Search results for: material management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15493

Search results for: material management

7063 Low Influenza Vaccine Coverage Rates among Polish Nurses

Authors: Aneta Nitsch-Osuch, Katarzyna Zycinska, Ewa Gyrczuk, Agnieszka Topczewska-Cabanek, Kazimierz Wardyn

Abstract:

Introduction: Influenza is an important clinical and epidemiological problem and should be considered as a possible nosocomial infection. The aim of the study was to determine the influenza vaccine coverage rates among Polish nurses and to find out drivers and barriers for influenza vaccination among this group of health care workers (HCWs). Material and methods: The self- fulfilled survey with 26 questions about the knowledge, perception, and influenza coverage rates was distributed among 461 nurses. Results: Only 15% of nurses were vaccinated against influenza in the consecutive seasons. The majority (75%) of the regularly vaccinated nurses were ambulatory careworkers. The difference between the number of vaccinated hospitals and ambulatory care nurses was statistically significant (p < 0.05). The main motivating factors for an influenza vaccination were: a fear of the illness and its complications (97%) and a free of charge vaccine available at the workplace (87%). Ambulatory care nurses more often declared that they were vaccinated mainly to protect themselves while hospital care nurses more often declared the will to protect their patients, these differences in the perception and attitudes to an influenza vaccination among hospital and ambulatory care nurses were statistically significant (p < 0.05). The main barriers for an influenza vaccination among the nursing staff were: a lack of reimbursement of the vaccine (95%), a lack of insufficient knowledge about the effectiveness, and safety of the influenza vaccine (54%). The ambulatory care nurses more often found influenza vaccination as the ethical duty compared to hospital care nurses (p < 0.05). Conclusions: The influenza vaccine coverage rates among the Polish nurses are low and must be improved in the future. More educational activities dedicated to HCWs may result in the increased awareness of influenza vaccination benefits for both medical professionals and patients.

Keywords: influenza, vaccination, nurses, ambulatory careworkers

Procedia PDF Downloads 284
7062 Multi-objective Rationality Optimisation for Robotic-fabrication-oriented Free-form Timber Structure Morphology Design

Authors: Yiping Meng, Yiming Sun

Abstract:

The traditional construction industry is unable to meet the requirements for novel fabrication and construction. Automated construction and digital design have emerged as industry development trends that compensate for this shortcoming under the backdrop of Industrial Revolution 4.0. Benefitting from more flexible working space and more various end-effector tools compared to CNC methods, robot fabrication and construction techniques have been used in irregular architectural design. However, there is a lack of a systematic and comprehensive design and optimisation workflow considering geometric form, material, and fabrication methods. This paper aims to propose a design optimisation workflow for improving the rationality of a free-form timber structure fabricated by the robotic arm. Firstly, the free-form surface is described by NURBS, while its structure is calculated using the finite element analysis method. Then, by considering the characteristics and limiting factors of robotic timber fabrication, strain energy and robustness are set as optimisation objectives to optimise structural morphology by gradient descent method. As a result, an optimised structure with axial force as the main force and uniform stress distribution is generated after the structure morphology optimisation process. With the decreased strain energy and the improved robustness, the generated structure's bearing capacity and mechanical properties have been enhanced. The results prove the feasibility and effectiveness of the proposed optimisation workflow for free-form timber structure morphology design.

Keywords: robotic fabrication, free-form timber structure, Multi-objective optimisation, Structural morphology, rational design

Procedia PDF Downloads 184
7061 Challenges to Quality Primary Health Care in Saudi Arabia and Potential Improvements Implemented by Other Systems

Authors: Hilal Al Shamsi, Abdullah Almutairi

Abstract:

Introduction: As primary healthcare centres play an important role in implementing Saudi Arabia’s health strategy, this paper offers a review of publications on the quality of the country’s primary health care. With the aim of deciding on solutions for improvement, it provides an overview of healthcare quality in this context and indicates barriers to quality. Method: Using two databases, ProQuest and Scopus, data extracted from published articles were systematically analysed for determining the care quality in Saudi primary health centres and obstacles to achieving higher quality. Results: Twenty-six articles met the criteria for inclusion in this review. The components of healthcare quality were examined in terms of the access to and effectiveness of interpersonal and clinical care. Good access and effective care were identified in such areas as maternal health care and the control of epidemic diseases, whereas poor access and effectiveness of care were shown for chronic disease management programmes, referral patterns (in terms of referral letters and feedback reports), health education and interpersonal care (in terms of language barriers). Several factors were identified as barriers to high-quality care. These included problems with evidence-based practice implementation, professional development, the use of referrals to secondary care and organisational culture. Successful improvements have been implemented by other systems, such as mobile medical units, electronic referrals, online translation tools and mobile devices and their applications; these can be implemented in Saudi Arabia for improving the quality of the primary healthcare system in this country. Conclusion: The quality of primary health care in Saudi Arabia varies among the different services. To improve quality, management programmes and organisational culture must be promoted in primary health care. Professional development strategies are also needed for improving the skills and knowledge of healthcare professionals. Potential improvements can be implemented to improve the quality of the primary health system.

