Search results for: contract management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9539

Search results for: contract management

5339 Patient Safety Culture in Brazilian Hospitals from Nurse's Team Perspective

Authors: Carmen Silvia Gabriel, Dsniele Bernardi da Costa, Andrea Bernardes, Sabrina Elias Mikael, Daniele da Silva Ramos

Abstract:

The goal of this quantitative study is to investigate patient safety culture from the perspective of professional from the hospital nursing team.It was conducted in two Brazilian hospitals,.The sample included 282 nurses Data collection occurred in 2013, through the questionnaire Hospital Survey on Patient Safety Culture.Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor overlooks patient safety problems.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.On hospital management support for patient safety, 52.8% refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.On frequency of event reporting, 64.7% said often and always notify events with no damages to patients..About teamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8 % disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6 % classified it as very good. it is concluded that there are positive points in the safety culture, and some weaknesses as a punitive culture and impaired patient safety due to work overload .

Keywords: quality of health care, health services evaluation, safety culture, patient safety, nursing team

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5338 The Role of Uterine Artery Embolization in the Management of Postpartum Hemorrhage

Authors: Chee Wai Ku, Pui See Chin

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As an emerging alternative to hysterectomy, uterine artery embolization (UAE) has been widely used in the management of fibroids and in controlling postpartum hemorrhage (PPH) unresponsive to other therapies. Research has shown UAE to be a safe, minimally invasive procedure with few complications and minimal effects on future fertility. We present two cases highlighting the use of UAE in preventing PPH in a patient with a large fibroid at the time of cesarean section and in the treatment of secondary PPH refractory to other therapies in another patient. We present a 36-year primiparous woman who booked at 18+6 weeks gestation with a 13.7 cm subserosal fibroid at the lower anterior wall of the uterus near the cervix and a 10.8 cm subserosal fibroid in the left wall. Prophylactic internal iliac artery occlusion balloons were placed prior to the planned classical midline cesarean section. The balloons were inflated once the baby was delivered. Bilateral uterine arteries were embolized subsequently. The estimated blood loss (EBL) was 400 mls and hemoglobin (Hb) remained stable at 10 g/DL. Ultrasound scan 2 years postnatally showed stable uterine fibroids 10.4 and 7.1 cm, which was significantly smaller than before. We present the second case of a 40-year-old G2P1 with a previous cesarean section for failure to progress. There were no antenatal problems, and the placenta was not previa. She presented with term labour and underwent an emergency cesarean section for failed vaginal birth after cesarean. Intraoperatively extensive adhesions were noted with bladder drawn high, and EBL was 300 mls. Postpartum recovery was uneventful. She presented with secondary PPH 3 weeks later complicated by hypovolemic shock. She underwent an emergency examination under anesthesia and evacuation of the uterus, with EBL 2500mls. Histology showed decidua with chronic inflammation. She was discharged well with no further PPH. She subsequently returned one week later for secondary PPH. Bedside ultrasound showed that the endometrium was thin with no evidence of retained products of conception. Uterotonics were administered, and examination under anesthesia was performed, with uterine Bakri balloon and vaginal pack insertion after. EBL was 1000 mls. There was no definite cause of PPH with no uterine atony or products of conception. To evaluate a potential cause, pelvic angiogram and super selective left uterine arteriogram was performed which showed profuse contrast extravasation and acute bleeding from the left uterine artery. Superselective embolization of the left uterine artery was performed. No gross contrast extravasation from the right uterine artery was seen. These two cases demonstrated the superior efficacy of UAE. Firstly, the prophylactic use of intra-arterial balloon catheters in pregnant patients with large fibroids, and secondly, in the diagnosis and management of secondary PPH refractory to uterotonics and uterine tamponade. In both cases, the need for laparotomy hysterectomy was avoided, resulting in the preservation of future fertility. UAE should be a consideration for hemodynamically stable patients in centres with access to interventional radiology.

Keywords: fertility preservation, secondary postpartum hemorrhage, uterine embolization, uterine fibroids

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5337 Hierarchical Operation Strategies for Grid Connected Building Microgrid with Energy Storage and Photovoltatic Source

Authors: Seon-Ho Yoon, Jin-Young Choi, Dong-Jun Won

Abstract:

This paper presents hierarchical operation strategies which are minimizing operation error between day ahead operation plan and real time operation. Operating power systems between centralized and decentralized approaches can be represented as hierarchical control scheme, featured as primary control, secondary control and tertiary control. Primary control is known as local control, featuring fast response. Secondary control is referred to as microgrid Energy Management System (EMS). Tertiary control is responsible of coordinating the operations of multi-microgrids. In this paper, we formulated 3 stage microgrid operation strategies which are similar to hierarchical control scheme. First stage is to set a day ahead scheduled output power of Battery Energy Storage System (BESS) which is only controllable source in microgrid and it is optimized to minimize cost of exchanged power with main grid using Particle Swarm Optimization (PSO) method. Second stage is to control the active and reactive power of BESS to be operated in day ahead scheduled plan in case that State of Charge (SOC) error occurs between real time and scheduled plan. The third is rescheduling the system when the predicted error is over the limited value. The first stage can be compared with the secondary control in that it adjusts the active power. The second stage is comparable to the primary control in that it controls the error in local manner. The third stage is compared with the secondary control in that it manages power balancing. The proposed strategies will be applied to one of the buildings in Electronics and Telecommunication Research Institute (ETRI). The building microgrid is composed of Photovoltaic (PV) generation, BESS and load and it will be interconnected with the main grid. Main purpose of that is minimizing operation cost and to be operated in scheduled plan. Simulation results support validation of proposed strategies.

Keywords: Battery Energy Storage System (BESS), Energy Management System (EMS), Microgrid (MG), Particle Swarm Optimization (PSO)

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5336 Architectural Framework to Preserve Information of Cardiac Valve Control

Authors: Lucia Carrion Gordon, Jaime Santiago Sanchez Reinoso

Abstract:

According to the relation of Digital Preservation and the Health field as a case of study, the architectural model help us to explain that definitions. .The principal goal of Data Preservation is to keep information for a long term. Regarding of Mediacal information, in order to perform a heart transplant, physicians need to preserve this organ in an adequate way. This approach between the two perspectives, the medical and the technological allow checking the similarities about the concepts of preservation. Digital preservation and medical advances are related in the same level as knowledge improvement.

