Search results for: value stream management (VSM) 4.0
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10205

Search results for: value stream management (VSM) 4.0

5525 Management of Myofascial Temporomandibular Disorder in Secondary Care: A Quality Improvement Project

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

Abstract:

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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5524 Oesteonecrosis In Patients Trated With Denosumab : a Case Report

Authors: Benhamouda Amira Chaimae

Abstract:

Osteonecrosis of the jaw (ONJ) is a rare but serious complication associated with the use of bone-modifying agents, such as Denosumab, commonly prescribed to treat osteoporosis and other bone-related conditions. This case report presents a detailed account of a patient who developed ONJ following treatment with Denosumab. The patient’s clinical presentation, diagnostic process, and management are discussed, highlighting the challenges of diagnosing and treating ONJ in individuals undergoing Denosumab therapy. The report examines the potential pathophysiological mechanisms linking Denosumab treatment to ONJ, including its effects on bone remodeling and the immune response.

Keywords: denosumab, bone loss, osteonecrosis, rankl

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5523 Improving Productivity in a Glass Production Line through Applying Principles of Total Productive Maintenance (TPM)

Authors: Omar Bataineh

Abstract:

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

Procedia PDF Downloads 339
5522 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

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5521 Impacts of Community Forest on Forest Resources Management and Livelihood Improvement of Local People in Nepal

Authors: Samipraj Mishra

Abstract:

Despite the successful implementation of community forestry program, a number of pros and cons have been raised on Terai community forestry in the case of lowland locally called Terai region of Nepal, which is climatically belongs to tropical humid and possessed high quality forests in terms of ecology and economy. The study aims to investigate the local pricing strategy of forest products and its impacts on equitable forest benefit sharing, collection of community fund and carrying out livelihood improvement activities. The study was carried out on six community forests revealed that local people have substantially benefited from the community forests. However, being the region is heterogeneous by socio-economic conditions and forest resources have higher economical potential, the decision of low pricing strategy made by the local people have created inequality problems while sharing the forest benefits, and poorly contributed to community fund collection and consequently carrying out limited activities of livelihood improvement. The paper argued that the decision of low pricing strategy of forest products is counter-productive to promote the equitable benefit sharing in the areas of heterogeneous socio-economic conditions with high value forests. The low pricing strategy has been increasing accessibility of better off households at higher rate than poor; as such households always have higher affording capacity. It is also defective to increase the community fund and carry out activities of livelihood improvement effectively. The study concluded that unilateral decentralized forest policy and decision-making autonomy to the local people seems questionable unless their decision-making capacities are enriched sufficiently. Therefore, it is recommended that empowerment of decision-making capacity of local people and their respective institutions together with policy and program formulation are prerequisite for efficient and equitable community forest management and its long-term sustainability.

Keywords: community forest, livelihood, socio-economy, pricing system, Nepal

Procedia PDF Downloads 275
5520 Organizational Resilience in the Perspective of Supply Chain Risk Management: A Scholarly Network Analysis

Authors: William Ho, Agus Wicaksana

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Anecdotal evidence in the last decade shows that the occurrence of disruptive events and uncertainties in the supply chain is increasing. The coupling of these events with the nature of an increasingly complex and interdependent business environment leads to devastating impacts that quickly propagate within and across organizations. For example, the recent COVID-19 pandemic increased the global supply chain disruption frequency by at least 20% in 2020 and is projected to have an accumulative cost of $13.8 trillion by 2024. This crisis raises attention to organizational resilience to weather business uncertainty. However, the concept has been criticized for being vague and lacking a consistent definition, thus reducing the significance of the concept for practice and research. This study is intended to solve that issue by providing a comprehensive review of the conceptualization, measurement, and antecedents of operational resilience that have been discussed in the supply chain risk management literature (SCRM). We performed a Scholarly Network Analysis, combining citation-based and text-based approaches, on 252 articles published from 2000 to 2021 in top-tier journals based on three parameters: AJG ranking and ABS ranking, UT Dallas and FT50 list, and editorial board review. We utilized a hybrid scholarly network analysis by combining citation-based and text-based approaches to understand the conceptualization, measurement, and antecedents of operational resilience in the SCRM literature. Specifically, we employed a Bibliographic Coupling Analysis in the research cluster formation stage and a Co-words Analysis in the research cluster interpretation and analysis stage. Our analysis reveals three major research clusters of resilience research in the SCRM literature, namely (1) supply chain network design and optimization, (2) organizational capabilities, and (3) digital technologies. We portray the research process in the last two decades in terms of the exemplar studies, problems studied, commonly used approaches and theories, and solutions provided in each cluster. We then provide a conceptual framework on the conceptualization and antecedents of resilience based on studies in these clusters and highlight potential areas that need to be studied further. Finally, we leverage the concept of abnormal operating performance to propose a new measurement strategy for resilience. This measurement overcomes the limitation of most current measurements that are event-dependent and focus on the resistance or recovery stage - without capturing the growth stage. In conclusion, this study provides a robust literature review through a scholarly network analysis that increases the completeness and accuracy of research cluster identification and analysis to understand conceptualization, antecedents, and measurement of resilience. It also enables us to perform a comprehensive review of resilience research in SCRM literature by including research articles published during the pandemic and connects this development with a plethora of articles published in the last two decades. From the managerial perspective, this study provides practitioners with clarity on the conceptualization and critical success factors of firm resilience from the SCRM perspective.

