Search results for: electronic product code

Authors: Tamar Lazariashvili

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Introduction: The agro-insurance has great importance for agricultural development in the country. In the article, the insurance market of the Georgian agricultural sector has been studied, the level of interest of farmers with insurance products and the trend of demand for those products are revealed; also, the importance of insurance is substantiated. Methodology: The following research methods are applied in the presented paper: statistical (selection, grouping, observation, trend) and qualitative research (in-depth interview with farmers). They claim that the main reason for aggravation is the low level of trust, less awareness about the conditions of the insurance contract. In order to eradicate distrust towards agro-insurance, it is recommended to increase awareness of insured farmers in terms of an insurance agreement. In the case of disputable issues between insurance companies and the customers (farmers), it is advisable to enact the Mediation Service, which will be able to protect the rights of insured farmers. Main Findings: Insurance companies prefer to deal with large farmers, the number of them is very small in Georgia as the credit market. The government interference in this sector is also a very cautious topic. However, the government can strengthen the awareness of farmers about the characteristics and advantages of the insurance system in order to increase the number of insured and reduce insurance premiums for farmers. Conclusion: Enactment of agro-insurance will increase the interest and confidence of financial institutions in the farming sector, financial resources will be accessible to the farmers that will facilitate the stable development of the sector in the country. The size of the agro-insurance market in the country should be increased, and the new territories should be covered. The State must have an obligation to ensure the risk of farmers and subsidize insurance companies. Based on the analysis of the insurance market, the conclusions on agro-insurance issues and the relevant recommendations are proposed.

Keywords: Agro-insurance, agricultural product, Agro-market, farming

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Authors: Abdullah N. Olimat, Ahmad S. Awad, Faisal M. AL-Ghathian

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Natural wood is used in many applications in Jordan such as furniture, partitions constructions, and cupboards. Experimental work for smoke produced by the combustion of certain wood samples was studied. Smoke generated from burning of natural wood, is considered as a major cause of death in furniture fires. The critical parameter for life safety in fires is the available time for escape, so the visual obscuration due to smoke release during fire is taken into consideration. The effect of smoke, produced by burning of wood, depends on the amount of smoke released in case of fire. The amount of smoke production, apparently, affects the time available for the occupants to escape. To achieve the protection of life of building occupants during fire growth, fire retardant painting products are tested. The tested samples of natural wood include Beech, Ash, Beech Pine, and white Beech Pine. A smoke density chamber manufactured by fire testing technology has been used to perform measurement of smoke properties. The procedure of test was carried out according to the ISO-5659. A nonflammable vertical radiant heat flux of 25 kW/m² is exposed to the wood samples in a horizontal orientation. The main objective of the current study is to carry out the experimental tests for samples of natural woods to evaluate the capability to escape in case of fire and the fire safety requirements. Specific optical density, transmittance, thermal conductivity, and mass loss are main measured parameters. Also, comparisons between samples with paint and with no paint are carried out between the selected samples of woods.

Keywords: extinction coefficient, optical density, transmittance, visibility

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Authors: Jutharat Attawet, Alex Y. Wang, Cindy M. Farquhar, Elizabeth A. Sullivan

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Background: Adverse maternal and perinatal outcomes of multiple pregnancies resulting from multiple embryo transfers (ET) has become significant concerns. This is particularly relevant for gestational carriers since they usually do not have infertility issues. Single embryo transfer (SET) therefore has been encouraged to assist reproductive technology (ART) practice in order to reduce multiple pregnancies. Objectives: This systematic review aims to investigate the pregnancy and birth outcomes of SET and multiple ET in surrogacy arrangements. Search methods: This study is a systematic review. Electronic databases were searched from CINAHL, Medline, Embase, Scopus and ProQuest for studies from 1980 to 2017. Cross-references and national ART reports were also manual searchings. Articles without restriction of English language and study types were accessed. Carrier cycles involving in SET and multiple ET were identified in database searching. The main outcome measures including clinical pregnancy, live delivery and multiple deliveries per gestational carrier cycle were compared between SET and multiple ET. Mantel-Haenzel risk ratios (RRs) with 95% confidence intervals (CIs), using the numbers of outcome events in SET and multiple ET of each study were calculated suing RevMan5.3. Outcomes: The search returned 97 articles of which 5 met the inclusion criteria. Approximately 50% of carrier cycles were transferred a single embryo and 50% were transferred more than one embryo. The clinical pregnancy rate (CPR) was 39% for SET and 53% for multiple ET, which was not significantly different with RR = 0.83 (95% CI: 0.67-1.03). The live delivery rate was 33% for SET and 57% for multiple ET which was not significantly different with RR = 0.78 (95% CI: 0.61-1.00). The multiple delivery rate per carrier was greater risks in the multiple ET carrier cycles (RR =0.4, 95% CI: 0.01-0.26). There were 104 sets of twins (including one set of twins selectively reduced from triplets to twins) and 1 set of triples in the multiple ET carrier cycle. In the SET carrier cycles, there were 2 sets of twins. Significance of the study: SET should be advocated among surrogate carriers to prevent multiple pregnancies and subsequent adverse outcomes for both carrier and baby. Surrogacy practice should be reviewed and surrogate carriers should be fully informed of the risk of adverse maternal and birth outcome of multiple pregnancies due to multiple embryo transfers.

Keywords: assisted reproduction, birth outcomes, carrier, gestational surrogacy, multiple embryo transfer, multiple pregnancy, pregnancy outcomes, single embryo transfer, surrogate mother, systematic review

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Authors: Idris M. Olatunde, Kareem B.

