Search results for: schedule risk management

Authors: Babawale Akin Adeyemi, Esan Temitayo, Adeyemi Olabisi Omowumi

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The paper analyzed waste disposal system in Akure, Ondo State using GIS techniques. Specifically, the study identified the spatial distribution of collection points and existing dumpsite; evaluated the accessibility of waste collection points and their proximity to each other with the view of enhancing better performance of the waste disposal system. Data for the study were obtained from both primary and secondary sources. Primary data were obtained through the administration of questionnaire. From field survey, 35 collection points were identified in the study area. 10 questionnaires were administered around each collection point making a total of 350 questionnaires for the study. Also, co-ordinates of each collection point were captured using a hand-held Global Positioning System (GPS) receiver which was used to analyze the spatial distribution of collection points. Secondary data used include administrative map collected from Akure South Local Government Secretariat. Data collected was analyzed using the GIS analytical tools which is neighborhood function. The result revealed that collection points were found in all parts of Akure with the highest concentration around the central business district. The study also showed that 80% of the collection points enjoyed efficient waste service while the remaining 20% does not. The study further revealed that most collection points in the core of the city were in close proximity to each other. In conclusion, the paper revealed the capability of Geographic Information System (GIS) as a technique in management of waste collection and disposal technique. The application of Geographic Information System (GIS) in the evaluation of the solid waste management in Akure is highly invaluable for the state waste management board which could also be beneficial to other states in developing a modern day solid waste management system. Further study on solid waste management is also recommended especially for updating of information on both spatial and non-spatial data.

Keywords: assessment, geospatial, system, waste disposal

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Authors: Asaiel Mubark Al Hadi

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Background: A frequent anorectal condition known as hemorrhoids, sometimes known as piles, is characterized by a weakening of the anal cushion and the supporting tissue as well as spasms of the internal sphincter. Hemorrhoids are most frequently identified by painless bright red bleeding, prolapse, annoying grape-like tissue prolapse, itching, or a combination of symptoms. digital rectal examination (DRE) and anoscope are used to diagnose it. Constipation, a low-fiber diet, a high body- mass index (BMI), pregnancy, and a reduced physical activity are among the factors that are typically thought to increase the risk of hemorrhoids. Golighers is the most commonly used hemorrhoid classification scheme It is 4 degrees, which determines the degree of the event. The purpose of this study is to assess knowledge and awareness level of the causes and stages of Hemorrhoids in the public of Saudi Arabia. Method: This cross-sectional study was conducted in the Saudi Arabia between Oct 2022- Dec 2022. The study group included at least 384 aged above 18 years. The outcomes of this study were analyzed using the SPSS program using a pre-tested questionnaire. Results: The study included 1410 participants, 69.9% of them were females and 30.1% were males. 53.7% of participants aged 20- 30 years old. 17% of participants had hemorrhoids and 42% had a relative who had hemorrhoids. 42.8% of participants could identify stage 1 of hemorrhoids correctly, 44.7% identified stage 2 correctly, 46.7% identified stage 3 correctly and 58.1% identified stage 4 correctly. Only 28.9% of participants had high level of knowledge about hemorrhoids, 62.7% had moderate knowledge and 8.4% had low knowledge. Conclusion: In conclusion, Saudi general population has poor knowledge of hemorrhoids, their causes and their management approach. There was a significant association between knowledge scores of hemorrhoids with age, gender, residence area and employment.

Keywords: hemorrhoids, external hemorrhoid, internal hemorrhoid, anal fissure, hemorrhoid stages, prolapse, rectal bleeding

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Authors: Hamideh Sadat Zekri, Seyed Mojtaba Hosseinalipour, Mohammadreza Hafezi

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Nowadays, an organization cannot usually overcome all tasks singly due to the increasing complexity and vast expanse of projects, increment in uncertainty of activities, fast advances in technology, advent and influence of various factors in decision-making and implication of projects, and competitive atmosphere of different affairs. Thus, firms proceed to outsource the tasks to subcontractors. Nevertheless, large Iranian contracting companies suffer from extra consumed costs and time owing to conflicts between the activities of suppliers and subcontractors. The paucity of coordination in planning and execution, scarcity of coordination among suppliers, subcontractors, and the main contractor during the implementation of construction activities and also the lack of proper management of the aforesaid situation result in the growth of contradictions, number of claims, and legal issues in a project and consequently impose enormous expenses on those companies. Regarding the prosperity of supply chain management in other industries, its importance is increasingly getting appreciated in the field of construction. The ultimate aim of supply chain management is an effective delivery of the best value for customers, which is achievable by encouraging the members to interact and collaborate. In the present research, there was an effort to obtain a set of relevant challenges in the managing of subcontractors by identifying the main contractors and subcontractors and their role in the execution of projects and the supply chain management in the construction industry. Then, some of those challenges were selected in accordance with the views of industry professionals and academic experts. In the next step, a questionnaire was prepared and completed based on the analytic hierarchy process (AHP) and the challenges were prioritized. When it comes to subcontractors, the findings of the research demonstrate that difficulties in timely payments, alterations in approved drawings and the lack of rectification of job after completion by the subcontractor, paucity of a predetermined and legal process for qualifications of subcontractors, neglecting the supply chain processes in material procurement from producers, and delays in delivery of works by a subcontractor are the most significant problems. Finally, some solutions for encountering, eradicating, or reducing of mentioned problems are presented in accordance with previous studies and a survey from specialists.