Keywords: supply chain risk management, organizational resilience, scholarly network analysis, systematic literature review

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5519 Risk-Sharing Financing of Islamic Banks: Better Shielded against Interest Rate Risk

Authors: Mirzet SeHo, Alaa Alaabed, Mansur Masih

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In theory, risk-sharing-based financing (RSF) is considered a corner stone of Islamic finance. It is argued to render Islamic banks more resilient to shocks. In practice, however, this feature of Islamic financial products is almost negligible. Instead, debt-based instruments, with conventional like features, have overwhelmed the nascent industry. In addition, the framework of present-day economic, regulatory and financial reality inevitably exposes Islamic banks in dual banking systems to problems of conventional banks. This includes, but is not limited to, interest rate risk. Empirical evidence has, thus far, confirmed such exposures, despite Islamic banks’ interest-free operations. This study applies system GMM in modeling the determinants of RSF, and finds that RSF is insensitive to changes in interest rates. Hence, our results provide support to the “stability” view of risk-sharing-based financing. This suggests RSF as the way forward for risk management at Islamic banks, in the absence of widely acceptable Shariah compliant hedging instruments. Further support to the stability view is given by evidence of counter-cyclicality. Unlike debt-based lending that inflates artificial asset bubbles through credit expansion during the upswing of business cycles, RSF is negatively related to GDP growth. Our results also imply a significantly strong relationship between risk-sharing deposits and RSF. However, the pass-through of these deposits to RSF is economically low. Only about 40% of risk-sharing deposits are channeled to risk-sharing financing. This raises questions on the validity of the industry’s claim that depositors accustomed to conventional banking shun away from risk sharing and signals potential for better balance sheet management at Islamic banks. Overall, our findings suggest that, on the one hand, Islamic banks can gain ‘independence’ from conventional banks and interest rates through risk-sharing products, the potential for which is enormous. On the other hand, RSF could enable policy makers to improve systemic stability and restrain excessive credit expansion through its countercyclical features.

Keywords: Islamic banks, risk-sharing, financing, interest rate, dynamic system GMM

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5518 The Impact of Artificial Intelligence on Legislations and Laws

Authors: Keroles Akram Saed Ghatas

Abstract:

The near future will bring significant changes in modern organizations and management due to the growing role of intangible assets and knowledge workers. The area of copyright, intellectual property, digital (intangible) assets and media redistribution appears to be one of the greatest challenges facing business and society in general and management sciences and organizations in particular. The proposed article examines the views and perceptions of fairness in digital media sharing among Harvard Law School's LL.M.s. Students, based on 50 qualitative interviews and 100 surveys. The researcher took an ethnographic approach to her research and entered the Harvard LL.M. in 2016. at, a Face book group that allows people to connect naturally and attend in-person and private events more easily. After listening to numerous students, the researcher conducted a quantitative survey among 100 respondents to assess respondents' perceptions of fairness in digital file sharing in various contexts (based on media price, its availability, regional licenses, copyright holder status, etc.). to understand better . .). Based on the survey results, the researcher conducted long-term, open-ended and loosely structured ethnographic interviews (50 interviews) to further deepen the understanding of the results. The most important finding of the study is that Harvard lawyers generally support digital piracy in certain contexts, despite having the best possible legal and professional knowledge. Interestingly, they are also more accepting of working for the government than the private sector. The results of this study provide a better understanding of how “fairness” is perceived by the younger generation of lawyers and pave the way for a more rational application of licensing laws.

Keywords: cognitive impairments, communication disorders, death penalty, executive function communication disorders, cognitive disorders, capital murder, executive function death penalty, egyptian law absence, justice, political cases piracy, digital sharing, perception of fairness, legal profession

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5517 A Case Study on the Effect of a Mobility Focused Exercise Training in Rehabilitation of an Elite Weightlifter with Shoulder Pain and Weakness

Authors: Lingling Li, Peng Zhao, Runze Guan, Alice Jones, Tao Yu

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Background: Shoulder pain and weakness are associated with complex pathologies and often precludes weightlifters from participation in training. The role and mode of exercise training in weightlifters with shoulder pathology remains unclear. Objectives: This case report described an exercise program in management of an elite weightlifter with primary complaint of right shoulder pain and weakness. Methods: A 22-year-old weightlifter presented with 2-year duration of right shoulder pain and weakness which was worsened by routine weightlifting training, and symptoms were not relieved with steroid injection, manual therapy nor usual physiotherapy. There was a limitation in all active range of motion especially horizontal extension (13ᵒ) and external rotation (41ᵒ) with pain intensity at 4/10 and 10/10 (numeric pain rating score) respectively. Muscle weakness was most significant at supraspinatus and teres minor, 38% and 27% respectively compared to his left shoulder (hand-held dynamometry, Micro FET2). An exercise training program focusing on improving mobility was designed for this athlete following a comprehensive physical assessment. Exercises included specific stretching, muscle activating and scapular stability training; once per day, and for 60 minutes each session. All exercises were completed under instruction as pain allowed. Quantitative assessment was conducted at the end of each week for 3 weeks. Outcomes: After the program, the athlete was pain-free in all movements except the O’Brien active compression internal rotation test, the pain was however reduced from 10/10 to 3/10. The horizontal extension and external rotation range increased to 79ᵒ to 120ᵒ respectively, and strength of all rotator cuff muscles returned to normal. At 1-month follow up, the athlete was totally pain-free and had returned to normal function and weightlifting training activities. The outcomes sustained through 6-month and one year. Conclusion: This case report supports the use of a mobility-focused exercise program for management of shoulder pain and weakness in an elite weightlifter athlete.