Keywords: medical management, digital, data, heritage, preservation

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5335 Experiences and Challenges of Menstruation Among Rural Schoolgirls in Ghana: A Case of Nadowli-Kaleo District in the Upper West Region of Ghana

Authors: Rosemond Mbii

Abstract:

Menstruation is a critical topic. However normal menstruation is, it has become a determinant in the education of young women today. The research focuses on Breaking the silence and accessing menstrual hygiene management's challenges and experiences among rural schoolgirls in Ghana. The study's goal was to examine the menstrual hygiene practices of female students. Participants described their menstrual hygiene practices, their problems, and how they coped with their menstrual symptoms. The research used a qualitative technique through group interviews, personal interviews, and open-ended questionnaires since it is easier to understand a phenomenon from the subject's viewpoint. Sen's capacities approach and Feminist Political Ecology (FPE) were used to analyze the data. Menstruation was known to girls even before their menarche. A mother or grandmother, friends, and teachers were the primary sources of menstrual knowledge. The study also found that most girls use sanitary products made of fabrics, pads, and cotton during menstruation. Among the difficulties the girls faced, the study found were emotional upset, physical discomfort (cramps in the stomach, fatigue), embarrassment, and inadequate sanitation hygiene facilities. The girls wore many garments to avoid leaks; checked their skirts continuously, went to the bathroom with their friends to act as spics while they changed; sat differently on the chairs, and took medicine to reduce period discomfort. Introduction of a health care teacher who supplies sanitary products and medications to girls during school time. Euphemisms as a form of communication amongst girls were all coping mechanisms girls and the school developed. Another finding was that some girls continued to go to school even while having their periods, while others did not. Discomfort and menstruation cramps hampered class participation. In addition, the study revealed insufficient sanitation and hygiene for females to change sanitary products in private and manage menstrual hygiene comfortably.

Keywords: MHM (menstrual hygiene management), rural area, sanitation, menstruation, water, schoolgirl, rural area, sanitation, menstruation, water

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5334 Rainwater Management in Smart City: Focus in Gomti Nagar Region, Lucknow, Uttar Pradesh, India

Authors: Priyanka Yadav, Rajkumar Ghosh, Alok Saini

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Human civilization cannot exist and thrive in the absence of adequate water. As a result, even in smart cities, water plays an important role in human existence. The key causes of this catastrophic water scarcity crisis are lifestyle changes, over-exploitation of groundwater, water over usage, rapid urbanization, and uncontrolled population growth. Furthermore, salty water seeps into deeper aquifers, causing land subsidence. The purpose of this study on artificial groundwater recharge is to address the water shortage in Gomti Nagar, Lucknow. Submersibles are the most common methods of collecting freshwater from groundwater in Gomti Nagar neighbourhood of Lucknow. Gomti Nagar area has a groundwater depletion rate of 1968 m3/day/km2 and is categorized as Zone-A (very high levels) based on the existing groundwater abstraction pattern - A to D. Harvesting rainwater using roof top rainwater harvesting systems (RTRWHs) is an effective method for reducing aquifer depletion in a sustainable water management system. Rainwater collecting using roof top rainwater harvesting systems (RTRWHs) is an effective method for reducing aquifer depletion in a sustainable water conservation system. Due to a water imbalance of 24519 ML/yr, the Gomti Nagar region is facing severe groundwater depletion. According to the Lucknow Development Authority (LDA), the impact of installed RTRWHs (plot area 300 sq. m.) is 0.04 percent of rainfall collected through RTRWHs in Gomti Nagar region of Lucknow. When RTRWHs are deployed in all buildings, their influence will be greater. Bye-laws in India have mandated the installation of RTRWHs on plots greater than 300 sq.m. A better India without any water problem is a pipe dream that may be realized by installing residential and commercial rooftop rainwater collecting systems in every structure. According to the current study, RTRWHs should be used as an alternate source of water to bridge the gap between groundwater recharge and extraction in smart city viz. Gomti Nagar, Lucknow, India.

Keywords: groundwater recharge, RTRWHs, harvested rainwater, rainfall, water extraction

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5333 To Upgrade Quality Services of Fashion Designer by Minimizing thought Communication Gap, Using the Projective Personality Tests

Authors: A. Hira Masood, B. Umer Hameed, C. Ezza Nasir

Abstract:

Contemporary studies support the strong co-relation between psychology and design. This study elaborates how different psychological personality test can help a fashion designer to judge the needs of their clients with respect to have products which will satisfy the client's request concerning costumised clothing. This study will also help the designer to improve the lacking in the personality and will enable him to put his effort in required areas for grooming the customer, control and direct organization regarding quality maintenance. The use of psychology test to support the choice of certain design strategies that how the right clothing can make client a better intellectual with enhanced self-esteem and confidence. Different projective personality test are being used to suggest to evaluate personality traits. The Rorschach Inkblot Test is projective mental comprising of 10 ink-blots synonymous with the clinical brain research. Lüsher Color Diagnostics measures a person’s psycho physical state, his or her ability to withstand stress to perform and communicate. HTP is a projective responsibility test measuring self-perception, attitudes. The TAT test intend to evaluate a person’s patterns of thoughts, attitudes, observation, capacity and emotional response to this ambiguous test materials. No doubt designers are already crucially redesigning the individuals by their attires, but to expose the behavioral mechanism of the customer, designers should be able to recognize the hidden complexity behind his client by using the above mentioned methods. The study positively finds the design and psychology need to become substantially contacted in order to create a new regime of norms to groom a personality under the concentration and services of a fashion designer in terms of clothing, This interactive activity altimately upgrade design team to help customers to find the suited way to satisfy their needs and wishes, offer client relible relationship and quality management services, and to become more disereable.

