Search results for: sustainable landscape management innovations

Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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Authors: Ashneel Ajay Singh, Anish Maharaj, Havish Naidu, Michelle Kumar

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Mangrove patches are the foundation species located in the estuarine land areas. These patches provide a nursery, food source and protection for numerous aquatic, intertidal and well as land-based organisms. Mangroves also help in coastal protection, maintain water clarity and are one of the biggest sinks for blue carbon sequestration. In the Pacific Island countries, numerous coastal communities have a heavy socioeconomic dependence on coastal resources and mangroves play a key ecological and economical role in structuring the availability of these resources. Fiji has a large mangrove patch located in the Votua area of the Ba province. Globally, mangrove population continues to decline with the changes in climatic conditions and anthropogenic activities. Baseline information through wetland maps and time series change are essential references for development of effective mangrove management plans. These maps reveal the status of the resource and the effects arising from anthropogenic activities and climate change. In this study, we used remote sensing and GIS tools for mapping and temporal change detection over a period of >20 years in Votua, Fiji using Landsat imagery. Landsat program started in 1972 initially as Earth Resources Technology Satellite. Since then it has acquired millions of images of Earth. This archive allows mapping of temporal changes in mangrove forests. Mangrove plants consisted of the species Rhizophora stylosa, Rhizophora samoensis, Bruguiera gymnorrhiza, Lumnitzera littorea, Heritiera littoralis, Excoecaria agallocha and Xylocarpus granatum. Change detection analysis revealed significant reduction in the mangrove patch over the years. This information serves as a baseline for the development and implementation of effective management plans for one of Fiji’s biggest mangrove patches.

Keywords: climate change, GIS, Landsat, mangrove, temporal change

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Authors: Guadalupe Pérez, Jorge Islas, Mirna Guevara, Raúl Suárez

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Jatropha curcas is a perennial oleaginous plant that is currently considered an energy crop with high potential as an environmentally sustainable biofuel. During the last decades, research in biofuels has grown in tropical and subtropical regions in Latin America. However, as far we know, there are no reports on the growth and yield patterns of Jatropha curcas under the specific agro climatic scenarios of the State of Morelos, Mexico. This study presents the results of 52 months monitoring of 10 toxic and non-toxic ecotypes of Jatropha curcas (E1M, E2M, E3M, E4M, E5M, E6O, E7O, E8O, E9C, E10C) in an experimental plantation with minimum watering and fertilization resources. The main objective is to identify the ecotypes with the highest potential as biodiesel raw material in the select region, by developing experimental information. Specifically, we monitored biophysical and growth parameters, including plant survival and seed production (at the end of month 52), to study the performance of each ecotype and to establish differences among the variables of morphological growth, net seed oil content, and toxicity. To analyze the morphological growth, a statistical approach to the biophysical parameters was used; the net seed oil content -80 to 192 kg/ha- was estimated with the first harvest; and the toxicity was evaluated by examining the phorbol ester concentration (µg/L) in the oil extracted from the seeds. The comparison and selection of ecotypes was performed through a methodology developed based on the normalization of results. We identified four outstanding ecotypes (E1M, E2M, E3M, and E4M) that can be used to establish Jatropha curcas as energy crops in the state of Morelos for feasible agro-industrial production of biodiesel and other products related to the use of biomass.

Keywords: biodiesel production, Jatropha curcas, seed oil content, toxic and non-toxic ecotypes

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Authors: Syed Hammad Ali, Rijan Bhakta Kayastha, Danial Hashmi, Richard Armstrong, Ahuti Shrestha, Iram Bano, Javed Hassan

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This paper presents the results of a semi-distributed modified positive degree-day model (MPDDM) for estimating snow and ice melt contributions to discharge from the glacierized Hunza River basin, Pakistan. The model uses daily temperature data, daily precipitation data, and positive degree day factors for snow and ice melt. The model is calibrated for the period 1995-2001 and validated for 2002-2013, and demonstrates close agreements between observed and simulated discharge with Nash–Sutcliffe Efficiencies of 0.90 and 0.88, respectively. Furthermore, the Weather Research and Forecasting model projected temperature, and precipitation data from 2016-2050 are used for representative concentration pathways RCP4.5 and RCP8.5, and bias correction was done using a statistical approach for future discharge estimation. No drastic changes in future discharge are predicted for the emissions scenarios. The aggregate snow-ice melt contribution is 39% of total discharge in the period 1993-2013. Snow-ice melt contribution ranges from 35% to 63% during the high flow period (May to October), which constitutes 89% of annual discharge; in the low flow period (November to April) it ranges from 0.02% to 17%, which constitutes 11 % of the annual discharge. The snow-ice melt contribution to total discharge will increase gradually in the future and reach up to 45% in 2041-2050. From a sensitivity analysis, it is found that the combination of a 2°C temperature rise and 20% increase in precipitation shows a 10% increase in discharge. The study allows us to evaluate the impact of climate change in such basins and is also useful for the future prediction of discharge to define hydropower potential, inform other water resource management in the area, to understand future changes in snow-ice melt contribution to discharge, and offer a possible evaluation of future water quantity and availability.