Keywords: exercise training, mobility, rehabilitation, shoulder pain, weightlifting

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5516 Understanding Tacit Knowledge and Its Role in Military Organizations: Methods of Managing Tacit Knowledge

Authors: M. Erhan Orhan, Onur Ozdemir

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Expansion of area of operation and increasing diversity of threats forced the military organizations to change in many ways. However, tacit knowledge still is the most fundamental component of organizational knowledge. Since it is human oriented and in warfare human stands at the core of the organization. Therefore, military organizations should find effective ways of systematically utilizing tacit knowledge. In this context, this article suggest some methods for turning tacit knowledge into explicit in military organizations.

Keywords: tacit knowledge, military, knowledge management, warfare, technology

Procedia PDF Downloads 488
5515 The Effect of Expanding the Early Pregnancy Assessment Clinic and COVID-19 on Emergency Department and Urgent Care Visits for Early Pregnancy Bleeding

Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

Abstract:

Background: Our study assesses the impact of the COVID-19 pandemic on early pregnancy assessment clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ± 4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID-19 compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID-19, but ectopic pregnancy operative management remained unchanged.

Keywords: early pregnancy, ultrasound, COVID-19, obstetrics

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5514 Proposal for a Framework for Teaching Entrepreneurship and Innovation Using the Methods and Current Methodologies

Authors: Marcelo T. Okano, Jaqueline C. Bueno, Oduvaldo Vendrametto, Osmildo S. Santos, Marcelo E. Fernandes, Heide Landi

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Developing countries are increasingly finding that entrepreneurship and innovation are the ways to speed up their developments and initiate or encourage technological development. The educational institutions such as universities, colleges and colleges of technology, has two main roles in this process, to guide and train entrepreneurs and provide technological knowledge and encourage innovation. Thus there was completing the triple helix model of innovation with universities, government and industry. But the teaching of entrepreneurship and innovation can not be only the traditional model, with blackboard, chalk and classroom. The new methods and methodologies such as Canvas, elevator pitching, design thinking, etc. require students to get involved and to experience the simulations of business, expressing their ideas and discussing them. The objective of this research project is to identify the main methods and methodologies used for the teaching of entrepreneurship and innovation, to propose a framework, test it and make a case study. To achieve the objective of this research, firstly was a survey of the literature on the entrepreneurship and innovation, business modeling, business planning, Canvas business model, design thinking and other subjects about the themes. Secondly, we developed the framework for teaching entrepreneurship and innovation based on bibliographic research. Thirdly, we tested the framework in a higher education class IT management for a semester. Finally, we detail the results in the case study in a course of IT management. As important results we improve the level of understanding and business administration students, allowing them to manage own affairs. Methods such as canvas and business plan helped students to plan and shape the ideas and business. Pitching for entrepreneurs and investors in the market brought a reality for students. The prototype allowed the company groups develop their projects. The proposed framework allows entrepreneurship education and innovation can leave the classroom, bring the reality of business roundtables to university relying on investors and real entrepreneurs.

Keywords: entrepreneurship, innovation, Canvas, traditional model

Procedia PDF Downloads 579
5513 Food Waste and Sustainable Management

Authors: Farhana Nosheen, Moeez Ahmad

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Throughout the food chain, the food waste from initial agricultural production to final household consumption has become a serious concern for global sustainability because of its adverse impacts on food security, natural resources, the environment, and human health. About a third of tomatoes (Lycopersicon esculentum L.) delivered to processing plants end as processing waste. The amount of such waste material is estimated to have increased with the emergence of mechanical harvesting. Experiments were made to determine the nutritional profile and antioxidant activity of tomato processing waste and to explore the bioactive compound in tomato waste, i.e., Lycopene. Tomato Variety of ‘SAHARA F1’ was used to make tomato waste. The tomatoes were properly cleaned, and then unwanted impurities were removed properly. The tomatoes were blanched at 90 ℃ for 5 minutes. After which, the skin of the tomatoes was removed, and the remaining part passed through the electric pulper. The pulp and seeds were collected separately. The seeds and skin of tomatoes were mixed and saved in a sterilized jar. The samples of tomato waste were found to contain 89.11±0.006 g/100g moisture, 10.13±0.115 g/100g protein, 2.066±0.57 g/100g fat, 4.81±0.10 g/100g crude fiber, and 4.06±0.057 g/100g ash and NFE 78.92±0.066 g/100g. The results confirmed that tomato waste contains a considerable amount of Lycopene 51.0667±0.00577 mg/100g and exhibited good antioxidant properties. Total phenolics showed average contents of 122.9600±0.01000 mg GAE/100g, of which flavonoids accounted for 41.5367±0.00577 mg QE/100g. Antioxidant activity of tomato processing waste was found 0.6833±0.00577 mmol Trolox/100g. Unsaturated fatty acids represent the major portion of total fatty acids, Linoleic acid being the major one. The mineral content of tomato waste showed a good amount of potassium 3030.1767 mg/100g and calcium 131.80 mg/100g, respectively were present in it. These findings suggest that tomato processing waste is rich in nutrients, antioxidants, fatty acids, and minerals. I recommend that this waste should be sun-dried to be used in the combination of feed of the animals. It can also be used in making some other products like lycopene tea or several other health-beneficial products.