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In manufacturing systems, especially job shops, service performance is a key factor that determines customer satisfaction. Service performance depends not only on the quality of the output but on the delivery lead times as well. Besides product quality enhancement, delivery lead time must be minimized for optimal patronage. Quoting accurate due dates is sine quo non for job shop operational survival in a global competitive environment. Quoting accurate due dates in job shops has been a herculean task that nearly defiled solutions from many methods employed due to complex jobs routing nature of the system. This class of NP-hard problems possessed no rigid algorithms that can give an optimal solution. Jobshop operational problem is more complex in developing nations due to some peculiar factors. Operational complexity in job shops emanated from political instability, poor economy, technological know-how, and the non-promising socio-political environment. The mentioned exogenous factors were hardly considered in the previous studies on scheduling problem related to due date determination in job shops. This study has filled the gap created in the past studies by developing a dynamic model that incorporated the exogenous factors for accurate determination of due dates for varying jobs complexity. Real data from six job shops selected from the different part of Nigeria, were used to test the efficacy of the model, and the outcomes were analyzed statistically. The results of the analyzes showed that the model is more promising in determining accurate due dates than the traditional models deployed by many job shops in terms of patronage and lead times minimization.

Keywords: due dates prediction, improved performance, customer satisfaction, dynamic model, exogenous factors, job shops

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Authors: Umut Tuğlu Karslı

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While, port function had a major role during the antiquity and medieval times, it has started to lose its significance in 19th century. In many port cities, while heavy industrial functions and ports have been moved out of the former port districts, the resulting derelict spaces have been transformed to new waterfront quarters to accommodate commercial, tourism, cultural, residential and public uses. Primary aim of these operations is to revitalize abandoned spaces of historical potential and re-establish a relationship between the city and the coast. Karakoy Port, field of this study, located in the Bosphorus, was surrounded by the city centre in time due to the transformation of urban functions, and as a result it has lost its former significance. While Karakoy has 24 hours lively residential and commercial uses in old times; in early 1980s, became a district of mechanical, plumbing and electronic parts suppliers during the day and a place for homeless at night. Today, activities for revitalization of this region continue in two forms and scales. First of these activities is the "planned transformation projects," which also includes the most important one “Galataport project”, and the second one is "spontaneous transformation," which consists of individual interventions. Galataport project that based on the idea of arranging the area specifically for tourists was prepared in 2005 and became a topic of tremendous public debate. On the other hand, the "spontaneous transformation" that is observed in the Karakoy District starts in 2004 with the foundation of “Istanbul Modern Museum”. Istanbul Modern, the first contemporary arts museum of the city, allowed the cultural integration of old naval warehouses of the port to the daily life. Following this adaptive reuse intervention, the district started to accommodate numerous art galleries, studios, café-workshops and design stores. In this context, this paper briefly examines revitalization studies in obsolete port regions, analyzes the planned and ongoing socio-spatial transformations in the specific case of Karakoy under the subjects of "planned transformation projects" and "spontaneous transformation", and realizes a critical review of the sustainability of the proposals on how to reinstate the district in the active life of Istanbul.

Keywords: port cities, socio-spatial transformation, urban regeneration, urban revitalization

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Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Amrutha Kishor

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Today, with the rising global warming and depletion of resources every industry is moving toward sustainability and energy efficiency. As part of this movement, it is nowadays obligatory for architects to play their part by creating energy predictions for their designs. But in a lot of cases, these predictions do not reflect the real quantities of energy in newly built buildings when operating. These can be described as ‘Energy Performance Gaps’. This study aims to determine the underlying reasons for these gaps. Seven houses designed by Allan Joyce Architects, UK from 1998 until 2019 were considered for this study. The data from the residents’ energy bills were cross-referenced with the predictions made with the software SefairaPro and from energy reports. Results indicated that the predictions did not match the actual energy usage. An account of how energy was used in these seven houses was made by means of personal interviews. The main factors considered in the study were occupancy patterns, heating systems and usage, lighting profile and usage, and appliances’ profile and usage. The study found that the main reasons for the creation of energy gaps were the discrepancies in occupant usage and patterns of energy consumption that are predicted as opposed to the actual ones. This study is particularly useful for energy-conscious architectural firms to fine-tune the approach to designing houses and analysing their energy performance. As the findings reveal that energy usage in homes varies based on the way residents use the space, it helps deduce the most efficient technological combinations. This information can be used to set guidelines for future policies and regulations related to energy consumption in homes. This study can also be used by the developers of simulation software to understand how architects use their product and drive improvements in its future versions.

Keywords: architectural simulation, energy efficient design, energy performance gaps, environmental design

Procedia PDF Downloads 110

Authors: Javkhlan Nyamjav, Simona Fischer, Lauren Garner, Veronica McCracken

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Current whole building life cycle assessments (LCA) primarily focus on structural and major architectural elements to measure building embodied carbon. Most of the interior finishes and fixtures are available on digital tools (such as Tally); however, furniture is still left unaccounted for. Due to its repeated refreshments and its complexity, furniture embodied carbon can accumulate over time, becoming comparable to structure and envelope numbers. This paper presents a method to calculate the Global Warming Potential (GWP) of furniture elements in commercial buildings. The calculator uses the quantity takeoff method with GWP averages gathered from environmental product declarations (EPD). The data was collected from EPD databases and furniture manufacturers from North America to Europe. A total of 48 GWP numbers were collected, with 16 GWP coming from alternative EPD. The finalized calculator shows the average GWP of typical commercial furniture and helps the decision-making process to reduce embodied carbon. The calculator was tested on MSR Design projects and showed furniture can account for more than half of the interior embodied carbon. The calculator highlights the importance of adding furniture to the overall conversation. However, the data collection process showed a) acquiring furniture EPD is not straightforward as other building materials; b) there are very limited furniture EPD, which can be explained from many perspectives, including the EPD price; c) the EPD themselves vary in terms of units, LCA scopes, and timeframes, which makes it hard to compare the products. Even though there are current limitations, the emerging focus on interior embodied carbon will create more demand for furniture EPD. It will allow manufacturers to represent all their efforts on reducing embodied carbon. In addition, the study concludes with recommendations on how designers can reduce furniture-embodied carbon through reuse and closed-loop systems.