Keywords: quality, primary health care, Saudi Arabia, health centres, general medical

Procedia PDF Downloads 182
7060 Testing of Protective Coatings on Automotive Steel, a Correlation Between Salt Spray, Electrochemical Impedance Spectroscopy, and Linear Polarization Resistance Test

Authors: Dhanashree Aole, V. Hariharan, Swati Surushe

Abstract:

Corrosion can cause serious and expensive damage to the automobile components. Various proven techniques for controlling and preventing corrosion depend on the specific material to be protected. Electrochemical Impedance Spectroscopy (EIS) and salt spray tests are commonly used to assess the corrosion degradation mechanism of coatings on metallic surfaces. While, the only test which monitors the corrosion rate in real time is known as Linear Polarisation Resistance (LPR). In this study, electrochemical tests (EIS & LPR) and spray test are reviewed to assess the corrosion resistance and durability of different coatings. The main objective of this study is to correlate the test results obtained using linear polarization resistance (LPR) and Electrochemical Impedance Spectroscopy (EIS) with the results obtained using standard salt spray test. Another objective of this work is to evaluate the performance of various coating systems- CED, Epoxy, Powder coating, Autophoretic, and Zn-trivalent coating for vehicle underbody application. The corrosion resistance coating are assessed. From this study, a promising correlation between different corrosion testing techniques is noted. The most profound observation is that electrochemical tests gives quick estimation of corrosion resistance and can detect the degradation of coatings well before visible signs of damage appear. Furthermore, the corrosion resistances and salt spray life of the coatings investigated were found to be according to the order as follows- CED> powder coating > Autophoretic > epoxy coating > Zn- Trivalent plating.

Keywords: Linear Polarization Resistance (LPR), Electrochemical Impedance Spectroscopy (EIS), salt spray test, sacrificial and barrier coatings

Procedia PDF Downloads 512
7059 Determination of Yield and Some Quality Characteristics of Winter Canola (Brassica napus ssp. oleifera L.) Cultivars

Authors: B. Coşgun, O. Ozturk

Abstract:

Canola is a specific edible type of rapeseed, developed in the 1970s, which contains about 40 percent oil. This research was carried out to determine the yield and some quality characteristics of some winter canola cultivars during the 2010-2011 vegetation period in Central Anatolia of Turkey. In this research; Oase, Dante, Californium, Excalibur, Elvis, ES Hydromel, Licord, Orkan, Vectra, Nelson, Champlain and NK Petrol winter canola varieties were used as material. The field experiment was set up in a “Randomized Complete Block Design” with three replications on 21 September 2010. In this research; seed yield, oil content, protein content, oil yield and protein yield were examined. As a result of this research; seed yield, oil content, oil yield and protein yield (except protein content) were significant differences between the cultivars. The highest seed yield (6348 kg ha-1) was obtained from the NK Petrol, while the lowest seed yield (3949 kg ha-1) was determined from the Champlain cultivar was obtained. The highest oil content (46.73%) was observed from Oase and the lowest value was obtained from Vectra (41.87%) cultivar. The highest oil yield (2950 kg ha-1) was determined from NK Petrol while the least value (1681 kg ha-1) was determined from Champlain cultivar. The highest protein yield (1539.3 kg ha-1) was obtained from NK Petrol and the lowest protein yield (976.5 kg ha-1) was obtained from Champlain cultivar. The main purpose of the cultivation of oil crops, to increase the yield of oil per unit area. According the result of this research, NK Petrol cultivar which ranks first with regard to both seed yield and oil yield between cultivars as the most suitable winter canola cultivar of local conditions.

Keywords: rapeseed, cultivar, seed yield, crude oil ratio, crude protein ratio, crude oil yield, crude protein yield

Procedia PDF Downloads 265
7058 Dermatomyositis: It is Not Always an Allergic Reaction

Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

Abstract:

Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

Procedia PDF Downloads 323
7057 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 130
7056 Improving Productivity in a Glass Production Line through Applying Principles of Total Productive Maintenance (TPM)

Authors: Omar Bataineh

Abstract:

Total productive maintenance (TPM) is a principle-based method that aims to get a high-level production with no breakdowns, no slow running and no defects. Key principles of TPM were applied in this work to improve the performance of the glass production line at United Beverage Company in Kuwait, which is producing bottles of soft drinks. Principles such as 5S as a foundation for TPM implementation, developing a program for equipment management, Cause and Effect Analysis (CEA), quality improvement, training and education of employees were employed. After the completion of TPM implementation, it was possible to increase the Overall Equipment Effectiveness (OEE) from 23% to 40%.

Keywords: OEE, TPM, FMEA, CEA

Procedia PDF Downloads 324
7055 Determination of Performances of Some Mulberry (Morus spp.) Species Selected from Different Places of Turkey under Kahramanmaras Conditions

Authors: Muruvvet Ilgin, Ilknur Agca

Abstract:

Common mulberry (Morus levigate Wall.) and purple mulberry (Morus rubra L.) species which were selected from different regions of Turkey were used as material in order to determine their performance. Therefore, phenological observations, pomological analysis (fruit size, fruit weight, fruit stalk length, acidity and TSS (Total Soluble Solids) and phytochemical properties organic acids (oxalic acid, succinic acid, citric acid, fumaric acid and malic acid) and vitamin C (ascorbic acid) total phenolics and antioxidant capacity values of mulberries) were determined. Phenological observations of seven different periods were also identified. Fruit weight values varied between 3.48 to 4.26 g. TSS contents value were from 14.36 to 21.30%, and fruit acidity was determined between 0.29 to 2.02%. The amount of ascorbic acid of Finger mulberry (Morus levigate Wall.) and purple mulberry (Morus rubra L.) species were identified as 35.60% and 363.28%. The highest value of total phenolic contents belonged to with a finger mulberry genotypes P1 934.80 mg/100g whereas the lowest one was of purple mulberry genotypes 278.70 mg/100g. FRAP and TEAC methods were used for determination of antioxidant capacity of the values of 0.58-22.65 micromol TE/kg and 20.34-31.6 micromol TE/kg. Total phenolics contents and antioxidant capacity strongly depends on fruit color intensity with a positive correlation. The obtained results have been found to be important as a source of future pharmacological studies and pomological and breeding programs.

