Search results for: urban environmental quality
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 17297

Search results for: urban environmental quality

9857 Assessment of Intern Students' Attitudes towards Medical Errors

Authors: Nilgün Katrancı, Pınar Göv

Abstract:

With the acceleration and assessment of quality and patient safety works in healthcare services in the 21st century, activities to reduce errors have gained importance. The prevention and reduction of unintended consequences related to healthcare services and errors made during the delivery of healthcare services can be achieved by understanding the causes of the errors. Communication is the basic reason most frequently seen in such cases. Nurses who communicate with patients more closely and for longer time play a more critical role in ensuring patient safety compared to other healthcare professionals. To reduce the risk of medical errors and increase the quality of care, it is important to raise the awareness of nurses about patient safety in training period. This descriptive study was conducted between February 2017 and May 2017 to assess intern students' attitudes towards and knowledge of patient safety and medical errors. The target population of the study consists of intern students at the Faculty of Nursing in Gaziantep University (N=180). The study did not apply any sample selection method, and the research group consisted of 90 female and 37 male senior students who were available and accepted to take part in the study (N=127). The study used personal information form and medical error attitude scale to collect data. The medical error attitude scale consists of 16 items and 3 sub-dimensions. The most frequently seen medical error in the clinics the interns worked at was found as ‘Failure to comply with asepsis rules’ with a rate of 67,7%. The most frequent case among reasons for not disclosing an error is ‘noticing and correcting the error before affecting the patient’ with the rate of 70,9%. The most frequently expressed implications of disclosing a serious error for the intern students participating in the study are ‘harming patient trust (78%)’ and ‘possibility of overreaction by patient (62,2%)’. According to the results of the study, the awareness of the students about the importance of medical errors and error reporting was found high (3,48 ± 0,49). Consequently, it is important to assess and positively improve the attitudes of nurses and other healthcare professionals towards medical errors for the determination of causes of medical errors and their prevention.

Keywords: healthcare service, intern student, medical error, patient safety

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9856 Road Accidents Bigdata Mining and Visualization Using Support Vector Machines

Authors: Usha Lokala, Srinivas Nowduri, Prabhakar K. Sharma

Abstract:

Useful information has been extracted from the road accident data in United Kingdom (UK), using data analytics method, for avoiding possible accidents in rural and urban areas. This analysis make use of several methodologies such as data integration, support vector machines (SVM), correlation machines and multinomial goodness. The entire datasets have been imported from the traffic department of UK with due permission. The information extracted from these huge datasets forms a basis for several predictions, which in turn avoid unnecessary memory lapses. Since data is expected to grow continuously over a period of time, this work primarily proposes a new framework model which can be trained and adapt itself to new data and make accurate predictions. This work also throws some light on use of SVM’s methodology for text classifiers from the obtained traffic data. Finally, it emphasizes the uniqueness and adaptability of SVMs methodology appropriate for this kind of research work.

Keywords: support vector mechanism (SVM), machine learning (ML), support vector machines (SVM), department of transportation (DFT)

Procedia PDF Downloads 255
9855 Allelopathic Action of Diferents Sorghum bicolor [L.] Moench Fractions on Ipomoea grandifolia [Dammer] O'Donell

Authors: Mateus L. O. Freitas, Flávia H. de M. Libório, Letycia L. Ricardo, Patrícia da C. Zonetti, Graciene de S. Bido

Abstract:

Weeds compete with agricultural crops for resources such as light, water, and nutrients. This competition can cause significant damage to agricultural producers, and, currently, the use of agrochemicals is the most effective method for controlling these undesirable plants. Morning glory (Ipomoea grandifolia [Dammer] O'Donell) is an aggressive weed and significantly reduces agricultural productivity making harvesting difficult, especially mechanical harvesting. The biggest challenge in modern agriculture is to preserve high productivity reducing environmental damage and maintaining soil characteristics. No-till is a sustainable practice that can reduce the use of agrochemicals and environmental impacts due to the presence of plant residues in the soil, which release allelopathic compounds and reduce the incidence or alter the growth and development of crops and weeds. Sorghum (Sorghum bicolor [L.] Moench) is a forage with proven allelopathic activity, mainly for producing sorgholeone. In this context, this research aimed to evaluate the allelopathic action of sorghum fractions using hexane, dichloromethane, butanol, and ethyl acetate on the germination and initial growth of morning glory. The parameters analyzed were the percentage of germination, speed of germination, seedling length, and biomass weight (fresh and dry). The bioassays were performed in Petri dishes, kept in an incubation chamber for 7 days, at 25 °C, with a 12h photoperiod. The experimental design was completely randomized, with five replicates of each treatment. The data were evaluated by analysis of variance, and the averages between each treatment were compared using the Scott Knott test at a 5% significance level. The results indicated that the dichloromethane and ethyl acetate fractions showed bioherbicidal effects, promoting effective reductions on germination and initial growth of the morning glory. It was concluded that allelochemicals were probably extracted in these fractions. These secondary metabolites can reduce the use of agrochemicals and environmental impact, making agricultural production systems more sustainable.

Keywords: allelochemicals, secondary metabolism, sorgoleone, weeds

Procedia PDF Downloads 136
9854 Passenger Flow Characteristics of Seoul Metropolitan Subway Network

Authors: Kang Won Lee, Jung Won Lee

Abstract:

Characterizing the network flow is of fundamental importance to understand the complex dynamics of networks. And passenger flow characteristics of the subway network are very relevant for an effective transportation management in urban cities. In this study, passenger flow of Seoul metropolitan subway network is investigated and characterized through statistical analysis. Traditional betweenness centrality measure considers only topological structure of the network and ignores the transportation factors. This paper proposes a weighted betweenness centrality measure that incorporates monthly passenger flow volume. We apply the proposed measure on the Seoul metropolitan subway network involving 493 stations and 16 lines. Several interesting insights about the network are derived from the new measures. Using Kolmogorov-Smirnov test, we also find out that monthly passenger flow between any two stations follows a power-law distribution and other traffic characteristics such as congestion level and throughflow traffic follow exponential distribution.

