Search results for: risk management failure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15694

Search results for: risk management failure

10594 Management Competency in Logistical Function: The Skills That Will Master a Logistical Manager

Authors: Fatima Ibnchahid

Abstract:

Competence approach is considered, since the early 80's as one of the major development of HR policies. Many approaches to manage the professional skills were declined. Some processes are mature whereas the others have been abandoned. Competence can be defined as the set of knowledge (theoretical and practical), know-how (experience) and life skills (personality traits) mobilized by a person in the company. The skills must master a logistics manager are divided into two main categories: depending on whether technical skills, or managerial skills and human. The firsts are broken down into skills on logistical techniques and on general skills in business, seconds in social skills (self with others) and personal (with oneself). Logisticians are faced with new challenges and new constraints that are revolutionizing the way to treat the physical movement of goods and operations related to information flows that trigger, they control and guide the physical movements of these major changes, we can mention the development of information technology and communication, the emergence of strong environmental and security constraints. These changes have important effects on the skills needs of the members of the logistical function and sensitive development for training requested by logistical managers to perform better in their job changes. In this article, we will address two main points, first, a brief overview of the management skills and secondly answer the question asked in the title of the article to know what are the skills that will master a logistical manager.

Keywords: skills, competence, management, logistical function

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10593 Urban Waste Water Governance in South Africa: A Case Study of Stellenbosch

Authors: R. Malisa, E. Schwella, K. I. Theletsane

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Due to climate change, population growth and rapid urbanization, the demand for water in South Africa is inevitably surpassing supply. To address similar challenges globally, there has been a paradigm shift from conventional urban waste water management “government” to a “governance” paradigm. From the governance paradigm, Integrated Urban Water Management (IUWM) principle emerged. This principle emphasizes efficient urban waste water treatment and production of high-quality recyclable effluent. In so doing mimicking natural water systems, in their processes of recycling water efficiently, and averting depletion of natural water resources.  The objective of this study was to investigate drivers of shifting the current urban waste water management approach from a “government” paradigm towards “governance”. The study was conducted through Interactive Management soft systems research methodology which follows a qualitative research design. A case study methodology was employed, guided by realism research philosophy. Qualitative data gathered were analyzed through interpretative structural modelling using Concept Star for Professionals Decision-Making tools (CSPDM) version 3.64.  The constructed model deduced that the main drivers in shifting the Stellenbosch municipal urban waste water management towards IUWM “governance” principles are mainly social elements characterized by overambitious expectations of the public on municipal water service delivery, mis-interpretation of the constitution on access to adequate clean water and sanitation as a human right and perceptions on recycling water by different communities. Inadequate public participation also emerged as a strong driver. However, disruptive events such as draught may play a positive role in raising an awareness on the value of water, resulting in a shift on the perceptions on recycled water. Once the social elements are addressed, the alignment of governance and administration elements towards IUWM are achievable. Hence, the point of departure for the desired paradigm shift is the change of water service authorities and serviced communities’ perceptions and behaviors towards shifting urban waste water management approaches from “government” to “governance” paradigm.

Keywords: integrated urban water management, urban water system, wastewater governance, wastewater treatment works

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10592 Neutrophil-to-Lymphocyte Ratio: A Predictor of Cardiometabolic Complications in Morbid Obese Girls

Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a low-grade inflammatory state. Childhood obesity is a multisystem disease, which is associated with a number of complications as well as potentially negative consequences. Gender is an important universal risk factor for many diseases. Hematological indices differ significantly by gender. This should be considered during the evaluation of obese children. The aim of this study is to detect hematologic indices that differ by gender in morbid obese (MO) children. A total of 134 MO children took part in this study. The parents filled an informed consent form and the approval from the Ethics Committee of Namik Kemal University was obtained. Subjects were divided into two groups based on their genders (64 females aged 10.2±3.1 years and 70 males aged 9.8±2.2 years; p ≥ 0.05). Waist-to-hip as well as head-to-neck ratios and body mass index (BMI) values were calculated. The children, whose WHO BMI-for age and sex percentile values were > 99 percentile, were defined as MO. Hematological parameters [haemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell distribution width, leukocyte count, neutrophil %, lymphocyte %, monocyte %, eosinophil %, basophil %, platelet count, platelet distribution width, mean platelet volume] were determined by the automatic hematology analyzer. SPSS was used for statistical analyses. P ≤ 0.05 was the degree for statistical significance. The groups included children having mean±SD value of BMI as 26.9±3.4 kg/m2 for males and 27.7±4.4 kg/m2 for females (p ≥ 0.05). There was no significant difference between ages of females and males (p ≥ 0.05). Males had significantly increased waist-to-hip ratios (0.95±0.08 vs 0.91±0.08; p=0.005) and mean corpuscular hemoglobin concentration values (33.6±0.92 vs 33.1±0.83; p=0.001) compared to those of females. Significantly elevated neutrophil (4.69±1.59 vs 4.02±1.42; p=0.011) and neutrophil-to-lymphocyte ratios (1.70±0.71 vs 1.39±0.48; p=0.004) were detected in females. There was no statistically significant difference between groups in terms of C-reactive protein values (p ≥ 0.05). Adipose tissue plays important roles during the development of obesity and associated diseases such as metabolic syndrom and cardiovascular diseases (CVDs). These diseases may cause changes in complete blood cell count parameters. These alterations are even more important during childhood. Significant gender effects on the changes of neutrophils, one of the white blood cell subsets, were observed. The findings of the study demonstrate the importance of considering gender in clinical studies. The males and females may have distinct leukocyte-trafficking profiles in inflammation. Female children had more circulating neutrophils, which may be the indicator of an increased risk of CVDs, than male children within this age range during the late stage of obesity. In recent years, females represent about half of deaths from CVDs; therefore, our findings may be the indicator of the increasing tendency of this risk in females starting from childhood.

