Search results for: nursing guideline

Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Tharaki S. Hettiarachchi

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Sustainable construction has gained massive attention in the present world as the construction industry is highly responsible for carbon emissions and other types of unsustainable practices. Yet, the construction industry has not been able to completely attain sustainable goals. Therefore, the present study aims to identify the extent to which sustainability has been considered within the scope of construction project management and to analyze the challenges, gaps, and constraints associated. Accordingly, this study develops a sustainable framework to integrate in construction project management. In accomplishing the research aim, this research integrates a qualitative approach while relying on secondary data sources. The data shall be then analyzed with the use of a systematic literature review (SLR) method while following the PRISMA (2020) guideline and represented in a statistical form. The outcomes of this study may become highly significant in identifying the nature of the existing sustainable frameworks associated with construction project management scopes and to develop a new framework to integrate in order to enhance the effectiveness of sustainable applications in construction management. The outcomes of this research may benefit present and future construction professionals and academicians to organize sustainable construction-related knowledge in a useful way to apply in practical implementation for effective project management. Overall, this study directs present and future construction professionals toward an advanced construction project management mechanism.

Keywords: construction, framework development, project management, sustainability

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Authors: Somruedee Pongsena

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The purpose of this study is to follow up on the graduated students of Bachelor of Science in Applied Statistics from Suan Sunandha Rajabhat University (SSRU) during the 1999 – 2012 academic years and to provide the fundamental guideline for developing the current curriculum according to Thai Qualifications Framework for Higher Education (TQF: HEd). The sample was collected from 75 graduates by interview and online questionnaire. The content covered 5 subjects: ethics and moral, knowledge, cognitive skills, interpersonal skills and responsibility, numerical analysis as well as communication and information technology skills. Data were analyzed by using statistical methods as percentiles, means, standard deviation, t-tests, and F-tests. The findings showed that samples were mostly females younger than 26 years old. The majority of graduates had income in the range of 10,001-20,000 Baht and their experience range was 2-5 years. In addition, overall opinions from receiving knowledge to apply to work were at agree; mean score was 3.97 and standard deviation was 0.40. In terms of opinion difference, the hypothesis' testing results indicate gender only had different opinion at a significant level of 0.05.

Keywords: follow-up, graduates, knowledge, opinion, work performance.

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Authors: Yi-De Liu

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For many European cities, a key motivation in developing event strategies is to use event as a catalyst for urban regeneration. One type of event that is particularly used as a means of urban development is the European Capital of Culture (ECOC) initiative. Based on a case study of the 2008 ECOC Liverpool, this paper aims at conceptualising the significance of major event for a city’s economic, cultural and social regenerations. In terms of economic regeneration, the role of the ECOC is central in creating Liverpool’s visitor economy and reshaping city image. Liverpool planned different themes for eight consecutive years as a way to ensure economic sustainability. As far as cultural regeneration is concerned, the ECOC contributed to the cultural regeneration of Liverpool by stimulating cultural participation and interest from the demand side, as well as improving cultural provision and collaboration within the cultural sector from the supply side. So as to social regeneration, Liverpool treated access development as a policy guideline and considered the ECOC as an opportunity to enhance the sense of place. The most significant lesson learned from Liverpool is its long-term planning and efforts made to integrate the ECOC into the overall urban development strategy. As a result, a more balanced and long-term effect on urban regeneration could be achieved.

Keywords: cultural event, urban regeneration, european capital of culture, Liverpool

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Authors: Putul Haldar, Yogendra Singh, D. K. Paul

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Un-Reinforced Masonry (URM) infilled RC framed buildings are the most common construction practice for modern multi-storey buildings in India like many other parts of the world. Although the behavior and failure pattern of the global structure changes significantly due to infill-frame interaction, the general design practice is to treat them as non-structural elements and their stiffness, strength and interaction with frame is often ignored, as it is difficult to simulate. Indian Standard, like many other major national codes, does not provide any explicit guideline for modeling of infills. This paper takes a stock of controlling design provisions in some of the major national seismic design codes (BIS 2002; CEN 2004; NZS-4230 2004; ASCE-41 2007) to ensure the desired seismic performance of infilled frame. Most of the national codes on seismic design of buildings still lack in adequate guidelines on modeling and design of URM infilled frames results in variable assumption in analysis and design. This paper, using nonlinear pushover analysis, also presents the effect of one of such assumptions of conventional ‘simultaneous’ analysis procedure of infilled frame on the seismic performance of URM infilled RC frame buildings.