Keywords: betweenness centrality, correlation coefficient, power-law distribution, Korea traffic DB

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9853 Positive Incentives to Reduce Private Car Use: A Theory-Based Critical Analysis

Authors: Rafael Alexandre Dos Reis

Abstract:

Research has shown a substantial increase in the participation of Conventionally Fuelled Vehicles (CFVs) in the urban transport modal split. The reasons for this unsustainable reality are multiple, from economic interventions to individual behaviour. The development and delivery of positive incentives for the adoption of more environmental-friendly modes of transport is an emerging strategy to help in tackling the problem of excessive use of conventionally fuelled vehicles. The efficiency of this approach, like other information-based schemes, can benefit from the knowledge of their potential impacts in theoretical constructs of multiple behaviour change theories. The goal of this research is to critically analyse theories of behaviour that are relevant to transport research and the impacts of positive incentives on the theoretical determinants of behaviour, strengthening the current body of evidence about the benefits of this approach. The main method to investigate this will involve a literature review on two main topics: the current theories of behaviour that have empirical support in transport research and the past or ongoing positive incentives programs that had an impact on car use reduction. The reviewed programs of positive incentives were the following: The TravelSmart®; Spitsmijden®; Incentives for Singapore Commuters® (INSINC); COMMUTEGREENER®; MOVESMARTER®; STREETLIFE®; SUPERHUB®; SUNSET® and the EMPOWER® project. The theories analysed were the heory of Planned Behaviour (TPB); The Norm Activation Theory (NAM); Social Learning Theory (SLT); The Theory of Interpersonal Behaviour (TIB); The Goal-Setting Theory (GST) and The Value-Belief-Norm Theory (VBN). After the revisions of the theoretical constructs of each of the theories and their influence on car use, it can be concluded that positive incentives schemes impact on behaviour change in the following manners: -Changing individual’s attitudes through informational incentives; -Increasing feelings of moral obligations to reduce the use of CFVs; -Increase the perceived social pressure to engage in more sustainable mobility behaviours through the use of comparison mechanisms in social media, for example; -Increase the perceived control of behaviour through informational incentives and training incentives; -Increasing personal norms with reinforcing information; -Providing tools for self-monitoring and self-evaluation; -Providing real experiences in alternative modes to the car; -Making the observation of others’ car use reduction possible; -Informing about consequences of behaviour and emphasizing the individual’s responsibility with society and the environment; -Increasing the perception of the consequences of car use to an individual’s valued objects; -Increasing the perceived ability to reduce threats to environment; -Help establishing goals to reduce car use; - iving personalized feedback on the goal; -Increase feelings of commitment to the goal; -Reducing the perceived complexity of the use of alternatives to the car. It is notable that the emerging technique of delivering positive incentives are systematically connected to causal determinants of travel behaviour. The preliminary results of the reviewed programs evidence how positive incentives might strengthen these determinants and help in the process of behaviour change.

Keywords: positive incentives, private car use reduction, sustainable behaviour, voluntary travel behaviour change

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9852 Research on Renovation of Existing Interior Space Based on Post Occupancy Evaluation: A Case Study of the Atrium Space of Zhejiang University Library in Hangzhou

Authors: Qin Dai

Abstract:

The renovation of existing interior space is big issue for architects in today’s China. However the traditional way of space renovation in China mostly focuses on the object itself, and the method also focuses on subjective level without the support of specific data. This research focuses the application of renovation of existing interior space based on post occupancy evaluation by a case study of a typical interior space. The research hopes to give a more scientific method of interior space renovation for architects and help promoting and guiding renovation practice. This research studies the post occupancy evaluation of the atrium space of Zhejiang University Library including subjective satisfaction and physical environmental satisfaction. The result provides necessary data support to conclude the design principles and strategies of renovation. Then the research uses simulation software to verify the availability of the strategy given based on the study. In conclusion, the research summarizes the application process of design methods of renovation of existing interior space based on the post-occupancy evaluation, and testifies to the practical significance of the renovation of existing interior space.

Keywords: existing interior space, physical environmental satisfaction, post occupancy evaluation, renovation of space, subjective satisfaction of space

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9851 Development of Multi-Leaf Collimator-Based Isocenter Verification Tool Using Electrical Portal Imaging Device for Stereotactic Radiosurgery

Authors: Panatda Intanin, Sangutid Thongsawad, Chirapha Tannanonta, Todsaporn Fuangrod

Abstract:

Stereotactic radiosurgery (SRS) is a highly precision delivery technique that requires comprehensive quality assurance (QA) tests prior to treatment delivery. An isocenter of delivery beam plays a critical role that affect the treatment accuracy. The uncertainty of isocenter is traditionally accessed using circular cone equipment, Winston-Lutz (WL) phantom and film. This technique is considered time consuming and highly dependent on the observer. In this work, the development of multileaf collimator (MLC)-based isocenter verification tool using electronic portal imaging device (EPID) was proposed and evaluated. A mechanical isocenter alignment with ball bearing diameter 5 mm and circular cone diameter 10 mm fixed to gantry head defines the radiation field was set as the conventional WL test method. The conventional setup was to compare to the proposed setup; using MLC (10 x 10 mm) to define the radiation filed instead of cone. This represents more realistic delivery field than using circular cone equipment. The acquisition from electronic portal imaging device (EPID) and radiographic film were performed in both experiments. The gantry angles were set as following: 0°, 90°, 180° and 270°. A software tool was in-house developed using MATLAB/SIMULINK programming to determine the centroid of radiation field and shadow of WL phantom automatically. This presents higher accuracy than manual measurement. The deviation between centroid of both cone-based and MLC-based WL tests were quantified. To compare between film and EPID image, the deviation for all gantry angle was 0.26±0.19mm and 0.43±0.30 for cone-based and MLC-based WL tests. For the absolute deviation calculation on EPID images between cone and MLC-based WL test was 0.59±0.28 mm and the absolute deviation on film images was 0.14±0.13 mm. Therefore, the MLC-based isocenter verification using EPID present high sensitivity tool for SRS QA.