Keywords: climate variability, future discharge projection, positive degree day, regional climate model, water resource management

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Authors: Vered Yeflach Wishkerman

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This research follows the implementation of a virtual educational escape room (VEER) in Biomimicry for high school students (n=90) in order to expose them to the innovative field of biomimicry. The main idea behind biomimicry is that many of the wondrous solutions found in nature may be imitated by human technology and harnessed to different needs so that naturally occurring processes can become a source of knowledge for sustainable solutions. The escape room was developed by student trainers in order to teach Biomimicry through games. The room includes a variety of riddles, puzzles and movies in order to teach interdisciplinary subjects and different skills required in the 21st. The purpose of the study was to examine the impact of the gaming experience on students' attitudes toward the learning process and their attitudes toward nature as derived from a virtual escape room game centered on the theme of biomimicry. Three instruments were used: (1) a pre-test and a post-test to measure pupils’ increase in knowledge, (2) a survey to collect their opinions (3) an interview with the pupils. The learning experience within the game influenced the pupils in both emotional and cognitive dimensions, thereby enhancing their motivation and competence. From the results, we learned that the players had positive attitudes towards the game and a high sense of flow. We also found evidence that the escape room contributed to the internalization of new knowledge and values, such as respect for nature and the awareness of nature's importance. Furthermore, the players also reported that they developed learning skills. We conclude that virtual escape rooms are a new tool for assembling new knowledge for the players. The room increased curiosity and engagement to learn new content. However, in order to achieve maximum benefit, we need good infrastructure in addition to interesting and challenging tasks.

Keywords: biomimicry, virtual escape room, attitudes, learning

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Authors: Aya Gamal Khattab

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Chronic infection with the hepatitis C virus (HCV) is now the leading cause of liver-related morbidity and mortality; Currently, alanine aminotransferase ALT measurement is not only widely used in detecting the incidence, development, and prognosis of liver disease with obvious clinical symptoms, but also provides reference on screening the overall health status during health check-ups. Exercise is a low-cost, reliable and sustainable therapy for many chronic diseases. Low-volume high intensity interval training HIT is time efficient while also having wider application to different populations including people at risk for chronic inflammatory diseases. Purpose of this study was to investigate the effect of low volume high intensity interval training on ALT, AST in HCV patients. All practical work was done in outpatient physiotherapy clinic of Suez Canal Authority Hospitals. Forty patients both gender (27 male, 13 female), age ranged (40-60) years old submitted to low volume high intensity interval training on treadmill for two months three sessions per week. Each session consisting of five min warming up, two bouts for 10 min each bout consisting of 30 sec - 1 min of high intensity (75%-85%) HRmax then two to four min active recovery at intensity (40%-60%) HRmax, so the sum of high intensity intervals was one to two min for each session and four to eight min active recovery, and ends with five min cooling down. ALT and AST were measured before starting exercise session and 2 months later after finishing the total exercise sessions through blood samples. Results showed significant decrease in ALT, AST with improvement percentage (18.85%), (23.87%) in the study, so the study concluded that low volume high intensity interval training had a significant effect in lowering the level of circulating liver enzymes (ALT, AST) which means protection of hepatic cells and restoration of its function.

Keywords: alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatitis C (HCV), low volume high intensity interval training

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Authors: Mercy Chepkirui, Reuben Omondi, Paul Orina, Albert Getabu, Lewis Sitoki, Jonathan Munguti

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Globally, the decline in capture fisheries as a result of the growing population and increasing awareness of the nutritional benefits of white meat has led to the development of aquaculture. This is anticipated to meet the increasing call for more food for the human population, which is likely to increase further by 2050. Statistics showed that more than 50% of the global future fish diet will come from aquaculture. Aquaculture began commercializing some decades ago; this is accredited to technological advancement from traditional to modern cultural systems, including cage farming. Cage farming technology has been rapidly growing since its inception in Lake Victoria, Kenya. Currently, over 6,000 cages have been set up in Kenyan waters, and this offers an excellent opportunity for recognition of Kenya’s government tactic to eliminate food insecurity and malnutrition, create employment and promote a Blue Economy. However, being an open farming enterprise is likely to emit large bulk of waste hence altering the ecosystem integrity of the lake. This is through increased chlorophyll-a pigments, alteration of the plankton community, macroinvertebrates, fish genetic pollution, transmission of fish diseases and pathogens. Cage farming further increases the nutrient loads leading to the production of harmful algal blooms, thus negatively affecting aquatic and human life. Despite the ecological transformation, cage farming provides a platform for the achievement of the Sustainable Development Goals of 2030, especially the achievement of food security and nutrition. Therefore, there is a need for Integrated Multitrophic Aquaculture as part of Blue Transformation for ecosystem monitoring.

Keywords: aquaculture, ecosystem, blue economy, food security

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Authors: Matthew Korey, Jeffrey Youngblood, John Howarter

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Background and Significance: Tannic acid (TA) is a bio-based high molecular weight organic, aromatic molecule that has been found to increase thermal stability and flame retardancy of many polymer matrices when used as an additive. Although it is biologically sourced, TA is a pollutant in industrial wastewater streams, and there is a desire to find applications in which to downcycle this molecule after extraction from these streams. Additionally, epoxy thermosets have revolutionized many industries, but are too flammable to be used in many applications without additives which augment their flame retardancy (FR). Many flame retardants used in epoxy thermosets are synthesized from petroleum-based monomers leading to significant environmental impacts on the industrial scale. Many of these compounds also have significant impacts on human health. Various bio-based modifiers have been developed to improve the FR of the epoxy resin; however, increasing FR of the system without tradeoffs with other properties has proven challenging, especially for TA. Methodologies: In this work, TA was incorporated into the thermoset by use of solvent-exchange using methyl ethyl ketone, a co-solvent for TA, and epoxy resin. Samples were then characterized optically (UV-vis spectroscopy and optical microscopy), thermally (thermogravimetric analysis and differential scanning calorimetry), and for their flame retardancy (mass loss calorimetry). Major Findings: Compared to control samples, all samples were found to have increased thermal stability. Further, the addition of tannic acid to the polymer matrix by the use of solvent greatly increased the compatibility of the additive in epoxy thermosets. By using solvent-exchange, the highest loading level of TA found in literature was achieved in this work (40 wt%). Conclusions: The use of solvent-exchange shows promises for circumventing the limitations of TA in epoxy.

