Search results for: Indian Institute of Management
5330 Nurses' Perception and Core Competencies for Disaster Preparedness: A Study from the Western Region of Turkey
Authors: Gülcan Taşkıran, Ülkü Tatar Baykal
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Aim: To identify nurses’ perceived competencies for disaster preparedness. Background: Recently, the number of disasters has increased worldwide. Since disasters often strike without warning, healthcare providers, especially nurses must be prepared with appropriate competencies for disaster procedures. Nurses’ perceptions of their own competencies for disaster preparedness need to be evaluated to aid in the creation of effective national plans and educational programs. Design: This study was conducted with a descriptive and cross-sectional design. Methods: Nurses’ perceptions were assessed using the 13-item Demographic Profile Questionnaire that is based on previous literature and the 45-item Nurses’ Perception of Core Competencies for Disaster Preparedness Scale (NPCDPS). Data were collected from June to September 2014 from 406 (79.9% return rate) Turkish nurses working in the western region of Turkey. Results: At the end of the study, it was found that out of the nurses whose mean age was 31.27 ± 5.86 and mean of working time was 8.07 ± 6.60 by the time vast majority of the nurses were women (85.7%), married (59.4%), bachelor’s degree holder (88.2%) and service nurses (56.2%). The most potential disaster that nurses think is an earthquake (70.9%) by the time majority of nurses consider having a role as a nurse at every stage of disasters. The mean total point score of nurses’ perception of disaster preparedness was 4.62. The mean total point score of the nurses from the Nurses’ Perception of Core Competencies for Disaster Preparedness Scale was 133.96. When the subscales’ mean scores are examined, the highest average of the mean score is for Technical Skills (44.52), and the lowest is for Critical Thinking Skills (10.47). When the subscales of Nurses’ Perception of Core Competencies for Disaster Preparedness Scale compared with sex, marital status and education level out of independent variable of nurses there is no significant difference (p > 0.05); compared with age group, working years, duty and being with a disaster out of independent variable of nurses there is a significant difference (p ≤ 0.05). Conclusion: Nurses generally perceive themselves as sufficient at a ‘medium level’ in terms of meeting the core competencies that are required for disaster preparedness. Nurses are not adequately prepared for disasters, but they are aware of the need for such preparation and disaster education. Disaster management training should be given to all nurses in their basic education.Keywords: disaster competencies, disaster management, disaster nursing, disaster preparedness, nursing, nursing administration, Turkish nurses
Procedia PDF Downloads 3685329 The Effect of Technology on International Marketing Trading Researches and Analysis
Authors: Omil Nady Mahrous Maximous
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The article deals with the use of modern information technologies to achieve pro-ecological marketing goals in company-customer relationships. The purpose of the article is to show the possibilities of implementing modern information technologies. In B2C relationships, marketing departments face challenges stemming from the need to quickly segment customers and the current fragmentation of data across many systems, which significantly hinders the achievement of marketing goals. Thus, Article proposes the use of modern IT solutions in the field of marketing activities of companies, taking into account their environmental goals. As a result, its importance for the economic and social development of the emerging countries has increased. While traditional companies emphasize profit maximization as a core business principle, social enterprises must solve social problems at the expense of profit. This rationale gives social enterprises an edge over traditional businesses by meeting the needs of those at the bottom of the pyramid. This also represents a major challenge for social business, since social business acts on the one hand for the benefit of the public and on the other strives for financial stability. Otherwise, the company is unlikely to be fired from the company. Cultures play a role in business communication and research. Using the example of language in international relations, the article presents the problem of the articulation of research cultures in management and linguistics and of cultures as such. After an overview of current research on language in international relations, this article presents the approach to communication in international economy from a linguistic point of view and tries to explain the problems of communication in business starting from linguistic research. A step towards interdisciplinary research that brings together research in the fields of management and linguistics.Keywords: international marketing, marketing mix, marketing research, small and medium-sized enterprises, strategic marketing, B2B digital marketing strategy, digital marketing, digital marketing maturity model, SWOT analysis consumer behavior, experience, experience marketing, marketing employee organizational performance, internal marketing, internal customer, direct marketing, mobile phones mobile marketing, Sms advertising
Procedia PDF Downloads 455328 Assessment of Potential Chemical Exposure to Betamethasone Valerate and Clobetasol Propionate in Pharmaceutical Manufacturing Laboratories
Authors: Nadeen Felemban, Hamsa Banjer, Rabaah Jaafari
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One of the most common hazards in the pharmaceutical industry is the chemical hazard, which can cause harm or develop occupational health diseases/illnesses due to chronic exposures to hazardous substances. Therefore, a chemical agent management system is required, including hazard identification, risk assessment, controls for specific hazards and inspections, to keep your workplace healthy and safe. However, routine management monitoring is also required to verify the effectiveness of the control measures. Moreover, Betamethasone Valerate and Clobetasol Propionate are some of the APIs (Active Pharmaceutical Ingredients) with highly hazardous classification-Occupational Hazard Category (OHC 4), which requires a full containment (ECA-D) during handling to avoid chemical exposure. According to Safety Data Sheet, those chemicals are reproductive toxicants (reprotoxicant H360D), which may affect female workers’ health and cause fatal damage to an unborn child, or impair fertility. In this study, qualitative (chemical Risk assessment-qCRA) was conducted to assess the chemical exposure during handling of Betamethasone Valerate and Clobetasol Propionate in pharmaceutical laboratories. The outcomes of qCRA identified that there is a risk of potential chemical exposure (risk rating 8 Amber risk). Therefore, immediate actions were taken to ensure interim controls (according to the Hierarchy of controls) are in place and in use to minimize the risk of chemical exposure. No open handlings should be done out of the Steroid Glove Box Isolator (SGB) with the required Personal Protective Equipment (PPEs). The PPEs include coverall, nitrile hand gloves, safety shoes and powered air-purifying respirators (PAPR). Furthermore, a quantitative assessment (personal air sampling) was conducted to verify the effectiveness of the engineering controls (SGB Isolator) and to confirm if there is chemical exposure, as indicated earlier by qCRA. Three personal air samples were collected using an air sampling pump and filter (IOM2 filters, 25mm glass fiber media). The collected samples were analyzed by HPLC in the BV lab, and the measured concentrations were reported in (ug/m3) with reference to Occupation Exposure Limits, 8hr OELs (8hr TWA) for each analytic. The analytical results are needed in 8hr TWA (8hr Time-weighted Average) to be analyzed using Bayesian statistics (IHDataAnalyst). The results of the Bayesian Likelihood Graph indicate (category 0), which means Exposures are de "minimus," trivial, or non-existent Employees have little to no exposure. Also, these results indicate that the 3 samplings are representative samplings with very low variations (SD=0.0014). In conclusion, the engineering controls were effective in protecting the operators from such exposure. However, routine chemical monitoring is required every 3 years unless there is a change in the processor type of chemicals. Also, frequent management monitoring (daily, weekly, and monthly) is required to ensure the control measures are in place and in use. Furthermore, a Similar Exposure Group (SEG) was identified in this activity and included in the annual health surveillance for health monitoring.Keywords: occupational health and safety, risk assessment, chemical exposure, hierarchy of control, reproductive