Keywords: food waste, tomato, bioactive compound, sustainable management

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5512 The Development of a Digitally Connected Factory Architecture to Enable Product Lifecycle Management for the Assembly of Aerostructures

Authors: Nicky Wilson, Graeme Ralph

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Legacy aerostructure assembly is defined by large components, low build rates, and manual assembly methods. With an increasing demand for commercial aircraft and emerging markets such as the eVTOL (electric vertical take-off and landing) market, current methods of manufacturing are not capable of efficiently hitting these higher-rate demands. This project will look at how legacy manufacturing processes can be rate enabled by taking a holistic view of data usage, focusing on how data can be collected to enable fully integrated digital factories and supply chains. The study will focus on how data is flowed both up and down the supply chain to create a digital thread specific to each part and assembly while enabling machine learning through real-time, closed-loop feedback systems. The study will also develop a bespoke architecture to enable connectivity both within the factory and the wider PLM (product lifecycle management) system, moving away from traditional point-to-point systems used to connect IO devices to a hub and spoke architecture that will exploit report-by-exception principles. This paper outlines the key issues facing legacy aircraft manufacturers, focusing on what future manufacturing will look like from adopting Industry 4 principles. The research also defines the data architecture of a PLM system to enable the transfer and control of a digital thread within the supply chain and proposes a standardised communications protocol to enable a scalable solution to connect IO devices within a production environment. This research comes at a critical time for aerospace manufacturers, who are seeing a shift towards the integration of digital technologies within legacy production environments, while also seeing build rates continue to grow. It is vital that manufacturing processes become more efficient in order to meet these demands while also securing future work for many manufacturers.

Keywords: Industry 4, digital transformation, IoT, PLM, automated assembly, connected factories

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5511 Managing the Blue Economy and Responding to the Environmental Dimensions of a Transnational Governance Challenge

Authors: Ivy Chen XQ

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This research places a much-needed focus on the conservation of the Blue Economy (BE) by focusing on the design and development of monitoring systems to track critical indicators on the status of the BE. In this process, local experiences provide an insight into important community issues, as well as the necessity to cooperate and collaborate in order to achieve sustainable options. Researchers worldwide and industry initiatives over the last decade show that the exploitation of marine resources has resulted in a significant decrease in the share of total allowable catch (TAC). The result has been strengthening law enforcement, yet the results have shown that problems were related to poor policies, a lack of understanding of over-exploitation, biological uncertainty and political pressures. This reality and other statistics that show a significant negative impact on the attainment of the Sustainable Development Goals (SDGs), warrant an emphasis on the development of national M&E systems, in order to provide evidence-based information, on the nature and scale of especially transnational fisheries crime and under-sea marine resources in the BE. In particular, a need exists to establish a compendium of relevant BE indicators to assess such impact against the SDGs by using selected SDG indicators for this purpose. The research methodology consists of ATLAS.ti qualitative approach and a case study will be developed of Illegal, unregulated and unreported (IUU) poaching and Illegal Wildlife Trade (IWT) as component of the BE as it relates to the case of abalone in southern Africa and Far East. This research project will make an original contribution through the analysis and comparative assessment of available indicators, in the design process of M&E systems and developing indicators and monitoring frameworks in order to track critical trends and tendencies on the status of the BE, to ensure specific objectives to be aligned with the indicators of the SDGs framework. The research will provide a set of recommendations to governments and stakeholders involved in such projects on lessons learned, as well as priorities for future research. The research findings will enable scholars, civil society institutions, donors and public servants, to understand the capability of the M&E systems, the importance of showing multi-level governance, in the coordination of information management, together with knowledge management (KM) and M&E at the international, regional, national and local levels. This coordination should focus on a sustainable development management approach, based on addressing socio-economic challenges to the potential and sustainability of BE, with an emphasis on ecosystem resilience, social equity and resource efficiency. This research and study focus are timely as the opportunities of the post-Covid-19 crisis recovery package will be grasped to set the economy on a path to sustainable development in line with the UN 2030 Agenda. The pandemic raises more awareness for the world to eliminate IUU poaching and illegal wildlife trade (IWT).

Keywords: Blue Economy (BE), transnational governance, Monitoring and Evaluation (M&E), Sustainable Development Goals (SDGs).

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5510 Improving Road Infrastructure Safety Management Through Statistical Analysis of Road Accident Data. Case Study: Streets in Bucharest

Authors: Dimitriu Corneliu-Ioan, Gheorghe FrațIlă

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Romania has one of the highest rates of road deaths among European Union Member States, and there is a concern that the country will not meet its goal of "zero deaths" by 2050. The European Union also aims to halve the number of people seriously injured in road accidents by 2030. Therefore, there is a need to improve road infrastructure safety management in Romania. The aim of this study is to analyze road accident data through statistical methods to assess the current state of road infrastructure safety in Bucharest. The study also aims to identify trends and make forecasts regarding serious road accidents and their consequences. The objective is to provide insights that can help prioritize measures to increase road safety, particularly in urban areas. The research utilizes statistical analysis methods, including exploratory analysis and descriptive statistics. Databases from the Traffic Police and the Romanian Road Authority are analyzed using Excel. Road risks are compared with the main causes of road accidents to identify correlations. The study emphasizes the need for better quality and more diverse collection of road accident data for effective analysis in the field of road infrastructure engineering. The research findings highlight the importance of prioritizing measures to improve road safety in urban areas, where serious accidents and their consequences are more frequent. There is a correlation between the measures ordered by road safety auditors and the main causes of serious accidents in Bucharest. The study also reveals the significant social costs of road accidents, amounting to approximately 3% of GDP, emphasizing the need for collaboration between local and central administrations in allocating resources for road safety. This research contributes to a clearer understanding of the current road infrastructure safety situation in Romania. The findings provide critical insights that can aid decision-makers in allocating resources efficiently and institutionally cooperating to achieve sustainable road safety. The data used for this study are collected from the Traffic Police and the Romanian Road Authority. The data processing involves exploratory analysis and descriptive statistics using the Excel tool. The analysis allows for a better understanding of the factors contributing to the current road safety situation and helps inform managerial decisions to eliminate or reduce road risks. The study addresses the state of road infrastructure safety in Bucharest and analyzes the trends and forecasts regarding serious road accidents and their consequences. It studies the correlation between road safety measures and the main causes of serious accidents. To improve road safety, cooperation between local and central administrations towards joint financial efforts is important. This research highlights the need for statistical data processing methods to substantiate managerial decisions in road infrastructure management. It emphasizes the importance of improving the quality and diversity of road accident data collection. The research findings provide a critical perspective on the current road safety situation in Romania and offer insights to identify appropriate solutions to reduce the number of serious road accidents in the future.

