Search results for: integrated groundwater management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12425

Search results for: integrated groundwater management

6725 Ukrainians Professors in a Luso-Hispanophone Brazilian Border Region: a Case-Study on the Management of Multilingualism in Higher Education

Authors: Isis Ribeiro Berger

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In view of recent war conflicts between Russia and Ukraine, the government of Paraná State, in Brazil, started a program to host Ukrainian scientists in state universities in 2022. The initiative aimed at integrating these scientists into the Brazilian academic community, strengthening the role of universities in producing science and innovation even in times of war, as well as fostering Higher Education internationalization. Paraná state was a pioneer in this initiative due to the fact it has been home to the largest contingent of immigrants and descendants of Ukrainians in Brazil because of migratory processes that began at the end of the 19th century. One of the universities receiving Ukrainian scientists is in Foz do Iguaçu, a city that borders Argentina and Paraguay. It is a multilingual environment, whose majority languages are Portuguese (the official language of Brazil), Spanish (the official language of both Argentina and Paraguay), as well as Guarani (the co-official indigenous language of Paraguay). It is in such a sociolinguistic environment that two Ukrainian professors began their activities within the scope of an Interdisciplinary Postgraduate Program (master’s and doctorate degree). This case study, whose theme is the management of multilingualism, was developed within the scope of Language Policy. It aimed at identifying the attitudes of both Ukrainian professors and postgraduate students towards multilingualism in this context, given the plural linguistic repertoire of the academic community, as well as identifying the language management strategies for the construction of knowledge implemented by the program and in the classroom by these participants. Therefore, the study was conducted under a qualitative approach, for which surveys and interviews were adopted as part of its methodological procedures. Data revealed the presence of different languages in the classroom (Portuguese, Spanish, English and Ukrainian), which made pedagogical practices challenging for both professors and students, whose levels of knowledge in the different languages varied significantly. The results indicate that multilingualism was the norm as the means of instruction adopted in this context, in which bilingual Portuguese-English-Ukrainian instruction was used by the professors in their lectures. Although English has been privileged for the internationalization of Higher Education in various contexts, it was not used as an exclusive means of instruction in this case, mostly because it is a predominantly Portuguese-Spanish-speaking environment. In addition, the professors counted on the mediation of an interpreter hired by the program since not every student had sufficient knowledge of English as part of their repertoires. The findings also suggest Portuguese is the language that most of the participants of this study prefer, both because it is the mother tongue of majority, and because it is the official language of the host country to the professors, who have sought to integrate to the local culture and community. This research is inserted in the Axis: Multilingualism and Education, of the UNESCO Chair on Language Policies for Multilingualism to which this study is related.

Keywords: attitudes, border region, multilingualism management, Ukrainian professors

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6724 Maintenance Work Order Management Tool (Desktop & Mobile Solution)

Authors: Haitham Al Rawahi

Abstract:

Oman Electricity Transmission Company (OETC) has implemented Computerized Maintenance Management System (CMMS), which is based on Oracle enterprise asset management model e-AM. This was implemented with cooperation of Nama Shared Services (NSS). CMMS is mainly used to create maintenance work orders with a preconfigured workflow of defined maintenance schedules/plans, required resources, and materials, obtaining shutdown approvals, completing maintenance activities, and closing the work orders. Furthermore, CMMS is also configured with asset failure classifications, asset hierarchy, asset maintenance activities, integration with spare inventories, etc. Since the year 2017, site engineer is working on CMMS by filling-in manually all related maintenance and inspection records on paper forms and then scanning and attaching it in CMMS for further analysis. Site engineer will finalize all paper works at site and then goes back to office to scan and attach it to work order in CMMS. This creates sub tasks for site engineer and makes it very difficult and lengthy process. Also, there is a significant risk for missing or deleted important fields on the paper due to usage of pen to fill the paper. In addition to that, site engineer may take time and days working outside of the office. therefore, OETC has decided to digitize these inspection and maintenance forms in one platform in CMMS, and it can be opened with both functionalities online and offline. The ArcGIS product formats or web-enabled solutions which has ability to access from mobile and desktop devices via arc map modules will be used too. The purpose of interlinking is to setup for maintenance and inspection forms to work orders in e-AM, which the site engineer has daily interactions with. This ArcGIS environment or tool is designed to link with e-AM, so when site engineer opens this application from the site and a window will take him through same ArcGIS. This window opens the maintenance forms and shows the required fields to fill-in and save the work through his mobile application. After saving his work with the availability of network (Off/In) line, notification will trigger to his line manager to review and take further actions (approve/reject/request more information). In this function, the user can see the assigned work orders to his departments as well as chart of all work orders with status. The approver has ability to see the statistics of all work.

Keywords: e-AM, GIS, CMMS, integration

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6723 Real-Time Course Recommendation System for Online Learning Platforms

Authors: benabbess anja

Abstract:

This research presents the design and implementation of a real-time course recommendation system for online learning platforms, leveraging user competencies and expertise levels. The system begins by extracting and classifying the complexity levels of courses from Udemy datasets using semantic enrichment techniques and resources such as WordNet and BERT. A predictive model assigns complexity levels to each course, adding columns that represent the course category, sub-category, and complexity level to the existing dataset. Simultaneously, user profiles are constructed through questionnaires capturing their skills, sub-skills, and proficiency levels. The recommendation process involves generating embeddings with BERT, followed by calculating cosine similarity between user profiles and courses. Courses are ranked based on their relevance, with the BERT model delivering the most accurate results. To enable real-time recommendations, Apache Kafka is integrated to track user interactions (clicks, comments, time spent, completed courses, feedback) and update user profiles. The embeddings are regenerated, and similarities with courses are recalculated to reflect users' evolving needs and behaviors, incorporating a progressive weighting of interactions for more personalized suggestions. This approach ensures dynamic and real-time course recommendations tailored to user progress and engagement, providing a more personalized and effective learning experience. This system aims to improve user engagement and optimize learning paths by offering courses that precisely match users' needs and current skill levels.