Keywords: URM infills, RC frame, seismic design codes, construction sequence of infilled frame

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Authors: Marthella Rivera Roidatua

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Since the release of Convention on the Rights of Persons with Disabilities in 2006, disability became a mainstreamed global issue. Many developed countries have shown the continuous effort to improve their disability employment policy, for example, the US and the UK with their integrated support system through disability benefits. Relative little recent research on developing country is available. Surprisingly, Indonesia, just enacted the Law No.8/2016 on Disability that bravely highlighted on integrating disabled people into the workforce. It shows a positive progress shifting traditional perspective to what Tom Shakespeare’s concept of a social model of disability. But, the main question is how can this law support the disabled people to access and maintain paid work. Thus, besides the earlier literature reviews, interviews with leading sectors, Ministry of Social Affairs and Ministry of Manpower, was conducted to examine government’s attitude towards the disabled worker. Insights from two local social enterprises on disability were also engaged in building better perspective. The various source of data was triangulated then analysed with a thematic approach. Results were encouraging the Indonesian government to have a better collaboration with other impactful local organisations in promoting the disability employment. In the end, this paper also recommends the government to make a reasonable adjustment and practical guideline for companies in hiring disabled.

Keywords: disability, employment, policy, Indonesia, collaboration, guidelines

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Authors: Giovanni Menichini, Salvatore Giacomo Morano, Gloria Terenzi, Luca Salvatori, Maurizio Orlando

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The “Guidelines for Risk Classification, Safety Assessment, and Structural Health Monitoring of Existing Bridges” were recently approved by the Italian Government to define technical standards for managing the national network of existing bridges. These guidelines provide a framework for risk mitigation and safety assessment of bridges, which are essential elements of the built environment and form the basis for the operation of transport systems. Within the guideline framework, a workflow based on three main points was proposed: (1) risk-based, i.e., based on typical parameters of hazard, vulnerability, and exposure; (2) multi-level, i.e., including six assessment levels of increasing complexity; and (3) multirisk, i.e., assessing structural/foundational, seismic, hydrological, and landslide risks. The paper focuses on applying the Italian Guidelines to specific case studies, aiming to identify the parameters that predominantly influence the determination of the “class of attention”. The significance of each parameter is determined via sensitivity analysis. Additionally, recommendations for enhancing the process of assigning the class of attention are proposed.

Keywords: bridge safety assessment, Italian guidelines implementation, risk classification, structural health monitoring

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Authors: Ikediobi Lottanna Samuel

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Days are gone when perpetrators of core international crimes hide under the cloak of sovereignty to go with impunity. The principle of international criminal responsibility is a reality. This move to end impunity for violation of human rights has led to the creation of international and hybrid tribunals, a permanent international criminal court, and increased prosecution of human rights violations in domestic courts. This article examines the attempts by the international community to bring perpetrators of heinous crimes to book. The work reveals the inadequacy of the current international mechanism for prosecuting core international crimes in order to end the culture of impunity and entrench the culture of accountability. It also identifies that ad hoc international criminal tribunals and the international criminal court face similar challenges ranging from lack of cooperation by nation states, non-existence of hierarchy of crimes, lack of effective enforcement mechanism, limited prosecutorial capacity and agenda, difficulty in apprehending suspects, difficulty in blending different legal tradition, absence of a coherent sentencing guideline, distant location of courts, selective indictment, etc. These challenges adversely affect the functioning of these courts. It is suggested that a more helpful way to end impunity would be to have a more robust and synergistic relationship between national, regional, and international approaches to prosecuting core international crimes.

Keywords: prosecution, criminal, international, tribunal, justice, ad hoc

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Authors: Karishma Chester, Sarvesh Paliwal, Sayeed Ahmad

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Solanumnigrum L. (Family: Solanaceae), is an important Indian medicinal plant and have been used in various traditional formulations for hepato-protection. It has been reported to contain significant amount of steroidal glycosides such as solamargine and solasonine as well as their aglycone part solasodine. Being important pharmacologically active metabolites of several members of Solanaceae these markers have been attempted various times for their extraction and quantification but separately for glycoside and aglycone part because of their opposite polarity. Here, we propose for the first time simultaneous extraction and quantification of aglycone (solasodine)and glycosides (solamargine and solasonine) inleaves and berries of S.nigrumusing solvent extraction followed by HPTLC analysis. Simultaneous extraction was carried out by sonication in mixture of chloroform and methanol as solvent. The quantification was done using silica gel 60F254HPTLC plates as stationary phase and chloroform: methanol: acetone: 0.5 % ammonia (7: 2.5: 1: 0.4 v/v/v/v) as mobile phaseat 400 nm, after derivatization with an isaldehydesul furic acid reagent. The method was validated as per ICH guideline for calibration, linearity, precision, recovery, robustness, specificity, LOD, and LOQ. The statistical data obtained for validation showed that method can be used routinely for quality control of various solanaceous drugs reported for these markers as well as traditional formulations containing those plants as an ingredient.

