Search results for: quality of product
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12727

Search results for: quality of product

7117 The Methods of Customer Satisfaction Measurement and Its Statistical Analysis towards Sales and Logistic Activities in Food Sector

Authors: Seher Arslankaya, Bahar Uludağ

Abstract:

Meeting the needs and demands of customers and pleasing the customers are important requirements for companies in food sectors where the growth of competition is significantly unpredictable. Customer satisfaction is also one of the key concepts which is mainly driven by wide range of customer preference and expectation upon products and services introduced and delivered to them. In order to meet the customer demands, the companies that engage in food sectors are expected to have a well-managed set of Total Quality Management (TQM), which sets out to improve quality of products and services; to reduce costs and to increase customer satisfaction by restructuring traditional management practices. It aims to increase customer satisfaction by meeting (their) customer expectations and requirements. The achievement would be determined with the help of customer satisfaction surveys, which is done to obtain immediate feedback and to provide quick responses. In addition, the surveys would also assist the making of strategic planning which helps to anticipate customer future needs and expectations. Meanwhile, periodic measurement of customer satisfaction would be a must because with the better understanding of customers perceptions from the surveys (done by questioners), the companies would have a clear idea to identify their own strengths and weaknesses that help the companies keep their loyal customers; to stand in comparison toward their competitors and map out their future progress and improvement. In this study, we propose a survey based on customer satisfaction measurement method and its statistical analysis for sales and logistic activities of food firms. Customer satisfaction would be discussed in details. Furthermore, after analysing the data derived from the questionnaire that applied to customers by using the SPSS software, various results obtained from the application would be presented. By also applying ANOVA test, the study would analysis the existence of meaningful differences between customer demographic proportion and their perceptions. The purpose of this study is also to find out requirements which help to remove the effects that decrease customer satisfaction and produce loyal customers in food industry. For this purpose, the customer complaints are collected. Additionally, comments and suggestions are done according to the obtained results of surveys, which would be useful for the making-process of strategic planning in food industry.

Keywords: customer satisfaction measurement and analysis, food industry, SPSS, TQM

Procedia PDF Downloads 256
7116 Development of Nanostructrued Hydrogel for Spatial and Temporal Controlled Release of Active Compounds

Authors: Shaker Alsharif, Xavier Banquy

Abstract:

Controlled drug delivery technology represents one of the most rapidly advancing areas of science in which chemists and chemical engineers are contributing to human health care. Such delivery systems provide numerous advantages compared to conventional dosage forms including improved efficacy, and improved patient compliance and convenience. Such systems often use synthetic polymers as carriers for the drugs. As a result, treatments that would not otherwise be possible are now in conventional use. The role of bilayered vesicles as efficient carriers for drugs, vaccines, diagnostic agents and other bioactive agents have led to a rapid advancement in the liposomal drug delivery system. Moreover, the site avoidance and site-specific drug targeting therapy could be achieved by formulating a liposomal product, so as to reduce the cytotoxicity of many potent therapeutic agents. Our project focuses on developing and building hydrogel with nanoinclusion of liposomes loaded with active compounds such as proteins and growth factors able to release them in a controlled fashion. In order to achieve that, we synthesize several liposomes of two different phospholipids concentrations encapsulating model drug. Then, formulating hydrogel with specific mechanical properties embedding the liposomes to manage the release of active compound.

Keywords: controlled release, hydrogel, liposomes, active compounds

Procedia PDF Downloads 452
7115 The Effects of Cow Manure Treated by Fruit Beetle Larvae, Waxworms and Tiger Worms on Plant Growth in Relation to Its Use as Potting Compost

Authors: Waleed S. Alwaneen

Abstract:

Dairy industry is flourishing in world to provide milk and milk products to local population. Besides milk products, dairy industries also generate a substantial amount of cow manure that significantly affects the environment. Moreover, heat produced during the decomposition of the cow manure adversely affects the crop germination. Different companies are producing vermicompost using different species of worms/larvae to overcome the harmful effects using fresh manure. Tiger worm treatment enhanced plant growth, especially in the compost-manure ratio (75% compost, 25% cow manure), followed by a ratio of 50% compost, 50% cow manure.  Results also indicated that plant growth in Waxworm treated manure was weak as compared to plant growth in compost treated with Fruit Beetle (FB), Waxworms (WW), and Control (C) especially in the compost (25% compost, 75% cow manure) and 100% cow manure where there was no growth at all. Freshplant weight, fresh leaf weight and fresh root weight were significantly higher in the compost treated with Tiger worms in (75% compost, 25% cow manure); no evidence was seen for any significant differences in the dry root weight measurement between FB, Tiger worms (TW), WW, Control (C) in all composts. TW produced the best product, especially at the compost ratio of 75% compost, 25% cow manure followed by 50% compost, 50% cow manure.

