Search results for: avoid target-point
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1431

Search results for: avoid target-point

651 The Determination of the Phosphorous Solubility in the Iron by the Function of the Other Components

Authors: Andras Dezső, Peter Baumli, George Kaptay

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The phosphorous is the important components in the steels, because it makes the changing of the mechanical properties and possibly modifying the structure. The phosphorous can be create the Fe3P compounds, what is segregated in the ferrite grain boundary in the intervals of the nano-, or microscale. This intermetallic compound is decreasing the mechanical properties, for example it makes the blue brittleness which means that the brittle created by the segregated particles at 200 ... 300°C. This work describes the phosphide solubility by the other components effect. We make calculations for the Ni, Mo, Cu, S, V, C, Si, Mn, and the Cr elements by the Thermo-Calc software. We predict the effects by approximate functions. The binary Fe-P system has a solubility line, which has a determinating equation. The result is below: lnwo = -3,439 – 1.903/T where the w0 means the weight percent of the maximum soluted concentration of the phosphorous, and the T is the temperature in Kelvin. The equation show that the P more soluble element when the temperature increasing. The nickel, molybdenum, vanadium, silicon, manganese, and the chromium make dependence to the maximum soluted concentration. These functions are more dependent by the elements concentration, which are lower when we put these elements in our steels. The copper, sulphur and carbon do not make effect to the phosphorous solubility. We predict that all of cases the maximum solubility concentration increases when the temperature more and more high. Between 473K and 673 K, in the phase diagram, these systems contain mostly two or three phase eutectoid, and the singe phase, ferritic intervals. In the eutectoid areas the ferrite, the iron-phosphide, and the metal (III)-phospide are in the equilibrium. In these modelling we predicted that which elements are good for avoid the phosphide segregation or not. These datas are important when we make or choose the steels, where the phosphide segregation stopping our possibilities.

Keywords: phosphorous, steel, segregation, thermo-calc software

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650 Survey on Awareness, Knowledge and Practices: Managing Osteoporosis among Practitioners in a Tertiary Hospital, Malaysia

Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

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This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: awareness, knowledge, osteoporosis, practices

Procedia PDF Downloads 126
649 Competency Model as a Key Tool for Managing People in Organizations: Presentation of a Model

Authors: Andrea ČopíKová

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Competency Based Management is a new approach to management, which solves organization’s challenges with complexity and with the aim to find and solve organization’s problems and learn how to avoid these in future. They teach the organizations to create, apart from the state of stability – that is temporary, vital organization, which is permanently able to utilize and profit from internal and external opportunities. The aim of this paper is to propose a process of competency model design, based on which a competency model for a financial department manager in a production company will be created. Competency models are very useful tool in many personnel processes in any organization. They are used for acquiring and selection of employees, designing training and development activities, employees’ evaluation, and they can be used as a guide for a career planning and as a tool for succession planning especially for managerial positions. When creating a competency model the method AHP (Analytic Hierarchy Process) and quantitative pair-wise comparison (Saaty’s method) will be used; these methods belong among the most used methods for the determination of weights, and it is used in the AHP procedure. The introduction part of the paper consists of the research results pertaining to the use of competency model in practice and then the issue of competency and competency models is explained. The application part describes in detail proposed methodology for the creation of competency models, based on which the competency model for the position of financial department manager in a foreign manufacturing company, will be created. In the conclusion of the paper, the final competency model will be shown for above mentioned position. The competency model divides selected competencies into three groups that are managerial, interpersonal and functional. The model describes in detail individual levels of competencies, their target value (required level) and the level of importance.

Keywords: analytic hierarchy process, competency, competency model, quantitative pairwise comparison

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648 Numerical Modeling of Film Cooling of the Surface at Non-Uniform Heat Flux Distributions on the Wall

Authors: M. V. Bartashevich

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The problem of heat transfer at thin laminar liquid film is solved numerically. A thin film of liquid flows down an inclined surface under conditions of variable heat flux on the wall. The use of thin films of liquid allows to create the effective technologies for cooling surfaces. However, it is important to investigate the most suitable cooling regimes from a safety point of view, in order, for example, to avoid overheating caused by the ruptures of the liquid film, and also to study the most effective cooling regimes depending on the character of the distribution of the heat flux on the wall, as well as the character of the blowing of the film surface, i.e., the external shear stress on its surface. In the statement of the problem on the film surface, the heat transfer coefficient between the liquid and gas is set, as well as a variable external shear stress - the intensity of blowing. It is shown that the combination of these factors - the degree of uniformity of the distribution of heat flux on the wall and the intensity of blowing, affects the efficiency of heat transfer. In this case, with an increase in the intensity of blowing, the cooling efficiency increases, reaching a maximum, and then decreases. It is also shown that the more uniform the heating of the wall, the more efficient the heat sink. A separate study was made for the flow regime along the horizontal surface when the liquid film moves solely due to external stress influence. For this mode, the analytical solution is used for the temperature at the entrance region for further numerical calculations downstream. Also the influence of the degree of uniformity of the heat flux distribution on the wall and the intensity of blowing of the film surface on the heat transfer efficiency was also studied. This work was carried out at the Kutateladze Institute of Thermophysics SB RAS (Russia) and supported by FASO Russia.