Keywords: sustainable, flame retardant, epoxy, tannic acid

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Authors: My Linh Hoang, Van Dung Hoang

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Environmental, Social, and Governance (ESG) factors have become a focus for companies globally, as businesses are now focusing on long-term sustainable goals rather than only operating for the goals of profit maximization. According to recent research, in several countries, companies have shown positive results in their financial performance by improving their ESG performance. The construction industry is one of the most crucial components of social and economic development; as a result, considerations for ESG factors are becoming more and more essential for companies in this sector. In Vietnam, the construction industry has been growing rapidly in recent years; however, it has yet to be discussed and studied extensively in Vietnam how ESG factors create impacts on corporate financial performance in general and construction corporations’ financial performance in particular. This research aims to examine the relationship between ESG factors and financial indicators in construction companies from 2011 to 2021 through panel data analysis of 75 listed construction companies in Vietnam and to provide insights into how these companies can better integrate ESG considerations into their operations to enhance their financial performance. The data was analyzed through 3 main methods: descriptive statistics, correlation coefficient analysis applied to all dependent, explanatory and control variables, and panel data analysis method. In panel data analysis, the study uses the fixed effects model (FEM) and random effects model (REM). The Hausman test will be used to select which model is suitable to be used. The findings indicate that maintaining a strong commitment to ESG principles can have a positive impact on financial performance. Finally, FGLS estimation will be performed when the problem of autocorrelation and variable variance appears in the model. This is significant for all parties involved, including investors, company managers, decision-makers, and industry regulators.

Keywords: ESG, financial performance, construction company, Vietnam

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Authors: Carole Salis, Marie F. Wilson, Fabrizio Murgia, Cristian Lai, Franco Atzori, Giulia M. Orrù

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ANDASA is a knowledge management platform for the capitalization of knowledge and cultural assets for the artistic and cultural sectors. It was built based on the priorities expressed by the participating artists. Through mapping artistic activities and specificities, it enables to highlight various aspects of the artistic research and production. Such instrument will contribute to create networks and partnerships, as it enables to evidentiate who does what, in what field, using which methodology. The platform is accessible to network participants and to the general public.

Keywords: cultural promotion, knowledge representation, cultural maping, ICT

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Authors: Alan Walsh, Peter Walker

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Differences in commercial, professional and personal cultural traditions between western consultants and project sponsors in the Gulf Cooperation Council (GCC) region are potentially significant in the workplace, and this can impact on project outcomes. These cultural differences can, for example, result in conflict amongst senior managers, which can negatively impact the megaproject. New entrants to the GCC often experience ‘culture shock’ as they attempt to integrate into their unfamiliar environments. Megaprojects are unique ventures with individual project characteristics, which need to be considered when managing their associated risks. Megaproject research to date has mostly ignored the significance of the absence of cultural congruence in the GCC, which is surprising considering that there are large volumes of megaprojects in various stages of construction in the GCC. An initial step to dealing with cultural issues is to acknowledge culture as a significant risk factor (SRF). This paper seeks to understand the criticality for western consultants to address these risks. It considers the cultural barriers that exist between GCC sponsors and western consultants and examines the cultural distance between the key actors. Initial findings suggest the presence to a certain extent of ethnocentricity. Other cultural clashes arise out of a lack of appreciation of the customs, practices and traditions of ‘the Other’, such as the need for avoiding public humiliation and the hierarchal significance rankings. The concept and significance of cultural shock as part of the integration process for new arrivals are considered. Culture shock describes the state of anxiety and frustration resulting from the immersion in a culture distinctly different from one's own. There are potentially substantial project risks associated with underestimating the process of cultural integration. This paper examines two distinct but intertwined issues: the societal and professional culture differences associated with expatriate assignments. A case study examines the cultural congruences between GCC sponsors and American, British and German consultants, over a ten-year cycle. This provides indicators as to which nationalities encountered the most profound cultural issues and the nature of these. GCC megaprojects are typically intensive fast track demanding ventures, where consultant turnover is high. The study finds that building trust-filled relationships is key to successful project team integration and therefore, to successful megaproject execution. Findings indicate that both professional and social inclusion processes have steep learning curves. Traditional risk management practice is to approach any uncertainty in a structured way to mitigate the potential impact on project outcomes. This research highlights cultural risk as a significant factor in the management of GCC megaprojects. These risks arising from high staff turnover typically include loss of project knowledge, delays to the project, cost and disruption in replacing staff. This paper calls for cultural risk to be recognised as an SRF, as the first step to developing risk management strategies, and to reduce staff turnover for western consultants in GCC megaprojects.