Keywords: fruit beetle, tiger worms, waxworms, control

Procedia PDF Downloads 137
7114 Estimation of Adult Patient Doses for Chest X-Ray Diagnostic Examinations in a Tertiary Institution Health Centre

Authors: G. E. Okungbowa, H. O. Adams, S. E. Eze

Abstract:

This study is on the estimation of adult patient doses for Chest X-ray diagnostic examinations of new admitted undergraduate students attending a tertiary institution health centre as part of their routine clearance and check up on admitted into the institution. A total of 531 newly admitted undergraduate students were recruited for this survey in the first quarter of 2016 (January to March, 2016). CALDOSE_X 5.0 software was used to compute the Entrance Surface Dose (ESD) and Effective Dose (ED); while the Statistical Package for Social Sciences (SPSS) version 21.0 was used to carry out the statistical analyses. The basic patients' data and exposure parameters required for the software are age, sex, examination type, projection posture, tube potential and current-time product. The mean Entrance Surface Dose and Effective Doses of the undergraduate students were calculated using the software, and the values were compared with existing literature and internationally established diagnostic reference levels. The mean ESD calculated is 0.29 mGy, and the mean effective dose is 0.04 mSv. The values of ESD and ED obtained are below the internationally established diagnostic reference levels, which could be attributed to good radiographic techniques employed during the chest X-ray procedure for these students.

Keywords: x-ray, dose, examination, chest

Procedia PDF Downloads 188
7113 End-to-End Spanish-English Sequence Learning Translation Model

Authors: Vidhu Mitha Goutham, Ruma Mukherjee

Abstract:

The low availability of well-trained, unlimited, dynamic-access models for specific languages makes it hard for corporate users to adopt quick translation techniques and incorporate them into product solutions. As translation tasks increasingly require a dynamic sequence learning curve; stable, cost-free opensource models are scarce. We survey and compare current translation techniques and propose a modified sequence to sequence model repurposed with attention techniques. Sequence learning using an encoder-decoder model is now paving the path for higher precision levels in translation. Using a Convolutional Neural Network (CNN) encoder and a Recurrent Neural Network (RNN) decoder background, we use Fairseq tools to produce an end-to-end bilingually trained Spanish-English machine translation model including source language detection. We acquire competitive results using a duo-lingo-corpus trained model to provide for prospective, ready-made plug-in use for compound sentences and document translations. Our model serves a decent system for large, organizational data translation needs. While acknowledging its shortcomings and future scope, it also identifies itself as a well-optimized deep neural network model and solution.

Keywords: attention, encoder-decoder, Fairseq, Seq2Seq, Spanish, translation

Procedia PDF Downloads 180
7112 Forecasting Optimal Production Program Using Profitability Optimization by Genetic Algorithm and Neural Network

Authors: Galal H. Senussi, Muamar Benisa, Sanja Vasin

Abstract:

In our business field today, one of the most important issues for any enterprises is cost minimization and profit maximization. Second issue is how to develop a strong and capable model that is able to give us desired forecasting of these two issues. Many researches deal with these issues using different methods. In this study, we developed a model for multi-criteria production program optimization, integrated with Artificial Neural Network. The prediction of the production cost and profit per unit of a product, dealing with two obverse functions at same time can be extremely difficult, especially if there is a great amount of conflict information about production parameters. Feed-Forward Neural Networks are suitable for generalization, which means that the network will generate a proper output as a result to input it has never seen. Therefore, with small set of examples the network will adjust its weight coefficients so the input will generate a proper output. This essential characteristic is of the most important abilities enabling this network to be used in variety of problems spreading from engineering to finance etc. From our results as we will see later, Feed-Forward Neural Networks has a strong ability and capability to map inputs into desired outputs.

Keywords: project profitability, multi-objective optimization, genetic algorithm, Pareto set, neural networks

Procedia PDF Downloads 448
7111 Next Generation Radiation Risk Assessment and Prediction Tools Generation Applying AI-Machine (Deep) Learning Algorithms

Authors: Selim M. Khan

Abstract:

Indoor air quality is strongly influenced by the presence of radioactive radon (222Rn) gas. Indeed, exposure to high 222Rn concentrations is unequivocally linked to DNA damage and lung cancer and is a worsening issue in North American and European built environments, having increased over time within newer housing stocks as a function of as yet unclear variables. Indoor air radon concentration can be influenced by a wide range of environmental, structural, and behavioral factors. As some of these factors are quantitative while others are qualitative, no single statistical model can determine indoor radon level precisely while simultaneously considering all these variables across a complex and highly diverse dataset. The ability of AI- machine (deep) learning to simultaneously analyze multiple quantitative and qualitative features makes it suitable to predict radon with a high degree of precision. Using Canadian and Swedish long-term indoor air radon exposure data, we are using artificial deep neural network models with random weights and polynomial statistical models in MATLAB to assess and predict radon health risk to human as a function of geospatial, human behavioral, and built environmental metrics. Our initial artificial neural network with random weights model run by sigmoid activation tested different combinations of variables and showed the highest prediction accuracy (>96%) within the reasonable iterations. Here, we present details of these emerging methods and discuss strengths and weaknesses compared to the traditional artificial neural network and statistical methods commonly used to predict indoor air quality in different countries. We propose an artificial deep neural network with random weights as a highly effective method for assessing and predicting indoor radon.