Keywords: mulberry, phenology, phytochemical property, pomology

Procedia PDF Downloads 218
7054 Investigate the Effect and the Main Influencing Factors of the Accelerated Reader Programme on Chinese Primary School Students’ Reading Achievement

Authors: Fujia Yang

Abstract:

Alongside technological innovation, the current “double reduction” policy and English Curriculum Standards for Compulsory Education in China both emphasise and encourage appropriately integrating educational technologies into the classroom. Therefore, schools are increasingly using digital means to engage students in English reading, but the impact of such technologies on Chinese pupils’ reading achievement remains unclear. To serve as a reference for reforming English reading education in primary schools under the double reduction policy, this study investigates the effects and primary influencing factors of a specific reading programme, Accelerated Reader (AR), on Chinese primary school students’ reading achievement. A quantitative online survey was used to collect 37 valid questionnaires from teachers, and the results demonstrate that, from teachers’ perspectives, the AR program seemed to positively affect students’ reading achievement by recommending material at the appropriate reading levels and developing students’ reading habits. Although the reading enjoyment derived from the AR program does not directly influence students’ reading achievement, these factors are strongly correlated. This can be explained by the self-paced, independent learning AR format, its high accuracy in predicting reading level, the quiz format and external motivation, and the importance of examinations and resource limitations in China. The results of this study may support reforming English reading education in Chinese primary schools.

Keywords: educational technology, reading programme, primary students, accelerated reader, reading effects

Procedia PDF Downloads 70
7053 Feasibilities for Recovering of Precious Metals from Printed Circuit Board Waste

Authors: Simona Ziukaite, Remigijus Ivanauskas, Gintaras Denafas

Abstract:

Market development of electrical and electronic equipment and a short life cycle is driven by the increasing waste streams. Gold Au, copper Cu, silver Ag and palladium Pd can be found on printed circuit board. These metals make up the largest value of printed circuit board. Therefore, the printed circuit boards scrap is valuable as potential raw material for precious metals recovery. A comparison of Cu, Au, Ag, Pd recovery from waste printed circuit techniques was selected metals leaching of chemical reagents. The study was conducted using the selected multistage technique for Au, Cu, Ag, Pd recovery of printed circuit board. In the first and second metals leaching stages, as the elution reagent, 2M H2SO4 and H2O2 (35%) was used. In the third stage, leaching of precious metals used solution of 20 g/l of thiourea and 6 g/l of Fe2 (SO4)3. Verify the efficiency of the method was carried out the metals leaching test with aqua regia. Based on the experimental study, the leaching efficiency, using the preferred methodology, 60 % of Au and 85,5 % of Cu dissolution was achieved. Metals leaching efficiency after waste mechanical crushing and thermal treatment have been increased by 1,7 times (40 %) for copper, 1,6 times (37 %) for gold and 1,8 times (44 %) for silver. It was noticed that, the Au amount in old (> 20 years) waste is 17 times more, Cu amount - 4 times more, and Ag - 2 times more than in the new (< 1 years) waste. Palladium in the new printed circuit board waste has not been found, however, it was established that from 1 t of old printed circuit board waste can be recovered 1,064 g of Pd (leaching with aqua regia). It was found that from 1 t of old printed circuit board waste can be recovered 1,064 g of Ag. Precious metals recovery in Lithuania was estimated in this study. Given the amounts of generated printed circuit board waste, the limits for recovery of precious metals were identified.

Keywords: leaching efficiency, limits for recovery, precious metals recovery, printed circuit board waste

Procedia PDF Downloads 380
7052 The Damage and Durability of a Sport Synthetic Resin Floor: A Case Study

Authors: C. Paglia, C. Mosca

Abstract:

Synthetic resin floorsare often used in sport infrastructure. These organic materials are often in contact with a bituminous substrate, which in turn is placed on the ground. In this work, the damage of a basket resin field surface was characterized by means of visual inspection, optical microscopy, resin thickness measurements, adhesion strength, water vapor transmission capacity, capillary water adsorption, granulometry of the bituminous conglomerate, the surface properties, and the water ground infiltration speed. The infiltration speed indicates water pemeability. This was due to its composition: clean sand mixed with gravel. Relatively good adhesion was present between the synthetic resin and the bituminous layer. The adhesion resistance of the bituminous layer was relatively low. According to the required bitumoniousasphalt-concrete mixes AC 11 S, the placed material was more porous. Insufficient constipation was present. The spaces values were above the standard limits, while the apparent densities were lower compared to the conventional AC 11 mixtures. The microstructure outlines the high permeability and porosity of the bituminous layer. The synthetic resin wasvapourproof and did not exhibit capillary adsorption. It exhibited a lower thickness as required, and no multiple placing steps were observed. Multiple cavities were detected along with the interface between the bituminous layer and the resin coating with no intermediate layers. The layer for the pore filling in the bituminous surface was not properly applied. The swelling bubbles on the synthetic pavement were caused by the humidity in the bituminous layer. Water or humidity were present prior to the application of the resin, and the effect was worsened by the upward movement of the water from the ground.

Keywords: resin, floor, damage, durability

Procedia PDF Downloads 152
7051 Clinical Implication of Hyper-Intense Signal Thyroid Incidentaloma on Time of Flight Magnetic Resonance Angiography

Authors: Inseon Ryoo, Soo Chin Kim, Hyena Jung, Sangil Suh

Abstract:

Objectives: The purpose of this study is to evaluate the clinical significance of hyper-intense signal thyroid incidentalomas on the time of flight magnetic resonance angiography (TOF-MRA) using correlation study with ultrasound (US). Methods: We retrospectively reviewed 3,505 non-contrast TOF-MRA performed at an institution between September 2014 and May 2017. Two radiologists correlated the thyroid incidentalomas detected on TOF-MRA with US features which was obtained within three months interval between MRA and US examinations in consensus method. Results: The prevalence of hyper-intense signal thyroid nodules incidentally detected on TOF-MRA was 1.2% (43/3505). Among them, 35 people (81.4%) underwent US examinations, and total 45 hyper-intense signal thyroid nodules were detected on US exams. Of these 45 nodules, 35 nodules (72.9%) were categorized as benign (K-TIRADS category 2) on US exams. Fine needle aspiration was performed on 9 nodules according to the indications recommended by Korean Society of Thyroid Radiology. All except one high-suspicious thyroid nodule were confirmed as benign (Bethesda 2) on cytologic exams. One high-suspicious nodule on US showed a non-diagnostic result (Bethesda 1) on cytologic exam. However, this nodule collapsed after aspiration of thick colloid material. Conclusions: Our study showed that the most hyper-intense signal thyroid nodules detected on TOF-MRA were benign. Therefore, if a hyper-intense signal incidentaloma is found on TOF-MRA, further evaluation, especially invasive biopsy of the nodules could be suspended unless the patient had other symptoms or clinical factors suggesting the need for further evaluation.

