Search results for: database management
5078 To Compare Norepinephrine and Norepinephrine with Methylene Blue for the Management of Septic Shock
Authors: K. Rajarajeswaran, Krishna Prasad
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Introduction: Refractory shock is a typical consequence of sepsis that does not improve with standard vasopressor therapy. A possible adjuvant therapeutic option for treating refractory shock in sepsis is methylene blue. This study looked at the effects of intravenous methylene blue plus norepinephrine given as a single bolus infusion on mortality and hemodynamic improvement in patients suffering from refractory shock. Methodology: This six-month observational prospective study was carried out at an intensive care unit, teaching hospital, and medical college. It involved 112 patients who had been diagnosed with refractory septic shock and needed vasopressor medication. Group B received injection norepinephrine 0.01 µg/kg/min infusion alone, while Group A received injection methylene blue 2 mg/kg iv single bolus (fixed dose) in addition to injection norepinephrine 0.01 µg/kg/min infusion. Both groups' noradrenaline doses were titrated to reach the desired MAP of 60–75 mm Hg. The amount of norepinephrine needed to sustain a MAP of more than 60 mm Hg was the data gathered. Serum lactate, procalcitonin level, C-reactive protein, length of stay in the intensive care unit (ICU), sequential organ failure assessment (SOFA) score, and duration of mechanical ventilation, incidence of acute kidney injury (AKI), and mortality were compared. Results: A total of 112 patients with refractory shock were included in the study. With the use of IV methylene blue, 36 (59.3%) patients showed significant improvement in MAP within 2 hours (77.12 ± 8.90 vs 74.28 ± 21.84, p = 0.005). Responders were 4.009 times more likely to have vasopressor-free time within 24 hours (19.5% vs 6.1%, p = 0.022, odds ratio 5.017, 95% confidence interval, 1.110–14.283). The serum lactate was lower, and urine output was higher in group I than in group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. However, there was no significant difference in terms of mortality, length of ICU stay, ventilator free days, and incidence of AKI. In the responder group, there was a significant increase in the MAP and decrease in vasopressor requirement pre- and post-infusion of methylene blue (p < 0.05). Responder had shorter vasopressor-free days as compared with non-responder (5.44 vs 6.99, p = 0.007). Conclusion: When administered as adjuvant therapy, a single-dose bolus infusion of Methylene Blue plus Norepinephrine may aid in meeting early resuscitation goals for the management of patients with septic shock. But the patients' death rate, ICU stay duration, ventilator-free days, or incidence of AKI were unchanged.Keywords: norepinephrine, methylene blue, shock, vasopressor
Procedia PDF Downloads 215077 Case Report of a Secretory Carcinoma of the Salivary Gland: Clinical Management Following High-Grade Transformation
Authors: Wissam Saliba, Mandy Nicholson
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Secretory carcinoma (SC) is a rare type of salivary gland cancer. It was first realized as a distinct type of malignancy in 2010and wasinitially termed “mammary analogue secretory carcinoma” because of similarities with secretory breast cancer. The name was later changed to SC. Most SCs originate in parotid glands, and most harbour a rare gene mutation: ETV6-NTRK3. This mutation is rare in common cancers and common in rare cancers; it is present in most secretory carcinomas. Disease outcomes for SC are usually described as favourable as many cases of SC are lowgrade (LG), and cancer growth is slow. In early stages, localized therapy is usually indicated (surgery and/or radiation). Despitea favourable prognosis, a sub-set of casescan be much more aggressive.These cases tend to be of high-grade(HG).HG casesare associated with a poorer prognosis.Management of such cases can be challenging due to limited evidence for effective systemic therapy options. This case report describes the clinical management of a 46-year-oldmale patient with a unique case of SC. He was initially diagnosed with a low/intermediate grade carcinoma of the left parotid gland in 2009; he was treated with surgery and adjuvant radiation. Surgical pathology favoured primary salivary adenocarcinoma, and 2 lymph nodes were positive for malignancy. SC was not yet realized as a distinct type of cancerat the time of diagnosis, and the pathology reportvalidated this gap by stating that the specimen lacked features of the defined types of salivary carcinoma.Slow-growing pulmonary nodules were identified in 2017. In 2020, approximately 11 years after the initial diagnosis, the patient presented with malignant pleural effusion. Pathology from a pleural biopsy was consistent with metastatic poorly differentiated cancer of likely parotid origin, likely mammary analogue secretory carcinoma. The specimen was sent for Next Generation Sequencing (NGS); ETV6-NTRK3 gene fusion was confirmed, and systemic therapy was initiated.One cycle ofcarboplatin/paclitaxel was given in June 2020. He was switched to Larotrectinib (NTRK inhibitor (NTRKi)) later that month. Larotrectinib continued for approximately 9 months, with discontinuation in March 2021 due to disease progression. A second-generation NTRKi (Selitrectinib) was accessed and prescribedthrough a single patient study. Selitrectinib was well tolerated. The patient experienced a complete radiological response within~4 months. Disease progression occurred once again in October 2021. Progression was slow, and Selitrectinib continuedwhile the medical team performed a thorough search for additional treatment options. In January 2022, a liver lesion biopsy was performed, and NGS showed an NTRKG623R solvent-front resistance mutation. Various treatment pathways were considered. The patient pursuedanother investigational NTRKi through a clinical trial, and Selitrectinib was discontinued in July 2022. Excellent performance status was maintained throughout the entire course of treatment.It can be concluded that NTRK inhibitors provided satisfactory treatment efficacy and tolerance for this patient with high-grade transformation and NTRK gene fusion cancer. In the future, more clinical research is needed on systemic treatment options for high-grade transformations in NTRK gene fusion SCs.Keywords: secretory carcinoma, high-grade transformations, NTRK gene fusion, NTRK inhibitor
Procedia PDF Downloads 1085076 Identification of Service Quality Determinants in the Hotel Sector - A Conceptual Review
Authors: Asem M. Othman
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The expansion of the hospitality industry is unmistakable. Services, by nature, are intangible. Hence, service quality, in general, is a complicated process to be measured and evaluated. Hotels, as a service sector and part of the hospitality industry, are growing rapidly. This research paper was carried out to identify the quality determinants that may affect hotel guests’ service quality perception. In this research paper, each quality determinant will be discussed, illustrated, and justified thoroughly via a systematic literature review. The purpose of this paper is to set the stage to measure the significant influence of the service quality determinants on guest satisfaction. The knowledge produced from this study will assist practitioners and/or hotel service providers to imply into their policies.Keywords: service quality, hotel service, quality management, quality determinants