Keywords: solanumnigrum, solasodine, solamargine, solasonine, quantification

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Authors: Akram Waheb Nasef Alzordoky

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The wars and armed conflicts have frequently ended in violations of global humanitarian law and regularly devote the maximum severe global crimes, which include war crimes, crimes towards humanity, aggression and genocide. But, simplest inside the XX century, the guideline changed into an articulated idea of establishing a frame of worldwide criminal justice so that you can prosecute those crimes and their perpetrators. The first steps on this subject were made with the aid of setting up the worldwide army tribunals for warfare crimes at Nuremberg and Tokyo, and the formation of ad hoc tribunals for the former Yugoslavia and Rwanda. Ultimately, the global criminal courtroom was established in Rome in 1998 with the aim of justice and that allows you to give satisfaction to the sufferers of crimes and their families. The aim of the paper was to provide an ancient and comparative analysis of the establishments of worldwide criminal justice primarily based on which those establishments de lege lata fulfilled the goals of individual criminal responsibility and justice. Moreover, the authors endorse de lege ferenda that the everlasting global crook Tribunal, in addition to the potential case, additionally takes over the current ICTY and ICTR cases.

Keywords: social networks privacy issues, social networks security issues, social networks privacy precautions measures, social networks security precautions measures

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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Authors: Jefferson S. Galanza, Jewel An Mischelle R.Camcam, Alyssa Karryl C. Co, Stephanie P. De Guzman, Jet Jet K. Dongui-is, Rodolfo Dane C. Frias, Ovelle C. Jueco, Harvey L. Matbagan, Victoria Luzette T. Rillon, Christelle Romyna H. Saruca, Jeanette Roma M. Villasper

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Background: Amidst numerous studies conducted on learning styles of students from a variety of courses, levels and school, a recent study recommended a great need for research on learning styles of student nurses. Moreover, related literatures have not been found exploring both the learning and teaching style of student nurses. Aims: The study aimed to determine the learning and teaching styles of student nurses and if there is an association between them. It also intended to discover whether student nurses are unimodal or multimodal in their styles and identified which faculty teaching style affords maximum outcome for student’s learning styles. Methods: Quantitative Descriptive-Correlational design was used. Participants were randomly selected 312 student nurses at School of Nursing X, Baguio City, Philippines. The questionnaire utilized a modified version of an adopted tool from Fleming’s VARK learning style version 7.2 (Visual, Auditory, Reader/Writer, Kinaesthetic) and Grasha’s teaching styles (Formal Authority, Demonstrator, Facilitator, Delegator). SPSS 19 was used for statistical treatment of data, where Chi square was used for the correlation of unimodal learning and teaching styles. Results/Finding: Majority of student nurses’ learning style is Kinesthetic and their teaching style is Demonstrator, which was also found to be significantly associated. Moreover, 8 out of 10 students are Unimodal in their learning and teaching modalities. In general, their preferred faculty teaching style is similar to their teaching style, which supports the concept, that teachers teach the way they learn. Conclusion: Study concludes that student nurses’ learning styles and teaching styles are varied, which exemplifies the uniqueness of every learner.This diversity in styles provided more evidence that a variety of mode of teaching and learning should be used by faculty and students to increase learning outcome and academic achievement. Recommendation: Future studies could be carried out in various schools of nursing utilizing faculty as respondents. Conduct assessment of learning style at the onset of classes/clinical placements so that faculty will become aware of the diversity of learners leading them to deliver diverse teaching methods.

Keywords: learning, learning styles, teaching styles, student nurses

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Authors: Md Mizanur Rahman, M. Aslam Alam, Muhammad Abu Yusuf

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The abundance of Jellyfish across the coasts of the Bay of Bengal is increasing sharply due to marine pollution, increased sea acidification and climate change. Jellyfish draws our attention to address the local and global stressors. This also indicates that something wrong is happening in this bay behind the scenes. This study aimed to investigate how the policy framework governing the sea can be reformed. To do so, this study evaluated the existing policy, regulatory and institutional framework. Empirical data were collected from the middle coastal zone of Bangladesh. The secondary literature on policy, legal documents, and institutional arrangements were reviewed. The causes of poor coordination among different public sectors and non-compliance of laws were identified. The key findings show that despite the existing of Department of Environment, poor coordination with other departments, and lack of logistics and technical staffs have resulted in severe marine pollution and degradation of coastal and marine living resources. The existing policies had no monitoring and evaluation mechanisms. Non-compliance of the existing laws has been fueling the problems. This study provides an integrated policy and a guideline for updating the legal and institutional mechanism to manage coastal and marine living resources sustainably in Bangladesh to achieve Sustainable Development Goal 14.