Keywords: furniture, embodied carbon, calculator, tenant improvement, interior design

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Authors: Venkatesh Kumar, Kasun Hewage, Rehan Sadiq

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Residential buildings consume significant amounts of energy and produce a large amount of emissions and waste. However, there is a substantial potential for energy savings in this sector which needs to be evaluated over the life cycle of residential buildings. Life Cycle Assessment (LCA) methodology has been employed to study the primary energy uses and associated environmental impacts of different phases (i.e., product, construction, use, end of life, and beyond building life) for residential buildings. Four different alternatives of residential buildings in Vancouver (BC, Canada) with a 50-year lifespan have been evaluated, including High Rise Apartment (HRA), Low Rise Apartment (LRA), Single family Attached House (SAH), and Single family Detached House (SDH). Life cycle performance of the buildings is evaluated for embodied energy, embodied environmental impacts, operational energy, operational environmental impacts, total life-cycle energy, and total life cycle environmental impacts. Estimation of operational energy and LCA are performed using DesignBuilder software and Athena Impact estimator software respectively. The study results revealed that over the life span of the buildings, the relationship between the energy use and the environmental impacts are identical. LRA is found to be the best alternative in terms of embodied energy use and embodied environmental impacts; while, HRA showed the best life-cycle performance in terms of minimum energy use and environmental impacts. Sensitivity analysis has also been carried out to study the influence of building service lifespan over 50, 75, and 100 years on the relative significance of embodied energy and total life cycle energy. The life-cycle energy requirements for SDH is found to be a significant component among the four types of residential buildings. The overall disclose that the primary operations of these buildings accounts for 90% of the total life cycle energy which far outweighs minor differences in embodied effects between the buildings.

Keywords: building simulation, environmental impacts, life cycle assessment, life cycle energy analysis, residential buildings

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Authors: Byung Lee, Charles Perschau

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This study analyzes the development of a communication journal, the Journal of Advertising Education (JAE) over the past 20 years by examining citations of all research articles there. The purpose of a journal is to offer a stable and transparent forum for the presentation, scrutiny, and discussion of research in a targeted domain. This study asks whether JAE has fulfilled this purpose. The authors and readers who are involved in a journal need to have common research topics of their interest. In the case of the discipline of communication, scholars have a variety of backgrounds beyond communication itself since the social scientific study of communication is a relatively recent development, one that emerged after World War II, and the discipline has been heavily indebted to other social sciences, such as psychology, sociology, social psychology, and political science. When authors impart their findings and knowledge to others, their work is not done in isolation. They have to stand on previous studies, which are listed as sources in the bibliography. Since communication has heavily piggybacked on other disciplines, cited sources should be as diverse as the resources it taps into. This paper analyzes 4,244 articles that were cited by JAE articles in the past 36 issues. Since journal article authors reveal their intellectual linkage by using bibliographic citations, the analysis of citations in journal articles will reveal various networks of relationships among authors, journal types, and fields in an objective and quantitative manner. The study found that an easier access to information sources because of the development of electronic databases and the growing competition among scholars for publication seemed to influence authors to increase the number of articles cited even though some variations existed during the examined period. The types of articles cited have also changed. Authors have more often cited journal articles, periodicals (most of them available online), and web site sources, while decreased their dependence on books, conference papers, and reports. To provide a forum for discussion, a journal needs a common topic or theme. This can be realized when an author writes an article about a topic, and that article is cited and discussed in another article. Thus, the citation of articles in the same journal is vital for a journal to form a forum for discussion. JAE has gradually increased the citations of in-house articles with a few fluctuations over the years. The study also examines not only specific articles that are often cited, but also specific authors often cited. The analysis of citations in journal articles shows how JAE has developed into a full academic journal while offering a communal forum even though the speed of its formation is not as fast as desired probably because of its interdisciplinary nature.

Keywords: citation, co-citation, the Journal of Advertising Education, development of a journal

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Authors: Miguel Pereira, Lígia Pimentel, Manuela Pintado

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Animal blood is a major by-product of slaughterhouses and still represents a cost and environmental problem in some countries. To be eliminated, blood should be stabilised by cooking and afterwards the slaughterhouses must have to pay for its incineration. In order to reduce the elimination costs and valorise the high protein content the aim of this study was the optimization of hydrolysis conditions, in terms of enzyme ratio and time, in order to obtain hydrolysates with biological activity. Two enzymes were tested in this assay: pepsin and proteases from Cynara cardunculus (cardosins). The latter has the advantage to be largely used in the Portuguese Dairy Industry and has a low price. The screening assays were carried out in a range of time between 0 and 10 h and using a ratio of enzyme/reaction volume between 0 and 5%. The assays were performed at the optimal conditions of pH and temperature for each enzyme: 55 °C at pH 5.2 for cardosins and 37 °C at pH 2.0 for pepsin. After reaction, the hydrolysates were evaluated by FPLC (Fast Protein Liquid Chromatography) and tested for their antioxidant activity by ABTS method. FPLC chromatograms showed different profiles when comparing the enzymatic reactions with the control (no enzyme added). The chromatogram exhibited new peaks with lower MW that were not present in control samples, demonstrating the hydrolysis by both enzymes. Regarding to the antioxidant activity, the best results for both enzymes were obtained using a ratio enzyme/reactional volume of 5% during 5 h of hydrolysis. However, the extension of reaction did not affect significantly the antioxidant activity. This has an industrial relevant aspect in what concerns to the process cost. In conclusion, the enzymatic blood hydrolysis can be a better alternative to the current elimination process allowing to the industry the reuse of an ingredient with biological properties and economic value.