Procedia PDF Downloads 2745075 Examination of the South African Fire Legislative Framework
Authors: Mokgadi Julia Ngoepe-Ntsoane
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The article aims to make a case for a legislative framework for the fire sector in South Africa. Robust legislative framework is essential for empowering those with obligatory mandate within the sector. This article contributes to the body of knowledge in the field of policy reviews particularly with regards to the legal framework. It has been observed overtime that the scholarly contributions in this field are limited. Document analysis was the methodology selected for the investigation of the various legal frameworks existing in the country. It has been established that indeed the national legislation on the fire industry does not exist in South Africa. From the documents analysed, it was revealed that the sector is dominated by cartels who are exploiting the new entrants to the market particularly SMEs. It is evident that these cartels are monopolising the system as they have long been operating in the system turning it into self- owned entities. Commitment to addressing the challenges faced by fire services and creating a framework for the evolving role that fire brigade services are expected to execute in building safer and sustainable communities is vital. Legislation for the fire sector ought to be concluded with immediate effect. The outdated national fire legislation has necessitated the monopolisation and manipulation of the system by dominating organisations which cause a painful discrimination and exploitation of smaller service providers to enter the market for trading in that occupation. The barrier to entry bears long term negative effects on national priority areas such as employment creation, poverty, and others. This monopolisation and marginalisation practices by cartels in the sector calls for urgent attention by government because if left attended, it will leave a lot of people particularly women and youth being disadvantaged and frustrated. The downcast syndrome exercised within the fire sector has wreaked havoc and is devastating. This is caused by cartels that have been within the sector for some time, who know the strengths and weaknesses of processes, shortcuts, advantages and consequences of various actions. These people take advantage of new entrants to the sector who in turn find it difficult to manoeuvre, find the market dissonant and end up giving up their good ideas and intentions. There are many pieces of legislation which are industry specific such as housing, forestry, agriculture, health, security, environmental which are used to regulate systems within the institutions involved. Other regulations exist as bi-laws for guiding the management within the municipalities.Keywords: sustainable job creation, growth and development, transformation, risk management
Procedia PDF Downloads 1755074 Opportunities for Reducing Post-Harvest Losses of Cactus Pear (Opuntia Ficus-Indica) to Improve Small-Holder Farmers Income in Eastern Tigray, Northern Ethiopia: Value Chain Approach
Authors: Meron Zenaselase Rata, Euridice Leyequien Abarca
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The production of major crops in Northern Ethiopia, especially the Tigray Region, is at subsistence level due to drought, erratic rainfall, and poor soil fertility. Since cactus pear is a drought-resistant plant, it is considered as a lifesaver fruit and a strategy for poverty reduction in a drought-affected area of the region. Despite its contribution to household income and food security in the area, the cactus pear sub-sector is experiencing many constraints with limited attention given to its post-harvest loss management. Therefore, this research was carried out to identify opportunities for reducing post-harvest losses and recommend possible strategies to reduce post-harvest losses, thereby improving production and smallholder’s income. Both probability and non-probability sampling techniques were employed to collect the data. Ganta Afeshum district was selected from Eastern Tigray, and two peasant associations (Buket and Golea) were also selected from the district purposively for being potential in cactus pear production. Simple random sampling techniques were employed to survey 30 households from each of the two peasant associations, and a semi-structured questionnaire was used as a tool for data collection. Moreover, in this research 2 collectors, 2 wholesalers, 1 processor, 3 retailers, 2 consumers were interviewed; and two focus group discussion was also done with 14 key farmers using semi-structured checklist; and key informant interview with governmental and non-governmental organizations were interviewed to gather more information about the cactus pear production, post-harvest losses, the strategies used to reduce the post-harvest losses and suggestions to improve the post-harvest management. To enter and analyze the quantitative data, SPSS version 20 was used, whereas MS-word were used to transcribe the qualitative data. The data were presented using frequency and descriptive tables and graphs. The data analysis was also done using a chain map, correlations, stakeholder matrix, and gross margin. Mean comparisons like ANOVA and t-test between variables were used. The analysis result shows that the present cactus pear value chain involves main actors and supporters. However, there is inadequate information flow and informal market linkages among actors in the cactus pear value chain. The farmer's gross margin is higher when they sell to the processor than sell to collectors. The significant postharvest loss in the cactus pear value chain is at the producer level, followed by wholesalers and retailers. The maximum and minimum volume of post-harvest losses at the producer level is 4212 and 240 kgs per season. The post-harvest loss was caused by limited farmers skill on-farm management and harvesting, low market price, limited market information, absence of producer organization, poor post-harvest handling, absence of cold storage, absence of collection centers, poor infrastructure, inadequate credit access, using traditional transportation system, absence of quality control, illegal traders, inadequate research and extension services and using inappropriate packaging material. Therefore, some of the recommendations were providing adequate practical training, forming producer organizations, and constructing collection centers.Keywords: cactus pear, post-harvest losses, profit margin, value-chain
Procedia PDF Downloads 1315073 Culturally Diverse Working Teams in Finnish and Italian Oil and Gas Industry: Intersecting Differences in Organizational and Employee Interactions
Authors: Elisa Bertagna
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The aim of the research is to study diversity issues and gender equality in the Finnish and Italian oil and gas companies. Particular attention is given to the effects on the organization’s and employees’ interactions resulting from intersecting social categories. The study is aimed to be settled in companies where social inequalities and diversity management problematics are present. Consequently, ten semi-structured interviews with key managers from the companies and four focus groups composed of culturally diverse employees aim to depict and analyze the situation from both points of view. Social discourse and intersectionality are employed as the analysis methods. Trainings, workshops, and suggestions are to be offered in the required situations.Keywords: diversity, gender, intersectionality, oil and gas companies, social constructionism