Keywords: Heat Flux, Heat Transfer Enhancement, External Blowing, Thin Liquid Film

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647 Treatment of Porphyromonas gingivalis Induced Gingivitis in Albino Rats with Tetracycline-Loaded Nanochitosan, an Immunohistochemical Analysis

Authors: Rania Hanafi Said, Rasha Mohamed Taha

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Background: By using nanoparticles as drug delivery, it may be possible to avoid the drawbacks of systemic antibiotic dosing, including bacterial antibiotic resistance. The goal of this study was to see how well tetracycline loaded on nanochitosan worked to treat gingival inflammation in albino rats caused by Porphyromonas gingivalis. The study analyzed immunohistochemically the localization of the pro-inflammatory cytokine Interleukin-1beta (IL-1β). Material and methods: In this study, fifty mature male albino rats weighing 150 to 180 grams each were used. They were randomly divided into five groups. We checked for weight changes in rats. Ten male albino rats were included in Group I, which served as a negative control group. Ten rats were included in Group II, where they were exposed once to Porphyromonas. Group III contained ten rats, which were treated the same as Group II plus daily injections of diluted tetracycline powder at the infection sites. Ten rats in Group IV received the same procedure as those in Group II before receiving daily injections of nanochitosan at the injection sites. Finally, Group V, which had ten rats. Following the same protocol as Group II, they received localized injections of tetracycline loaded on nanochitosan once daily. Rats' gingivae were extracted and prepared after they were anesthetized. The biopsies were examined histologically and immunohistochemically by light microscopy. Results: Groups I and V had a nearly normal histological appearance of gingival tissue. In Groups II, III, and IV, degeneration was seen because the epithelial cells were bigger, collagen fibers were pulling away from the lamina propria connective tissue, and the basement membranes had come to an end. There was no discernible difference between groups V and I when they were examined immunohistochemically. Conclusion: The use of nano chitosan as a tetracycline carrier is a novel technique to overcome the drug's rising level of resistance.

Keywords: Immunohistochemistry, Nanochitosan, porphyromonas gingivitis, Tetracycline

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646 Correction Factors for Soil-Structure Interaction Predicted by Simplified Models: Axisymmetric 3D Model versus Fully 3D Model

Authors: Fu Jia

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The effects of soil-structure interaction (SSI) are often studied using axial-symmetric three-dimensional (3D) models to avoid the high computational cost of the more realistic, fully 3D models, which require 2-3 orders of magnitude more computer time and storage. This paper analyzes the error and presents correction factors for system frequency, system damping, and peak amplitude of structural response computed by axisymmetric models, embedded in uniform or layered half-space. The results are compared with those for fully 3D rectangular foundations of different aspect ratios. Correction factors are presented for a range of the model parameters, such as fixed-base frequency, structure mass, height and length-to-width ratio, foundation embedment, soil-layer stiffness and thickness. It is shown that the errors are larger for stiffer, taller and heavier structures, deeper foundations and deeper soil layer. For example, for a stiff structure like Millikan Library (NS response; length-to-width ratio 1), the error is 6.5% in system frequency, 49% in system damping and 180% in peak amplitude. Analysis of a case study shows that the NEHRP-2015 provisions for reduction of base shear force due to SSI effects may be unsafe for some structures and need revision. The presented correction factor diagrams can be used in practical design and other applications.

Keywords: 3D soil-structure interaction, correction factors for axisymmetric models, length-to-width ratio, NEHRP-2015 provisions for reduction of base shear force, rectangular embedded foundations, SSI system frequency, SSI system damping

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645 Optimal Seismic Design of Reinforced Concrete Shear Wall-Frame Structure

Authors: H. Nikzad, S. Yoshitomi

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In this paper, the optimal seismic design of reinforced concrete shear wall-frame building structures was done using structural optimization. The optimal section sizes were generated through structural optimization based on linear static analysis conforming to American Concrete Institute building design code (ACI 318-14). An analytical procedure was followed to validate the accuracy of the proposed method by comparing stresses on structural members through output files of MATLAB and ETABS. In order to consider the difference of stresses in structural elements by ETABS and MATLAB, and to avoid over-stress members by ETABS, a stress constraint ratio of MATLAB to ETABS was modified and introduced for the most critical load combinations and structural members. Moreover, seismic design of the structure was done following the International Building Code (IBC 2012), American Concrete Institute Building Code (ACI 318-14) and American Society of Civil Engineering (ASCE 7-10) standards. Typical reinforcement requirements for the structural wall, beam and column were discussed and presented using ETABS structural analysis software. The placement and detailing of reinforcement of structural members were also explained and discussed. The outcomes of this study show that the modification of section sizes play a vital role in finding an optimal combination of practical section sizes. In contrast, the optimization problem with size constraints has a higher cost than that of without size constraints. Moreover, the comparison of optimization problem with that of ETABS program shown to be satisfactory and governed ACI 318-14 building design code criteria.

Keywords: structural optimization, seismic design, linear static analysis, etabs, matlab, rc shear wall-frame structures

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644 Effect of Austenitizing Temperature, Soaking Time and Grain Size on Charpy Impact Toughness of Quenched and Tempered Steel

Authors: S. Gupta, R. Sarkar, S. Pathak, D. H. Kela, A. Pramanick, P. Talukdar

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Low alloy quenched and tempered steels are typically used in cast railway components such as knuckles, yokes, and couplers. Since these components experience extensive impact loading during their service life, adequate impact toughness of these grades need to be ensured to avoid catastrophic failure of parts in service. Because of the general availability of Charpy V Test equipment, Charpy test is the most common and economical means to evaluate the impact toughness of materials and is generally used in quality control applications. With this backdrop, an experiment was designed to evaluate the effect of austenitizing temperature, soaking time and resultant grain size on the Charpy impact toughness and the related fracture mechanisms in a quenched and tempered low alloy steel, with the aim of optimizing the heat treatment parameters (i.e. austenitizing temperature and soaking time) with respect to impact toughness. In the first phase, samples were austenitized at different temperatures viz. 760, 800, 840, 880, 920 and 960°C, followed by quenching and tempering at 600°C for 4 hours. In the next phase, samples were subjected to different soaking times (0, 2, 4 and 6 hours) at a fixed austenitizing temperature (980°C), followed by quenching and tempering at 600°C for 4 hours. The samples corresponding to different test conditions were then subjected to instrumented Charpy tests at -40°C and energy absorbed were recorded. Subsequently, microstructure and fracture surface of samples corresponding to different test conditions were observed under scanning electron microscope, and the corresponding grain sizes were measured. In the final stage, austenitizing temperature, soaking time and measured grain sizes were correlated with impact toughness and the fracture morphology and mechanism.