Keywords: recommendation system, online learning, real-time, user skills, expertise level, personalized recommendations, dynamic suggestions

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6722 Antibacterial Effects of Some Medicinal and Aromatic Plant Extracts on Pathogenic Bacteria Isolated from Pear Orchards

Authors: Kubilay Kurtulus Bastas

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Bacterial diseases are very destructive and cause economic losses on pears. Promising plant extracts for the management of plant diseases are environmentally safe, long-lasting and extracts of certain plants contain alkaloids, tannins, quinones, coumarins, phenolic compounds, and phytoalexins. In this study, bacteria were isolated from different parts of pear exhibiting characteristic symptoms of bacterial diseases from the Central Anatolia, Turkey. Pathogenic bacteria were identified by morphological, physiological, biochemical and molecular methods as fire blight (Erwinia amylovora (39%)), bacterial blossom blast and blister bark (Pseudomonas syringae pv. syringae (22%)), crown gall (Rhizobium radiobacter (1%)) from different pear cultivars, and determined virulence levels of the pathogens with pathogenicity tests. The air-dried 25 plant material was ground into fine powder and extraction was performed at room temperature by maceration with 80% (v/v) methanol/distilled water. The minimum inhibitory concentration (MIC) values were determined by using modified disc diffusion method at five different concentrations and streptomycin sulphate was used as control chemical. Bacterial suspensions were prepared as 108 CFU ml⁻¹ densities and 100 µl bacterial suspensions were spread to TSA medium. Antimicrobial activity was evaluated by measuring the inhibition zones in reference to the test organisms. Among the tested plants, Origanum vulgare, Hedera helix, Satureja hortensis, Rhus coriaria, Eucalyptus globulus, Rosmarinus officinalis, Ocimum basilicum, Salvia officinalis, Cuminum cyminum and Thymus vulgaris showed a good antibacterial activity and they inhibited the growth of the pathogens with inhibition zone diameter ranging from 7 to 27 mm at 20% (w/v) in absolute methanol in vitro conditions. In vivo, the highest efficacy was determined as 27% on reducing tumor formation of R. radiobacter, and 48% and 41% on reducing shoot blight of E. amylovora and P. s. pv. syringae on pear seedlings, respectively. Obtaining data indicated that some plant extracts may be used against the bacterial diseases on pome fruits within sustainable and organic management programs.

Keywords: bacteria, eco-friendly management, organic, pear, plant extract

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6721 Foreign Artificial Intelligence Investments and National Security Exceptions in International Investment Law

Authors: Ying Zhu

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Recent years have witnessed a boom of foreign investments in the field of artificial intelligence (AI). Foreign investments provide critical capital for AI development but also trigger national security concerns of host states. A notable example is an increasing number of cases in which the Committee on Foreign Investment in the United States (CFIUS) has denied Chinese acquisitions of US technology companies on national security grounds. On July 19, 2018, the Congress has reached a deal on the final draft of a new provision to strengthen CFIUS’s authority to review overseas transactions involving sensitive US technology. The question is: how to reconcile the emerging tension between, on the one hand, foreign AI investors’ expectations of a predictable investment environment, and on the other hand, host states’ regulatory power on national security? This paper provides a methodology to reconcile this tension under international investment law. Based on an examination, the national security exception clauses in international investment treaties and the application of national security justification in investor-state arbitration jurisprudence, the paper argues that a traditional interpretation of the national security exception, based on the necessity concept in customary international law, fails to take into account new risks faced by countries, including security concerns over strategic industries such as AI. To overcome this shortage, the paper proposes to incorporate an integrated national security clause in international investment treaties, which includes a two-tier test: a ‘self-judging’ test in the pre-establishment period and a ‘proportionality’ test in the post-establishment period. At the end, the paper drafts a model national security clause for future treaty-drafting practice.

Keywords: foreign investment, artificial intelligence, international investment law, national security exception

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6720 Investigating the Relationship between Bioethics and Sports

Authors: Franco Bruno Castaldo

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Aim: The term bioethics is a term coined by VanPotter R ., who in 1970 thought of a discipline, capable of contributing to a better quality of human life and the cosmos. At first he intended bioethics as a wisdom capable of creating a bridge between bios and ethos and between bio-experimental science and ethical-anthropological sciences.Similarly, the modern sport is presented as a polysemic phenomenon, multidisciplinary, pluris value. From the beginning, the sport is included in the discussion of bioethical problems with doping. Today, the ethical problems of the sport are not only ascribable to doping, the medicalization of society, Techniques for enhancement, violence, Fraud, corruption, even the acceptance of anthropological transhumanist theories. Our purpose is to shed light on these issues so that there is a discernment, a fine-tuning also in educational programs, for the protection of all the sport from a scientist adrift, which would lead to an imbalance of values. Method: Reading, textual and documentary analysis, evaluation of critical examples. Results: Harold VanderZwaag, (1929-2011) in ancient times, asked: how many athletic directors have read works of sport philosophy or humanities? Along with E.A. Zeigler (North American Society for Sport Management) are recognized as pioneers of educational Sport Management. Comes the need to leave the confines of a scientific field, In order to deal with other than itself. Conclusion: The quantitative sciences attracts more funds than qualitative ones, the philosopher M. Nussbaum, has relaunched the idea that the training of students will have to be more disinterested than utilitarian, Offering arguments against the choice of anti-classical, analyzing and comparing different educational systems. schools, universities must assign a prominent place in the program of study to the humanistic, literary and artistic subjects, cultivating a participation that can activate and improve the ability to see the world through the eyes of another person. In order to form citizens who play their role in society, science and technology alone are not enough, we need disciplines that are able to cultivate critical thinking, respect for diversity, solidarity, the judgment, the freedom of expression. According to A. Camelli, the humanities faculties prepare for that life-long learning, which will characterize tomorrow's jobs.