Procedia PDF Downloads 1785072 A Method for Quantitative Assessment of the Dependencies between Input Signals and Output Indicators in Production Systems
Authors: Maciej Zaręba, Sławomir Lasota
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Knowing the degree of dependencies between the sets of input signals and selected sets of indicators that measure a production system's effectiveness is of great importance in the industry. This paper introduces the SELM method that enables the selection of sets of input signals, which affects the most the selected subset of indicators that measures the effectiveness of a production system. For defined set of output indicators, the method quantifies the impact of input signals that are gathered in the continuous monitoring production system.Keywords: manufacturing operation management, signal relationship, continuous monitoring, production systems
Procedia PDF Downloads 1195071 Predicting the Areal Development of the City of Mashhad with the Automaton Fuzzy Cell Method
Authors: Mehran Dizbadi, Daniyal Safarzadeh, Behrooz Arastoo, Ansgar Brunn
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Rapid and uncontrolled expansion of cities has led to unplanned aerial development. In this way, modeling and predicting the urban growth of a city helps decision-makers. In this study, the aspect of sustainable urban development has been studied for the city of Mashhad. In general, the prediction of urban aerial development is one of the most important topics of modern town management. In this research, using the Cellular Automaton (CA) model developed for geo data of Geographic Information Systems (GIS) and presenting a simple and powerful model, a simulation of complex urban processes has been done.Keywords: urban modeling, sustainable development, fuzzy cellular automaton, geo-information system
Procedia PDF Downloads 1335070 Clinical Features, Diagnosis and Treatment Outcomes in Necrotising Autoimmune Myopathy: A Rare Entity in the Spectrum of Inflammatory Myopathies
Authors: Tamphasana Wairokpam
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Inflammatory myopathies (IMs) have long been recognised as a heterogenous family of myopathies with acute, subacute, and sometimes chronic presentation and are potentially treatable. Necrotizing autoimmune myopathies (NAM) are a relatively new subset of myopathies. Patients generally present with subacute onset of proximal myopathy and significantly elevated creatinine kinase (CK) levels. It is being increasingly recognised that there are limitations to the independent diagnostic utility of muscle biopsy. Immunohistochemistry tests may reveal important information in these cases. The traditional classification of IMs failed to recognise NAM as a separate entity and did not adequately emphasize the diversity of IMs. This review and case report on NAM aims to highlight the heterogeneity of this entity and focus on the distinct clinical presentation, biopsy findings, specific auto-antibodies implicated, and available treatment options with prognosis. This article is a meta-analysis of literatures on NAM and a case report illustrating the clinical course, investigation and biopsy findings, antibodies implicated, and management of a patient with NAM. The main databases used for the search were Pubmed, Google Scholar, and Cochrane Library. Altogether, 67 publications have been taken as references. Two biomarkers, anti-signal recognition protein (SRP) and anti- hydroxyl methylglutaryl-coenzyme A reductase (HMGCR) Abs, have been found to have an association with NAM in about 2/3rd of cases. Interestingly, anti-SRP associated NAM appears to be more aggressive in its clinical course when compared to its anti-HMGCR associated counterpart. Biopsy shows muscle fibre necrosis without inflammation. There are reports of statin-induced NAM where progression of myopathy has been seen even after discontinuation of statins, pointing towards an underlying immune mechanism. Diagnosisng NAM is essential as it requires more aggressive immunotherapy than other types of IMs. Most cases are refractory to corticosteroid monotherapy. Immunosuppressive therapy with other immunotherapeutic agents such as IVIg, rituximab, mycophenolate mofetil, azathioprine has been explored and found to have a role in the treatment of NAM. In conclusion,given the heterogeneity of NAM, it appears that NAM is not just a single entity but consists of many different forms, despite the similarities in presentation and its classification remains an evolving field. A thorough understanding of underlying mechanism and the clinical correlation with antibodies associated with NAM is essential for efficacious management and disease prognostication.Keywords: inflammatory myopathies, necrotising autoimmune myopathies, anti-SRP antibody, anti-HMGCR antibody, statin induced myopathy
Procedia PDF Downloads 1035069 Cultural and Natural Heritage Conservation by GIS Tourism Inventory System Project
Authors: Gamze Safak, Umut Arslanoglu
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Cultural and tourism conservation and development zones and tourism centers are the boundaries declared for the purpose of protecting, using, and evaluating the sectoral development and planned development in areas where historical and cultural values are heavily involved and/or where tourism potential is high. The most rapidly changing regions in Turkey are tourism areas, especially the coastal areas. Planning these regions is not about only an economic gain but also a natural and physical environment and refers to a complex process. If the tourism sector is not well controlled, excessive use of natural resources and wrong location choices may cause damage to natural areas, historical values, and socio-cultural structure. Since the strategic decisions taken in the environmental order and zoning plans, which are the means of guiding the physical environment of the Ministry of Culture and Tourism, which have the authority to make plans in tourism centers, are transformed into plan decisions that find the spatial expression, comprehensive evaluation of all kinds of data, following the historical development and based on the correct and current data is required. In addition, the authority has a number of competences in tourism promotion as well as the authority to plan, leading to the necessity of taking part in the applications requiring complex analysis such as the management and integration of the country's economic, political, social and cultural resources. For this purpose, Tourism Inventory System (TES) project, which consists of a series of subsystems, has been developed in order to solve complex planning and method problems in the management of site-related information. The scope of the project is based on the integration of numerical and verbal data in the regions within the jurisdiction of the authority, and the monitoring of the historical development of urban planning studies, making the spatial data of the institution easily accessible, shared, questionable and traceable in international standards. A dynamic and continuous system design has been put into practice by utilizing the advantage of the use of Geographical Information Systems in the planning process to play a role in making the right decisions, revealing the tools of social, economic, cultural development, and preservation of natural and cultural values. This paper, which is prepared by the project team members in TES (Tourism Inventory System), will present a study regarding the applicability of GIS in cultural and natural heritage conservation.Keywords: cultural conservation, GIS, geographic information system, tourism inventory system, urban planning