Keywords: children, gender, morbid obesity, neutrophil-to-lymphocyte ratio

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10591 Management Methods of Food Losses in Polish Processing Plants

Authors: Beata Bilska, Marzena Tomaszewska, Danuta Kolozyn-Krajewska

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Food loss and food waste are a global problem of the modern economy. The research undertaken aimed to analyze how food is handled in catering establishments when it comes to food waste and to demonstrate the main ways of management with foods/dishes not served to consumers. A survey study was conducted from January to June 2019. The selection of catering establishments participating in the study was deliberate. The study included establishments located only in Mazowieckie Voivodeship (Poland). Forty-two completed questionnaires were collected. In some questions, answers were based on a 5-point scale of 1 to 5 (from "always" / "every day" to "never"). The survey also included closed questions with a suggested cafeteria of answers. The respondents stated that in their workplaces, dishes served cold and hot ready meals are discarded every day or almost every day (23.7% and 20.5% of answers respectively). A procedure most frequently used for dealing with dishes not served to consumers on a given day is their storage at a cool temperature until the following day. In the research, 1/5 of respondents admitted that consumers "always" or "usually" leave uneaten meals on their plates, and over 41% "sometimes" do so. It was found additionally that food not used in the foodservice sector is most often thrown into a public container for rubbish. Most often thrown into the public container (with communal trash) were: expired products (80.0%), plate waste (80.0%) and inedible products (fruit and vegetable peels, eggshells) (77.5%). Most frequently into the container dedicated only to food waste were thrown out used deep-frying oil (62.5%). 10% of respondents indicated that inedible products in their workplaces are allocated for animal feeds. Food waste in the foodservice sector remains an insufficiently studied issue, as owners of these objects are often unwilling to disclose data about the subject. Incorrect ways of management with foods not served to consumers were observed. There is a need to develop educational activities for employees and management in the context of food waste management in the foodservice sector.

Keywords: food waste, inedible products, plate waste, used deep-frying oil

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10590 Structural Reliability Analysis Using Extreme Learning Machine

Authors: Mehul Srivastava, Sharma Tushar Ravikant, Mridul Krishn Mishra

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In structural design, the evaluation of safety and probability failure of structure is of significant importance, mainly when the variables are random. On real structures, structural reliability can be evaluated obtaining an implicit limit state function. The structural reliability limit state function is obtained depending upon the statistically independent variables. In the analysis of reliability, we considered the statistically independent random variables to be the load intensity applied and the depth or height of the beam member considered. There are many approaches for structural reliability problems. In this paper Extreme Learning Machine technique and First Order Second Moment Method is used to determine the reliability indices for the same set of variables. The reliability index obtained using ELM is compared with the reliability index obtained using FOSM. Higher the reliability index, more feasible is the method to determine the reliability.

Keywords: reliability, reliability index, statistically independent, extreme learning machine

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10589 Prevalence, Median Time, and Associated Factors with the Likelihood of Initial Antidepressant Change: A Cross-Sectional Study

Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

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Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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10588 Working Capital Management Practices in Small Businesses in Victoria

Authors: Ranjith Ihalanayake, Lalith Seelanatha, John Breen

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In this study, we explored the current working capital management practices as applied in small businesses in Victoria, filling an existing theoretical and empirical gap in literature in general and in Australia in particular. Amidst the current global competitive and dynamic environment, the short term insolvency of small businesses is very critical for the long run survival. A firm’s short-term insolvency is dependent on the availability of sufficient working capital for feeding day to day operational activities. Therefore, given the reliance for short-term funding by small businesses, it has been recognized that the efficient management of working capital is crucial in respect of the prosperity and survival of such firms. Against this background, this research was an attempt to understand the current working capital management strategies and practices used by the small scale businesses. To this end, we conducted an internet survey among 220 small businesses operating in Victoria, Australia. The survey results suggest that the majority of respondents are owner-manager (73%) and male (68%). Respondents participated in this survey mostly have a degree (46%). About a half of respondents are more than 50 years old. Most of respondents (64%) have business management experience more than ten years. Similarly, majority of them (63%) had experience in the area of their current business. Types of business of the respondents are: Private limited company (41%), sole proprietorship (37%), and partnership (15%). In addition, majority of the firms are service companies (63%), followed by retailed companies (25%), and manufacturing (17%). Size of companies of this survey varies, 32% of them have annual sales $100,000 or under, while 22% of them have revenue more than $1,000,000 every year. In regards to the total assets, majority of respondents (43%) have total assets $100,000 or less while 20% of respondents have total assets more than $1,000,000. In regards to WCMPs, results indicate that almost 70% of respondents mentioned that they are responsible for managing their business working capital. The survey shows that majority of respondents (65.5%) use their business experience to identify the level of investment in working capital, compared to 22% of respondents who seek advice from professionals. The other 10% of respondents, however, follow industry practice to identify the level of working capital. The survey also shows that more than a half of respondents maintain good liquidity financial position for their business by having accounts payable less than accounts receivable. This study finds that majority of small business companies in western area of Victoria have a WCM policy but only about 8 % of them have a formal policy. Majority of the businesses (52.7%) have an informal policy while 39.5% have no policy. Of those who have a policy, 44% described their working capital management policies as a compromise policy while 35% described their policy as a conservative policy. Only 6% of respondents apply aggressive policy. Overall the results indicate that the small businesses pay less attention into the management of working capital of their business despite its significance in the successful operation of the business. This approach may be adopted during favourable economic times. However, during relatively turbulent economic conditions, such an approach could lead to greater financial difficulties i.e. short-term financial insolvency.