Keywords: isocenter verification, quality assurance, EPID, SRS

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9850 Measures of Corporate Governance Efficiency on the Quality Level of Value Relevance Using IFRS and Corporate Governance Acts: Evidence from African Stock Exchanges

Authors: Tchapo Tchaga Sophia, Cai Chun

Abstract:

This study measures the efficiency level of corporate governance to improve the quality level of value relevance in the resolution of market value efficiency increase issues, transparency problems, risk frauds, agency problems, investors' confidence, and decision-making issues using IFRS and Corporate Governance Acts (CGA). The final sample of this study contains 3660 firms from ten countries' stock markets from 2010 to 2020. Based on the efficiency market theory and the positive accounting theory, this paper uses multiple econometrical methods (DID method, multivariate and univariate regression methods) and models (Ohlson model and compliance index model) regression to see the incidence results of corporate governance mechanisms on the value relevance level under the influence of IFRS and corporate governance regulations act framework in Africa's stock exchanges for non-financial firms. The results on value relevance show that the corporate governance system, strengthened by the adoption of IFRS and enforcement of new corporate governance regulations, produces better financial statement information when its compliance level is high. And that is both value-relevant and comparable to results in more developed markets. Similar positive and significant results were obtained when predicting future book value per share and earnings per share through the determination of stock price and stock return. The findings of this study have important implications for regulators, academics, investors, and other users regarding the effects of IFRS and the Corporate Governance Act (CGA) on the relationship between corporate governance and accounting information relevance in the African stock market. The contributions of this paper are also based on the uniqueness of the data used in this study. The unique data is from Africa, and not all existing findings provide evidence for Africa and of the DID method used to examine the relationship between corporate governance and value relevance on African stock exchanges.

Keywords: corporate governance value, market efficiency value, value relevance, African stock market, stock return-stock price

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9849 Assessment of the Physico-Chemical Parameters and Heavy Metal Concentration in Water and Callinectes amnicola (Swimming Crab) in a Crude Oil Exposed Community (Bodo Creek), Rivers State, Nigeria

Authors: Ehiedu Philomina Kika, Jessica Chinonso Ehilegbu

Abstract:

The exploration and production of fossil fuel particularly crude oil has led to some serious environmental damage in some oil producing communities like the Bodo Community who rely heavily on their aquatic environment for food and water. This study was therefore carried out to investigate the level of some heavy metals in water and Callinectes amnicola (Swimming Crab) in the month of August, September and October from Bodo creek, Rivers State, Nigeria. The physico-chemical parameters of the water were also analyzed in-situ. The levels of heavy metals, Lead (Pb), Cadmium (Cd), Chromium (Cr), Zinc (Zn), Copper (Cu) were analyzed in water and in Callinectes amnicola (Swimming Crab), using Atomic Absorption Spectrophotometer (AAS) after acid digestion. For the concentration of heavy metals in water, Pb ranged from 0.103 - 0.791 mg/l, Zn 0.0025 - 0.342 mg/l, Cr < 0.001 - 0.304 mg/l, Cd 0.011 - 0.116 mg/l and Cu <0.001 - 0.079 mg/l. For the concentration of heavy metals in Callinectes amnicola (Swimming Crab), the level of Pb ranged from 0.359 - 0.849 mg/l, Zn 0.134 - 0.342 mg/l, Cd 0.053 - 0.103 mg/l, Cr < 0.001 - <0.001 mg/l, Cu < 0.001 - 0.131 mg/l. The concentrations of Pb, Cd and Cr for all water and crab samples collected from the various stations were higher than permissible level suggesting serious anthropogenic influence. Thus, precaution needs to be taken to prevent further contamination and adequate purification measures need to be put in place. Therefore, there should be periodic environmental pollution monitoring, for assessment and awareness especially with regards heavy metal.

Keywords: Bodo creek, crude oil, heavy metal, swimming crab

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9848 Coastal Water Characteristics along the Saudi Arabian Coastline

Authors: Yasser O. Abualnaja1, Alexandra Pavlidou2, Taha Boksmati3, Ahmad Alharbi3, Hammad Alsulmi3, Saleh Omar Maghrabi3, Hassan Mowalad3, Rayan Mutwalli3, James H. Churchill4, Afroditi Androni2, Dionysios Ballas2, Ioannis Hatzianestis2, Harilaos Kontoyiannis2, Angeliki Konstantinopoulou2, Georgios Krokkos1, 5, Georgios Pappas2, Vassilis P. Papadopoulos2, Konstantinos Parinos2, Elvira Plakidi2, Eleni Rousselaki2, Dimitris Velaoras2, Panagiota Zachioti2, Theodore Zoulias2, Ibrahim Hoteit5.

Abstract:

The coastal areas along the Kingdom of Saudi Arabia on both the Red Sea and Arabian Gulf have been witnessing in the past decades an unprecedented economic growth and a rapid increase in anthropogenic activities. Therefore, the Saudi Arabian government has decided to frame a strategy for sustainable development of the coastal and marine environments, which comes in the context of the Vision 2030, aimed at providing the first comprehensive ‘Status Quo Assessment’ of the Kingdom’s coastal and marine environments. This strategy will serve as a baseline assessment for future monitoring activities; this baseline is relied on scientific evidence of the drivers, pressures, and their impact on the environments of the Red Sea and Arabian Gulf. A key element of the assessment was the cumulative pressures of the hotspots analysis, which was developed following the principles of the Driver-Pressure-State-Impact-Response (DPSIR) framework and using the cumulative pressure and impact assessment methodology. Ten hotspot sites were identified, eight in the Red Sea and two in the Arabian Gulf. Thus, multidisciplinary research cruises were conducted throughout the Red Sea and the Arabian Gulf coastal and marine environments in June/July 2021 and September 2021, respectively, in order to understand the relative impact of hydrography and the various pressures on the quality of seawater and sediments. The main objective was to record the physical and biogeochemical parameters along the coastal waters of the Kingdom, tracing the dispersion of contaminants related to specific pressures. The assessment revealed the effect of hydrography on the trophic status of the southern marine coastal areas of the Red Sea. Jeddah Lagoon system seems to face significant eutrophication and pollution challenges, whereas sediments are enriched in some heavy metals in many areas of the Red Sea and the Arabian Gulf. This multidisciplinary research in the Red Sea and the Arabian Gulf coastal waters will pave the way for future detailed environmental monitoring strategies for the Saudi Arabian marine environment.