Procedia PDF Downloads 1195068 A Bi-Objective Model to Address Simultaneous Formulation of Project Scheduling and Material Ordering
Authors: Babak H. Tabrizi, Seyed Farid Ghaderi
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Concurrent planning of project scheduling and material ordering has been increasingly addressed within last decades as an approach to improve the project execution costs. Therefore, we have taken the problem into consideration in this paper, aiming to maximize schedules quality robustness, in addition to minimize the relevant costs. In this regard, a bi-objective mathematical model is developed to formulate the problem. Moreover, it is possible to utilize the all-unit discount for materials purchasing. The problem is then solved by the constraint method, and the Pareto front is obtained for a variety of robustness values. The applicability and efficiency of the proposed model is tested by different numerical instances, finally.Keywords: e-constraint method, material ordering, project management, project scheduling
Procedia PDF Downloads 2955067 Study of Biofouling Wastewater Treatment Technology
Authors: Sangho Park, Mansoo Kim, Kyujung Chae, Junhyuk Yang
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The International Maritime Organization (IMO) recognized the problem of invasive species invasion and adopted the "International Convention for the Control and Management of Ships' Ballast Water and Sediments" in 2004, which came into force on September 8, 2017. In 2011, the IMO approved the "Guidelines for the Control and Management of Ships' Biofouling to Minimize the Transfer of Invasive Aquatic Species" to minimize the movement of invasive species by hull-attached organisms and required ships to manage the organisms attached to their hulls. Invasive species enter new environments through ships' ballast water and hull attachment. However, several obstacles to implementing these guidelines have been identified, including a lack of underwater cleaning equipment, regulations on underwater cleaning activities in ports, and difficulty accessing crevices in underwater areas. The shipping industry, which is the party responsible for understanding these guidelines, wants to implement them for fuel cost savings resulting from the removal of organisms attached to the hull, but they anticipate significant difficulties in implementing the guidelines due to the obstacles mentioned above. Robots or people remove the organisms attached to the hull underwater, and the resulting wastewater includes various species of organisms and particles of paint and other pollutants. Currently, there is no technology available to sterilize the organisms in the wastewater or stabilize the heavy metals in the paint particles. In this study, we aim to analyze the characteristics of the wastewater generated from the removal of hull-attached organisms and select the optimal treatment technology. The organisms in the wastewater generated from the removal of the attached organisms meet the biological treatment standard (D-2) using the sterilization technology applied in the ships' ballast water treatment system. The heavy metals and other pollutants in the paint particles generated during removal are treated using stabilization technologies such as thermal decomposition. The wastewater generated is treated using a two-step process: 1) development of sterilization technology through pretreatment filtration equipment and electrolytic sterilization treatment and 2) development of technology for removing particle pollutants such as heavy metals and dissolved inorganic substances. Through this study, we will develop a biological removal technology and an environmentally friendly processing system for the waste generated after removal that meets the requirements of the government and the shipping industry and lays the groundwork for future treatment standards.Keywords: biofouling, ballast water treatment system, filtration, sterilization, wastewater
Procedia PDF Downloads 1095066 Remote Wireless Communications Lab in Real Time
Authors: El Miloudi Djelloul
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Technology nowadays enables the remote access to laboratory equipment and instruments via Internet. This is especially useful in engineering education, where students can conduct laboratory experiment remotely. Such remote laboratory access can enable student to use expensive laboratory equipment, which is not usually available to students. In this paper, we present a method of creating a Web-based Remote Laboratory Experimentation in the master degree course “Wireless Communications Systems” which is part of “ICS (Information and Communication Systems)” and “Investment Management in Telecommunications” curriculums. This is done within the RIPLECS Project and the NI2011 FF005 Research Project “Implementation of Project-Based Learning in an Interdisciplinary Master Program”.Keywords: remote access, remote laboratory, wireless telecommunications, external antenna-switching controller board (EASCB)
Procedia PDF Downloads 5155065 Integration of Technology into Nursing Education: A Collaboration between College of Nursing and University Research Center
Authors: Lori Lioce, Gary Maddux, Norven Goddard, Ishella Fogle, Bernard Schroer
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This paper presents the integration of technologies into nursing education. The collaborative effort includes the College of Nursing (CoN) at the University of Alabama in Huntsville (UAH) and the UAH Systems Management and Production Center (SMAP). The faculty at the CoN conducts needs assessments to identify education and training requirements. A team of CoN faculty and SMAP engineers then prioritize these requirements and establish improvement/development teams. The development teams consist of nurses to evaluate the models and to provide feedback and of undergraduate engineering students and their senior staff mentors from SMAP. The SMAP engineering staff develops and creates the physical models using 3D printing, silicone molds and specialized molding mixtures and techniques. The collaboration has focused on developing teaching and training, or clinical, simulators. In addition, the onset of the Covid-19 pandemic has intensified this relationship, as 3D modeling shifted to supplied personal protection equipment (PPE) to local health care providers. A secondary collaboration has been introducing students to clinical benchmarking through the UAH Center for Management and Economic Research. As a result of these successful collaborations the Model Exchange & Development of Nursing & Engineering Technology (MEDNET) has been established. MEDNET seeks to extend and expand the linkage between engineering and nursing to K-12 schools, technical schools and medical facilities in the region to the resources available from the CoN and SMAP. As an example, stereolithography (STL) files of the 3D printed models, along with the specifications to fabricate models, are available on the MEDNET website. Ten 3D printed models have been developed and are currently in use by the CoN. The following additional training simulators are currently under development:1) suture pads, 2) gelatin wound models and 3) printed wound tattoos. Specification sheets have been written for these simulations that describe the use, fabrication procedures and parts list. These specifications are available for viewing and download on MEDNET. Included in this paper are 1) descriptions of CoN, SMAP and MEDNET, 2) collaborative process used in product improvement/development, 3) 3D printed models of training and teaching simulators, 4) training simulators under development with specification sheets, 5) family care practice benchmarking, 6) integrating the simulators into the nursing curriculum, 7) utilizing MEDNET as a pandemic response, and 8) conclusions and lessons learned.Keywords: 3D printing, nursing education, simulation, trainers