Procedia PDF Downloads 1735327 Physicochemical Characterizations of Marine and River Sediments in the North of France
Authors: Abriak Nor Edine, Zentar Rachid, Achour Raouf, Tran Ngoc Thanh
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This work is undertaken to develop a methodology to enhance the management of dredged marine and river sediments in the North of France. The main objective of this study is to determine the main characteristics of these sediments. In this order, physical, mineralogical and chemical properties of both types of sediments are measured. Moreover, their potential impacts on the environment are assessed throughout leaching tests. From the obtained results, the potential of their use in road engineering is discussed.Keywords: marine sediments, river sediments, physico chemical characterizations, environmental characterizations
Procedia PDF Downloads 5485326 Using the Dokeos Platform for Industrial E-Learning Solution
Authors: Kherafa Abdennasser
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The application of Information and Communication Technologies (ICT) to the training area led to the creation of this new reality called E-learning. That last one is described like the marriage of multi- media (sound, image and text) and of the internet (diffusion on line, interactivity). Distance learning became an important totality for training and that last pass in particular by the setup of a distance learning platform. In our memory, we will use an open source platform named Dokeos for the management of a distance training of GPS called e-GPS. The learner is followed in all his training. In this system, trainers and learners communicate individually or in group, the administrator setup and make sure of this system maintenance.Keywords: ICT, E-learning, learning plate-forme, Dokeos, GPS
Procedia PDF Downloads 4775325 Towards a Measuring Tool to Encourage Knowledge Sharing in Emerging Knowledge Organizations: The Who, the What and the How
Authors: Rachel Barker
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The exponential velocity in the truly knowledge-intensive world today has increasingly bombarded organizations with unfathomable challenges. Hence organizations are introduced to strange lexicons of descriptors belonging to a new paradigm of who, what and how knowledge at individual and organizational levels should be managed. Although organizational knowledge has been recognized as a valuable intangible resource that holds the key to competitive advantage, little progress has been made in understanding how knowledge sharing at individual level could benefit knowledge use at collective level to ensure added value. The research problem is that a lack of research exists to measure knowledge sharing through a multi-layered structure of ideas with at its foundation, philosophical assumptions to support presuppositions and commitment which requires actual findings from measured variables to confirm observed and expected events. The purpose of this paper is to address this problem by presenting a theoretical approach to measure knowledge sharing in emerging knowledge organizations. The research question is that despite the competitive necessity of becoming a knowledge-based organization, leaders have found it difficult to transform their organizations due to a lack of knowledge on who, what and how it should be done. The main premise of this research is based on the challenge for knowledge leaders to develop an organizational culture conducive to the sharing of knowledge and where learning becomes the norm. The theoretical constructs were derived and based on the three components of the knowledge management theory, namely technical, communication and human components where it is suggested that this knowledge infrastructure could ensure effective management. While it is realised that it might be a little problematic to implement and measure all relevant concepts, this paper presents effect of eight critical success factors (CSFs) namely: organizational strategy, organizational culture, systems and infrastructure, intellectual capital, knowledge integration, organizational learning, motivation/performance measures and innovation. These CSFs have been identified based on a comprehensive literature review of existing research and tested in a new framework adapted from four perspectives of the balanced score card (BSC). Based on these CSFs and their items, an instrument was designed and tested among managers and employees of a purposefully selected engineering company in South Africa who relies on knowledge sharing to ensure their competitive advantage. Rigorous pretesting through personal interviews with executives and a number of academics took place to validate the instrument and to improve the quality of items and correct wording of issues. Through analysis of surveys collected, this research empirically models and uncovers key aspects of these dimensions based on the CSFs. Reliability of the instrument was calculated by Cronbach’s a for the two sections of the instrument on organizational and individual levels.The construct validity was confirmed by using factor analysis. The impact of the results was tested using structural equation modelling and proved to be a basis for implementing and understanding the competitive predisposition of the organization as it enters the process of knowledge management. In addition, they realised the importance to consolidate their knowledge assets to create value that is sustainable over time.Keywords: innovation, intellectual capital, knowledge sharing, performance measures
Procedia PDF Downloads 1955324 Argos-Linked Fastloc GPS Reveals the Resting Activity of Migrating Sea Turtles
Authors: Gail Schofield, Antoine M. Dujon, Nicole Esteban, Rebecca M. Lester, Graeme C. Hays