Keywords: arabian gulf, contaminants, hotspot, red sea

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9847 Sustainable Investing and Corporate Performance: Evidence from Shariah Compliant Companies in Southeast Asia

Authors: Norashikin Ismail, Nadia Anridho

Abstract:

Sustainable investing is a responsible investment that focuses on Environmental, Social, and Governance (ESG) elements. ESG integration is essential in the investment process as it provides a positive contribution to the corporate performance for stakeholders, specifically investors. Sustainable investing is in line with the objectives of Shariah (Maqasid of Shariah), such as social inclusion as well as environmental preservation. This study attempts to evaluate the impact of ESG elements to the corporate financial performance among Shariah compliant stocks listed in two countries, namely Malaysia and Indonesia. The motivation of this study is to provide a further understanding in corporate sustainability for two different Islamic capital markets. The existence of the FTSE4Good Asean Index has played a vital role for ESG practices and eventually encouraged specific index for ESG and Shariah Compliant stocks. Our sample consists of 60 companies over the period 2010-2020 from two Southeast countries. We employ System Generalized Method of Moments (GMM) to reduce bias and more specific parameter estimation. Shariah Compliant companies tend to have higher ESG scores and are positively correlated to corporate financial performance. ESG integration with Shariah based investing would provide higher returns and lower risks for Muslim investors. Essentially, integrating ESG and Shariah, compliant companies lead to better financial performance.

Keywords: shariah compliant, southeast asia, corporate performance, sustainable investing

Procedia PDF Downloads 175
9846 A Morphological Thinking Approach for Conceptualising Product-Service Systems Solutions

Authors: Nicolas Haber

Abstract:

The study addresses the conceptual design of Product-Service Systems (PSSs) as a means of innovating solutions with the aim of reducing the environmental load of conventional product based solutions. Functional approaches targeting PSS solutions are developed in instinctive methods within the constraints of the setting in which they are conceived. Adopting morphological matrices in designing PSS concepts allows a thorough understanding of the settings, stakeholders, and functional requirements. Additionally, such a methodology is robust and adaptable to product-oriented, use-oriented and result-oriented systems. The research is based on a functional decomposition of the task in a similar way as in product design; while extended to include service components, providers, and receivers, while assessing the adaptability and homogeneity of the selected components and actors. A use-oriented concept is presented via a practical case study at an agricultural boom-sprayer manufacturer to demonstrate the effectiveness of the morphological approach to justify its viability. Additionally, a life cycle analysis is carried out in order to evaluate the environmental advantages inherited in a PSS solution versus a conventional solution. In light of the applications presented, the morphological approach appears to be a valid and generic tactic to conceiving integrated solutions whilst capturing the interrelations between the actors and elements of an integrated product-service system.

Keywords: conceptual design, design for sustainability, functional decomposition, product-service systems

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9845 Earth Flat Roofs

Authors: Raúl García de la Cruz

Abstract:

In the state of Hidalgo and to the vicinity to the state of Mexico, there is a network of people who also share a valley bordered by hills with agave landscape of cacti and shared a bond of building traditions inherited from pre-Hispanic times and according to their material resources, habits and needs have been adapted in time. Weather has played an important role in the way buildings and roofs are constructed. Throughout the centuries, the population has developed very sophisticated building techniques like the flat roof, made out of a layer of earth; that is usually identified as belonging to architecture of the desert, but it can also be found in other climates, such as semi-arid and even template climates. It is an example of a constructive logic applied efficiently to various cultures proving its thermal isolation. So far it has done a review and analysis of the use of the roof in different areas, from pre-Hispanic architecture to traditional Moroccan architecture , finding great similarities in the elements of the system to be incorporated into the contemporary architecture. The rescue of a lore that dissolves with the changing environment, depends in principle on the links created towards the use of environmental resources as the anchor of the people to retain and preserve a building tradition which has viability deep league with the possibility of obtaining the raw material from the immediate environment. The objective of the research is the documentation of existing earth flat roofs in the state of Hidalgo and Mexico, as evidence of the importance of constructive system and its historical value in the area, considering its environmental, social aspects, also understanding the process of transformation of public housing at the time replaced the traditional techniques for industrial materials on a path towards urbanization. So far it has done a review and analysis of the use of the roof in different areas, from pre-Hispanic architecture to traditional Moroccan architecture, finding great similarities in the elements of the system to be incorporated into the contemporary architecture. The rescue of a lore that dissolves with the changing environment, depends in principle on the links created towards the use of environmental resources as the anchor of the people to retain and preserve a building tradition which has viability deep league with the possibility of obtaining the raw material from the immediate environment.

Keywords: earth roof, low impact building system, sustainable architecture, vernacular architecture

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9844 Qualitative and Quantitative Characterization of Generated Waste in Nouri Petrochemical Complex, Assaluyeh, Iran

Authors: L. Heidari, M. Jalili Ghazizade

Abstract:

In recent years, different petrochemical complexes have been established to produce aromatic compounds. Among them, Nouri Petrochemical Complex (NPC) is the largest producer of aromatic raw materials in the world, and is located in south of Iran. Environmental concerns have been raised in this region due to generation of different types of solid waste generated in the process of aromatics production, and subsequently, industrial waste characterization has been thoroughly considered. The aim of this study is qualitative and quantitative characterization of industrial waste generated in the aromatics production process and determination of the best method for industrial waste management. For this purpose, all generated industrial waste during the production process was determined using a checklist. Four main industrial wastes were identified as follows: spent industrial soil, spent catalyst, spent molecular sieves and spent N-formyl morpholine (NFM) solvent. The amount of heavy metals and organic compounds in these wastes were further measured in order to identify the nature and toxicity of such a dangerous compound. Then industrial wastes were classified based on lab analysis results as well as using different international lists of hazardous waste identification such as EPA, UNEP and Basel Convention. Finally, the best method of waste disposal is selected based on environmental, economic and technical aspects. 

Keywords: aromatic compounds, industrial soil, molecular sieve, normal formyl morpholine solvent

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9843 Bridge Construction and Type of Bridges and Their Construction Methods

Authors: Mokhtar Nikgoo

Abstract:

Definition of bridge: A bridge is a structure that allows people to pass through the communication road with two points. There are many different types of bridges, each of which is designed to perform a specific function. This article introduces the concept, history, components, uses, types, construction methods, selected factors, damage factors and principles of bridge maintenance. A bridge is a structure to cross a passage such as a water, valley or road without blocking another path underneath. This structure makes it possible to pass obstacles that are difficult or impossible to pass. There are different designs for bridge construction, each of which is used for a particular function and condition. In the old definition, a bridge is an arch over a river, valley, or any type of passage that makes traffic possible. But today, in the topic of urban management, the bridge is considered as a structure to cross physical barriers, so that while using space (not just the surface of the earth), it can facilitate the passage and access to places. The useful life of bridges may be between 30 and 80 years depending on the location and the materials used. But with proper maintenance and improvement, their life may last for hundreds of years.