Procedia PDF Downloads 1225064 Participatory Cartography for Disaster Reduction in Pogreso, Yucatan Mexico
Authors: Gustavo Cruz-Bello
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Progreso is a coastal community in Yucatan, Mexico, highly exposed to floods produced by severe storms and tropical cyclones. A participatory cartography approach was conducted to help to reduce floods disasters and assess social vulnerability within the community. The first step was to engage local authorities in risk management to facilitate the process. Two workshop were conducted, in the first, a poster size printed high spatial resolution satellite image of the town was used to gather information from the participants: eight women and seven men, among them construction workers, students, government employees and fishermen, their ages ranged between 23 and 58 years old. For the first task, participants were asked to locate emblematic places and place them in the image to familiarize with it. Then, they were asked to locate areas that get flooded, the buildings that they use as refuges, and to list actions that they usually take to reduce vulnerability, as well as to collectively come up with others that might reduce disasters. The spatial information generated at the workshops was digitized and integrated into a GIS environment. A printed version of the map was reviewed by local risk management experts, who validated feasibility of proposed actions. For the second workshop, we retrieved the information back to the community for feedback. Additionally a survey was applied in one household per block in the community to obtain socioeconomic, prevention and adaptation data. The information generated from the workshops was contrasted, through T and Chi Squared tests, with the survey data in order to probe the hypothesis that poorer or less educated people, are less prepared to face floods (more vulnerable) and live near or among higher presence of floods. Results showed that a great majority of people in the community are aware of the hazard and are prepared to face it. However, there was not a consistent relationship between regularly flooded areas with people’s average years of education, house services, or house modifications against heavy rains to be prepared to hazards. We could say that the participatory cartography intervention made participants aware of their vulnerability and made them collectively reflect about actions that can reduce disasters produced by floods. They also considered that the final map could be used as a communication and negotiation instrument with NGO and government authorities. It was not found that poorer and less educated people are located in areas with higher presence of floods.Keywords: climate change, floods, Mexico, participatory mapping, social vulnerability
Procedia PDF Downloads 1145063 Rethinking Pathways to Shared Prosperity for Forest Communities: A Case Study of Nigerian REDD+ Readiness Project
Authors: U. Isyaku, C. Upton, J. Dickinson
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Critical institutional approach for understanding pathways to shared prosperity among forest communities enabled questioning the underlying rational choice assumptions that have dominated traditional institutional thinking in natural resources management. Common pool resources framing assumes that communities as social groups share collective interests and values towards achieving greater development. Hence, policies related to natural resources management in the global South prioritise economic prosperity by focusing on how to maximise material benefits and improve the livelihood options of resource dependent communities. Recent trends in commodification and marketization of ecosystem goods and services into tradable natural capital and incentivising conservation are structured in this paradigm. Several researchers however, have problematized this emerging market-based model because it undermines cultural basis for protecting natural ecosystems. By exploring how forest people’s motivations for conservation differ within the context of reducing emissions from deforestation and forest degradation (REDD+) project in Nigeria, we aim to provide an alternative approach to conceptualising prosperity beyond the traditional economic thinking. Through in depth empirical work over seven months with five communities in Nigeria’s Cross River State, Q methodology was used to uncover communities’ perspectives and meanings of forest values that underpin contemporary and historic conservation practices, expected benefits, and willingness to participate in the REDD+ process. Our study finds six discourses about forest and conservation values that transcend wealth creation, poverty reduction and livelihoods. We argue that communities’ decisions about forest conservation consist of a complex mixture of economic, emotional, moral, and ecological justice concerns that constitute new meanings and dimensions of prosperity. Prosperity is thus reconfigured as having socio-cultural and psychological pathways that could be derived through place identity and attachment, connectedness to nature, family ties, and ability to participate in everyday social life. We therefore suggest that natural resources policy making and development interventions should consider institutional arrangements that also include the psycho-cultural dimensions of prosperity among diverse community groups.Keywords: critical institutionalism, Q methodology, REDD+, shared prosperity
Procedia PDF Downloads 3455062 Countering the Bullwhip Effect by Absorbing It Downstream in the Supply Chain
Authors: Geng Cui, Naoto Imura, Katsuhiro Nishinari, Takahiro Ezaki
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The bullwhip effect, which refers to the amplification of demand variance as one moves up the supply chain, has been observed in various industries and extensively studied through analytic approaches. Existing methods to mitigate the bullwhip effect, such as decentralized demand information, vendor-managed inventory, and the Collaborative Planning, Forecasting, and Replenishment System, rely on the willingness and ability of supply chain participants to share their information. However, in practice, information sharing is often difficult to realize due to privacy concerns. The purpose of this study is to explore new ways to mitigate the bullwhip effect without the need for information sharing. This paper proposes a 'bullwhip absorption strategy' (BAS) to alleviate the bullwhip effect by absorbing it downstream in the supply chain. To achieve this, a two-stage supply chain system was employed, consisting of a single retailer and a single manufacturer. In each time period, the retailer receives an order generated according to an autoregressive process. Upon receiving the order, the retailer depletes the ordered amount, forecasts future demand based on past records, and places an order with the manufacturer using the order-up-to replenishment policy. The manufacturer follows a similar process. In essence, the mechanism of the model is similar to that of the beer