Keywords: legal, institutional, framework, jellyfish

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Authors: Muzaffar Iqbal, Essam Ezzeldin, Khalid A. Al-Rashood

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Pomalidomide is a second generation oral immunomodulatory agent, being used for the treatment of multiple myeloma in patients with disease refractory to lenalidomide and bortezomib. In this study, a sensitive UPLC-MS/MS assay was developed and validated for high-throughput determination of pomalidomide in rat plasma using celecoxib as an internal standard (IS). Liquid liquid extraction using dichloromethane as extracting agent was employed to extract pomalidomide and IS from 200 µL of plasma. Chromatographic separation was carried on Acquity BEHTM C18 column (50 × 2.1 mm, 1.7 µm) using an isocratic mobile phase of acetonitrile:10 mM ammonium acetate (80:20, v/v), at a flow rate of 0.250 mL/min. Both pomalidomide and IS were eluted at 0.66 ± 0.03 and 0.80 ± 0.03 min, respectively with a total run time of 1.5 min only. Detection was performed on a triple quadrupole tandem mass spectrometer using electrospray ionization in negative mode. The precursor to product ion transitions of m/z 272.01 → 160.89 for pomalidomide and m/z 380.08 → 316.01 for IS were used to quantify them respectively, using multiple reaction monitoring mode. The developed method was validated according to regulatory guideline for bioanalytical method validation. The linearity in plasma sample was achieved in the concentration range of 0.47–400 ng/mL (r2 ≥ 0.997). The intra and inter-day precision values were ≤ 11.1% (RSD, %) whereas accuracy values ranged from - 6.8 – 8.5% (RE, %). In addition, other validation results were within the acceptance criteria and the method was successfully applied in a pharmacokinetic study of pomalidomide in rats.

Keywords: pomalidomide, pharmacokinetics, LC-MS/MS, celecoxib

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Authors: Nicolas Koslover, Tamara Levene

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Aims: Tonsilitis is one of the most common presentations to the A+E department. We aimed to assess whether patients presenting with tonsilitis are being managed in-line with current guidance. We then set out to educate A+E staff about tonsilitis management and then assessed for improvement in management. Methods: All patients presenting to A+E in one fortnight with a documented diagnosis of tonsilitis were included. We reviewed the notes to assess the choice of treatment in each case and whether a clinical score (CENTOR or FEVERPain score) was used to guide choice of treatment (in accordance with NICE guideline [NG84]). We designed and delivered an educational intervention for A+E staff covering tonsilitis guidelines. The audit was repeated two weeks later. Results: Over the study period, 49 patients were included; only 35% (n=17) had either a clinical score documented or had all components of a score recorded. In total, 39% (n=19) were treated with antibiotics. Of these, 63% (n=12) should not have been prescribed an antibiotic and 37% (n=7) were prescribed an inappropriate antibiotic. At re-audit, (n=50 cases), 58% (n=29) had a clinical score documented and 28% (n=14) were treated with antibiotics. Of these, 29% (n=4) should not have been prescribed antibiotics and 21% (n=3) were prescribed an inappropriate antibiotic. Thus, after this teaching session, there was a significant improvement in antibiotic prescribing practices (63% vs. 29%, p=0.026). Conclusions: A+E assessment and management of tonsilitis frequently deviated from guidelines, but a single teaching session vastly improved clinical scoring and antibiotic prescribing practices.