Keywords: bridge, road construction, surveying, transportation

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9842 Effects of Hydraulic Loading Rates and Porous Matrix in Constructed Wetlands for Wastewater Treatment

Authors: Li-Jun Ren, Wei Pan, Li-Li Xu, Shu-Qing An

Abstract:

This study evaluated whether different matrix composition volume ratio can improve water quality in the experiment. The mechanism and adsorption capability of wetland matrixes (oyster shell, coarse slag, and volcanic rock) and their different volume ratio in group configuration during pollutants removal processes were tested. When conditions unchanged, the residence time affects the reaction effect. The average removal efficiencies of four kinds of matrix volume ratio on the TN were 62.76%, 61.54%, 64.13%, and 55.89%, respectively.

Keywords: hydraulic residence time, matrix composition, removal efficiency, volume ratio

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9841 Establishments of an Efficient Platform for Genome Editing in Grapevine

Authors: S. Najafi, E. Bertini, M. Pezzotti, G.B. Tornielli, S. Zenoni

Abstract:

Grapevine is an important agricultural fruit crop plant consumed worldwide and with a key role in the global economy. Grapevine is strongly affected by both biotic and abiotic stresses, which impact grape growth at different stages, such as during plant and berry development and pre- and post-harvest, consequently causing significant economic losses. Recently global warming has propelled the anticipation of the onset of berry ripening, determining the reduction of a grape color and increased volatilization of aroma compounds. Climate change could negatively alter the physiological characteristics of the grape and affect the berry and wine quality. Modern plant breeding can provide tools such as genome editing for improving grape resilience traits while maintaining intact the viticultural and oenological quality characteristics of the genotype. This study aims at developing a platform for genome editing application in grapevine plants with the final goal to improve berry quality, biotic, and abiotic resilience traits. We chose to directly deliver ribonucleoproteins (RNP, preassembled Cas protein and guide RNA) into plant protoplasts, and, from these cell structures, regenerate grapevine plants edited in specific selected genes controlling traits of interest. Edited plants regenerated by somatic embryogenesis from protoplasts will then be sequenced and molecularly characterized. Embryogenic calli of Sultana and Shiraz cultivars were initiated from unopened leaves of in-vitro shoot tip cultures and from stamens, respectively. Leaves were placed on NB2 medium while stamens on callus initiation medium (PIV) medium and incubated in the dark at 28 °C for three months. Viable protoplasts, tested by FDA staining, isolated from embryogenic calli were cultured by disc method at 1*105 protoplasts/ml. Mature well-shaped somatic embryos developed directly in the protoplast culture medium two months later and were transferred in the light into to shooting medium for further growth. Regenerated plants were then transferred to the greenhouse; no phenotypic alterations were observed when compared to non in-vitro cultured plants. The performed experiments allowed to established an efficient protocol of embryogenic calli production, protoplast isolation, and regeneration of the whole plant through somatic embryogenesis in both Sultana and Shiraz. Regenerated plants, through direct somatic embryogenesis deriving from a single cell, avoid the risk of chimerism during the regeneration process, therefore improving the genome editing process. As pre-requisite of genome editing, an efficient method for transfection of protoplast by yellow fluorescent protein (YFP) marker genes was also established and experiments of direct delivery of CRISPR–Cas9 ribonucleoproteins (RNPs) in protoplasts to achieve efficient DNA-free targeted mutations are in progress.

Keywords: CRISPR-cas9, plant regeneration, protoplast isolation, Vitis vinifera

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9840 Effect Of Selected Food And Nutrition Environments On Prevalence Of Cardio-Metabolic Risk Factors With Emphasis On Worksite Environment In Urban Delhi

Authors: Deepa Shokeen, Bani Tamber Aeri

Abstract:

Food choice is a complex process influenced by the interplay of multiple factors, including physical, socio-cultural and economic factors comprising macro or micro level food environments. While a clear understanding of the relationship between what we eat and the environmental context in which these food choices are made is still needed; it has however now been shown that food environments do play a significant role in the obesity epidemic and increasing cardio-metabolic risk factors. Evidence in other countries indicates that the food environment may strongly influence the prevalence of obesity and cardio-metabolic risk factors among young adults. Although in the Indian context, data does indicate the associations between sedentary lifestyle, stress, faulty diets but very little evidence supports the role of food environment in influencing cardio-metabolic health among employed adults. Thus, this research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. Methodology: The objective of the present study is to assess the effect of selected food and nutrition environments with emphasis on worksite environment and to analyse its impact on the food choices and dietary behaviour of the employees (25-45 years of age) of the organizations under study. In the proposed study an attempt will be made to randomly select various worksite environments from Delhi and NCR. The study will be conducted in two phases. In phase I, Information will be obtained on their socio-demographic profile and various factors influencing their food choices including most commonly consumed foods and most frequently visited eating outlets in and around the work place. Data will also be gathered on anthropometry (height, weight, waist circumference), biochemical parameters (lipid profile and fasting glucose), blood pressure and dietary intake. Based on the findings of phase I, a list of the most frequently visited eating outlets in and around the workplace will be prepared in Phase II. These outlets will then be subjected to nutrition environment assessment survey (NEMS). On the basis of the information gathered from phase I and phase II, influence of selected food and nutrition environments on food choice, dietary behaviour and prevalence of cardio-metabolic risk factors among employed adults will be assessed. Expected outcomes: The proposed study will try to ascertain the impact of selected food and nutrition environments on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behavior of the adults. In addition to this, anthropometry blood pressure and biochemical assessment of the subjects will be done to assess the prevalence of cardio-metabolic risk factors. If the findings indicate that the work environment, where most of these young adults spend their productive hours of the day, influence their health, than perhaps steps maybe needed to make these environments more conducive to health.

