Search results for: fast healthcare interoperability resources (fhir)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8288

Search results for: fast healthcare interoperability resources (fhir)

2618 Green Technologies Developed by JSC “NIUIF”

Authors: Andrey Norov

Abstract:

In the recent years, Samoilov Research Institute for Mineral Fertilizers JSC “NIUIF”, the oldest (established in September 1919) industry-oriented institute in Russia, has developed a range of sustainable, environment-friendly, zero-waste technologies that ensure minimal consumption of materials and energy resources and fully consistent with the principles of Green Chemistry that include: - Ecofriendly energy and resource saving technology of sulfuric acid from sulfur according to DC-DA scheme (double conversion - double absorption); - Improved zero-waste technology of wet phosphoric acid (WPA) by dihydrate-hemihydrate process applicable to various types of phosphate raw materials; - Flexible, efficient, zero-waste, universal technology of NP / NPS / NPK / NPKS fertilizers with maximum heat recovery from chemical processes; - Novel, zero-waste, no-analogue technology of granular PK / PKS / NPKS fertilizers with controlled dissolution rate and nutrient supply into the soil, which allows to process a number of wastes and by-products; - Innovative resource-saving joint processing of wastes from the production of phosphogypsum and fluorosilicic acid (FSA) into ammonium sulfate with simultaneous neutralization of fluoride compounds with no lime used. - New fertilizer technology of increased environmental and agrochemical efficiency (currently under development). All listed green technologies are patented with Russian and Eurasian patents. The development of ecofriendly, safe, green technologies is ongoing in JSC “NIUIF”.

Keywords: NPKS fertilizers, FSA, sulfuric acid, WPA

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2617 A Study of Level of Happiness in Orphans of Patna District

Authors: Riya Kartikee, Uday Shankar

Abstract:

Background –.Happiness refers to a range of the balance of positive and pleasant emotions of joy, pride, contentment, gratitude, and living with ethics. Happiness is an experience combined with a sense that one’s life is good, meaningful, and worth a while, but in the context of orphans who have lost their birthgivers, their parents who play an important role in bringing necessities and comfort to them, but many terms of the above phases are missing in the life of orphan So, stress increases because of lack of love, attention, sympathy, care, they experience many kind of trauma and also in some cases their lives get worst as they face some physiological abuse, sexual abuse, they are forced to have stress at a not only mentally but physically also in the context of Patna, Bihar where many people are below poverty line, lack of resources is a normal condition for the Orphanages.AIM- The present study was intended to study the level of Happiness among the orphans of Patna District, also it was attempted to find the role of happiness in their lives as an individual.Method- The sample of 70 Orphans in the age group of 12 to 18 years were taken from the orphanages of Patna district-Apnaghar, Rainbow homes, etc. Purposive sampling was used in the study, There has been one research tool used in the study, which is Happiness scale by Dr.R.L Bhardwaj and Dr.Poonam R Das. Results- Results have revealed that Orphans have possessed a very low level of happiness and unhappiness was related due to their living conditions in the orphanage.Conclusion-It can be stated that the Level of happiness is an important missing determinant in the lives of orphans.

Keywords: happiness, orphans, patna, orphanage

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2616 A Machine Learning Model for Predicting Students’ Academic Performance in Higher Institutions

Authors: Emmanuel Osaze Oshoiribhor, Adetokunbo MacGregor John-Otumu

Abstract:

There has been a need in recent years to predict student academic achievement prior to graduation. This is to assist them in improving their grades, especially for those who have struggled in the past. The purpose of this research is to use supervised learning techniques to create a model that predicts student academic progress. Many scholars have developed models that predict student academic achievement based on characteristics including smoking, demography, culture, social media, parent educational background, parent finances, and family background, to mention a few. This element, as well as the model used, could have misclassified the kids in terms of their academic achievement. As a prerequisite to predicting if the student will perform well in the future on related courses, this model is built using a logistic regression classifier with basic features such as the previous semester's course score, attendance to class, class participation, and the total number of course materials or resources the student is able to cover per semester. With a 96.7 percent accuracy, the model outperformed other classifiers such as Naive bayes, Support vector machine (SVM), Decision Tree, Random forest, and Adaboost. This model is offered as a desktop application with user-friendly interfaces for forecasting student academic progress for both teachers and students. As a result, both students and professors are encouraged to use this technique to predict outcomes better.

Keywords: artificial intelligence, ML, logistic regression, performance, prediction

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2615 The Role of Human Resource Capabilities and Knowledge Management on Employees’ Performance in the Nuclear Energy Sector of Nigeria

Authors: Hakeem Ade Omokayode Idowu

Abstract:

The extent of the role played by human capabilities developments as well as knowledge management on employees’ performance in the nuclear energy sector of Nigeria remains unclear. This is in view of the important role which human resource capabilities could play in the desire to generate energy using nuclear resources. This study appraised the extent of human resource capabilities available in the nuclear energy sector of Nigeria. It further examined the relationship between knowledge management and employees’ performance in the nuclear energy sector. The study adopted a descriptive research design with a population that comprised all the 1736 members of staff of the selected centres, institutes, and the headquarters of the Nigeria Atomic Energy Commission (NAEC), Nigerian Nuclear Regulatory Authority (NNRA), and Energy Commission of Nigeria (ECN) and a sample size of 332 employees was selected using purposive and convenience sampling techniques. Data collected were subjected to analysis using frequency counts and simple regression. The results showed that majority of the employees perceived that they have to a high extent of availability of knowledge (118, 35.5%), credibility (134, 40.4%), alignment (130, 39.2%), performance (126, 38%) and innovation (138, 41.6%) The result of the hypothesis tested indicated that knowledge management has a positive and significant effect on employees’ performance (Beta weight = 0.336, R2 =0.113, F-value = 41.959, p-value = 0.000< 0.05). The study concluded that human resource capabilities and knowledge management could enhance employee performance within the nuclear energy sector of Nigeria.