Keywords: incidentaloma, thyroid nodule, TOF MR angiography, ultrasound

Procedia PDF Downloads 155
7050 Development of Orthogonally Protected 2,1':4,6-Di-O-Diisopropylidene Sucrose as the Versatile Intermediate for Diverse Synthesis of Phenylpropanoid Sucrose Esters

Authors: Li Lin Ong, Duc Thinh Khong, Zaher M. A. Judeh

Abstract:

Phenylpropanoid sucrose esters (PSEs) are natural compounds found in various medicinal plants which exhibit important biological activities such as antiproliferation and α- and β-glucosidase inhibitory activities. Despite their potential as new therapeutics, total synthesis of PSEs has been very limited as their inherent structures contain one or more (substituted) cinnamoyl groups randomly allocated on the sucrose core via ester linkage. Since direct acylation of unprotected sucrose would be complex and tedious due to the presence of eight free hydroxyl groups, partially protected 2,1’:4,6-di-O-diisopropylidene sucrose was used as the starting material instead. However, similar reactivity between the remaining four hydroxyl groups still pose a challenge in the total synthesis of PSEs as the lack of selectivity can restrict customisation where acylation at specific OH is desired. To overcome this problem, a 4-step orthogonal protection scheme was developed. In this scheme, the remaining four hydroxyl groups on 2,1’:4,6-di-O-diisopropylidene sucrose, 6’-OH, 3’-OH, 4’-OH, and 3-OH, were protected with different protecting groups with an overall yield of > 40%. This orthogonally protected intermediate would provide a convenient and divergent access to a wider range of natural and synthetic PSEs as (substituted) cinnamoyl groups can be selectively introduced at desired positions. Using this scheme, three different series of monosubstituted PSEs were successfully synthesized where (substituted) cinnamoyl groups were introduced selectively at O-3, O-3’, and O-4’ positions, respectively. The expanded library of PSEs would aid in structural-activity relationship study of PSEs for identifying key components responsible for their biological activities.

Keywords: orthogonal protection, phenylpropanoid sucrose esters, selectivity, sucrose

Procedia PDF Downloads 145
7049 Maternal, Fetal and Neonatal Outcomes of Elective Versus Emergency Cesarean Deliveries

Authors: Poonam Chouhan, Rama Thakur, R. J. Mahajan, Kushla Pathania, Mehnaz Kumar

Abstract:

Background: Cesarean sections are associated with short- and long-term risks and affect the health of the woman, her child, and future pregnancies. We conducted a study to compare Maternal, fetal, and neonatal elective versus emergency cesarean deliveries in a tertiary care center. Material & Methods: This was a cross-sectional comparative hospital-based study conducted at Kamla Nehru State Hospital for the mother and Child, Department of Obstetrics and Gynecology, Indira Gandhi Medical College, Shimla, from June 1, 2020, to May 31ˢᵗ, 2021). A total of 200 consenting participants (100 participants undergoing elective cesarean section & 100 participants undergoing emergency cesarean section) were enrolled. The analysis was performed using the statistical package for social sciences (SPSS) version 21. Results: Antenatal complications were more in women who had an emergency cesarean section (95%) as compared to those who had an elective cesarean section (46%) (p=0.0076). 26.5% of women had fetal complications, and out of them, 92.4% (49/53) underwent emergency cesarean section. IUGR was diagnosed in 8% of women, out of them, 56.2% had elective cesarean section & 43.8% had an emergency cesarean section. Malpresentation other than breech presentation were present in 3.5% (7/200) of women. Six (3%) women had cesarean section for macrosomia. Of these, 66.7% (4/6) had elective cesarean section & 33.3% had emergency cesarean section. 23% (46/200) neonates required NICU admission, and 5% (10/200) had transient tachypnoea of new-born (TTNB). Conclusion: Our study concluded that maternal and fetal Complications of an emergency cesarean are more as compared to a planned elective cesarean. An elective cesarean conducted well in time will prevent an emergency cesarean delivery and its related complications.

Keywords: maternal, fetal, neonatal, complications, cesareans

Procedia PDF Downloads 76
7048 Molecular-Dynamics Study of H₂-C₃H₈-Hydrate Dissociation: Non-Equilibrium Analysis

Authors: Mohammad Reza Ghaani, Niall English

Abstract:

Hydrogen is looked upon as the next-generation clean-energy carrier; the search for an efficient material and method for storing hydrogen has been, and is, pursued relentlessly. Clathrate hydrates are inclusion compounds wherein guest gas molecules like hydrogen are trapped in a host water-lattice framework. These types of materials can be categorised as potentially attractive hosting environments for physical hydrogen storage (i.e., no chemical reaction upon storage). Non-equilibrium molecular dynamics (NEMD) simulations have been performed to investigate thermal-driven break-up of propane-hydrate interfaces with liquid water at 270-300 K, with the propane hydrate containing either one or no hydrogen molecule in each of its small cavities. In addition, two types of hydrate-surface water-lattice molecular termination were adopted, at the hydrate edge with water: a 001-direct surface cleavage and one with completed cages. The geometric hydrate-ice-liquid distinction criteria of Báez and Clancy were employed to distinguish between the hydrate, ice lattices, and liquid-phase. Consequently, the melting temperatures of interface were estimated, and dissociation rates were observed to be strongly dependent on temperature, with higher dissociation rates at larger over-temperatures vis-à-vis melting. The different hydrate-edge terminations for the hydrate-water interface led to statistically-significant differences in the observed melting point and dissociation profile: it was found that the clathrate with the planar interface melts at around 280 K, whilst the melting temperature of the cage-completed interface was determined to be circa 270 K.