game. The BAS is implemented at the retailer's level to counteract the bullwhip effect. This strategy requires the retailer to reduce the uncertainty in its orders, thereby absorbing the bullwhip effect downstream in the supply chain. The advantage of the BAS is that upstream participants can benefit from a reduced bullwhip effect. Although the retailer may incur additional costs, if the gain in the upstream segment can compensate for the retailer's loss, the entire supply chain will be better off. Two indicators, order variance and inventory variance, were used to quantify the bullwhip effect in relation to the strength of absorption. It was found that implementing the BAS at the retailer's level results in a reduction in both the retailer's and the manufacturer's order variances. However, when examining the impact on inventory variances, a trade-off relationship was observed. The manufacturer's inventory variance monotonically decreases with an increase in absorption strength, while the retailer's inventory variance does not always decrease as the absorption strength grows. This is especially true when the autoregression coefficient has a high value, causing the retailer's inventory variance to become a monotonically increasing function of the absorption strength. Finally, numerical simulations were conducted for verification, and the results were consistent with our theoretical analysis.Keywords: bullwhip effect, supply chain management, inventory management, demand forecasting, order-to-up policy
Procedia PDF Downloads 765061 Responses of Grain Yield, Anthocyanin and Antioxidant Capacity to Water Condition in Wetland and Upland Purple Rice Genotypes
Authors: Supaporn Yamuangmorn, Chanakan Prom-U-Thai
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Wetland and upland purple rice are the two major types classified by its original ecotypes in Northern Thailand. Wetland rice is grown under flooded condition from transplanting until the mutuality, while upland rice is naturally grown under well-drained soil known as aerobic cultivations. Both ecotypes can be grown and adapted to the reverse systems but little is known on its responses of grain yield and qualities between the 2 ecotypes. This study evaluated responses of grain yield as well as anthocyanin and antioxidant capacity between the wetland and upland purple rice genotypes grown in the submerged and aerobic conditions. A factorial arrangement in a randomized complete block design (RCBD) with two factors of rice genotype and water condition were carried out in three replications. The two wetland genotypes (Kum Doi Saket: KDK and Kum Phayao: KPY) and two upland genotypes (Kum Hom CMU: KHCMU and Pieisu1: PES1) were used in this study by growing under submerged and aerobic conditions. Grain yield was affected by the interaction between water condition and rice genotype. The wetland genotypes, KDK and KPY grown in the submerged condition produced about 2.7 and 0.8 times higher yield than in the aerobic condition, respectively. The 0.4 times higher grain yield of upland genotype (PES1) was found in the submerged condition than in the aerobic condition, but no significant differences in KHCMU. In the submerged condition, all genotypes produced higher yield components of tiller number, panicle number and percent filled grain than in the aerobic condition by 24% and 32% and 11%, respectively. The thousand grain weight and spikelet number were affected by water condition differently among genotypes. The wetland genotypes, KDK and KPY, and upland genotype, PES1, grown in the submerged condition produced about 19-22% higher grain weight than in the aerobic condition. The similar effect was found in spikelet number which the submerged condition of wetland genotypes, KDK and KPY, and the upland genotype, KHCMU, had about 28-30% higher than the aerobic condition. In contrast, the anthocyanin concentration and antioxidant capacity were affected by both the water condition and genotype. Rice grain grown in the aerobic condition had about 0.9 and 2.6 times higher anthocyanin concentration than in the submerged condition was found in the wetland rice, KDK and upland rice, KHCMU, respectively. Similarly, the antioxidant capacity of wetland rice, KDK and upland rice, KHCMU were 0.5 and 0.6 times higher in aerobic condition than in the submerged condition. There was a negative correlation between grain yield and anthocyanin concentration in wetland genotype KDK and upland genotype KHCMU, but it was not found in the other genotypes. This study indicating that some rice genotype can be adapted in the reverse ecosystem in both grain yield and quality, especially in the wetland genotype KPY and upland genotype PES1. To maximize grain yield and quality of purple rice, proper water management condition is require with a key consideration on difference responses among genotypes. Increasing number of rice genotypes in both ecotypes is needed to confirm their responses on water management.Keywords: purple rice, water condition, anthocyanin, grain yield
Procedia PDF Downloads 1615060 Management and Genetic Characterization of Local Sheep Breeds for Better Productive and Adaptive Traits
Authors: Sonia Bedhiaf-Romdhani
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The sheep (Ovis aries) was domesticated, approximately 11,000 years ago (YBP), in the Fertile Crescent from Asian Mouflon (Ovis Orientalis). The Northern African (NA) sheep is 7,000 years old, represents a remarkable diversity of sheep populations reared under traditional and low input farming systems (LIFS) over millennia. The majority of small ruminants in developing countries are encountered in low input production systems and the resilience of local communities in rural areas is often linked to the wellbeing of small ruminants. Regardless of the rich biodiversity encountered in sheep ecotypes there are four main sheep breeds in the country with 61,6 and 35.4 percents of Barbarine (fat tail breed) and Queue Fine de l’Ouest (thin tail breed), respectively. Phoenicians introduced the Barbarine sheep from the steppes of Central Asia in the Carthaginian period, 3000 years ago. The Queue Fine de l’Ouest is a thin-tailed meat breed heavily concentrated in the Western and the central semi-arid regions. The Noire de Thibar breed, involving mutton-fine wool producing animals, has been on the verge of extinction, it’s a composite black coated sheep breed found in the northern sub-humid region because of its higher nutritional requirements and non-tolerance of the prevailing harsher condition. The D'Man breed, originated from Morocco, is mainly located in the southern oases of the extreme arid ecosystem. A genetic investigation of Tunisian sheep breeds using a genome-wide scan of approximately 50,000 SNPs was performed. Genetic analysis of relationship between breeds highlighted the genetic differentiation of Noire de Thibar breed from the other local breeds, reflecting the effect of past events of introgression of European gene pool. The Queue Fine de l’Ouest breed showed a genetic heterogeneity and was close to Barbarine. The D'Man breed shared a considerable gene flow with the thin-tailed Queue Fine de l'Ouest breed. Native small ruminants breeds, are capable to be efficiently productive if essential ingredients and coherent breeding schemes are implemented and followed. Assessing the status of genetic variability of native sheep breeds could provide important clues for research and policy makers to devise better strategies for the conservation and management of genetic resources.Keywords: sheep, farming systems, diversity, SNPs.