Keywords: human resource capabilities, knowledge management, employees productivity, national development

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2614 Accessing the 'No-Harm' Principle of Protection of the Mekong River’s Environment

Authors: Hang Thuy Tran, Hanh Hong Pham, Ha Thanh Hoa

Abstract:

From 2009 up to now, the water quantity and water quality of the Mekong River, located in the South of Vietnam, have been significantly reduced. The phenomenon happened as a result of climate change and human activities. The Mekong River is an international source of water, flowing across the borders of 6 countries, with Vietnam downstream. Activities to block the flow or build dams to construct hydroelectricity or diversion in upstream countries are either the direct cause or the risk of further deterioration of the water quality and quantity of the Mekong River, as evidenced by two phenomena which are a saline intrusion and transboundary water pollution. The protection of the crucial source of water is done through bilateral and multilateral cooperation mechanisms, notably the Mekong River Commission, established by members of the Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin 1995. In this document, under Article 7, the 'no-harm' principle requires member states to take appropriate measures to prevent causing substantial damage to other member states. This principle has been practiced through the work of a number of committees established by the commission. However, the content of the rules is undetailed, lacks an implementation monitoring mechanism, and has an unreasonable dispute solution. With such difficulties, the provisions in the principle of no-harm are not adequate to protect the Mekong River's water resources in the current context.

Keywords: no-harm principle, transboundary water pollution, Mekong Commission, international source of water

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2613 Development of mHealth Information in Community Based on Geographical Information: A Case Study from Saraphi District, Chiang Mai, Thailand

Authors: Waraporn Boonchieng, Ekkarat Boonchieng, Wilawan Senaratana, Jaras Singkaew

Abstract:

Geographical information system (GIS) is a designated system widely used for collecting and analyzing geographical data. Since the introduction of ultra-mobile, 'smart' devices, investigators, clinicians, and even the general public have had powerful new tools for collecting, uploading and accessing information in the field. Epidemiology paired with GIS will increase the efficacy of preventive health care services. The objective of this study is to apply GPS location services that are available on the common mobile device with district health systems, storing data on our private cloud system. The mobile application has been developed for use on iOS, Android, and web-based platforms. The system consists of two parts of district health information, including recorded resident data forms and individual health recorded data forms, which were developed and approved by opinion sharing and public hearing. The application's graphical user interface was developed using HTML5 and PHP with MySQL as a database management system (DBMS). The reporting module of the developed software displays data in a variety of views, from traditional tables to various types of high-resolution, layered graphics, incorporating map location information with street views from Google Maps. Multi-extension exporting is also supported, utilizing standard platforms such as PDF, PNG, JPG, and XLS. The data were collected in the database beginning in March 2013, by district health volunteers and district youth volunteers who had completed the application training program. District health information consisted of patients’ household coordinates, individual health data, social and economic information. This was combined with Google Street View data, collected in March 2014. Studied groups consisted of 16,085 (67.87%) and 47,811 (59.87%) of the total 23,701 households and 79,855 people were collected by the system respectively, in Saraphi district, Chiang Mai Province. The report generated from the system has had a major benefit directly to the Saraphi District Hospital. Healthcare providers are able to use the basic health data to provide a specific home health care service and also to create health promotion activities according to medical needs of the people in the community.

Keywords: health, public health, GIS, geographic information system

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2612 Pinch Technology for Minimization of Water Consumption at a Refinery

Authors: W. Mughees, M. Alahmad

Abstract:

Water is the most significant entity that controls local and global development. For the Gulf region, especially Saudi Arabia, with its limited potable water resources, the potential of the fresh water problem is highly considerable. In this research, the study involves the design and analysis of pinch-based water/wastewater networks. Multiple water/wastewater networks were developed using pinch analysis involving direct recycle/material recycle method. Property-integration technique was adopted to carry out direct recycle method. Particularly, a petroleum refinery was considered as a case study. In direct recycle methodology, minimum water discharge and minimum fresh water resource targets were estimated. Re-design (or retrofitting) of water allocation in the networks was undertaken. Chemical Oxygen Demand (COD) and hardness properties were taken as pollutants. This research was based on single and double contaminant approach for COD and hardness and the amount of fresh water was reduced from 340.0 m3/h to 149.0 m3/h (43.8%), 208.0 m3/h (61.18%) respectively. While regarding double contaminant approach, reduction in fresh water demand was 132.0 m3/h (38.8%). The required analysis was also carried out using mathematical programming technique. Operating software such as LINGO was used for these studies which have verified the graphical method results in a valuable and accurate way. Among the multiple water networks, the one possible water allocation network was developed based on mass exchange.

Keywords: minimization, water pinch, water management, pollution prevention

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2611 Chronic Hepatitis C Virus Screening: The Role, Strategies and Challenging of Primary Healthcare Faced to Augment and Identify Asymptomatic Infected Patients

Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

Abstract:

Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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2610 Social Economy Effects on Wetlands Change in China during Three Decades Rapid Growth Period

Authors: Ying Ge

Abstract:

Wetlands are one of the essential types of ecosystems in the world. They are of great value to human society thanks to their special ecosystem functions and services, such as protecting biodiversity, adjusting hydrology and climate, providing essential habitats and, products and tourism resources. However, wetlands worldwide are degrading severely due to climate change, accelerated urbanization, and rapid economic development. Both nature and human factors drive wetland change, and the influences are variable from wetland types. Thus, the objectives of this study were to (1) to compare the changes in China’s wetland area during the three decades rapid growth period (1978-2008); (2) to analyze the effects of social economy and environmental factors on wetlands change (area loss and change of wetland types) in China during the high-speed economic development. The socio-economic influencing factors include population, income, education, development of agriculture, industry, infrastructure, wastewater amount, etc. Several statistical methods (canonical correlation analysis, principal component analysis, and regression analysis) were employed to analyze the relationship between socio-economic indicators and wetland area change. This study will determine the relevant driving socio-economic factors on wetland changes, which is of great significance for wetland protection and management.