Keywords: projective personality tests, customized clothing, Rorschach Inkblot test, TAT, HTP, Lüsher color diagnostics, quality management services

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5332 Response of Wheat (Triticum aestivum L.) to Deficit Irrigation Management in the Semi-Arid Awash Basin of Ethiopia

Authors: Gobena D. Bayisa, A. Mekonen, Megersa O. Dinka, Tilahun H. Nebi, M. Boja

Abstract:

Crop production in arid and semi-arid regions of Ethiopia is largely limited by water availability. Changing climate conditions and declining water resources increase the need for appropriate approaches to improve water use and find ways to increase production through reduced and more reliable water supply. In the years 2021/22 and 2022/23, a field experiment was conducted to evaluate the effect of limited irrigation water use on bread wheat (Triticum aestivum L.) production, water use efficiency, and financial benefits. Five irrigation treatments, i.e., full irrigation (100% ETc/ control), 85% ETc, 70% ETc, 55% ETc, and 40% ETc, were evaluated using a randomized complete block design (RCBD) with four replicates in the semi-arid climate condition of Awash basin of Ethiopia. Statistical analysis showed a significant effect of irrigation levels on wheat grain yield, water use efficiency, crop water response factor, economic profit, wheat grain quality, aboveground biomass, and yield index. The highest grain yield (5085 kg ha⁻¹) was obtained with 100% ETc irrigation (417.2 mm), and the lowest grain yield with 40% ETc (223.7 mm). Of the treatments, 70% ETc produced the higher wheat grain yield (4555 kg ha⁻¹), the highest water use efficiency (1.42 kg m⁻³), and the highest yield index (0.43). Using the saved water, wheat could be produced 23.4% more with a 70% ETc deficit than full irrigation on 1.38 ha of land, and it could get the highest profit (US$2563.9) and higher MRR (137%). The yield response factor and crop-water production function showed potential reductions associated with increased irrigation deficits. However, a 70% ETc deficit is optimal for increasing wheat grain yield, water use efficiency, and economic benefits of irrigated wheat production. The result indicates that deficit irrigation of wheat under the typical arid and semi-arid climatic conditions of the Awash Basin can be a viable irrigation management approach for enhancing water use efficiency while minimizing the decrease in crop yield could be considered effective.

Keywords: crop-water response factor, deficit irrigation, water use efficiency, wheat production

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5331 Study and Analysis of the Factors Affecting Road Safety Using Decision Tree Algorithms

Authors: Naina Mahajan, Bikram Pal Kaur

Abstract:

The purpose of traffic accident analysis is to find the possible causes of an accident. Road accidents cannot be totally prevented but by suitable traffic engineering and management the accident rate can be reduced to a certain extent. This paper discusses the classification techniques C4.5 and ID3 using the WEKA Data mining tool. These techniques use on the NH (National highway) dataset. With the C4.5 and ID3 technique it gives best results and high accuracy with less computation time and error rate.

Keywords: C4.5, ID3, NH(National highway), WEKA data mining tool

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5330 The Impact of Human Intervention on Net Primary Productivity for the South-Central Zone of Chile

Authors: Yannay Casas-Ledon, Cinthya A. Andrade, Camila E. Salazar, Mauricio Aguayo

Abstract:

The sustainable management of available natural resources is a crucial question for policy-makers, economists, and the research community. Among several, land constitutes one of the most critical resources, which is being intensively appropriated by human activities producing ecological stresses and reducing ecosystem services. In this context, net primary production (NPP) has been considered as a feasible proxy indicator for estimating the impacts of human interventions on land-uses intensity. Accordingly, the human appropriation of NPP (HANPP) was calculated for the south-central regions of Chile between 2007 and 2014. The HANPP was defined as the difference between the potential NPP of the naturally produced vegetation (NPP0, i.e., the vegetation that would exist without any human interferences) and the NPP remaining in the field after harvest (NPPeco), expressed in gC/m² yr. Other NPP flows taken into account in HANPP estimation were the harvested (NPPh) and the losses of NPP through land conversion (NPPluc). The ArcGIS 10.4 software was used for assessing the spatial and temporal HANPP changes. The differentiation of HANPP as % of NPP0 was estimated by each landcover type taken in 2007 and 2014 as the reference years. The spatial results depicted a negative impact on land use efficiency during 2007 and 2014, showing negative HANPP changes for the whole region. The harvest and biomass losses through land conversion components are the leading causes of loss of land-use efficiency. Furthermore, the study depicted higher HANPP in 2014 than in 2007, representing 50% of NPP0 for all landcover classes concerning 2007. This performance was mainly related to the higher volume of harvested biomass for agriculture. In consequence, the cropland depicted the high HANPP followed by plantation. This performance highlights the strong positive correlation between the economic activities developed into the region. This finding constitutes the base for a better understanding of the main driving force influencing biomass productivity and a powerful metric for supporting the sustainable management of land use.

Keywords: human appropriation, land-use changes, land-use impact, net primary productivity

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5329 Understanding Co-Living Experience through University Residential Halls - A Pilot Study

Authors: Michelle W. T. Cheng, Yau Y.

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Hong Kong continues to be ranked as the least affordable housing market in the world, making co-living a feasible alternative in this high-density city. Although the number of co-living residences has increased in Hong Kong, co-living as a housing typology is still a new concept for many. Little research has been conducted on this new housing typology, let alone the co-living experience. To address this gap, this study targeted student residents in university residential halls as it is a more controlled environment (e.g., with established rules and guidelines regarding the use of communal facilitates and housing management) for studying co-living experiences in Hong Kong. To date, no research study has systematically identified anti-social behavior (ASB) in co-living spaces. Since ASB can be influenced by factors such as social norms and individual interpretation, it has an elastic definition that results in different levels of acceptance. Unlike other types of housing, co-living spaces can be potentially more influenced by the neighborhood as residents share more time and space. As a pilot study, this research targeted one university residential hall to examine student co-living experiences. To clarify, the research question is focused on identifying the social factors that impact the residential satisfaction of those who co-living in residential halls. Quantitative data (n=100) were collected via a structured questionnaire to measure the residential environment, including ASB, social neighboring, community attachment, and perceived hall management efficacy. The survey was distributed at the end of the academic year to ensure that respondents had at least one year of first-hand experience living in a co-living space. To gather qualitative data, follow-up focus group interviews were conducted with 16 participants who completed the survey. The semi-structured interviews aimed to elicit the participants' perspectives on their co-living experience. Through analyzing their co-living experiences, the researcher identified factors that affected their residential satisfaction and provided recommendations to enhance their co-living experience.