Keywords: small business, working capital management, Australia, sufficient, financial insolvency

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10587 Management Practices in Holding Pens in Pig’s Slaughterhouses in the Valle De Aburrá, Antioquia and Animal Welfare

Authors: Natalia Uribe Corrales, Santiago Henao Villegas

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Introduction: The management of pigs in the holding pens at the slaughterhouses is a key point to minimize levels of stress and fear, improve efficiency, maintain a good quality of meat and avoid economic losses. Holding pens should guarantee drinking water continuously, a minimum space of 1.2 m2/ animal; As well as an adequate management in the conduction of the animals towards stun. Objective: To characterize the management practices in holding pens in slaughterhouses in the Valle de Aburrá. Methods: A descriptive cross - sectional study was carried out in Valle de Aburrá benefit plants, which were authorized by National Institute for Food and Medicine Surveillance (INVIMA). Variables such as management mechanisms to the pens, time of housing, water supply, load density, vocalization, slips and falls of the animals in the pens and mechanism of conduction towards desensitization were analyzed. Results: 225 pigs were analyzed, finding that 35.6% were lowered with slaps from the trucks to the waiting pens; The lairage time was greater than 10 hours in 16% of the animals; 12.9% of pigs had no water permanently; 40.9% was subjected to a high load density, while 19.6% had a low load density. Regarding aspects of animal welfare, 37.3% presented high vocalizations; 29.3% and 14.2% presented slips or falls respectively. Regarding the mechanism of conduction towards desensitization, slapping was used in 56% and electrical prod in 4%. Conclusions: It is necessary to continue promoting the learning of the densities of load, since both high and low densities generate inconveniences in animal welfare, favoring the appearance of lesions and stress in the animals. Also, to promote the rule of permanent water in the pens and a time of housing less than 10 hours. In relation to the driving mechanisms, it is necessary to continue animal husbandry campaigns, encouraging the use of other alternatives such as boards or panels to assist the movement of pigs.

Keywords: animal welfare, quality of meat, swine, waiting pens

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10586 Evaluating an Educational Intervention to Reduce Pesticide Exposure Among Farmers in Nigeria

Authors: Gift Udoh, Diane S. Rohlman, Benjamin Sindt

Abstract:

BACKGROUND: There is concern regarding the widespread use of pesticides and impacts on public health. Farmers in Nigeria frequently apply pesticides, including organophosphate pesticides which are known neurotoxicants. They receive little guidance on how much to apply or information about safe handling practices. Pesticide poisoning is one of the major hazards that farmers face in Nigeria. Farmers continue to use highly neurotoxic pesticides for agricultural activities. Because farmers receive little or no information on safe handling and how much to apply, they continue to develop severe and mild illnesses caused by high exposures to pesticides. The project aimed to reduce pesticide exposure among rural farmers in Nigeria by identifying hazards associated with pesticide use and developing and pilot testing training to reduce exposures to pesticides utilizing the hierarchy of controls system. METHODS: Information on pesticide knowledge, behaviors, barriers to safety, and prevention methods was collected from farmers in Nigeria through workplace observations, questionnaires, and interviews. Pre and post-surveys were used to measure farmer’s knowledge before and after the delivery of pesticide safety training. Training topics included the benefits and risks of using pesticides, routes of exposure and health effects, pesticide label activity, use and selection of PPE, ways to prevent exposure and information on local resources. The training was evaluated among farmers and changes in knowledge, attitudes and behaviors were collected prior to and following the training. RESULTS: The training was administered to 60 farmers, a mean age of 35, with a range of farming experience (<1 year to > 50 years). There was an overall increase in knowledge after the training. In addition, farmers perceived a greater immediate risk from exposure to pesticides and their perception of their personal risk increased. For example, farmers believed that pesticide risk is greater to children than to adults, recognized that just because a pesticide is put on the market doesn’t mean it is safe, and they were more confident that they could get advice about handling pesticides. Also, there was greater awareness about behaviors that can increase their exposure (mixing pesticides with bare hands, eating food in the field, not washing hands before eating after applying pesticides, walking in fields recently sprayed, splashing pesticides on their clothes, pesticide storage). CONCLUSION: These results build on existing evidence from a 2022 article highlighting the need for pesticide safety training in Nigeria which suggested that pesticide safety educational programs should focus on community-based, grassroots-style, and involve a family-oriented approach. Educating farmers on agricultural safety while letting them share their experiences with their peers is an effective way of creating awareness on the dangers associated with handling pesticides. Also, for rural communities, especially in Nigeria, pesticide safety pieces of training may not be able to reach some locations, so intentional scouting of rural farming communities and delivering pesticide safety training will improve knowledge of pesticide hazards. There is a need for pesticide information centers to be situated in rural farming communities or agro supply stores, which gives rural farmers information.