Keywords: heat treatment, grain size, microstructure, retained austenite and impact toughness

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643 Use of Waste Tire Rubber Alkali-Activated-Based Mortars in Repair of Concrete Structures

Authors: Mohammad Ebrahim Kianifar, Ehsan Ahmadi

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Reinforced concrete structures experience local defects such as cracks over their lifetime under various environmental loadings. Consequently, they are repaired by mortars to avoid detrimental effects such as corrosion of reinforcement, which in long-term may lead to strength loss of a member or collapse of structures. However, repaired structures may need multiple repairs due to changes in load distribution, and thus, lack of compatibility between mortar and substrate concrete. On the other hand, waste tire rubber alkali-activated (WTRAA)-based materials have very high potential to be used as repair mortars because of their ductility and flexibility, which may delay the failure of repair mortar and thus, provide sufficient compatibility. Hence, this work presents a pioneering study on suitability of WTRAA-based materials as mortars for the repair of concrete structures through an experimental program. To this end, WTRAA mortars with 15% aggregate replacement, alkali-activated (AA) mortars, and ordinary mortars are made to repair a number of concrete beams. The WTRAA mortars are composed of slag as base material, sodium hydroxide as an alkaline activator, and different gradations of waste tire rubber (fine and coarse gradations). Flexural tests are conducted on the concrete beams repaired by the ordinary, AA, and WTRAA mortars. It is found that, despite having lower compressive strength and modulus of elasticity, the WTRAA and AA mortars increase the flexural strength of the repaired beams, give compatible failures, and provide sufficient mortar-concrete interface bondings. The ordinary mortars, however, show incompatible failure modes. This study demonstrates the promising application of WTRAA mortars in the practical repairs of concrete structures.

Keywords: alkali-activated mortars, concrete repair, mortar compatibility, flexural strength, waste tire rubber

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642 Factors Influencing Violence Experienced by Medical Staff in Primary Health Care Centers, Taif City

Authors: Turki Adnan Kamal, Abdulmajeed Ahmad Alsofiany, Nemer Khidhran Husain Alghamdi, Ali Eissa Hassan Al-Rajhi

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Background:- Health care workers are ranked as one of the most vulnerable groups experiencing violence and aggressive behavior compared to other occupational groups. Objectives:- To estimate the prevalence rate and characteristics and assess the avoidance measures, and notification of the violence among medical staff working in primary health care centers in Taif city. Subject and methods:- A cross-sectional study design was applied among all physicians and a representative sample of nurses working in primary health care centers affiliated with the Ministry of Health (MOH) in Taif city. A predesigned Arabic/English validated self-administered questionnaire was used. Results:- In this study, 56 physicians and 145 nurses responded, giving a response rate of 77.6%. Their age ranged from 25 and 60 years (36.2±8.2), with 59.7% of them aged between 25 and 35 years. Males represent 55.7% of them. More than half of them (52.2%) were Saudis. The prevalence of workplace violence was 30.3%. Verbal abuse was the commonest reported type (86.9%). The absence of security, training on the procedures that must be followed and special uniforms at the workplace were significantly associated with workplace violence. We concluded that workplace violence is a significant problem facing a considerable proportion of HCWs in primary health care centers in Taif, Saudi Arabia. Most violence incidents were verbal. Conclusion:- Findings of this study revealed that HCWs who were dealing with male patients only were at high risk of workplace violence and the absence of measures to avoid workplace violence, particularly security, training on the procedures that must be followed and special uniform at the workplace was significantly associated with workplace violence.

Keywords: violence, workplace, primary health care, prevalence, avoidance

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641 Honor Endorsement from the Perspective of System Justification and Regulatory Focus Orientation

Authors: Gülçin Akbas Uslu

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Honor cultures put importance on the sexual purity of women. Women are expected to avoid acts that may spoil their honor. The emphasis on honor leads to the subordination of women and the dominance of men. In order to protect and clean honor, women are exposed to physical and psychological violence. Therefore, understanding the motivations driving people to endorse honor bears importance. For this purpose, this study aims to explore honor endorsement from the joint perspective of System Justification Theory (SJT) and Regulatory Focus Theory (RFT). SJT asserts that people have a tendency to support and rationalize the system. The motivation to maintain the system may be a factor in the endorsement of honor. RFT proposes two distinct regulatory processes, namely promotion and prevention focus. Having a dominant prevention focus, such as a deep concern for responsibilities, risk avoidance, and minimizing negative outcomes, may have a role in honor. Data were collected conveniently from 366 participants (216 women; 150 men). Participants filled out Honor Endorsement Index, Honor Based System Justification Scale and Regulatory Focus Orientation Scale Results revealed that both regulatory focus and system justification play a role in understanding honor. One-way ANOVA findings showed that individuals with a dominant prevention focus endorse honor beliefs more than individuals with a dominant promotion focus. Besides, regression analysis revealed that prevention focus and system justification significantly and positively predict honor. Results provide clarifications for why honor has an important meaning in individuals’ life and why honor-based violence is approved. These findings bear great importance in Turkey, where emphasis on honor is high and can be used in reducing people’s adherence to honor, which is based on women’s sexuality and men’s power over women.