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Variation in diel movement patterns during migration provides information on the strategies used by animals to maximize energy efficiency and ensure the successful completion of migration. For instance, many flying and land-based terrestrial species stop to rest and refuel at regular intervals along the migratory route, or at transitory ‘stopover’ sites, depending on resource availability. However, in cases where stopping is not possible (such as over–or through deep–open oceans, or over deserts and mountains), non-stop travel is required, with animals needing to develop strategies to rest while actively traveling. Recent advances in biologging technologies have identified mid-flight micro sleeps by swifts in Africa during the 10-month non-breeding period, and the use of lateralized sleep behavior in orca and bottlenose dolphins during migration. Here, highly accurate locations obtained by Argos-linked Fastloc-GPS transmitters of adult green (n=8 turtles, 9487 locations) and loggerhead (n=46 turtles, 47,588 locations) sea turtles migrating around thousand kilometers (over several weeks) from breeding to foraging grounds across the Indian and Mediterranean oceans were used to identify potential resting strategies. Stopovers were only documented for seven turtles, lasting up to 6 days; thus, this strategy was not commonly used, possibly due to the lack of potential ‘shallow’ ( < 100 m seabed depth) sites along routes. However, observations of the day versus night speed of travel indicated that turtles might use other mechanisms to rest. For instance, turtles traveled an average 31% slower at night compared to day during oceanic crossings. Slower travel speeds at night might be explained by turtles swimming in a less direct line at night and/or deeper dives reducing their forward motion, as indicated through studies using Argos-linked transmitters and accelerometers. Furthermore, within the first 24 h of entering waters shallower than 100 m towards the end of migration (the depth at which sea turtles can swim and rest on the seabed), some individuals travelled 72% slower at night, repeating this behavior intermittently (each time for a one-night duration at 3–6-day intervals) until reaching the foraging grounds. If the turtles were, in fact, resting on the seabed at this point, they could be inactive for up to 8-hours, facilitating protracted periods of rest after several weeks of constant swimming. Turtles might not rest every night once within these shallower depths, due to the time constraints of reaching foraging grounds and restoring depleted energetic reserves (as sea turtles are capital breeders, they tend not to feed for several months during migration to and from the breeding grounds and while breeding). In conclusion, access to data-rich, highly accurate Argos-linked Fastloc-GPS provided information about differences in the day versus night activity at different stages of migration, allowing us, for the first time, to compare the strategies used by a marine vertebrate with terrestrial land-based and flying species. However, the question of what resting strategies are used by individuals that remain in oceanic waters to forage, with combinations of highly accurate Argos-linked Fastloc-GPS transmitters and accelerometry or time-depth recorders being required for sufficient numbers of individuals.Keywords: argos-linked fastloc GPS, data loggers, migration, resting strategy, telemetry
Procedia PDF Downloads 1565323 Robotic Arm Allowing a Diabetic Quadriplegic Patient to Self-Administer Insulin
Authors: L. Parisi
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A method which allows a diabetic quadriplegic patient that has had four limb amputations (above the knee and elbow) to self-administer injections of insulin has been designed. The aim of this research project is to improve a quadriplegic patient’s self-management, affected by diabetes, by designing a suitable device for self-administering insulin.The quadriplegic patient affected by diabetes has to be able to self-administer insulin safely and independently to guarantee stable healthy conditions. The device also should be designed to adapt to a number of different varying personal characteristics such as height and body weight.Keywords: robotic arm, self-administration, insulin, diabetes, quadriplegia
Procedia PDF Downloads 3725322 The Methods of Customer Satisfaction Measurement and Its Statistical Analysis towards Sales and Logistic Activities in Food Sector
Authors: Seher Arslankaya, Bahar Uludağ
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Meeting the needs and demands of customers and pleasing the customers are important requirements for companies in food sectors where the growth of competition is significantly unpredictable. Customer satisfaction is also one of the key concepts which is mainly driven by wide range of customer preference and expectation upon products and services introduced and delivered to them. In order to meet the customer demands, the companies that engage in food sectors are expected to have a well-managed set of Total Quality Management (TQM), which sets out to improve quality of products and services; to reduce costs and to increase customer satisfaction by restructuring traditional management practices. It aims to increase customer satisfaction by meeting (their) customer expectations and requirements. The achievement would be determined with the help of customer satisfaction surveys, which is done to obtain immediate feedback and to provide quick responses. In addition, the surveys would also assist the making of strategic planning which helps to anticipate customer future needs and expectations. Meanwhile, periodic measurement of customer satisfaction would be a must because with the better understanding of customers perceptions from the surveys (done by questioners), the companies would have a clear idea to identify their own strengths and weaknesses that help the companies keep their loyal customers; to stand in comparison toward their competitors and map out their future progress and improvement. In this study, we propose a survey based on customer satisfaction measurement method and its statistical analysis for sales and logistic activities of food firms. Customer satisfaction would be discussed in details. Furthermore, after analysing the data derived from the questionnaire that applied to customers by using the SPSS software, various results obtained from the application would be presented. By also applying ANOVA test, the study would analysis the existence of meaningful differences between customer demographic proportion and their perceptions. The purpose of this study is also to find out requirements which help to remove the effects that decrease customer satisfaction and produce loyal customers in food industry. For this purpose, the customer complaints are collected. Additionally, comments and suggestions are done according to the obtained results of surveys, which would be useful for the making-process of strategic planning in food industry.Keywords: customer satisfaction measurement and analysis, food industry, SPSS, TQM
Procedia PDF Downloads 2505321 Simulating the Interaction of Strategy Development and Project Delivery
Authors: Nipun Agarwal, David Paul, Fareed Un Din
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Every organization develops a strategy that needs to be implemented and is undertaken through project delivery. In essence, project requirements should exactly replicate an organization’s strategy. In reality this does not happen, and behavioral factors deviate the project delivery from the strategic objectives. This occurs as project stakeholders can have competing objectives. Resultantly, requirements that are implemented through projects are less aligned to the strategy. This paper develops a game theoretic model to simulate why such deviations occur. That explains the difference between strategy development and implementation.Keywords: strategy, simulation, project management, game theory
Procedia PDF Downloads 1385320 Sustainability in Higher Education: A Case of Transition Management from a Private University in Turkey (Ongoing Study)
Authors: Ayse Collins
