Search results for: medication therapy management

Authors: Paulo Sergio Altman Ferreira

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Relationship development plays an essential role in every logistics company. Logistics companies are service-based businesses essentially performing the flow of materials, housing, and inventory management for a wide range of customers. The service encounter between the logistics provider’s personnel and the customers may form a connection that will demonstrate a strong impact, not only to the customers' overall satisfaction but may also provide the perception of individualized services. Logistics services must drive value. It also shows a close influence on the quality and costs of client-centered services. If we describe logistics value creation as the function of quality perception of the client divided by service costs, there is a requirement to better outline and explain the measures and analytics for logistics costs and relationship performance. This critical shift to understand logistics services is a relevant contribution to capture how relationship value can be quantified. This might involve changing our current perspective on logistics providers beyond uniquely measuring the services in terms of activities, personnel levels, and financial/costs ratios. This paper argues that measuring value creation accomplishments of logistics services needs to consider the relational improvements for the wider range of logistics companies. Accurate logistics value requires a description of the financial impact of the relational perspective of the service.

Keywords: logistics services providers, financial metrics, relationship management, value creation

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Authors: C. Asha Poorna, P. G. Vinod, A. R. R. Menon

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Currently increasing population and their activities like urbanization and industrialization generating the greatest environmental, issue called Waste. And the major problem in waste management is selection of an appropriate site for waste disposal. The selection of suitable site have constrains like environmental, economical and political considerations. In this paper we discuss the strategies to be followed while selecting a site for decentralized system for solid waste disposal, using Geographic Information System (GIS), the Analytical Hierarchy Process (AHP) and the remote sensing method for Thiruvananthapuram corporation area. It is located on the west coast of India near the extreme south of the mainland. It lies on the shores of Killiyar and Karamana River. Being on the basin the waste managements must be regulated with the water body. The different criteria considered for waste disposal site selection are lithology, surface water, aquifer, groundwater, land use, contours, aspect, elevation, slope, and distance to road, distance from settlement are examined in relation to land fill site selection. Each criterion was identified and weighted by AHP score and mapped using GIS technique and suitable map is prepared by overlay analysis.

Keywords: waste disposal, solid waste management, Geographic Information System (GIS), Analytical Hierarchy Process (AHP)

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Authors: Erin V. Kelly, Nicola C. Newton, Lexine A. Stapinski, Maree Teesson

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Introduction: There is a lack of targeted prevention programs for reducing bullying and distress among adolescents involved in bullying. The current study aimed to examine the impact of a personality-targeted intervention (Preventure) on bullying (victimization and perpetration) and distress among adolescent victims/bullies with high-risk personality types. Method: A cluster randomized trial (RCT) was conducted in 26 secondary schools (2190 students) in NSW and Victoria, Australia, as part of the Climate Schools and Preventure trial. The schools were randomly allocated to Preventure (13 schools received Preventure, 13 did not). Students were followed up at 4 time points (6, 12, 24 and 36 months post-baseline). Preventure involves two group sessions, based on cognitive behavioral therapy, and tailored to four personality types shown to increase risk of substance misuse and other emotional and behavioural problems, including impulsivity, sensation-seeking, anxiety sensitivity and hopelessness. Students were allocated to the personality-targeted groups based on their scores on the Substance Use Risk Profile Scale. Bullying was measured using an amended version of the Revised Olweus Bully/Victim Scale. Psychological distress was measured using the Kessler Psychological Distress Scale. Results: Among high-risk students classified as victims at baseline, those in Preventure schools reported significantly less victimization and distress over time than those in control schools. Among high-risk students classified as bullies at baseline, those in Preventure schools reported significantly less distress over time than those in control schools (no difference for perpetration). Conclusion: Preventure is a promising intervention for reducing bullying victimization and psychological distress among adolescents involved in bullying.

Keywords: adolescents, bullying, personality, prevention

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Authors: Danila Zuffetti, Lorenzo Chiesa

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Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.

Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease

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Authors: Joanna Bajerska, Agata Chmurzyńska, Agata Muzsik, Patrycja Krzyżanowska, Klaudia Łochocka, Jarosław Walkowiak

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The Mediterranean diet (MED) is regarded as beneficial in the therapy of central obesity-associated metabolic abnormalities. However, in the traditional diet of the Central European countries, food items with positive nutritional profiles (rye bread, oats, buckwheat, herrings, linseed and rapeseed oil, berries, apples, plums, root vegetables etc.) are also used. We hypothesized that the Central European Diet (CED) may be comparatively effective in reducing symptoms of central obesity as MED. We tested the health effects of the CED, which is an environmentally friendly regional diet and the traditional MED diet in a group of postmenopausal centrally obese women. A total 58 with a mean age of 60 y (50-70y), body mass index (in kg/m(2)) of 33.4 (22.6-47.3), and waist circumference of 105 cm (87.5-137 cm) were randomly assigned to receive either the diet based on food items commonly used in Central Europe (the CED group; n = 29) or the Mediterranean diet (the MED group; n = 29) for 15 weeks. Body mass and body composition were measured with a Bod Pod (Cosmed, Italy). A non-elastic flexible measuring tape was used to measure waist circumference. Additionally, blood pressure, plasma lipid and glucose levels were assessed with the use of a biochemical analyzer. A total of 50 subjects [86% (CED 83%; MED 90%)] completed the intervention. A high dietary compliance for both described diets was achieved. The mean (±SEM) weight and waist circumference changes were -7.4 ± 0.7 kg; -8.3 ± 0.7 cm and -8.1 ± 0.5 kg; -7.1 ± 0.6 cm for the CED and MED groups, respectively. Moreover, there were no differences between the effectiveness of the diets used in terms of the influence on fat mass, blood pressure, and biochemical parameters. The preliminary data suggest that both described diets may be successfully used for improving central obesity-associated metabolic abnormalities. The project was financed by the National Science Centre awarded based on the number of decision DEC-013/09/B/NZ9/02365