Keywords: food and nutrition environment, cardio-metabolic risk factors, India, worksite environment

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9839 Unbranched, Saturated, Carboxylic Esters as Phase-Change Materials

Authors: Anastasia Stamatiou, Melissa Obermeyer, Ludger J. Fischer, Philipp Schuetz, Jörg Worlitschek

Abstract:

This study evaluates unbranched, saturated carboxylic esters with respect to their suitability to be used as storage media for latent heat storage applications. Important thermophysical properties are gathered both by means of literature research as well as by experimental measurements. Additionally, esters are critically evaluated against other common phase-change materials in terms of their environmental impact and their economic potential. The experimental investigations are performed for eleven selected ester samples with a focus on the determination of their melting temperature and their enthalpy of fusion using differential scanning calorimetry. Transient Hot Bridge was used to determine the thermal conductivity of the liquid samples while thermogravimetric analysis was employed for the evaluation of the 5% weight loss temperature as well as of the decomposition temperature of the non-volatile samples. Both experimental results and literature data reveal the high potential of esters as phase-change materials. Their good thermal and environmental properties as well as the possibility for production from natural sources (e.g. vegetable oils) render esters as very promising for future storage applications. A particularly high short term application potential of esters could lie in low temperature storage applications where the main alternative is using salt hydrates as phase-change material.

Keywords: esters, phase-change materials, thermal properties, latent heat storage

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9838 Effect of the Workpiece Position on the Manufacturing Tolerances

Authors: Rahou Mohamed , Sebaa Fethi, Cheikh Abdelmadjid

Abstract:

Manufacturing tolerancing is intended to determine the intermediate geometrical and dimensional states of the part during its manufacturing process. These manufacturing dimensions also serve to satisfy not only the functional requirements given in the definition drawing but also the manufacturing constraints, for example geometrical defects of the machine, vibration, and the wear of the cutting tool. The choice of positioning has an important influence on the cost and quality of manufacture. To avoid this problem, a two-step approach have been developed. The first step is dedicated to the determination of the optimum position. As for the second step, a study was carried out for the tightening effect on the tolerance interval.

Keywords: dispersion, tolerance, manufacturing, position

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9837 Lessons Learned from Implementation of Remote Pregnant and Newborn Care Service for Vulnerable Women and Children During COVID-19 and Political Crisis in Myanmar

Authors: Wint Wint Thu, Htet Ko Ko Win, Myat Mon San, Zaw Lin Tun, Nandar Than Aye, Khin Nyein Myat, Hayman Nyo Oo, Nay Aung Lin, Kusum Thapa, Kyaw Htet Aung

Abstract:

Background: In Myanmar, the intense political instability happened to start in Feb-2021, while the COVID-19 pandemic waves are also threatening the public health system, which subsequently led to severe health sector crisis, including difficulties in accessing maternal and newborn health care for vulnerable women and children. The Remote Pregnant and Newborn Care (RPNC) uses a telehealth approach United States Agency for International Development (USAID)-funded Essential Health Project. Implementation: The Remote Pregnant and Newborn Care (RPNC) service has adapted to the MNCH needs of vulnerable pregnant women and was implemented to mitigate the risk of limited access to essential quality MNH care in Yangon, Myanmar, under women, and the project trained 13 service providers on a telehealth care package for pregnancy and newborn developed Jhpiego to ensure understanding of evidence-based MNCH care practices. The phone numbers of the pregnant women were gathered through the preexisting and functioning community volunteers, who reach the most vulnerable pregnant women in the project's targeted area. A total of 212 pregnant women have been reached by service providers for RPNC during the implementation period. The trained service providers offer quality antenatal and postnatal care, including newborn care, via telephone calls. It includes 24/7 incoming calls and time-allotted outgoing calls to the pregnant women during antenatal and postnatal periods, including the newborn care. The required data were collected daily in time with the calls, and the quality of the medical services is made assured with the track of the calls, ensuring data privacy and patient confidentiality. Lessons learned: The key lessons are 1) cost-effectiveness: RPNC service could reduce out of pocket expenditure of pregnant women as it only costs 1.6 United States dollars (USD) per one telehealth call while it costs 8 to 10 USD per one time in-person care service at private service providers, including transportation cost, 2) network of care: telehealth call could not replace the in-person antenatal and postnatal care services, and integration of telehealth calls with in-person care by local healthcare providers with the support of the community is crucial for accessibility to essential MNH services by poor and vulnerable women, and 3) sharing information on health access points: most of the women seem to have financial barriers in accessing private health facilities while public health system collapse and telehealthcare could provide information on low-cost facilities and connect women to relevant health facilities. These key lessons are important for future efforts regarding the implementation of remote pregnancy and newborn care in Myanmar, especially during the political crisis and COVID-19 pandemic situation.

Keywords: telehealth, accessibility, maternal care, newborn care

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9836 Comparative Analysis of Different Land Use Land Cover (LULC) Maps in WRF Modelling Over Indian Region

Authors: Sen Tanmoy, Jain Sarika, Panda Jagabandhu

Abstract:

The studies regarding the impact of urbanization using the WRF-ARW model rely heavily on the static geographical information selected, including domain configuration and land use land cover (LULC) data. Accurate representation of LULC data provides essential information for understanding urban growth and simulating meteorological parameters such as temperature, precipitation etc. Researchers are using different LULC data as per availability and their requirements. As far as India is concerned, we have very limited resources and data availability. So, it is important to understand how we can optimize our results using limited LULC data. In this review article, we explored how a LULC map is generated from different sources in the Indian context and what its significance is in WRF-ARW modeling to study urbanization/Climate change or any other meteorological parameters. Bibliometric analyses were also performed in this review article based on countries of study and indexed keywords. Finally, some key points are marked out for selecting the most suitable LULC map for any urbanization-related study.

Keywords: LULC, LULC mapping, LANDSAT, WRF-ARW, ISRO, bibliometric Analysis.