Keywords: hydrogen storage, clathrate hydrate, molecular dynamics, thermal dissociation

Procedia PDF Downloads 261
7047 Impacts of Community Forest on Forest Resources Management and Livelihood Improvement of Local People in Nepal

Authors: Samipraj Mishra

Abstract:

Despite the successful implementation of community forestry program, a number of pros and cons have been raised on Terai community forestry in the case of lowland locally called Terai region of Nepal, which is climatically belongs to tropical humid and possessed high quality forests in terms of ecology and economy. The study aims to investigate the local pricing strategy of forest products and its impacts on equitable forest benefit sharing, collection of community fund and carrying out livelihood improvement activities. The study was carried out on six community forests revealed that local people have substantially benefited from the community forests. However, being the region is heterogeneous by socio-economic conditions and forest resources have higher economical potential, the decision of low pricing strategy made by the local people have created inequality problems while sharing the forest benefits, and poorly contributed to community fund collection and consequently carrying out limited activities of livelihood improvement. The paper argued that the decision of low pricing strategy of forest products is counter-productive to promote the equitable benefit sharing in the areas of heterogeneous socio-economic conditions with high value forests. The low pricing strategy has been increasing accessibility of better off households at higher rate than poor; as such households always have higher affording capacity. It is also defective to increase the community fund and carry out activities of livelihood improvement effectively. The study concluded that unilateral decentralized forest policy and decision-making autonomy to the local people seems questionable unless their decision-making capacities are enriched sufficiently. Therefore, it is recommended that empowerment of decision-making capacity of local people and their respective institutions together with policy and program formulation are prerequisite for efficient and equitable community forest management and its long-term sustainability.

Keywords: community forest, livelihood, socio-economy, pricing system, Nepal

Procedia PDF Downloads 265
7046 Organizational Resilience in the Perspective of Supply Chain Risk Management: A Scholarly Network Analysis

Authors: William Ho, Agus Wicaksana

Abstract:

Anecdotal evidence in the last decade shows that the occurrence of disruptive events and uncertainties in the supply chain is increasing. The coupling of these events with the nature of an increasingly complex and interdependent business environment leads to devastating impacts that quickly propagate within and across organizations. For example, the recent COVID-19 pandemic increased the global supply chain disruption frequency by at least 20% in 2020 and is projected to have an accumulative cost of $13.8 trillion by 2024. This crisis raises attention to organizational resilience to weather business uncertainty. However, the concept has been criticized for being vague and lacking a consistent definition, thus reducing the significance of the concept for practice and research. This study is intended to solve that issue by providing a comprehensive review of the conceptualization, measurement, and antecedents of operational resilience that have been discussed in the supply chain risk management literature (SCRM). We performed a Scholarly Network Analysis, combining citation-based and text-based approaches, on 252 articles published from 2000 to 2021 in top-tier journals based on three parameters: AJG ranking and ABS ranking, UT Dallas and FT50 list, and editorial board review. We utilized a hybrid scholarly network analysis by combining citation-based and text-based approaches to understand the conceptualization, measurement, and antecedents of operational resilience in the SCRM literature. Specifically, we employed a Bibliographic Coupling Analysis in the research cluster formation stage and a Co-words Analysis in the research cluster interpretation and analysis stage. Our analysis reveals three major research clusters of resilience research in the SCRM literature, namely (1) supply chain network design and optimization, (2) organizational capabilities, and (3) digital technologies. We portray the research process in the last two decades in terms of the exemplar studies, problems studied, commonly used approaches and theories, and solutions provided in each cluster. We then provide a conceptual framework on the conceptualization and antecedents of resilience based on studies in these clusters and highlight potential areas that need to be studied further. Finally, we leverage the concept of abnormal operating performance to propose a new measurement strategy for resilience. This measurement overcomes the limitation of most current measurements that are event-dependent and focus on the resistance or recovery stage - without capturing the growth stage. In conclusion, this study provides a robust literature review through a scholarly network analysis that increases the completeness and accuracy of research cluster identification and analysis to understand conceptualization, antecedents, and measurement of resilience. It also enables us to perform a comprehensive review of resilience research in SCRM literature by including research articles published during the pandemic and connects this development with a plethora of articles published in the last two decades. From the managerial perspective, this study provides practitioners with clarity on the conceptualization and critical success factors of firm resilience from the SCRM perspective.

Keywords: supply chain risk management, organizational resilience, scholarly network analysis, systematic literature review

Procedia PDF Downloads 63
7045 A Study to Explore the Views of Students regarding E-Learning as an Instructional Tool at University Level

Authors: Zafar Iqbal

Abstract:

This study involved students of 6th semester enrolled in a Bachelor of Computer Science Program at university level. In this era of science and technology, e-learning can be helpful for grassroots in providing them access to education tenant in less developed areas. It is a potential substitute of face-to-face teaching being used in different countries. The purpose of the study was to explore the views of students about e-learning (Facebook) as an instructional tool. By using purposive sampling technique an intact class of 30 students included both male and female were selected where e-learning was used as an instructional tool. The views of students were explored through qualitative approach by using focus group interviews. The approach was helpful to develop comprehensive understanding of students’ views towards e- learning. In addition, probing questions were also asked and recorded. Data was transcribed, generated nodes and then coded text against these nodes. For this purpose and further analysis, NVivo 10 software was used. Themes were generated and tangibly presented through cluster analysis. Findings were interesting and provide sufficient evidence that face book is a subsequent e-learning source for students of higher education. Students acknowledged it as best source of learning and it was aligned with their academic and social behavior. It was not time specific and therefore, feasible for students who work day time and can get on line access to the material when they got free time. There were some distracters (time wasters) reported by the students but can be minimized by little effort. In short, e-learning is need of the day and potential learning source for every individual who have access to internet living at any part of the globe.