Keywords: honor, system justification theory, regulatory focus theory, prevention focus

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640 Sex Difference of the Incidence of Sudden Cardiac Arrest/Death in Athletes: A Systematic Review and Meta-analysis

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

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639 Dewatering of Brewery Sludge through the Use of Biopolymers

Authors: Audrey Smith, M. Saifur Rahaman

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The waste crisis has become a global issue, forcing many industries to reconsider their disposal methods and environmental practices. Sludge is a form of waste created in many fields, which include water and wastewater, pulp and paper, as well as from breweries. The composition of this sludge differs between sources and can, therefore, have varying disposal methods or future applications. When looking at the brewery industry, it produces a significant amount of sludge with a high water content. In order to avoid landfilling, this waste can further be processed into a valuable material. Specifically, the sludge must undergo dewatering, a process which typically involves the addition of coagulants like aluminum sulfate or ferric chloride. These chemicals, however, limit the potential uses of the sludge since it will contain traces of metals. In this case, the desired outcome of the brewery sludge would be to produce animal feed; however, these conventional coagulants would add a toxic component to the sludge. The use of biopolymers like chitosan, which act as a coagulant, can be used to dewater brewery sludge while allowing it to be safe for animal consumption. Chitosan is also a by-product created by the shellfish processing industry and therefore reduces the environmental imprint since it involves using the waste from one industry to treat the waste from another. In order to prove the effectiveness of this biopolymer, experiments using jar-tests will be utilised to determine the optimal dosages and conditions, while variances of contaminants like ammonium will also be observed. The efficiency of chitosan can also be compared to other polysaccharides to determine which is best suited for this waste. Overall a significant separation has been achieved between the solid and liquid content of the waste during the coagulation-flocculation process when applying chitosan. This biopolymer can, therefore, be used to dewater brewery sludge such that it can be repurposed as animal feed. The use of biopolymers can also be applied to treat sludge from other industries, which can reduce the amount of waste produced and allow for more diverse options for reuse.

Keywords: animal feed, biopolymer, brewery sludge, chitosan

Procedia PDF Downloads 153
638 Analysis of a Damage-Control Target Displacement of Reinforced Concrete Bridge Pier for Seismic Design

Authors: Mohd Ritzman Abdul Karim, Zhaohui Huang

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A current focus in seismic engineering practice is the development of seismic design approach that focuses on the performance-based design. Performance-based design aims to design the structures to achieve specified performance based on the damage limit states. This damage limit is more restrictive limit than life safety and needs to be carefully estimated to avoid damage in piers due to failure in transverse reinforcement. In this paper, a different perspective of damage limit states has been explored by integrating two damage control material limit state, concrete and reinforcement by introduced parameters such as expected yield stress of transverse reinforcement where peak tension strain prior to bar buckling is introduced in a recent study. The different perspective of damage limit states with modified yield displacement and the modified plastic-hinge length is used in order to predict damage-control target displacement for reinforced concreate (RC) bridge pier. Three-dimensional (3D) finite element (FE) model has been developed for estimating damage target displacement to validate proposed damage limit states. The result from 3D FE analysis was validated with experimental study found in the literature. The validated model then was applied to predict the damage target displacement for RC bridge pier and to validate the proposed study. The tensile strain on reinforcement and compression on concrete were used to determine the predicted damage target displacement and compared with the proposed study. The result shows that the proposed damage limit states were efficient in predicting damage-control target displacement consistent with FE simulations.

Keywords: damage-control target displacement, damage limit states, reinforced concrete bridge pier, yield displacement

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637 Homosexuality and Culture: A Case Study Depicting the Struggles of a Married Lady

Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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636 The Culex Pipiens Niche: Assessment with Climatic and Physiographic Variables via a Geographic Information System

Authors: Maria C. Proença, Maria T. Rebelo, Marília Antunes, Maria J. Alves, Hugo Osório, Sofia Cunha, João Casaca

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Using a geographic information system (GIS), the relations between a georeferenced data set of Culex pipiens sl. mosquitoes collected in Portugal mainland during seven years (2006-2012) and meteorological and physiographic parameters such as: air relative humidity, air temperature (minima, maxima and mean daily temperatures), daily total rainfall, altitude, land use/land cover and proximity to water bodies are evaluated. Focus is on the mosquito females; the characterization of its habitat is the key for the planning of chirurgical non-aggressive prophylactic countermeasures to avoid ambient degradation. The GIS allow for the spatial determination of the zones were the mosquito mean captures has been above average; using the meteorological values at these coordinates, the limits of each parameter are identified/computed. The meteorological parameters measured at the net of weather stations all over the country are averaged by month and interpolated to produce raster maps that can be segmented according to the thresholds obtained for each parameter. The intersection of the maps obtained for each month show the evolution of the area favorable to the species through the mosquito season, which is from May to October at these latitudes. In parallel, mean and above average captures were related to the physiographic parameters. Three levels of risk could be identified for each parameter, using above average captures as an index. The results were applied to the suitability meteorological maps of each month. The Culex pipiens critical niche is delimited, reflecting the critical areas and the level of risk for transmission of the pathogens to which they are competent vectors (West Nile virus, iridoviruses, rheoviruses and parvoviruses).