Procedia PDF Downloads 1475059 Passing-On Cultural Heritage Knowledge: Entrepreneurial Approaches for a Higher Educational Sustainability
Authors: Ioana Simina Frincu
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As institutional initiatives often fail to provide good practices when it comes to heritage management or to adapt to the changing environment in which they function and to the audiences they address, private actions represent viable strategies for sustainable knowledge acquisition. Information dissemination to future generations is one of the key aspects in preserving cultural heritage and is successfully feasible even in the absence of original artifacts. Combined with the (re)discovery of natural landscape, open-air exploratory approaches (archeoparks) versus an enclosed monodisciplinary rigid framework (traditional museums) are more likely to 'speak the language' of a larger number of people, belonging to a variety of categories, ages, and professions. Interactive sites are efficient ways of stimulating heritage awareness and increasing the number of visitors of non-interactive/static cultural institutions owning original pieces of history, delivering specialized information, and making continuous efforts to preserve historical evidence (relics, manuscripts, etc.). It is high time entrepreneurs took over the role of promoting cultural heritage, bet it under a more commercial yet more attractive form (business). Inclusive, participatory type of activities conceived by experts from different domains/fields (history, anthropology, tourism, sociology, business management, integrative sustainability, etc.) have better chances to ensure long term cultural benefits for both adults and children, especially when and where the educational discourse fails. These unique self-experience leisure activities, which offer everyone the opportunity to recreate history by him-/her-self, to relive the ancestors’ way of living, surviving and exploring should be regarded not as pseudo-scientific approaches but as important pre-steps to museum experiences. In order to support this theory, focus will be laid on two different examples: one dynamic, in the outdoors (the Boario Terme Archeopark from Italy) and one experimental, held indoor (the reconstruction of the Neolithic sanctuary of Parta, Romania as part of a transdisciplinary academic course) and their impact on young generations. The conclusion of this study shows that the increasingly lower engagement of youth (students) in discovering and understanding history, archaeology, and heritage can be revived by entrepreneurial projects.Keywords: archeopark, educational tourism, open air museum, Parta sanctuary, prehistory
Procedia PDF Downloads 1405058 Teaching Contemporary Power Distribution and Industrial Networks in Higher Education Vocational Studies
Authors: Rade M. Ciric
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The paper shows the development and implementation of the syllabus of the subject 'Distribution and Industrial Networks', attended by the vocational specialist Year 4 students of the Electric Power Engineering study programme at the Higher Education Technical School of Vocational Studies in Novi Sad. The aim of the subject is to equip students with the knowledge necessary for planning, exploitation and management of distributive and industrial electric power networks in an open electricity market environment. The results of the evaluation of educational outcomes on the subject are presented and discussed.Keywords: engineering education, power distribution network, syllabus implementation, outcome evaluation
Procedia PDF Downloads 4045057 People Participation as Social Capital Form for Realizing Sustainable Ecotourism
Authors: I. Putu Eka N. Kencana, I. Wayan Mertha
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A variety of research’s evidence suggests that community involvement is one of the vital elements in the development of sustainable tourism. As an entity of the tourism system, local communities are considered have better understanding of their region as well as influenced positively or negatively by the tourism activities in the region. This study elaborates role of community involvement in the development of ecotourism in Kintamani Bali from two perspectives of view, namely participation in the process of initiatives development and participation in the economic benefits of tourism. As one element of social capital form, community participation on the development and management of ecotourism in Kintamani, could be expected maintain its sustainability.Keywords: community involvement, ecotourism, participation, social capital
Procedia PDF Downloads 5225056 A Global Business Network Built on Hive: Two Use Cases: Buying and Selling of Products and Services and Carrying Out of Social Impact Projects
Authors: Gheyzer Villegas, Edgardo Cedeño, Veruska Mata, Edmundo Chauran
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One of the most significant changes that occurred in global commerce was the emergence of cryptocurrencies and blockchain technology. There is still much debate about the adoption of the economic model based on crypto assets, and myriad international projects and initiatives are being carried out to try and explore the potential that this new field offers. The Hive blockchain is a prime example of this, featuring two use cases: of how trade based on its native currencies can give successful results in the exchange of goods and services and in the financing of social impact projects. Its decentralized management model and visionary administration of its development fund have become a key part of its success.Keywords: Hive, business, network, blockchain
Procedia PDF Downloads 685055 An E-Retailing System Architecture Based on Cloud Computing
Authors: Chanchai Supaartagorn
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E-retailing is the sale of goods online that takes place over the Internet. The Internet has shrunk the entire World. The world e-retailing is growing at an exponential rate in the Americas, Europe, and Asia. However, e-retailing costs require expensive investment, such as hardware, software, and security systems. Cloud computing technology is internet-based computing for the management and delivery of applications and services. Cloud-based e-retailing application models allow enterprises to lower their costs with their effective implementation of e-retailing activities. In this paper, we describe the concept of cloud computing and present the architecture of cloud computing, combining the features of e-retailing. In addition, we propose a strategy for implementing cloud computing with e-retailing. Finally, we explain the benefits from the architecture.Keywords: architecture, cloud computing, e-retailing, internet-based
Procedia PDF Downloads 3975054 Uterine Leiomyomas and Urological Complications
Authors: Dharshini Selvarajah, Nicula Lui, Karen Kong
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Background: Uterine fibroids are a common benign gynaecologic neoplasm in reproductive-aged women. Fibroids may become symptomatic in a vast majority of nulliparous women. Their diagnosis and management is often coordinated between gyneacologists, radiologists and urologists depending on the anatomical location, growth, size and the fibroids sarcomatous evolvement. Some patients may develop obstructive uropathy symptoms, either uni or bilateral secondary urethral obstruction causing hydronephrosis. Uterine artery emoblisation (UAE) has previously shown to effectively resolve symptoms as well as relieve urethral obstruction and resolve the hydronephrosis. UAE has now established itself as an organ preserving and minimally invasive procedure in the management of symptomatic uterine fibroids. It is a safe and effective alternative to hysterectomy for resolving fibroid related pressure symptoms. The case presented examines the clinical manifestations and impact of uterine fibroids on the urinary tract system. The therapeutic options to relieve the urological symptoms as well as preserve fertility are explored and presented. Case: The case is a 29-year-old Nepalese female admitted to hospital with recurrent urosepsis with multiresistant organisms. This was on a background of an enlarged uterus (measuring 17cm x11cm) with multiple subserosal, intramural and exophytic fibroids- causing external ureteric compression. She had bilateral ureteric stents insitu and required bilateral right and left nephrostomies during repeated episodes of urosepsis and bilateral ureteric obstruction. The left nephrostomy was removed a month prior to admission and her most recent CT KUB demonstrated hypofunctioning ureteric stents with bilateral hydronephrosis. Options of hysterectomy versus uterine artery emoblisation (UAE) were extensively explored. The patient was keen to preserve fertility. Risks associated with UAE such as expulsion of the submucosal component of the fibroids and the possibilities