Keywords: e-learning, facebook, instructional tool, higher education

Procedia PDF Downloads 367
7044 Multi-Point Dieless Forming Product Defect Reduction Using Reliability-Based Robust Process Optimization

Authors: Misganaw Abebe Baye, Ji-Woo Park, Beom-Soo Kang

Abstract:

The product quality of multi-point dieless forming (MDF) is identified to be dependent on the process parameters. Moreover, a certain variation of friction and material properties may have a substantially worse influence on the final product quality. This study proposed on how to compensate the MDF product defects by minimizing the sensitivity of noise parameter variations. This can be attained by reliability-based robust optimization (RRO) technique to obtain the optimal process setting of the controllable parameters. Initially two MDF Finite Element (FE) simulations of AA3003-H14 saddle shape showed a substantial amount of dimpling, wrinkling, and shape error. FE analyses are consequently applied on ABAQUS commercial software to obtain the correlation between the control process setting and noise variation with regard to the product defects. The best prediction models are chosen from the family of metamodels to swap the computational expensive FE simulation. Genetic algorithm (GA) is applied to determine the optimal process settings of the control parameters. Monte Carlo Analysis (MCA) is executed to determine how the noise parameter variation affects the final product quality. Finally, the RRO FE simulation and the experimental result show that the amendment of the control parameters in the final forming process leads to a considerably better-quality product.

Keywords: dimpling, multi-point dieless forming, reliability-based robust optimization, shape error, variation, wrinkling

Procedia PDF Downloads 239
7043 Human Trafficking the Kosovar Perspective of Fighting the Phenomena through Police and Civil Society Cooperation

Authors: Samedin Mehmeti

Abstract:

The rationale behind this study is considering combating and preventing the phenomenon of trafficking in human beings from a multidisciplinary perspective that involves many layers of the society. Trafficking in human beings is an abhorrent phenomenon highly affecting negatively the victims and their families in both human and material aspect, sometimes causing irreversible damages. The longer term effects of this phenomenon, in countries with a weak economic development and extremely young and dynamic population, such as Kosovo, without proper measures to prevented and control can cause tremendous damages in the society. Given the fact that a complete eradication of this phenomenon is almost impossible, efforts should be concentrated at least on the prevention and controlling aspects. Treating trafficking in human beings based on traditional police tactics, methods and proceedings cannot bring satisfactory results. There is no doubt that a multi-disciplinary approach is an irreplaceable requirement, in other words, a combination of authentic and functional proactive and reactive methods, techniques and tactics. Obviously, police must exercise its role in preventing and combating trafficking in human beings, a role sanctioned by the law, however, police role and contribution cannot by any means considered complete if all segments of the society are not included in these efforts. Naturally, civil society should have an important share in these collaborative and interactive efforts especially in preventive activities such as: awareness on trafficking risks and damages, proactive engagement in drafting appropriate legislation and strategies, law enforcement monitoring and direct or indirect involvement in protective and supporting activities which benefit the victims of trafficking etc.

Keywords: civil society, cooperation, police, human trafficking

Procedia PDF Downloads 354
7042 Direct Cost of Anesthesia in Traumatic Patients with Massive Bleeding: A Prospective Micro-Costing Study

Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

Abstract:

Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

Procedia PDF Downloads 134
7041 The Effect of Fetal Movement Counting on Maternal Antenatal Attachment

Authors: Esra Güney, Tuba Uçar

Abstract:

Aim: This study has been conducted for the purpose of determining the effects of fetal movement counting on antenatal maternal attachment. Material and Method: This research was conducted on the basis of the real test model with the pre-test /post-test control groups. The study population consists of pregnant women registered in the six different Family Health Centers located in the central Malatya districts of Yeşilyurt and Battalgazi. When power analysis is done, the sample size was calculated for each group of at least 55 pregnant women (55 tests, 55 controls). The data were collected by using Personal Information Form and MAAS (Maternal Antenatal Attachment Scale) between July 2015-June 2016. Fetal movement counting training was given to pregnant women by researchers in the experimental group after the pre-test data collection. No intervention was applied to the control group. Post-test data for both groups were collected after four weeks. Data were evaluated with percentage, chi-square arithmetic average, chi-square test and as for the dependent and independent group’s t test. Result: In the MAAS, the pre-test average of total scores in the experimental group is 70.78±6.78, control group is also 71.58±7.54 and so there was no significant difference in mean scores between the two groups (p>0.05). MAAS post-test average of total scores in the experimental group is 78.41±6.65, control group is also is 72.25±7.16 and so the mean scores between groups were found to have statistically significant difference (p<0.05). Conclusion: It was determined that fetal movement counting increases the maternal antenatal attachments.