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The Agenda 2030 puts Higher Education Institutions (HEIs) in the situation where they should emphasize ways to promote sustainability accordingly. However, it is still unclear: a) how sustainability is understood, and b) which actions have been taken in both discourse and practice by HEIs regarding the three pillars of sustainability, society, environment, and economy. There are models of sustainable universities developed by different authors from different countries; For Example, The Global Reporting Initiative (GRI) methodology which offers a variety of indicators to diagnose performance. However, these models have never been developed for universities in particular. Any model, in this sense, cannot be completed adequately without defining the appropriate tools to measure, analyze and control the performance of initiatives. There is a need to conduct researches in different universities from different countries to understand where we stand in terms of sustainable higher education. Therefore, this study aims at exploring the actions taken by a university in Ankara, Turkey, since Agenda 2030 should consider localizing its objectives and targets according to a certain geography. This university just announced 2021-2022 as “Sustainability Year.” Therefore, this research is a multi-methodology longitudinal study and uses the theoretical framework of the organization and transition management (TM). It is designed to examine the activities as being strategic, tactical, operational, and reflexive in nature and covers the six main aspects: academic community, administrative staff, operations and services, teaching, research, and extension. The preliminary research will answer the role of the top university governance, perception of the stakeholders (students, instructors, administrative and support staff) regarding sustainability, and the level of achievement at the mid-evaluation and final, end of year evaluation. TM Theory is a multi-scale, multi-actor, process-oriented approach with the analytical framework to explore and promote change in social systems. Therefore, the stages and respective methodology for collecting data in this research is: Pre-development Stage: a) semi-structured interviews with university governance, c) open-ended survey with faculty, students, and administrative staff d) Semi-structured interviews with support staff, and e) analysis of current secondary data for sustainability. Take-off Stage: a) semi-structured interviews with university governance, faculty, students, administrative and support staff, b) analysis of secondary data. Breakthrough stabilization a) survey with all stakeholders at the university, b) secondary data analysis by using selected indicators for the first sustainability report for universities The findings from the predevelopment stage highlight how stakeholders, coming from different faculties, different disciplines with different identities and characteristics, face the sustainability challenge differently. Though similar sustainable development goals ((social, environmental, and economic) are set in the institution, there are differences across disciplines and among different stakeholders, which need to be considered to reach the optimum goal. It is believed that the results will help changes in HEIs organizational culture to embed sustainability values in their strategic planning, academic and managerial work by putting enough time and resources to be successful in coping with sustainability.Keywords: higher education, sustainability, sustainability auditing, transition management
Procedia PDF Downloads 1085319 Circular Tool and Dynamic Approach to Grow the Entrepreneurship of Macroeconomic Metabolism
Authors: Maria Areias, Diogo Simões, Ana Figueiredo, Anishur Rahman, Filipa Figueiredo, João Nunes
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It is expected that close to 7 billion people will live in urban areas by 2050. In order to improve the sustainability of the territories and its transition towards circular economy, it’s necessary to understand its metabolism and promote and guide the entrepreneurship answer. The study of a macroeconomic metabolism involves the quantification of the inputs, outputs and storage of energy, water, materials and wastes for an urban region. This quantification and analysis representing one opportunity for the promotion of green entrepreneurship. There are several methods to assess the environmental impacts of an urban territory, such as human and environmental risk assessment (HERA), life cycle assessment (LCA), ecological footprint assessment (EF), material flow analysis (MFA), physical input-output table (PIOT), ecological network analysis (ENA), multicriteria decision analysis (MCDA) among others. However, no consensus exists about which of those assessment methods are best to analyze the sustainability of these complex systems. Taking into account the weaknesses and needs identified, the CiiM - Circular Innovation Inter-Municipality project aims to define an uniform and globally accepted methodology through the integration of various methodologies and dynamic approaches to increase the efficiency of macroeconomic metabolisms and promoting entrepreneurship in a circular economy. The pilot territory considered in CiiM project has a total area of 969,428 ha, comprising a total of 897,256 inhabitants (about 41% of the population of the Center Region). The main economic activities in the pilot territory, which contribute to a gross domestic product of 14.4 billion euros, are: social support activities for the elderly; construction of buildings; road transport of goods, retailing in supermarkets and hypermarkets; mass production of other garments; inpatient health facilities; and the manufacture of other components and accessories for motor vehicles. The region's business network is mostly constituted of micro and small companies (similar to the Central Region of Portugal), with a total of 53,708 companies identified in the CIM Region of Coimbra (39 large companies), 28,146 in the CIM Viseu Dão Lafões (22 large companies) and 24,953 in CIM Beiras and Serra da Estrela (13 large companies). For the construction of the database was taking into account data available at the National Institute of Statistics (INE), General Directorate of Energy and Geology (DGEG), Eurostat, Pordata, Strategy and Planning Office (GEP), Portuguese Environment Agency (APA), Commission for Coordination and Regional Development (CCDR) and Inter-municipal Community (CIM), as well as dedicated databases. In addition to the collection of statistical data, it was necessary to identify and characterize the different stakeholder groups in the pilot territory that are relevant to the different metabolism components under analysis. The CIIM project also adds the potential of a Geographic Information System (GIS) so that it is be possible to obtain geospatial results of the territorial metabolisms (rural and urban) of the pilot region. This platform will be a powerful visualization tool of flows of products/services that occur within the region and will support the stakeholders, improving their circular performance and identifying new business ideas and symbiotic partnerships.Keywords: circular economy tools, life cycle assessment macroeconomic metabolism, multicriteria decision analysis, decision support tools, circular entrepreneurship, industrial and regional symbiosis
Procedia PDF Downloads 1015318 Screening for Women with Chorioamnionitis: An Integrative Literature Review
Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo
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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women
Procedia PDF Downloads 1235317 Assessing the Channel Design of the Eco-Friendly ‘Falaj’ Water System in Meeting the Optimal Water Demand: A Case Study of Falaj Al-Khatmain, Sultanate of Oman
Authors: Omer Al-Kaabi, Ahmed Nasr, Abdullah Al-Ghafri, Mohammed Abdelfattah