Keywords: radon, radiation protection, lung cancer, aI-machine deep learnng, risk assessment, risk prediction, Europe, North America

Procedia PDF Downloads 99
7110 Inhibition of the Corrosion of Copper in 0.5 NaCl Solutions by Aqueous Extract and Hydrolysis Acid of Olive Leaf Extract

Authors: Chahla Rahal, Philippe Refait

Abstract:

Oleuropein-rich extract from olive leaf and acid hydrolysates, rich in hydroxytyrosol and elenolic acid was prepared under different experimental conditions. These phenolic compounds may be used as a corrosion inhibitor. The inhibitive action of these extracts and its major constituents on the corrosion of copper in 0.5 M NaCl solution has been evaluated by potentiodynamic polarization, electrochemical impedance spectroscopy (EIS) and weight loss measurements. The product of extraction was analyzed with high performance liquid chromatography (HPLC), whose analysis shows that olive leaf extract are greatly rich in phenolic compounds, mainly Oleuropeine (OLE), Hydroxytyrosol (HT) and elenolic acid (EA). After the acid hydrolysis and high temperature of extraction, an increase in hydroxytyrosol concentration was detected, coupled with relatively low oleuropeine content and high concentration of elenolic acid. The potentiodynamic measurements have shown that this extract acts as a mixed-type corrosion inhibitor, and good inhibition efficiency is observed with the increase in HT and EA concentration. These results suggest that the inhibitive effect of olive leaf extract might be due to the adsorption of the various phenolic compounds onto the copper surface.

Keywords: olive leaf extract, oleuropein, voltammetry, copper, corrosion, HPLC, EIS

Procedia PDF Downloads 308
7109 Evaluation of Microbiological Quality and Safety of Two Types of Salads Prepared at Libyan Airline Catering Center in Tripoli

Authors: Elham A. Kwildi, Yahia S. Abugnah, Nuri S. Madi

Abstract:

This study was designed to evaluate the microbiological quality and safety of two types of salads prepared at a catering center affiliated with Libyan Airlines in Tripoli, Libya. Two hundred and twenty-one (221) samples (132 economy-class and 89 first- class) were used in this project which lasted for ten months. Biweekly, microbiological tests were performed which included total plate count (TPC) and total coliforms (TCF), in addition to enumeration and/or detection of some pathogenic bacteria mainly Escherichia coli, Staphylococcus aureus, Bacillus cereus, Salmonella sp, Listeria sp and Vibrio parahaemolyticus parahaemolyticus, By using conventional as well as compact dry methods. Results indicated that TPC of type 1 salad ranged between (<10 – 62 x 103 cfu/gm) and (<10 to 36 x103 cfu/g), while TCF were (<10 – 41 x 103 cfu/gm) and (< 10 to 66 x102 cfu/g) using both methods of detection respectively. On the other hand, TPC of type 2 salad were: (1 × 10 – 52 x 103) and (<10 – 55 x 103 cfu/gm) and in the range of (1 x10 to 45x103 cfu/g), and the (TCF) counts were between (< 10 to 55x103 cfu/g) and (< 10 to 34 x103 cfu/g) using the 1st and the 2nd methods of detection respectively. Also, the pathogens mentioned above were detected in both types of salads, but their levels varied according to the type of salad and the method of detection. The level of Staphylococcus aureus, for instance, was 17.4% using conventional method versus 14.4% using the compact dry method. Similarly, E. coli was 7.6% and 9.8%, while Salmonella sp. recorded the least percentage i.e. 3% and 3.8% with the two mentioned methods respectively. First class salads were also found to contain the same pathogens, but the level of E. coli was relatively higher in this case (14.6% and 16.9%) using conventional and compact dry methods respectively. The second rank came Staphylococcus aureus (13.5%) and (11.2%), followed by Salmonella (6.74%) and 6.70%). The least percentage was for Vibrio parahaemolyticus (4.9%) which was detected in the first class salads only. The other two pathogens Bacillus cereus and Listeria sp. were not detected in either one of the salads. Finally, it is worth mentioning that there was a significant decline in TPC and TCF counts in addition to the disappearance of pathogenic bacteria after the 6-7th month of the study which coincided with the first trial of the HACCP system at the center. The ups and downs in the counts along the early stages of the study reveal that there is a need for some important correction measures including more emphasis on training of the personnel in applying the HACCP system effectively.

Keywords: air travel, vegetable salads, foodborne outbreaks, Libya

Procedia PDF Downloads 329
7108 Induced Breeding of Neolissochilus hexagonolepis Using Pituitary and Synthetic Hormone under the Agro-Climatic Condition of Meghalaya, India

Authors: Lydia Booney Jyrwa, Rabindra Nath Bhuyan

Abstract:

Chocolate Mahseer (Neolissochilus hexagonolepis) is one of the Mahseer species inhabiting the North-eastern region of India and is a native species to the state of Meghalaya since it can adapt and grow well under the agro climatic conditions of the region. The natural population of this fish has been declining over the years from this part of the country. The natural population of this fish has been declining over the years from this part of the country. The fish is considered as one of the endangered species of the Mahseer group, which is having tremendous scope for culture, sports and tourism. But non-availability of quality seed is a hindrance for the culture of this fish. Thus induced breeding of the fish by hormonal administration with pituitary gland and synthetic hormones is the only reliable method to procure the pure seed of the fish. Chocolate Mahseer was successfully bred at the Hatchery Complex, St. Anthony’s College, Shillong, Meghalaya by using pituitary extract and synthetic hormone viz. ovaprim, ovatide and gonopro-FH. The dose standardized is @ 4mg/kg body weight to both male and female as 1st dose and @ 7.9 mg/kg body weight only to female as 2nd dose for pituitary extract and single dose @ 0.8 ml/kg body weight to female and @ 0.3 ml/kg body weight to male of both ovaprim and ovatide, while a single dose @ 0.9 ml/kg body weight to female and @ 0.3 ml/kg body weight to male of gonopro-FH. The doses are standardized after a series of trial and error experiment performed. The fecundity of the fish was 3500 eggs/ kg body weight. The final hatching percentage achieved was 60%. The survival rate of hatchling was 50% up to fry stage. The use of synthetic hormone and positive response of the fish to the hormone will go in long way for production of quality seed of the fish which in turn help in culture of the species as the fish can be a very good candidate species for the culture in the state. This study will also help in the ranching of the fish in the natural habitat leading to conservation of the species. However, the study should be continued further for the large scale production of seeds.