Keywords: socioeconomic effects, China, wetland change, wetland type

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2609 The Research Experiences of Supervisors and Postgraduate Research Students at One South African Higher Education Institution

Authors: Madoda Cekiso, Thenjiwe Meyiwa

Abstract:

Successful postgraduate supervision involves possessing research capabilities, being knowledgeable in specific disciplines, understanding interpersonal relations, exercising mentoring/guidance skills and having appropriate knowledge of own institutional regulatory systems for postgraduate studies. On the other hand, postgraduate students are expected to know what the postgraduate journey entails and the elements and requirements of a postgraduate study. This paper sought to explore and analyse the research experiences of supervisors and postgraduate research students at one South African higher education institution. The study was qualitative in nature and a case study design was followed. The sample was purposively selected and comprised 25 postgraduate students and 20 postgraduate supervisors from one Faculty of the said university. The study findings revealed that there was no clear contract or memorandum of understanding between the postgraduate students and their supervisors. As a result, both supervisors and postgraduate students were not aware of their responsibilities. Both supervisors and postgraduate students complained about the non-availability of postgraduate facilities and resources for postgraduate students. The results further revealed that the allocation of students to supervisors who are not experts in a particular field was a challenge for both postgraduate students and supervisors. The results also revealed that the supervisors were not happy about the commitment of the postgraduate students towards their studies. The supervisors also complained about the postgraduate students who cannot work independently. Based on the findings, the authors recommended that a memorandum of understanding between a postgraduate student and a supervisor might solve some of the challenges. We further recommended a match between the supervisor’s expertise and the student’s focus area.

Keywords: feedback, mentoring, postgraduate, supervisors, student, memorandum of understanding

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2608 Development of Taiwanese Sign Language Receptive Skills Test for Deaf Children

Authors: Hsiu Tan Liu, Chun Jung Liu

Abstract:

It has multiple purposes to develop a sign language receptive skills test. For example, this test can be used to be an important tool for education and to understand the sign language ability of deaf children. There is no available test for these purposes in Taiwan. Through the discussion of experts and the references of standardized Taiwanese Sign Language Receptive Test for adults and adolescents, the frame of Taiwanese Sign Language Receptive Skills Test (TSL-RST) for deaf children was developed, and the items were further designed. After multiple times of pre-trials, discussions and corrections, TSL-RST is finally developed which can be conducted and scored online. There were 33 deaf children who agreed to be tested from all three deaf schools in Taiwan. Through item analysis, the items were picked out that have good discrimination index and fair difficulty index. Moreover, psychometric indexes of reliability and validity were established. Then, derived the regression formula was derived which can predict the sign language receptive skills of deaf children. The main results of this study are as follows. (1). TSL-RST includes three sub-test of vocabulary comprehension, syntax comprehension and paragraph comprehension. There are 21, 20, and 9 items in vocabulary comprehension, syntax comprehension, and paragraph comprehension, respectively. (2). TSL-RST can be conducted individually online. The sign language ability of deaf students can be calculated fast and objectively, so that they can get the feedback and results immediately. This can also contribute to both teaching and research. The most subjects can complete the test within 25 minutes. While the test procedure, they can answer the test questions without relying on their reading ability or memory capacity. (3). The sub-test of the vocabulary comprehension is the easiest one, syntax comprehension is harder than vocabulary comprehension and the paragraph comprehension is the hardest. Each of the three sub-test and the whole test are good in item discrimination index. (4). The psychometric indices are good, including the internal consistency reliability (Cronbach’s α coefficient), test-retest reliability, split-half reliability, and content validity. The sign language ability are significantly related to non-verbal IQ, the teachers’ rating to the students’ sign language ability and students’ self-rating to their own sign language ability. The results showed that the higher grade students have better performance than the lower grade students, and students with deaf parent perform better than those with hearing parent. These results made TLS-RST have great discriminant validity. (5). The predictors of sign language ability of primary deaf students are age and years of starting to learn sign language. The results of this study suggested that TSL-RST can effectively assess deaf student’s sign language ability. This study also proposed a model to develop a sign language tests.

Keywords: comprehension test, elementary school, sign language, Taiwan sign language

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2607 Environmental Governance and Opportunities for Disaster Risk Reduction in Nigeria

Authors: Willie Eselebor

Abstract:

Environmental governance is not new, but may consist of a series of actions taken to establish sanity and ensure sustainable environment. While there is a growing accord linking disaster risk reduction with the management of environment and natural resources, little is known about failure to act which constitute vulnerability and how improved governance reduces risk globally. The paper reviews emerging trends in the field of application of governance tools and approaches for reducing disaster risk. The Hyogo Framework for Action (HFA) enjoin all stakeholders to stimulate the sustainable use and management of ecosystems, which promote the implementation of integrated environmental and natural resource planning that incorporate disaster risk reduction, including structural and non-structural measures, such as integrated management of fragile ecosystems. The methodology adopted is a case study of disaster-prone sites, prompting guided analysis on which hazards are traceable to environmental degradation, why a degraded environment reduces community resilience; how healthy ecosystems provide natural defense, and which opportunities exist to address gaps in reduction of disasters in Nigeria. The paper further analyses the interaction between disaster risk and environmental change. It is established that environmental governance remains a challenge; which implies that there is the need for a shift in traditional approaches to disaster risk management; exploring new initiatives and allowing environmental managers to be docketed as disaster risk managers in context, potentially opening up a window of dialogue on disaster risk management.