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9835 Barriers for Appropriate Palliative Symptom Management: A Qualitative Research in Kazakhstan, a Medium-Income Transitional-Economy Country

Authors: Ibragim Issabekov, Byron Crape, Lyazzat Toleubekova

Abstract:

Background: Palliative care substantially improves the quality of life of terminally-ill patients. Symptom control is one of the keystones in the management of patients in palliative care settings, lowering distress as well as improving the quality of life of patients with end-stage diseases. The most common symptoms causing significant distress for patients are pain, nausea and vomiting, increased respiratory secretions and mental health issues like depression. Aims are: 1. to identify best practices in symptom management in palliative patients in accordance with internationally approved guidelines and compare aforementioned with actual practices in Kazakhstan; to evaluate the criteria for assessing symptoms in terminally-ill patients, 2. to review the availability and utilization of pharmaceutical agents for pain control, management of excessive respiratory secretions, nausea, and vomiting, and delirium and 3. to develop recommendations for the systematic approach to end-of-life symptom management in Kazakhstan. Methods: The use of qualitative research methods together with systematic literature review have been employed to provide a rigorous research process to evaluate current approaches for symptom management of palliative patients in Kazakhstan. Qualitative methods include in-depth semi-structured interviews of the healthcare professionals involved in palliative care provision. Results: Obstacles were found in appropriate provision of palliative care. Inadequate education and training to manage severe symptoms, poorly defined laws and regulations for palliative care provision, and a lack of algorithms and guidelines for care were major barriers in the effective provision of palliative care. Conclusion: Assessment of palliative care in this medium-income transitional-economy country is one of the first steps in the initiation of integration of palliative care into the existing health system. Achieving this requires identifying obstacles and resolving these issues.

Keywords: end-of-life care, middle income country, palliative care, symptom control

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9834 Indirect Solar Desalination: Value Engineering and Cost Benefit Analysis

Authors: Grace Rachid, Mutasem El Fadel, Mahmoud Al Hindi, Ibrahim Jamali, Daniel Abdel Nour

Abstract:

This study examines the feasibility of indirect solar desalination in oil producing countries in the Middle East and North Africa (MENA) region. It relies on value engineering (VE) and cost-benefit with sensitivity analyses to identify optimal coupling configurations of desalination and solar energy technologies. A comparative return on investment was assessed as a function of water costs for varied plant capacities (25,000 to 75,000 m3/day), project lifetimes (15 to 25 years), and discount rates (5 to 15%) taking into consideration water and energy subsidies, land cost as well as environmental externalities in the form of carbon credit related to greenhouse gas (GHG) emissions reduction. The results showed reverse osmosis (RO) coupled with photovoltaic technologies (PVs) as the most promising configuration, robust across different prices for Brent oil, discount rates, as well as different project lifetimes. Environmental externalities and subsidies analysis revealed that a 16% reduction in existing subsidy on water tariffs would ensure economic viability. Additionally, while land costs affect investment attractiveness, the viability of RO coupled with PV remains possible for a land purchase cost < $ 80/m2 or a lease rate < $1/m2/yr. Beyond those rates, further subsidy lifting is required.

Keywords: solar energy, desalination, value engineering, CBA, carbon credit, subsidies

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9833 Ten Minutes Neighbourhood as a Basic PlanningUnit for Happiness in Egypt

Authors: Abeer Elshater

Abstract:

This paper pursues the relationship between the inhabitants’ happiness and the right to the city in an Egyptian neighbourhood status quo. Although the optimum of getting the services comes from ten mints walking in a suitable ambiance, the happiness is not acquired. The research objective is, first, to review the literature that get a guideline of 10 minutes neighbourhoods. Second make a comparative content analysis to recent online articles to the right to the city. Third is to test the concluded principles in Egyptian neighbourhood settings. The idea of ten minutes neighbourhood is manageable. The hypothesis concerns a compliant design. The logic of people who live close to within ten minutes’ walk to essential settings in their area can minimize several problems and maximize a healthy lifestyle. The supposed issue makes the right to the city affect the relationship between ten minutes neighbourhood and citizen happiness. This assumption can be intervention through site observation and oriented questionnaire. The contribution comes from presenting new planning units in away suits the current context of the old cities in MENA region based on ten-minute walking or less distance with a reference to the right to the city. This planning unit can find it way to citizens' happiness.

Keywords: happiness, ten-minute neighbourhood, urban design, well-being

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9832 The Impact of Right to Repair Initiatives on Environmental and Financial Performance in European Consumer Electronics Firms: An Econometric Analysis

Authors: Daniel Stabler, Anne-Laure Mention, Henri Hakala, Ahmad Alaassar

Abstract:

In Europe, 2.2 billion tons of waste annually generate severe environmental damage and economic burdens, and negatively impact human health. A stark illustration of the problem is found within the consumer electronics industry, which reflects one of the most complex global waste streams. Of the 5.3 billion globally discarded mobile phones in 2022, only 17% were properly recycled. To address these pressing issues, Europe has made significant strides in developing waste management strategies, Circular Economy initiatives, and Right to Repair policies. These endeavors aim to make product repair and maintenance more accessible, extend product lifespans, reduce waste, and promote sustainable resource use. European countries have introduced Right to Repair policies, often in conjunction with extended producer responsibility legislation, repair subsidies, and consumer repair indices, to varying degrees of regulatory rigor. Changing societal trends emphasizing sustainability and environmental responsibility have driven consumer demand for more sustainable and repairable products, benefiting repair-focused consumer electronics businesses. In academic research, much of the literature in Management studies has examined the European Circular Economy and the Right to Repair from firm-level perspectives. These studies frequently employ a business-model lens, emphasizing innovation and strategy frameworks. However, this study takes an institutional perspective, aiming to understand the adoption of Circular Economy and repair-focused business models within the European consumer electronics market. The concepts of the Circular Economy and the Right to Repair align with institutionalism as they reflect evolving societal norms favoring sustainability and consumer empowerment. Regulatory institutions play a pivotal role in shaping and enforcing these concepts through legislation, influencing the behavior of businesses and individuals. Compliance and enforcement mechanisms are essential for their success, compelling actors to adopt sustainable practices and consider product life extension. Over time, these mechanisms create a path for more sustainable choices, underscoring the influence of institutions and societal values on behavior and decision-making. Institutionalism, particularly 'neo-institutionalism,' provides valuable insights into the factors driving the adoption of Circular and repair-focused business models. Neo-institutional pressures can manifest through coercive regulatory initiatives or normative standards shaped by socio-cultural trends. The Right to Repair movement has emerged as a prominent and influential idea within academic discourse and sustainable development initiatives. Therefore, understanding how macro-level societal shifts toward the Circular Economy and the Right to Repair trigger firm-level responses is imperative. This study aims to answer a crucial question about the impact of European Right to Repair initiatives had on the financial and environmental performance of European consumer electronics companies at the firm level. A quantitative and statistical research design will be employed. The study will encompass an extensive sample of consumer electronics firms in Northern and Western Europe, analyzing their financial and environmental performance in relation to the implementation of Right to Repair mechanisms. The study's findings are expected to provide valuable insights into the broader implications of the Right to Repair and Circular Economy initiatives on the European consumer electronics industry.