Keywords: pesticide exposure, pesticide safety, nigeria, rural farming, pesticide education

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10585 Health Assessment of Power Transformer Using Fuzzy Logic

Authors: Yog Raj Sood, Rajnish Shrivastava, Anchal Wadhwa

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Power transformer is one of the electrical equipment that has a central and critical role in the power system. In order to avoid power transformer failure, information system that provides the transformer condition is needed. This paper presents an information system to know the exact situations prevailing within the transformer by declaring its health index. Health index of a transformer is decided by considering several diagnostic tools. The current work deals with UV-Vis, IFT, FP, BDV and Water Content. UV/VIS results have been pre-accessed using separate FL controller for concluding with the Furan contents. It is broadly accepted that the life of a power transformer is the life of the oil/ paper insulating system. The method relies on the use of furan analysis (insulation paper), and other oil analysis results as a means to declare health index. Fuzzy logic system is used to develop the information system. The testing is done on 5 samples of oil of transformers of rating 132/66 KV to obtain the results and results are analyzed using fuzzy logic model.

Keywords: interfacial tension analyzer (ift), flash point (fp), furfuraldehyde (fal), health index

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10584 RFID Logistic Management with Cold Chain Monitoring: Cold Store Case Study

Authors: Mira Trebar

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Logistics processes of perishable food in the supply chain include the distribution activities and the real time temperature monitoring to fulfil the cold chain requirements. The paper presents the use of RFID (Radio Frequency Identification) technology as an identification tool of receiving and shipping activities in the cold store. At the same time, the use of RFID data loggers with temperature sensors is presented to observe and store the temperatures for the purpose of analyzing the processes and having the history data available for traceability purposes and efficient recall management.

Keywords: logistics, warehouse, RFID device, cold chain

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10583 Hyponatremia in Community-Acquired Pneumonia

Authors: Emna Ketata, Wafa Farhat

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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

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10582 Application of Costing System in the Small and Medium Sized Enterprises (SME) in Turkey

Authors: Hamide Özyürek, Metin Yılmaz

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Standard processes, similar and limited production lines, the production of high direct costs will be more accurate than the use of parts of the traditional cost systems in the literature. However, direct costs, overhead expenses, in turn, decreases the burden of increasingly sophisticated production facilities, a situation that led the researchers to look for the cost of traditional systems of alternative techniques. Variety cost management approaches for example Total quality management (TQM), just-in-time (JIT), benchmarking, kaizen costing, targeting cost, life cycle costs (LLC), activity-based costing (ABC) value engineering have been introduced. Management and cost applications have changed over the past decade and will continue to change. Modern cost systems can provide relevant and accurate cost information. These methods provide the decisions about customer, product and process improvement. The aim of study is to describe and explain the adoption and application of costing systems in SME. This purpose reports on a survey conducted during 2014 small and medium sized enterprises (SME) in Ankara. The survey results were evaluated using SPSS package program.

Keywords: modern costing systems, managerial accounting, cost accounting, costing

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10581 Post-Covid 19 Pandemic Economy: Corporate Governance and Performance of Private Security Firms in Kenya

Authors: Sewe Silvanus Odhiambo

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Globally, many governments have publicly recognized private security firms as essential services providers. The private security firms face a lot of challenges, but the COVID-19 situation also has exacerbated them to another level. This paper locates its relevance in the post-coronavirus era. The COVID-19 pandemic has redefined the world operation, which shows a higher impact on the security field. Accordingly, the purpose of the study was to examine the role of corporate governance on the performance of private security firms in a post-covid pandemic era in Kenya. The study employed a descriptive research design, which included a quantitative approach and secondary data. The study was carried in the month of July 2021 from the registered private security firms. After targeting all private security firms, only 54 firms had disclosed their annual report by the time of conducting the study. The results depicted that pandemic has affected the performance of private security firms measures unfavorably. Further, boards of directors show a positive association with security firm performance. The study recommends that there is need board of directors to enhance management’s risk assessments in the midst of COVID-19; ensure that there are business continuity plans; there is organizational resilience; there is need for the development of new digital strategies; enabling the digital workforce in the firms and have effective communication plans with both internal and external stakeholders to deal with uncertainties and develop more post-COVID practices for boards of directors to improve performance of private security firms in Kenya. The practical implications of the study are that the research outcomes might assist regulatory bodies, investors, policymakers, and the security sector in general in their formulation of public and corporate governance strategies concerning future emergency preparedness and responses. This study also provides a unique contribution to the literature of COVID-19 and security firm performance in emerging economies context.