Keywords: road death rate, strategic objective, serious road accidents, road safety, statistical analysis

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5509 Drug and Poison Information Centers: An Emergent Need of Health Care Professionals in Pakistan

Authors: Asif Khaliq, Sayeeda A. Sayed

Abstract:

The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

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5508 Maximizing Giant Prawn Resource Utilization in Banjar Regency, Indonesia: A CPUE and MSY Analysis

Authors: Ahmadi, Iriansyah, Raihana Yahman

Abstract:

The giant freshwater prawn (Macrobrachium rosenbergii de Man, 1879) is a valuable species for fisheries and aquaculture, especially in Southeast Asia, including Indonesia due to their high market demand and potential for export. The growing demand for prawns is straining the sustainability of the Banjar Regency fishery. To ensure the long-term sustainability and economic viability of the prawn fishing in this region, it is imperative to implement evidence-based management practices. This requires comprehensive data on the Catch per Unit Effort (CPUE), Maximum Sustainable Yield (MSY) and the current rate of prawn resource exploitation. it analyzed five years of prawn catch data (2019-2023) obtained from South Kalimantan Marine and Fisheries Services. Fishing gears (e.g. hook & line and cast net) were first standardized with Fishing Power Index, and then calculated effort and MSY. The intercept (a) and the slope (b) values of regression curve were used to estimate the catch-maximum sustainable yield (CMSY) and optimal fishing effort (Fopt) levels within the framework of the Surplus Production Model. The estimated rates of resource utilization were then compared to the criteria of The National Commission of Marine Fish Stock Assessment. The findings showed that the CPUE value peaked in 2019 at 33.48 kg/trip, while the lowest value observed in 2022 at 5.12 kg/trip. The CMSY value was estimated to be 17,396 kg/year, corresponding to the Fopt level of 1,636 trips/year. The highest utilization rate was 56.90% recorded in 2020, while the lowest rate was observed in 2021 at 46.16%. The annual utilization rates were classified as “medium”, suggesting that increasing fishing effort by 45% could potentially maximize prawn catches at an optimum level. These findings provide a baseline for sustainable fisheries management in the region.

Keywords: giant prawns, CPUE, fishing power index, sustainable potential, utilization rate

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5507 Improving Sanitation and Hygiene Using a Behavioral Change Approach in Public and Private Schools in Kampala, Uganda

Authors: G. Senoga, D. Nakimuli, B. Ndagire, B. Lukwago, D. Kyamagwa

Abstract:

Background: The COVID-19 epidemic affected the education sector, with some private schools closing while other children missed schooling for fear contracting COVID-19. Post COVID-19, PSIU in collaborated with Kampala City Council Authority Directorate of Education and Social Science, Water and Sanitation department, and Directorate of Public Health and Environment to improve sanitation and hygiene among pupils and staff in 50 public and private school system in Kampala city. The “Be Clean, Stay Healthy Campaign” used a behavioral change approach in educating, reinforcing and engaging learners on proper hand washing behaviors, proper toilet usage and garbage disposal. In April 2022, 40 Washa lots were constructed, to reduce the pupil - hand wash station ratio; distributed KCCA approved printed materials; oriented 50 teachers, WASH committees to execute and implement hygiene promotion. To ensure sustainability, WASH messages were memorized and practiced through hand washing songs, Pledge, prayer, Poems, Skits, Music, dance and drama, coupled with participatory, practical demonstrations using peer to peer approach, guest speakers at assemblies and in classes. This improved hygiene and sanitation practices. Premised on this, PSI conducted an end line assessment to explore the impact of a hand washing campaign in regards to improvements in hand washing practices and hand hygiene among pupils, accessibility, functionality and usage of the constructed hygiene and sanitation facilities. Method: A cross-sectional post intervention assessment using a mixed methods approach, targeting headteachers, wash committee members and pupils less <17 years was used. Quantitative approaches with a mix of open-ended questions were used in purposively selected respondents in 50 schools. Primary three to primary seven pupils were randomly selected, data was analyzed using the Statistical Package for Social Scientists (SPSS) Outcomes and Findings: 46,989 pupils (51% female), 1,127 and 524 teaching and non-teaching staff were reached by the intervention, respectively. 96% of schools trained on sanitation, sustainable water usage and hygiene constituted 17-man school WASH committees with teacher, parents and pupils representatives. (31%) of the WASH committees developed workplans, (78%) held WASH meetings monthly. This resulted into improved sanitation, water usage, waste management, proper use of toilets, and improved pupils’ health with reduced occurrences of stomach upsets, diarrhoea initially attributed to improper use of latrines and general waste management. Teachers reported reduced number of school absenteeism due to improved hygiene and general waste management at school, especially proper management of sanitary pads. School administrations response rate in purchase of hygiene equipment’s and detergents like soap improved. Regular WASH meetings in classes, teachers and community supervision ensured WASH facilities are used appropriately. Conclusion and Recommendations: Practical behaviour change innovations improves pupil’s knowledge and understanding of hygiene messages and usage. Over 70% of pupils had clear recall of key WASH Messages. There is need for continuous water flow in the Washa lots, harvesting rain water would reduce water bills while complementing National water supply coupled with increasing on Washa lots in densely populated schools.