Keywords: bioethics, management, sport, transhumanist, medicalization

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6719 Strategies for Good Governance during Crisis in Higher Education

Authors: Naziema B. Jappie

Abstract:

Over the last 23 years leaders in government, political parties and universities have been spending much time on identifying and discussing various gaps in the system that impact systematically on students especially those from historically Black communities. Equity and access to higher education were two critical aspects that featured in achieving the transformation goals together with a funding model for those previously disadvantaged. Free education was not a feasible option for the government. Institutional leaders in higher education face many demands on their time and resources. Often, the time for crisis management planning or consideration of being proactive and preventative is not a standing agenda item. With many issues being priority in academia, people become complacent and think that crisis may not affect them or they will cross the bridge when they get to it. Historically South Africa has proven to be a country of militancy, strikes and protests in most industries, some leading to disastrous outcomes. Higher education was not different between October 2015 and late 2016 when the #Rhodes Must Fall which morphed into the # Fees Must Fall protest challenged the establishment, changed the social fabric of universities, bringing the sector to a standstill. Some institutional leaders and administrators were better at handling unexpected, high-consequence situations than others. At most crisis leadership is viewed as a situation more than a style of leadership which is usually characterized by crisis management. The objective of this paper is to show how institutions managed catastrophes of disastrous proportions, down through unexpected incidents of 2015/2016. The content draws on the vast past crisis management experience of the presenter and includes the occurrences of the recent protests giving an event timeline. Using responses from interviews with institutional leaders and administrators as well as students will ensure first-hand information on their experiences and the outcomes. Students have tasted the power of organized action and they demand immediate change, if not the revolt will continue. This paper will examine the approaches that guided institutional leaders and their crisis teams and sector crisis response. It will further expand on whether the solutions effectively changed governance in higher education or has it minimized the need for more protests. The conclusion will give an insight into the future of higher education in South Africa from a leadership perspective.

Keywords: crisis, governance, intervention, leadership, strategies, protests

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6718 Northern Nigeria Vaccine Direct Delivery System

Authors: Evelyn Castle, Adam Thompson

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Background: In 2013, the Kano State Primary Health Care Management Board redesigned its Routine immunization supply chain from diffused pull to direct delivery push. It addressed issues around stockouts and reduced time spent by health facility staff collecting, and reporting on vaccine usage. The health care board sought the help of a 3PL for twice-monthly deliveries from its cold store to 484 facilities across 44 local governments. eHA’s Health Delivery Systems group formed a 3PL to serve 326 of these new facilities in partnership with the State. We focused on designing and implementing a technology system throughout. Basic methodologies: GIS Mapping: - Planning the delivery of vaccines to hundreds of health facilities requires detailed route planning for delivery vehicles. Mapping the road networks across Kano and Bauchi with a custom routing tool provided information for the optimization of deliveries. Reducing the number of kilometers driven each round by 20%, - reducing cost and delivery time. Direct Delivery Information System: - Vaccine Direct Deliveries are facilitated through pre-round planning (driven by health facility database, extensive GIS, and inventory workflow rules), manager and driver control panel customizing delivery routines and reporting, progress dashboard, schedules/routes, packing lists, delivery reports, and driver data collection applications. Move: Last Mile Logistics Management System: - MOVE has improved vaccine supply information management to be timely, accurate and actionable. Provides stock management workflow support, alerts management for cold chain exceptions/stock outs, and on-device analytics for health and supply chain staff. Software was built to be offline-first with user-validated interface and experience. Deployed to hundreds of vaccine storage site the improved information tools helps facilitate the process of system redesign and change management. Findings: - Stock-outs reduced from 90% to 33% - Redesigned current health systems and managing vaccine supply for 68% of Kano’s wards. - Near real time reporting and data availability to track stock. - Paperwork burdens of health staff have been dramatically reduced. - Medicine available when the community needs it. - Consistent vaccination dates for children under one to prevent polio, yellow fever, tetanus. - Higher immunization rates = Lower infection rates. - Hundreds of millions of Naira worth of vaccines successfully transported. - Fortnightly service to 326 facilities in 326 wards across 30 Local Government areas. - 6,031 cumulative deliveries. - Over 3.44 million doses transported. - Minimum travel distance covered in a round of delivery is 2000 kms & maximum of 6297 kms. - 153,409 kms travelled by 6 drivers. - 500 facilities in 326 wards. - Data captured and synchronized for the first time. - Data driven decision making now possible. Conclusion: eHA’s Vaccine Direct delivery has met challenges in Kano and Bauchi State and provided a reliable delivery service of vaccinations that ensure t health facilities can run vaccination clinics for children under one. eHA uses innovative technology that delivers vaccines from Northern Nigerian zonal stores straight to healthcare facilities. Helped healthcare workers spend less time managing supplies and more time delivering care, and will be rolled out nationally across Nigeria.

Keywords: direct delivery information system, health delivery system, GIS mapping, Northern Nigeria, vaccines

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6717 Accreditation and Quality Assurance of Nigerian Universities: The Management Imperative

Authors: F. O Anugom

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The general functions of the university amongst other things include teaching, research and community service. Universities are recognized as the apex of learning, accumulating and imparting knowledge and skills of all kinds to students to enable them to be productive, earn their living and to make optimum contributions to national development. This is equivalent to the production of human capital in the form of high level manpower needed to administer the educational society, be useful to the society and manage the economy. Quality has become a matter of major importance for university education in Nigeria. Accreditation is the systematic review of educational programs to ensure that acceptable standards of education, scholarship and infrastructure are being maintained. Accreditation ensures that institution maintain quality. The process is designed to determine whether or not an institution has met or exceeded the published standards for accreditation, and whether it is achieving its mission and stated purposes. Ensuring quality assurance in accreditation process falls in the hands of university management which justified the need for this study. This study examined accreditation and quality assurance: the management imperative. Three research questions and three hypotheses guided the study. The design was a correlation survey with a population of 2,893 university administrators out of which 578 Heads of department and Dean of faculties were sampled. The instrument for data collection was titled Programme Accreditation Exercise scale with high levels of reliability. The research questions were answered with Pearson ‘r’ statistics. T-test statistics was used to test the hypotheses. It was found among others that the quality of accredited programme depends on the level of funding of universities in Nigeria. It was also indicated that quality of programme accreditation and physical facilities of universities in Nigeria have high relationship. But it was also revealed that programme accreditation is positively related to staffing in Nigerian universities. Based on the findings of the study, the researcher recommend that academic administrators should be included in the team of those who ensure quality programs in the universities. Private sector partnership should be encouraged to fund programs to ensure quality of programme in the universities. Independent agencies should be engaged to monitor the activities of accreditation teams to avoid bias.