Keywords: co-living, university residential hall, anti-social behabiour, neighbour relationship, community attachement

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5328 Sustainable Ecological Agricultural Systems in Bangladesh: Environmental, Economic and Social Perspective of Compost

Authors: Protima Chakraborty

Abstract:

The sustainability of conventional agriculture in Bangladesh is under threat from the continuous degradation of land and water resources, and from declining yields due to indiscriminate use of agrochemicals. NASL (Northern Agro Services Limited) is pursuing efforts to promote ecological agriculture with emphasis on better use of organic fertilizer resources and the reduction of external inputs. This paper examines the sustainability of two production systems in terms of their environmental soundness, economic viability and social acceptability based on empirical data collected through making demonstration land cultivation, a household survey, soil sample analysis, observations and discussions with key informants. Twelve indicators were selected to evaluate sustainability. Significant differences were found between the two systems in crop diversification, soil fertility management, pests and diseases management, and use of agrochemicals & Organic Compost. However, significant variations were found in other indicators such as land-use pattern, crop yield and stability, risk and uncertainties, and food security. Although crop yield and financial return were found to be slightly higher in the ecological system, the economic return and value addition per unit of land show the positive difference of using compost rather than chemical fertilizer. The findings suggest that ecological agriculture has a tendency towards becoming ecologically, economically and socially more sound than conventional agriculture, as it requires considerably fewer agro-chemicals, adds more organic matter to the soil, provides balanced food, and requires higher local inputs without markedly compromising output and financial benefits. Broad-policy measures, including the creation of mass awareness of adverse health effects of agrochemical-based products, are outlined for the promotion of ecological agriculture.

Keywords: Bangladesh, compost, conventional agriculture, organic fertilizer, environmental sustainability, economic viability, social acceptability

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5327 The Effectiveness of Laughing Qigong for Women with Breast Cancer in Community

Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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5326 Spatial Mapping and Change Detection of a Coastal Woodland Mangrove Habitat in Fiji

Authors: Ashneel Ajay Singh, Anish Maharaj, Havish Naidu, Michelle Kumar

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Mangrove patches are the foundation species located in the estuarine land areas. These patches provide a nursery, food source and protection for numerous aquatic, intertidal and well as land-based organisms. Mangroves also help in coastal protection, maintain water clarity and are one of the biggest sinks for blue carbon sequestration. In the Pacific Island countries, numerous coastal communities have a heavy socioeconomic dependence on coastal resources and mangroves play a key ecological and economical role in structuring the availability of these resources. Fiji has a large mangrove patch located in the Votua area of the Ba province. Globally, mangrove population continues to decline with the changes in climatic conditions and anthropogenic activities. Baseline information through wetland maps and time series change are essential references for development of effective mangrove management plans. These maps reveal the status of the resource and the effects arising from anthropogenic activities and climate change. In this study, we used remote sensing and GIS tools for mapping and temporal change detection over a period of >20 years in Votua, Fiji using Landsat imagery. Landsat program started in 1972 initially as Earth Resources Technology Satellite. Since then it has acquired millions of images of Earth. This archive allows mapping of temporal changes in mangrove forests. Mangrove plants consisted of the species Rhizophora stylosa, Rhizophora samoensis, Bruguiera gymnorrhiza, Lumnitzera littorea, Heritiera littoralis, Excoecaria agallocha and Xylocarpus granatum. Change detection analysis revealed significant reduction in the mangrove patch over the years. This information serves as a baseline for the development and implementation of effective management plans for one of Fiji’s biggest mangrove patches.

Keywords: climate change, GIS, Landsat, mangrove, temporal change

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5325 Estimation of Snow and Ice Melt Contributions to Discharge from the Glacierized Hunza River Basin, Karakoram, Pakistan

Authors: Syed Hammad Ali, Rijan Bhakta Kayastha, Danial Hashmi, Richard Armstrong, Ahuti Shrestha, Iram Bano, Javed Hassan

Abstract:

This paper presents the results of a semi-distributed modified positive degree-day model (MPDDM) for estimating snow and ice melt contributions to discharge from the glacierized Hunza River basin, Pakistan. The model uses daily temperature data, daily precipitation data, and positive degree day factors for snow and ice melt. The model is calibrated for the period 1995-2001 and validated for 2002-2013, and demonstrates close agreements between observed and simulated discharge with Nash–Sutcliffe Efficiencies of 0.90 and 0.88, respectively. Furthermore, the Weather Research and Forecasting model projected temperature, and precipitation data from 2016-2050 are used for representative concentration pathways RCP4.5 and RCP8.5, and bias correction was done using a statistical approach for future discharge estimation. No drastic changes in future discharge are predicted for the emissions scenarios. The aggregate snow-ice melt contribution is 39% of total discharge in the period 1993-2013. Snow-ice melt contribution ranges from 35% to 63% during the high flow period (May to October), which constitutes 89% of annual discharge; in the low flow period (November to April) it ranges from 0.02% to 17%, which constitutes 11 % of the annual discharge. The snow-ice melt contribution to total discharge will increase gradually in the future and reach up to 45% in 2041-2050. From a sensitivity analysis, it is found that the combination of a 2°C temperature rise and 20% increase in precipitation shows a 10% increase in discharge. The study allows us to evaluate the impact of climate change in such basins and is also useful for the future prediction of discharge to define hydropower potential, inform other water resource management in the area, to understand future changes in snow-ice melt contribution to discharge, and offer a possible evaluation of future water quantity and availability.

Keywords: climate variability, future discharge projection, positive degree day, regional climate model, water resource management

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5324 Observing Sustainability: Case Studies of Chandigarh Boutiques and Their Textile Waste Reuse

Authors: Prabhdip Brar

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Since the ancient times recycling, reusing and upcycling has been strongly practiced in India. However, previously reprocess was common due to lack of resources and availability of free time, especially with women who were homemakers. The upward strategy of design philosophy and drift of sustainability is sustainable fashion which is also termed eco fashion, the aspiration of which is to craft a classification which can be supported ad infinitum in terms of environmentalism and social responsibility. The viable approach of sustaining fashion is part of the larger trend of justifiable design where a product is generated and produced while considering its social impact to the environment. The purpose of this qualitative research paper is to find out if the apparel design boutiques in Chandigarh, (an educated fashion-conscious city) are contributing towards making conscious efforts with the re-use of environmentally responsive materials to rethink about eco-conscious traditional techniques and socially responsible approaches of the invention. Observation method and case studies of ten renowned boutiques of Chandigarh were conducted to find out about the creativity of their waste management and social contribution. Owners were interviewed with open-ended questions to find out their understanding of sustainability. This paper concludes that there are many sustainable ideas existing within India from olden times that can be incorporated into modern manufacturing techniques. The results showed all the designers are aware of sustainability as a concept. In all practical purposes, a patch of fabric is being used for bindings or one over the other as surface ornamentation techniques. Plain Fabrics and traditional prints and fabrics are valued more by the owners for using on other garments. Few of them sort their leftover pieces according to basic colors. Few boutique owners preferred donating it to Non-Government organizations. Still, they have enough waste which is not utilized because of lack of time and labor. This paper discusses how the Indian traditional techniques still derive influences though design and techniques, making India one of the contributing countries to the sustainability of fashion and textiles.