Keywords: antioxidant activity, blood, by-products, enzymatic hydrolysis

Procedia PDF Downloads 503

Authors: Thipsupar Pureprasert, Niwat Anuwongnukroh, Surachai Dechkunakorn, Surapich Loykulanant, Chaveewan Kongkaew, Wassana Wichai

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Objective: Orthodontic elastic bands made from natural rubber continue to be commonly used due to their favorable characteristics. However, there are concerns associated cytotoxicity due to harmful components released during conventional vulcanization (sulfur-based method). With the co-operation of The National Metal and Materials Technology Center (MTEC) and Faculty of Dentistry Mahidol University, a method was introduced to reduce toxic components by leaching the orthodontic elastic bands with NaOH solution. Objectives: To evaluate the mechanical properties of Thai and commercial orthodontic elastic brands (Ormco and W&H) leached with NaOH solution. Material and methods: Three elastic brands (N =30, size ¼ inch, 4.5 oz.) were tested for mechanical properties in terms of initial extension force, residual force, force loss, breaking strength and maximum displacement using a Universal Testing Machine. Results : Force loss significantly decreased in Thai-LEACH and W&H-LEACH, whereas the values increased in Ormco-LEACH (P < 0.05). The data exhibited a significantly decrease in breaking strength with Thai-LEACH and Ormco-LEACH, whereas all 3 brands revealed a significantly decrease in maximum displacement with the leaching process (P < 0.05). Conclusion: Leaching with NaOH solution is a new method, which can remove toxic components from orthodontic latex elastic bands. However, this process can affect their mechanical properties. Leached elastic bands from Thai had comparable properties with Ormco and have potential to be developed as a promising product.

Keywords: leaching, orthodontic elastics, natural rubber latex, orthodontic

Procedia PDF Downloads 267

Authors: Amin Asgarian, Ghyslaine McClure

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Proper seismic evaluation of Non-Structural Components (NSCs) mandates an accurate estimation of floor seismic demands (i.e. acceleration and displacement demands). Most of the current international codes incorporate empirical equations to calculate equivalent static seismic force for which NSCs and their anchorage system must be designed. These equations, in general, are functions of component mass and peak seismic acceleration to which NSCs are subjected to during the earthquake. However, recent studies have shown that these recommendations are suffered from several shortcomings such as neglecting the higher mode effect, tuning effect, NSCs damping effect, etc. which cause underestimation of the component seismic acceleration demand. This work is aimed to circumvent the aforementioned shortcomings of code provisions as well as improving them by proposing a simplified, practical, and yet accurate approach to generate acceleration Floor Design Spectra (FDS) directly from corresponding Uniform Hazard Spectra (UHS) (i.e. design spectra for structural components). A database of 27 Reinforced Concrete (RC) buildings in which Ambient Vibration Measurements (AVM) have been conducted. The database comprises 12 low-rise, 10 medium-rise, and 5 high-rise buildings all located in Montréal, Canada and designated as post-disaster buildings or emergency shelters. The buildings are subjected to a set of 20 compatible seismic records and Floor Response Spectra (FRS) in terms of pseudo acceleration are derived using the proposed approach for every floor of the building in both horizontal directions considering 4 different damping ratios of NSCs (i.e. 2, 5, 10, and 20% viscous damping). Several effective parameters on NSCs response are evaluated statistically. These parameters comprise NSCs damping ratios, tuning of NSCs natural period with one of the natural periods of supporting structure, higher modes of supporting structures, and location of NSCs. The entire spectral region is divided into three distinct segments namely short-period, fundamental period, and long period region. The derived roof floor response spectra for NSCs with 5% damping are compared with the 5% damping UHS and procedure are proposed to generate roof FDS for NSCs with 5% damping directly from 5% damped UHS in each spectral region. The generated FDS is a powerful, practical, and accurate tool for seismic design and assessment of acceleration-sensitive NSCs particularly in existing post-critical buildings which have to remain functional even after the earthquake and cannot tolerate any damage to NSCs.

Keywords: earthquake engineering, operational and functional components (OFCs), operational modal analysis (OMA), seismic assessment and design

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Authors: Oluwabiyi Adeola Ayodele

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This study analysed the Policy and general issues that have arisen over time in Nigeria’ Cashless banking environment as a result of the lack of a Legal framework on Electronic banking in Nigeria. It undertook an in-depth study of the cashless banking system. It discussed the evolution, growth and development of cashless banking in Nigeria; It revealed the expected benefits of the cashless banking system; It appraised regulatory issues and other prevalent problems on cashless banking in Nigeria; and made appropriate recommendations where necessary. The study relied on primary and secondary sources of information. The primary sources included the Constitution of the Federal Republic of Nigeria, Statutes, Conventions and Judicial decisions, while the secondary sources included Books, Journals Articles, Newspapers and Internet Materials. The study revealed that cashless banking has been adopted in Nigeria but still at the developing stage. It revealed that there is no law for the regulation of cashless banking in Nigeria, what Nigeria relies on for regulation is the Central Bank of Nigeria’s Cashless Policy, 2014. The Banks and Other Financial Institutions Act Chapter B3, LFN, 2004 of Nigeria lack provision to accommodate issues on Internet banking. However, under the general principles of legality in criminal law, and by the provisions of the Nigerian Constitution, a person can only be punished for conducts that have been defined to be criminal by written laws with the penalties specifically stated in the law. Although Nigeria has potent laws for the regulation of paper banking, these laws cannot be substituted for paperless transactions. This is because the issues involved in both transactions vary. The study also revealed that the absence of law in the cashless banking environment in Nigeria will subject consumers to endless risks. This study revealed that the creation of banking markets via the Internet relies on both available technologies and appropriate laws and regulations. It revealed however that Law of some of the countries considered on cashless banking has taken care of most of the legal issues and other problems prevalent in the cashless banking environment. The study also revealed some other problems prevalent in the Nigerian cashless banking environment. The study concluded that for Nigeria to find solutions to the legal issues raised in its cashless banking environment and other problems of cashless banking, it should have a viable legal Frame work for internet banking. The study concluded that the Central Bank of Nigeria’s Policy on Cashless banking is not potent enough to tackle the challenges posed to cashless banking in Nigeria because policies only have a persuasive effect and not a binding effect. There is, therefore, a need for appropriate Laws for the regulation of cashless Banking in Nigeria. The study also concluded that there is a need to create more awareness of the system among Nigerians and solve infrastructural problems like prevalent power outage which often have been creating internet network problem.