Keywords: western consultants in megaprojects, national culture impacts on GCC megaprojects, significant risk factors in megaprojects, professional culture in megaprojects

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Authors: Abdullah Ay, Şehnaz Şener

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It is of great importance to reveal their current status and conduct research in this direction for the sustainable use and protection of lakes, which are among the most important water resources for meeting water needs and ensuring ecological balance. In this context, the purpose of this study is to determine the hydrogeochemical properties, as well as water quality and usability characteristics of Işıklı Lake within the Lakes Region of Turkey. Işıklı Lake is a tectonic lake located in the Aegean Region of Turkey. The lake has a surface area of approximately 36 km². Temperature (T), electrical conductivity (EC) and hydrogen ion concentration (pH), dissolved oxygen (%, mg/l), Oxidation Reduction Potential (ORP; mV), and amount of dissolved solids in water (TDS; mg/l) of water samples taken from the lake values were determined by in situ analysis. Major ion and heavy metal analyses were carried out under laboratory conditions. Additionally, the relationship between major ion concentrations and TDS values of Işıklı Lake water samples was determined by correlation analysis. According to the results obtained, it is seen that especially Mg, Ca and HCO₃ ions are dominant in the lake water, and it has been determined that the lake water is in the Ca-Mg-HCO₃ water facies. According to statistical analysis, a strong and positive relationship was found between the TDS value and bicarbonate and calcium (R² = 0.61 and 0.7, respectively). However, no significant relationship was detected between the TDS value and other chemical elements. Although the waters are generally in water quality class I, they are in class IV in terms of sulfur and aluminum. It is included in the water quality class. This situation is due to the rock-water interaction in the region. When the analysis results of the lake water were compared with the drinking water limit values specified by TSE-266 (2005) and WHO (2017), it was determined that it was not suitable for drinking water use in terms of Pb, Se, As, and Cr. When the waters were evaluated in terms of pollution, it was determined that 50% of the samples carried pollution loads in terms of Al, As, Fe, NO3, and Cu.

Keywords: Işıklı Lake, water chemistry, water quality, pollution, arsenic, Denizli

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Authors: M. Abu Hanif, Anika Tabassum, Fuad Hasan Ovi, Ishrat Islam

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Water is essential for life. Enormous quantities of water are cycled each year through hydrologic cycle but only a fraction of circulated water is available each year for human use. Dhaka, the capital of Bangladesh is the 19th mega city in the world with a population of over 14 million (World City Information, 2011). As a result the growth of urban population is increasing rapidly; the city is not able to manage with altering situations due to resource limitations and management capacity. Water crisis has become an acute problem faced by the inhabitants of Dhaka city. It is found that total water demand in Dhaka city is 2,240 million liter per day (MLD) whereas supply is 2,150 (MLD). According to Dhaka Water Supply and Sewerage Authority about 87 percent of this supply comes from groundwater resources and rest 13 percent from surface water. According to Dhaka Water Supply and Sewerage Authority it has been found that the current groundwater depletion rate is 3.52 meter per year. Such a fast depletion of the water table will result in intrusion of southern saline water into the groundwater reservoir, depriving this mega city of pure drinking water. This study mainly focus on the potential of Rainwater Harvesting System(RWHS) in Kazipara area of Dhaka city, determine the perception level of local people in installation of rainwater harvesting system in their building and identify the factors regarding willingness of owner in installing rainwater harvesting system. As most of the residential area of Dhaka city is unplanned with small plots, Kazipara area has been chosen as study area which depicts similar characteristics. In this study only roof top area is considered as catchment area and potential of rainwater harvesting has been calculated. From the calculation it is found that harvested rainwater can serve the 66% of demand of water for toilet flushing and cleaning purposes for the people of Kazipara. It is also observed that if only rooftop rainwater harvesting applied to all the structures of the study area then two third of surface runoff would be reduced than present surface runoff. In determining the perception of local people only owners of the buildings were. surveyed. From the questionnaire survey it is found that around 75% people have no idea about the rainwater harvesting system. About 83% people are not willing to install rainwater harvesting system in their dwelling. The reasons behind the unwillingness are high cost of installation, inadequate space, ignorance about the system, etc. Among 16% of the willing respondents who are interested in installing RWHS system, it was found that higher income, bigger size of buildings are important factors in willingness of installing rainwater harvesting system. Majority of the respondents demanded for both technical and economical support to install the system in their buildings. Government of Bangladesh has taken some initiatives to promote rainwater harvesting in urban areas. It is very much necessary to incorporate rainwater harvesting device and artificial recharge system in every building of Dhaka city to make Dhaka city self sufficient in water supply management and to solve water crisis problem of megacity like as Dhaka city.

Keywords: rainwater harvesting, water table, willingness, storm water

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Authors: Shanorfizah Mohd Safar, Shaizatulaqma Kamalul Ariffin

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Internationalization of halal small and medium-sized enterprises (SMEs) is necessary for SMEs to become more involved in regional trade and business cooperation. By internationalization, SMEs' profit can increase, and market expansion of SMEs is basic for rising economies of countries to contend all around in the halal industry globally. There are several modes of internationalization; exporting is one of the first steps for internationalization with less capital needed. The study examines the influential factors of export performance amongst halal SMEs in Malaysia. Specifically, this study examines the positive and significant relationships amongst human capital, managerial capability, Halal Assurance Management System (HAMS), digital transformation, government support, and networking capability on halal SMEs' export performance toward SMEs' competitive advantage. In addition, this study will examine innovation capabilities as a moderator in the relationship between independence variables and competitive advantage. Competitive advantage is the most compelling perspective that drives the export performance of halal SMEs in Malaysia. A quantitative method will be used: an online questionnaire survey distributed through emails and face-to-face toward selected halal-certificated SMEs registered in JAKIM, MATRADE website and SME Corp Malaysia website. Nevertheless, whether the halal SMEs practice global business, they will still be the potential respondents. The data were examined and obtained using the statistical software Smart PLS. The analysis used is reliability, correlation, and regression analysis to meet the research objectives. This study contributes significantly to the theory by integrating Resource Based View (RBV) theory, Technology–Organization–Environment (TOE) framework and Networking theory. In addition, this research extends the RBV by extending a variable, the Halal Assurance Management System. This study also examines a moderating role of innovation capabilities in the framework and competitive advantage as a mediator. This research aims to analyze the factors that will impact the internationalization of halal SMEs.