Keywords: COVID-19, corporate governance, firm performance, private security firms

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10580 An Investigation of the Relevant Factors of Unplanned Readmission within 14 Days of Discharge in a Regional Teaching Hospital in South Taiwan

Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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10579 Life Cycle-Based Analysis of Meat Production: Ecosystem Impacts

Authors: Michelle Zeyuan Ma, Hermann Heilmeier

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Recently, meat production ecosystem impacts initiated many hot discussions and researchers, and it is a difficult implementation to reduce such impacts due to the demand of meat products. It calls for better management and control of ecosystem impacts from every aspects of meat production. This article analyzes the ecosystem impacts of meat production based on meat products life cycle. The analysis shows that considerable ecosystem impacts are caused by different meat production steps: initial establishment phase, animal raising, slaughterhouse processing, meat consumption, and wastes management. Based on this analysis, the impacts are summarized as: leading factor for biodiversity loss; water waste, land use waste and land degradation; greenhouse gases emissions; pollution to air, water, and soil; related major diseases. The article also provides a discussion on a solution-sustainable food system, which could help in reducing ecosystem impacts. The analysis method is based on the life cycle level, it provides a concept of the whole meat industry ecosystem impacts, and the analysis result could be useful to manage or control meat production ecosystem impacts from investor, producer and consumer sides.

Keywords: eutrophication, life cycle based analysis, sustainable food, waste management

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10578 The Role of Flowering Pesticidal Plants for Sustainable Pest Management

Authors: Baltazar Ndakidemi

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The resource-constrained farmers, especially those in sub-Saharan Africa, encounter significant challenges related to agriculture, notably diseases and pests. The sustainable means of pest management are not well known to farmers. As a result, some farmers use synthetic pesticides whose environmental impacts, ill health, and other negative impacts of synthetic pesticides on natural enemies have posed a great need for more sustainable means of pest management. Pesticidal plant resources can replace synthetic pesticides because their secondary metabolites can exhibit insecticidal activities such as deterrence, repellence, and pests' mortality. Additionally, the volatiles from these plants can have positive effects of attracting populations of natural enemies. Pesticidal plants can be grown as field margin plants or in strips for supporting natural enemies' populations. However, this is practically undetermined. Hence, there is a need to investigate the roles played by pesticidal plants in supporting natural enemies of pests and their applications in different cropping systems such as legumes. This study investigates different pesticidal plants with a high potential for pest control in agricultural fields. The information sheds light on potential plants that can be used for different crop pests.

Keywords: natural enemies, biological control, synthetic pesticides, pesticidal plants, predators, parasitoids

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10577 Magnitude and Factors of Risky Sexual Practice among Day Laborers in Ethiopia: A Systematic Review and Meta-Analysis, 2023

Authors: Kalkidan Worku, Eniyew Tegegne, Menichil Amsalu, Samuel Derbie Habtegiorgis

Abstract:

Introduction: Because of the seasonal nature of the work, day laborers are exposed to risky sexual practices. Since the majority of them are living far away from their birthplace and family, they engage in unplanned and multiple sexual practices. These unplanned and unprotected sexual experiences are a risk for different types of sexual-related health crises. This study aimed to assess the pooled prevalence of risky sexual practices and its determinants among day laborers in Ethiopia. Methods: Online databases, including PubMed, Google Scholar, Science Direct, African Journal of Online, Academia Edu, Semantic Scholar, and university repository sites, were searched from database inception until March 2023. PRISMA 2020 guideline was used to conduct the review. Among 851 extracted studies, ten articles were retained for the final quantitative analysis. To identify the source of heterogeneity, a sub-group analysis and I² test were performed. Publication bias was assessed by using a funnel plot and the Egger and Beg test. The pooled prevalence of risky sexual practices was calculated. Besides, the association between determinant factors and risky sexual practice was determined using a pooled odds ratio (OR) with a 95% confidence interval. Result: The pooled prevalence of risky sexual practices among day laborers was 46.00% (95% CI: 32.96, 59.03). Being single (OR: 2.49; 95% CI: 1.29 to 4.83), substance use (OR: 1.79; 95% CI: 1.40 to 2.29), alcohol intake (OR: 4.19; 95% CI: 2.19 to 8.04), watching pornographic (OR: 5.49; 95% CI: 2.99 to 10.09), discussion about SRH (OR: 4.21; 95% CI: 1.34 to 13.21), visiting night clubs (OR: 2.86 95% CI: 1.79 to 4.57) and risk perception (OR: 0.37 95% CI: 0.20 to 0.70) were the possible factors for risky sexual practice of day laborers in Ethiopia. Conclusions: A large proportion of day laborers engaged in risky sexual practices. Interventions targeting creating awareness of sexual and reproductive health for day laborers should be implemented. Continuous peer education on sexual health should be given to day laborers. Sexual and reproductive health services should be accessible in their workplaces to maximize condom utilization and to facilitate sexual health education for all day laborers.

Keywords: day laborers, sexual health, risky sexual practice, unsafe sex, multiple sexual partners

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10576 Conviviality as a Principle in Natural and Social Realms

Authors: Xiao Wen Xu

Abstract:

There exists a challenge of accommodating/integrating people at risk and those from various backgrounds in urban areas. The success of interdependence as a tool for survival largely rests on the mutually beneficial relationships amongst individuals within a given society. One approach to meeting this challenge has been written by Ivan Illich in his book, Tools for Conviviality, where he defines 'conviviality' as interactions that help individuals. With the goal of helping the community and applying conviviality as a principle to actors in both natural and social realms of Moss Park in Toronto, the proposal involves redesigning the park and buildings as a series of different health care, extended learning, employment support, armoury, and recreation facilities that integrate the exterior landscape as treatment, teaching, military, and recreation areas; in other words, the proposal links services with access to park space. While buildings are traditionally known to physically provide shelter, parks embody shelter and act as service, as people often find comfort and relief from being in nature, and Moss Park, in particular, is home to many people at risk. This landscape is not only an important space for the homeless community but also the rest of the neighborhood. The thesis proposes that the federal government rebuilds the current armoury, as it is an obsolete building while acknowledging the extensive future developments proposed by developers and its impact on public space. The neighbourhood is an underserved area, and the new design develops not just a new armoury, but also a complex of interrelated services, which are completely integrated into the park. The armoury is redesigned as an integral component of the community that not only serves as training facilities for reservists but also serves as an emergency shelter in sub-zero temperatures for the homeless community. This paper proposes a new design for Moss Park through examining how 'park buildings', interconnected buildings and parks, can foster empowering relationships that create a supportive public realm.