Keywords: handwashing, hygyiene, sanitation, behaviour change

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5506 Conceptual Model for Logistics Information System

Authors: Ana María Rojas Chaparro, Cristian Camilo Sarmiento Chaves

Abstract:

Given the growing importance of logistics as a discipline for efficient management of materials flow and information, the adoption of tools that permit to create facilities in making decisions based on a global perspective of the system studied has been essential. The article shows how from a concepts-based model is possible to organize and represent in appropriate way the reality, showing accurate and timely information, features that make this kind of models an ideal component to support an information system, recognizing that information as relevant to establish particularities that allow get a better performance about the evaluated sector.

Keywords: system, information, conceptual model, logistics

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5505 Manifestations of Moral Imagination during the COVID-19 Pandemic in the Debates of Lithuanian Parliament

Authors: Laima Zakaraite, Vaidas Morkevicius

Abstract:

The COVID-19 pandemic brought important and pressing challenges for politicians around the world. Governments, parliaments, and political leaders had to make quick decisions about containment of the pandemic, usually without clear knowledge about the factual spread of the virus, the possible expected speed of spread, and levels of mortality. Opinions of experts were also divided, as some advocated for ‘herd immunity’ without closing down the economy and public life, and others supported the idea of strict lockdown. The debates about measures of pandemic containment were heated and involved strong moral tensions with regard to the possible outcomes. This paper proposes to study the manifestations of moral imagination in the political debates regarding the COVID-19 pandemic. Importantly, moral imagination is associated with twofold abilities of a decision-making actor: the ability to discern the moral aspects embedded within a situation and the ability to envision a range of possibilities alternative solutions to the situation from a moral perspective. The concept was most thoroughly investigated in business management studies. However, its relevance for the study of political decision-making is also rather clear. The results of the study show to what extent politicians are able to discern the wide range of moral issues related to a situation (in this case, consequences of COVID-19 pandemic in a country) and how broad (especially, from a moral perspective) are discussions of the possible solutions proposed for solving the problem (situation). Arguably, political discussions and considerations are broader and affected by a wider and more varied range of actors and ideas compared to decision making in the business management sector. However, the debates and ensuing solutions may also be restricted by ideological maxims and advocacy of special interests. Therefore, empirical study of policy proposals and their debates might reveal the actual breadth of moral imagination in political discussions. For this purpose, we carried out the qualitative study of the parliamentary debates related to the COVID-19 pandemic in Lithuania during the first wave (containment of which was considered very successful) and at the beginning and consequent acceleration of the second wave (when the spread of the virus became uncontrollable).

Keywords: decision making, moral imagination, political debates, political decision

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5504 Ultrafiltration Process Intensification for Municipal Wastewater Reuse: Water Quality, Optimization of Operating Conditions and Fouling Management

Authors: J. Yang, M. Monnot, T. Eljaddi, L. Simonian, L. Ercolei, P. Moulin

Abstract:

The application of membrane technology to wastewater treatment has expanded rapidly under increasing stringent legislation and environmental protection requirements. At the same time, the water resource is becoming precious, and water reuse has gained popularity. Particularly, ultrafiltration (UF) is a very promising technology for water reuse as it can retain organic matters, suspended solids, colloids, and microorganisms. Nevertheless, few studies dealing with operating optimization of UF as a tertiary treatment for water reuse on a semi-industrial scale appear in the literature. Therefore, this study aims to explore the permeate water quality and to optimize operating parameters (maximizing productivity and minimizing irreversible fouling) through the operation of a UF pilot plant under real conditions. The fully automatic semi-industrial UF pilot plant with periodic classic backwashes (CB) and air backwashes (AB) was set up to filtrate the secondary effluent of an urban wastewater treatment plant (WWTP) in France. In this plant, the secondary treatment consists of a conventional activated sludge process followed by a sedimentation tank. The UF process was thus defined as a tertiary treatment and was operated under constant flux. It is important to note that a combination of CB and chlorinated AB was used for better fouling management. The 200 kDa hollow fiber membrane was used in the UF module, with an initial permeability (for WWTP outlet water) of 600 L·m-2·h⁻¹·bar⁻¹ and a total filtration surface of 9 m². Fifteen filtration conditions with different fluxes, filtration times, and air backwash frequencies were operated for more than 40 hours of each to observe their hydraulic filtration performances. Through comparison, the best sustainable condition was flux at 60 L·h⁻¹·m⁻², filtration time at 60 min, and backwash frequency of 1 AB every 3 CBs. The optimized condition stands out from the others with > 92% water recovery rates, better irreversible fouling control, stable permeability variation, efficient backwash reversibility (80% for CB and 150% for AB), and no chemical washing occurrence in 40h’s filtration. For all tested conditions, the permeate water quality met the water reuse guidelines of the World Health Organization (WHO), French standards, and the regulation of the European Parliament adopted in May 2020, setting minimum requirements for water reuse in agriculture. In permeate: the total suspended solids, biochemical oxygen demand, and turbidity were decreased to < 2 mg·L-1, ≤ 10 mg·L⁻¹, < 0.5 NTU respectively; the Escherichia coli and Enterococci were > 5 log removal reduction, the other required microorganisms’ analysis were below the detection limits. Additionally, because of the COVID-19 pandemic, coronavirus SARS-CoV-2 was measured in raw wastewater of WWTP, UF feed, and UF permeate in November 2020. As a result, the raw wastewater was tested positive above the detection limit but below the quantification limit. Interestingly, the UF feed and UF permeate were tested negative to SARS-CoV-2 by these PCR assays. In summary, this work confirms the great interest in UF as intensified tertiary treatment for water reuse and gives operational indications for future industrial-scale production of reclaimed water.