Keywords: internationalization, halal SMEs, competitive advantage, export performance

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Authors: Marta Polec

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The paper outlines the problem of street performances in Poland in context of humanistic management studies. The Author perceives activity of street performers of various art and entertainment actions as a phenomenon of informal organizing, self-management and cultural entrepreneurship in urban sphere. What has to be highlighted, performative street art is not currently being an interest of scientific research as often as visual street art. That is why the Author indicates the need of including new approaches of humanistic and social disciplines, especially different management paradigms, in examining various aspects of the activity of street performers. The paper shows the results of ethnographic study based on anthropological interviews, participant observation non-participant observation, shadowing, field notes, audiovisual documentation and text analysis. The fieldwork was performed since 2014 in the old towns and major areas of several the most popular touristic Polish cities, mainly in Gdansk, Cracow, Lublin, Warsaw, and Wroclaw. The research group included street artists of various kinds of performative arts. The investigation was prepared within the ‘Ethnography of the informal organization of street artists in Poland’ project, as a part of Diamond Grant programme (the Ministry of Science and Higher Education in Poland). The first conclusion of the study is that street shows form a way of artistic self-realization and unusual promotion of creative activity in public space. As street performance helps to make some extra money and even earning a living in general, it seems to constitute a new profession. Street performers as a specific environment usually know each other and in many ways cooperate informally to carry on their shows successfully. Secondly, this activity brings plenty benefits for the local communities. Street shows attract inhabitants and tourists quite often by appealing to intangible cultural heritage and memorializing it. They also pose a space for discussing current social issues. Moreover, they disseminate relatively inexpensive public access to culture, but also state an example of social courage of choosing unconventional occupation. Finally, currently being used terms of street performers/street artists/buskers in different languages, as instance as in Polish, are still fluent and undefined. As a consequence, it brings implications for existing common knowledge about street performers, for example in establishing and implementing public policies. It impedes solving many ethical and social dilemmas concerning the question of performances in public sphere, which in some cases seem to be related to, as: children’s work, beggars’ practices or question of harmony of public space. The main aim of this study was to expose street performances as yet undefined profession, including different possibilities of interacting with the audience, based on providing impressions, experiences and memories. Although the issue seems to be current and common, in indicated context there is a lack of equal and unified approach of managing urban sphere, which in practice differs both in informal rules and official policies concerning street performances not only in cities in Poland, but also generally in Europe.

Keywords: informal, organizing, street performance, urban sphere

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Authors: Tomasz Smolinski, Irena Herdzik-Koniecko, Marta Pyszynska, M. Rogowski

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Old electronic components can be easily found nowadays. Significant quantities of valuable metals such as gold, silver or copper are used for the production of advanced electronic devices. Old useless electronic device slowly became a new source of precious metals, very often more efficient than natural. For example, it is possible to recover more gold from 1-ton personal computers than seventeen tons of gold ore. It makes urban mining industry very profitable and necessary for sustainable development. For the recovery of metals from waste of electronic equipment, various treatment options based on conventional physical, hydrometallurgical and pyrometallurgical processes are available. In this group hydrometallurgy processes with their relatively low capital cost, low environmental impact, potential for high metal recoveries and suitability for small scale applications, are very promising options. Institute of Nuclear Chemistry and Technology has great experience in hydrometallurgy processes especially focused on recovery metals from industrial and agricultural wastes. At the moment, urban mining project is carried out. The method of effective recovery of valuable metals from central processing units (CPU) components has been developed. The principal processes such as acidic leaching and solvent extraction were used for precious metals recovery from old processors and graphic cards. Electronic components were treated by acidic solution at various conditions. Optimal acid concentration, time of the process and temperature were selected. Precious metals have been extracted to the aqueous phase. At the next step, metals were selectively extracted by organic solvents such as oximes or tributyl phosphate (TBP) etc. Multistage mixer-settler equipment was used. The process was optimized.

Keywords: electronic waste, leaching, hydrometallurgy, metal recovery, solvent extraction

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Authors: Samira Rostom, Robert Symonds, Robin W. Hughes

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Hydrogen is considered as one of the most important clean and renewable energy carriers for a sustainable energy future. However, its efficient and cost-effective purification remains challenging. This paper presents the potential of using metal–organic frameworks (MOFs) in combination with pressure swing adsorption (PSA) technology for syngas based H2 purification. PSA process analysis is done considering high pressure and elevated temperature process conditions, it reduces the demand for off-gas recycle to the fuel reactor and simultaneously permits higher desorption pressure, thereby reducing the parasitic load on the hydrogen compressor. The elevated pressure and temperature adsorption we present here is beneficial to minimizing overall process heating and cooling demand compared to existing processes. Here, we report the comparative performance of zeolite-5A, Cu-BTC, and the mix of zeolite-5A/Cu-BTC for H2 purification from syngas typical of those exiting water-gas-shift reactors. The MOFs were synthesized hydrothermally and then mixed systematically at different weight ratios to find the optimum composition based on the adsorption performance. The formation of different compounds were characterized by XRD, N2 adsorption and desorption, SEM, FT-IR, TG, and water vapor adsorption technologies. Single-component adsorption isotherms of CO2, CO, CH4, N2, and H2 over single materials and composites were measured at elevated pressures and different temperatures to determine their equilibrium adsorption capacity. The examination of the stability and regeneration performance of metal–organic frameworks was carried out using a gravimetric system at temperature ranges of 25-150℃ for a pressure range of 0-30 bar. The studies of adsorption/desorption on the MOFs showed selective adsorption of CO2, CH4, CO, and N2 over H2. Overall, the findings of this study suggest that the Ni-MOF-74/Cu-BTC composites are promising candidates for industrial H2 purification processes.