Keywords: accreditation, quality assurance, national universities commission , physical facilities, staffing

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6716 Sociocultural Context of Pain Management in Oncology and Palliative Nursing Care

Authors: Andrea Zielke-Nadkarni

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Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: pain management, migrants, sociocultural context, palliative care

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6715 Performance Management in Serbian Banks: Balanced Scorecard Approach

Authors: Nela Milosevic, Sladjana Barjaktarovic Rakocevic, Sladjana Benkovic, Nemanja Milanovic

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Nowadays, performance measurement systems play a key role in evaluating the strategic performances of an organization. On the other hand, there has been a shift towards the Balanced Scorecard (BSC), which has been recognized as a valuable managerial approach. The main goal of this paper is to analyze the main performances of Serbian banks measured at the branches level, through the usage of the Balanced Scorecard framework. Although an extensive number of practitioners have an interest in the Balanced Scorecard approach, little empirical research has been conducted on the implementation of its concept in the service sector like banks, especially within developing countries. From the beginning of August till the end of September 2015, authors have been conducting in-depth interviews among a number of experts from the most successful banks in Serbia. The results show that the non-financial measures, especially, customer oriented indicators and product/ service oriented indicators, seem to be very important factors for improving not only the financial situation within the bank, but also overall business performances. Additionally, the findings prove that there is the cause-effect relationship between non-financial and financial dimensions of the Balanced Scorecard. Having in mind that the banks are still using outdated performance evaluation systems, such as annual, quarterly and monthly reports, we hope that this paper will contribute to the knowledge of how banks in Serbia may apply the Balanced Scorecard approach to evaluate their performance on the most efficient and effective way.

Keywords: balanced scorecard approach, bank management, performance measurement systems, strategic performances

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6714 A Sustainable Energy Portfolio for Greater Kampala Metropolitan Area by the Mid-Century

Authors: Ismail Kimuli

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With a steadfast economic development, the Greater Kampala metropolitan area (GKMA) faces increasing pressures to increasetheshare of low-carbon electricity in the energy balance, abate CO2 emissions and also restructure the transportation sector for a sustainable 2050. GKMA, is Uganda’s commercial, political, social, and industrial hub with a population of 4.1 million, contributing 60% tothe nation’s GDP and accounts for 80% of Uganda’s industrial sector.However, with the rampant anthropogenic interference that causes climate change, CO2 emissions in the metropolitan are contributing to global warming. Many economies across the globe are addressing this challengethrough development and analysis of sustainable energy portfolios.A sustainable energy portfolio is a low-carbon scenario. The study reviews the literature to establish the current energy management situation of GKMA and finds it wanting in addressing the immediate challenges associated with energy management of the metropolitan. Then, the study develops and examines a sustainable energy portfolio for GKMA using TIMES-VEDA and then presents it as an investigative low-carbon energy scenario that could propel the metropolitan sustainably towards 2050.Sustainability is plausible by optimizing the total primary energy supply, generating low-carbon electricity from hydropower and PV-solar renewables, improving heating technologies for residential & commercial sectors, and switching 90% of land passengers from road to a Kampala metro for a sustainable mid-century.

Keywords: GKMA, sustainability, TIMES-VEDA, low-carbon scenario

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6713 A Framework Factors Influencing Accounting Information Systems Adoption Success

Authors: Manirath Wongsim

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AIS plays an important role in business management, strategic and can provide assistance in all phases of decision making. Thus, many organisations needs to be seen as well adopting AIS, which is critical to a company in order to organise, manage and operate process in all sections. In order to implement AIS successfully, it is important to understand the underlying factors that influence the AIS adoption. Therefore, this research intends to study this perspective of factors influence and impact on AIS adoption’s success. The model has been designed to illustrate factors influences in AIS adoption. It also attempts to identify the critical success factors that organisations should focus on, to ensure the adoption on accounting process. This framework will be developed from case studies by collecting qualitative and quantitative data. Case study and survey methodology were adopted for this research. Case studies in two Thai- organisations were carried out. The results of the two main case studies suggested 9 factors that may have impact on in AIS adoption. Survey instrument was developed based on the findings from case studies. Two large-scale surveys were sent to selected members of Thailand Accountant, and Thailand Computer Society to further develop and test the research framework. The top three critical factors for ensuring AIS adoption were: top management commitment, steering committees, and Technical capability of AIS personnel. That is, it is now clear which factors impact in AIS adoption, and which of those factors are critical success factors for ensuring AIS adoption successes

Keywords: accounting information system, accounting information systems adoption, and inflecting AIS adoption

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6712 Effectiveness of Jute Geotextiles for Hill Slope Stabilization in Adverse Climatic Condition

Authors: Pradip Choudhury, Tapobrata Sanyal

Abstract:

Effectiveness of Jute Geotextiles (JGT) in hill slope management now stands substantiated. The reasons of its efficacy are attributed to its bio-degradability, hygroscopic property and its thickness. Usually open weave JGT is used for slope management. Thickness of JGT helps in reducing the velocity of surface run-off, thus curbing the extent of migration of soil particles detached as a result of kinetic energy of rain-drops and also of wind effects. Initially JGT acts as cover of the surface of slope thus protect movement of loose soil particles. Hygroscopic property of jute effects overland storage of the flow. JGT acts as mulch and creates a congenial micro-climate that fosters quick growth of vegetation on bio-degradation. In fact JGT plays an important role in bio-remediation of slope-erosion problems. Considering the environmental aftermath, JGT is the preferred option in developed countries for surface soil conservation against erosion. In India JGT has not been tried in low temperature zones at high altitudes where temperature goes below the freezing point (even below - 25° Celsius). The behavior of JGT in such low-temperature zones is not precisely known. The 16th BRTF of Project Himank of Border Roads Organization (BRO) has recently taken the initiative to try two varieties of JGT , ie, 292 gsm and 500 gsm at two different places for hill slope management in Leh, a high altitude place of about 2,660 mtrs and 4900 mtrs above MSL respectively in Jammu & Kashmir where erosion is caused more as a result of rapid movement of sand particles due to high wind (wind erosion. Soil particles of the region formed naturally by weathering of fragile rocks are usually loosely bonded (non-cohesive), undergo dissociation with the rise in wind force and kinetic energy of rain drops and are blown away by wind. Open weave JGT interestingly was observed to contain the dissociated soil particles within its pores and lend stability the affected soil mass to a great extent thus preventing its movement by extraneous agents such as wind. The paper delineates about climatic factors, type of JGT used and the prevailing site conditions with an attempt to analyze the mechanism of functioning of JGT in low temperature zones.

Keywords: climate, erosion, jutegeotextile, stabilize

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6711 Workforce Optimization: Fair Workload Balance and Near-Optimal Task Execution Order

Authors: Alvaro Javier Ortega

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A large number of companies face the challenge of matching highly-skilled professionals to high-end positions by human resource deployment professionals. However, when the professional list and tasks to be matched are larger than a few dozens, this process result is far from optimal and takes a long time to be made. Therefore, an automated assignment algorithm for this workforce management problem is needed. The majority of companies are divided into several sectors or departments, where trained employees with different experience levels deal with a large number of tasks daily. Also, the execution order of all tasks is of mater consequence, due to some of these tasks just can be run it if the result of another task is provided. Thus, a wrong execution order leads to large waiting times between consecutive tasks. The desired goal is, therefore, creating accurate matches and a near-optimal execution order that maximizes the number of tasks performed and minimizes the idle time of the expensive skilled employees. The problem described before can be model as a mixed-integer non-linear programming (MINLP) as it will be shown in detail through this paper. A large number of MINLP algorithms have been proposed in the literature. Here, genetic algorithm solutions are considered and a comparison between two different mutation approaches is presented. The simulated results considering different complexity levels of assignment decisions show the appropriateness of the proposed model.

Keywords: employees, genetic algorithm, industry management, workforce

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6710 Uncommon Presentation of Iscahemic Heart Disease with Sheehan’s Syndrome at Mid-Level Private Hospital of Bangladesh and Its Management- A Case Report

Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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6709 Predicting Foreign Direct Investment of IC Design Firms from Taiwan to East and South China Using Lotka-Volterra Model

Authors: Bi-Huei Tsai

Abstract:

This work explores the inter-region investment behaviors of integrated circuit (IC) design industry from Taiwan to China using the amount of foreign direct investment (FDI). According to the mutual dependence among different IC design industrial locations, Lotka-Volterra model is utilized to explore the FDI interactions between South and East China. Effects of inter-regional collaborations on FDI flows into China are considered. Evolutions of FDIs into South China for IC design industry significantly inspire the subsequent FDIs into East China, while FDIs into East China for Taiwan’s IC design industry significantly hinder the subsequent FDIs into South China. The supply chain along IC industry includes IC design, manufacturing, packing and testing enterprises. I C manufacturing, packaging and testing industries depend on IC design industry to gain advanced business benefits. The FDI amount from Taiwan’s IC design industry into East China is the greatest among the four regions: North, East, Mid-West and South China. The FDI amount from Taiwan’s IC design industry into South China is the second largest. If IC design houses buy more equipment and bring more capitals in South China, those in East China will have pressure to undertake more FDIs into East China to maintain the leading position advantages of the supply chain in East China. On the other hand, as the FDIs in East China rise, the FDIs in South China will successively decline since capitals have concentrated in East China. Prediction of Lotka-Volterra model in FDI trends is accurate because the industrial interactions between the two regions are included. Finally, this work confirms that the FDI flows cannot reach a stable equilibrium point, so the FDI inflows into East and South China will expand in the future.

Keywords: Lotka-Volterra model, foreign direct investment, competitive, Equilibrium analysis

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6708 Crowdsensing Project in the Brazilian Municipality of Florianópolis for the Number of Visitors Measurement

Authors: Carlos Roberto De Rolt, Julio da Silva Dias, Rafael Tezza, Luca Foschini, Matteo Mura

Abstract:

The seasonal population fluctuation presents a challenge to touristic cities since the number of inhabitants can double according to the season. The aim of this work is to develop a model that correlates the waste collected with the population of the city and also allow cooperation between the inhabitants and the local government. The model allows public managers to evaluate the impact of the seasonal population fluctuation on waste generation and also to improve planning resource utilization throughout the year. The study uses data from the company that collects the garbage in Florianópolis, a Brazilian city that presents the profile of a city that attracts tourists due to numerous beaches and warm weather. The fluctuations are caused by the number of people that come to the city throughout the year for holidays, summer time vacations or business events. Crowdsensing will be accomplished through smartphones with access to an app for data collection, with voluntary participation of the population. Crowdsensing participants can access information collected in waves for this portal. Crowdsensing represents an innovative and participatory approach which involves the population in gathering information to improve the quality of life. The management of crowdsensing solutions plays an essential role given the complexity to foster collaboration, establish available sensors and collect and process the collected data. Practical implications of this tool described in this paper refer, for example, to the management of seasonal tourism in a large municipality, whose public services are impacted by the floating of the population. Crowdsensing and big data support managers in predicting the arrival, permanence, and movement of people in a given urban area. Also, by linking crowdsourced data to databases from other public service providers - e.g., water, garbage collection, electricity, public transport, telecommunications - it is possible to estimate the floating of the population of an urban area affected by seasonal tourism. This approach supports the municipality in increasing the effectiveness of resource allocation while, at the same time, increasing the quality of the service as perceived by citizens and tourists.