Keywords: antenatal maternal attachment, fetal movement counting, pregnancy, midwifery

Procedia PDF Downloads 255
7040 Risk-Sharing Financing of Islamic Banks: Better Shielded against Interest Rate Risk

Authors: Mirzet SeHo, Alaa Alaabed, Mansur Masih

Abstract:

In theory, risk-sharing-based financing (RSF) is considered a corner stone of Islamic finance. It is argued to render Islamic banks more resilient to shocks. In practice, however, this feature of Islamic financial products is almost negligible. Instead, debt-based instruments, with conventional like features, have overwhelmed the nascent industry. In addition, the framework of present-day economic, regulatory and financial reality inevitably exposes Islamic banks in dual banking systems to problems of conventional banks. This includes, but is not limited to, interest rate risk. Empirical evidence has, thus far, confirmed such exposures, despite Islamic banks’ interest-free operations. This study applies system GMM in modeling the determinants of RSF, and finds that RSF is insensitive to changes in interest rates. Hence, our results provide support to the “stability” view of risk-sharing-based financing. This suggests RSF as the way forward for risk management at Islamic banks, in the absence of widely acceptable Shariah compliant hedging instruments. Further support to the stability view is given by evidence of counter-cyclicality. Unlike debt-based lending that inflates artificial asset bubbles through credit expansion during the upswing of business cycles, RSF is negatively related to GDP growth. Our results also imply a significantly strong relationship between risk-sharing deposits and RSF. However, the pass-through of these deposits to RSF is economically low. Only about 40% of risk-sharing deposits are channeled to risk-sharing financing. This raises questions on the validity of the industry’s claim that depositors accustomed to conventional banking shun away from risk sharing and signals potential for better balance sheet management at Islamic banks. Overall, our findings suggest that, on the one hand, Islamic banks can gain ‘independence’ from conventional banks and interest rates through risk-sharing products, the potential for which is enormous. On the other hand, RSF could enable policy makers to improve systemic stability and restrain excessive credit expansion through its countercyclical features.

Keywords: Islamic banks, risk-sharing, financing, interest rate, dynamic system GMM

Procedia PDF Downloads 310
7039 High Temperature Oxidation of Additively Manufactured Silicon Carbide/Carbon Fiber Nanocomposites

Authors: Saja M. Nabat Al-Ajrash, Charles Browning, Rose Eckerle, Li Cao, Robyn L. Bradford, Donald Klosterman

Abstract:

An additive manufacturing process and subsequent pyrolysis cycle were used to fabricate SiC matrix/carbon fiber hybrid composites. The matrix was fabricated using a mixture of preceramic polymer and acrylate monomers, while polyacrylonitrile (PAN) precursor was used to fabricate fibers via electrospinning. The precursor matrix and reinforcing fibers at 0, 2, 5, or 10 wt% were printed using digital light processing, and both were simultaneously pyrolyzed to yield the final ceramic matrix composite structure. After pyrolysis, XRD and SEAD analysis proved the existence of SiC nanocrystals and turbostratic carbon structure in the matrix, while the reinforcement phase was shown to have a turbostratic carbon structure similar to commercial carbon fibers. Thermogravimetric analysis (TGA) in the air up to 1400 °C was used to evaluate the oxidation resistance of this material. TGA results showed some weight loss due to oxidation of SiC and/or carbon up to about 900 °C, followed by weight gain to about 1200 °C due to the formation of a protective SiO2 layer. Although increasing carbon fiber content negatively impacted the total mass loss for the first heating cycle, exposure of the composite to second-run air revealed negligible weight chance. This is explained by SiO2 layer formation, which acts as a protective film that prevents oxygen diffusion. Oxidation of SiC and the formation of a glassy layer has been proven to protect the sample from further oxidation, as well as provide healing of surface cracks and defects, as revealed by SEM analysis.

Keywords: silicon carbide, carbon fibers, additive manufacturing, composite

Procedia PDF Downloads 61
7038 Pragmatic Competence in Pakistani English Language Learners

Authors: Ghazala Kausar

Abstract:

This study investigates Pakistani first year university students’ perception of the role of pragmatics in their general approach to learning English. The research is triggered by National Curriculum’s initiative to provide holistic opportunities to the students for language development and to equip them with competencies to use English language in academic and social contexts (New English National Curriculum for I-XII). The traditional grammar translation and examination oriented method is believed to reduce learners to silent listener (Zhang, 2008: Zhao 2009). This lead to the inability of the students to interpret discourse by relating utterances to their meaning, understanding the intentions of the users and how language is used in specific setting (Bachman & Palmer, 1996, 2010). Pragmatic competence is a neglected area as far as teaching and learning English in Pakistan is concerned. This study focuses on the different types of pragmatic knowledge, learners perception of such knowledge and learning strategies employed by different learners to process the learning in general and pragmatic in particular. This study employed three data collecting tools; a questionnaire, discourse completion task and interviews to elicit data from first year university students regarding their perception of pragmatic competence. Results showed that Pakistani first year university learners have limited pragmatic knowledge. Although they acknowledged the importance of linguistic knowledge for linguistic competence in the students but argued that insufficient English proficiency, limited knowledge of pragmatics, insufficient language material and tasks were major reasons of pragmatic failure.

Keywords: pragmatic competence, Pakistani college learners, linguistic competence

Procedia PDF Downloads 726
7037 Design of a CO₂-Reduced 3D Concrete Mixture Using Circular (Clay-Based) Building Materials

Authors: N. Z. van Hierden, Q. Yu, F. Gauvin

Abstract:

Cement manufacturing is, because of its production process, among the highest contributors to CO₂ emissions worldwide. As cement is one of the major components in 3D printed concrete, achieving sustainability and carbon neutrality can be particularly challenging. To improve the sustainability of 3D printed materials, different CO₂-reducing strategies can be used, each one with a distinct level of impact and complexity. In this work, we focus on the development of these sustainable mixtures and finding alternatives. Promising alternatives for cement and clinker replacement include the use of recycled building materials, amongst which (calcined) bricks and roof tiles. To study the potential of recycled clay-based building materials, the application of calcinated clay itself is studied as well. Compared to cement, the calcination temperature of clay-based materials is significantly lower, resulting in reduced CO₂ output. Reusing these materials is therefore a promising solution for utilizing waste streams while simultaneously reducing the cement content in 3D concrete mixtures. In addition, waste streams can be locally sourced, thereby reducing the emitted CO₂ during transportation. In this research, various alternative binders are examined, such as calcined clay blends (LC3) from recycled tiles and bricks, or locally obtained clay resources. Using various experiments, a high potential for mix designs including these resources has been shown with respect to material strength, while sustaining decent printability and buildability. Therefore, the defined strategies are promising and can lead to a more sustainable, low-CO₂ mixture suitable for 3D printing while using accessible materials.