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The Falaj system, derived from natural water sources, is a man-made canal system designed to supply communities of farmers with water for domestic and agricultural purposes. For thousands of years, Falaj has served communities by harnessing the force of gravity; it persists as a vital water management system in numerous regions across the Sultanate of Oman. Remarkably, predates the establishment of many fundamental hydraulic principles used today. Al-Khatmain Falaj, with its accessibility and historical significance spanning over 2000 years, was chosen as the focal point of this study. The research aimed to investigate the efficiency of Al-Khatmain Falaj in meeting specific water demands. The HEC-RAS model was utilized to visualize water flow dynamics within the Falaj channels, accompanied by graphical representations of pertinent variables. The application of HEC-RAS helped to measure different water flow scenarios within the channel, enabling a clear comparison with the demand area catchment. The cultivated land of Al-Khatmain is 723,124 m² and consists of 16,873 palm trees representing 91% of the total area and the remaining 9% is mixed types of trees counted 3,920 trees. The study revealed a total demand of 8,244 m³ is required to irrigate the cultivated land. Through rigorous analysis, the study has proven that the Falaj system in Al-Khatmain operates with high efficiency, as the average annual water supply is 9676.8 m3/day. Additionally, the channel designed at 0.6m width x 0.3m height efficiently holds the optimal water supply, with an average flow depth of 0.21m. Also, the system includes an overflow drainage channel to mitigate floods and prevent crop damage based on seasonal requirements. This research holds promise for examining diverse hydrological conditions and devising effective strategies to manage scenarios of both high and low flow rates.Keywords: Al-Khatmain, sustainability, Falaj, HEC-RAS, water management system
Procedia PDF Downloads 445316 Forest Products Pricing System in Community Forestry Program: An Analysis of Its Impacts on Forest Resources Management and Livelihood Improvement of Local People
Authors: Mohan Bikram Thapa
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Despite the successful implementation of community forestry program, a number of pros and cons have been raised on Terai community forestry in the case of lowland locally called Terai region of Nepal, which climatically belongs to tropical humid and possessed high-quality forests in terms of ecology and economy. The study aims to investigate the local pricing strategy of forest products and its impacts on equitable forest benefits sharing, the collection of community fund and carrying out livelihood improvement activities. The study was carried out on six community forests revealed that local people have substantially benefited from the community forests. However, being the region is heterogeneous by socio-economic conditions and forest resources have higher economic potential, the decision of low pricing strategy made by the local people have created inequality problems while sharing the forest benefits, and poorly contributed to community fund collection and consequently carrying out limited activities of livelihood improvement. The paper argued that the decision of low pricing strategy of forest products is counterproductive to promote the equitable benefit-sharing in the areas of heterogeneous socio-economic conditions with high-value forests. The low pricing strategy has been increasing accessibility of better off households at a higher rate than poor, as such households always have the higher affording capacity. It is also defective to increase the community fund and carry out activities of livelihood improvement effectively. The study concluded that unilateral decentralized forest policy and decision-making autonomy to the local people seems questionable unless their decision-making capacities are enriched sufficiently. Therefore, it is recommended that empowerments of decision-making capacity of local people and their respective institutions together with policy and program formulation are prerequisite for efficient and equitable community forest management and its long-term sustainability.Keywords: benefit sharing, community forest, livelihood, pricing mechanism, Nepal
Procedia PDF Downloads 3675315 Assessing the Eutrophication Risk in the Suat Uğurlu Dam Lake by Evaluation of Trophic Variables
Authors: Bilge Aydın Er, Yuksel Ardalı
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In Ayvacık village, 80-90% of the population is engaged in agriculture. The pollution was adversely affecting the properties of agricultural origin of the lake. This study is to determine pollution caused by unwanted changes in the Suat Ugurlu Dam Lake has been launched to monitor. Yesilirmak basin is located in the proximal part of the Black Sea. Therefore it was exposed to impact many pollution. In this study, sediment samples from selected points along the lake was made on the analysis. This work was supported by the results of water analyzes. It is clear that urgent measures should be taken to the area of water managementKeywords: eutrophication, Black sea, lake, pollution
Procedia PDF Downloads 3995314 Optimum Irrigation System Management for Climate Resilient and Improved Productivity of Flood-based Livelihood Systems
Authors: Mara Getachew Zenebe, Luuk Fleskens, Abdu Obieda Ahmed
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This paper seeks to advance our scientific understanding of optimizing flood utilization in regions impacted by climate change, with a focus on enhancing agricultural productivity through effective irrigation management. The study was conducted as part of a three-year (2021 to 2023) USAID-supported initiative aimed at promoting Economic Growth and Peace in the Gash Agricultural Scheme (GAS), situated in Sudan's water-stressed Eastern region. GAS is the country's largest flood-irrigated scheme, covering 100,800 hectares of cultivable land, with a potential to provide the food security needs of over a quarter of a million agro-pastoral community members. GAS relies on the Gash River, which sources its water from high-intensity rainfall events in the highlands of Ethiopia and Eritrea. However, climate change and variations in these highlands have led to increased variability in the Gash River's flow. The study conducted water balance analyses based on a ten-year dataset of the annual Gash River flow, irrigated area; as well as the evapotranspiration demand of the major sorghum crop. Data collection methods included field measurements, surveys, remote sensing, and CropWat modelling. The water balance assessment revealed that the existing three-year rotation-based irrigation system management, capping cultivated land at 33,000 hectares annually, is excessively risk-averse. While this system reduced conflicts among the agro-pastoral communities by consistently delivering on the land promised to be annually cultivated, it also increased GAS's vulnerability to flood damage due to several reasons. The irrigation efficiency over the past decade was approximately 30%, leaving significant unharnessed floodwater that caused damage to infrastructure and agricultural land. The three-year rotation resulted in inadequate infrastructural maintenance, given the destructive nature of floods. Additionally, it led to infrequent land tillage, allowing the encroachment of mesquite trees hindering major sorghum crop growth. Remote sensing data confirmed that mesquite trees have overtaken 70,000 hectares in the past two decades, rendering them unavailable for agriculture. The water balance analyses suggest shifting to a two-year rotation, covering approximately 50,000 hectares annually while maintaining risk aversion. This shift could boost GAS's annual sorghum production by two-thirds, exceeding 850,000 tons. The scheme's efficiency can be further enhanced through low-cost on-farm interventions. Currently, large irrigation plots that range from 420 to 756 hectares are irrigated with limited water distribution guidance, leading to uneven irrigation. As demonstrated through field trials, implementing internal longitudinal bunds and horizontal deflector bunds can increase adequately irrigated parts of the irrigation plots from 50% to 80% and thus nearly double the sorghum yield to 2 tons per hectare while reducing the irrigation duration from 30 days to a maximum of 17 days. Flow measurements in 2021 and 2022 confirmed that these changes sufficiently meet the sorghum crop's water requirements, even with a conservative 60% field application efficiency assumption. These insights and lessons from the GAS on enhancing agricultural resilience and sustainability in the face of climate change are relevant to flood-based livelihood systems globally.Keywords: climate change, irrigation management and productivity, variable flood flows, water balance analysis