of sepsis in the setting of ongoing ureteric colonisation were particularly high. The patient opted to trial UAE even though the risks of recurrent hospital admissions with urosepsis were going to be particularly high. In the event, the uterus fails to shrink adequately enough to relieve the obstructed ureters a hysterectomy would inevitably be required in future. Day 3 post UAE the patient developed fevers, was hypotensive and tachycardic post-receiving prophylactic meropenem and fluconazole pre emoblisation. She was noted to have a CRP of 293 with the most recent urine culture during this time growing Candida albicans. The patient was recommenced on oral fluconazole and IV meropenem, with good effect. Her repeat renal tract ultrasound post-UAE showed ongoing marked left hydronephrosis relatively unchanged from the scan one month prior to the procedure, however the right-sided hydronephrosis had resolved. The patient was discharged on a 2-week course of antibiotics. The patient will have a repeat renal tract ultrasound and MRI of the ureters to re-evaluate the degree of hydronephrosis and progress- this was unavailable at the time of abstract submission and will be presented at the conference. Conclusion: Fibroids are a common benign tumour of the uterus and can frequently impact the lower urinary system resulting in significant uropathy. They often enlarge and compress the urinary bladder, urethra and lower end of the ureters. The effectiveness of UAE as a fertility preserving option is described.Keywords: Uterine leiomyomas and urological complications, uterine artery embolisation for fibroids, Uterine fibroids and complications, Management of uterine fibroids
Procedia PDF Downloads 2245053 GIS Pavement Maintenance Selection Strategy
Authors: Mekdelawit Teferi Alamirew
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As a practical tool, the Geographical information system (GIS) was used for data integration, collection, management, analysis, and output presentation in pavement mangement systems . There are many GIS techniques to improve the maintenance activities like Dynamic segmentation and weighted overlay analysis which considers Multi Criteria Decision Making process. The results indicated that the developed MPI model works sufficiently and yields adequate output for providing accurate decisions. Hence considering multi criteria to prioritize the pavement sections for maintenance, as a result of the fact that GIS maps can express position, extent, and severity of pavement distress features more effectively than manual approaches, lastly the paper also offers digitized distress maps that can help agencies in their decision-making processes.Keywords: pavement, flexible, maintenance, index
Procedia PDF Downloads 625052 Working Mode and Key Technology of Thermal Vacuum Test Software for Spacecraft Test
Authors: Zhang Lei, Zhan Haiyang, Gu Miao
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A universal software platform is developed for improving the defects in the practical one. This software platform has distinct advantages in modularization, information management, and the interfaces. Several technologies such as computer technology, virtualization technology, network technology, etc. are combined together in this software platform, and four working modes are introduced in this article including single mode, distributed mode, cloud mode, and the centralized mode. The application area of the software platform is extended through the switch between these working modes. The software platform can arrange the thermal vacuum test process automatically. This function can improve the reliability of thermal vacuum test.Keywords: software platform, thermal vacuum test, control and measurement, work mode
Procedia PDF Downloads 4165051 An Innovation Decision Process View in an Adoption of Total Laboratory Automation
Authors: Chia-Jung Chen, Yu-Chi Hsu, June-Dong Lin, Kun-Chen Chan, Chieh-Tien Wang, Li-Ching Wu, Chung-Feng Liu
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With fast advances in healthcare technology, various total laboratory automation (TLA) processes have been proposed. However, adopting TLA needs quite high funding. This study explores an early adoption experience by Taiwan’s large-scale hospital group, the Chimei Hospital Group (CMG), which owns three branch hospitals (Yongkang, Liouying and Chiali, in order by service scale), based on the five stages of Everett Rogers’ Diffusion Decision Process. 1.Knowledge stage: Over the years, two weaknesses exists in laboratory department of CMG: 1) only a few examination categories (e.g., sugar testing and HbA1c) can now be completed and reported within a day during an outpatient clinical visit; 2) the Yongkang Hospital laboratory space is dispersed across three buildings, resulting in duplicated investment in analysis instruments and inconvenient artificial specimen transportation. Thus, the senior management of the department raised a crucial question, was it time to process the redesign of the laboratory department? 2.Persuasion stage: At the end of 2013, Yongkang Hospital’s new building and restructuring project created a great opportunity for the redesign of the laboratory department. However, not all laboratory colleagues had the consensus for change. Thus, the top managers arranged a series of benchmark visits to stimulate colleagues into being aware of and accepting TLA. Later, the director of the department proposed a formal report to the top management of CMG with the results of the benchmark visits, preliminary feasibility analysis, potential benefits and so on. 3.Decision stage: This TLA suggestion was well-supported by the top management of CMG and, finally, they made a decision to carry out the project with an instrument-leasing strategy. After the announcement of a request for proposal and several vendor briefings, CMG confirmed their laboratory automation architecture and finally completed the contracts. At the same time, a cross-department project team was formed and the laboratory department assigned a section leader to the National Taiwan University Hospital for one month of relevant training. 4.Implementation stage: During the implementation, the project team called for regular meetings to review the results of the operations and to offer an immediate response to the adjustment. The main project tasks included: 1) completion of the preparatory work for beginning the automation procedures; 2) ensuring information security and privacy protection; 3) formulating automated examination process protocols; 4) evaluating the performance of new instruments and the instrument connectivity; 5)ensuring good integration with hospital information systems (HIS)/laboratory information systems (LIS); and 6) ensuring continued compliance with ISO 15189 certification. 5.Confirmation stage: In short, the core process changes include: 1) cancellation of signature seals on the specimen tubes; 2) transfer of daily examination reports to a data warehouse; 3) routine pre-admission blood drawing and formal inpatient morning blood drawing can be incorporated into an automatically-prepared tube mechanism. The study summarizes below the continuous improvement orientations: (1) Flexible reference range set-up for new instruments in LIS. (2) Restructure of the specimen category. (3) Continuous review and improvements to the examination process. (4) Whether installing the tube (specimen) delivery tracks need further evaluation.Keywords: innovation decision process, total laboratory automation, health care
Procedia PDF Downloads 4195050 Job Shop Scheduling: Classification, Constraints and Objective Functions
Authors: Majid Abdolrazzagh-Nezhad, Salwani Abdullah
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The job-shop scheduling problem (JSSP) is an important decision facing those involved in the fields of industry, economics and management. This problem is a class of combinational optimization problem known as the NP-hard problem. JSSPs deal with a set of machines and a set of jobs with various predetermined routes through the machines, where the objective is to assemble a schedule of jobs that minimizes certain criteria such as makespan, maximum lateness, and total weighted tardiness. Over the past several decades, interest in meta-heuristic approaches to address JSSPs has increased due to the ability of these approaches to generate solutions which are better than those generated from heuristics alone. This article provides the classification, constraints and objective functions imposed on JSSPs that are available in the literature.Keywords: job-shop scheduling, classification, constraints, objective functions
Procedia PDF Downloads 4475049 Antenatal Monitoring of Pre-Eclampsia in a Low Resource Setting
Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik
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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda
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