Keywords: Culex pipiens, ecological niche, risk assessment, risk management

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635 Intracranial Hypertension without CVST in Apla Syndrome: An Unique Association

Authors: Camelia Porey, Binaya Kumar Jaiswal

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BACKGROUND: Antiphospholipid antibody (APLA) syndrome is an autoimmune disorder predisposing to thrombotic complications affecting CNS either by arterial vasooclusion or venous thrombosis. Cerebral venous sinus thrombosis (CVST) secondarily causes raised intracranial pressure (ICP). However, intracranial hypertension without evidence of CVST is a rare entity. Here we present two cases of elevated ICP with absence of identifiable CVST. CASE SUMMARY: Case 1, 28-year female had a 2 months history of holocranial headache followed by bilateral painless vision loss reaching lack of light perception over 20 days. CSF opening pressure was elevated. Fundoscopy showed bilateral grade 4 papilledema. MRI revealed a partially empty sella with bilateral optic nerve tortuosity. Idiopathic intracranial hypertension (IIH) was diagnosed. With acetazolamide, there was complete resolution of the clinical and radiological abnormalities. 5 months later she presented with acute onset right-sided hemiparesis. MRI was suggestive of acute left MCA infarct.MR venogram was normal. APLA came positive with high titres of Anticardiolipin and Beta 2 glycoprotein both IgG and IgM. Case 2, 23-year female, presented with headache and diplopia of 2 months duration. CSF pressure was elevated and Grade 3 papilledema was seen. MRI showed bilateral optic nerve hyperintensities with nerve head protrusion with normal MRV. APLA profile showed elevated beta 2 glycoprotein IgG and IgA. CONCLUSION: This is an important non thrombotic complication of APLA syndrome and requires further large-scale study for insight into the pathogenesis and early recognition to avoid future complications.

Keywords: APLA syndrome, idiopathic intracranial hypertension, MR venogram, papilledema

Procedia PDF Downloads 171
634 Governance Challenges of Consolidated Destinations. The Case of Barcelona

Authors: Montserrat Crespi-Vallbona; Oscar Mascarilla-Miró

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Mature destinations have different challenges trying to attract tourism and please its citizens. Hence, they have to maintain their touristic interest to standard demand and also not to undeceive those tourists with more advanced experiences. Second, they have to be concerned for the daily life of citizens and avoid the negative effects of touristification. This balance is quite delicate and often has to do with the sensitivity and commitment of the party in the local government. However, what is a general consensus is the need for destinations to differentiate from the homogeneous rest of regions and create new content, consumable resources or marketing events to guarantee their positioning. In this sense, the main responsibility of destinations is to satisfy users, tourists and citizens. Hence, its aim has to do with holistic experiences, which collect these wide approaches. Specifically, this research aims to analyze the volume and growth of tourist houses in the central touristic neighborhoods of Barcelona (this is Ciutat Vella) as the starting point to identify the behavior of tourists regarding their interests in searching for local heritage attractiveness and community atmosphere. Then, different cases are analyzed in order to show how Barcelona struggles to keep its attractive brand for the visitors, as well as for its inhabitants. Methodologically, secondary data used in this research comes from official registered tourist houses (Catalunya Government), Open Data (Barcelona municipality), the Airbnb tourist platform, from the Incasol Data and Municipal Register of Inhabitants. Primary data are collected through in-depth interviews with neighbors, social movement managers and political representatives from Turisme de Barcelona (local DMO, Destination Management Organization). Results show what the opportunities and priorities are for key actors to design policies to find a balance between all different interests.

Keywords: touristification, tourist houses, governance, tourism demand, airbnbfication

Procedia PDF Downloads 61
633 Knowledge and Practice of Family Planning among Rural Women in Ogun State, South West Nigeria

Authors: Tope Olubodun

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Background: Family planning practices help individuals and couples avoid unwanted pregnancies, regulate intervals between pregnancies, and determine the number of children in the family. Family planning is an effective intervention for promoting maternal health, but its acceptability and utilization are impeded by many factors in Southwest Nigeria. Aim: This study was conducted to assess women’s knowledge and practice of family planning in two rural communities in Ogun State, Southwest Nigeria, and to determine factors associated with the utilization of family planning among these women. Methods: This was a cross-sectional study conducted among 561 women of reproductive age selected by multistage sampling. The data collection was done using interviewer-administered questionnaires. Data obtained were analyzed using IBM SPSS Statistics version 20. Frequencies were generated, and chi-square test was used to explore associations. The level of significance was set at 0.05. Result: The majority of the respondents were aware of family planning 410 (73.1%). The method most commonly known was male condom 348 (62.0%), then pills 276 (49.2%) and injectables 231(41.3%). The commonest sources of information on family planning were health workers 158 (26.8%), outreaches 162 (27.5%) and TV/radio 136 (23.1%). Respondents that had used family planning, however, only constituted forty–five percent. The methods commonly used were injectables 104 (39.2%) and pills 85 (32.1%). Reasons for choosing not to use family planning include the desire for more children 78 (26.3%), because spouse does not support family planning 56 (18.9%), fear of unbearable side effects 44 (14.9%), and poor knowledge of the methods of family planning as well as where the services can be obtained 39 (13.2%). There is a statistically significant association between age, ethnicity, education, occupation, average monthly income, and use of family planning. Conclusion: Campaigns that promote male involvement in family planning, use of family planning for child spacing, and dispelling of fears is recommended to improve the practice of family planning among such a group of women.

Keywords: family planning, rural, knowledge, practice

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632 Applying Swanson's Theory of Caring to Manage Multiple Trauma Patient

Authors: Hsin-Yi Lo, Chia-Yu Hsu

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This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

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631 Ensuring Safe Operation by Providing an End-To-End Field Monitoring and Incident Management Approach for Autonomous Vehicle Based on ML/Dl SW Stack

Authors: Lucas Bublitz, Michael Herdrich

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By achieving the first commercialization approval in San Francisco the Autonomous Driving (AD) industry proves the technology maturity of the SAE L4 AD systems and the corresponding software and hardware stack. This milestone reflects the upcoming phase in the industry, where the focus is now about scaling and supervising larger autonomous vehicle (AV) fleets in different operation areas. This requires an operation framework, which organizes and assigns responsibilities to the relevant AV technology and operation stakeholders from the AV system provider, the Remote Intervention Operator, the MaaS provider and regulatory & approval authority. This holistic operation framework consists of technological, processual, and organizational activities to ensure safe operation for fully automated vehicles. Regarding the supervision of large autonomous vehicle fleets, a major focus is on the continuous field monitoring. The field monitoring approach must reflect the safety and security criticality of incidents in the field during driving operation. This includes an automatic containment approach, with the overall goal to avoid safety critical incidents and reduce downtime by a malfunction of the AD software stack. An End-to-end (E2E) field monitoring approach detects critical faults in the field, uses a knowledge-based approach for evaluating the safety criticality and supports the automatic containment of these E/E faults. Applying such an approach will ensure the scalability of AV fleets, which is determined by the handling of incidents in the field and the continuous regulatory compliance of the technology after enhancing the Operational Design Domain (ODD) or the function scope by Functions on Demand (FoD) over the entire digital product lifecycle.