Keywords: MOF, H2 purification, high T, PSA

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Authors: Muhammad Shahid, Kafait Ullah, Kashif Imran, Arshad Mahmood, Maarten Arentsen

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Poor planning and governance in the power sector of Pakistan have generated several issues ranging from gradual reliance on thermal-based expensive energy mix, supply shortages, unrestricted demand, subsidization, inefficiencies at different levels of the value chain and resultantly, the circular debt. This situation in the power sector has also hampered the growth of allied economic sectors. This study uses the Long-range Energy Alternative Planning (LEAP) system for electricity modelling of Pakistan from the period of 2016 to 2040. The study has first time in Pakistan forecasted the electricity demand at the provincial level. At the supply side, five scenarios Business as Usual Scenario (BAUS), Coal Scenario (CS), Gas Scenario (GS), Nuclear Scenario (NS) and Renewable Scenario (RS) have been analyzed based on the techno-economic and environmental parameters. The study has also included environmental externality costs for evaluating the actual costs and benefits of different scenarios. Contrary to the expectations, RS has a lower output than even BAUS. The study has concluded that the generation from RS has five times lesser costs than BAUS, CS, and GS. NS can also be an alternative for the sustainable future of Pakistan. Generation from imported coal is not a good option, however, indigenous coal with clean coal technologies should be promoted. This paper proposes energy planners of the country to devise incentives for the utilization of indigenous energy resources including renewables on priority and then clean coal to reduce the energy crises of Pakistan.

Keywords: economic evaluation, externality cost, penetration of renewable energy, regional electricity supply-demand planning

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Authors: Muhammad Dildar Gogi, Muhammad Jalal Arif, Muhammad Junaid Nisar, Mubashir Iqbal, Waleed Afzal Naveed, Muhammad Ahsan Khan, Ahmad Nawaz, Muhammad Sufian, Muhammad Arshad, Amna Jalal

Abstract:

Fruit flies of Bactrocera genus cause heavy losses in fruits and vegetables globally and insecticide-application for their control creates issues of ecological backlash, environmental pollution, and food safety. There is need to explore alternatives and food-baits application is considered safe for the environment and effective for fruit fly management. Present experiment was carried out to assess the attractancy of five phagostimulant-Mixtures (PHS-Mix) prepared by mixing banana-squash, mulberry, protein-hydrolysate and molasses with some phagostimulant-lure sources including beef extract, fish extract, yeast, starch, rose oil, casein and cedar oil in five different ratios i.e., PHS-Mix-1 (1 part of all ingredients), PHS-Mix-2 (1 part of banana with 0.75 parts of all other ingredients), PHS-Mix-3 (1 part of banana with 0.5 parts of all other ingredients), PHS-Mix-4 (1 part of banana with 0.25 parts of all other ingredients) and PHS-Mix-5 (1 part of banana with 0.125 parts of all other ingredients). These were evaluated in comparison with a standard (GF-120). PHS-Mix-4 demonstrated 40.5±1.3-46.2±1.6% AI for satiated flies (class-II i.e., moderately attractive) and 59.5±2.0-68.6±3.0% AI for starved flies (class-III i.e., highly attractive) for both B. dorsalis and B. zonata in olfactometric study while the same exhibited 51.2±0.53% AI (class-III i.e., highly attractive) for B. zonata and 45.4±0.89% AI (class-II i.e., moderately attractive) for B. dorsalis in field study. PHS-Mix-1 proved non-attractive (class-I) and moderately attractive (class-II) phagostimulant in olfactometer and field studies, respectively. PHS-Mix-2 exhibited moderate attractiveness for starved lots in olfactometer and field-lot in field studies. PHS-Mix-5 proved non-attractive to starved and satiated lots of B. zonata and B. dorsalis females in olfactometer and field studies. Overall PHS-Mix-4 proved better phagostimulant-mixture followed by PHS-Mix-3 which was categorized as class-II (moderately attractive) phagostimulant for starved and satiated lots of female flies of both species in olfactometer and field studies; hence these can be exploited for fruit fly management.

Keywords: attractive index, field conditions, olfactometer, Tephritid flies

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Authors: Beyene Daniel, Herbert Ntuli

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Agritourism in Eritrea is increasingly threatened by climate change, manifesting through rising temperatures, shifting rainfall patterns, and resource scarcity. This study employs quantitative methods to assess the economic and environmental impacts of climate change on agritourism, utilizing metrics such as annual income fluctuations, changes in visitor numbers, and energy consumption patterns. The methodology relies on secondary data sourced from the World Bank, government reports, and academic publications to analyze the economic viability of integrating solar energy into agritourism operations. Key variables include the Benefits from Renewable Energy (BRE), encompassing cost savings from reduced energy expenses and the monetized value of avoided greenhouse gas emissions. Using a net present value (NPV) framework, the research compares the impact of solar energy against traditional fossil fuel sources by evaluating the Value of Reduced Greenhouse Gas Emissions (CO2) and the Value of Health-Related Costs (VHRC) due to air pollution. The preliminary findings of this research are of utmost importance. They indicate that the adoption of solar energy can enhance energy independence by up to 40%, reduce operational costs by 25%, and stabilize agritourism activities in climate-sensitive regions. This research aims to provide actionable insights for policymakers and stakeholders, supporting the sustainable development of agritourism in Eritrea and contributing to broader climate adaptation strategies. By employing a comprehensive cost-benefit analysis, the study highlights the economic advantages and environmental benefits of transitioning to renewable energy in the face of climate change.