Keywords: big data, dashboards, floating population, smart city, urban management solutions

Procedia PDF Downloads 293
6707 Assessment of the Standard of Referrals for Extraction of Carious Primary Teeth under General Anaesthetic

Authors: Emma Carr, Jennifer Morrison, Peter Walker

Abstract:

Background: Due to COVID-19, there was a significant reduction in the number of children being treated under general anaesthetic (GA) within the health board, which led to a backlog of referrals. The referrals were being triaged and added to a waiting list in order of priority -determined by the information given. By implementing a checklist, it is anticipated that at least 70% of referrals will have the majority of the information required to effectively prioritise patients. The gold standard, as defined in ‘Guidelines For The Management Of Children Referred For Dental Extractions Under General Anaesthesia’, indicates that all referrals should mention: (i) Inability of the child to cooperate, (ii) Previously tried anxiety management techniques, (iii) Existence of psychological disorders, (iv) Presence of acute dental infection, (v) Requirement for extractions in multiple quadrants. Method: 130 referrals were examined over three months and compared to the recommended standard. A letter was emailed to referring dentists within Ayrshire & Arran outlining the recommended information to be included within the referral. The second round of data collection was then carried out, which involved an examination of 105 referrals. Results: The first round revealed that only 28% of referrals mentioned at least four defined standards outlined above. Following issuing a checklist to all dentists, this increased to 72%. Conclusion: As many of the children referred for extractions under GA have suffered pain and infection because of dental caries, it is important that delay of treatment is minimised, where possible. The implementation of a standardised checklist has enabled more effective prioritisation of patients.

Keywords: caries, dentistry, general anaesthetic, paediatrics

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6706 The Effectiveness of High-Frequency Repetitive Transcranial Magnetic Stimulation in Persistent Somatic Symptoms Disorder: A Case Report Study

Authors: Mohammed Khamis Albalushi

Abstract:

Background: Somatic symptoms disorders are usually comorbid with depressive disorders despite the fact that there is little evidence for effective treatment for it. Repetitive transcranial magnetic stimulation (rTMS) has been approved by the FDA for mildly resistant depression. From this point, we hypothesized that rTMS delivered over the prefrontal cortex (PFC) may be useful in somatic symptoms disorder. Therefore, in our case report, we want to shed light on the potential effectiveness of rTMS in somatic symptoms disorder. Case Report: A 65-year-old Omani female with multiple medical comorbidities on multiple medications. She presented complaining of multiple somatic complaints in the last 2 years after visiting multiple clinics and underwent several specialists’ examinations, investigations and procedures for somatic treatments; all of them were normal. Then patient was seen by a different psychiatric clinic; multiple anti-depressant and adjuvant anti-psychotic medications were tried, patient still did not improve. The patient was admitted to the hospital for observation and management. Initially, she was preoccupied with her somatic complaint and kept on Fluoxetine and Olanzapine along with that, topiramate was added, but still with minimal improvement. Then rTMS was added to her management plan following Intermittent theta burst (iTBS) rTMS protocol. After completing all sessions of rTMS, the patient was recovering from all her symptoms, and no complaints were reported from her. Conclusion: Our case highlights the importance of investigating more thoroughly in rTMS as a treatment option for Persistent Somatic symptoms Disorder.

Keywords: rTMS, somatic symptoms disorder, resistive cases, TMS

Procedia PDF Downloads 64
6705 The Relationship between the Use of Social Networks with Executive Functions and Academic Performance in High School Students in Tehran

Authors: Esmail Sadipour

Abstract:

The use of social networks is increasing day by day in all societies. The purpose of this research was to know the relationship between the use of social networks (Instagram, WhatsApp, and Telegram) with executive functions and academic performance in first-year female high school students. This research was applied in terms of purpose, quantitative in terms of data type, and correlational in terms of technique. The population of this research consisted of all female high school students in the first year of district 2 of Tehran. Using Green's formula, the sample size of 150 people was determined and selected by cluster random method. In this way, from all 17 high schools in district 2 of Tehran, 5 high schools were selected by a simple random method and then one class was selected from each high school, and a total of 155 students were selected. To measure the use of social networks, a researcher-made questionnaire was used, the Barclay test (2012) was used for executive functions, and last semester's GPA was used for academic performance. Pearson's correlation coefficient and multivariate regression were used to analyze the data. The results showed that there is a negative relationship between the amount of use of social networks and self-control, self-motivation and time self-management. In other words, the more the use of social networks, the fewer executive functions of students, self-control, self-motivation, and self-management of their time. Also, with the increase in the use of social networks, the academic performance of students has decreased.

Keywords: social networks, executive function, academic performance, working memory

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6704 Electronic Payment Recording with Payment History Retrieval Module: A System Software

Authors: Adrian Forca, Simeon Cainday III

Abstract:

The Electronic Payment Recording with Payment History Retrieval Module is developed intendedly for the College of Science and Technology. This system software innovates the manual process of recording the payments done in the department through the development of electronic payment recording system software shifting from the slow and time-consuming procedure to quick yet reliable and accurate way of recording payments because it immediately generates receipts for every transaction. As an added feature to its software process, generation of recorded payment report is integrated eliminating the manual reporting to a more easy and consolidated report. As an added feature to the system, all recorded payments of the students can be retrieved immediately making the system transparent and reliable payment recording software. Viewing the whole process, the system software will shift from the manual process to an organized software technology because the information will be stored in a logically correct and normalized database. Further, the software will be developed using the modern programming language and implement strict programming methods to validate all users accessing the system, evaluate all data passed into the system and information retrieved to ensure data accuracy and reliability. In addition, the system will identify the user and limit its access privilege to establish boundaries of the specific access to information allowed for the store, modify, and update making the information secure against unauthorized data manipulation. As a result, the System software will eliminate the manual procedure and replace with an innovative modern information technology resulting to the improvement of the whole process of payment recording fast, secure, accurate and reliable software innovations.