Keywords: disaster, ecosystem, environment, risk

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2606 Coping Life with Female Autistic and Cerebral Palsy Teenagers: Stress Developed by Parental Care in Ghana

Authors: Edwina Owusu Panin, Derrick Antwi

Abstract:

Autism and cerebral palsy are fraternal twins in the world of communication and social interaction challenges. Caring for autistic and cerebral palsied female teenagers in Ghana can be difficult and stressful for parents. We highlight the findings of dealing with stress, where female teenagers are more daunting than male teenagers, related to the demand for a lot of attention linked to the puberty transition. This brief examines the challenges that parents face in caring for teenagers with autism and cerebral palsy in Ghana and the stress that can develop from parental care. The article also highlights the importance of identifying and addressing mental health and self-care issues in parents of disabled female teenagers, as these issues can significantly affect the well-being of both parents and their children. Parents of teenagers with disabilities often face a variety of challenges, including managing their children's care and medical needs, navigating the educational system, and addressing social and emotional needs. These challenges can be even more disheartening in Ghana, where resources and support for families of children with disabilities are limited. In a nutshell, the challenges of caring for female teenagers with autism and cerebral palsy can be significant in Ghana. The article outlines methods that parents in Ghana can take to manage their stress and provide a brighter future for their female teenagers. Parents are better able to cope with the challenges of parenting and provide the best care possible for their female teenagers with disabilities.

Keywords: autism, cerebral palsy, female teenagers, parental care

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2605 Evaluating the Factors That Influence Caries Reduction During Pregnancy

Authors: Mimoza Canga, Irene Malagnino, Vergjini Mulo, Alketa Qafmolla, Vito Antonio Malagnino

Abstract:

Background: Dental caries is the most common dental disease and pregnancy represents a special process of physical, hormonal and metabolic changes in pregnant women, which is accompanied by an imbalance in the oral cavity. Objective: The objective of this study is to evaluate caries reduction after dental visits, the scaling of teeth, fluoridated water, brushing of the teeth and using fluoride toothpaste before and during pregnancy. Materials and methods: This study was conducted in the time period March 2018- September 2021, the age range of the participants was: 18-41 years old. The sample taken under observation was composed of 84 pregnant women. The questionnaire included the demographic characteristics of the sample, such as age, women's education level was primary, secondary, and higher education. Based on women's education level, our analysis found that 25.9% of pregnant women had completed primary education, 35.2% of them had secondary education and 38.9% of pregnant women had higher education. The descriptive and analytical research analysis is formulated as a longitudinal study. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: In the present study, it was observed that there is a strong relationship between dental visits and the scaling of the teeth with the value of P˂ .0001. While the number of teeth with caries before pregnancy and fluoridated water have a P-value=0.002. If we compare the same factor with the number of teeth with dental caries during pregnancy, the correlation is P-value = 0.0001. The number of teeth with caries before pregnancy and carbohydrates consumption has a strong relation with P-value=0.05. According to the present research, the number of teeth with dental caries before pregnancy in relation to brushing the teeth has a P-value ˂ 0.05. Furthermore, in the actual research, it was established that using fluoride toothpaste doesn’t affect the number of teeth with caries before pregnancy with a P-value= .314. Conclusion: According to the results of the present study performed in Albania, it was found out that the periodical dental visits, scaling of the teeth, fluoridated water, brushing of the teeth influenced caries reduction before and during pregnancy. In comparison, the usage of fluoride toothpaste did not have any effect on dental caries reduction in the same time period. The recommendations are as follows: maintaining oral hygiene, using fluoridated water and brushing the teeth regularly. Healthcare providers should inform pregnant women about the importance of oral health and the implementation of measures to manage dental caries.

Keywords: brushing of the teeth, dental visits, dental scaling, fluoridated water, pregnancy

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2604 An Electrode Material for Ultracapacitors: Hydrothermal Synthesis of Neodymium Oxide/Manganese Oxide/Nitrogen Doped Reduced Graphene Oxide Ternary Nanocomposites

Authors: K. Saravanan, K. A.Rameshkumar, P. Maadeswaran

Abstract:

The depletion of fossil resources and the rise in global temperatures are two of the most important concerns we confront today. There are numerous renewable energy sources like solar power, tidal power, wind energy, radiant energy, hydroelectricity, geothermal energy, and biomass available to generate the needed energy demand. Engineers and scientists around the world are facing a massive barrier in the development of storage technologies for the energy developed from renewable energy sources. The development of electrochemical capacitors as a future energy storage technology is at the forefront of current research and development. This is due to the fact that the electrochemical capacitors have a significantly higher energy density, a faster charging-discharging rate, and a longer life span than capacitors, and they also have a higher power density than batteries, making them superior to both. In this research, electrochemical capacitors using the Nd2O3/Mn3O4/ N-rGO electrode material is chosen since the of hexagonal and tetragonal crystal structures of Nd2O3 and Mn3O4 and also has cycling stability of 68% over a long time at 50mVs-1 and a high coulombic efficiency of 99.64% at 5 Ag-1. This approach may also be used to create novel electrode materials with improved electrochemical and cyclic stability for high-performance supercapacitors.