Keywords: central european diet, central obesity, Mediterranean diet, metabolic abnormalities

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Authors: Paul J Yazaki, Michael Bouvet, John Shively

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Surgery for solid gastrointestinal (GI) cancers such as pancreatic, colorectal, and gastric adenocarcinoma remains the mainstay of curative therapy. Complete resection of the primary tumor with negative margins (R0 resection), its draining lymph nodes, and distant metastases offers the optimal surgical benefit. Real-time fluorescence guided surgery (FGS) promises to improve GI cancer outcomes and is rapidly advancing with tumor-specific antibody conjugated fluorophores that can be imaged using near infrared (NIR) technology. Carcinoembryonic Antigen (CEA) is a non-internalizing tumor antigen validated as a surface tumor marker expressed in >95% of colorectal, 80% of gastric, and 60% of pancreatic adenocarcinomas. Our humanized anti-CEA hT84.66-M5A (M5A) monoclonal antibody (mAb)was conjugated with the NHS-IRDye800CW fluorophore and shown it can rapidly and effectively NIRoptical imageorthotopically implanted human colon and pancreatic cancer in mouse models. A limitation observed is that these NIR-800 dye conjugated mAbs have a rapid clearance from the blood, leading to a narrow timeframe for FGS and requiring high doses for effective optical imaging. We developed a novel antibody-fluorophore conjugate by incorporating a PEGylated sidearm linker to shield or mask the IR800 dye’s hydrophobicity which effectively extended the agent’s blood circulation half-life leading to increased tumor sensitivity and lowered normal hepatic uptake. We hypothesized that our unique anti-CEA linked to the fluorophore, IR800 by PEGylated sidewinder, M5A-SW-IR800 will become the next generation optical imaging agent, safe, effective, and widely applicable for intraoperative image guided surgery in CEA expressing GI cancers.

Keywords: optical imaging, anti-CEA, cancer, fluorescence-guided surgery

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Authors: Fadime Eroglu

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Acanthamoeba genus belongs to kingdom protozoa, and it is known as free-living amoebae. Acanthamoeba genus has been isolated from human bodies, swimming pools, bottled mineral water, contact lens solutions, dust, and soil. The members of the genus Acanthamoeba causes Acanthamoeba Keratitis which is a painful sight-threatening disease of the eyes. In recent years, the prevalence of Acanthamoeba keratitis has been high rate reported. The eight different Acanthamoeba species are known to be effective in Acanthamoeba keratitis. These species are Acanthamoeba castellanii, Acanthamoeba polyphaga, Acanthamoeba griffini, Acanthamoeba hatchetti, Acanthamoeba culbertsoni and Acanhtamoeba rhysodes. The conventional diagnosis of Acanthamoeba Keratitis has relied on cytological preparations and growth of Acanthamoeba in culture. However molecular methods such as real-time PCR has been found to be more sensitive. The real-time PCR has now emerged as an effective method for more rapid testing for the diagnosis of infectious disease in decade. Therefore, a real-time PCR assay for the detection of Acanthamoeba keratitis and Acanthamoeba species have been developed in this study. The 18S rRNA sequences from Acanthamoeba species were obtained from National Center for Biotechnology Information and sequences were aligned with MEGA 6 programme. Primers and probe were designed using Custom Primers-OligoPerfectTMDesigner (ThermoFisherScientific, Waltham, MA, USA). They were also assayed for hairpin formation and degree of primer-dimer formation with Multiple Primer Analyzer ( ThermoFisherScientific, Watham, MA, USA). The eight different ATCC Acanthamoeba species were obtained, and DNA was extracted using the Qiagen Mini DNA extraction kit (Qiagen, Hilden, Germany). The DNA of Acanthamoeba species were analyzed using newly designed primer and probe set in real-time PCR assay. The early definitive laboratory diagnosis of Acanthamoeba Keratitis and the rapid initiation of suitable therapy is necessary for clinical prognosis. The results of the study have been showed that new primer and probes could be used for detection and distinguish for Acanthamoeba species. These new developing methods are helpful for diagnosis of Acanthamoeba Keratitis.