Keywords: chocolate mahseer, induced breeding, pituitary extract, synthetic hormone

Procedia PDF Downloads 243
7107 A Literature Review of Precision Agriculture: Applications of Diagnostic Diseases in Corn, Potato, and Rice Based on Artificial Intelligence

Authors: Carolina Zambrana, Grover Zurita

Abstract:

The food loss production that occurs in deficient agricultural production is one of the major problems worldwide. This puts the population's food security and the efficiency of farming investments at risk. It is to be expected that this food security will be achieved with the own and efficient production of each country. It will have an impact on the well-being of its population and, thus, also on food sovereignty. The production losses in quantity and quality occur due to the lack of efficient detection of diseases at an early stage. It is very difficult to solve the agriculture efficiency using traditional methods since it takes a long time to be carried out due to detection imprecision of the main diseases, especially when the production areas are extensive. Therefore, the main objective of this research study is to perform a systematic literature review, of the latest five years, of Precision Agriculture (PA) to be able to understand the state of the art of the set of new technologies, procedures, and optimization processes with Artificial Intelligence (AI). This study will focus on Corns, Potatoes, and Rice diagnostic diseases. The extensive literature review will be performed on Elsevier, Scopus, and IEEE databases. In addition, this research will focus on advanced digital imaging processing and the development of software and hardware for PA. The convolution neural network will be handling special attention due to its outstanding diagnostic results. Moreover, the studied data will be incorporated with artificial intelligence algorithms for the automatic diagnosis of crop quality. Finally, precision agriculture with technology applied to the agricultural sector allows the land to be exploited efficiently. This system requires sensors, drones, data acquisition cards, and global positioning systems. This research seeks to merge different areas of science, control engineering, electronics, digital image processing, and artificial intelligence for the development, in the near future, of a low-cost image measurement system that allows the optimization of crops with AI.

Keywords: precision agriculture, convolutional neural network, deep learning, artificial intelligence

Procedia PDF Downloads 85
7106 A Framework Based Blockchain for the Development of a Social Economy Platform

Authors: Hasna Elalaoui Elabdallaoui, Abdelaziz Elfazziki, Mohamed Sadgal

Abstract:

Outlines: The social economy is a moral approach to solidarity applied to the projects’ development. To reconcile economic activity and social equity, crowdfunding is as an alternative means of financing social projects. Several collaborative blockchain platforms exist. It eliminates the need for a central authority or an inconsiderate middleman. Also, the costs for a successful crowdfunding campaign are reduced, since there is no commission to be paid to the intermediary. It improves the transparency of record keeping and delegates authority to authorities who may be prone to corruption. Objectives: The objectives are: to define a software infrastructure for projects’ participatory financing within a social and solidarity economy, allowing transparent, secure, and fair management and to have a financial mechanism that improves financial inclusion. Methodology: The proposed methodology is: crowdfunding platforms literature review, financing mechanisms literature review, requirements analysis and project definition, a business plan, Platform development process and implementation technology, and testing an MVP. Contributions: The solution consists of proposing a new approach to crowdfunding based on Islamic financing, which is the principle of Mousharaka inspired by Islamic financing, which presents a financial innovation that integrates ethics and the social dimension into contemporary banking practices. Conclusion: Crowdfunding platforms need to secure projects and allow only quality projects but also offer a wide range of options to funders. Thus, a framework based on blockchain technology and Islamic financing is proposed to manage this arbitration between quality and quantity of options. The proposed financing system, "Musharaka", is a mode of financing that prohibits interests and uncertainties. The implementation is offered on the secure Ethereum platform as investors sign and initiate transactions for contributions using their digital signature wallet managed by a cryptography algorithm and smart contracts. Our proposal is illustrated by a crop irrigation project in the Marrakech region.

Keywords: social economy, Musharaka, blockchain, smart contract, crowdfunding

Procedia PDF Downloads 81
7105 NOx Abatement by CO with the Use of Grain Catalysts with Active Coating Made of Transition Metal (Cu, Mn, Nb) Oxides Prepared by Electroless Chemical Deposition Method

Authors: Davyd Urbanas, Pranas Baltrenas

Abstract:

It is well-known that, despite the constant increase of alternative energy sources usage, today combustible fuels are still widely used in power engineering. As a result of fuel combustion, significant amounts of nitrogen oxides (NOx) and carbon monoxide (CO is a product of incomplete combustion) are supplied to the atmosphere. Also, these pollutants are formed in industry (chemical production, refining, and metal production). In this work, the investigation of nitrogen oxides CO-selective catalytic reduction using new grain load-type catalysts was carried out. The catalysts containing the substrate and a thin active coating made of transition metal (Mn, Cu, and Nb) oxides were prepared with the use of electroless chemical deposition method. Chemical composition, chemical state, and morphology of the formed active coating were investigated using ICP-OES, EDX, SEM, and XPS techniques. The obtained results revealed that the prepared catalysts (Cu-Mn-oxide and Cu-Mn-Nb-oxide) have rough and developed surface and can be successfully used for the flue gas catalytic purification. The significant advantage of prepared catalysts is their suitability from technological application point of view, which differs this work from others dedicated to gas purification by SCR.