Keywords: eco-fashion textile, sustainable textiles, sustainability in india, waste management

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5323 Human Pressure Threaten Swayne’s Hartebeest to Point of Local Extinction from the Savannah Plains of Nech Sar National Park, South Rift Valley, Ethiopia

Authors: Simon Shibru, Karen Vancampenhout, Jozef Deckers, Herwig Leirs

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We investigated the population size of the endemic and endangered Swayne’s Hartebeest (Alcelaphus buselaphus swaynei) in Nech Sar National Park from 2012 to 2014 and document the major threats why the species is on the verge of local extinction. The park was once known for its abundant density of Swayne’s Hartebeest. We used direct total count methods for a census. We administered semi-structured interviews and open-ended questionnaires with senior scouts who are the member of the local communities. Historical records were obtained to evaluate the population trends of the animals since 1974. The density of the animal decreased from 65 in 1974 to 1 individual per 100 km2 in 2014 with a decline of 98.5% in the past 40 years. The respondents agreed that the conservation status of the park was in its worst condition ever now with only 2 Swayne’s Hartebeest left, with a rapid decline from 4 individuals in 2012 and 12 individuals in 2009. Mainly hunting and habitat loss, but also the unsuitable season of reproduction and shortage of forage as minor factors were identified as threats for a local extinction of the Swayne’s Hartebeests. On the other hand, predation, fire, disease, and ticks were not considered a cause for the declining trend. Hunting happens mostly out of some kind of revenge since the local community thought that they were pushed out from the land because of the presence of Swayne's Hartebeest in the area. Respondents agreed that the revenge action of the local communities was in response to their unwillingness to be displaced from the park in 1982/3. This conflict situation is resulting from the exclusionary wildlife management policy of the country. We conclude that the human interventions in general and illegal hunting, in particular, pushed the Swayne’s Hartebeest to a point of local extinction. Therefore, we recommend inclusive wildlife management approach for continuing existence of the park together with its natural resources so that sustainable use of the resources is in place.

Keywords: hunting, habitat destruction, local extinction, Nech Sar National Park, Swayne’s Hartebeest

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5322 ANDASA: A Web Environment for Artistic and Cultural Data Representation

Authors: Carole Salis, Marie F. Wilson, Fabrizio Murgia, Cristian Lai, Franco Atzori, Giulia M. Orrù

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ANDASA is a knowledge management platform for the capitalization of knowledge and cultural assets for the artistic and cultural sectors. It was built based on the priorities expressed by the participating artists. Through mapping artistic activities and specificities, it enables to highlight various aspects of the artistic research and production. Such instrument will contribute to create networks and partnerships, as it enables to evidentiate who does what, in what field, using which methodology. The platform is accessible to network participants and to the general public.

Keywords: cultural promotion, knowledge representation, cultural maping, ICT

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5321 The Significance of Cultural Risks for Western Consultants Executing Gulf Cooperation Council Megaprojects

Authors: Alan Walsh, Peter Walker

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Differences in commercial, professional and personal cultural traditions between western consultants and project sponsors in the Gulf Cooperation Council (GCC) region are potentially significant in the workplace, and this can impact on project outcomes. These cultural differences can, for example, result in conflict amongst senior managers, which can negatively impact the megaproject. New entrants to the GCC often experience ‘culture shock’ as they attempt to integrate into their unfamiliar environments. Megaprojects are unique ventures with individual project characteristics, which need to be considered when managing their associated risks. Megaproject research to date has mostly ignored the significance of the absence of cultural congruence in the GCC, which is surprising considering that there are large volumes of megaprojects in various stages of construction in the GCC. An initial step to dealing with cultural issues is to acknowledge culture as a significant risk factor (SRF). This paper seeks to understand the criticality for western consultants to address these risks. It considers the cultural barriers that exist between GCC sponsors and western consultants and examines the cultural distance between the key actors. Initial findings suggest the presence to a certain extent of ethnocentricity. Other cultural clashes arise out of a lack of appreciation of the customs, practices and traditions of ‘the Other’, such as the need for avoiding public humiliation and the hierarchal significance rankings. The concept and significance of cultural shock as part of the integration process for new arrivals are considered. Culture shock describes the state of anxiety and frustration resulting from the immersion in a culture distinctly different from one's own. There are potentially substantial project risks associated with underestimating the process of cultural integration. This paper examines two distinct but intertwined issues: the societal and professional culture differences associated with expatriate assignments. A case study examines the cultural congruences between GCC sponsors and American, British and German consultants, over a ten-year cycle. This provides indicators as to which nationalities encountered the most profound cultural issues and the nature of these. GCC megaprojects are typically intensive fast track demanding ventures, where consultant turnover is high. The study finds that building trust-filled relationships is key to successful project team integration and therefore, to successful megaproject execution. Findings indicate that both professional and social inclusion processes have steep learning curves. Traditional risk management practice is to approach any uncertainty in a structured way to mitigate the potential impact on project outcomes. This research highlights cultural risk as a significant factor in the management of GCC megaprojects. These risks arising from high staff turnover typically include loss of project knowledge, delays to the project, cost and disruption in replacing staff. This paper calls for cultural risk to be recognised as an SRF, as the first step to developing risk management strategies, and to reduce staff turnover for western consultants in GCC megaprojects.