Keywords: Nd2O3/Mn3O4/N-rGO, nanocomposites, hydrothermal method, electrode material, specific capacitance, use of supercapacitors

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2603 Six Years Antimicrobial Resistance Trends among Bacterial Isolates in Amhara National Regional State, Ethiopia

Authors: Asrat Agalu Abejew

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Background: Antimicrobial resistance (AMR) is a silent tsunami and one of the top global threats to health care and public health. It is one of the common agendas globally and in Ethiopia. Emerging AMR will be a double burden to Ethiopia, which is facing a series of problems from infectious disease morbidity and mortality. In Ethiopia, although there are attempts to document AMR in healthcare institutions, comprehensive and all-inclusive analysis is still lacking. Thus, this study is aimed to determine trends in AMR from 2016-2021. Methods: A retrospective analysis of secondary data recorded in the Amhara Public Health Institute (APHI) from 2016 to 2021 G.C was conducted. Blood, Urine, Stool, Swabs, Discharge, body effusions, and other Microbiological specimens were collected from each study participants, and Bacteria identification and Resistance tests were done using the standard microbiologic procedure. Data was extracted from excel in August 2022, Trends in AMR were analyzed, and the results were described. In addition, the chi-square (X2) test and binary logistic regression were used, and a P. value < 0.05 was used to determine a significant association. Results: During 6 years period, there were 25143 culture and susceptibility tests. Overall, 265 (46.2%) bacteria were resistant to 2-4 antibiotics, 253 (44.2%) to 5-7 antibiotics, and 56 (9.7%) to >=8 antibiotics. The gram-negative bacteria were 166 (43.9%), 155 (41.5%), and 55 (14.6%) resistant to 2-4, 5-7, and ≥8 antibiotics, respectively, whereas 99(50.8%), 96(49.2% and 1 (0.5%) of gram-positive bacteria were resistant to 2-4, 5-7 and ≥8 antibiotics respectively. K. pneumonia 3783 (15.67%) and E. coli 3199 (13.25%) were the most commonly isolated bacteria, and the overall prevalence of AMR was 2605 (59.9%), where K. pneumonia 743 (80.24%), E. cloacae 196 (74.81%), A. baumannii 213 (66.56%) being the most common resistant bacteria for antibiotics tested. Except for a slight decline during 2020 (6469 (25.4%)), the overall trend of AMR is rising from year to year, with a peak in 2019 (8480 (33.7%)) and in 2021 (7508 (29.9%). If left un-intervened, the trend in AMR will increase by 78% of variation from the study period, as explained by the differences in years (R2=0.7799). Ampicillin, Augmentin, ciprofloxacin, cotrimoxazole, tetracycline, and Tobramycin were almost resistant to common bacteria they were tested. Conclusion: AMR is linearly increasing during the last 6 years. If left as it is without appropriate intervention after 15 years (2030 E.C), AMR will increase by 338.7%. A growing number of multi-drug resistant bacteria is an alarm to awake policymakers and those who do have the concern to intervene before it is too late. This calls for a periodic, integrated, and continuous system to determine the prevalence of AMR in commonly used antibiotics.

Keywords: AMR, trend, pattern, MDR

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2602 Use of Technology Based Intervention for Continuous Professional Development of Teachers in Pakistan

Authors: Rabia Aslam

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Overwhelming evidence from all around the world suggests that high-quality teacher professional development facilitates the improvement of teaching practices which in turn could improve student learning outcomes. The new Continuous Professional Development (CPD) model for primary school teachers in Punjab uses a blended approach in which pedagogical content knowledge is delivered through technology (high-quality instructional videos and lesson plans delivered to school tablets or mobile phones) with face-to-face support by Assistant Education Officers (AEOs). The model also develops Communities of Practice operationalized through formal meetings led by the AEOs and informal interactions through social media groups to provide opportunities for teachers to engage with each other and share their ideas, reflect on learning, and come up with solutions to issues they experience. Using Kirkpatrick’s 4 levels of the learning evaluation model, this paper investigates how school tablets and teacher mobile phones may act as transformational cultural tools to potentially expand perceptions and access to teaching and learning resources and explore some of the affordances of social media (Facebook, WhatsApp groups) in learning in an informal context. The results will be used to inform policy-level decisions on what shape could CPD of all teachers take in the context of a developing country like Pakistan.

Keywords: CPD, teaching & learning, blended learning, learning technologies

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2601 The Impact of Fiscal Policy on Gross Domestic Product under Contributions of Level of External Debt in Developing Countries

Authors: Zohreh Bang Tavakoli, Shuktika Chatterjee

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This study investigates the fiscal policy impact on countries’ economic growth in developing countries with a different external debt level. The fiscal policy effectiveness has been re-emphasized in the global financial crisis of 2008 with the external debt as its new contemporary driver (Ruščáková and Semančíková, 2016). According to Bouakez, (2014 ) different theories have proposed the economic consequence of fiscal policy, specifically for developing countries. However, fiscal policy literature is lacking research regarding the fiscal policy’s effectiveness with the external debt’s contributions through comprehensive study (Canh, 2018). Also, according to scholars, high levels of external debt will influence economic growth. First, through foreign resources and channel of investment in which high level of debt decreases the amount of foreign investment in the developing countries. Second, through the deterioration of foreign investors and fiscal policies related to a high level of debt (Cordella, et.al., 2010). Therefore, this study proposed that only countries with a low external debt level and appropriate fiscal policies and good quality institutions can gain the proper quantity and quality of foreign investors, which will help the economic growth. For this, this research is examining the impact of fiscal policy on developing countries' economic growth in the situation of different external debt levels.

Keywords: fiscal policy, external debt, gross domestic product, developing countries

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2600 A Contemporary Gender Predominance: A Honduran Textile Manufacturing Diagnose

Authors: Jesús David Argueta Moreno, Taria Ruiz, Cesar Ortega

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This qualitative investigation represents the first stage of the human capital engineering analysis, along the small and medium textile manufacturing companies, located on the city of Tegucigalpa, Honduras where the symptoms of the local manufacturing industry´s describe a severe gender displacement phenomenon. The evaluation of this phenomena, intends to trigger the Honduran small and medium technology manufactures into a collective performance, analysis through the development of a sectorial diagnose and the creation of a manufacturers guide, personalized. In accordance to the Honduran textile manufacturing needs, in order to strengthen their personnel capacities and thereby smoothen the gender equilibrium on this particular sector. It is worth mentioning, that on the last decade, the female gender has gathered positive statistics upon Central American job market´s, were the local business landscape describes a significant displacement of the Honduran female operators over the male gender workers that has significantly diminished their employment predominance. On the other hand, this study aims to evaluate the main features that impact on the job market local gender supplanting. On the other hand, this document aims to holistically describe the Honduran manufacturing context, as well as the current textile operator qualifications, in order to infer over the most proper human resources enforcement approaches/techniques on the industry.