Keywords: Acathamoeba Keratitis, Acanthamoeba species, fast diagnosis, Real-Time PCR

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Authors: Calvin A. Omolo, Rahul S. Kalhapure, Mahantesh Jadhav, Sanjeev Rambharose, Chunderika Mocktar, Thirumala Govender

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Treatment of infections is compromised by limitations of conventional dosage forms and drug resistance. Nanocarrier system is a strategy to overcome these challenges and improve therapy. Thus, the development of novel materials for drug delivery via nanocarriers is essential. The aim of the study was to synthesize a multi-arm polymer (6-mPEPEA) for enhanced activity of vancomycin (VM) against susceptible and resistant Staphylococcus aureus (MRSA). The synthesis steps of the star polymer followed reported procedures. The synthesized 6-mPEPEA was characterized by FTIR, ¹H and ¹³CNMR and MTT assays. VM loaded micelles were prepared from 6-mPEPEA and characterized for size, polydispersity index (PI) and surface charge (ZP) (Dynamic Light Scattering), morphology by TEM, drug loading (UV Spectrophotometry), drug release (dialysis bag), in vitro and in vivo efficacy against sensitive and resistant S. aureus. 6-mPEPEA was synthesized, and its structure was confirmed. MTT assays confirmed its nontoxic nature with a high cell viability (77%-85%). Unimolecular spherical micelles were prepared. Size, PI, and ZP was 52.48 ± 2.6 nm, 0.103 ± 0.047, -7.3 ± 1.3 mV, respectively and drug loading was 62.24 ± 3.8%. There was a 91% drug release from VCM-6-mPEPEA after 72 hours. In vitro antibacterial test revealed that VM-6-mPEPEA had 8 and 16-fold greater activity against S. aureus and MRSA when compared to bare VM. Further investigations using flow cytometry showed that VM-6-mPEPEA had 99.5% killing rate of MRSA at the MIC concentration. In vivo antibacterial activity revealed that treatment with VM-6-mPEPEA had a 190 and a 15-fold reduction in the MRSA load in untreated and VM treated respectively. These findings confirmed the potential of 6-mPEPEA as a promising bio-degradable nanocarrier for antibiotic delivery to improve treatment of bacterial infections.

Keywords: biosafe, MRSA, nanocarrier, resistance, unimolecular-micelles

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Authors: Luziane De Fatima Kirchner, Maria De Jesus Dutra Dos Reis, Francine Nathalie Ferraresi Rodrigues Queluz

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This study evaluated the effect of two components of analytic-behavioral intervention (1-management of conditions of the physical environment, 2-management of the interpersonal relationship) of women with fibromyalgia (FM), besides Clinical Significance and Reliable Change at the end of the intervention. Self-report instruments were used to evaluate stress, anxiety, depression, social skills and disability due to pain and Cortisol Awakening Response (CAR). Four women with a medical diagnosis of FM (mean age 52.7; sd = 6.65), participated of the following procedures: initial evaluation, 10 sessions of component 1, intermediate evaluation, 10 sessions of component 2, and final evaluation. The 20 sessions were effective, with positive changes in the scores of all the self-report instruments, highlighting the results of the stress symptoms that had improvement in the intermediate evaluation. There was, however, no change in the cortisol response on awakening. The Clinical Significance or Reliable Change observed, according to the scores of the stress, anxiety, depression and social skills instruments, corroborated the reports of the participants in the session and the objectives of the treatment. Implications for future studies are discussed, above all, the importance in conducting evaluations with the use of direct measures together with self-report measures.

Keywords: behavioral intervention, clinical significance, fibromyalgia, reliable change

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Authors: Davood Barari Tari

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In order to investigate the correlation of rice traits in different nitrogen management methods by modeling programming, an experiment was laid out in rice paddy field in an experimental field at Caspian Coastal Sea region from 2013 to 2014. Variety used was Shiroudi as a high yielding variety. Nitrogen management was in two methods. Amount of nitrogen at four levels (30, 60, 90, and 120 Kg N ha-1 and control) and nitrogen-splitting at four levels (T1: 50% in base + 50% in maximum tillering stage, T2= 33.33% basal +33.33% in maximum tillering stage +33.33% in panicle initiation stage, T3=25% basal+37.5% in maximum tillering stage +37.5% in panicle initiation stage, T4: 25% in basal + 25% in maximum tillering stage + 50% in panicle initiation stage). Results showed that nitrogen traits, total grain number, filled spikelets, panicle number per m2 had a significant correlation with grain yield. Results related to calibrated and validation of rice model methods indicated that correlation between rice yield and yield components was accurate. The correlation between panicle length and grain yield was minimum. Physiological indices was simulated with low accuracy. According to results, investigation of the correlation between rice traits in physiological, morphological and phenological characters and yield by modeling and simulation methods are very useful.