Procedia PDF Downloads 755313 Dynamic Ambulance Deployment to Reduce Ambulance Response Times Using Geographic Information Systems
Authors: Masoud Swalehe, Semra Günay
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Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest
Procedia PDF Downloads 3005312 An Approach towards Smart Future: Ict Infrastructure Integrated into Urban Water Networks
Authors: Ahsan Ali, Mayank Ostwal, Nikhil Agarwal
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Abstract—According to a World Bank report, millions of people across the globe still do not have access to improved water services. With uninterrupted growth of cities and urban inhabitants, there is a mounting need to safeguard the sustainable expansion of cities. Efficient functioning of the urban components and high living standards of the residents are needed to be ensured. The water and sanitation network of an urban development is one of its most essential parts of its critical infrastructure. The growth in urban population is leading towards increased water demand, and thus, the local water resources are severely strained. 'Smart water' is referred to water and waste water infrastructure that is able to manage the limited resources and the energy used to transport it. It enables the sustainable consumption of water resources through co-ordinate water management system, by integrating Information Communication Technology (ICT) solutions, intended at maximizing the socioeconomic benefits without compromising the environmental values. This paper presents a case study from a medium sized city in North-western Pakistan. Currently, water is getting contaminated due to the proximity between water and sewer pipelines in the study area, leading to public health issues. Due to unsafe grey water infiltration, the scarce ground water is also getting polluted. This research takes into account the design of smart urban water network by integrating ICT (Information and Communication Technology) with urban water network. The proximity between the existing water supply network and sewage network is analyzed and a design of new water supply system is proposed. Real time mapping of the existing urban utility networks will be projected with the help of GIS applications. The issue of grey water infiltration is addressed by providing sustainable solutions with the help of locally available materials, keeping in mind the economic condition of the area. To deal with the current growth of urban population, it is vital to develop new water resources. Hence, distinctive and cost effective procedures to harness rain water would be suggested as a part of the research study experiment.Keywords: GIS, smart water, sustainability, urban water management
Procedia PDF Downloads 2175311 Resilience-Based Emergency Bridge Inspection Routing and Repair Scheduling under Uncertainty
Authors: Zhenyu Zhang, Hsi-Hsien Wei
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Highway network systems play a vital role in disaster response for disaster-damaged areas. Damaged bridges in such network systems can impede disaster response by disrupting transportation of rescue teams or humanitarian supplies. Therefore, emergency inspection and repair of bridges to quickly collect damage information of bridges and recover the functionality of highway networks is of paramount importance to disaster response. A widely used measure of a network’s capability to recover from disasters is resilience. To enhance highway network resilience, plenty of studies have developed various repair scheduling methods for the prioritization of bridge-repair tasks. These methods assume that repair activities are performed after the damage to a highway network is fully understood via inspection, although inspecting all bridges in a regional highway network may take days, leading to the significant delay in repairing bridges. In reality, emergency repair activities can be commenced as soon as the damage data of some bridges that are crucial to emergency response are obtained. Given that emergency bridge inspection and repair (EBIR) activities are executed simultaneously in the response phase, the real-time interactions between these activities can occur – the blockage of highways due to repair activities can affect inspection routes which in turn have an impact on emergency repair scheduling by providing real-time information on bridge damages. However, the impact of such interactions on the optimal emergency inspection routes (EIR) and emergency repair schedules (ERS) has not been discussed in prior studies. To overcome the aforementioned deficiencies, this study develops a routing and scheduling model for EBIR while accounting for real-time inspection-repair interactions to maximize highway network resilience. A stochastic, time-dependent integer program is proposed for the complex and real-time interacting EBIR problem given multiple inspection and repair teams at locations as set post-disaster. A hybrid genetic algorithm that integrates a heuristic approach into a traditional genetic algorithm to accelerate the evolution process is developed. Computational tests are performed using data from the 2008 Wenchuan earthquake, based on a regional highway network in Sichuan, China, consisting of 168 highway bridges on 36 highways connecting 25 cities/towns. The results show that the simultaneous implementation of bridge inspection and repair activities can significantly improve the highway network resilience. Moreover, the deployment of inspection and repair teams should match each other, and the network resilience will not be improved once the unilateral increase in inspection teams or repair teams exceeds a certain level. This study contributes to both knowledge and practice. First, the developed mathematical model makes it possible for capturing the impact of real-time inspection-repair interactions on inspection routing and repair scheduling and efficiently deriving optimal EIR and ERS on a large and complex highway network. Moreover, this study contributes to the organizational dimension of highway network resilience by providing optimal strategies for highway bridge management. With the decision support tool, disaster managers are able to identify the most critical bridges for disaster management and make decisions on proper inspection and repair strategies to improve highway network resilience.Keywords: disaster management, emergency bridge inspection and repair, highway network, resilience, uncertainty
Procedia PDF Downloads 1095310 Synthesis of Microencapsulated Phase Change Material for Adhesives with Thermoregulating Properties
Authors: Christin Koch, Andreas Winkel, Martin Kahlmeyer, Stefan Böhm