Keywords: flue gas, nitrogen oxides, selective catalytic reduction, transition metal oxides

Procedia PDF Downloads 163
7104 The Study of Natural Synthetic Linalool Isolated from Ginger (Zingiber officinale) Using Photochemical Reactions

Authors: Elgendy M. Eman, Sameeh Y. Manal

Abstract:

Ginger (Zingiber officinale) is so important plant for its medicinal properties from ancient time and used as a spicy herb all over the world. This study was designed to examine the chemical composition of the essential oil and various crude extracts (n-hexane, chloroform and ethanol) of Zingiber officinale as well. GC–MS analyses of the essential oil resulted in the identification of 68 compounds,; 1,8-cineole (8.9%) and linalool (15.1%) were the main components in the essential oil .The crude extracts were analyzed with TLC plates and revealed several spots under UV light; however the hexane extract exhibited the highest number of spots compared to the other extracts. Hexane extract was selected for GC-MS profile, and the results revealed the presence of several volatile compounds and linalool was the major component with high percentage (11.4 %). Further investigation on the structure elucidation of the bioactive compound (linalool) using IR, GC-MS and NMR techniques compared to authenticated linalool then subjected to purification using preparative and column chromatography. Linalool has been epoxidized using m-chloroperbenzoicacid (mcpba) at room temperature in the presence of florescent lamps to give two cyclic oxygenated products (furan epoxide & pyran epoxide) as a stereospecific product.it is concluded that, oxidation process is enhanced by irradiation to form epoxide derivative, which acts as the precursor of important products.

Keywords: epoxide, ginger, irradiation, linalool

Procedia PDF Downloads 307
7103 An Object-Based Image Resizing Approach

Authors: Chin-Chen Chang, I-Ta Lee, Tsung-Ta Ke, Wen-Kai Tai

Abstract:

Common methods for resizing image size include scaling and cropping. However, these two approaches have some quality problems for reduced images. In this paper, we propose an image resizing algorithm by separating the main objects and the background. First, we extract two feature maps, namely, an enhanced visual saliency map and an improved gradient map from an input image. After that, we integrate these two feature maps to an importance map. Finally, we generate the target image using the importance map. The proposed approach can obtain desired results for a wide range of images.

Keywords: energy map, visual saliency, gradient map, seam carving

Procedia PDF Downloads 478
7102 Fight the Burnout: Phase Two of a NICU Nurse Wellness Bundle

Authors: Megan Weisbart

Abstract:

Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

Procedia PDF Downloads 91
7101 Waste Management in a Hot Laboratory of Japan Atomic Energy Agency – 3: Volume Reduction and Stabilization of Solid Waste

Authors: Masaumi Nakahara, Sou Watanabe, Hiromichi Ogi, Atsuhiro Shibata, Kazunori Nomura

Abstract:

In the Japan Atomic Energy Agency, three types of experimental research, advanced reactor fuel reprocessing, radioactive waste disposal, and nuclear fuel cycle technology, have been carried out at the Chemical Processing Facility. The facility has generated high level radioactive liquid and solid wastes in hot cells. The high level radioactive solid waste is divided into three main categories, a flammable waste, a non-flammable waste, and a solid reagent waste. A plastic product is categorized into the flammable waste and molten with a heating mantle. The non-flammable waste is cut with a band saw machine for reducing the volume. Among the solid reagent waste, a used adsorbent after the experiments is heated, and an extractant is decomposed for its stabilization. All high level radioactive solid wastes in the hot cells are packed in a high level radioactive solid waste can. The high level radioactive solid waste can is transported to the 2nd High Active Solid Waste Storage in the Tokai Reprocessing Plant in the Japan Atomic Energy Agency.

Keywords: high level radioactive solid waste, advanced reactor fuel reprocessing, radioactive waste disposal, nuclear fuel cycle technology

Procedia PDF Downloads 162
7100 A Validated UPLC-MS/MS Assay Using Negative Ionization Mode for High-Throughput Determination of Pomalidomide in Rat Plasma

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

Abstract:

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

Procedia PDF Downloads 392
7099 Determinants of Post-Psychotic Depression in Schizophrenia Patients in ACSH and Mekellle Hospital Tigray, Ethiopia, 2019

Authors: Ashenafi Ayele, Shewit Haftu, Tesfalem Araya

Abstract:

Background: “Post-psychotic depression”, “post schizophrenic depression”, and “secondary depression” have been used to describe the occurrence of depressive symptoms during the chronic phase of schizophrenia. Post-psychotic depression is the most common cause of death due to suicide in schizophrenia patients. Overall lifetime risk for patients with schizophrenia is 50% for suicide attempts and 9-13% lifetime risk for completed suicide and also it is associated with poor prognosis and poor quality of life. Objective: To assess determinant of post psychotic depression in schizophrenia patients ACSH and Mekelle General Hospital, Tigray Ethiopia 2019. Methods: An institutional based unmatched case control study was conducted among 69 cases and 138 controls with the ratio of case to control 1 ratio 2. The sample is calculated using epi-info 3.1 to assess the determinant factors of post-psychotic depression in schizophrenia patients. The cases were schizophrenia patients who have been diagnosed at least for more than one-year stable for two months, and the controls are any patients who are diagnosed as schizophrenia patients. Study subjects were selected using a consecutive sampling technique. The Calgary depression scale for schizophrenia self-administered questionnaire was used. Before the interview, it was assessed the client’s capacity to give intended information using a scale called the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). Bivariant and multiple Logistic regression analysis was performed to determine between the independent and dependent variables. The significant independent predictor was declared at 95% confidence interval and P-value of less than 0.05. Result: Females were affected by post psychotic depression with the (AOR=2.01, 95%CI: 1.003- 4.012, P= 0.49).Patients who have mild form of positive symptom of schizophrenia affected by post psychotic depression with (AOR =4.05, 95%CI: 1.888- 8.7.8, P=0001).Patients who have minimal form of negative symptom of schizophrenia are affected by post psychotic depression with (AOR =4.23, 95%CI: 1.081-17.092, P=.038). Conclusion: In this study, sex (female) and presence of positive and negative symptoms of schizophrenia were significantly associated. It is recommended that the post psychotic depression should be assessed in every schizophrenia patient to decrease the severity of illness, and to improve patient’s quality of life.