Keywords: main contractors, subcontractors, supply chain management, construction supply chain, analytic hierarchy process, solution

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Authors: Jonathan A. Akinwale, Ibukun J. Agotola

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There is a need to rethink how technology is being disseminated to end users in order to ensure wide adoption and utilisation. Aflasafe bio-control was developed to combat aflatoxin in maize to ensure food safety for the end users. This study was designed to assess how the pull mechanism is enhancing the utilisation of this proven technology among maize farmers in Oyo State, Nigeria. The study determines the awareness of farmers on Aflasafe, sources of purchase of Aflasafe, incentives towards the usage of Aflasafe, constraints to farmers’ utilisation and factors influencing farmers’ utilisation of Aflasafe bio-control measures. Respondents were selected using a multi-stage sampling procedure. Data were collected from respondents through interview schedule and analyzed using descriptive statistics (means, frequencies, and percentages) and inferential statistics (Pearson Product Moment Correlation and regression analysis). The result showed that 89% of the farmers indicated implementers as the outlet for the purchase of Aflasafe. Also, premium payment and provision of technical assistance were the highly ranked incentives to the utilisation of Aflasafe among the farmers. The study also revealed that the major constraints face by respondents were low access to credit facility, inadequate sources of purchase, and lack of storage facilities. A little above half (54%) of the farmers were found to have fully utilized Aflasafe in maize production. Pearson Product Moment Correlation (PPMC) analysis revealed that there was a significant correlation between incentives and utilisation of Aflasafe (r-value=0.274; p ≤ 0.01). The result of the regression analysis indicated maize production experience (β=0.572), output (β=0.531), years of formal education (β=0.404) and household size (β=0.391) as the leading factors influencing farmers utilisation of Aflasafe bio-control in maize production. The study, therefore, recommends that governments and non-governmental organisations should be interested in making Aflasafe available to the maize farmers either through loan provision or price subsidy.

Keywords: Aflasafe bio-control, maize production, production incentives, pull mechanism, utilisation

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Authors: Raymond Treacy, Paul Humphreys, Ronan McIvor, Trevor Cadden, Alan McKittrick

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This study employed event study methodology to examine the role of institutions, resources and dynamic capabilities in the relationship between the Environmental Management System ISO 14001 adoption and firm performance. Utilising financial data from 140 ISO 14001 certified firms and 320 non-certified firms, the results of the study suggested that the UK and Irish manufacturers were not implementing ISO 14001 solely to gain legitimacy. In contrast, the results demonstrated that firms were fully integrating the ISO 14001 standard within their operations as certified firms were able to improve both financial and operating performance when compared to non-certified firms. However, while there were significant and long lasting improvements for employee productivity, manufacturing cost efficiency, return on assets and sales turnover, the sample firms operating cycle and fixed asset efficiency displayed evidence of diminishing returns in the long-run, underlying the observation that no operating advantage based on incremental improvements can be everlasting. Hence, there is an argument for investing in dynamic capabilities which help renew and refresh the resource base and help the firm adapt to changing environments. Indeed, the results of the regression analysis suggest that dynamic capabilities for innovation acted as a moderator in the relationship between ISO 14001 certification and firm performance. This, in turn, will have a significant and symbiotic influence on sustainability practices within the participating organisations. The study not only provides new and original insights, but demonstrates pragmatically how firms can take advantage of environmental management systems as a moderator to significantly enhance firm performance. However, while it was shown that firm innovation aided both short term and long term ROA performance, adaptive market capabilities only aided firms in the short-term at the marketing strategy deployment stage. Finally, the results have important implications for firms operating in an economic recession as the results suggest that firms should scale back investment in R&D while operating in an economic downturn. Conversely, under normal trading conditions, consistent and long term investments in R&D was found to moderate the relationship between ISO 14001 certification and firm performance. Hence, the results of the study have important implications for academics and management alike.

Keywords: supply chain management, environmental management systems, quality management, sustainability, firm performance

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Authors: Firas A. Al Laban, Mohamed Chabi, Sammani Danwawu Abdullahi

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There are a real needs to integrate types of Open Educational Resources (OER) with an intelligent system to extract information and knowledge in the semantic searching level. Those needs raised because most of current learning standard adopted web based learning and the e-learning systems does not always serve all educational goals. Semantic Web systems provide educators, students, and researchers with intelligent queries based on a semantic knowledge management learning system. An ontology-based learning system is an advanced system, where ontology plays the core of the semantic web in a smart learning environment. The objective of this paper is to discuss the potentials of ontologies and mapping different kinds of ontologies; heterogeneous or homogenous to manage and control different types of Open Educational Resources. The important contribution of this research is to approach a methodology uses logical rules and conceptual relations to map between ontologies of different educational resources. We expect from this methodology to establish for an intelligent educational system supporting student tutoring, self and lifelong learning system.

Keywords: knowledge management systems, ontologies, semantic web, open educational resources

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Authors: Sunitha Thappa

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Business environment is a set of complex interdependent dimensions that corporates have to always be vigil in identifying the influential waves. Over the year business environment has evolved into a basket of uncertainties. Every organization strives to counter this dynamic nature of business environment by recurrently evaluating the primary and support activities of its value chain. This has led to companies redesigning their business models, reinvent business processes and operating procedure on unremitting basis. A few specific issues that are placed before the present day managers are breaking down the functional interpretation of any challenge that organizations confronts, reduction in organizational hierarchy and tackling the components of the value chain to retain their competitive advantage. It is how effectively managers detect the changes and swiftly reorient themselves to these changes that define their success or failure. Given the complexity of decision making in this dynamic environment, two important question placed before the B-schools of today. Firstly, are they grooming and nurturing managerial talent proficient enough to thrive in this multifaceted business environment? Secondly, are the management graduates walking through their portals, able to view challenges from a cross-functional perspective with emphasis to customer and process rather than hierarchy and functions. This paper focuses on the need for a process oriented approach to management education.