Keywords: cashless-banking, Nigeria, policies, laws

Procedia PDF Downloads 487

Authors: M. E. Razipoor, T. Masunaga, K. Sato, M. S. Saboory

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Estimation of soil erosion is economically and environmentally important in Herat, Afghanistan. Degradation of soil has negative impact (decreased soil fertility, destroyed soil structure, and consequently soil sealing and crusting) on life of Herat residents. Water and wind are the main erosive factors causing soil erosion in Herat. Furthermore, scarce vegetation cover, exacerbated by socioeconomic constraint, and steep slopes accelerate soil erosion. To sustain soil productivity and reduce soil erosion impact on human life, due to sustaining agricultural production and auditing the environment, it is needed to quantify the magnitude and extent of soil erosion in a spatial domain. Thus, this study aims to estimate soil loss potential and its spatial distribution in Herat, Afghanistan by applying RUSLE in GIS environment. The rainfall erosivity factor ranged between values of 125 and 612 (MJ mm ha-1 h-1 year-1). Soil erodibility factor varied from 0.036 to 0.073 (Mg h MJ-1 mm-1). Slope length and steepness factor (LS) values were between 0.03 and 31.4. The vegetation cover factor (C), derived from NDVI analysis of Landsat-8 OLI scenes, resulting in range of 0.03 to 1. Support practice factor (P) were assigned to a value of 1, since there is not significant mitigation practices in the study area. Soil erosion potential map was the product of these factors. Mean soil erosion rate of Herat Province was 29 Mg ha-1 year-1 that ranged from 0.024 Mg ha-1 year-1 in flat areas with dense vegetation cover to 778 Mg ha-1 year-1 in sharp slopes with high rainfall but least vegetation cover. Based on land cover map of Afghanistan, areas with soil loss rate higher than soil loss tolerance (8 Mg ha-1 year-1) occupies 98% of Forests, 81% rangelands, 64% barren lands, 60% rainfed lands, 28% urban area and 18% irrigated Lands.

Keywords: Afghanistan, erosion, GIS, Herat, RUSLE

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Authors: Pia Moschall, Kathrin Sackmann

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Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

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Authors: Samitharathana R. Wadigala

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The peace will not be established until the self-consciousness would reveal in the human beings. In this nuclear age, the establishment of a lasting peace on the earth represents the primary condition for the preservation of human civilization and survival of human beings. Nothing perhaps is so important and indispensable as the achievement and maintenance of peace in the modern world today. Peace in today’s world implies much more than the mere absence of war and violence. In the interdependent world of today the United Nations needs to be representative of the modern world and democratic in its functioning because it came into existence to save the generations from the scourge of war and conflict. Buddhism is the religion of peaceful co-existence and philosophy of enlightenment. Violence and conflict from the perspective of the Buddhist theory of interdependent origination (Paṭiccasamuppāda) are same with everything else in the world a product of causes and conditions. Buddhism is totally compatible with the congenial and peaceful global order. The canonical literature, doctrines, and philosophy of Buddhism are the best suited for inter-faith dialogue, harmony, and universal peace. Even today Buddhism can resurrect the universal brotherhood, peaceful co-existence and harmonious surroundings in the comity of nations. With its increasing vitality in regions around the world, many people today turn to Buddhism for relief and guidance at the time when peace seems to be a deferred dream more than ever. From a Buddhist point of view the roots of all unwholesome actions (Conflict) i. e. greed, hatred and delusion are viewed as the root cause of all human conflicts. Conflict often emanates from attachment to material things: pleasures, property, territory, wealth, economic dominance or political superiority. Buddhism has some particularly rich resources for deployment in dissolving conflict. Buddhism addresses the Buddhist perspective on the causes of conflict and ways to resolve conflict to realize world peace. The world has enough to satisfy every body’s needs but not every body’s greed.

Keywords: Buddhism, conflict-violence, peace, self-consciousness

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Authors: Mahtab Abdollahi Sarvi, Siamak Epackachi, Ali Imanpour

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Reinforced concrete shear walls are commonly used as the lateral load-resisting system of mid- to high-rise office or residential buildings around the world. Design of such systems is often governed by wind rather than seismic effects, in particular in low-to-moderate seismic regions. The current design philosophy as per the majority of building codes under wind loads require elastic response of lateral load-resisting systems including reinforced concrete shear walls when subjected to the rare design wind load, resulting in significantly large wall sections needed to meet strength requirements and drift limits. The latter can highly influence the design in upper stories due to stringent drift limits specified by building codes, leading to substantial added costs to the construction of the wall. However, such walls may offer limited to moderate over-strength and ductility due to their large reserve capacity provided that they are designed and detailed to appropriately develop such over-strength and ductility under extreme wind loads. This would significantly contribute to reducing construction time and costs, while maintaining structural integrity under gravity and frequently-occurring and less frequent wind events. This paper aims to investigate the over-strength and ductility capacity of several imaginary office buildings located in Edmonton, Canada with a glance at earthquake design philosophy. Selected models are 10- to 25-story buildings with three types of reinforced concrete shear wall configurations including rectangular, barbell, and flanged. The buildings are designed according to National Building Code of Canada. Then fiber-based numerical models of the walls are developed in Perform 3D and by conducting nonlinear static (pushover) analysis, lateral nonlinear behavior of the walls are evaluated. Ductility and over-strength of the structures are obtained based on the results of the pushover analyses. The results confirmed moderate nonlinear capacity of reinforced concrete shear walls under extreme wind loads. This is while lateral displacements of the walls pass the serviceability limit states defined in Pre standard for Performance-Based Wind Design (ASCE). The results indicate that we can benefit the limited nonlinear response observed in the reinforced concrete shear walls to economize the design of such systems under wind loads.