Keywords: field monitoring, incident management, multicompliance management for AI in AD, root cause analysis, database approach

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630 Guidelines for School Management to Enhance School Engagement of Bangkok Christian College Students

Authors: Wichai Srisud, Shunnawat Pungbangkradee, Sukanya Chaemchoy

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This research study aims to analyze and assess school management guidelines designed to enhance the level of Student School Engagement of students at Bangkok Christian College, according to three following primary objectives: 1) to evaluate the level of Student School Engagement among Bangkok Christian College students, 2) to examine the Priority Needs Index of school management for promoting an optimum level of Student School Engagement among Bangkok Christian College students, and 3) to develop additional guidelines for school management to further enhance the level of Student School Engagement of Bangkok Christian College students. The research was conducted using Explanatory Design research methodology, with data obtained from a sample comprised of 291 students and 6 administrative personnel. The research findings indicated that: 1) The overall level of Student School Engagement was high. Emotional engagement averaged at the highest level, followed by Behavioral Engagement and Cognitive Engagement, respectively. 2) The Priority Needs Index of school management for promoting Student School Engagement of Bangkok Christian College students was examined, revealing that Evaluation averaged at the highest PNI level, followed by Planning and Implementation, respectively. 3) Guidelines for school management to enhance Student School Engagement of Bangkok Christian College students should consist of four approaches: 3.1) A Cognitive Engagement Enhancing Approach, which must include (1) fostering students’ problem-solving flexibility, and their ability to devise solutions for overcoming potential challenges, and (2) encouraging students to deal effectively with academic setbacks, rather than becoming overwhelmed by what they may perceive as failures, 3.2) An Emotional Engagement Enhancing Approach, cultivating students’ interests, aspirations and goals in learning to maximize emotional investment in their academic pursuits, and 3.3) A Behavioral Engagement Enhancing Approach, for elevating students’ focus and attentiveness during learning, and improving their ability to avoid distractions during study time.

Keywords: school engagement, guidelines for school management

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629 Use and Health Effects of Caffeinated Beverages in Omani Students

Authors: Nasiruddin Khan

Abstract:

The increased use of caffeinated beverages and energy drink is posing threat to all ages and gender especially, younger adults. There is a lack of scientific evidence in Oman regarding caffeine and energy drink consumption. Our study aims to demonstrate the prevalence, pattern, knowledge and awareness, and side effects of caffeine intake among university students. This cross-sectional study including (N=365) apparently healthy male and female Omani university students aged 18-30 years, was carried out from February 2018-June 2018. A self-administered questionnaire with various sections was used to obtain information. The prevalence of caffeinated beverage consumption was commonly high among participants (97%). The males preferred Nescafe, coffee (both p < 0.001), espresso (p < 0.022), and soda (p < 0.008) while females consumed more tea (p < 0.029). The awareness about negative health impact of caffeine intake was significantly higher in females rather than males (p < 0.002). The overall prevalence of energy drink consumption was 42.1% (n=149), and higher in males (75%, p < 0.001). More males consumed 3-5 and > 5 cans/day while females used 1-2 cans/day. The starting age of energy drink use was higher in females (16-20 years (51.1%)) as compared to males (11-15 years (33.3%)). Females were more aware of caffeine as energy drink ingredient (p < 0.036) than males. The major source of information about enery drink was family and friends (58.3%). Red Bull was the commonly used brand (55.5%) among participants. Common reasons for high energy drink consumption were energy boost (68.4 %), taste (62.9%), reduce fatigue (52.1%), and better performance (47.3%). Females reported breathing problem, and abnormal heart beat (p < 0.004, 0.054, respectively), while more males reported irritability than females (p < 0.052). The prevalence of caffeinated beverage and energy drink consumption is high among participants. The awareness, and knowledge among university student is not satisfactory and needs immediate action to avoid excess use of such consumption.

Keywords: energy drink, caffeinated beverages, awareness, Oman

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628 Factor Structure of the Korean Version of Multidimensional Experiential Avoidance Questionnaire (MEAQ)