Keywords: management education, pedagogy, functional, process

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Authors: Ireen Manase Kabembo, Patrick Chanda

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Background: Substance use disorders are among the chronic conditions that affect all age groups. Worldwide, there is an increase in young people affected by SUDs, which implies that more family members are transitioning into the caregiver role. Family caregivers play a buffering role in the formal healthcare system due to their involvement in caring for persons with acute and chronic conditions in the home setting. Family carers of youth with problematic alcohol and marijuana use experience myriad challenges in managing daily care for this medically vulnerable group. In addition, the poor health-seeking behaviours of youth with SUDs characterized by eluding treatment and runaway tendencies coupled with the effects of the pandemic made caregiving a daunting task for most family caregivers. Issues such as limited and unavailable psychotropic medications, social stigma and discrimination, financial hurdles, systemic barriers in adolescent and young adult mental healthcare services, and the lack of a perceived vulnerability to Covid-19 by youth with SUDs are experiences of family caretakers. Methods: A qualitative study with 30 family caregivers of youth aged 16-24 explored their lived experiences and subjective meanings using two in-depth semi-structured interviews, a caregiving timeline, and participant observation. Findings: Results indicate that most family caregivers had challenges managing care for treatment elusive youth, let alone having them adhere to Covid-19 regulations. However, youth who utilized healthcare services and adhered to treatment regimens had positive outcomes and sustained recovery. The effects of the pandemic, such as job losses and the closure of businesses, further exacerbated the financial challenges experienced by family caregivers, making it difficult to purchase needed medications and daily necessities for the youth. The unabated stigma and discrimination of families of substance-dependent youth in Zambian communities further isolated family caregivers, leaving them with limited support. Conclusion: Since young people with SUDs have a compromised mental capacity due to the cognitive impairments that come with continued substance abuse, they often have difficulties making sound judgements, including the need to utilize SUD recovery services. Also, their tendency to not adhere to the Covid-19 pandemic requirements places them at a higher risk for adverse health outcomes in the (post) pandemic era. This calls for urgent implementation of robust youth mental health services that address prevention and recovery for these emerging adults grappling with substance use disorders. Support for their family caregivers, often overlooked, cannot be overemphasized.

Keywords: chronic care management, Covid-19 pandemic, family caregivers, youth with substance use disorders

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Authors: Iwuchukwu J. C., Ekeh G. Madukwe, M. C., Asadu A. N.

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Melon has significant importance of easy to plant, early maturing, low nutrient requirement and high yielding. Yet many melon farmers in the study area are either diversifying or abandoning this enterprise probably because of lack of agricultural knowledge/information and consequent reduction in output and income. The study was therefore carried out to asses effects of agricultural information on income of melon farmers in Enugu-Ezike Agricultural zone of Enugu state, Nigeria. Three blocks, nine circles and ninety melon farmers who were purposively selected constituted the sample for the study..Data were collected with interview schedule. Percentage and chart were used to present some of the data while some were analysed with mean score and correlation. The findings reveal that. average annual income of these respondents from melon was about seven thousand and five hundred Naira (approximately forty five Dollars). while their total average monthly income (income from melon and other sources) was about one thousand and two hundred Naira (approximately seven Dollars). About 42.% and 62% of the respondents in their respective order did not receive information on agricultural matters and melon production. Among the minority that received information on melon production, most of them sourced it from neighbours/friends/relatives. Majority of the respondents needed information on how to plant melon through interpersonal contact (face to face) using Igbo language as medium of communication and extension agent as teacher or resource person. The study also reveal a significant and positive relationship between number of times respondents received information on agriculture and their total monthly income. There was also a strong, positive and significant relationship between number of times respondents received information on melon and their annual income on melon production. The study therefore recommends that governmental and non-governmental organizations/ institutions should strengthen these farmers access to information on agriculture and melon specifically so as to boost their output and income.

Keywords: farmers, income, information, melon

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Authors: Maryam Kheirollahpour, Mahmoud Danaee, Amir Faisal Merican, Asma Ahmad Shariff

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Background: The presence of nonlinearity among the risk factors of eating behavior causes a bias in the prediction models. The accuracy of estimation of eating behaviors risk factors in the primary prevention of obesity has been established. Objective: The aim of this study was to explore the potential of a hybrid model of structural equation modeling (SEM) and Artificial Neural Networks (ANN) to predict eating behaviors. Methods: The Partial Least Square-SEM (PLS-SEM) and a hybrid model (SEM-Artificial Neural Networks (SEM-ANN)) were applied to evaluate the factors affecting eating behavior patterns among university students. 340 university students participated in this study. The PLS-SEM analysis was used to check the effect of emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) on different categories of eating behavior patterns (EBP). Then, the hybrid model was conducted using multilayer perceptron (MLP) with feedforward network topology. Moreover, Levenberg-Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The Tangent/sigmoid function was used for the input layer while the linear function applied for the output layer. The coefficient of determination (R²) and mean square error (MSE) was calculated. Results: It was proved that the hybrid model was superior to PLS-SEM methods. Using hybrid model, the optimal network happened at MPLP 3-17-8, while the R² of the model was increased by 27%, while, the MSE was decreased by 9.6%. Moreover, it was found that which one of these factors have significantly affected on healthy and unhealthy eating behavior patterns. The p-value was reported to be less than 0.01 for most of the paths. Conclusion/Importance: Thus, a hybrid approach could be suggested as a significant methodological contribution from a statistical standpoint, and it can be implemented as software to be able to predict models with the highest accuracy.