Keywords: concrete shear wall, high-rise buildings, nonlinear static analysis, response modification factor, wind load

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Authors: Osamede Asowata, Christo Pienaar, Johan Bekker

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Photovoltaic (PV) modules may become a trend for future PV systems because of their greater flexibility in distributed system expansion, easier installation due to their nature, and higher system-level energy harnessing capabilities under shaded or PV manufacturing mismatch conditions. This is as compared to the single or multi-string inverters. Novel residential scale PV arrays are commonly connected to the grid by a single DC–AC inverter connected to a series, parallel or series-parallel string of PV panels, or many small DC–AC inverters which connect one or two panels directly to the AC grid. With an increasing worldwide interest in sustainable energy production and use, there is renewed focus on the power electronic converter interface for DC energy sources. Three specific examples of such DC energy sources that will have a role in distributed generation and sustainable energy systems are the photovoltaic (PV) panel, the fuel cell stack, and batteries of various chemistries. A high-efficiency inverter using Metal Oxide Semiconductor Field-Effect Transistors (MOSFETs) for all active switches is presented for a non-isolated photovoltaic and AC-module applications. The proposed configuration features a high efficiency over a wide load range, low ground leakage current and low-output AC-current distortion with no need for split capacitors. The detailed power stage operating principles, pulse width modulation scheme, multilevel bootstrap power supply, and integrated gate drivers for the proposed inverter is described. Experimental results of a hardware prototype, show that not only are MOSFET efficient in the system, it also shows that the ground leakage current issues are alleviated in the proposed inverter and also a 98 % maximum associated driver circuit is achieved. This, in turn, provides the need for a possible photovoltaic panel switching technique. This will help to reduce the effect of cloud movements as well as improve the overall efficiency of the system.

Keywords: grid connected photovoltaic (PV), Matlab efficiency simulation, maximum power point tracking (MPPT), module integrated converters (MICs), multilevel converter, series connected converter

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Authors: Benedetta Isella, Aleksander Drinic, Alissa Heim, Phillip Czichowski, Lisa Lauts, Hans Leemhuis

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Introduction: Membranes for guided bone regeneration are essential to perform a barrier function between the soft and the regenerating bone tissue. Bioabsorbable membranes are desirable in this field as they do not require a secondary surgery for removal, decreasing patient surgical risk. Collagen was the first bioabsorbable alternative introduced on the market, but its degradation time may be too fast to guarantee bone regeneration, and optimisation is needed. Silk fibroin, being biocompatible, slowly bioabsorbable, and processable into different scaffold types, could be a promising alternative. Objectives: The objective is to compare the general performance of a silk fibroin membrane for guided bone regeneration to current collagen alternatives developing suitable standardized tests for the mechanical and morphological characterization. Methods: Silk fibroin and collagen-based membranes were compared from the morphological and chemical perspective, with techniques such as SEM imaging and from the mechanical point of view with techniques such as tensile and suture retention strength (SRS) tests. Results: Silk fibroin revealed a high degree of reproducibility in surface density. The SRS of silk fibroin (0.76 ± 0.04 N), although lower than collagen, was still comparable to native tissues such as the internal mammary artery (0.56 N), and the same can be extended to general mechanical behaviour in tensile tests. The SRS could be increased by an increase in thickness. Conclusion: Silk fibroin is a promising material in the field of guided bone regeneration, covering the interesting position of not being considered a product containing cells or tissues of animal origin from the regulatory perspective and having longer degradation times with respect to collagen.

Keywords: guided bone regeneration, mechanical characterization, membrane, silk fibroin

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Authors: Suphaphon Udomluck, Pannathorn Chachvarat

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Information Communication Technology (ICT) using management is essential for effective decision making in organization. The Concerns Based Adoption Model (CBAM) was employed as the conceptual framework. The purposes of the study were to assess the situation of Information Communication Technology (ICT) using management in College of Nursing under the Praboromarajchanok Institute. The samples were multi – stage sampling of 10 colleges of nursing that participated include directors, vice directors, head of learning groups, teachers, system administrator and responsible for ICT. The total participants were 280; the instrument used were questionnaires that include 4 parts, general information, Information Communication Technology (ICT) using management, the Stage of concern Questionnaires (SoC), and the Levels of Use (LoU) ICT Questionnaires respectively. Reliability coefficients were tested; alpha coefficients were 0.967for Information Communication Technology (ICT) using management, 0.884 for SoC and 0.945 for LoU. The data were analyzed by frequency, percentage, mean, standard deviation, Pearson Product Moment Correlation and Multiple Regression. They were founded as follows: The high level overall score of Information Communication Technology (ICT) using management and issue were administration, hardware, software, and people. The overall score of the Stage of concern (SoC)ICTis at high level and the overall score of the Levels of Use (LoU) ICTis at moderate. The Information Communication Technology (ICT) using management had the positive relationship with the Stage of concern (SoC)ICTand the Levels of Use (LoU) ICT(p < .01). The results of Multiple Regression revealed that administration hardwear, software and people ware could predict SoC of ICT (18.5%) and LoU of ICT (20.8%).The factors that were significantly influenced by SoCs were people ware. The factors that were significantly influenced by LoU of ICT were administration hardware and people ware.

Keywords: information communication technology (ICT), management, the concerns-based adoption model (CBAM), stage of concern(SoC), the levels of use(LoU)

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Authors: Saleh Alumaran, Giampaolo Bella, Feng Chen

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The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified six cultural dimensions: Saudi national culture, Saudi health service leadership, employees’ trust, technology, multicultural interactions and employees’ job roles. The research also identified a set of cultural sub-dimensions. These include working values and norms, tribe values and norms, attitudes towards women, power sharing, vision, social interaction, respect and understanding, hospital intra-net, hospital employees’ language(s) used, multi-national culture, communication system, employees’ job satisfaction and job security. The research identified that (a) the human behaviour towards medical information in SA is one of the main threats to information security and one of the main challenges to SA health authority, (b) The current situation of SA hospitals’ IS cultures is falling short in protecting medical information due to the current value and norms towards information security, (c) Saudi national culture and employees’ job role are the main dimensions playing major roles in the employees’ attitude, and technology is the least important dimension playing a role in the employees’ attitudes.