Keywords: determinants, post-psychotic depression, Mekelle city

Procedia PDF Downloads 128
7098 Surface Enhanced Raman Substrate Detection on the Structure of γ-Aminobutyric Acid(GABA) Connected with Modified Gold-Chitosan Nanoparticles by Mercaptopropionic Acid (MPA)

Authors: Bingjie Wang, Su-Yeon Kwon, Ik-Joong Kang

Abstract:

A Surface-enhanced Raman Scattering (SERS) as the principle for enhancing Raman scattering by molecules adsorbed on rough metal surfaces or by nanostructures is used to detect the concentration change of γ-Aminobutyric Acid (GABA). As for the gold-chitosan nanoshell, it is made by using chitosan nanoparticles crosslinking with sodium tripolyphosphate(TPP) for the first step to form the chitosan nanoparticles, which would be covered with the gold sequentially. The size of the fabricated product was around 100nm. Based on the method that the sulfur end of the MPA linked to gold can form the very strong S–Au bond, and the carboxyl group, the other end of the MPA, can easily absorb the GABA. GABA is the mainly inhibitory neurotransmitter in the mammalian central nervous system in the human body. It plays such significant role in reducing neuronal excitability throughout the nervous system. When the system formed, it generated SERS, which made a clear difference in the intensity of Raman scattering within the range of GABA concentration. So it is obtained from the experiment that the calibration curve according to the GABA concentration relevant with the SERS scattering. In this study, DLS, SEM, FT-IR, UV, SERS were used to analyze the products to obtain the conclusion.

Keywords: chitosan-gold nanoshell, mercaptopropionic acid, γ-aminobutyric acid, surface-enhanced Raman scattering

Procedia PDF Downloads 268
7097 Effluent from Royal LERD Wastewater Treatment Systems to Furnish Nutrients for Phytoplankton to Generate the Abundance of Hard Clam (Meretrix spp.) on Muddy Beach

Authors: O. Phewnil, S. Khowhit, W. Inkapatanakul, A. Boutson, K. Chunkao, O. Chueawong, T. Pattamapitoon, N. Chanwong, C. Nimpee

Abstract:

The King’s Royally Initiated Laem Phak Bia Environmental Research and Development Project (“the Royal LERD Project”) is located in Laem Phak Bia Sub-District, Ban Laem District, Phetchaburi Province, Thailand. Phetchaburi municipal wastewater was treated with a simple technology by using aquatic plants, constructed wetland, oxidation ponds through a nature-by-nature process. The effluent from the Royal LERD Project was discharged into Laem Phak Bia muddy beach. The soil sediment samples were collected from two zones (200 and 600 meters from the coast of the beach), and tested for cation-exchange capacity (CEC), pH and organic matter and soil particles content. The marine water samples were also collected from the beach in wet and dry seasons and analyzed for its quality and compositions, including but not limited to, biochemical oxygen demand (BOD), dissolved oxygen (DO), suspended solids (SS), nutrients, heavy metals (As, Cd, Cr, Hg, and Pb), and phytoplankton at high and low tides. The soil texture was sandy loam with high concentration of calcium and magnesium which showed a property of base (pH 8). The marine water was qualified with the standard limits of coastal water quality. A dominant species was Coscinodiscus sp. It was found approximately 70.46% of total phytoplankton species in Meretrix casta gastrointestinal tract. The concentration of the heavy metals (As, Cd, Cr, Hg, Ni and Pb) in the tissues and water content of two species of hard clams indicated that heavy metals in Meretrix casta were higher than those in Meretrix meretrix. However, the heavy metals in both species were under the standard limits and safe for consumption. It can be concluded that nutrients in effluent from the wastewater treatment systems play important role in promoting the growth of phytoplankton and generating abundance of hard clams on muddy beach.