Keywords: semi-industrial UF pilot plant, water reuse, fouling management, coronavirus

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5503 Production and Recycling of Construction and Demolition Waste

Authors: Vladimira Vytlacilova

Abstract:

Recycling of construction and demolition waste (C&DW) and their new reuse in structures is one of the solutions of environmental problems. Construction and demolition waste creates a major portion of total solid waste production in the world and most of it is used in landfills all the time. The paper deals with the situation of the recycling of the building and demolition waste in the Czech Republic during the recent years. The paper is dealing with questions of C&D waste recycling, it also characterizes construction and demolition waste in general, furthermore it analyses production of construction waste and subsequent production of recycled materials.

Keywords: Recycling, Construction and demolition waste, Recycled rubble, Waste management

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5502 Prioritization of Sub-Watersheds in Semi Arid Region: A Case Study of Shevgaon and Pathardi Tahsils in Maharashtra

Authors: Dadasaheb R. Jawre, Maya G. Unde

Abstract:

Prioritization of sub-watershed plays important role in watershed management. It shows the requirement of watershed to give a treatment for the green growth of the region and conservation of the sub-watersheds. There is a number of factors like topography of the region, climatic characteristics like rainfall and runoff, land-use land-cover, social factors which are related to the development of watershed for agricultural uses and domestic purposes in the region. The present research is throwing a focus on how morphometric parameters in association with GIS analysis will help in identifying the ranking of the sub-watersheds for further development which help of suggested watershed structures. Shevgaon and Pathardi tahsils are drought prone tahsils of Ahmednagar district in Maharashtra. These tahsils come under the semi-arid region. Sub-watershed prioritization is necessary for proper planning and management of natural resources for sustainable development of the study area. Less rainfall and increasing population pressure on the land as well as water resources lead to scarcity of the water in the region. Hence, researcher has selected Shevgaon and Pathardi tahsils for sub-watershed prioritization. There are seven sub-watersheds which selected for the present research paper. In the morphological analysis linear aspects, aerial aspects and relief aspects are considered for the prioritization. The largest sub-watershed is Erdha which is located at Karanji in Pathardi tahsil having an area of 145.06 km2 and smallest sub-watershed is Erandgaon which is located in Shevgaon tahsil having an area of 40.143 km2. For all seven sub-watersheds, seven morphometric parameters were considered for calculating the compound parameter values. Finally, compound parameter values are grouped into three groups such as, high priority (below 4.0), moderate priority (4.0 to 5.0) and low priority (above 5.0) according to the compound value Erandgaon, Chapadgaon and Tarak sub-watersheds comes under high priority group, Erdha and Domeshwar sub-watersheds come under moderate priority group and Chandani and Kasichi sub-watershed come under low priority group. Both the tahsils falls in drought prone area, after getting the watershed structure overall development of the region will take place.

Keywords: sub-watersheds, GIS and remote sensing, morphometric analysis, compound parameter value, prioritization

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5501 Understanding Organizational Capabilities and Dynamic Capabilities in the Context of Micro Enterprises: A Research Agenda

Authors: G. Gurkan Inan, Umit S. Bititci

Abstract:

Purpose of this study is to understand development of organizational capabilities in micro enterprises. Organizational capabilities underpin companies` competitive advantages as well as their ability to respond internal and external change. Current literature is focused on mainly large enterprises, with some interest on SMEs. However there is little research attempting to understand the applicability of organizational capability theories on micro enterprises. In this paper we propose a research framework and a research agenda for addressing this gap.

Keywords: micro enterprises, organizational capabilities, dynamic capabilities, management

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5500 An International Comparison of Global Financial Centers: Major Competitive Strategies

Authors: I. Hakki Eraslan, Birol Ozturk, Istemi Comlekci

Abstract:

This paper begins by defining what is meant by “globalization” in finance and by identifying the sources of value-added in the internationally-competitive financial services sector origination, trading and distribution of debt and equity capital market instruments and their derivatives, foreign exchange trading and securities brokerage, management of market risk and credit risk, loan syndication and structured bank financings, corporate finance and advisory services, and asset management. These activities are considered in terms of a “value-chain” one that ultimately gives rise to the real economic gains attributable to financial-center operations. The research presents available evidence as to where the relevant value-added activities usually take place. It then examines the “centrifugal” and “centripetal” forces that determine the concentration or dispersal of value-added activity in financial intermediation, both interregionally and internationally. Next, the research assesses the factors, which appear to underlie the locational pattern of international financial centers that has evolved. In preparing this paper, also it is examined the current position and the main opportunities and challenges facing world major financial services sector, and attempted to lay out a potential vision and strategies. It is conducted extensive research, including many internal research materials and publications. It is also engaged closely with the academia, industry practitioners and regulators, and consulted market experts from major world financial centers. More than 60 in‐depth consultative sessions were conducted in the past two years which provided insightful suggestions and innovative ideas on how to further financial industry’s position as an international financial centre. The paper concludes with the outlook for the future pattern of financial centers in the global competitive environment. The ideas and advice gathered are condensed into this paper that recommends to the strategic decision leaders a vision and a strategy for financial services sector to move forward amid a highly competitive environment.