Keywords: conviviality, natural, social, Ivan Illich

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10575 Correction Requirement to AISC Design Guide 31: Case Study of Web Post Buckling Design for Castellated Beams

Authors: Kitjapat Phuvoravan, Phattaraphong Ponsorn

Abstract:

In the design of Castellated beams (CB), the web post buckling acted by horizontal shear force is one of the important failure modes that have to be considered. It is also a dominant governing mode when design following the AISC 31 design guideline which is just published. However, the equation of the web post buckling given by the guideline is still questionable for most of the engineers. So the purpose of this paper is to study and provide a proposed equation for design the web post buckling with more simplified and convenient to use. The study is also including the improper of the safety factor given by the guideline. The proposed design equation is acquired by regression method based on the results of finite element analysis. An amount of Cellular beam simulated to study is modelled by using shell element, analysis with both geometric and material nonlinearity. The results of the study show that the use of the proposed equation to design the web post buckling in Castellated beams is more simple and precise for computation than the equations provided from the guideline.

Keywords: castellated beam, web opening, web post buckling, design equation

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10574 Methodological Approach for the Prioritization of Different Micro-Contaminants as Potential River Basin Specific Pollutants in the Upper Tisza River Watershed

Authors: Mihail Simion Beldean-Galea, Virginia Coman, Florina Copaciu, Mihaela Vlassa, Radu Mihaiescu, Adina Croitoru, Viorel Arghius, Modest Gertsiuk, Mikola Gertsiuk

Abstract:

Taking into consideration the huge number of chemicals released into environment compartments a proper environmental risk assessment is difficult to predict due to the gap of legislation and improper toxicological assessment of chemicals compounds. In Romania as well as in many other countries from Europe, the chemical status of the water body is characterized taking into consideration the Water Framework Directive (WFD) and the substances listed in Annex X. This Annex includes 45 substances from different classes of organic compounds and heavy metals for which AA-EQS and MAC-EQS have been established. For other compounds which are not included in Annex X, different methodologies to prioritize chemicals for risk assessment and monitoring has been proposed. These methodologies take into account Predicted No-Effect Concentrations (PNECs) of different classes of chemicals compounds available from existing risk assessments or from read-across models for acute toxicity to the standard test organisms such as Daphnia magna and Selenastrum capricornutum. Our work presents the monitoring results of 30 priority substances including polyaromatic hydrocarbons, pesticides, halogenated compounds, plasticizers and heavy metals and other 34 substances from different classes of pesticides and pharmaceuticals which are not included on the list of priority substances, performed in the Upper Tisza River Watershed from Romania and Ukraine. The obtained monitoring data were used for the establishment of the list of more relevant pollutants in the studied area and to establish the potential river basin specific pollutants. For this purpose, two indicators such as the Frequency of exceedance and Extent of exceedance of Predicted no-Effect Concentration (PNEC) were evaluated. These two indicators are based on maximum environmental concentrations (MECs) of priority substances and for other pollutants is use statistically based averages of obtained measured concentration compared to the lowest PNEC thresholds. From the obtained results it can be concluded that polyaromatic hydrocarbon such as Fluoranthene, Benzo[a]pyrene, Benzo[b]fluorathene, benzo[k]fluoranthene, Benzo(g.h.i)perylene, Indeno(1.2.3-cd)-pyrene, heavy metals such as Cadmium, Lead and Nickel can be considered as river basin specific pollutants, their concentration exceeding the Annual Average EQS concentration. Other compounds such as estrone, estriol, 174-β estradiol, naproxen or some antibiotics (Penicillin G, Tetracycline or Ceftazidime) should be taken into account for a long monitoring, in some cases their concentration exceeding PNEC. Acknowledgements: This work is performed in the frame of NATO SfP Programme, Project no. 984440.

Keywords: prioritization, river basin specific pollutants, Tisza River, water framework directive

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10573 Community Radio Broadcasting in Phutthamonthon District, Nakhon Pathom, Thailand

Authors: Anchana Sooksomchitra

Abstract:

This study aims to explore and compare the current condition of community radio stations in Phutthamonthon district, Nakhon Pathom province, Thailand, as well as the challenges they are facing. Qualitative research tools including in-depth interviews, documentary analysis, focus group interviews, and observation are used to examine the content, programming, and management structure of three community radio stations currently in operation within the district. Research findings indicate that the management and operational approaches adopted by the two non-profit stations included in the study, Salaya Pattana and Voice of Dhamma, are more structured and effective than that of the for-profit Tune Radio. Salaya Pattana, backed by the Faculty of Engineering, Mahidol University, and the charity-funded Voice of Dhamma are comparatively free from political and commercial influence, and able to provide more relevant and consistent community-oriented content to meet the real demand of the audience. Tune Radio, on the other hand, has to rely solely on financial support from political factions and business groups, which heavily influence its content.