Keywords: rice, physiology, modelling, simulation, yield traits

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Authors: Sharif Abdelghany

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Polymeric nanoparticles have been widely investigated as a controlled release drug delivery platform for the treatment of tuberculosis (TB). These nanoparticles were also readily internalised into macrophages, leading to high intracellular drug concentration. In this study two anti-TB drugs, amikacin and moxifloxacin were encapsulated into PLGA nanoparticles. The novelty of this work appears in: (1) the efficient encapsulation of two hydrophilic second-line anti-TB drugs, and (2) intramacrophage delivery of this synergistic combination potentially for rapid treatment of multi-drug resistant TB (MDR-TB). Two water-oil-water (w/o/w) emulsion strategies were employed in this study: (1) alginate coated PLGA nanoparticles, and (2) alginate entrapped PLGA nanoparticles. The average particle size and polydispersity index (PDI) of the alginate coated PLGA nanoparticles were found to be unfavourably high with values of 640 ± 32 nm and 0.63 ± 0.09, respectively. In contrast, the alginate entrapped PLGA nanoparticles were within the desirable particle size range of 282 - 315 nm and the PDI was 0.08 - 0.16, and therefore were chosen for subsequent studies. Alginate entrapped PLGA nanoparticles yielded a drug loading of over 10 µg/mg powder for amikacin, and more than 5 µg/mg for moxifloxacin and entrapment efficiencies range of approximately 25-31% for moxifloxacin and 51-59% for amikacin. To study macrophage uptake efficiency, the nanoparticles of alginate entrapped nanoparticle formulation were loaded with acridine orange as a marker, seeded to THP-1 derived macrophages and viewed under confocal microscopy. The particles were readily internalised into the macrophages and highly concentrated in the nucleus region. Furthermore, the anti-mycobacterial activity of the drug-loaded particles was evaluated using M. tuberculosis-infected macrophages, which revealed a significant reduction (4 log reduction) of viable bacterial count compared to the untreated group. In conclusion, the amikacin-moxifloxacin alginate entrapped PLGA nanoparticles are promising for further in vivo studies.

Keywords: moxifloxacin and amikacin, nanoparticles, multidrug resistant TB, PLGA

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Authors: Safa Gharbi, Hayfa Zgaya, Nesrine Zoghlami, Slim Hammadi, Cyril De Barbarin, Laurent Vinatier, Christiane Coupier

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Increasing productivity and quality of service, improving the working comfort and ensuring the efficiency of all processes are important challenges for every warehouse. The order picking is recognized to be the most important and costly activity of all the process in warehouses. This paper presents a new approach using Augmented Reality (AR) in the field of logistics. It aims to create a Head-Up Display (HUD) interface with a Warehouse Management System (WMS), using AR glasses. Integrating AR technology allows the optimization of order picking by reducing time of picking process, increasing the efficiency and delivering quickly. The picker will be able to access immediately to all the information needed for his tasks. All the information is displayed when needed in the field of vision (FOV) of the operator, without any action requested from him. These research works are part of the industrial project RASL (Réalité Augmentée au Service de la Logistique) which gathers two major partners: the LAGIS (Laboratory of Automatics, Computer Engineering and Signal Processing in Lille-France) and Genrix Group, European leader in warehouses logistics, who provided his software for implementation, and his logistics expertise.

Keywords: Augmented Reality (AR), logistics and optimization, Warehouse Management System (WMS), Head-Up Display (HUD)

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Authors: Yen-Hsia Lin, Ya-Fang Cheng, Hui-Zhu Chen, Chi-Hui Tiao

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This is a case study of a 70-year-old man suffering from Type 2 diabetes mellitus and hyperglycemia hyperosmolarity state. He was admitted into the intensive care unit from the 20th to 26th of October, 2015. After receiving relevant information through open-ended conversations, observation, and physical assessment, as well as the psychological, social and spiritual holistic nursing assessment, several clinical health problems such as unstable blood sugar, impaired skin integrity and lack of self-care management knowledge were identified by the author. During the period of care, the patient was encouraged to share and express his feelings, an active listening and initiating approach from the nursing team had led to the understanding of why the patient refused to use insulin. This knowledge enabled the nursing team to manage patient care by educating the patient with self-care management skills, such as foot wound care and insulin injection skills to slow the deterioration of complications. Also, the implementation of appropriate diet and exercise routine to improve patients’ style. By enhancing self-care ability in diabetic patients, they are able to return home with the skill to improve better quality life style.

Keywords: hyperglycemia hyperosmolar state, type2 diabetes Mellitu, diabetes Mellitu foot care, intensive care

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Authors: Raja Asad Zaheer, Aisha Tanveer, Hafza Mehreen Fatima

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Global Software Development (GSD) is becoming a common norm in software industry, despite of the fact that global distribution of the teams presents special issues for effective communication and coordination of the teams. Now trends are changing and project management for distributed teams is no longer in a limbo. GSD can be effectively established using agile and project managers can use different agile techniques/tools for solving the problems associated with distributed teams. Agile methodologies like scrum and XP have been successfully used with distributed teams. We have employed exploratory research method to analyze different recent studies related to challenges of GSD and their proposed solutions. In our study, we had deep insight in six commonly faced challenges: communication and coordination, temporal differences, cultural differences, knowledge sharing/group awareness, speed and communication tools. We have established that each of these challenges cannot be neglected for distributed teams of any kind. They are interlinked and as an aggregated whole can cause the failure of projects. In this paper we have focused on creating a scalable framework for detecting and overcoming these commonly faced challenges. In the proposed solution, our objective is to suggest agile techniques/tools relevant to a particular problem faced by the organizations related to the management of distributed teams. We focused mainly on scrum and XP techniques/tools because they are widely accepted and used in the industry. Our solution identifies the problem and suggests an appropriate technique/tool to help solve the problem based on globally shared knowledgebase. We can establish a cause and effect relationship using a fishbone diagram based on the inputs provided for issues commonly faced by organizations. Based on the identified cause, suitable tool is suggested, our framework suggests a suitable tool. Hence, a scalable, extensible, self-learning, intelligent framework proposed will help implement and assess GSD to achieve maximum out of it. Globally shared knowledgebase will help new organizations to easily adapt best practices set forth by the practicing organizations.