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Due to environmental regulations on greenhouse gas emissions and the depletion of fossil fuels, there is an increasing interest in electric vehicles.To maximize their driving range, batteries with high storage capacities are needed. In most electric cars, rechargeable lithium-ion batteries are used because of their high energy density. However, it has to be taken into account that these batteries generate a large amount of heat during the charge and discharge processes. This leads to a decrease in a lifetime and damage to the battery cells when the temperature exceeds the defined operating range. To ensure an efficient performance of the battery cells, reliable thermal management is required. Currently, the cooling is achieved by heat sinks (e.g., cooling plates) bonded to the battery cells with a thermally conductive adhesive (TCA) that directs the heat away from the components. Especially when large amounts of heat have to be dissipated spontaneously due to peak loads, the principle of heat conduction is not sufficient, so attention must be paid to the mechanism of heat storage. An efficient method to store thermal energy is the use of phase change materials (PCM). Through an isothermal phase change, PCM can briefly absorb or release thermal energy at a constant temperature. If the phase change takes place in the transition from solid to liquid, heat is stored during melting and is released to the ambient during the freezing process upon cooling. The presented work displays the great potential of thermally conductive adhesives filled with microencapsulated PCM to limit peak temperatures in battery systems. The encapsulation of the PCM avoids the effects of aging (e.g., migration) and chemical reactions between the PCM and the adhesive matrix components. In this study, microencapsulation has been carried out by in situ polymerization. The microencapsulated PCM was characterized by FT-IR spectroscopy, and the thermal properties were measured by DSC and laser flash method. The mechanical properties, electrical and thermal conductivity, and adhesive toughness of the TCA/PCM composite were also investigated.Keywords: phase change material, microencapsulation, adhesive bonding, thermal management
Procedia PDF Downloads 725309 The Use of a Novel Visual Kinetic Demonstration Technique in Student Skill Acquisition of the Sellick Cricoid Force Manoeuvre
Authors: L. Nathaniel-Wurie
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The Sellick manoeuvre a.k.a the application of cricoid force (CF), was first described by Brian Sellick in 1961. CF is the application of digital pressure against the cricoid cartilage with the intention of posterior force causing oesophageal compression against the vertebrae. This is designed to prevent passive regurgitation of gastric contents, which is a major cause of morbidity and mortality during emergency airway management inside and outside of the hospital. To the authors knowledge, there is no universally standardised training modality and, therefore, no reliable way to examine if there are appropriate outcomes. If force is not measured during training, how can one surmise that appropriate, accurate, or precise amounts of force are being used routinely. Poor homogeneity in teaching and untested outcomes will correlate with reduced efficacy and increased adverse effects. For this study, the accuracy of force delivery in trained professionals was tested, and outcomes contrasted against a novice control and a novice study group. In this study, 20 operating department practitioners were tested (with a mean experience of 5.3years of performing CF). Subsequent contrast with 40 novice students who were randomised into one of two arms. ‘Arm A’ were explained the procedure, then shown the procedure then asked to perform CF with the corresponding force measurement being taken three times. Arm B had the same process as arm A then before being tested, they had 10, and 30 Newtons applied to their hands to increase intuitive understanding of what the required force equated to, then were asked to apply the equivalent amount of force against a visible force metre and asked to hold that force for 20 seconds which allowed direct visualisation and correction of any over or under estimation. Following this, Arm B were then asked to perform the manoeuvre, and the force generated measured three times. This study shows that there is a wide distribution of force produced by trained professionals and novices performing the procedure for the first time. Our methodology for teaching the manoeuvre shows an improved accuracy, precision, and homogeneity within the group when compared to novices and even outperforms trained practitioners. In conclusion, if this methodology is adopted, it may correlate with higher clinical outcomes, less adverse events, and more successful airway management in critical medical scenarios.Keywords: airway, cricoid, medical education, sellick
Procedia PDF Downloads 795308 Experience of Inpatient Life in Korean Complex Regional Pain Syndrome: A Phenomenological Study
Authors: Se-Hwa Park, En-Kyung Han, Jae-Young Lim, Hye-Jung Ahn
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Purpose: The objective of this study is to provide basic data for understanding the substance of inpatient life with CRPS (Complex Regional Pain Syndrome) and developing efficient and effective nursing intervention. Methods: From September 2018 to November, we have interviewed 10 CRPS patients about inpatient experiences. To understand the implication of inpatient life experiences with CRPS and intrinsic structure, we have used the question: 'How about the inpatient experiences with CRPS'. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. Results: According to the analysis, the study participants' inpatient life process was structured in six categories: (a) breakthrough pain experience (b) the limitation of pain treatment, (c) worsen factors of pain during inpatient period, (d) treat method for pain, (e) positive experience for inpatient period, (f) requirements for medical team, family and people in hospital room. Conclusion: Inpatient with CRPS have experienced the breakthrough pain. They had expected immediate treatment for breakthrough pain, but they experienced severe pain because immediate treatment was not implemented. Pain-worsening factors which patients with CRPS are as follows: personal factors from negative emotions such as insomnia, stress, sensitive character, pain part touch or vibration stimulus on the bed, physical factors from high threshold or rapid speed during fast transfer, conflict with other people, climate factors such as humidity or low temperature, noise, smell, lack of space because of many visitors. Patients actively manage the pain committing into another tasks or diversion. And also, patients passively manage the pain, just suppress, give-up. They think positively about rehabilitation treatment. And they require the understanding and sympathy for other people, and emotional support, immediate intervention for medical team. Based on the results of this study, we suppose the guideline of systematic breakthrough pain management for the relaxation of sudden pain, using notice of informing caution for touch or vibration. And we need to develop non-medicine pain management nursing intervention.Keywords: breakthrough pain, CRPS, complex regional pain syndrome, inpatient life experiences, phenomenological method
Procedia PDF Downloads 1295307 A Review: The Impact of Core Quality the Empirical Review of Critical Factors on the Causes of Delay in Road Constructions Projects in the GCC Countries
Authors: Sulaiman Al-Hinai, Setyawan Widyarto