Keywords: hybrid model, structural equation modeling, artificial neural networks, eating behavior patterns

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Authors: Harveen Kaur Tatla, Parisa Niknejad, Rajender Gupta, Bipro Ranjan Dhar, Mohd. Adana Khan

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Sewage sludge management presents a pressing challenge in the realm of wastewater treatment, calling for sustainable and efficient solutions. This study explores the integration of Hydrothermal Liquefaction (HTL) and Anaerobic Digestion (AD) as a promising approach to address the complexities associated with sewage sludge treatment. The integration of these two processes offers a complementary and synergistic framework, allowing for the mitigation of inherent limitations, thereby enhancing overall efficiency, product quality, and the comprehensive utilization of sewage sludge. In this research, we investigate the optimal sequencing of HTL and AD within the treatment framework, aiming to discern which sequence, whether HTL followed by AD or AD followed by HTL, yields superior results. We explore a range of HTL working temperatures, including 250°C, 300°C, and 350°C, coupled with residence times of 30 and 60 minutes. To evaluate the effectiveness of each sequence, a battery of tests is conducted on the resultant products, encompassing Total Ammonia Nitrogen (TAN), Chemical Oxygen Demand (COD), and Volatile Fatty Acids (VFA). Additionally, elemental analysis is employed to determine which sequence maximizes energy recovery. Our findings illuminate the intricate dynamics of HTL and AD integration for sewage sludge management, shedding light on the temperature-residence time interplay and its impact on treatment efficiency. This study not only contributes to the optimization of sewage sludge treatment but also underscores the potential of integrated processes in sustainable waste management strategies. The insights gleaned from this research hold promise for advancing the field of wastewater treatment and resource recovery, addressing critical environmental and energy challenges.

Keywords: Anaerobic Digestion (AD), aqueous phase, energy recovery, Hydrothermal Liquefaction (HTL), sewage sludge management, sustainability.

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Authors: Jaeyoung Lee, Minji Je

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Objectives: The adolescents not attending school are named out-of-school adolescents. They are more vulnerable to health management and are likely to be exposed to a number of risk factors. This study was conducted to investigate the problem behavior of out-of-school adolescents and analyze the difference caused by gender. Methods: In this study, the problem behaviors of out-of-school adolescents, the vulnerable class, were defined in 8 types and based on this definition, the survey on run away from home, drop out, prostitution, violence, internet game addiction, theft, drug addiction, and smoking was conducted. The study was conducted in a total of 507 out-of-school adolescents, including 342 males, and 165 females. The type, frequency and start time of the 8 problem behaviors were identified. The collected data were analyzed with chi-square test and t-test using SPSS statistics 22. Results: Among the problem behaviors of the subjects, violence ( =17.41, p < .001), internet game addiction ( =16.14, p < .001), theft ( =22.48, p < .001), drug addiction ( =4.17, p=.041), and smoking ( =3.90, p=.048) were more significantly high in male out-of-school adolescents than female out-of-school adolescents. In addition, the frequency of the problem behavior was higher in male out-of-school adolescents with statistical significance than in female out-of-school adolescents (t=5.08, p= < .001). In terms of the start time of the problem behavior, only internet game addiction was higher in male out-of-school adolescents with the statistical significance than in female out-of-school adolescents ( =6.22, p=.032). No statistically significant difference was found in other problem behaviors (p > .05). Conclusions: In this study, it was found that gender difference in problem behaviors of out-of-school adolescents exists, and its frequency and difference of types were identified. When the social countermeasures were provided for those adolescents, a distinguished approach is required depending on the patterns of problem behavior and gender. When preparing policy alternatives and interventions for out-of-school adolescents, it is required to reflect the results of this study.

Keywords: addictive behavior, adolescent, gender, problem behavior

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Authors: K. Caban-Piaskowska

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The aim of the article is to show how the role of a designer has changed, from the point of view of human resources management and thanks to the increased importance of design management, and is to present how a rehabilitation product, through technology approach to designing, becomes a universal product. Designing for the disabled is a very undiscovered area on the pattern-designing market, most often because it is associated with devices which support rehabilitation. In consequence, it means that the realizations have a limited group of receivers and are not that attractive for designers. The relation between using modern design in building rehabilitation devices and increasing the efficiency of treatment and physiotherapy. Using modern technology can have marketing significance. Rehabilitation products designed and produced in a modern way makes an impression that experts and professionals are involved in the lives of the user – patient. In order to illustrate the problem presented above i.e. Creating a rehabilitation product as an example of design management, the case study method was used in the research. The analysis of the case was created on the basis of an interview conducted by the author with a designer who took part in meetings with people who use rehabilitation and their physiotherapists, and created universal products in Poland in the years of 2012 to 2017. Usually, engineers and constructors deal with creating products which remind us of old torture devices, however, they are indestructible in construction. Such image of those products for the disabled clearly indicates that it is a wonderful niche for designers and emphasizes the need to make those products more attractive and innovative. Products for the disabled cannot be limited to rehabilitation equipment only e.g. wheelchairs or standing frames. Introducing the idea of universal designing can significantly broaden the circle of pattern-designing receivers – everyday-use items – with the disabled people. Fulfilling these criteria will decide about the advantage on the competitive market. It is possible due to the usage of the design management concept in the functioning of an organization. Using modern technology and materials in the production of equipment, and changing the role of a designer broadening the circle of receivers by designing a wide use process which makes it possible to use the product by people with various needs. What is more, introducing rehabilitation functions in everyday-use items can also become an innovative accent in designing. In the reality of the market, each group of users can and should be treated as a problem and a realization task.