Keywords: agile project management, agile tools/techniques, distributed teams, global software development

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Authors: Walid Moudani

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The Crew Reserve Assignment Problem (CRAP) considers the assignment of the crew members to a set of reserve activities covering all the scheduled flights in order to ensure a continuous plan so that operations costs are minimized while its solution must meet hard constraints resulting from the safety regulations of Civil Aviation as well as from the airlines internal agreements. The problem considered in this study is of highest interest for airlines and may have important consequences on the service quality and on the economic return of the operations. In this communication, a new mathematical formulation for the CRAP is proposed which takes into account the regulations and the internal agreements. While current solutions make use of Artificial Intelligence techniques run on main frame computers, a low cost approach is proposed to provide on-line efficient solutions to face perturbed operating conditions. The proposed solution method uses a dynamic programming approach for the duties scheduling problem and when applied to the case of a medium airline while providing efficient solutions, shows good potential acceptability by the operations staff. This optimization scheme can then be considered as the core of an on-line Decision Support System for crew reserve assignment operations management.

Keywords: airlines operations management, combinatorial optimization, dynamic programming, crew scheduling

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Authors: Zahra Khodaee

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Background and Objective: The attractive potential for tourism in the southern islands of Iran, Kish, and Qeshm and recently Hendurabi, are becoming more and more popular and object of increased attention from the investors. The Iranian coral reef islands, with the exception of Kish and Qeshm, have not undergone sufficient development. The southern islands of Iran have faced two problems with climate change and the desire for the presence of tourists. The lack of proper planning, inefficient management, and lack of adequate knowledge of ecosystems of offshore regions have severely damaged the world natural heritage. This study was conducted to consider the correlation of tourism, development, and ecosystem because there is a need for further addressing the ecotourism in coral islands. Method: Through qualitative research, this paper was used of library studies and field studies and surveying to study the physical (objective-subjective) physical factors of ecotourism development in Honduran Island. Using SPSS software and descriptive-analytical method was shown the results. The survey was conducted with the participation of 150 tourists on Kish islands, who were chosen at random and who expressed their desire to travel to Hendurabi Island. Information was gathered using SPSS software and unique statistical T-test. The questionnaire was put together using AMOS software to ensure that the questions asked were sufficiently relevant. Findings: The results of this study presented that physical factors affecting the development of ecotourism in two categories are objective and subjective factors because IFI factor = 0.911 and CFI Factor = 0.907 into the target community. Discussion and conclusion: The results were satisfactory in that they showed that eco-tourists attached importance to see views, quiet, secluded areas, tranquility security, quality of the area being visited, easy access to services these were the top criteria for those visiting the area while they adhere to environmental compliance. Developing Management of these regions should maintain appropriate utilization along with sustainable and ecological responsibility.

Keywords: ecotourism, coral reef island, development management, Hendurabi Island

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Authors: Aulon Shabani, Denis Panxhi, Orion Zavalani

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This paper presents the modelling and development of a simulator for residential electrical appliances. The simulator is developed on MATLAB providing the possibility to analyze and simulate energy consumption of frequently used home appliances in Albania. Modelling of devices considers the impact of different factors, mentioning occupant behavior and climacteric conditions. Most devices are modeled as an electric circuit, and the electric energy consumption is estimated by the solutions of the guiding differential equations. The provided models refer to devices like a dishwasher, oven, water heater, air conditioners, light bulbs, television, refrigerator water, and pump. The proposed model allows us to simulate beforehand the energetic behavior of the largest consumption home devices to estimate peak consumption and improving its reduction. Simulated home prototype results are compared to real measurement of a considered typical home. Obtained results from simulator framework compared to monitored typical household using EmonTxV3 show the effectiveness of the proposed simulation. This conclusion will help for future simulation of a large group of typical household for a better understanding of peak consumption.

Keywords: electrical appliances, energy management, modelling, peak estimation, simulation, smart home

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Authors: Mojtaba Javdan, Kamran Jafarpour Ghalehteimouri, Moslem Ghasemi, Arezu Riazi

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Tourism has a huge multiplier effect on other socioeconomic sectors, resulting in better infrastructure and public services. However, its environmental impact is still a source of concern. As a result, a greater emphasis has been placed on improving the sustainability of tourist destinations. Despite the global significance of sustainability assessment, only a few widely accepted methods for measuring sustainability exist. As a result, the life cycle concept is used to evaluate environmental, economic, and social consequences. The Social Life Cycle Assessment (S-LCA) is a crucial life cycle tool. Due to the tourism-specific service specifications, tourism-related activities are well-suited for the elaboration of data related to social sustainability. Therefore, the possibility of how the S-LCA is involved in ensuring cultural tourism destinations' long-term viability can be the main question. To answer this question, this article examines the theoretical evolution of both the S-LCA and cultural tourism. Potential application gaps are investigated, and an S-LCA framework for sustainable cultural tourism destinations is proposed and discussed. Thus, by bringing all stakeholders' interests together, the proposed S-LCA conceptual framework can play an effective role in achieving the principles and objectives of sustainable tourism destination management.