Keywords: radio broadcasting, programming, management, community radio, Thailand

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10572 Damage Analysis in Open Hole Composite Specimens by Acoustic Emission: Experimental Investigation

Authors: Youcef Faci, Ahmed Mebtouche, Badredine Maalem

Abstract:

n the present work, an experimental study is carried out using acoustic emission and DIC techniques to analyze the damage of open hole woven composite carbon/epoxy under solicitations. Damage mechanisms were identified based on acoustic emission parameters such as amplitude, energy, and cumulative account. The findings of the AE measurement were successfully identified by digital image correlation (DIC) measurements. The evolution value of bolt angle inclination during tensile tests was studied and analyzed. Consequently, the relationship between the bolt inclination angles during tensile tests associated with failure modes of fastened joints of composite materials is determined. Moreover, there is an interaction between laminate pattern, laminate thickness, fastener size and type, surface strain concentrations, and out-of-plane displacement. Conclusions are supported by microscopic visualizations of the composite specimen.

Keywords: tensile test, damage, acoustic emission, digital image correlation

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10571 Identification of Toxic Metal Deposition in Food Cycle and Its Associated Public Health Risk

Authors: Masbubul Ishtiaque Ahmed

Abstract:

Food chain contamination by heavy metals has become a critical issue in recent years because of their potential accumulation in bio systems through contaminated water, soil and irrigation water. Industrial discharge, fertilizers, contaminated irrigation water, fossil fuels, sewage sludge and municipality wastes are the major sources of heavy metal contamination in soils and subsequent uptake by crops. The main objectives of this project were to determine the levels of minerals, trace elements and heavy metals in major foods and beverages consumed by the poor and non-poor households of Dhaka city and assess the dietary risk exposure to heavy metal and trace metal contamination and potential health implications as well as recommendations for action. Heavy metals are naturally occurring elements that have a high atomic weight and a density of at least 5 times greater than that of water. Their multiple industrial, domestic, agricultural, medical and technological applications have led to their wide distribution in the environment; raising concerns over their potential effects on human health and the environment. Their toxicity depends on several factors including the dose, route of exposure, and chemical species, as well as the age, gender, genetics, and nutritional status of exposed individuals. Because of their high degree of toxicity, arsenic, cadmium, chromium, lead, and mercury rank among the priority metals that are of public health significance. These metallic elements are considered systemic toxicants that are known to induce multiple organ damage, even at lower levels of exposure. This review provides an analysis of their environmental occurrence, production and use, potential for human exposure, and molecular mechanisms of toxicity, and carcinogenicity.

Keywords: food chain, determine the levels of minerals, trace elements, heavy metals, production and use, human exposure, toxicity, carcinogenicity

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10570 The Factors Affecting the Operations of the Industrial Enterprises of Cassava in the Northeast of Thailand

Authors: Thanasuwit Thabhiranrak

Abstract:

This research aims to study factors that affected the operations of the cassava industrial enterprises in northeast of Thailand. Hypothesis was tested by regress analysis and also the analysis in order to determine the relationship between variables with Pearson correlation and show a class action in cassava process including the owner of business executives and supervisors. The research samples were 400 people in northeast region of Thailand. The research results revealed that success of entrepreneurs related to transformation leadership and knowledge management in a positive way at statistical significance level of 0.01 and respondents also emphasized on the importance of transformational leadership factors. The individual and the use of intelligence affect the success of entrepreneurs in cassava industry at statistical significance level of 0.05. The qualitative data were also collected by interviewing with operational level staff, supervisors, executives, and enterprise owners in the northeast of Thailand. The result was found that knowledge management was important in their business operations. Personnel in the organizations should learn from working experience, develop their skills, and increase knowledge from education.

Keywords: transformational leadership, knowledge management (KM), cassava, northeast of Thailand, industrial

Procedia PDF Downloads 289
10569 Management of Jebusaea hammerschmidtii and Batrachedra amydraula on Date Palm Trees in UAE

Authors: Mohammad Ali Al-Deeb, Hamda Ateeq Al Dhaheri

Abstract:

Insects cause major damage to crops and fruit trees worldwide. In the United Arab Emirates, the date palm tree is the most economically important tree which is used for date production as well as an ornamental tree. In 2002, the number of date palm trees in UAE was 40,700,000 and it is increasing over time. The longhorn stem borer (Jebusaea hammerschmidtii) and the lesser date month (Batrachedra amydraula) are important insect pests causing damage to date palm trees in UAE. Population dynamics of the Jebusaea hammerschmidtii and Batrachedra amydraula were studied by using light and pheromons traps, respectively in Al-Ain, UAE. The first trap catch of B. amydraula adults occurred on 19 April and the insect population peaked up on 26 April 2014. The first trap catch of J. hammerschmidtii occurred in April 2014. The numbers increased over time and the population peak occurred in June. The trapping was also done in 2015. The changes in insect numbers in relation to weather parameters are discussed. Also, the importance of the results on the management of these two pests is highlighted.