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The aim of this study is to identify the critically dominating factors on the delays of road constructions in the GCC countries and their effects on project delivery in Arab countries. Towards the achieved of the objectives the study used the empirical literature from the all relevant online sources and database as many as possible. The findings of this study have summarized and short listed of the success factors in the two categories such as internal and external factors have caused to be influenced to delay of road constructions in the Arab regions. However, in the category of internal factors, there are 63 factors short listed from seven group of factors which has revealed to effects on the delay of road constructions especially, the consultant related factors, the contractor related factors, designed related factors, client related factors, labor related factors, material related issues, equipment related issues respectively. Moreover, for external related factors are also considered to summarized especially natural disaster (flood, hurricanes and cyclone etc.), conflict, war, global financial crisis, compensation delay to affected property owner, price fluctuated, unexpected ground conditions (soil and high-water level), changing of government regulations and laws, delays in obtaining permission from municipality, loss of time by traffic control and restrictions at job site, problem with inhabitant of community, delays in providing service from utilities (water and electricity’s) and accident during constructions accordingly. The present study also concluded the effects of above factors which has delay road constructions through increasing of cost and overrun it, taken overtime, creating of disputes, going for lawsuits, finally happening of abandon of projects. Thus, the present study has given the following recommendations to overcome of above problems by increasing of detailed site investigations, ensure careful monitoring and regular meetings, effective site management, collaborative working and effective coordination’s, proper and comprehensive planning and scheduling and ensure full and intensive commitment from all parties accordingly.Keywords: Arab GCC countries, critical success factors, road constructions delay, project management
Procedia PDF Downloads 1275306 Enhancing Skills of Mothers of Asthmatic Children in Techniques of Drug Administration
Authors: Erna Judith Roach, Nalini Bhaskaranand
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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.Keywords: childhood asthma, drug administration, mothers of children, inhaler
Procedia PDF Downloads 4235305 Half Dose Tissue Plasminogen Activator for Intermediate-Risk Pulmonary Embolism
Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson
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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event
Procedia PDF Downloads 755304 Family Medicine Residents in End-of-Life Care
Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal
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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.Keywords: end of life care, geriatrics, palliative care, residency training skill
Procedia PDF Downloads 2575303 Turn Organic Waste to Green Fuels with Zero Landfill
Authors: Xu Fei (Philip) WU
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As waste recycling concept been accepted more and more in modern societies, the organic portion of the municipal waste become a sires issue in today’s life. Depend on location and season, the organic waste can bee anywhere between 40-65% of total municipal solid waste. Also composting and anaerobic digestion technologies been applied in this field for years, however both process have difficulties been selected by economical and environmental factors. Beside environmental pollution and risk of virus spread, the compost is not a product been welcomed by people even the waste management has to give up them at no cost. The anaerobic digester has to have 70% of water and keep at 35 degree C or above; base on above conditions, the retention time only can be up to two weeks and remain solid has to be dewater and composting again. The enhancive waste water treatment has to be added after. Because these reasons, the voice of suggesting cancelling recycling program and turning all waste to mass burn incinerations have been raised-A process has already been proved has least energy efficiency and most air pollution problem associated process. A newly developed WXF Bio-energy process employs recently developed and patented pre-designed separation, multi-layer and multi-cavity successive bioreactor landfill technology. It features an improved leachate recycling technology, technologies to maximize the biogas generation rate and a reduced overall turnaround period on the land. A single properly designed and operated site can be used indefinitely. In this process, all collected biogas will be processed to eliminate H2S and other hazardous gases. The methane, carbon dioxide and hydrogen will be utilized in a proprietary process to manufacture methanol which can be sold to mitigate operating costs of the landfill. This integration of new processes offers a more advanced alternative to current sanitary landfill, incineration and compost technology. Xu Fei (Philip) Wu Xu Fei Wu is founder and Chief Scientist of W&Y Environmental International Inc. (W & Y), a Canadian environmental and sustainable energy technology company with patented landfill processes and proprietary waste to energy technologies. He has worked in environmental and sustainable energy fields over the last 25 years. Before W&Y, he worked for Conestoga-Rovers & Associates Limited, Microbe Environmental Science and Technology Inc. of Canada and The Ministry of Nuclear Industry and Ministry of Space Flight Industry of China. Xu Fei Wu holds a Master of Engineering Science degree from The University of Western Ontario. I wish present this paper as an oral presentation only Selected Conference Presentations: • “Removal of Phenolic Compounds with Algae” Presented at 25th Canadian Symposium on Water Pollution Research (CAWPRC Conference), Burlington, Ontario Canada. February, 1990 • “Removal of Phenolic Compounds with Algae” Presented at Annual Conference of Pollution Control Association of Ontario, London, Ontario, Canada. April, 1990 • “Removal of Organochlorine Compounds in a Flocculated Algae Photo-Bioreactor” Presented at International Symposium on Low Cost and Energy Saving Wastewater Treatment Technologies (IAWPRC Conference), Kiyoto, Japan, August, 1990 • “Maximizing Production and Utilization of Landfill Gas” 2009 Wuhan International Conference on Environment(CAWPRC Conference, sponsored by US EPA) Wuhan, China. October, 2009. • “WXF Bio-Energy-A Green, Sustainable Waste to Energy Process” Presented at 9Th International Conference Cooperation for Waste Issues, Kharkiv, Ukraine March, 2012 • “A Lannfill Site Can Be Recycled Indefinitely” Presented at 28th International Conference on solid Waste Technology and Management, Philadelphia, Pennsylvania, USA. March, 2013. Hosted by The Journal of Solid Waste Technology and Management.Keywords: green fuel, waste management, bio-energy, sustainable development, methanol
Procedia PDF Downloads 2775302 Effect of R&D Human Capital Support for SMEs: An Analysis of Smes Support Program in South Korea
Authors: Misun Kim, Beomsoo Park
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Korean government has strongly supported SMEs financially and technically. It has also changed R&D manpower management so that SMEs can benefit from the knowledge of highly qualified experts. This study evaluates the impacts of such policy on SMEs and analyzes the factors affecting the growth of the firms. Then we compare the characteristics of high growth companies to general companies. This factors could be use in the future for identifying firms that would significantly benefit from manpower help.Keywords: dispatch human Ccapital, high growth, science and technology policy, SMEs
Procedia PDF Downloads 3035301 Active Learning through a Game Format: Implementation of a Nutrition Board Game in Diabetes Training for Healthcare Professionals
Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan
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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.Keywords: active learning, game, diabetes, nutrition
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