Keywords: gender predominance, manufacturing, higher education institutions, emerging trends

Procedia PDF Downloads 421
2599 Identification and Characterization of Antimicrobial Peptides Isolated from Entophytic Bacteria and Their Activity against Multidrug-Resistance Gram-Negative Bacteria in South Korea

Authors: Maryam Beiranvand

Abstract:

Multi-drug resistance in various microorganisms has increased globally in many healthcare facilities. Less effective antimicrobial activity of drug therapies for infection control becomes trouble. Since 1980, no new type of antimicrobial drug has been identified, even though combinations of antibiotic drugs have been discovered almost every decade. Between 1981 and 2006, over 70% of novel pharmaceuticals and chemical agents came from natural sources. Microorganisms have yielded almost 22,000 natural compounds. The identification of antimicrobial components from endophytes bacteria could help overcome the threat posed by multi-drug resistant strains. The project aims to analyze and identify antimicrobial peptides isolated from entophytic bacteria and their activity against multidrug-resistant Gram-negative bacteria in South Korea. Endophytic Paenibacillus polymyxa. 4G3 isolated from the plant, Gynura procumbery exhibited considerable antimicrobial activity against Methicillin-resistant Staphylococcus aureus, and Escherichia coli. The Rapid Annotations using Subsystems Technology showed that the total size of the draft genome was 5,739,603bp, containing 5178 genes with 45.8% G+C content. Genome annotation using antiSMASH version 6.0.0 was performed, which predicted the most common types of non-ribosomal peptide synthetase (NRPS) and polyketide synthase (PKS). In this study, diethyl aminoethyl cellulose (DEAEC) resin was used as the first step in purifying for unknown peptides, and then the target protein was identified using hydrophilic and hydrophobic solutions, optimal pH, and step-by-step tests for antimicrobial activity. This crude was subjected to C18 chromatography and elution with 0, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100% methanol, respectively. Only the fraction eluted with 20% -60% methanol demonstrated good antimicrobial activity against MDR E. coli. The concentration of the active fragment was measured by the Brad-ford test, and Protein A280 - Thermo Fisher Scientific at the end by examining the SDS PAGE Resolving Gel, 10% Acrylamide and purity were confirmed. Our study showed that, based on the combined results of the analysis and purification. P polymyxa. 4G3 has a high potential exists for producing novel functions of polymyxin E and bacitracin against bacterial pathogens.

Keywords: endophytic bacteria, antimicrobial activity, antimicrobial peptide, whole genome sequencing analysis, multi -drug resistance gram negative bacteria

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2598 Institutional Legitimacy and Professional Boundary: Western Medicine-Trained Doctors' Attitudes and Behaviors toward Traditional Chinese Medicine

Authors: Xiaoli Tian

Abstract:

The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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2597 Real-Time Water Quality Monitoring and Control System for Fish Farms Based on IoT

Authors: Nadia Yaghoobi, Seyed Majid Esmaeilzadeh

Abstract:

Due to advancements in wireless communication, new sensor capabilities have been created. In addition to the automation industry, the Internet of Things (IoT) has been used in environmental issues and has provided the possibility of communication between different devices for data collection and exchange. Water quality depends on many factors which are essential for maintaining the minimum sustainability of water. Regarding the great dependence of fishes on the quality of the aquatic environment, water quality can directly affect their activity. Therefore, monitoring water quality is an important issue to consider, especially in the fish farming industry. The conventional method of water quality testing is to collect water samples manually and send them to a laboratory for testing and analysis. This time-consuming method is a waste of manpower and is not cost-effective. The water quality measurement system implemented in this project monitors water quality in real-time through various sensors (parameters: water temperature, water level, dissolved oxygen, humidity and ambient temperature, water turbidity, PH). The Wi-Fi module, ESP8266, transmits data collected by sensors wirelessly to ThingSpeak and the smartphone app. Also, with the help of these instantaneous data, water temperature and water level can be controlled by using a heater and a water pump, respectively. This system can have a detailed study of the pollution and condition of water resources and can provide an environment for safe fish farming.

Keywords: dissolved oxygen, IoT, monitoring, ThingSpeak, water level, water quality, WiFi module

Procedia PDF Downloads 188
2596 Frequency of Problem Drinking and Depression in Males with a History of Alcohol Consumption Admitted to a Tertiary Care Setting in Southern Sri Lanka

Authors: N. H. D. P. Fonseka, I. H. Rajapakse, A. S. Dissanayake

Abstract:

Background: Problem drinking, namely alcohol dependence (AD) and alcohol abuse (AA) are associated with major medical, social and economic adverse consequences. Problem drinking behavior is noted among those admitted to hospitals due to alcohol-related medical/surgical complaints as well as those with unrelated complaints. Literature shows an association between alcohol consumption and depression. Aims of this study were to determine the frequency of problem drinking and depression among males with a history of alcohol consumption tertiary care setting in Southern Sri Lanka. Method: Two-hundred male patients who consumed alcohol, receiving care in medical and surgical wards in Teaching Hospital Galle, were assessed. A validated J12 questionnaire of the Mini International Neuropsychiatric Interview was administered to determine frequency AA and AD. A validated PHQ 9 questionnaire to determine the prevalence and severity of depression. Results: Sixty-three participants (31%) had problem drinking. Of them, 61% had AD, and 39% had AA. Depression was noted in 39 (19%) subjects. In those who reported alcohol consumption not amounting to problem drinking, depression was noted in 23 (16%) participants. Mild depression was seen in 17, moderate in five and moderately severe in one. Among those who had problem drinking, 16 (25%) had depression. Mild depression was seen in four, moderate in seven, moderately severe in three and severe in two. Conclusions: A high proportion alcohol users had problem drinking. Adverse consequences associated with problem drinking places a major strain on the health system especially in a low resource setting where healthcare spending is limited and alcohol cessation support services are not well organised. Thus alcohol consumption and problem drinking behaviour need to be inquired into all medical consultations. Community prevalence of depression in Sri Lanka is approximately 10%. Depression among those consuming alcohol was two times higher compared to the general population. The rates of depression among those with problem drinking were especially high being 2.5 times more common than in the general population. A substantial proportion of these patients with depression had moderately severe or severe depression. When depression coexists with problem drinking, it may increase the tendency to consume alcohol as well as act as a barrier to the success of alcohol cessation interventions. Thus screening all patients who consume alcohol for depression, especially those who are problem drinkers becomes an important step in their clinical evaluation. In addition, in view of the high prevalence of problem drinking and coexistent depression, the need to organize a structured alcohol cessation support service in Sri Lanka as well as the need for increasing access to psychological evaluation and treatment of those with problem drinking are highlighted.