Authors: Juyeon Lee, Sungeun You

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Experiential avoidance is one’s tendency to avoid painful internal experience, unwanted adverse thoughts, emotions, and physical sensations. The Multidimensional Experiential Avoidance Questionnaire (MEAQ) is a measure of experiential avoidance, and the original scale consisted of 62 items with six subfactors including behavioral avoidance, distress aversion, procrastination, distraction/suppression, repression/denial, and distress endurance. The purpose of this study was to examine the factor structure of the MEAQ in a Korean sample. Three hundred community adults and university students aged 18 to 35 participated in an online survey assessing experiential avoidance (MEAQ and Acceptance and Action Questionnaire-II; AAQ-II), depression (Patient Health Questionnaire-9; PHQ-9), anxiety (Generalized Anxiety Disoder-7; GAD-7), negative affect (Positive and Negative Affect Scale; PANAS), neuroticism (Big Five Inventory; BFI), and quality of life (Satisfaction with Life Scale; SWLS). Factor analysis with principal axis with direct oblimin rotation was conducted to examine subfactors of the MEAQ. Results indicated that the six-factor structure of the original scale was adequate. Eight items out of 62 items were removed due to insufficient factor loading. These items included 3 items of behavior avoidance (e.g., “When I am hurting, I would do anything to feel better”), 2 items of repression/denial (e.g., “I work hard to keep out upsetting feelings”), and 3 items of distress aversion (e.g., “I prefer to stick to what I am comfortable with, rather than try new activities”). The MEAQ was positively associated with the AAQ-II (r = .47, p < .001), PHQ-9 (r = .37, p < .001), GAD-7 (r = .34, p < .001), PANAS (r = .35, p < .001), and neuroticism (r = .24, p < .001), and negatively correlated with the SWLS (r = -.38, p < .001). Internal consistency was good for the MEAQ total (Cronbach’s α = .90) as well as all six subfactors (Cronbach’s α = .83 to .87). The findings of the study support the multidimensional feature of experiential avoidance and validity of the MEAQ in a sample of Korean adults.

Keywords: avoidance, experiential avoidance, factor structure, MEAQ

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627 The Effect of Extracts of 12 Local Medicinal Plants Against Uropathogenic Escherichia Coli

Authors: Hafida Merzouk

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Urinary tract infections are among the most serious public health issues in all age groups. Thus, the empirical therapy should based on local levels of resistance, as indicated in several studies from different countries, to effectively avoid the emergence of multidrug-resistant bacterial strains and recurrent infections. Numerous effective antibiotic treatments are available, but wouldbe ineffective for treating recurrent cystitis caused by a urinary tract infection, as well as the emergence of drug resistance. That iswhy the aim of this study was to highlight the antibacterial and the antioxidant activity of 11 medicinal plants used traditionally in Algeria against E. coli, the most responsible urinary tract infections. First, the extraction of total polyphenols with aqueous acetone showed variable yields. The highest yield was obtained by Asplenium trichomanes with 27%, followed by Petroselinum crispum and Ciannamomum cassia with an equal yield of 21%. Artemisia herba-alba gave the lowest yield (9%). The extracts of different plants showed variable contents of phenolic compounds. Reducing power and DPPH (2,2-diphenyl-1-picrylhydrazyl) scavenging activity revealed that most of the extracts studied had significant activity. The anti-free radical activity was very high in the extract of A splenium adiantum-nigrum compared with the other extracts studied, but Petroselinum crispum and Parietaria officinalis had the lowest reducing activity; Antibacterial activity was determined on E. coli strainsusing the diffusion, MICs (Minimum Inhibitory Concentrations) and MBCs (Minimum Bactericidal concentrations) methods. The strains tested were sensitive to most extracts studied, except Asplenium adiantum-nigrum extract, for which both strains showed resistance.

Keywords: E. coli, medicinal plants, phenolic compounds, urinary infections

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626 Measurements of Scattering Cross Sections for 5.895 keV Photons in Various Polymers

Authors: H. Duggal, G. Singh, G. Singh, A. Bhalla, S. Kumar, J. S. Shahi, D. Mehta

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The total differential cross section for scattering of the 5.895 keV photons by various polymers has been measured at scattering angle of 135o. The experimental measurements were carried out using the energy dispersive setup involving annular source of the 55Fe radioisotope and a low energy germanium (LEGe) detector. The cross section values are measured for 20 polymer targets namely, Paraffin Wax, Polytetrafluoro ethylene (PTFE), Cellulose, Silicone oil, Polyvinyl alcohol (PVA), Polyvinyl purrolidone (PVP), Polymethyl methacrylate (PMMA), Kapton, Mylar, Chitosan, Polyvinyl chloride (PVC), Bakelite, Carbopol, Chlorobutyl rubber (CBR), Polyetylene glycol (PEG), Polysorbate-20, Nylon-6, Cetyl alcohol, Carboxyl methyl sodium cellulose and Sodium starch glucolate. The measurements were performed in vacuum so as to avoid scattering contribution due to air and strong absorption of low energy photons in the air column. In the present investigations, the geometrical factor and efficiency of the detector were determined by measuring the K x-rays emitted from the 22Ti and 23V targets excited by the Mn K x-rays in the same experimental set up. The measured scattering cross sections have been compared with the sum of theoretically calculated elastic and inelastic scattering cross sections. The theoretical elastic (Rayleigh) scattering cross sections based on the various form factor approximations, namely, non-relativistic form factor (NF), relativistic form factor (RF), modified form factor (MF), and MF with anomalous scattering factor (ASF) as well as the second order S-matrix formalisms, and the inelastic scattering differential cross sections based on the Klein-Nishina formula after including the inelastic scattering function (KN+ISF) have been calculated. The experimental results show fairly good agreement with theoretical cross sections.

Keywords: photon, polymers, elastic and inelastic, scattering cross sections

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625 Development of Personal and Social Identity in Immigrant Deaf Adolescents

Authors: Marialuisa Gennari, Giancarlo Tamanza, Ilaria Montanari

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Identity development in adolescence is characterized by many risks and challenges, and becomes even more complex by the situation of migration and deafness. In particular, the condition of the second generation of migrant adolescents involves the comparison between the family context in which everybody speaks a language and deals with a specific culture (usually parents’ and relatives’ original culture), the social context (school, peer groups, sports groups), where a foreign language is spoken and a new culture is faced, and finally in the context of the “deaf” world. It is a dialectic involving unsolved differences that have to be treated in a discontinuous process, which will give complex outcomes and chances depending on the process of elaboration of the themes of growth and development, culture and deafness. This paper aims to underline the problems and opportunities for each issue which immigrant deaf adolescents must deal with. In particular, it will highlight the importance of a multifactorial approach for the analysis of personal resources (both intra-psychic and relational); the level of integration of the family of origin in the migration context; the elaboration of the migration event, and finally, the tractability of the condition of deafness. Some psycho-educational support objectives will be also highlighted for the identity development of deaf immigrant adolescents, with particular emphasis on the construction of the adolescents’ useful abilities to decode complex emotions, to develop self-esteem and to get critical thoughts about the inevitable attempts to build their identity. Remarkably, and of importance, the construction of flexible settings which support adolescents in a supple, “decentralized” way in order to avoid the regressive defenses that do not allow for the development of an authentic self.