Keywords: western consultants in megaprojects, national culture impacts on GCC megaprojects, significant risk factors in megaprojects, professional culture in megaprojects

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5320 Environmental Risk Assessment of Mechanization Waste Collection Scheme in Tehran

Authors: Amin Padash, Javad Kazem Zadeh Khoiy, Hossein Vahidi

Abstract:

Purpose: The mechanization system for the urban services was implemented in Tehran City in the year 2004 to promote the collection of domestic wastes; in 2010, in order to achieve the objectives of the project of urban services mechanization and qualitative promotion and improve the urban living environment, sustainable development and optimization of the recyclable solid wastes collection systems as well as other dry and non-organic wastes and conformity of the same to the modern urban management methods regarding integration of the mechanized urban services contractors and recycling contractors and in order to better and more correct fulfillment of the waste separation and considering the success of the mechanization plan of the dry wastes in most of the modern countries. The aim of this research is analyzing of Environmental Risk Assessment of the mechanization waste collection scheme in Tehran. Case Study: Tehran, the capital of Iran, with the population of 8.2 million people, occupies 730 km land expanse, which is 4% of total area of country. Tehran generated 2,788,912 ton (7,641 ton/day) of waste in year 2008. Hospital waste generation rate in Tehran reaches 83 ton/day. Almost 87% of total waste was disposed of by placing in a landfill located in Kahrizak region. This large amount of waste causes a significant challenge for the city. Methodology: To conduct the study, the methodology proposed in the standard Mil-St-88213 is used. This method is an efficient method to examine the position in opposition to the various processes and the action is effective. The method is based on the method of Military Standard and Specialized in the military to investigate and evaluate options to locate and identify the strengths and weaknesses of powers to decide on the best determining strategy has been used. Finding and Conclusion: In this study, the current status of mechanization systems to collect waste and identify its possible effects on the environment through a survey and assessment methodology Mil-St-88213, and then the best plan for action and mitigation of environmental risk has been proposed as Environmental Management Plan (EMP).

Keywords: environmental risk assessment, mechanization waste collection scheme, Mil-St-88213

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5319 Rainwater Harvesting is an Effective Tool for City’s Storm Water Management and People’s Willingness to Install Rainwater Harvesting System in Buildings: A Case Study in Kazipara, Dhaka, Bangladesh

Authors: M. Abu Hanif, Anika Tabassum, Fuad Hasan Ovi, Ishrat Islam

Abstract:

Water is essential for life. Enormous quantities of water are cycled each year through hydrologic cycle but only a fraction of circulated water is available each year for human use. Dhaka, the capital of Bangladesh is the 19th mega city in the world with a population of over 14 million (World City Information, 2011). As a result the growth of urban population is increasing rapidly; the city is not able to manage with altering situations due to resource limitations and management capacity. Water crisis has become an acute problem faced by the inhabitants of Dhaka city. It is found that total water demand in Dhaka city is 2,240 million liter per day (MLD) whereas supply is 2,150 (MLD). According to Dhaka Water Supply and Sewerage Authority about 87 percent of this supply comes from groundwater resources and rest 13 percent from surface water. According to Dhaka Water Supply and Sewerage Authority it has been found that the current groundwater depletion rate is 3.52 meter per year. Such a fast depletion of the water table will result in intrusion of southern saline water into the groundwater reservoir, depriving this mega city of pure drinking water. This study mainly focus on the potential of Rainwater Harvesting System(RWHS) in Kazipara area of Dhaka city, determine the perception level of local people in installation of rainwater harvesting system in their building and identify the factors regarding willingness of owner in installing rainwater harvesting system. As most of the residential area of Dhaka city is unplanned with small plots, Kazipara area has been chosen as study area which depicts similar characteristics. In this study only roof top area is considered as catchment area and potential of rainwater harvesting has been calculated. From the calculation it is found that harvested rainwater can serve the 66% of demand of water for toilet flushing and cleaning purposes for the people of Kazipara. It is also observed that if only rooftop rainwater harvesting applied to all the structures of the study area then two third of surface runoff would be reduced than present surface runoff. In determining the perception of local people only owners of the buildings were. surveyed. From the questionnaire survey it is found that around 75% people have no idea about the rainwater harvesting system. About 83% people are not willing to install rainwater harvesting system in their dwelling. The reasons behind the unwillingness are high cost of installation, inadequate space, ignorance about the system, etc. Among 16% of the willing respondents who are interested in installing RWHS system, it was found that higher income, bigger size of buildings are important factors in willingness of installing rainwater harvesting system. Majority of the respondents demanded for both technical and economical support to install the system in their buildings. Government of Bangladesh has taken some initiatives to promote rainwater harvesting in urban areas. It is very much necessary to incorporate rainwater harvesting device and artificial recharge system in every building of Dhaka city to make Dhaka city self sufficient in water supply management and to solve water crisis problem of megacity like as Dhaka city.

Keywords: rainwater harvesting, water table, willingness, storm water

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5318 The Influencing Factors of Export Performance Amongst Halal Small and Medium-Sized Enterprises (SMEs) in Malaysia

Authors: Shanorfizah Mohd Safar, Shaizatulaqma Kamalul Ariffin

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Internationalization of halal small and medium-sized enterprises (SMEs) is necessary for SMEs to become more involved in regional trade and business cooperation. By internationalization, SMEs' profit can increase, and market expansion of SMEs is basic for rising economies of countries to contend all around in the halal industry globally. There are several modes of internationalization; exporting is one of the first steps for internationalization with less capital needed. The study examines the influential factors of export performance amongst halal SMEs in Malaysia. Specifically, this study examines the positive and significant relationships amongst human capital, managerial capability, Halal Assurance Management System (HAMS), digital transformation, government support, and networking capability on halal SMEs' export performance toward SMEs' competitive advantage. In addition, this study will examine innovation capabilities as a moderator in the relationship between independence variables and competitive advantage. Competitive advantage is the most compelling perspective that drives the export performance of halal SMEs in Malaysia. A quantitative method will be used: an online questionnaire survey distributed through emails and face-to-face toward selected halal-certificated SMEs registered in JAKIM, MATRADE website and SME Corp Malaysia website. Nevertheless, whether the halal SMEs practice global business, they will still be the potential respondents. The data were examined and obtained using the statistical software Smart PLS. The analysis used is reliability, correlation, and regression analysis to meet the research objectives. This study contributes significantly to the theory by integrating Resource Based View (RBV) theory, Technology–Organization–Environment (TOE) framework and Networking theory. In addition, this research extends the RBV by extending a variable, the Halal Assurance Management System. This study also examines a moderating role of innovation capabilities in the framework and competitive advantage as a mediator. This research aims to analyze the factors that will impact the internationalization of halal SMEs.