Keywords: cultural dimension, electronic health record, information security, privacy

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Authors: Gonzalo Ortiz de Elguea-Culebras, Raúl Sánchez-Vioquea, Adela Mena-Morales, Manuel Alaiz, Enrique Melero-Bravo, Esteban García-Romero, Javier Vioque, Lourdes Marchante-Cuevas, Julio Girón-Calle

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Saffron (Crocus sativus L.) is a highly valued crop for the manufacture of spice that consists of the dried stigma of the flowers. This is in contrast to other underutilized parts of the saffron plant as leaves, which represent abundant biomass whose use might help to enhance the sustainability of the saffron crop. Saffron leaves contain significant amounts of phenolic compounds, 7.8 equivalent grams of gallic acid per 100g of extract, and are very promising compounds in terms of exploring novel uses of saffron leaves. Given that phenolic compounds have numerous effects on cancer-related biological pathways, we have investigated the in vitro antiproliferative effect of saffron leaf polyphenols against human colon adenocarcinoma cells (Caco-2). Polyphenols were extracted from leaves with 70% ethanol, defatted with hexane, and purified by solid phase extraction using C18 silica gel and then silica gel 60. Analysis of polyphenols was performed by HPLC-ESI-MS. Di-, tri-, and tetrahexosides of quercetin, kaempferol, and isorhamnetin, as well as C-hexosides like isoorientin and vitexin, were tentatively identified. Polyphenols strongly inhibited the proliferation of Caco-2 cells, which is consistent with model studies in which several of the polyphenols identified in saffron leaves have demonstrated their potential as chemopreventive agents in cancer. Due to the low profitability that saffron leaf currently represents, we consider these results very encouraging and that this by-product deserves further investigation as a potential source of active molecules against colorectal cancer.

Keywords: saffron leaves, agricultural by-products, polyphenols, antiproliferative effect, human colon adenocarcinoma cells

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Authors: Kimuel Suyat, Francis Aldrine Uy, John Paul Carreon

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The Philippines, composed of many islands, is connected with approximately 8030 bridges. Continuous evaluation of the structural condition of these bridges is needed to safeguard the safety of the general public. With most bridges reaching its design life, retrofitting and replacement may be needed. Concerned government agencies allocate huge costs for periodic monitoring and maintenance of these structures. The rising volume of traffic and aging of these infrastructures is challenging structural engineers to give rise for structural health monitoring techniques. Numerous techniques are already proposed and some are now being employed in other countries. Vibration Analysis is one way. The natural frequency and vibration of a bridge are design criteria in ensuring the stability, safety and economy of the structure. Its natural frequency must not be so high so as not to cause discomfort and not so low that the structure is so stiff causing it to be both costly and heavy. It is well known that the stiffer the member is, the more load it attracts. The frequency must not also match the vibration caused by the traffic loads. If this happens, a resonance occurs. Vibration that matches a systems frequency will generate excitation and when this exceeds the member’s limit, a structural failure will happen. This study presents a method for calculating dynamic fragility through the use of vibration-based monitoring system. Dynamic fragility is the probability that a structural system exceeds a limit state when subjected to dynamic loads. The bridge is modeled in SAP2000 based from the available construction drawings provided by the Department of Public Works and Highways. It was verified and adjusted based from the actual condition of the bridge. The bridge design specifications are also checked using nondestructive tests. The approach used in this method properly accounts the uncertainty of observed values and code-based structural assumptions. The vibration response of the structure due to actual loads is monitored using installed sensors on the bridge. From the determinacy of these dynamic characteristic of a system, threshold criteria can be established and fragility curves can be estimated. This study conducted in relation with the research project between Department of Science and Technology, Mapúa Institute of Technology, and the Department of Public Works and Highways also known as Mapúa-DOST Smart Bridge Project deploys Structural Health Monitoring Sensors at Zamora Bridge. The bridge is selected in coordination with the Department of Public Works and Highways. The structural plans for the bridge are also readily available.

Keywords: structural health monitoring, dynamic characteristic, threshold criteria, traffic loads

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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Background: A mixed method systematic review was undertaken in order to explore issues related to the experiences of health care providers and parents in the care of children with palliative care needs. The aims of this systematic review were to identify existing evidence about the experiences of communication in the care of children with palliative care needs, to appraise the research conducted in this area and to identify gaps in the literature in order to recommend for future related studies. Method: A mixed method systematic review of research on the experience of communication in the care of children with palliative care needs, conducted with parents and health professionals was undertaken. The electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period of 2000-2016. Inclusion was limited to studies of communication experience in the care of children with palliative care needs. Result: Thirty-eight studies were found. The studies were conducted in a variety of countries: Uganda, Jordan, USA, UK, Taiwan, Turkey, Ireland, Poland, Brazil, Australia, Switzerland, Sweden, Netherland, Lebanon, Spain, Greece, and China. The current review shows that parents tend to protect their children when they are discussing their illnesses with them, particularly where they have a life-threatening or life-limiting condition. The approach of parents towards the discussion of sensitive issues concerning death with their children is significantly affected by the cultural background of the families. Conservative cultures encourage collusion behaviours which tend to keep children unaware of the incurable nature of the disease. The major communication challenges reported by health professionals are facing difficulties in judging how much information should be given to parents, responding to difficult questions, conflicts with families and inadequate skills to support grieving families. Conclusion: It is probably significant for the future studies to consider the change of parent-child communication experience over time in order to understand how the parents could change their interaction styles with their children according to the different stages of their children’s disease. Moreover, further studies are required to investigate the experience of communication of parents of children with non-malignant life-threatening and life-limiting illnesses.