Keywords: tonsilitis, education, emergency medicine, ENT

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Authors: Chia Yu Chen, Shu Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Shu Jiuan Chen, Yen Ling Liu

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Aim: It remains undetermined that whether increased work stress may affect the job satisfaction and career loyalty among nursing staffs in the operating room. The long-term goal of this study is to lengthen the professional life of operating room nurses by attenuating the work stress and enhancing their contentment in work. Method: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in the southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses. Chi-square test was used to analyze the categorical data and Pearson correlation was used to analyze the association between two numerical datasets (SPSS version 20.0). Results: The response rate was 80% (80/100) and a total of 73 (73%) completed forms were eventually proceeded for analysis. The average scores for work stress and job satisfaction of the operating room nurses were 145.96±32.91 and 47.38±6.07, respectively. The correlation coefficients of work stress versus job satisfaction and organizational identity were (r=-0.338, p=0.003 and r=-0.354, p=0.002), respectively. There were more nurses who took rotating shift quitted works from the operating room than those who took only dayshift (2＝5.176, p<0.05). Nurses who reported of having lower job satisfaction were associated with significantly higher turnover intention (t=3.714, p< 0.01). Following multivariate regression analysis, rotating shift and low job satisfaction were identified as the two independent predictors of intention to quit from working in the operating room. Conclusion: Our study clearly demonstrates that increased work stress significantly attenuates job satisfaction and organizational identity. Rotating shift is associated with higher work stress, lower job satisfaction, and higher turnover intention, which is consistent with the previous surveys carried out in the department of medical technology. Therefore, improvement of working quality in the operating rooms is essential to increase the retain intention of the well-trained nursing staffs. Further investigation into types of work shifts and other strategies of attenuating stress in workplace is currently undertaken in order to improve the job satisfaction and to decrease turnover intention in the operating room.

Keywords: rotating shift, work stress, job satisfaction, turnover intention

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Authors: Hossein Alimohammadi, Mohsen Amirmojahedi, Mehrdad Rowhani

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Soil properties are used by geotechnical engineers to evaluate and analyze site conditions for designing purposes. Although basic soil classification tests are easy to perform and provide useful information to determine the properties of soils, it may take time to get the result and add some costs to the projects. Standard Penetration Test (SPT) provides an opportunity to evaluate soil parameters without performing laboratory tests. In addition to its simplicity and cheapness, the results become available immediately. This research provides a guideline on the application of the SPT test method, reliability of adapting the SPT test results in evaluating soil physical and mechanical properties such as Atterberg limits, shear strength, and compressive strength compressibility parameters. A total of 70 boreholes were investigated in this study by taking soil samples between depths of 1.2 to 15.25 meters. The project site was located in Morrow County, Ohio. A regression-based formula was proposed based on Tobit regression with a stepwise variable selection analysis conducted between SPT and other typical soil properties obtained from soil tests. The results of the research illustrated that the shear strength and physical properties of the soil affect the SPT number. The proposed correlation can help engineers to use SPT test results in their design with higher accuracy.

Keywords: standard penetration test, soil properties, soil classification, regression method

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Authors: Shoufeng Cao, Kim Bryceson, Damian Hine

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The existing supply chain risk management (SCRM) research is currently chaotic and somewhat disorganized, and the topic has been addressed conceptually more often than empirically. This paper, using both qualitative and quantitative data, employs a modified Meta-study method to investigate the SCRM empirical research published in quality journals over the period of 12 years (2004-2015). The purpose is to outline the extent research trends and the employed research methodologies (i.e., research method, data collection and data analysis) across the sub-field that will guide future research. The synthesized findings indicate that empirical study on risk ripple effect along an entire supply chain, industry-specific supply chain risk management and global/export supply chain risk management has not yet given much attention than it deserves in the SCRM field. Besides, it is suggested that future empirical research should employ multiple and/or mixed methods and multi-source data collection techniques to reduce common method bias and single-source bias, thus improving research validity and reliability. In conclusion, this paper helps to stimulate more quality empirical research in the SCRM field via identifying promising research directions and providing some methodology guidelines.

Keywords: empirical research, meta-study, methodology guideline, research direction, supply chain risk management

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Authors: Daniela Greven, Kathrin Endres, Shugana Sundralingam

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The use of chatbots has hardly been established in B2B companies to date and involves various challenges. The goal of this paper is to identify the biggest obstacles to the successful implementation of chatbots in B2B companies and to develop measures to overcome them. The obstacles are identified by conducting expert interviews within the framework of Eisenhardt's case study research. These are examined through a socio-technical analysis focusing on people, technology, and organization. By means of systematic literature research and in-depth interviews with German chatbot providers and customers of chatbots, measures for overcoming the obstacles are identified. Using interviews with experts from German chatbot providers, the responsible stakeholders of each measure according to the RASCI Responsibility Matrix are identified. The study shows that there are major obstacles in all areas of a socio-technical system that can cause the implementation of a chatbot to fail. A total of 44 implementation obstacles and 58 measures to overcome these obstacles are identified. The study shows that there are major obstacles in the areas of people, technology, and organization of a socio-technical system that can cause the implementation of a chatbot to fail. A holistic view is therefore essential. The results provide firms with a guideline on how to overcome potential obstacles during chatbot implementation in B2B customer service.