Keywords: alcohol abuse, alcohol, depression, problem drinking

Procedia PDF Downloads 157
2595 Coupling of Microfluidic Droplet Systems with ESI-MS Detection for Reaction Optimization

Authors: Julia R. Beulig, Stefan Ohla, Detlev Belder

Abstract:

In contrast to off-line analytical methods, lab-on-a-chip technology delivers direct information about the observed reaction. Therefore, microfluidic devices make an important scientific contribution, e.g. in the field of synthetic chemistry. Herein, the rapid generation of analytical data can be applied for the optimization of chemical reactions. These microfluidic devices enable a fast change of reaction conditions as well as a resource saving method of operation. In the presented work, we focus on the investigation of multiphase regimes, more specifically on a biphasic microfluidic droplet systems. Here, every single droplet is a reaction container with customized conditions. The biggest challenge is the rapid qualitative and quantitative readout of information as most detection techniques for droplet systems are non-specific, time-consuming or too slow. An exception is the electrospray mass spectrometry (ESI-MS). The combination of a reaction screening platform with a rapid and specific detection method is an important step in droplet-based microfluidics. In this work, we present a novel approach for synthesis optimization on the nanoliter scale with direct ESI-MS detection. The development of a droplet-based microfluidic device, which enables the modification of different parameters while simultaneously monitoring the effect on the reaction within a single run, is shown. By common soft- and photolithographic techniques a polydimethylsiloxane (PDMS) microfluidic chip with different functionalities is developed. As an interface for the MS detection, we use a steel capillary for ESI and improve the spray stability with a Teflon siphon tubing, which is inserted underneath the steel capillary. By optimizing the flow rates, it is possible to screen parameters of various reactions, this is exemplarity shown by a Domino Knoevenagel Hetero-Diels-Alder reaction. Different starting materials, catalyst concentrations and solvent compositions are investigated. Due to the high repetition rate of the droplet production, each set of reaction condition is examined hundreds of times. As a result, of the investigation, we receive possible reagents, the ideal water-methanol ratio of the solvent and the most effective catalyst concentration. The developed system can help to determine important information about the optimal parameters of a reaction within a short time. With this novel tool, we make an important step on the field of combining droplet-based microfluidics with organic reaction screening.

Keywords: droplet, mass spectrometry, microfluidics, organic reaction, screening

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2594 Fuzzy Set Qualitative Comparative Analysis in Business Models' Study

Authors: K. Debkowska

Abstract:

The aim of this article is presenting the possibilities of using Fuzzy Set Qualitative Comparative Analysis (fsQCA) in researches concerning business models of enterprises. FsQCA is a bridge between quantitative and qualitative researches. It's potential can be used in analysis and evaluation of business models. The article presents the results of a study conducted on the basis of enterprises belonging to different sectors: transport and logistics, industry, building construction, and trade. The enterprises have been researched taking into account the components of business models and the financial condition of companies. Business models are areas of complex and heterogeneous nature. The use of fsQCA has enabled to answer the following question: which components of a business model and in which configuration influence better financial condition of enterprises. The analysis has been performed separately for particular sectors. This enabled to compare the combinations of business models' components which actively influence the financial condition of enterprises in analyzed sectors. The following components of business models were analyzed for the purposes of the study: Key Partners, Key Activities, Key Resources, Value Proposition, Channels, Cost Structure, Revenue Streams, Customer Segment and Customer Relationships. These components of the study constituted the variables shaping the financial results of enterprises. The results of the study lead us to believe that fsQCA can help in analyzing and evaluating a business model, which is important in terms of making a business decision about the business model used or its change. In addition, results obtained by fsQCA can be applied by all stakeholders connected with the company.

Keywords: business models, components of business models, data analysis, fsQCA

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2593 Crop Classification using Unmanned Aerial Vehicle Images

Authors: Iqra Yaseen

Abstract:

One of the well-known areas of computer science and engineering, image processing in the context of computer vision has been essential to automation. In remote sensing, medical science, and many other fields, it has made it easier to uncover previously undiscovered facts. Grading of diverse items is now possible because of neural network algorithms, categorization, and digital image processing. Its use in the classification of agricultural products, particularly in the grading of seeds or grains and their cultivars, is widely recognized. A grading and sorting system enables the preservation of time, consistency, and uniformity. Global population growth has led to an increase in demand for food staples, biofuel, and other agricultural products. To meet this demand, available resources must be used and managed more effectively. Image processing is rapidly growing in the field of agriculture. Many applications have been developed using this approach for crop identification and classification, land and disease detection and for measuring other parameters of crop. Vegetation localization is the base of performing these task. Vegetation helps to identify the area where the crop is present. The productivity of the agriculture industry can be increased via image processing that is based upon Unmanned Aerial Vehicle photography and satellite. In this paper we use the machine learning techniques like Convolutional Neural Network, deep learning, image processing, classification, You Only Live Once to UAV imaging dataset to divide the crop into distinct groups and choose the best way to use it.