Keywords: climate change, renewable energy, resilience, cost-benefit analysis

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Authors: Valentine Ndi

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This multi-sited research will make use of primary and secondary data to understand the multiple implications of land grabbing for local food production and rural livelihoods in Cameroon. Amidst restricted access to land and forest resources, this study will demonstrate how land previously accessed by communities to grow crops and to harvest forest resources is being acquired and transformed into commercial oil palm plantations by Herakles Farms, a US-based company, with Sithe Global Sustainable Oils Cameroon as its local subsidiary. Focusing on selected land grabbing communities in Cameroon, the study uses a feminist political ecology lens to examine the gendered nature in resources access and its impacts for women’s food production in particular, and rural livelihoods in general. The paper will argue that the change in land use particularly erodes women’s rights to access land and forest resources, and in turn negatively affects local food production and rural livelihood in the region. It will show how women in the region play instrumental and dominant roles in ensuring local food production through subsistence and semi-subsistence agriculture but are unfortunately the main losers of territory that the state considers as ‘empty’ or underutilized - and is subjected to appropriation. The paper will conclude that, rural women’s active participation in the decision-making processes concerning the use of and/or allotment of land to foreign investors is indispensable to guarantee local, national and global food security, but also to ensure that alternative livelihood options are provided, particularly to those rural women facing dispossession or at risk of being dispossessed.

Keywords: land grabbing, feminst political ecology, gender, access to resources, rural livelihoods, Cameroon

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Authors: Malgorzata Sekulowicz, Krystyna Boron-Krupinska, Paulina Morga, Blazej Cieslik

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Burnout is highly prevalent in health care employees, especially in physicians. It significantly reduces the efficiency of these employees, which can have negative consequences for both physicians and patients. Resilience and mindfulness enhancing positive emotions, leading to sustainable development and personal commitment, can have a significant impact on burnout. Therefore, the aim of this study was to determine the relationship between burnout symptoms and mindfulness and resilience among physicians. The authors conducted a cross-sectional survey study among seventy-four polish physicians. Participants filled out the following psychometric tools: the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), Five Facet Mindfulness Questionnaire (FFMQ), Areas of Work-Life Survey (AWS), International Personality Item Pool (IPIP), the Resilience Assessment Scale (SPP-25) and the Mini-COPE Inventory. The relationship between burnout and resilience and mindfulness was assessed with path analysis. Analyzing the relationship between MBI-HSS components and mindfulness, a significant negative correlation of the FFMQ score with emotional exhaustion (-0.50, p < 0.05) and depersonalization (-0.43, p < 0.05) and a positive correlation with personal accomplishment (0.50, p < 0.05) was demonstrated. Analyzing resilience, a statistically significant relationship of SPP-25 with all tested components of MBI-HSS was demonstrated: emotional exhaustion (-0.54, p < 0.05), depersonalization (-0.31, p < 0.05) and personal accomplishment (0.35, p < 0.05). In the group of medical doctors, the higher the level of mindfulness and resilience, the lower the risk of burnout. Furthermore, the more frequently used active coping strategies (planning, acceptance), the lower the risk of burnout, while the use of passive, evasive strategies increases the risk of burnout. It may be worth considering implementing mindfulness intervention to effectively manage burnout symptoms in this group.

Keywords: burnout, medical doctors, mindfulness, physicians, resilience

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Authors: Ilaha Rzayeva, Emin Alasgarov, Orkhan Karim-Zada

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This study attempts to consider the linkage between management and computer sciences in order to develop the software named “IntelSymb” as a demo application to prove data analysis of non-energy* fields’ diversification, which will positively influence on energy dependency mitigation of countries. Afterward, we analyzed 18 years of economic fields of development (5 sectors) of 13 countries by identifying which patterns mostly prevailed and which can be dominant in the near future. To make our analysis solid and plausible, as a future work, we suggest developing a gateway or interface, which will be connected to all available on-line data bases (WB, UN, OECD, U.S. EIA) for countries’ analysis by fields. Sample data consists of energy (TPES and energy import indicators) and non-energy industries’ (Main Science and Technology Indicator, Internet user index, and Sales and Production indicators) statistics from 13 OECD countries over 18 years (1995-2012). Our results show that the diversification of non-energy industries can have a positive effect on energy sector dependency (energy consumption and import dependence on crude oil) deceleration. These results can provide empirical and practical support for energy and non-energy industries diversification’ policies, such as the promoting of Information and Communication Technologies (ICTs), services and innovative technologies efficiency and management, in other OECD and non-OECD member states with similar energy utilization patterns and policies. Industries, including the ICT sector, generate around 4 percent of total GHG, but this is much higher — around 14 percent — if indirect energy use is included. The ICT sector itself (excluding the broadcasting sector) contributes approximately 2 percent of global GHG emissions, at just under 1 gigatonne of carbon dioxide equivalent (GtCO2eq). Ergo, this can be a good example and lesson for countries which are dependent and independent on energy, and mainly emerging oil-based economies, as well as to motivate non-energy industries diversification in order to be ready to energy crisis and to be able to face any economic crisis as well.