Keywords: cement replacement, 3DPC, circular building materials, calcined clay, CO₂ reduction

Procedia PDF Downloads 74
7036 Space Debris: An Environmental Hazard

Authors: Anwesha Pathak

Abstract:

Space law refers to all legal provisions that may regulate or apply to space travel, as well as to space-related activity. Although there is undoubtedly a core corpus of “space law,” rather than designating a conceptually distinct single kind of law, the phrase can be seen as a label applied to a bucket that includes a variety of different laws and regulations. Similar to ‘family law' or ‘environmental law' "space law" refers to a variety of laws that are identified by the subject matter they address rather than by the logical extension of a single legal concept. The word "space law" refers to the Law of Space, which can cover anything from the specifics of an insurance agreement for a specific space launch to the most general guidelines that direct state behaviour in space. Space debris, often referred to as space junk, space pollution, space waste, space trash, or space garbage, is a term used to describe abandoned human-made objects in space, primarily in Earth orbit. These include disused spacecraft, discarded launch vehicle stages, mission-related detritus, and fragmentation material from the destruction of disused rocket bodies and spacecraft, which is particularly prevalent in Earth orbit. Other types of space debris, besides abandoned human-made objects in orbit, include pieces left over from collisions, erosion, and disintegration, or even paint specks, solidified liquids ejected from spacecraft, and unburned components from solid rocket engines. The initial action of launching or using a spacecraft in near-Earth orbit imposes an external cost on others that is typically not taken into account or fully accounted for in the cost by the launcher or payload owner.

Keywords: space, outer space treaty, geostationary orbit, satellites, spacecrafts

Procedia PDF Downloads 78
7035 The Impact of Artificial Intelligence on Legislations and Laws

Authors: Keroles Akram Saed Ghatas

Abstract:

The near future will bring significant changes in modern organizations and management due to the growing role of intangible assets and knowledge workers. The area of copyright, intellectual property, digital (intangible) assets and media redistribution appears to be one of the greatest challenges facing business and society in general and management sciences and organizations in particular. The proposed article examines the views and perceptions of fairness in digital media sharing among Harvard Law School's LL.M.s. Students, based on 50 qualitative interviews and 100 surveys. The researcher took an ethnographic approach to her research and entered the Harvard LL.M. in 2016. at, a Face book group that allows people to connect naturally and attend in-person and private events more easily. After listening to numerous students, the researcher conducted a quantitative survey among 100 respondents to assess respondents' perceptions of fairness in digital file sharing in various contexts (based on media price, its availability, regional licenses, copyright holder status, etc.). to understand better . .). Based on the survey results, the researcher conducted long-term, open-ended and loosely structured ethnographic interviews (50 interviews) to further deepen the understanding of the results. The most important finding of the study is that Harvard lawyers generally support digital piracy in certain contexts, despite having the best possible legal and professional knowledge. Interestingly, they are also more accepting of working for the government than the private sector. The results of this study provide a better understanding of how “fairness” is perceived by the younger generation of lawyers and pave the way for a more rational application of licensing laws.

Keywords: cognitive impairments, communication disorders, death penalty, executive function communication disorders, cognitive disorders, capital murder, executive function death penalty, egyptian law absence, justice, political cases piracy, digital sharing, perception of fairness, legal profession

Procedia PDF Downloads 48
7034 A Case Study on the Effect of a Mobility Focused Exercise Training in Rehabilitation of an Elite Weightlifter with Shoulder Pain and Weakness

Authors: Lingling Li, Peng Zhao, Runze Guan, Alice Jones, Tao Yu

Abstract:

Background: Shoulder pain and weakness are associated with complex pathologies and often precludes weightlifters from participation in training. The role and mode of exercise training in weightlifters with shoulder pathology remains unclear. Objectives: This case report described an exercise program in management of an elite weightlifter with primary complaint of right shoulder pain and weakness. Methods: A 22-year-old weightlifter presented with 2-year duration of right shoulder pain and weakness which was worsened by routine weightlifting training, and symptoms were not relieved with steroid injection, manual therapy nor usual physiotherapy. There was a limitation in all active range of motion especially horizontal extension (13ᵒ) and external rotation (41ᵒ) with pain intensity at 4/10 and 10/10 (numeric pain rating score) respectively. Muscle weakness was most significant at supraspinatus and teres minor, 38% and 27% respectively compared to his left shoulder (hand-held dynamometry, Micro FET2). An exercise training program focusing on improving mobility was designed for this athlete following a comprehensive physical assessment. Exercises included specific stretching, muscle activating and scapular stability training; once per day, and for 60 minutes each session. All exercises were completed under instruction as pain allowed. Quantitative assessment was conducted at the end of each week for 3 weeks. Outcomes: After the program, the athlete was pain-free in all movements except the O’Brien active compression internal rotation test, the pain was however reduced from 10/10 to 3/10. The horizontal extension and external rotation range increased to 79ᵒ to 120ᵒ respectively, and strength of all rotator cuff muscles returned to normal. At 1-month follow up, the athlete was totally pain-free and had returned to normal function and weightlifting training activities. The outcomes sustained through 6-month and one year. Conclusion: This case report supports the use of a mobility-focused exercise program for management of shoulder pain and weakness in an elite weightlifter athlete.

Keywords: exercise training, mobility, rehabilitation, shoulder pain, weightlifting

Procedia PDF Downloads 167