Keywords: design management, innovation, rehabilitation product, universal product

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Authors: Gloria Chen

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When offering conventional level-appropriate ESL classes for adults is not feasible, a multilevel adult ESL class can be formed to benefit those who need to learn English for daily function. This paper examines the rationale, the process, the contents, and the outcomes of a multilevel ESL class for adults. The action research discusses a variety of assessments, lesson plans, teaching strategies that facilitate lifelong language learning. In small towns where adult ESL learners are only a handful, often advanced students and inexperienced students have to be placed in one class. Such class might not be viewed as desirable, but with on-going assessments, careful lesson plans, and purposeful strategies, a multilevel ESL class for adults can overcome the obstacles and help learners to reach a higher level of English proficiency. This research explores some hand-on strategies, such as group rotating, cooperative learning, and modifying textbook contents for practical purpose, and evaluate their effectiveness. The data collected in this research include Needs Assessment (beginning of class term), Mid-term Self-Assessment (5 months into class term), End-of-term Student Reflection (10 months into class), and End-of-term Assessment from the Instructor (10 months into class). A descriptive analysis of the data explains the practice of this particular learning community, and reveal the areas for improvement and enrichment. This research answers the following questions: (1) How do the assessments positively help both learners and instructors? (2) How do the learning strategies prepare students to become independent, life-long English learners? (3) How do materials, grouping, and class schedule enhance the learning? The result of the research contributes to the field of teaching and learning in language, not limited in English, by (a) examining strategies of conducting a multilevel adult class, (b) involving adult language learners with various backgrounds and learning styles for reflection and feedback, and (c) improving teaching and learning strategies upon research methods and results. One unique feature of this research is how students can work together with the instructor to form a learning community, seeking and exploring resources available to them, to become lifelong language learners.

Keywords: adult language learning, assessment, multilevel, teaching strategies

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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Authors: Anastasios Manos, Despina Elisabeth Filippidou

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Introduction: Historical buildings are an inte-gral part of the cultural heritage of every place, and beyond the obvious need for protection against risks, they have specific requirements regarding the handling of hazards and disasters such as fire, floods, earthquakes, etc. Ensuring high levels of protection and safety for these buildings is impera-tive for two distinct but interconnected reasons: a) they themselves constitute cultural heritage, and b) they are often used as museums/cultural spaces, necessitating the protection of both human life (vis-itors and workers) and the cultural treasures they house. However, these buildings present serious constraints in implementing the necessary measures to protect them from destruction due to their unique architecture, construction methods, and/or the structural materials used in the past, which have created an existing condition that is sometimes challenging to reshape and operate within the framework of modern regulations and protection measures. One of the most devastating risks that threaten historical buildings is fire. Catastrophic fires demonstrate the need for timely evaluation of fire safety measures in historical buildings. Recog-nizing the criticality of protecting historical build-ings from the risk of fire, the Confederation of Fire Protection Associations in Europe (CFPA E) issued specific guidelines in 2013 (CFPA-E Guideline No 30:2013 F) for the fire protection of historical buildings at the European level. However, until now, few actions have been implemented towards leveraging modern technologies in the field of con-struction and maintenance of buildings, such as Building Information Modeling (BIM) and the Inter-net of Things (IoT), for the protection of historical buildings from risks like fires, floods, etc. The pro-ject BIM4Cult has bee developed in order to fill this gap. It is a tool for timely assessing and monitoring of the fire safety level of historical buildings using BIM and IoT technologies in an integrated manner. The tool serves as a decision support expert system for improving the fire safety of historical buildings by continuously monitoring, controlling and as-sessing critical risk factors for fire.

Keywords: Iot, fire, BIM, expert system

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Authors: Raymond Puijk, Rachid Rassir, Inger N. Sierevelt, Anneke Spekenbrink-Sporen, Bart G. C. W. Pijls, Rob G. H. H. Nelissen, Peter A. Nolte

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Background: Among uncemented total knee arthroplasty (TKA), a wide variety of metal surface structures (MSS) and coatings exist to enhance implants' biological properties (i.e., bone ingrowth). This study explores the variety of MSS-coating combinations and compares their mid-long-term survivorships with cemented TKAs, by using data from the Dutch Arthroplasty Register. Methods: A total of 235,500 cemented and 11,132 uncemented primary TKAs with a median follow-up of 5.1 years were included. MSS-coating combinations were (1) Porous-uncoated (n=8986), (2) Beaded-hydroxyapatite (HA)(n=1093), (3) Matte-uncoated (n=846), (4) Matte-Titanium-nitride (TiN) (n=207). Five- and 10-year revision-free survival for all-cause revisions, and aseptic loosening of the tibial component, were calculated and compared by using Kaplan-Meier, Log-rank tests, and multivariable Cox proportional hazard regression analyses. Results: Ten-year survival rates with all-cause revisions as an endpoint, were 94.2% for cement, and 94.7%, 96.3%, 92.1%, and 79.0% for porous-uncoated, beaded-HA, matte-uncoated, and Matte-TiN, respectively (p<0.01). Rates for aseptic loosening were 98.8% for cemented, and 98.7%, 99.8%, 97.2%, and 94.9% for the uncemented, respectively (p<0.01).The beaded-HA implants were half the risk for an all-cause revision compared to cemented implants (p<0.01). Matte-uncoated and matte-TiN implants were at more risk of an all-cause revision than cemented implants (p=0.01, p<0.01). Proportions of revisions for aseptic loosening were comparable among most groups. Conclusion: Based on Dutch registry data, four main MSS-coating combinations among uncemented TKAs were found. survivorships for all-cause revisions and aseptic release differed widely between groups. Beaded-HA and porous-uncoated implants had the best survival rates among the uncemented TKAs and were non-inferior to the cemented TKAs.