Keywords: internationalization, halal SMEs, competitive advantage, export performance

Procedia PDF Downloads 53
5317 Ethnographic Approach for Street Performers as Cultural Entrepreneurs

Authors: Marta Polec

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The paper outlines the problem of street performances in Poland in context of humanistic management studies. The Author perceives activity of street performers of various art and entertainment actions as a phenomenon of informal organizing, self-management and cultural entrepreneurship in urban sphere. What has to be highlighted, performative street art is not currently being an interest of scientific research as often as visual street art. That is why the Author indicates the need of including new approaches of humanistic and social disciplines, especially different management paradigms, in examining various aspects of the activity of street performers. The paper shows the results of ethnographic study based on anthropological interviews, participant observation non-participant observation, shadowing, field notes, audiovisual documentation and text analysis. The fieldwork was performed since 2014 in the old towns and major areas of several the most popular touristic Polish cities, mainly in Gdansk, Cracow, Lublin, Warsaw, and Wroclaw. The research group included street artists of various kinds of performative arts. The investigation was prepared within the ‘Ethnography of the informal organization of street artists in Poland’ project, as a part of Diamond Grant programme (the Ministry of Science and Higher Education in Poland). The first conclusion of the study is that street shows form a way of artistic self-realization and unusual promotion of creative activity in public space. As street performance helps to make some extra money and even earning a living in general, it seems to constitute a new profession. Street performers as a specific environment usually know each other and in many ways cooperate informally to carry on their shows successfully. Secondly, this activity brings plenty benefits for the local communities. Street shows attract inhabitants and tourists quite often by appealing to intangible cultural heritage and memorializing it. They also pose a space for discussing current social issues. Moreover, they disseminate relatively inexpensive public access to culture, but also state an example of social courage of choosing unconventional occupation. Finally, currently being used terms of street performers/street artists/buskers in different languages, as instance as in Polish, are still fluent and undefined. As a consequence, it brings implications for existing common knowledge about street performers, for example in establishing and implementing public policies. It impedes solving many ethical and social dilemmas concerning the question of performances in public sphere, which in some cases seem to be related to, as: children’s work, beggars’ practices or question of harmony of public space. The main aim of this study was to expose street performances as yet undefined profession, including different possibilities of interacting with the audience, based on providing impressions, experiences and memories. Although the issue seems to be current and common, in indicated context there is a lack of equal and unified approach of managing urban sphere, which in practice differs both in informal rules and official policies concerning street performances not only in cities in Poland, but also generally in Europe.

Keywords: informal, organizing, street performance, urban sphere

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5316 Assessment of Attractency of Bactrocera Zonata and Bactrocera dorsalis (Diptera:Tephritidae) to Different Biolure Phagostimulant-Mixtures

Authors: Muhammad Dildar Gogi, Muhammad Jalal Arif, Muhammad Junaid Nisar, Mubashir Iqbal, Waleed Afzal Naveed, Muhammad Ahsan Khan, Ahmad Nawaz, Muhammad Sufian, Muhammad Arshad, Amna Jalal

Abstract:

Fruit flies of Bactrocera genus cause heavy losses in fruits and vegetables globally and insecticide-application for their control creates issues of ecological backlash, environmental pollution, and food safety. There is need to explore alternatives and food-baits application is considered safe for the environment and effective for fruit fly management. Present experiment was carried out to assess the attractancy of five phagostimulant-Mixtures (PHS-Mix) prepared by mixing banana-squash, mulberry, protein-hydrolysate and molasses with some phagostimulant-lure sources including beef extract, fish extract, yeast, starch, rose oil, casein and cedar oil in five different ratios i.e., PHS-Mix-1 (1 part of all ingredients), PHS-Mix-2 (1 part of banana with 0.75 parts of all other ingredients), PHS-Mix-3 (1 part of banana with 0.5 parts of all other ingredients), PHS-Mix-4 (1 part of banana with 0.25 parts of all other ingredients) and PHS-Mix-5 (1 part of banana with 0.125 parts of all other ingredients). These were evaluated in comparison with a standard (GF-120). PHS-Mix-4 demonstrated 40.5±1.3-46.2±1.6% AI for satiated flies (class-II i.e., moderately attractive) and 59.5±2.0-68.6±3.0% AI for starved flies (class-III i.e., highly attractive) for both B. dorsalis and B. zonata in olfactometric study while the same exhibited 51.2±0.53% AI (class-III i.e., highly attractive) for B. zonata and 45.4±0.89% AI (class-II i.e., moderately attractive) for B. dorsalis in field study. PHS-Mix-1 proved non-attractive (class-I) and moderately attractive (class-II) phagostimulant in olfactometer and field studies, respectively. PHS-Mix-2 exhibited moderate attractiveness for starved lots in olfactometer and field-lot in field studies. PHS-Mix-5 proved non-attractive to starved and satiated lots of B. zonata and B. dorsalis females in olfactometer and field studies. Overall PHS-Mix-4 proved better phagostimulant-mixture followed by PHS-Mix-3 which was categorized as class-II (moderately attractive) phagostimulant for starved and satiated lots of female flies of both species in olfactometer and field studies; hence these can be exploited for fruit fly management.

Keywords: attractive index, field conditions, olfactometer, Tephritid flies

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5315 Impact of the Non-Energy Sectors Diversification on the Energy Dependency Mitigation: Visualization by the “IntelSymb” Software Application

Authors: Ilaha Rzayeva, Emin Alasgarov, Orkhan Karim-Zada

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This study attempts to consider the linkage between management and computer sciences in order to develop the software named “IntelSymb” as a demo application to prove data analysis of non-energy* fields’ diversification, which will positively influence on energy dependency mitigation of countries. Afterward, we analyzed 18 years of economic fields of development (5 sectors) of 13 countries by identifying which patterns mostly prevailed and which can be dominant in the near future. To make our analysis solid and plausible, as a future work, we suggest developing a gateway or interface, which will be connected to all available on-line data bases (WB, UN, OECD, U.S. EIA) for countries’ analysis by fields. Sample data consists of energy (TPES and energy import indicators) and non-energy industries’ (Main Science and Technology Indicator, Internet user index, and Sales and Production indicators) statistics from 13 OECD countries over 18 years (1995-2012). Our results show that the diversification of non-energy industries can have a positive effect on energy sector dependency (energy consumption and import dependence on crude oil) deceleration. These results can provide empirical and practical support for energy and non-energy industries diversification’ policies, such as the promoting of Information and Communication Technologies (ICTs), services and innovative technologies efficiency and management, in other OECD and non-OECD member states with similar energy utilization patterns and policies. Industries, including the ICT sector, generate around 4 percent of total GHG, but this is much higher — around 14 percent — if indirect energy use is included. The ICT sector itself (excluding the broadcasting sector) contributes approximately 2 percent of global GHG emissions, at just under 1 gigatonne of carbon dioxide equivalent (GtCO2eq). Ergo, this can be a good example and lesson for countries which are dependent and independent on energy, and mainly emerging oil-based economies, as well as to motivate non-energy industries diversification in order to be ready to energy crisis and to be able to face any economic crisis as well.