Keywords: financial centers, competitiveness, financial services industry, economics

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5499 Eco-Friendly Cleansers Initiation for Eco-Campsite Development in Khao Yai National Park, Thailand

Authors: Tatsanawalai Utarasakul

Abstract:

Environmental impact has occurred at Khao Yai National Park, especially the water pollution by tourist activities as a result of 800,000 tourists visiting annually. To develop an eco-campsite, eco-friendly cleansers were implemented in Lam Ta Khlong and Pha Kluay Mai Campsites for tourists and restaurants. The results indicated the positive effects of environmentally friendly cleansers on water quality in Lam Ta Khlong River and can be implemented in other protected areas to decrease chemical contamination in ecosystems.

Keywords: sustainable tourism management, eco-campsite, Khao Yai National Park, ecology

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5498 Lightning Protection Design Applied to Sustainable Development

Authors: Sylvain Fauveaux, T. Nowicki

Abstract:

Lightning protection is nowadays applied worldwide since the advent of international standards. Lightning protection is widely justified by the casualties and damages involved. As a matter of fact, the lightning business is constantly growing as more and more sensible areas need to be protected. However, the worldwide demand of copper materiel is increasing as well, its price too. Furthermore, the most frequently used method of protection is consuming a lot of copper. The copper production is also consuming a large amount of natural and power resources, not to mention the ecologic balance.

Keywords: ESEAT, Lightning protection , natural resources management, NF C 17-102, sustainable development

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5497 Optimal Utilization of Space in a Warehouse: A Case Study

Authors: Arun Kumar R. K. Gothra, Hasan Alhakamy

Abstract:

With increasing expectations and demands for warehousing and distribution, Warehouse Solution Incorporated in Victoria has been looking at ways to improve on its business processes to maintain the competitive edge. To maintain the provision of high quality service standards at competitive and affordable prices, improvements in the logistics management are necessary. One such avenue is to make efficient use of space available in the warehouse. This paper is based on a study of the collaboration of Warehouse Solution Inc with Dandenong Distribution Centre (DDC) to solve congestion problem and enhance efficiency of the whole warehouse activities.

Keywords: space optimization, optimal utilization, warehouse, DDC

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5496 Effectiveness of Simulation Resuscitation Training to Improve Self-Efficacy of Physicians and Nurses at Aga Khan University Hospital in Advanced Cardiac Life Support Courses Quasi-Experimental Study Design

Authors: Salima R. Rajwani, Tazeen Ali, Rubina Barolia, Yasmin Parpio, Nasreen Alwani, Salima B. Virani

Abstract:

Introduction: Nurses and physicians have a critical role in initiating lifesaving interventions during cardiac arrest. It is important that timely delivery of high quality Cardio Pulmonary Resuscitation (CPR) with advanced resuscitation skills and management of cardiac arrhythmias is a key dimension of code during cardiac arrest. It will decrease the chances of patient survival if the healthcare professionals are unable to initiate CPR timely. Moreover, traditional training will not prepare physicians and nurses at a competent level and their knowledge level declines over a period of time. In this regard, simulation training has been proven to be effective in promoting resuscitation skills. Simulation teaching learning strategy improves knowledge level, and skills performance during resuscitation through experiential learning without compromising patient safety in real clinical situations. The purpose of the study is to evaluate the effectiveness of simulation training in Advanced Cardiac Life Support Courses by using the selfefficacy tool. Methods: The study design is a quantitative research design and non-randomized quasi-experimental study design. The study examined the effectiveness of simulation through self-efficacy in two instructional methods; one is Medium Fidelity Simulation (MFS) and second is Traditional Training Method (TTM). The sample size was 220. Data was compiled by using the SPSS tool. The standardized simulation based training increases self-efficacy, knowledge, and skills and improves the management of patients in actual resuscitation. Results: 153 students participated in study; CG: n = 77 and EG: n = 77. The comparison was done between arms in pre and post-test. (F value was 1.69, p value is <0.195 and df was 1). There was no significant difference between arms in the pre and post-test. The interaction between arms was observed and there was no significant difference in interaction between arms in the pre and post-test. (F value was 0.298, p value is <0.586 and df is 1. However, the results showed self-efficacy scores were significantly higher within experimental group in post-test in advanced cardiac life support resuscitation courses as compared to Traditional Training Method (TTM) and had overall (p <0.0001) and F value was 143.316 (mean score was 45.01 and SD was 9.29) verses pre-test result showed (mean score was 31.15 and SD was 12.76) as compared to TTM in post-test (mean score was 29.68 and SD was 14.12) verses pre-test result showed (mean score was 42.33 and SD was 11.39). Conclusion: The standardized simulation-based training was conducted in the safe learning environment in Advanced Cardiac Life Suport Courses and physicians and nurses benefited from self-confidence, early identification of life-threatening scenarios, early initiation of CPR, and provides high-quality CPR, timely administration of medication and defibrillation, appropriate airway management, rhythm analysis and interpretation, and Return of Spontaneous Circulation (ROSC), team dynamics, debriefing, and teaching and learning strategies that will improve the patient survival in actual resuscitation.

Keywords: advanced cardiac life support, cardio pulmonary resuscitation, return of spontaneous circulation, simulation

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