfaces to absorb storm-water. Therefore, there is a need to plan upcoming areas with more effective solutions to manage storm-water. This paper is focusing on the management of stormwater for new development by retaining natural hydrology. The Low Impact Development (LID) concept is used to manage storm-water efficiently. Ahmedabad city has a tool called the “Town Planning Scheme,” which helps the local body drive new development by land pooling mechanism. This paper gives a detailed analysis of the selected area (proposed Town Planning Scheme area by the local authority) in Ahmedabad. Here the development control regulations for individual developers and some physical elements for public places are presented to manage storm-water. There is a different solution for the Town Planning scheme than that of the conventional way. A local authority can use it for any area, but it can be site-specific. In the end, there are benefits to locals with some financial analysis and comparisons.

Keywords: water management, green field development, low impact development, town planning scheme

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7096 A Review on the Impact of Institutional Setting on Land Use Conflicts in Coastal Areas

Authors: Roni Susman, Thomas Weith

Abstract:

This article explores how institutional setting, mainly from institutionalism, could clearly explain the understanding of land use conflict analysis in coastal areas and has been used in current practices. Institutional setting appears as a guideline that is committed by the stakeholders who are involved directly or indirectly in land management process. This paper is aimed to identify the setting of institutional and to measure how the conflicts occur, how the actors act and influence the process, how is the condition to apply the appropriate framework for adequate solution of land use conflict in coastal area in order to enhance better decisions. To reflect the current practice and use of theories a qualitative review of 150 scientific peer-reviewed papers regarding the issue of land use conflicts in coastal areas as well as institutional process is included. The selection of peer-reviewed papers is obtained through a structured literature survey of the recently published database in a way to investigate the variances of institutional between theory and practices specifically in the case of coastal land management.

Keywords: coastal areas, institutional settings, land use conflict, land governance, actors’ constellation, analytical framework

Procedia PDF Downloads 170
7095 Design and Implementation of a Geodatabase and WebGIS

Authors: Sajid Ali, Dietrich Schröder

Abstract:

The merging of internet and Web has created many disciplines and Web GIS is one these disciplines which is effectively dealing with the geospatial data in a proficient way. Web GIS technologies have provided an easy accessing and sharing of geospatial data over the internet. However, there is a single platform for easy and multiple accesses of the data lacks for the European Caribbean Association (Europaische Karibische Gesselschaft - EKG) to assist their members and other research community. The technique presented in this paper deals with designing of a geodatabase using PostgreSQL/PostGIS as an object oriented relational database management system (ORDBMS) for competent dissemination and management of spatial data and Web GIS by using OpenGeo Suite for the fast sharing and distribution of the data over the internet. The characteristics of the required design for the geodatabase have been studied and a specific methodology is given for the purpose of designing the Web GIS. At the end, validation of this Web based geodatabase has been performed over two Desktop GIS software and a web map application and it is also discussed that the contribution has all the desired modules to expedite further research in the area as per the requirements.

Keywords: desktop GISSoftware, European Caribbean association, geodatabase, OpenGeo suite, postgreSQL/PostGIS, webGIS, web map application

Procedia PDF Downloads 323
7094 Ensuring Safe Operation by Providing an End-To-End Field Monitoring and Incident Management Approach for Autonomous Vehicle Based on ML/Dl SW Stack

Authors: Lucas Bublitz, Michael Herdrich

Abstract:

By achieving the first commercialization approval in San Francisco the Autonomous Driving (AD) industry proves the technology maturity of the SAE L4 AD systems and the corresponding software and hardware stack. This milestone reflects the upcoming phase in the industry, where the focus is now about scaling and supervising larger autonomous vehicle (AV) fleets in different operation areas. This requires an operation framework, which organizes and assigns responsibilities to the relevant AV technology and operation stakeholders from the AV system provider, the Remote Intervention Operator, the MaaS provider and regulatory & approval authority. This holistic operation framework consists of technological, processual, and organizational activities to ensure safe operation for fully automated vehicles. Regarding the supervision of large autonomous vehicle fleets, a major focus is on the continuous field monitoring. The field monitoring approach must reflect the safety and security criticality of incidents in the field during driving operation. This includes an automatic containment approach, with the overall goal to avoid safety critical incidents and reduce downtime by a malfunction of the AD software stack. An End-to-end (E2E) field monitoring approach detects critical faults in the field, uses a knowledge-based approach for evaluating the safety criticality and supports the automatic containment of these E/E faults. Applying such an approach will ensure the scalability of AV fleets, which is determined by the handling of incidents in the field and the continuous regulatory compliance of the technology after enhancing the Operational Design Domain (ODD) or the function scope by Functions on Demand (FoD) over the entire digital product lifecycle.

Keywords: field monitoring, incident management, multicompliance management for AI in AD, root cause analysis, database approach

Procedia PDF Downloads 53