Keywords: collection, information system, manual procedure, payment

Procedia PDF Downloads 171
6703 Information Management Approach in the Prediction of Acute Appendicitis

Authors: Ahmad Shahin, Walid Moudani, Ali Bekraki

Abstract:

This research aims at presenting a predictive data mining model to handle an accurate diagnosis of acute appendicitis with patients for the purpose of maximizing the health service quality, minimizing morbidity/mortality, and reducing cost. However, acute appendicitis is the most common disease which requires timely accurate diagnosis and needs surgical intervention. Although the treatment of acute appendicitis is simple and straightforward, its diagnosis is still difficult because no single sign, symptom, laboratory or image examination accurately confirms the diagnosis of acute appendicitis in all cases. This contributes in increasing morbidity and negative appendectomy. In this study, the authors propose to generate an accurate model in prediction of patients with acute appendicitis which is based, firstly, on the segmentation technique associated to ABC algorithm to segment the patients; secondly, on applying fuzzy logic to process the massive volume of heterogeneous and noisy data (age, sex, fever, white blood cell, neutrophilia, CRP, urine, ultrasound, CT, appendectomy, etc.) in order to express knowledge and analyze the relationships among data in a comprehensive manner; and thirdly, on applying dynamic programming technique to reduce the number of data attributes. The proposed model is evaluated based on a set of benchmark techniques and even on a set of benchmark classification problems of osteoporosis, diabetes and heart obtained from the UCI data and other data sources.

Keywords: healthcare management, acute appendicitis, data mining, classification, decision tree

Procedia PDF Downloads 354
6702 The Impact of Supply Chain Strategy and Integration on Supply Chain Performance: Supply Chain Vulnerability as a Moderator

Authors: Yi-Chun Kuo, Jo-Chieh Lin

Abstract:

The objective of a supply chain strategy is to reduce waste and increase efficiency to attain cost benefits, and to guarantee supply chain flexibility when facing the ever-changing market environment in order to meet customer requirements. Strategy implementation aims to fulfill common goals and attain benefits by integrating upstream and downstream enterprises, sharing information, conducting common planning, and taking part in decision making, so as to enhance the overall performance of the supply chain. With the rise of outsourcing and globalization, the increasing dependence on suppliers and customers and the rapid development of information technology, the complexity and uncertainty of the supply chain have intensified, and supply chain vulnerability has surged, resulting in adverse effects on supply chain performance. Thus, this study aims to use supply chain vulnerability as a moderating variable and apply structural equation modeling (SEM) to determine the relationships among supply chain strategy, supply chain integration, and supply chain performance, as well as the moderating effect of supply chain vulnerability on supply chain performance. The data investigation of this study was questionnaires which were collected from the management level of enterprises in Taiwan and China, 149 questionnaires were received. The result of confirmatory factor analysis shows that the path coefficients of supply chain strategy on supply chain integration and supply chain performance are positive (0.497, t= 4.914; 0.748, t= 5.919), having a significantly positive effect. Supply chain integration is also significantly positively correlated to supply chain performance (0.192, t = 2.273). The moderating effects of supply chain vulnerability on supply chain strategy and supply chain integration to supply chain performance are significant (7.407; 4.687). In Taiwan, 97.73% of enterprises are small- and medium-sized enterprises (SMEs) focusing on receiving original equipment manufacturer (OEM) and original design manufacturer (ODM) orders. In order to meet the needs of customers and to respond to market changes, these enterprises especially focus on supply chain flexibility and their integration with the upstream and downstream enterprises. According to the observation of this research, the effect of supply chain vulnerability on supply chain performance is significant, and so enterprises need to attach great importance to the management of supply chain risk and conduct risk analysis on their suppliers in order to formulate response strategies when facing emergency situations. At the same time, risk management is incorporated into the supply chain so as to reduce the effect of supply chain vulnerability on the overall supply chain performance.

Keywords: supply chain integration, supply chain performance, supply chain vulnerability, structural equation modeling

Procedia PDF Downloads 325
6701 The Identification of Environmentally Friendly People: A Case of South Sumatera Province, Indonesia

Authors: Marpaleni

Abstract:

The intergovernmental Panel on Climate Change (IPCC) declared in 2007 that global warming and climate change are not just a series of events caused by nature, but rather caused by human behaviour. Thus, to reduce the impact of human activities on climate change it is required to have information about how people respond to the environmental issues and what constraints they face. However, information on these and other phenomena remains largely missing, or not fully integrated within the existing data systems. The proposed study is aimed at filling the gap in this knowledge by focusing on Environmentally Friendly Behaviour (EFB) of the people of Indonesia, by taking the province of South Sumatera as a case of study. EFB is defined as any activity in which people engage to improve the conditions of the natural resources and/or to diminish the impact of their behaviour on the environment. This activity is measured in terms of consumption in five areas at the household level, namely housing, energy, water usage, recycling and transportation. By adopting the Indonesia’s Environmentally Friendly Behaviour conducted by Statistics Indonesia in 2013, this study aims to precisely identify one’s orientation towards EFB based on socio demographic characteristics such as: age, income, occupation, location, education, gender and family size. The results of this research will be useful to precisely identify what support people require to strengthen their EFB, to help identify specific constraints that different actors and groups face and to uncover a more holistic understanding of EFB in relation to particular demographic and socio-economics contexts. As the empirical data are examined from the national data sample framework, which will continue to be collected, it can be used to forecast and monitor the future of EFB.