Keywords: social life cycle assessment, sustainable cultural tourism destinations, sustainable tourism destination management, S-LCA framework

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Authors: Amira Abdelrasoul

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This study aimed to ascertain the controlled permeability of biomimetic cellulose triacetate (CTA) membranes by investigating the electrical oscillatory behavior across impregnated membranes (IM). The biomimetic CTA membranes were infused with a fatty acid to induce electrical oscillatory behavior and, hence, to ensure controlled permeability. In situ synchrotron radiation micro-computed tomography (SR-μCT) at the BioMedical Imaging and Therapy (BMIT) Beamline at the Canadian Light Source (CLS) was used to evaluate the main morphology of IMs compared to neat CTA membranes to ensure fatty acid impregnation inside the pores of the membrane matrices. A monochromatic beam at 20 keV was used for the visualization of the morphology of the membrane. The X-ray radiographs were recorded by means of a beam monitor AA-40 (500 μm LuAG scintillator, Hamamatsu, Japan) coupled with a high-resolution camera, providing a pixel size of 5.5 μm and a field of view (FOV) of 4.4 mm × 2.2 mm. Changes were evident in the phase transition temperatures of the impregnated CTA membrane at the melting temperature of the fatty acid. The pulsations of measured voltages were related to changes in the salt concentration of KCl in the vicinity of the electrode. Amplitudes and frequencies of voltage pulsations were dependent on the temperature and concentration of the KCl solution, which controlled the permeability of the biomimetic membranes. The presented smart biomimetic membrane successfully combined porous polymer support and impregnating liquid not only imitate the main barrier properties of the biological membranes but could be easily modified to achieve some new properties, such as facilitated and active transport, regulation by chemical, physical and pharmaceutical factors. These results open new frontiers for the facilitation and regulation of active transport and permeability through biomimetic smart membranes for a variety of biomedical and drug delivery applications.

Keywords: biomimetic, membrane, synchrotron, permeability, morphology

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Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali

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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.

Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team

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Authors: Samah Senbel

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Database Design is a fundamental part of the Computer Science and Information technology curricula in any school, as well as in the study of management, business administration, and data analytics. In this study, we compare the performance of two groups of students studying the same database design and implementation course at Sacred Heart University in the fall of 2018. Both courses used the same textbook and were taught by the same professor, one for seven graduate students and one for 26 undergraduate students (juniors). The undergraduate students were aged around 20 years old with little work experience, while the graduate students averaged 35 years old and all were employed in computer-related or management-related jobs. The textbook used was 'Database Systems, Design, Implementation, and Management' by Coronel and Morris, and the course was designed to follow the textbook roughly a chapter per week. The first 6 weeks covered the design aspect of a database, followed by a paper exam. The next 6 weeks covered the implementation aspect of the database using SQL followed by a lab exam. Since the undergraduate students are on a 16 week semester, we spend the last three weeks of the course covering NoSQL. This part of the course was not included in this study. After the course was over, we analyze the results of the two groups of students. An interesting discrepancy was observed: In the database design part of the course, the average grade of the graduate students was 92%, while that of the undergraduate students was 77% for the same exam. In the implementation part of the course, we observe the opposite: the average grade of the graduate students was 65% while that of the undergraduate students was 73%. The overall grades were quite similar: the graduate average was 78% and that of the undergraduates was 75%. Based on these results, we concluded that having both classes follow the same time schedule was not beneficial, and an adjustment is needed. The graduates could spend less time on design and the undergraduates would benefit from more design time. In the fall of 2019, 30 students registered for the undergraduate course and 15 students registered for the graduate course. To test our conclusion, the undergraduates spend about 67% of time (eight classes) on the design part of the course and 33% (four classes) on the implementation part, using the exact exams as the previous year. This resulted in an improvement in their average grades on the design part from 77% to 83% and also their implementation average grade from 73% to 79%. In conclusion, we recommend using two separate schedules for teaching the database design course. For undergraduate students, it is important to spend more time on the design part rather than the implementation part of the course. While for the older graduate students, we recommend spending more time on the implementation part, as it seems that is the part they struggle with, even though they have a higher understanding of the design component of databases.

Keywords: computer science education, database design, graduate and undergraduate students, pedagogy

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Authors: Jyh-Cherng Gu, Ming-Ta Yang, Chao-Fong Yan, Hsin-Yung Chung, Yung-Ruei Chang, Yih-Der Lee, Chen-Min Chan, Chia-Hao Hsu

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There are a number of distributed generations (DGs) installed in microgrid, which may have diverse path and direction of power flow or fault current. The overcurrent protection scheme for the traditional radial type distribution system will no longer meet the needs of microgrid protection. Integrating the intelligent electronic device (IED) and a supervisory control and data acquisition (SCADA) with IEC 61850 communication protocol, the paper proposes a microgrid protection management system (MPMS) to protect power system from the fault. In the proposed method, the MPMS performs logic programming of each IED to coordinate their tripping sequence. The GOOSE message defined in IEC 61850 is used as the transmission information medium among IEDs. Moreover, to cope with the difference in fault current of microgrid between grid-connected mode and islanded mode, the proposed MPMS applies the group setting feature of IED to protect system and robust adaptability. Once the microgrid topology varies, the MPMS will recalculate the fault current and update the group setting of IED. Provided there is a fault, IEDs will isolate the fault at once. Finally, the Matlab/Simulink and Elipse Power Studio software are used to simulate and demonstrate the feasibility of the proposed method.