Keywords: total knee arthroplasty, cement, uncemented, cementless;, metal surface structure, coating

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Authors: Esha Saha, Pradip Kumar Ray

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A hospital inventory comprises of a large number and great variety of items for the proper treatment and care of patients, such as pharmaceuticals, medical equipment, surgical items, etc. Improper management of these items, i.e. stockouts, may lead to delay in treatment or other fatal consequences, even death of the patient. So, generally the hospitals tend to overstock items to avoid the risk of stockout which leads to unnecessary investment of money, difficulty in storing, more expiration and wastage, etc. Thus, in such challenging environment, it is necessary for hospitals to follow an inventory policy considering the stochasticity of demand in a hospital. Statistical analysis captures the correlation of patient condition based on bed occupancy with the patient demand which changes stochastically. Due to the dependency on bed occupancy, the markov model is developed that helps to map the changes in demand of hospital inventory based on the changes in the patient condition represented by the movements of bed occupancy states (acute care state, rehabilitative state and long-care state) during the length-of-stay of patient in a hospital. An inventory policy is developed for a hospital based on the fulfillment of patient demand with the objective of minimizing the frequency and quantity of placement of orders of inventoried items. The analytical structure of the model based on probability calculation is provided to show the optimal inventory-related decisions. A case-study is illustrated in this paper for the development of hospital inventory model based on patient demand for multiple inpatient pharmaceutical items. A sensitivity analysis is conducted to investigate the impact of inventory-related parameters on the developed optimal inventory policy. Therefore, the developed model and solution approach may help the hospital managers and pharmacists in managing the hospital inventory in case of stochastic demand of inpatient pharmaceutical items.

Keywords: bed occupancy, hospital inventory, markov model, patient condition, pharmaceutical items

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Authors: Tendü H. Göktuğ, Gönül T. İçemer, Bülent Deniz

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National parks, which are rich in natural and cultural resources values are protected in the context of the idea to develop sustainability, are among the most important recreated areas demanding with each passing day. Increasing recreational use or unplanned use forms negatively affect the resource values and visitor satisfaction. The intent of national parks management is to protect the natural and cultural resource values and to provide the visitors with a quality of recreational experience, as well. In this context, the current studies to improve the appropriate tourism and recreation planning and visitor management, approach have focused on recreational carrying capacity analysis. The aim of this study is to analyze recreational carrying capacity of Çıralı Coast in the Bey Mountains Coastal National Park to compare the analyze results with the current usage format and to develop alternative management strategies. In the first phase of the study, the annual and daily visitations, geographic, bio-physical, and managerial characteristics of the park and the type of recreational usage and the recreational areas were analyzed. In addition to these, ecological observations were carried out in order to determine recreational-based pressures on the ecosystems. On-site questionnaires were administrated to a sample of 284 respondents in the August 2015 - 2016 to collect data concerning the demographics and visit characteristics. The second phase of the study, the coastal area separated into four different usage zones and the methodology proposed by Cifuentes (1992) was used for capacity analyses. This method supplies the calculation of physical, real and effective carrying capacities by using environmental, ecological, climatic and managerial parameters in a formulation. Expected numbers which estimated three levels of carrying capacities were compared to current numbers of national parks’ visitors. In the study, it was determined that the current recreational uses in the north of the beach were caused by ecological pressures, and the current numbers in the south of beach much more than estimated numbers of visitors. Based on these results management strategies were defined and the appropriate management tools were developed in accordance with these strategies. The authors are grateful for the financial support of this project by The Scientific and Technological Research Council of Turkey (No: 114O344)

Keywords: Çıralı Coast, national parks, recreational carrying capacity, visitor management

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Hanan Algarni

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Background: Impairment of walking and balance skills has negative impact on functional independence and community participation after stroke. Gait recovery is considered a primary goal in rehabilitation by both patients and physiotherapists. Treadmill training coupled with virtual reality technology is a new emerging approach that offers patients with feedback, open and random skills practice while walking and interacting with virtual environmental scenes. Objectives: To synthesize the evidence around the effects of the VR treadmill training on gait speed and balance primarily, functional independence and community participation secondarily in stroke patients. Methods: Systematic review was conducted; search strategy included electronic data bases: MEDLINE, AMED, Cochrane, CINAHL, EMBASE, PEDro, Web of Science, and unpublished literature. Inclusion criteria: Participant: adult >18 years, stroke, ambulatory, without severe visual or cognitive impartments. Intervention: VR treadmill training alone or with physiotherapy. Comparator: any other interventions. Outcomes: gait speed, balance, function, community participation. Characteristics of included studies were extracted for analysis. Risk of bias assessment was performed using Cochrane's ROB tool. Narrative synthesis of findings was undertaken and summary of findings in each outcome was reported using GRADEpro. Results: Four studies were included involving 84 stroke participants with chronic hemiparesis. Interventions intensity ranged (6-12 sessions, 20 minutes-1 hour/session). Three studies investigated the effects on gait speed and balance. 2 studies investigated functional outcomes and one study assessed community participation. ROB assessment showed 50% unclear risk of selection bias and 25% of unclear risk of detection bias across the studies. Heterogeneity was identified in the intervention effects at post training and follow up. Outcome measures, training intensity and durations also varied across the studies, grade of evidence was low for balance, moderate for speed and function outcomes, and high for community participation. However, it is important to note that grading was done on few numbers of studies in each outcome. Conclusions: The summary of findings suggests positive and statistically significant effects (p<0.05) of VR treadmill training compared to other interventions on gait speed, dynamic balance skills, function and participation directly after training. However, the effects were not sustained at follow up in two studies (2 weeks-1 month) and other studies did not perform follow up measurements. More RCTs with larger sample sizes and higher methodological quality are required to examine the long term effects of VR treadmill effects on function independence and community participation after stroke, in order to draw conclusions and produce stronger robust evidence.

Keywords: virtual reality, treadmill, stroke, gait rehabilitation

Procedia PDF Downloads 264

Authors: Umar D. M., Aminu A. M., Izaddeen K. Y.