Keywords: date palm, integrated pest management, UAE, light trap, pheromone trap

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10568 Exploring Factors Related to Unplanning Readmission of Elderly Patients in Taiwan

Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

Abstract:

Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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10567 Effect of Incremental Forming Parameters on Titanium Alloys Properties

Authors: P. Homola, L. Novakova, V. Kafka, M. P. Oscoz

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Shear spinning is closely related to the asymmetric incremental sheet forming (AISF) that could significantly reduce costs incurred by the fabrication of complex aeronautical components with a minimal environmental impact. The spinning experiments were carried out on commercially pure titanium (Ti-Gr2) and Ti-6Al-4V (Ti-Gr5) alloy. Three forming modes were used to characterize the titanium alloys properties from the point of view of different spinning parameters. The structure and properties of the materials were assessed by means of metallographic analyses and micro-hardness measurements. The highest value wall angle failure limit was achieved using spinning parameters mode for both materials. The feed rate effect was observed only in the samples from the Ti-Gr2 material, when a refinement of the grain microstructure with lower feed rate and higher tangential speed occurred. Ti-Gr5 alloy exhibited a decrease of the micro-hardness at higher straining due to recovery processes.

Keywords: incremental forming, metallography, shear spinning, titanium alloys

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10566 Role of Community Based Forest Management to Address Climate Change Problem: A Case of Nepalese Community Forestry

Authors: Bikram Jung Kunwar

Abstract:

Forests have central roles in climate change. The conservation of forests sequestrates the carbon from the atmosphere and also regulates the carbon cycle. However, knowingly and unknowingly the world’s forests were deforested and degraded annually at the rate of 0.18% and emitted the carbon to the atmosphere. The IPCC reports claimed that the deforestation and forest degradation accounts 1/5th of total carbon emission, which is second position after fossil fuels. Since 1.6 billion people depend on varying degree on forests for their daily livelihood, not all deforestation are undesirable. Therefore, to conserve the forests and find the livelihood opportunities for forest surrounding people is prerequisites to address the climate change problems especially in developing countries, and also a growing concern to the forestry sector researchers, planners and policy makers. The study examines the role of community based forest management in carbon mitigation and adaptation taking the examples of Nepal’s community forestry program. In the program, the government hands over a part of national forests to the local communities with sole forest management authorities. However, the government itself retained the ownership rights of forestland. Local communities organized through a local institution called Community Forest User Group (CFUG) managed the forests. They also formed an operational plan with technical prescriptions and a constitution with forest management rules and regulations. The implementation results showed that the CFUGs are not only found effective to organize the local people and construct a local institution to forest conservation and management activities, but also they are able to collect a community fund from the sale of forest products and carried out various community development activities. These development activities have decisive roles to improve the livelihood of forest surrounding people and eventually to address the climate change problems.

Keywords: climate change, community forestry, local institution, Nepal

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10565 Long-Term Results of Coronary Bifurcation Stenting with Drug Eluting Stents

Authors: Piotr Muzyk, Beata Morawiec, Mariusz Opara, Andrzej Tomasik, Brygida Przywara-Chowaniec, Wojciech Jachec, Ewa Nowalany-Kozielska, Damian Kawecki

Abstract:

Background: Coronary bifurcation is one of the most complex lesion in patients with coronary ar-tery disease. Provisional T-stenting is currently one of the recommended techniques. The aim was to assess optimal methods of treatment in the era of drug-eluting stents (DES). Methods: The regis-try consisted of data from 1916 patients treated with coronary percutaneous interventions (PCI) using either first- or second-generation DES. Patients with bifurcation lesion entered the analysis. Major adverse cardiac and cardiovascular events (MACCE) were assessed at one year of follow-up and comprised of death, acute myocardial infarction (AMI), repeated PCI (re-PCI) of target ves-sel and stroke. Results: Of 1916 registry patients, 204 patients (11%) were diagnosed with bifurcation lesion >50% and entered the analysis. The most commonly used technique was provi-sional T-stenting (141 patients, 69%). Optimization with kissing-balloons technique was performed in 45 patients (22%). In 59 patients (29%) second-generation DES was implanted, while in 112 pa-tients (55%), first-generation DES was used. In 33 patients (16%) both types of DES were used. The procedure success rate (TIMI 3 flow) was achieved in 98% of patients. In one-year follow-up, there were 39 MACCE (19%) (9 deaths, 17 AMI, 16 re-PCI and 5 strokes). Provisional T-stenting resulted in similar rate of MACCE to other techniques (16% vs. 5%, p=0.27) and similar occurrence of re-PCI (6% vs. 2%, p=0.78). The results of post-PCI kissing-balloon technique gave equal out-comes with 3% vs. 16% of MACCE in patients in whom no optimization technique was used (p=0.39). The type of implanted DES (second- vs. first-generation) had no influence on MACCE (4% vs 14%, respectively, p=0.12) and re-PCI (1.7% vs. 51% patients, respectively, p=0.28). Con-clusions: The treatment of bifurcation lesions with PCI represent high-risk procedures with high rate of MACCE. Stenting technique, optimization of PCI and the generation of implanted stent should be personalized for each case to balance risk of the procedure. In this setting, the operator experience might be the factor of better outcome, which should be further investigated.

Keywords: coronary bifurcation, drug eluting stents, long-term follow-up, percutaneous coronary interventions

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