Keywords: circular economy, right to repair, institutionalism, environmental management, european union

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9831 Social Network Analysis, Social Power in Water Co-Management (Case Study: Iran, Shemiranat, Jirood Village)

Authors: Fariba Ebrahimi, Mehdi Ghorbani, Ali Salajegheh

Abstract:

Comprehensively water management considers economic, environmental, technical and social and also sustainability of water resources for future generations. Grassland management implies cooperative approach and involves all stakeholders and also introduces issues to managers, decision and policy makers. Solving these issues needs integrated and system approach. According to the recognition of actors or key persons in necessary to apply cooperative management of Water. Therefore, based on stakeholder analysis and social network analysis can be used to demonstrate the most effective actors for environmental decisions. In this research, social powers according are specified to social network approach at Water utilizers’ level of Natural in Jirood catchment of Latian basin. In this paper, utilizers of water resources were recognized using field trips and then, trust and collaboration matrix produced using questionnaires. In the next step, degree centrality index were Examined. Finally, geometric position of each actor was illustrated in the network. The results of the research based on centrality index have a key role in recognition of cooperative management of Water in Jirood and also will help managers and planners of water in the case of recognition of social powers in order to organization and implementation of sustainable management of Water.

Keywords: social network analysis, water co-management, social power, centrality index, local stakeholders network, Jirood catchment

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9830 Mechanical, Thermal and Biodegradable Properties of Bioplast-Spruce Green Wood Polymer Composites

Authors: A. Atli, K. Candelier, J. Alteyrac

Abstract:

Environmental and sustainability concerns push the industries to manufacture alternative materials having less environmental impact. The Wood Plastic Composites (WPCs) produced by blending the biopolymers and natural fillers permit not only to tailor the desired properties of materials but also are the solution to meet the environmental and sustainability requirements. This work presents the elaboration and characterization of the fully green WPCs prepared by blending a biopolymer, BIOPLAST® GS 2189 and spruce sawdust used as filler with different amounts. Since both components are bio-based, the resulting material is entirely environmentally friendly. The mechanical, thermal, structural properties of these WPCs were characterized by different analytical methods like tensile, flexural and impact tests, Thermogravimetric Analysis (TGA), Differential Scanning Calorimetry (DSC) and X-ray Diffraction (XRD). Their water absorption properties and resistance to the termite and fungal attacks were determined in relation with different wood filler content. The tensile and flexural moduli of WPCs increased with increasing amount of wood fillers into the biopolymer, but WPCs became more brittle compared to the neat polymer. Incorporation of spruce sawdust modified the thermal properties of polymer: The degradation, cold crystallization, and melting temperatures shifted to higher temperatures when spruce sawdust was added into polymer. The termite, fungal and water absorption resistance of WPCs decreased with increasing wood amount in WPCs, but remained in durability class 1 (durable) concerning fungal resistance and quoted 1 (attempted attack) in visual rating regarding to the termites resistance except that the WPC with the highest wood content (30 wt%) rated 2 (slight attack) indicating a long term durability. All the results showed the possibility to elaborate the easy injectable composite materials with adjustable properties by incorporation of BIOPLAST® GS 2189 and spruce sawdust. Therefore, lightweight WPCs allow both to recycle wood industry byproducts and to produce a full ecologic material.

Keywords: biodegradability, color measurements, durability, mechanical properties, melt flow index, MFI, structural properties, thermal properties, wood-plastic composites, WPCs

Procedia PDF Downloads 127
9829 A Methodology to Virtualize Technical Engineering Laboratories: MastrLAB-VR

Authors: Ivana Scidà, Francesco Alotto, Anna Osello

Abstract:

Due to the importance given today to innovation, the education sector is evolving thanks digital technologies. Virtual Reality (VR) can be a potential teaching tool offering many advantages in the field of training and education, as it allows to acquire theoretical knowledge and practical skills using an immersive experience in less time than the traditional educational process. These assumptions allow to lay the foundations for a new educational environment, involving and stimulating for students. Starting from the objective of strengthening the innovative teaching offer and the learning processes, the case study of the research concerns the digitalization of MastrLAB, High Quality Laboratory (HQL) belonging to the Department of Structural, Building and Geotechnical Engineering (DISEG) of the Polytechnic of Turin, a center specialized in experimental mechanical tests on traditional and innovative building materials and on the structures made with them. The MastrLAB-VR has been developed, a revolutionary innovative training tool designed with the aim of educating the class in total safety on the techniques of use of machinery, thus reducing the dangers arising from the performance of potentially dangerous activities. The virtual laboratory, dedicated to the students of the Building and Civil Engineering Courses of the Polytechnic of Turin, has been projected to simulate in an absolutely realistic way the experimental approach to the structural tests foreseen in their courses of study: from the tensile tests to the relaxation tests, from the steel qualification tests to the resilience tests on elements at environmental conditions or at characterizing temperatures. The research work proposes a methodology for the virtualization of technical laboratories through the application of Building Information Modelling (BIM), starting from the creation of a digital model. The process includes the creation of an independent application, which with Oculus Rift technology will allow the user to explore the environment and interact with objects through the use of joypads. The application has been tested in prototype way on volunteers, obtaining results related to the acquisition of the educational notions exposed in the experience through a virtual quiz with multiple answers, achieving an overall evaluation report. The results have shown that MastrLAB-VR is suitable for both beginners and experts and will be adopted experimentally for other laboratories of the University departments.

Keywords: building information modelling, digital learning, education, virtual laboratory, virtual reality

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9828 Management of Myofascial Temporomandibular Disorder in Secondary Care: A Quality Improvement Project

Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

Abstract:

Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: myofascial, quality Improvement, PDSA, TMD

Procedia PDF Downloads 126