Keywords: chatbots, socio-technical analysis, B2B customer service, implementation success factors

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Authors: Pei-Shan Liang

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Objective: This article explores the care experience of a terminal lung cancer patient who developed lower limb paralysis after surgery for aortic dissection. The patient, diagnosed with aortic dissection during chemotherapy for lung cancer, faced post-surgical lower limb paralysis, leading to feelings of helplessness and hopelessness as they approached death with reduced mobility. Methods: The nursing period was from July 19 to July 27, during which the author, alongside the intensive care team and palliative care specialists, conducted a comprehensive assessment through observation, direct care, conversations, physical assessments, and medical record review. Gordon's eleven functional health patterns were used for a holistic evaluation, identifying four nursing health issues: "pain related to terminal lung cancer and invasive procedures," "decreased cardiac tissue perfusion due to hemodynamic instability," "impaired physical mobility related to lower limb paralysis," and "hopelessness due to the unpredictable prognosis of terminal lung cancer." Results: The medical team initially focused on symptom relief, administering Morphine 5mg in 0.9% N/S 50ml IVD q6h for pain management and continuing chemotherapy as prescribed. Open communication was employed to address the patient's physical, psychological, and spiritual concerns. Non-pharmacological interventions, including listening, caring, companionship, opioid medication, and distraction techniques like comfortable positioning and warm foot baths, were used to alleviate pain, reducing the pain score to 3 on the numeric rating scale and easing respiratory discomfort. The palliative care team was also involved, guiding the patient and family through the "Four Paths of Life," helping the patient achieve a good end-of-life experience and the family to experience a peaceful life. This process also served to promote the concept of palliative care, enabling more patients and families to receive high-quality and dignified care. The patient was encouraged to express inner anxiety through drawing or writing, which helped reduce the hopelessness caused by psychological distress and uncertainty about the disease's prognosis, as assessed by the Hospital Anxiety and Depression Scale, reaching a level of mild anxiety but acceptable without affecting sleep. Conclusion: What left a deep impression during the care process was the need for intensive care providers to consider the patient's psychological state, not just their physical condition, when the patient's situation changes. Family support and involvement often provide the greatest solace for the patient, emphasizing the importance of comfort and dignity. This includes oral care to maintain cleanliness and comfort, frequent repositioning to alleviate pressure and discomfort, and timely removal of invasive devices and unnecessary medications to avoid unnecessary suffering. The nursing process should also address the patient's psychological needs, offering comfort and support to ensure that they can face the end of life with peace and dignity.

Keywords: intensive care, lung cancer, aortic dissection, lower limb paralysis

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Authors: Ria M. Caramoan, Analiza P. Rollon, Karl N. Vergel

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The Simple Interactive Models for Better Air Quality (SIM-air) is an integrated approach model that allows the available information to support the integrated urban air quality management. This study utilized the vehicular air pollution information system module of SIM-air for the assessment of vehicular emissions in Commonwealth Avenue, Quezon City, Philippines. The main objective of the study is to assess and predict the contribution of different types of vehicles to the vehicular emissions in terms of PM₁₀, SOₓ, and NOₓ at different policy and technology scenarios. For the base year 2017, the results show vehicular emissions of 735.46 tons of PM₁₀, 108.90 tons of SOₓ, and 2,101.11 tons of NOₓ. Motorcycle is the major source of particulates contributing about 52% of the PM₁₀ emissions. Meanwhile, Public Utility Jeepneys contribute 27% of SOₓ emissions and private cars using gasoline contribute 39% of NOₓ emissions. Ambient air quality monitoring was also conducted in the study area for the standard parameters of PM₁₀, S0₂, and NO₂. Results show an average of 88.11 µg/Ncm, 47.41 µg/Ncm and 22.54 µg/Ncm for PM₁₀, N0₂, and SO₂, respectively, all were within the DENR National Ambient Air Quality Guideline Values. Future emissions of PM₁₀, NOₓ, and SOₓ are estimated at different scenarios. Results show that in the year 2030, PM₁₀ emissions will be increased by 186.2%. NOₓ emissions and SOₓ emissions will also be increased by 38.9% and 5.5%, without the implementation of the scenarios.