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Deployments of mini macrocell base stations also referred to as femtocells, improve the quality of service of indoor and outdoor users. Nevertheless, mobility management remains a key issue with regards to their deployment. This paper is leaned towards this issue, with an in-depth focus on the most important aspect of mobility management -handover. In handover management, making a handover decision in the LTE two-tier macrocell femtocell network is a crucial research area. Decision algorithms in this research are classified and comparatively analyzed according to received signal strength, user equipment speed, cost function, and interference. However, it was observed that most of the discussed decision algorithms fail to consider cell selection with hybrid access policy in a single macrocell multiple femtocell scenario, another observation was a majority of these algorithms lack the incorporation of user equipment residence parameter. Not including this parameter boosts the number of unnecessary handover occurrence. To deal with these issues, a sophisticated handover decision algorithm is proposed. The proposed algorithm considers the user’s velocity, received signal strength, residence time, as well as the femtocell base station’s access policy. Simulation results have shown that the proposed algorithm reduces the number of unnecessary handovers when compared to conventional received signal strength-based handover decision algorithm.

Keywords: user-equipment, radio signal service, long term evolution, mobility management, handoff

Procedia PDF Downloads 109

Authors: Helen K. Buteme, Rebecca Axelsson-Robertson, Moses L. Joloba, Henry W. Boom, Gunilla Kallenius, Markus Maeurer

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Background: The Ugandan population is heavily affected by infectious diseases and Human leukocyte antigen (HLA) diversity plays a crucial role in the host-pathogen interaction and affects the rates of disease acquisition and outcome. The identification of HLA class 1 alleles and determining which alleles are associated with tuberculosis (TB) outcomes would help in screening individuals in TB endemic areas for susceptibility to TB and to predict resistance or progression to TB which would inevitably lead to better clinical management of TB. Aims: To be able to determine the HLA class 1 phenotype distribution in a Ugandan TB cohort and to establish the relationship between these phenotypes and active and latent TB. Methods: Blood samples were drawn from 32 HIV negative individuals with active TB and 45 HIV negative individuals with latent MTB infection. DNA was extracted from the blood samples and the DNA samples HLA typed by the polymerase chain reaction-sequence specific primer method. The allelic frequencies were determined by direct count. Results: HLA-A*02, A*01, A*74, A*30, B*15, B*58, C*07, C*03 and C*04 were the dominant phenotypes in this Ugandan cohort. There were differences in the distribution of HLA types between the individuals with active TB and the individuals with LTBI with only HLA-A*03 allele showing a statistically significant difference (p=0.0136). However, after FDR computation the corresponding q-value is above the expected proportion of false discoveries (q-value 0.2176). Key findings: We identified a number of HLA class I alleles in a population from Central Uganda which will enable us to carry out a functional characterization of CD8+ T-cell mediated immune responses to MTB. Our results also suggest that there may be a positive association between the HLA-A*03 allele and TB implying that individuals with the HLA-A*03 allele are at a higher risk of developing active TB.

Keywords: HLA, phenotype, tuberculosis, Uganda

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Authors: Moses Balina, Archbald Bahizi

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Introduction: Early onset neonatal sepsis is a systemic infection in a newborn baby during the first week after birth and contributes to 50% of neonatal deaths each year. Risk factors for early onset neonatal sepsis, which can be maternal, health care provider, or health care facility associated, can be prevented with access to quality antenatal care. Objective: The objective of the study was to assess early onset neonatal sepsis and antenatal factors associated with Fort Portal Regional Referral Hospital. Methodology: A cross sectional study design was used. The study involved 60 respondents who were mothers of breastfeeding neonates being treated for early onset neonatal sepsis at Fort Portal Regional Referral Hospital neonatal intensive care unit. Simple random sampling was used to select study participants. Data were collected using questionnaires, entered in Stata 16, and analysed using logistic regression. Results: The prevalence of early onset neonatal sepsis at Fort Portal Regional Referral Hospital was 25%. Multivariate analysis revealed that institutional factors were the only antenatal factors found to be significantly associated with early onset neonatal sepsis at Fort Portal Regional Referral Hospital (p < 0.01). Bivariate analysis revealed that attending antenatal care at a health centre III or IV instead of a hospital (p = 0.011) and attending antenatal care in health care facilities with no laboratory investigations (p = 0.048) were risk factors for early onset neonatal sepsis in the newborn at Fort Portal Regional Referral Hospital. Conclusion: Antenatal factors were associated with early onset neonatal sepsis, and health care facility factors like lower level health centre and unavailability of quality laboratory investigations to pregnant women contributed to early onset neonatal sepsis in the newborn. Mentorships, equipping/stocking laboratories, and improving staffing levels were necessary to reduce early onset neonatal sepsis.

Keywords: antenatal factors, early onset neonatal sepsis, neonates 0-7 days, fort portal regional referral hospital

Procedia PDF Downloads 90

Authors: Soheila Ghanbari

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After the Civil Rights Act of 1964 was enacted, federal policy transformed employment rights. Equal employment opportunity law, legislation for occupational safety and health, and regulations for fringe benefits were established to ensure that employees have rights to equal protection, health and safety, and the benefits guaranteed by employers. In research analyzing data from 279 organizations over time, it was discovered that legal changes prompted organizations to establish personnel, antidiscrimination, safety, and benefits departments to ensure compliance. However, as the process of institutionalization advanced, middle managers began to separate these fresh offices from policy and rationalize them solely in economic terms as a component of the new human resources management model. This common occurrence is seen in the United States, where the Constitution represents government control of business as unlawful. It could potentially clarify the extended lack of a state theory in organizational analysis and shed light on a puzzle pointed out by state theorists: the federal state is weak in terms of administration but strong in terms of norms.