Keywords: energy policy, energy diversification, “IntelSymb” software, renewable energy

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5314 Challenges to Quality Primary Health Care in Saudi Arabia and Potential Improvements Implemented by Other Systems

Authors: Hilal Al Shamsi, Abdullah Almutairi

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Introduction: As primary healthcare centres play an important role in implementing Saudi Arabia’s health strategy, this paper offers a review of publications on the quality of the country’s primary health care. With the aim of deciding on solutions for improvement, it provides an overview of healthcare quality in this context and indicates barriers to quality. Method: Using two databases, ProQuest and Scopus, data extracted from published articles were systematically analysed for determining the care quality in Saudi primary health centres and obstacles to achieving higher quality. Results: Twenty-six articles met the criteria for inclusion in this review. The components of healthcare quality were examined in terms of the access to and effectiveness of interpersonal and clinical care. Good access and effective care were identified in such areas as maternal health care and the control of epidemic diseases, whereas poor access and effectiveness of care were shown for chronic disease management programmes, referral patterns (in terms of referral letters and feedback reports), health education and interpersonal care (in terms of language barriers). Several factors were identified as barriers to high-quality care. These included problems with evidence-based practice implementation, professional development, the use of referrals to secondary care and organisational culture. Successful improvements have been implemented by other systems, such as mobile medical units, electronic referrals, online translation tools and mobile devices and their applications; these can be implemented in Saudi Arabia for improving the quality of the primary healthcare system in this country. Conclusion: The quality of primary health care in Saudi Arabia varies among the different services. To improve quality, management programmes and organisational culture must be promoted in primary health care. Professional development strategies are also needed for improving the skills and knowledge of healthcare professionals. Potential improvements can be implemented to improve the quality of the primary health system.

Keywords: quality, primary health care, Saudi Arabia, health centres, general medical

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5313 Dermatomyositis: It is Not Always an Allergic Reaction

Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

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Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

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5312 Management of Myofascial Temporomandibular Disorder in Secondary Care: A Quality Improvement Project

Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

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Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: myofascial, quality Improvement, PDSA, TMD

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5311 Improving Productivity in a Glass Production Line through Applying Principles of Total Productive Maintenance (TPM)

Authors: Omar Bataineh

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Total productive maintenance (TPM) is a principle-based method that aims to get a high-level production with no breakdowns, no slow running and no defects. Key principles of TPM were applied in this work to improve the performance of the glass production line at United Beverage Company in Kuwait, which is producing bottles of soft drinks. Principles such as 5S as a foundation for TPM implementation, developing a program for equipment management, Cause and Effect Analysis (CEA), quality improvement, training and education of employees were employed. After the completion of TPM implementation, it was possible to increase the Overall Equipment Effectiveness (OEE) from 23% to 40%.

Keywords: OEE, TPM, FMEA, CEA

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5310 Developing a GIS-Based Tool for the Management of Fats, Oils, and Grease (FOG): A Case Study of Thames Water Wastewater Catchment

Authors: Thomas D. Collin, Rachel Cunningham, Bruce Jefferson, Raffaella Villa

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Fats, oils and grease (FOG) are by-products of food preparation and cooking processes. FOG enters wastewater systems through a variety of sources such as households, food service establishments, and industrial food facilities. Over time, if no source control is in place, FOG builds up on pipe walls, leading to blockages, and potentially to sewer overflows which are a major risk to the Environment and Human Health. UK water utilities spend millions of pounds annually trying to control FOG. Despite UK legislation specifying that discharge of such material is against the law, it is often complicated for water companies to identify and prosecute offenders. Hence, it leads to uncertainties regarding the attitude to take in terms of FOG management. Research is needed to seize the full potential of implementing current practices. The aim of this research was to undertake a comprehensive study to document the extent of FOG problems in sewer lines and reinforce existing knowledge. Data were collected to develop a model estimating quantities of FOG available for recovery within Thames Water wastewater catchments. Geographical Information System (GIS) software was used in conjunction to integrate data with a geographical component. FOG was responsible for at least 1/3 of sewer blockages in Thames Water waste area. A waste-based approach was developed through an extensive review to estimate the potential for FOG collection and recovery. Three main sources were identified: residential, commercial and industrial. Commercial properties were identified as one of the major FOG producers. The total potential FOG generated was estimated for the 354 wastewater catchments. Additionally, raw and settled sewage were sampled and analysed for FOG (as hexane extractable material) monthly at 20 sewage treatment works (STW) for three years. A good correlation was found with the sampled FOG and population equivalent (PE). On average, a difference of 43.03% was found between the estimated FOG (waste-based approach) and sampled FOG (raw sewage sampling). It was suggested that the approach undertaken could overestimate the FOG available, the sampling could only capture a fraction of FOG arriving at STW, and/or the difference could account for FOG accumulating in sewer lines. Furthermore, it was estimated that on average FOG could contribute up to 12.99% of the primary sludge removed. The model was further used to investigate the relationship between estimated FOG and number of blockages. The higher the FOG potential, the higher the number of FOG-related blockages is. The GIS-based tool was used to identify critical areas (i.e. high FOG potential and high number of FOG blockages). As reported in the literature, FOG was one of the main causes of sewer blockages. By identifying critical areas (i.e. high FOG potential and high number of FOG blockages) the model further explored the potential for source-control in terms of ‘sewer relief’ and waste recovery. Hence, it helped targeting where benefits from implementation of management strategies could be the highest. However, FOG is still likely to persist throughout the networks, and further research is needed to assess downstream impacts (i.e. at STW).

Keywords: fat, FOG, GIS, grease, oil, sewer blockages, sewer networks

Procedia PDF Downloads 190