Keywords: children with life-threatening or life- limiting illnesses, end of life, experience of communication, healthcare care providers, paediatric palliative care

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Authors: Ridhish Kumar, Sudeep Nadukkandy, Anirban Roy

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The development of reverse osmosis happened in 1960. Along the years this technique has been widely accepted all over the world for varied applications ranging from seawater desalination to municipal water treatment. Forward osmosis (FO) is one of the foremost technologies for low energy consuming solutions for water purification. In this study, we have carried out a detailed analysis on selection, design, and pricing for a prototype of potable water system for purifying water in emergency situations. The portable and light purification system is envisaged to be driven by FO. This pouch will help to serve as an emergency water filtration device. The current effort employs a model to understand the interplay of permeability and area on the rate of purification of water from any impure source/brackish water. The draw solution for the FO pouch is considered to be a combination of salt and sugar such that dilution of the same would result in an oral rehydration solution (ORS) which is a boon for dehydrated patients. However, the effort takes an extra step to actually estimate the cost and pricing of designing such a prototype. While the mathematical model yields the best membrane (compositions are taken from literature) combination in terms of permeability and area, the pricing takes into account the feasibility of such a solution to be made available as a retail item. The product is envisaged to be a market competitor for packaged drinking water and ORS combination (costing around $0.5 combined) and thus, to be feasible has to be priced around the same range with greater margins in order to have a better distribution. Thus a proper business plan and production of the same has been formulated in order to be a feasible solution for unprecedented calamities and emergency situations.

Keywords: forward osmosis, water treatment, oral rehydration solution, prototype

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Authors: Mi-Ju Kim, Hae-Yeong Kim

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Product mislabeling and adulteration have been increasing the concerns in processed meat products. Relatively inexpensive pork meat compared to meat such as beef was adulterated for economic benefit. These food fraud incidents related to pork were concerned due to economic, religious and health reasons. In this study, a rapid on-site detection method using loop-mediated isothermal amplification (LAMP) was developed for the simultaneous identification of beef and pork. Each specific LAMP primer for beef and pork was designed targeting on mitochondrial D-loop region. The LAMP assay reaction was performed at 65 ℃ for 40 min. The specificity of each primer for beef and pork was evaluated using DNAs extracted from 13 animal species including beef and pork. The sensitivity of duplex LAMP assay was examined by serial dilution of beef and pork DNAs, and reference binary mixtures. This assay was applied to processed meat products including beef and pork meat for monitoring. Each set of primers amplified only the targeted species with no cross-reactivity with animal species. The limit of detection of duplex real-time LAMP was 1 pg for each DNA of beef and pork and 1% pork in a beef-meat mixture. Commercial meat products that declared the presence of beef and/or pork meat on the label showed positive results for those species. This method was successfully applied to detect simultaneous beef and pork meats in processed meat products. The optimized duplex LAMP assay can identify simultaneously beef and pork meat within less than 40 min. A portable real-time fluorescence device used in this study is applicable for on-site detection of beef and pork in processed meat products. Thus, this developed assay was considered to be an efficient tool for monitoring meat products.

Keywords: beef, duplex real-time LAMP, meat identification, pork

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Authors: Isam A. H. Al Zubaidy

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A quick process may be needed to get the benefit the big generated quantity of waste oil sludge (WOS). The process includes the mixing process of WOS with commercial diesel fuel. Different ratios of WOS to diesel fuel were prepared ranging 1:1 to 20:1 by mass. The mixture was continuously mixing for 10 minutes using bench type overhead stirrer and followed by filtration process to separate the soil waste from filtrate oil product. The quantity and the physical properties of the oil filtrate were measured. It was found that the addition of up to 15% WOS to diesel fuel was accepted without dramatic changes to the properties of diesel fuel. The amount of waste oil sludge was decreased by about 60% by mass. This means that about 60 % of the mass of sludge was recovered as light fuel oil. The physical properties of the resulting fuel from 10% sludge mixing ratio showed that the specific gravity, ash content, carbon residue, asphaltene content, viscosity, diesel index, cetane number, and calorific value were affected slightly. The color was changed to light black color. The sulfur content was increased also. This requires other processes to reduce the sulfur content of the resulting light fuel. A new desulfurization process was achieved using adsorption techniques with activated biomaterial to reduce the sulfur content to acceptable limits. Adsorption process by ZnCl₂ activated date palm kernel powder was effective for improvement of the physical properties of diesel like fuel. The final sulfur content was increased to 0.185 wt%. This diesel like fuel can be used in all tractors, buses, tracks inside and outside the refineries. The solid remaining seems to be smooth and can be mixed with asphalt mixture for asphalting the roads or can be used with other materials as an asphalt coating material for constructed buildings. Through this process, valuable fuel has been recovered, and the amount of waste material had decreased.

Keywords: oil sludge, diesel fuel, blending process, filtration process

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Authors: Nurlaili Syafar Wulan, Almurdi, Suprianto Kosno

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Introduction: Periodontitis defined as an inflammatory disease of teeth supporting tissue with irritation of specific pathogens as the main aetiology. Periodontitis can be cured by giving medical action accompanied by administration of an antibiotic, but the use of antibiotic has a side effect that can cause bacterial resistance. This side effect can be corrected by probiotic, which has antibiotic-like substance but do not have bacterial resistance effect; it makes probiotic became a promising future periodontitis medication. West Sumatran people has their own typical traditional food product made from fermented buffalo’s milk called dadih, and it contained probiotics. Objectives: The aim of this study was to determine the ability of probiotic Pediococcus pentosaceus isolated from dadih in inhibiting the growth of bacteria Aggregatibacter actinomycetemcomitans. Material and Method: This was a true experimental study with post-test and control group design. This study was conducted on 36 samples of 2 treatment groups, the test group with probiotic Pediococcus pentosacesus isolated from dadih and the negative control group with sterile aquadest. The antibacterial effect was tested using the Kirby-Bauer disk diffusion method and calculated by measuring the zone of inhibition on MHA around paper disk using a sliding caliper with 0.5 mm accuracy. Result: The result of bivariate analysis using Independent t-test was p=0.00 where p < 0.05 means that there is a significant difference between the tested group and negative control group. Conclusion: Probiotic Pediococcus pentosaceus isolated from dadih are able to inhibit the growth of Aggregatibacter actinomycetemcomitans.

Keywords: aggregatibacter actinomycetemcomitans, antibacterial activities, periodontitis, probiotic Pediococcus pentosaceus

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Authors: D. M. Lewis, L. Frisby, U. Stead

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Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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