Keywords: ambient air quality, emissions inventory, mobile air pollution, vehicular emissions

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Authors: M. Nikafrooz, J. Darsareh

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Due to the COVID-19 pandemic, its impacts on education all over the world and the problems arising from the use of traditional methods in education, it was necessary to apply alternative solutions to achieve educational goals. In this regard, electronic content production through screen recording and giving educational services in virtual classes became popular among many teachers. But the production of screen recorded videos involves special technical and educational considerations so that educators could be able to produce valuable and well-made videos by taking those considerations into account. The purpose of this study was to extract and find the technical and educational considerations of producing screen recorded videos to provide a useful and comprehensive guideline for e-content producers to enable them to produce high-quality educational videos. This study is fundamental research and data collection has been done using the Delphi method. In this research, an attempt has been made to provide the necessary criteria and considerations regarding the design and production of screen recorded videos by studying the literatures, identifying and analyzing learners' and teachers' needs and expectations, reviewing the previously produced videos. The results of these studies led to the finding and extracting 129 indicators in the form of 6 criteria. Such considerations are expected to reduce production and editing time, increase the technical and educational quality, and finally facilitating and enhancing the processes of teaching and learning.

Keywords: e-content, screen recorded videos, screen recording software, technical and pedagogical considerations

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Authors: Pawit Tangviroon, Apichit Svang-Ariyaskul

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Rubber seed oil is an attractive alternative feedstock for biodiesel production because it is not related to food-chain plant. Rubber seed oil contains large amount of free fatty acids, which causes problem in biodiesel production. Free fatty acids can react with alkaline catalyst in biodiesel production. Acid esterification is used as pre-treatment to convert unwanted compound to desirable biodiesel. Phase separation of oil and methanol occurs at low ratio of methanol to oil and causes low reaction rate and conversion. Acid esterification requires large excess of methanol in order to increase the miscibility of methanol in oil and accordingly, it is a more expensive separation process. In this work, the kinetics of esterification of rubber seed oil with methanol is developed from available experimental results. Reactive distillation process was designed by using Aspen Plus program. The effects of operating parameters such as feed ratio, molar reflux ratio, feed temperature, and feed stage are investigated in order to find the optimum conditions. Results show that the reactive distillation process is proved to be better than conventional process. It consumes less feed methanol and less energy while yielding higher product purity than the conventional process. This work can be used as a guideline for further development to industrial scale of biodiesel production using reactive distillation.

Keywords: biodiesel, reactive distillation, rubber seed oil, transesterification

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Authors: Hyunchul Oh

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One of the challenges in modern separation science and technology is the separation of hydrogen isotopes mixtures since D2 and H2 consist of almost identical size, shape and thermodynamic properties. Recently, quantum sieving of isotopes by confinement in narrow space has been proposed as an alternative technique. Despite many theoretical suggestions, however, it has been difficult to discover a feasible microporous material up to now. Among various porous materials, the novel class of microporous framework materials (COFs, ZIFs and MOFs) is considered as a promising material class for isotope sieving due to ultra-high porosity and uniform pore size which can be tailored. Hence, we investigate experimentally the fundamental correlation between D2/H2 molar ratio and pore size at optimized operating conditions by using different ultramicroporous frameworks. The D2/H2 molar ratio is strongly depending on pore size, pressure and temperature. An experimentally determined optimum pore diameter for quantum sieving lies between 3.0 and 3.4 Å which can be an important guideline for designing and developing feasible microporous frameworks for isotope separation. Afterwards, we report a novel strategy for efficient hydrogen isotope separation at technologically relevant operating pressure through the development of quantum sieving exploited by the pore aperture engineering. The strategy involves installation of flexible components in the pores of the framework to tune the pore surface.

Keywords: gas adsorption, hydrogen isotope, metal organic frameworks(MOFs), quantum sieving

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Authors: W. E. Igwegbe, B. C. Okoro, J. C. Osuagwu

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The study was aimed at assessing the effectiveness of reducing the concentrations of heavy metals in waste water using Pawpaw (Carica papaya) wood as a bio-sorbent. The heavy metals considered include; zinc, cadmium, lead, copper, iron, selenium, nickel, and manganese. The physiochemical properties of carica papaya stem were studied. The experimental sample was obtained from a felled trunk of matured pawpaw tree. Waste water for experimental use was prepared by dissolving soil samples collected from a dump site at Owerri, Imo state in water. The concentration of each metal remaining in solution as residual metal after bio-sorption was determined using Atomic absorption Spectrometer. The effects of ph, contact time and initial heavy metal concentration were studied in a batch reactor. The results of Spectrometer test showed that there were different functional groups detected in the carica papaya stem biomass. Optimum bio-sorption occurred at pH 5.9 with 5g/100ml solution of bio-sorbent. The results of the study showed that the treated wastewater is fit for irrigation purpose based on Canada wastewater quality guideline for the protection of Agricultural standard. This approach thus provides a cost effective and environmentally friendly option for treating waste water.