Keywords: management, state, human, resources, employment

Procedia PDF Downloads 26

Authors: B. Saripah, A. Alias

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Cocoa Theobroma cacao (Linnaeus) (Malvales: Sterculiaceae) is subjected to be infested by various numbers of insect pests, and Conopomorpha cramerella Snellen (Lepidoptera: Gracillariidae) is the most serious pest of cocoa in Malaysia. The pest was indigenous to the South East Asia. Several control measures have been implemented and the chemicals have been a major approach if not unilateral, in the management of CPB. Despite extensive use of insecticides, CPB continues to cause an unacceptable level of damage; thus, the combination of several control approaches should be sought. The study was commenced for 12 months at three blocks; Block 18C with complete management practices which include insecticide application, pruning, fertilization and frequent harvesting, Block 17C was treated with frequent harvesting at intervals of 7-8 days, and Block 19C was served as control block. The results showed that the mean numbers of CPB eggs were recorded higher in Block 17C compared with Block 18C in all sampling occasions. Block 18C shows the lowest mean number of CPB eggs in both sampling plots, outside and core plots and it was found significantly different (p ≤ 0. 05) compared to the other blocks. The mean number of CPB eggs was fluctuated throughout sampling occasions, the lowest mean number of eggs was recorded in January (17C) and November (18C), while the highest was recorded in April (17C) and December 2012 (18C). Frequent spraying with insecticides at the adjacent block (18C) helps in reducing CPB eggs in the control block (Block 19C), although there was no spraying was implemented Block 19C. In summary, the combination of complete management practices at Block 18C seems to have some effect on the CPB population at Blocks 17 and 19C because all blocks are adjacent to each other.

Keywords: cocoa, theobroma cacao, cocoa pod borer, conopomorpha cramerella

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Authors: Christopher Schwarz, Katrin Riegler, Erwin Zinser

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The management of outsourcing relationships between IT service providers and their customers proofs to be a critical issue that has to be stipulated by means of Service Level Agreements (SLAs). Since service requirements differ from customer to customer, SLA content and language structures vary largely, standardized SLA templates may not be used and an automated processing of SLA content is not possible. Hence, SLA management is usually a time-consuming and inefficient manual process. For overcoming these challenges, this paper presents an innovative and ITIL V3-conform approach for automated SLA design and management using controlled natural language in enterprise collaboration portals. The proposed novel concept is based on a self-developed controlled natural language that follows a subject-predicate-object approach to specify well-defined SLA content structures that act as templates for customized contracts and support automated SLA processing. The derived results eventually enable IT service providers to automate several SLA request, approval and negotiation processes by means of workflows and business rules within an enterprise collaboration portal. The illustrated prototypical realization gives evidence of the practical relevance in service-oriented scenarios as well as the high flexibility and adaptability of the presented model. Thus, the prototype enables the automated creation of well defined, customized SLA documents, providing a knowledge representation that is both human understandable and machine processable.

Keywords: automated processing, controlled natural language, knowledge representation, information technology outsourcing, service level management

Procedia PDF Downloads 417

Authors: Iman Nezamzadeh, Ali Faghih, Behnam Oveisi

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In order to reduce earthquake hazards in urban areas, it is necessary to perform comprehensive studies to understand the dynamics of the active faults and identify potentially high risk areas. The fault slip-rates in Late Quaternary sediment are critical indicators of seismic hazard and also provide valuable data to recognize young crustal deformations. To measure slip-rates accurately, is needed to displacement of geomorphic markers and ages of quaternary sediment samples of alluvial deposit that deformed by movements on fault. In this study we produced information about Intermediate term slip rate of Sabzpushan Fault Zone (SPF) within the central part of the Zagros Mountains of Iran using OSL dating technique to make better analysis of seismic hazard and seismic risk reduction for Shiraz city. For this purpose identifiable geomorphic fluvial surfaces help us to provide a reference frame to determine differential or absolute horizontal and vertical deformation. Optically stimulated luminescence (OSL) is an alternative and independent method of determining the burial age of mineral grains in Quaternary sediments. Field observation and satellite imagery show geomorphic markers that deformed horizontally along the Sabzpoushan Fault. Here, drag folds is forming because of evaporites material of Miocen Formation. We estimate 2.8±0.5 mm/yr (mm/y) horizontal slip rate along the Sabzpushan fault zone, where ongoing deformation is involve with drug folding. The Soltan synclinal structure, close to the Sabzpushan fault, shows slight uplift rate due to active core-extrousion.

Keywords: slip rate, active tectonics, OSL, geomorphic markers, Sabzpushan Fault Zone, Zagros, Iran

Procedia PDF Downloads 335

Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

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Authors: Sana Masmoudi, Yosra Makni

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Regulators highlight the importance of the Audit Committee (AC) as a key internal corporate governance mechanism. One of the most important roles of this committee is to oversee the financial reporting process. The purpose of this paper is to examine the link between the characteristics of an audit committee and the financial reporting quality by investigating whether the formation of audit committees and their characteristics are associated with improved financial reporting quality. This study provides empirical evidence of the association between audit committee independence, financial expertise, gender diversity, and meetings and Real Earnings Management (REM) as a proxy of financial reporting quality. Using data from, with a sample of 80 companies listed on the Amsterdam Stock Exchange during 2010-2017, the study finds that independence and AC Gender diversity are strongly related to financial reporting quality. In fact, these two characteristics constrain REM. The results also suggest that AC-financial expertise reduces to some extent, the likelihood of engaging in REM. These conclusions provide support then to the audit committee requirement under the Dutch Corporate Governance Code rules regarding gender diversity and AC meetings.

Keywords: audit committee, financial expertise, independence, real earnings management

Procedia PDF Downloads 154