Keywords: environmentally friendly behavior, demographic, South Sumatera, Indonesia

Procedia PDF Downloads 287
6700 A Framework for University Social Responsibility and Sustainability: The Case of South Valley University, Egypt

Authors: Alaa Tag-Eldin Mohamed

Abstract:

The environmental, cultural, social, and technological changes have led higher education institutes to question their traditional roles. Many declarations and frameworks highlight the importance of fulfilling social responsibility of higher education institutes. The study aims at developing a framework of university social responsibility and sustainability (USR&S) with focus on South Valley University (SVU) as a case study of Egyptian Universities. The study used meetings with 12 vice deans of community services and environmental affairs on social responsibility and environmental issues. The proposed framework integrates social responsibility with strategic management through the establishment and maintenance of the vision, mission, values, goals and management systems; elaboration of policies; provision of actions; evaluation of services and development of social collaboration with stakeholders to meet current and future needs of the community and environment. The framework links between different stakeholders internally and externally using communication and reporting tools. The results show that SVU integrates social responsibility and sustainability in its strategic plans. It has policies and actions however fragmented and lack of appropriate structure and budgeting. The proposed framework could be valuable for researchers and decision makers of the Egyptian Universities. The study proposed recommendations and highlighted building on the results and conducting future research.

Keywords: corporate social responsibility (CSR), south valley university, sustainable university, university social responsibility and sustainability (USR&S)

Procedia PDF Downloads 350
6699 Endometrial Thickness Cut-Off for Evacuation of Retained Product of Conception

Authors: Nambiar Ritu, Ali Ban, Munawar Farida, Israell Imelda, T. Farouk Eman Rasheeda, Jangalgi Renuka, S. Boma Nellie

Abstract:

Aim: To define the ultrasonographic endometrial thickness (USG ET) cutoff for evacuation of retained pieces of conception (ERPC). Background: Studies of conservative management of 1st trimester miscarriage have questioned the need for post miscarriage curettage. Therapeutic decision making with transvaginal scan post miscarriage endometrial thickness in patients clinically thought to be incomplete miscarriage is often not clear. Method: Retrospective analysis of all 1ST trimester ERPC at Al Rahba Hospital from June 2012 to July 2013 was done. Total of 164 patients underwent ERPC. All cases were reviewed for pre-operative USG ET and post ERPC histopathological examination. TVS was done to evaluate the maximum ET of the uterine cavity along the long axis of the uterus and features of retained products was noted. All cases without preoperative USG ET measurement were excluded from the study, therefore only 62 out of 164 cases were included in the study. The patients were divided into three groups: o Group A: have retained products within endometrial cavity. o Group B: endometrial thickness equal or more than 20 mm. o Group C: endometrial thickness equal or less than 19.9 mm. o Post ERPC product was sent for HPE and the results were compared. Transvaginal sonographic findings can be used as a deciding factor in the management of patients with 1st trimester miscarriage who need ERPC. Our proposed cutoff in clinically stable patients requiring ERPC is more than 20 mm.

Keywords: ERPC, histopathological examination, long axis of the uterus, USG ET

Procedia PDF Downloads 220
6698 Flexible and Color Tunable Inorganic Light Emitting Diode Array for High Resolution Optogenetic Devices

Authors: Keundong Lee, Dongha Yoo, Youngbin Tchoe, Gyu-Chul Yi

Abstract:

Light emitting diode (LED) array is an ideal optical stimulation tool for optogenetics, which controls inhibition and excitation of specific neurons with light-sensitive ion channels or pumps. Although a fiber-optic cable with an external light source, either a laser or LED mechanically connected to the end of the fiber-optic cable has widely been used for illumination on neural tissue, a new approach to use micro LEDs (µLEDs) has recently been demonstrated. The LEDs can be placed directly either on the cortical surface or within the deep brain using a penetrating depth probe. Accordingly, this method would not need a permanent opening in the skull if the LEDs are integrated with miniature electrical power source and wireless communication. In addition, multiple color generation from single µLED cell would enable to excite and/or inhibit neurons in localized regions. Here, we demonstrate flexible and color tunable µLEDs for the optogenetic device applications. The flexible and color tunable LEDs was fabricated using multifaceted gallium nitride (GaN) nanorod arrays with GaN nanorods grown on InxGa1−xN/GaN single quantum well structures (SQW) anisotropically formed on the nanorod tips and sidewalls. For various electroluminescence (EL) colors, current injection paths were controlled through a continuous p-GaN layer depending on the applied bias voltage. The electric current was injected through different thickness and composition, thus changing the color of light from red to blue that the LED emits. We believe that the flexible and color tunable µLEDs enable us to control activities of the neuron by emitting various colors from the single µLED cell.

Keywords: light emitting diode, optogenetics, graphene, flexible optoelectronics

Procedia PDF Downloads 212
6697 Institutional Design for Managing Irrigation Problems: A Case Study of Farmers'- and Agency-Managed Irrigation Systems of Nepal

Authors: Tirtha Raj Dhakal, Brian Davidson, Bob Farquharson

Abstract:

Institutional design is an important aspect in efficient water resource management. In Nepal, the water supply in both farmers’- and agency-managed irrigation systems has become sub-standard because of the weak institutional framework. This study characterizes both forms of the schemes and links existing institution and governance of the schemes with its performance with reference to cost recovery, maintenance of the schemes and water distribution throughout the schemes. For this, two types of surveys were conducted. A management survey of ten farmers’-managed and five agency-managed schemes of Chitwan valley and its periphery was done. Also, a farm survey comprising 25 farmers from each of head, middle and tail regions of both schemes; Narayani Lift Irrigation Project (agency-managed) and Khageri Irrigation System (farmers’-managed) of Chitwan Valley as a case study was conducted. The results showed that cost recovery of agency-managed schemes in 2015 was less than two percent whereas service fee collection rate in farmers’-managed schemes was nearly 2/3rd that triggered poor maintenance of the schemes and unequal distribution of water throughout the schemes. Also, the institution on practice is unable to create any incentives for farmers for economical use of water as well as willingness to pay for its use. This, thus, compels the need of refined institutional framework which has been suggested in this paper aiming to improve the cost recovery and better water distribution throughout the irrigation schemes.

Keywords: cost recovery, governance, institution, schemes' performance

Procedia PDF Downloads 263
6696 Exploring the Issue of Occult Hypoperfusion in the Pre-Hospital Setting

Authors: A. Fordham, A. Hudson

Abstract:

Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.

Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma

Procedia PDF Downloads 361