Keywords: biomass, bio-sorption, Carica papaya, heavy metal, wastewater

Procedia PDF Downloads 371

Authors: Fatima Mehmood, Khalid Farooq

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After the Mangla dam raising in 2010, the maximum reservoir impoundment level of 378.5 m SPD (Survey of Pakistan Datum) was achieved in September 2014. The reservoir drawdown was started on September 29, 2014 and a landslide occurred on Mirpur-Kotli Road near Khaliqabad on November 27, 2014. This landslide took place due to the failure of a slope along the reservoir rim. This study was undertaken to investigate the causative factors of Khaliqabad landslide. Site visits were carried out for recording the field observations and collection of the soil samples. The soil was subjected to different laboratory tests for the determination of index and engineering properties. The shear strength tests were performed at various levels of density and degrees of saturation. These soil parameters were used in an integrated SEEP-SLOPE/W analysis to obtain the drop in factor of safety with time and reservoir drawdown. The results showed the factor of safety dropped from 1.28 to 0.85 over a period of 60 days. The ultimate reduction in the shear strength of soil due to saturation with the simultaneous removal of the stabilizing effect of reservoir caused the disturbing forces to increase, and thus failure happened. The findings of this study can serve as a guideline for the modeling of the slopes experiencing rapid drawdown scenario with the consideration of more realistic distribution of soil moisture/ properties across the slope

Keywords: geotechnical investigation, landslide, reservoir drawdown, shear strength, slope stability

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Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

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Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

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Authors: Rabiaal Adawiyah Shazali, Corina Joseph

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The disclosure of Intellectual Capital (IC) information is getting more vital in today’s era of a knowledge-based economy. Companies are advised by accounting bodies to enhance IC disclosure which complements the conventional financial disclosures. There are no accounting standards for Intellectual Capital Disclosure (ICD), therefore the disclosure is entirely voluntary. Hence, this study aims to investigate the extent of ICD and to examine the relationship between corporate governance and ICD in Malaysia. This study employed content analysis of 100 annual reports by the top 100 public listed companies in Malaysia during 2012. The uniqueness of this study lies on its underpinning theory used where it applies the institutional isomorphism theory to support the effect of the attributes of corporate governance towards ICD. In order to achieve the stated objective, multiple regression analysis were employed to conduct this study. From the descriptive statistics, it was concluded that public listed companies in Malaysia have increased their awareness towards the importance of ICD. Furthermore, results from the multiple regression analysis confirmed that corporate governance affects the company’s ICD where the frequency of audit committee meetings and the board size has positively influenced the level of ICD in companies. Findings from this study would provide an incentive for companies in Malaysia to enhance the disclosure of IC. In addition, this study would assist Bursa Malaysia and other regulatory bodies to come up with a proper guideline for the disclosure of IC.

Keywords: annual report, content analysis, corporate governance, intellectual capital disclosure

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

Procedia PDF Downloads 497

Authors: Joel C. Navarez

Abstract:

The current study investigated the Filipino school counselor’s knowledge, attitudes, and competencies in suicide intervention as well as their experiences and practices in suicide intervention. The study also aimed to develop and standardize suicide intervention guidelines. The study has two (2) phases. Phase 1 utilized the descriptive and generic qualitative inquiry methods of research. Purposive and convenience sampling was applied, and participants were college counselors from the National Capital Region (NCR), Luzon, Visayas, and Mindanao. Results revealed that counselors do not have high level of knowledge on suicidal behaviors, have some negative attitudes toward suicidal behavior, and need to acquire better intervention skills. The findings also showed that the trainings received by counselors are not enough to advance their suicide intervention skills, which would help enhance positive attitudes towards suicide risk assessment and management. Some common experiences of the counselors in suicide intervention were focused on the areas of accountability, stigmatizing attitudes of parents, and confidentiality issues. Phase 2 of the study was the development of suicide intervention practice guidelines using the Delphi process. The tentative guideline was based on the content analysis of interventions taken from literature and from the actual intervention practices of counselors, as seen from the findings of the qualitative study of Phase 1. After three (3) Delphi rounds and the consensus from sixteen (16) mental health experts, 145 recommended actions can be implemented by school counselors in suicide.

Keywords: counselor competencies, counselor development, suicide, suicide intervention

Procedia PDF Downloads 159