Keywords: wastewater, phytoplankton, hard clam (Meretrix spp.), muddy beach

Procedia PDF Downloads 313
7096 Effect of Nutrient Limitations in Phycocyanin Formation by Spirulina platensis

Authors: Hugo F. Lobaton

Abstract:

The cyanobacterium Spirulina platensis is a prokaryotic photoautotrophic microorganism that is successfully cultivated for the commercialization as whole biomass due to its high protein content and promising valuable substance. For instance, phycocyanin has recently drawn the interest of the food and cosmetic industries due to its bright blue colour and its strong antioxidant capacities. The phycocyanin (PC) is the main protein-pigment in S. platensis (4% to 20%). In batches, the rate of overproduction of metabolites by cyanobacteria is limited or activated by the depletion of required substrates. The aim of this study was to develop a kinetic law that describes phycocyanin formation during batch cultivation. S. platensis was cultivated in 1 L bubble column photobioreactor with 30°C and 700 µmol m⁻² s⁻¹. Culture samples were daily collected from the bubble columns in sterile conditions. The biomass (g l⁻¹) was measured directly after a biomass lyophilisation process, and phycocyanin extractions and measurements were done according to a well-established protocol. A kinetic law for phycocyanin formation that includes nitrate and bicarbonate limitations was proposed and linked to the biomass core model. The set of differential equations were solved in MATLAB. Concerning to product formation, the experimental results show that phycocyanin mass fraction is degraded as results of the complete nitrate depletion and nitrate additions during the cultivation help to keep constant this molecule until new macro-element limitation appear. According to the model, bicarbonate is this limitation.

Keywords: phycocyanin, nitrate, bicarbonate, spirulina

Procedia PDF Downloads 151
7095 The Dependency of the Solar Based Disinfection on the Microbial Quality of the Source Water

Authors: M. T. Amina, A. A. Alazba, U. Manzoor

Abstract:

Solar disinfection (SODIS) is a viable method for household water treatment and is recommended by the World Health Organization as cost effective approach that can be used without special skills. The efficiency of both SODIS and solar collector disinfection (SOCODIS) system was evaluated using four different sources of water including stored rainwater, storm water, ground water and treated sewage. Samples with naturally occurring microorganisms were exposed to sunlight for about 8-9 hours in 2-L polyethylene terephthalate bottles under similar experimental conditions. Total coliform (TC), Escherichia coli (E. coli) and heterotrophic plate counts (HPC) were used as microbial water quality indicators for evaluating the disinfection efficiency at different sunlight intensities categorized as weak, mild and strong weathers. Heterotrophic bacteria showed lower inactivation rates compared to E. coli and TC in both SODIS and SOCODIS system. The SOCODIS system at strong weather was the strongest disinfection system in this study and the complete inactivation of HPC was observed after 8-9 hours of exposure with SODIS being ineffective for HPC. At moderate weathers, however, the SOCODIS system did not show complete inactivation of HPC due to very high concentrations (up to 5x10^7 CFU/ml) in both storm water and treated sewage. SODIS even remained ineffective for the complete inactivation of E. coli due to its high concentrations of about 2.5x10^5 in treated sewage compared with other waters even after 8-9 hours of exposure. At weak weather, SODIS was not effective at all while SOCODIS system, though incomplete, showed good disinfection efficiency except for HPC and to some extent for high E. coli concentrations in storm water. Largest reduction of >5 log occurred for TC when used stored rainwater even after 6 hours of exposure in the case of SOCODIS system at strong weather. The lowest E. coli and HPC reduction of ~2 log was observed in SODIS system at weak weather. Further tests with varying pH and turbidity are required to understand the effects of reaction parameters that could be a step forward towards maximizing the disinfection efficiency of such systems for the complete inactivation of naturally occurring E. coli or HPC at moderate or even at weak weathers.

Keywords: efficiency, microbial, SODIS, SOCODIS, weathers

Procedia PDF Downloads 266
7094 Renewable and Functional Biopolymers Using Green Chemistry

Authors: Aman Ullah

Abstract:

The use of renewable resources in supplementing and/or replacing traditional petrochemical products, through green chemistry, is becoming the focus of research. The utilization of oils can play a primitive role towards sustainable development due to their large scale availability, built-in-functionality, biodegradability and no net CO2 production. Microwaves, being clean, green and environmentally friendly, are emerging as an alternative source for product development. Solvent free conversion of fatty acid methyl esters (FAME's) derived from canola oil and waste cooking oil under microwave irradiation demonstrated dramatically enhanced rates. The microwave-assisted reactions lead to the most valuable terminal olefins with enhanced yields, purities and dramatic shortening of reaction times. Various monomers/chemicals were prepared in high yield in very short time. The complete conversions were observed at temperatures as low as 40 ºC within less than five minutes. The products were characterized by GC-MS, GC-FID and NMR. The monomers were separated and polymerized into different polymers including biopolyesthers, biopolyesters, biopolyamides and biopolyolefins. The polymers were characterized in details for their structural, thermal, mechanical and viscoelastic properties. The ability for complete conversion of oils under solvent free conditions and synthesis of different biopolymers is undoubtedly an attractive concept from both an academic and an industrial point of view.

Keywords: monomers, biopolymers, green chemistry, bioplastics, biomaterials

Procedia PDF Downloads 113
7093 Aptitude of a Lactococcus Strain to Grow on Whey Medium

Authors: Souid Wafa, Boudjenah-Haroun Saliha, Khacef Linda

Abstract:

In this work, we focused on the valuation of discharges from the dairy industry. Whey is by-product of dairy industry, which is a formidable pollution factor and contains components (lactose, minerals and proteins) with high nutritional value. Whey is an excellent culture medium for microorganisms. The objective of our work is to investigate the ability of a lactic strain (of the genus Lactococcus) to grow in culture media based on whey of cattle and camels and comparing it with that recorded on M17 as indicator medium. In this study we isolated from a local sample of camel milk a lactic strain (S1).the strain had positive Gram shaped, cocci form and catalase (-). The strain has been purified by the method of streaks on M17 medium. Phenotypic identification allows us to classify this strain in the species: Lactococcus lactis subsp. Cremoris. We subsequently tested the ability of this strain to grow in cattle whey medium and camel whey, both media were deproteinized and unsupplemented. The obtained results revealed that: The cattle and camel whey are appropriate media for the growth of the strain Lactococcus lactis subsp cremoris but is more adapted to grow on a medium rich in lactose as the camel whey. In fact, after 48h and at initial pH 6.8 this strain acidified more camel whey (pH 3.99) than cattle whey (pH 4.8). And biomass produced in the camel whey is 1.50g /1 by contributing to the cattle whey which is 1g / l.