Keywords: IEC 61850, IED, group Setting, microgrid

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Authors: Emilia-Gheorghina Negru

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As an EU goal, gender diversity in early year’s education aims and promotes equality of chances and respect for gender peculiarities of the pupils which are involved in formal educational activities. Early year’s education, as the first step to the Curriculum, prints to teachers the need to identify the role of the gender dimension on this stage, depending on the age level of preschool children through effective, complex, innovative and analytical awareness of gender diversity teaching and management strategies. Through gender educational work we, as teachers, will examine the effectiveness of the PATHS (Promoting Alternative Thinking Strategies) curriculum the gender development of school-aged children. PATHS and a school-based preventive intervention model are necessary to be designed to improve children's ability to discuss and understand equality and gender concepts. Our teachers must create an intervention model and provide PATHS lessons during the school year. Results of the intervention will be effective for both low- and high-risk children in improving their range of math’s skills for girls and vocabulary, fluency and emotional part for boys in discussing gender experiences, their efficacy beliefs regarding the management of equality in gender area, and their developmental understanding of some aspects of gender.

Keywords: gender, gender differences, gender equality, gender role, gender stereotypes

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Authors: Mylene T. Caytap-Milan

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This study was materialized with the purpose of determining the anxieties of students towards spoken English, sources of the specified anxiety, coping mechanisms to counter the apprehensions, and teacher management to reduce the anxiety within the classroom. Being qualitative in nature, interview as the data gathering tool was utilized with an audio-recorder. Participants of the study included thirteen teachers and students of speech classes in a state university in Region I, Philippines. Data elicited were transcribed in verbatim, confirmed by the participants, coded and categorized, and themed accordingly. A triangulation method was applied to establish the stronger validity of the data. Findings confirmed teachers’ and students’ awareness of the existence of Anxiety in speaking English (ASE). Based on the data gathered from the teachers, the following themes on students’ ASE were identified: (1) No Brain and Mouth Coordination, (2) Center of Attention, and (3) Acting Out Loud. However, the following themes were formulated based on the responses made by the students themselves: (1) The Common Feeling, (2) The Incompetent Me, and (3) The Limelight. With regard the sources of students’ ASE according to teachers are the following: (1) It Began at Home, (2) It Continued in School, (3) It’s not for me at all. On the other hand, the sources of students’ ASE according to students themselves are: (1) It Comes from Within, (2) It wasn’t Nursed Well, and (3) They’re Looking for Errors. In terms of coping with ASE, students identified the following mechanisms, which were themed into: (1) Acceptance, (2) Application, and (3) Apathy. Moreover, to reduce the ASE phenomenon within the classroom, the teachers demonstrate the following roles according to themes: (1) The Compass, (2) The Counselor, (3) The Referee, (4) The Polyglot, and (5) The English Nazi. Based on the findings, the following conclusions were drawn: (1) ASE can both serve positive and negative influences to the English speaking skills of students, (2) ASE can be reduced with teachers’ provision of more English speaking opportunities and with students’ initiative of personal training, (3) ASE can be reduced when English is introduced and practiced by children at an early age, and (4) ASE is inevitable in the affective domain thus teachers are encouraged to apply psychological positivism in the classroom. Studies related to the present undertaking may refer to the succeeding recommendations: (1) experiment on activities that will reduce anxiety ASE, (2) involve a psychologist for more critical but reliable results and recommendations, and (3) conduct the study among high school and primary students.

Keywords: coping mechanisms, sources, speaking anxiety, teacher management

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Authors: Osman Yildiz

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As it is predicted 2559 years before there is nothing permanent except change. In our turbulent World, Organizations will always be faced with the challenge of determining the path that will always keep them on balance en route that will bring success. That means from top to bottom, every organisation is exposed to fight to stay afloat and compete while they face the continuous prospect of change in an increasingly competitive and globalized World. Otherwise, they would fail to realize their goals and targets, and ultimately would disappear. But the organizations that will celebrate success five or ten years from now will be the winners of the fight by having recognizing that planning the change was only the first step in the journey and put sufficient efforts into the task of leading change. Increasingly unpredictable and competitive organizational environments have put pressure on leaders across all industries to better manage the change. The key of establishing effective change and transformation in organisations lies on the steps taken before the change happens depending to the quality of the human sources; readiness for change, acknowledgement by management, prepared leaders, motivated employees, overcoming the resistance to change and ultimately adapting change into the organization. Due to these factors, leaders managing the organisational development can ensure organizations and employees to meet new performance targets, motivation and skills rapidly and effectively. Finally, this article will provide some tools for leaders, and discuss how to catch organisational development and manage the innovations in effective ways.