Keywords: image processing, UAV, YOLO, CNN, deep learning, classification

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2592 Effect of Credit Use on Technical Efficiency of Cassava Farmers in Ondo State, Nigeria

Authors: Adewale Oladapo, Carolyn A. Afolami

Abstract:

Agricultural production should be the major financial contributor to the Nigerian economy; however, the petroleum sector had taken the importance attached to this sector. The situation tends to be more worsening unless necessary attention is given to adequate credit supply among food crop farmers. This research analyses the effect of credit use on the technical efficiency of cassava farmers in Ondo State, Nigeria. Primary data were collected from two hundred randomly selected cassava farmers through a multistage sampling procedure in the study area. Data were analysed using descriptive statistics and stochastic frontier analysis (SFA). Findings revealed that 95.0% of the farmers were male while 56.0% had no formal education and were married. The SFA showed that cassava farmer’s efficiency increased with farm size, herbicide and planting material at 5%,10% and 1% respectively but decreased with fertilizer application at 1% level while farmers’ age, education, household size, experience and access to credit increased technical inefficiency at 10%. The study concluded that cassava farmers are technically inefficient in the use of farm resources and recommended that adequate and workable agricultural policy measures that will ensure availability and efficient fertilizer distribution should be put in place to increase efficiency. Furthermore, the government should encourage youth participation in cassava production and ensure improvement in farmer’s access to credit to increase farmer’s technical efficiency.

Keywords: agriculture, access to credit, cassava farmers, technical efficiency

Procedia PDF Downloads 176
2591 Contribution of Remote Sensing and GIS to the Study of the Impact of the Salinity of Sebkhas on the Quality of Groundwater: Case of Sebkhet Halk El Menjel (Sousse)

Authors: Gannouni Sonia, Hammami Asma, Saidi Salwa, Rebai Noamen

Abstract:

Water resources in Tunisia have experienced quantitative and qualitative degradation, especially when talking about wetlands and Sbekhas. Indeed, the objective of this work is to study the spatio-temporal evolution of salinity for 29 years (from 1987 to 2016). A study of the connection between surface water and groundwater is necessary to know the degree of influence of the Sebkha brines on the water table. The evolution of surface salinity is determined by remote sensing based on Landsat TM and OLI/TIRS satellite images of the years 1987, 2007, 2010, and 2016. The processing of these images allowed us to determine the NDVI(Normalized Difference Vegetation Index), the salinity index, and the surface temperature around Sebkha. In addition, through a geographic information system(GIS), we could establish a map of the distribution of salinity in the subsurface of the water table of Chott Mariem and Hergla/SidiBouAli/Kondar. The results of image processing and the calculation of the index and surface temperature show an increase in salinity downstream of in addition to the sebkha and the development of vegetation cover upstream and the western part of the sebkha. This richness may be due both to contamination by seawater infiltration from the barrier beach of Hergla as well as the passage of groundwater to the sebkha.

Keywords: spatio-temporal monitoring, salinity, satellite images, NDVI, sebkha

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2590 Development of a Classification Model for Value-Added and Non-Value-Added Operations in Retail Logistics: Insights from a Supermarket Case Study

Authors: Helena Macedo, Larissa Tomaz, Levi Guimarães, Luís Cerqueira-Pinto, José Dinis-Carvalho

Abstract:

In the context of retail logistics, the pursuit of operational efficiency and cost optimization involves a rigorous distinction between value-added and non-value-added activities. In today's competitive market, optimizing efficiency and reducing operational costs are paramount for retail businesses. This research paper focuses on the development of a classification model adapted to the retail sector, specifically examining internal logistics processes. Based on a comprehensive analysis conducted in a retail supermarket located in the north of Portugal, which covered various aspects of internal retail logistics, this study questions the concept of value and the definition of wastes traditionally applied in a manufacturing context and proposes a new way to assess activities in the context of internal logistics. This study combines quantitative data analysis with qualitative evaluations. The proposed classification model offers a systematic approach to categorize operations within the retail logistics chain, providing actionable insights for decision-makers to streamline processes, enhance productivity, and allocate resources more effectively. This model contributes not only to academic discourse but also serves as a practical tool for retail businesses, aiding in the enhancement of their internal logistics dynamics.

Keywords: lean retail, lean logisitcs, retail logistics, value-added and non-value-added

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2589 How to Improve the Environmental Performance in a HEI in Mexico, an EEA Adaptation

Authors: Stephanie Aguirre Moreno, Jesús Everardo Olguín Tiznado, Claudia Camargo Wilson, Juan Andrés López Barreras

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This research work presents a proposal to evaluate the environmental performance of a Higher Education Institution (HEI) in Mexico in order to minimize their environmental impact. Given that public education has limited financial resources, it is necessary to conduct studies that support priorities in decision-making situations and thus obtain the best cost-benefit ratio of continuous improvement programs as part of the environmental management system implemented. The methodology employed, adapted from the Environmental Effect Analysis (EEA), weighs the environmental aspects identified in the environmental diagnosis by two characteristics. Number one, environmental priority through the perception of the stakeholders, compliance of legal requirements, and environmental impact of operations. Number two, the possibility of improvement, which depends of factors such as the exchange rate that will be made, the level of investment and the return time of it. The highest environmental priorities, or hot spots, identified in this evaluation were: electricity consumption, water consumption and recycling, and disposal of municipal solid waste. However, the possibility of improvement for the disposal of municipal solid waste is higher, followed by water consumption and recycling, in spite of having an equal possibility of improvement to the energy consumption, time of return and cost-benefit is much greater.

Keywords: environmental performance, environmental priority, possibility of improvement, continuous improvement programs

Procedia PDF Downloads 489