Keywords: immigrant deaf adolescents, identity development, personal and social challenges, psycho-educational support

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624 Promoting Academic and Social-Emotional Growth of Students with Learning Differences Through Differentiated Instruction

Authors: Jolanta Jonak

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Traditional classrooms are challenging for many students, but especially for students that learn differently due to cognitive makeup, learning preferences, or disability. These students often require different teaching approaches and learning opportunities to benefit from learning. Teachers frequently divert to using one teaching approach, the one that matches their own learning style. For instance, teachers that are auditory learners, likely default to providing auditory learning opportunities. However, if a student is a visual learner, he/she may not fully benefit from that teaching style. Based on research, students and their parents’ feedback, large numbers of students are not provided the type of education and types of supports they need in order to be successful in an academic environment. This eventually leads to not learning at an appropriate rate and ultimately leading to skill deficiencies and deficits. Providing varied learning approaches promote high academic and social-emotional growth of all students and it will prevent inaccurate Special Education referrals. Varied learning opportunities can be delivered for all students by providing Differentiated Instruction (DI). This type of instruction allows each student to learn in the most optimal way regardless of learning preferences and cognitive learning profiles. Using Differentiated Instruction will lead to a high level of student engagement and learning. In addition, experiencing success in the classroom, will contribute to increased social emotional wellbeing. Being cognizant of how teaching approaches impact student's learning, school staff can avoid inaccurate perceptions about the students’ learning abilities, unnecessary referrals for special education evaluations, and inaccurate decisions about the presence of a disability. This presentation will illustrate learning differences due to various factors, how to recognize them, and how to address them through Differentiated Instruction.

Keywords: special education, disability, differences, differentiated instruction, social emotional wellbeing

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623 Modifications in Design of Lap Joint of Fiber Metal Laminates

Authors: Shaher Bano, Samia Fida, Asif Israr

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The continuous development and exploitation of materials and designs have diverted the attention of the world towards the use of robust composite materials known as fiber-metal laminates in many high-performance applications. The hybrid structure of fiber metal laminates makes them a material of choice for various applications such as aircraft skin panels, fuselage floorings, door panels and other load bearing applications. The synergistic effect of properties of metals and fibers reinforced laminates are responsible for their high damage tolerance as the metal element provides better fatigue and impact properties, while high stiffness and better corrosion properties are inherited from the fiber reinforced matrix systems. They are mostly used as a layered structure in different joint configurations such as lap and but joints. The FML layers are usually bonded with each other using either mechanical fasteners or adhesive bonds. This research work is also focused on modification of an adhesive bonded joint as a single lap joint of carbon fibers based CARALL FML has been modified to increase interlaminar shear strength and avoid delamination. For this purpose different joint modification techniques such as the introduction of spews and shoulder to modify the bond shape and use of nanofillers such as carbon nano-tubes as a reinforcement in the adhesive materials, have been utilized to improve shear strength of lap joint of the adhesively bonded FML layers. Both the simulation and experimental results showed that lap joint with spews and shoulders configuration have better properties due to stress distribution over a large area at the corner of the joint. The introduction of carbon nanotubes has also shown a positive effect on shear stress and joint strength as they act as reinforcement in the adhesive bond material.

Keywords: adhesive joint, Carbon Reinforced Aluminium Laminate (CARALL), fiber metal laminates, spews

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622 Modelling Patient Condition-Based Demand for Managing Hospital Inventory

Authors: Esha Saha, Pradip Kumar Ray

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A hospital inventory comprises of a large number and great variety of items for the proper treatment and care of patients, such as pharmaceuticals, medical equipment, surgical items, etc. Improper management of these items, i.e. stockouts, may lead to delay in treatment or other fatal consequences, even death of the patient. So, generally the hospitals tend to overstock items to avoid the risk of stockout which leads to unnecessary investment of money, difficulty in storing, more expiration and wastage, etc. Thus, in such challenging environment, it is necessary for hospitals to follow an inventory policy considering the stochasticity of demand in a hospital. Statistical analysis captures the correlation of patient condition based on bed occupancy with the patient demand which changes stochastically. Due to the dependency on bed occupancy, the markov model is developed that helps to map the changes in demand of hospital inventory based on the changes in the patient condition represented by the movements of bed occupancy states (acute care state, rehabilitative state and long-care state) during the length-of-stay of patient in a hospital. An inventory policy is developed for a hospital based on the fulfillment of patient demand with the objective of minimizing the frequency and quantity of placement of orders of inventoried items. The analytical structure of the model based on probability calculation is provided to show the optimal inventory-related decisions. A case-study is illustrated in this paper for the development of hospital inventory model based on patient demand for multiple inpatient pharmaceutical items. A sensitivity analysis is conducted to investigate the impact of inventory-related parameters on the developed optimal inventory policy. Therefore, the developed model and solution approach may help the hospital managers and pharmacists in managing the hospital inventory in case of stochastic demand of inpatient pharmaceutical items.

Keywords: bed occupancy, hospital inventory, markov model, patient condition, pharmaceutical items

Procedia PDF Downloads 320