Keywords: cremoris, dairy industry, Lactococcus lactis subsp, medium, whey

Procedia PDF Downloads 368
7092 The Climate Change and Soil Degradation in the Czech Republic

Authors: Miroslav Dumbrovsky

Abstract:

The paper deals with impacts of climate change with the main emphasis on land degradation, agriculture and forestry management in the landscape. Land degradation, due to adverse effect of farmers activities, as a result of inappropriate conventional technologies, was a major issue in the Czech Republic during the 20th century and will remain for solving in the 21st century. The importance of land degradation is very high because of its impact on crop productivity and many other adverse effects. Land degradation through soil degradation is causing losses on crop productivity and quality of the environment, through decreasing quality of soil and water (especially water resources). Negative effects of conventional farming practices are increased water erosion, as well as crusting and compaction of the topsoil and subsoil. Soil erosion caused by water destructs the soil’s structure, reduces crop productivity due to deterioration in soil physical and chemical properties such as infiltration rate, water-holding capacity, loss of nutrients needed for crop production, and loss of soil carbon. Water erosion occurs on fields with row crops (maize, sunflower), especially during the rainfall period from April to October. Recently there is a serious problem of greatly expanded production of biofuels and bioenergy from field crops. The result is accelerated soil degradation. The damages (on and off- site) are greater than the benefits. An effective soil conservation requires an appropriate complex system of measures in the landscape. They are also important to continue to develop new sophisticated methods and technologies for decreasing land degradation. The system of soil conservation solving land degradation depend on the ability and the willingness of land users to apply them. When we talk about land degradation, it is not just a technical issue but also an economic and political issue. From a technical point of view, we have already made many positive steps, but for successful solving the problem of land degradation is necessary to develop suitable economic and political tools to increase the willingness and ability of land users to adopt conservation measures.

Keywords: land degradation, soil erosion, soil conservation, climate change

Procedia PDF Downloads 377
7091 Reliability-Based Codified Design of Concrete Structures

Authors: Naser Alenezi, Ibrahim Alsakkaf, Osama Eid

Abstract:

The main objective of this study is to develop an independent reliability based code for reinforced concrete (R/C) structural components and elements solely for the State of Kuwait and its neighboring countries. The proposed code will take into account the harsh Kuwait’s harsh environment, loading conditions and material strengths. The method for developing such a code is based on structural reliability theory that takes into accounts the specific geographical and the various prescribed societal environment of the Kuwait region. These methods were developed according to the following four components: (1) loads, (2) structural strength, (3) reliability analysis, and (4) achieving target reliability levels (reliability index ’s ). The final product from this study will be a design code for R/C structural elements that include beams and columns, and some other structural members. This reliability-based LRFD design code will provide appropriate, easy, fast, and economical approach for designing R/C structural elements such as, beams and columns, for both houses and bridges, and other concrete structures. In addition, this reliability-based codified design of R/C beams, columns, and, possibly, concrete slabs will improve the design and serviceability of R/C bridge and building systems in Kuwait and neighboring GCC countries. Also, it has the potential to reduce the cost of new concrete structures, as fewer materials are used with more design efficiency.

Keywords: live laod, design, evaluation, structural building

Procedia PDF Downloads 349
7090 Patient Understanding of Health Information: Implications for Organizational Health Literacy in Germany

Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

Abstract:

Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

Procedia PDF Downloads 170
7089 Inerting and Upcycling of Foundry Fines

Authors: Chahinez Aissaoui, Cecile Diliberto, Jean-Michel Mechling

Abstract:

The manufacture of metal foundry products requires the use of sand moulds, which are destroyed, and new ones made each time metal is poured. However, recycled sand requires a regeneration process that produces a polluted fine mineral phase. Particularly rich in heavy metals and organic residues, this foundry co-product is disposed of in hazardous waste landfills and requires an expensive stabilisation process. This paper presents the results of research that valorises this fine fraction of foundry sand by inerting it in a cement phase. The fines are taken from the bag filter suction systems of a foundry. The sample is in the form of filler, with a fraction of less than 140µm, the D50 is 43µm. The Blaine fineness is 3120 cm²/g, and the fines are composed mainly of SiO₂, Al₂O₃ and Fe₂O₃. The loss on ignition at 1000°C of this material is 20%. The chosen inerting technique is to manufacture cement pastes which, once hardened, will be crushed for use as artificial aggregates in new concrete formulations. Different percentages of volume substitutions of Portland cement were tested: 30, 50 and 65%. The substitution rates were chosen to obtain the highest possible recycling rate while satisfying the European discharge limits (these values are assessed by leaching). They were also optimised by adding water-reducing admixtures to increase the compressive strengths of the mixes.

Keywords: leaching, upcycling, waste, residuals

Procedia PDF Downloads 71
7088 Improving the Quality of Discussion and Documentation of Advance Care Directives in a Community-Based Resident Primary Care Clinic

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

Abstract:

Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

Procedia PDF Downloads 167