Keywords: managing the change, organizational change, human factor, leaders, globalization, organisational development

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Nelson F. F. Ebecken, Gilberto C. Pereira, Lucio P. de Andrade

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Bays, estuaries and coastal ecosystems are some of the most used and threatened natural systems globally. Its deterioration is due to intense and increasing human activities. This paper aims to monitor the socio-ecological in Brazil, model and simulate it through a multilayer network representing a DPSIR structure (Drivers, Pressures, States-Impacts-Responses) considering the concept of Management based on Ecosystems to support decision-making under the National/State/Municipal Coastal Management policy. This approach considers several interferences and can represent a significant advance in several scientific aspects. The main objective of this paper is the coupling of three different types of complex networks, the first being an ecological network, the second a social network, and the third a network of economic activities, in order to model the marine ecosystem. Multilayer networks comprise two or more "layers", which may represent different types of interactions, different communities, different points in time, and so on. The dependency between layers results from processes that affect the various layers. For example, the dispersion of individuals between two patches affects the network structure of both samples. A multilayer network consists of (i) a set of physical nodes representing entities (e.g., species, people, companies); (ii) a set of layers, which may include multiple layering aspects (e.g., time dependency and multiple types of relationships); (iii) a set of state nodes, each of which corresponds to the manifestation of a given physical node in a layer-specific; and (iv) a set of edges (weighted or not) to connect the state nodes among themselves. The edge set includes the intralayer edges familiar and interlayer ones, which connect state nodes between layers. The applied methodology in an existent case uses the Flow cytometry process and the modeling of ecological relationships (trophic and non-trophic) following fuzzy theory concepts and graph visualization. The identification of subnetworks in the fuzzy graphs is carried out using a specific computational method. This methodology allows considering the influence of different factors and helps their contributions to the decision-making process.

Keywords: marine ecosystems, complex systems, multilayer network, ecosystems management

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Authors: Meryem Saban Guler, Saniye Bilici

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Malnutrition is a problem that significantly affects patients with cancer throughout the course of their illness, and it may be present from the moment of diagnosis until the end of treatment. We searched electronic databases using key terms such as ‘malnutrition in cancer patients’ or ‘nutritional status in cancer’ or ‘nutritional screening tools’ etc. Decline in nutritional status and continuing weight loss are associated with an increase in number and severity of complications, impaired quality of life and decreased survival rate. Nutrition is an important factor in the treatment and progression of cancer. Cancer patients are particularly susceptible to nutritional depletion due to the combined effects of the malignant disease and its treatment. With increasing incidence of cancer, identification and management of nutritional deficiencies are needed. Early identification of malnutrition, is substantial to minimize or prevent undesirable outcomes throughout clinical course. In determining the nutritional status; food consumption status, anthropometric methods, laboratory tests, clinical symptoms, psychosocial data are used. First-line strategies must include routine screening and identification of inpatients or outpatients at nutritional risk with the use of a simple and standardized screening tool. There is agreement among international nutrition organizations and accredited health care organizations that routine nutritional screening should be a standard procedure for every patient admitted to a hospital. There are f management of all cancer patients therefore routine nutritional screening with validated tools can identify cancer patients at risk.

Keywords: cancer, malnutrition, nutrition, nutritional screening

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Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

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Agriculture is the mainstay of the Ethiopian economy; however, the sector is dominated by smallholder farmers resulting in land fragmentation and suffering from low productivity. Due to these issues, much effort has been put into the transformation of the sector to bring about more sustainable rural economic development. Technological advancements have been applied for the betterment of farmers resulting in the design of tools that are potentially capable of supporting the agricultural sector; however, their use and relevance are still alien to the local rural communities. The notion of the creating, capturing and sharing of knowledge has also been repetitively raised by many international donor agencies to transform the sector, yet the most current approaches to knowledge dissemination focus on knowledge that originates from the western view of scientific rationality while overlooking the role of indigenous knowledge (IK). Therefore, in agricultural knowledge management system (KMS) development, the integration of IKS with scientific knowledge is a critical success factor. The present study aims to contribute in the discourse on how to best integrate scientific and IK in agricultural KMS development. The conceptual framework of the research is anchored in concepts drawn from the theory of situated learning in communities of practice (CoPs): knowledge brokering. Using the KMS development practices of Ethiopian agricultural transformation agency as a case area, this research employed an interpretive analysis using primary and secondary qualitative data acquired through in-depth semi-structured interviews and participatory observations. As a result, concepts are identified for understanding the integration of the two major knowledge systems (i.e., indigenous and scientific knowledge) and participation of relevant stakeholders in particular the local farmers in agricultural KMS development through the roles of extension agent as a knowledge broker including crossing boundaries, in-between position, translation and interpretation, negotiation, and networking. The research shall have a theoretical contribution in addressing the incorporation of a variety of knowledge systems in agriculture and practically to provide insight for policy makers in agriculture regarding the importance of IK integration in agricultural KMS development and support marginalized small-scale farmers.

Keywords: communities of practice, indigenous knowledge, knowledge management system development, knowledge brokering

Procedia PDF Downloads 320