Keywords: energy policy, energy diversification, “IntelSymb” software, renewable energy

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Authors: Deria Adi Wijaya, Amad Saeroji, Jimmi Sandi P., Nanang Wijayanto

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Tourism and the creative economy are combinations that can become a sustainable source of welfare that can boost the economy so as to increase the country's foreign exchange. Therefore the development of the tourism sector is one of the priorities in President Joko Widodo's leadership framework for the 2019-2024 period. Entering the current pandemic, each party is required to be able to implement strict health protocols to slow the rate of SARS-Cov2 infection, or what is known as the coronavirus, but on the other hand, the need to turn the wheels of the economy must continue. Therefore, an effort is needed to develop tourism activities that are full of experiences that add health benefits. Anticipating this, the Ministry of Tourism and Creative Economy collaborated with the Ministry of Health to offer an innovative development model, namely wellness tourism. The development of wellness tourism is an alternative that can make a positive contribution to the development of Indonesian tourism during the pandemic. This research seeks to synergize efforts to develop national tourism into the regional sphere; in this case, Baluwarti Tourism Village, which is located within the walls of the Surakarta Sunanate Palace, has the potential to be developed into a wellness tourism destination in Surakarta City. Considering that a village that is in the immediate vicinity of a palace certainly has a variety of potential attractions for royal wellness tourism. The main objectives of this study are 1) to identify the potential for palace-style wellness tourism in Baluwarti Tourism Village; 2) to formulate development in the form of tour packages in Baluwarti Tourism Village. Of course, the development of the wellness tour package is still based on local wisdom, namely a tour package that raises local potential as a palace-style wellness tourism attraction that can improve the economy of the local people through the tourism sector in the post-pandemic era.

Keywords: potential, wellness tourism, Baluwarti Tourism Village, Surakarta Sunanate Palace, Surakarta City

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Authors: Fouzia Ajmal

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Global Citizenship Education (GCED) could prove to be the best solution to prevent violent extremism as it will sustain a respect for all and build up a feeling of having a place with humankind. To meet the target 4.7 of sustainable development goals, it is important to focus on global citizenship education at all levels of education in general and in pre-service teacher education in particular so that the message and practices reach the young masses. The pre-service education is imperative to develop knowledge, skills and disposition of prospective teachers. The current study was conducted to investigate the integration of GCED in pre-service teacher education curriculum of Pakistan. The study was delimited to B.Ed (hons) Elementary Education programme. The curriculum of B.Ed Elementary developed by Higher Education Commission was analyzed through Curriculum Alignment Matrix. 31 course outlines were analyzed, and percentage was used to analyze the level of integration of GCED in courses. The analyses depicted that the concepts of civic sense, tolerance, duties and rights of citizens and fundamental rights of humans are partially aligned in a few of the courses. The tolerance, active citizenship, and respect for cultural diversity and religious harmony are evident in Pakistan Studies and teaching of social studies courses. The relevant books are also mentioned as resources in these courses. The intercultural understanding is not very evident while globalization is mentioned in a few courses. It is recommended that a deliberate effort may be made to integrate concepts of Global Citizenship Education so as to enable the prospective teachers in developing necessary skills to play their active role in promoting peace and building resilience to extremism in elementary school students.

Keywords: curriculum analysis, global citizenship education, preservice teacher education, resilience building

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Authors: Hilal Al Shamsi, Abdullah Almutairi

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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

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Authors: Chukwudi S. Osondu

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Currently, the two most economically viable states in Nigeria, Lagos State and Rivers, are challenging the National Government over the legality of the latter’s continued collection and disbursement of the Value Added Tax (VAT) in their respective states. These states recently enacted laws empowering their respective states agencies to collect and administer the Value Added Tax (VAT) in their states. Before now, it was the Federal Inland Revenue Service (FIRS) that is mandated by the National Government to collect VAT throughout the Federation, and have same administered by the Federal Revenue Mobilization Allocation and Fiscal Commission, another Federal agency. Most states in the South-South and South-West geopolitical zones and a handful of states in the South-East are supportive of the actions taken by Lagos and Rivers states and are ready to follow suit. This action is seen as the beginning of resistance by the states over the continued strangulating over-centralized systems operating in the country. The Nigeria Federation has over the years operated a unitary system with grave consequences for development and possible implosion of the polity. The Quota System, the Federal Character policy, the control of the natural resources, and the security infrastructure by the National Government have been in place for decades with the attendant misgivings by some sections in the Nigeria Project. This paper evaluates the impact of the over-centralization power on the National Government with reference to fiscal policies, security, resource exploitation, infrastructural development, and national cohesion. It concludes that “unitary federalism” scuttles national development, inflames disunity, and stokes dissatisfaction among states in the federation. The paper concludes by suggesting a federation where power is devolved to the states, with the states as the federating units allowed to, each develop at its own pace.

Keywords: peace, conflict, insecurity, corporate existence, sustainable development, peaceful coexistence

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Authors: Jackson Niyongabo

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This study addresses a notable gap in the existing literature on the relationship between energy consumption, economic growth, and CO₂ emissions, particularly within the African context. While numerous studies have explored these dynamics globally and regionally across various development levels, few have delved into the nuances of regions and income levels specific to African countries. Furthermore, the evaluation of the interplay between green growth policies, green energy technologies, and their impact on environmental quality has been underexplored. This research aims to fill these gaps by conducting a comprehensive analysis of the transition from conventional economic growth and energy consumption to a paradigm of green growth coupled with green energy utilization across the African continent from 1980 to 2018. The study is structured into three main parts: an empirical examination of the long-term effects of energy intensity, renewable energy consumption, and economic growth on CO₂ emissions across diverse African regions and income levels; an estimation of the long-term impact of green growth and green energy use on CO₂ emissions for countries implementing green policies within Africa, as well as at regional and global levels; and a comparative analysis of the impact of green growth policies on environmental degradation before and after implementation. Employing advanced econometric methods and panel estimators, the study utilizes a testing framework, panel unit tests, and various estimators to derive meaningful insights. The anticipated results and conclusions will be elucidated through causality tests, impulse response, and variance decomposition analyses, contributing valuable knowledge to the discourse on sustainable development in the African context.

Keywords: economic growth, green growth, energy consumption, CO₂ emissions, econometric models, green energy

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Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

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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

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

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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 146