Search results for: halal compliance rating
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1358

Search results for: halal compliance rating

458 A Corporate Social Responsibility Project to Improve the Democratization of Scientific Education in Brazil

Authors: Denise Levy

Abstract:

Nuclear technology is part of our everyday life and its beneficial applications help to improve the quality of our lives. Nevertheless, in Brazil, most often the media and social networks tend to associate radiation to nuclear weapons and major accidents, and there is still great misunderstanding about the peaceful applications of nuclear science. The Educational Portal Radioatividades (Radioactivities) is a corporate social responsibility initiative that takes advantage of the growing impact of Internet to offer high quality scientific information for teachers and students throughout Brazil. This web-based initiative focusses on the positive applications of nuclear technology, presenting the several contributions of ionizing radiation in different contexts, such as nuclear medicine, agriculture techniques, food safety and electric power generation, proving nuclear technology as part of modern life and a must to improve the quality of our lifestyle. This educational project aims to contribute for democratization of scientific education and social inclusion, approaching society to scientific knowledge, promoting critical thinking and inspiring further reflections. The website offers a wide variety of ludic activities such as curiosities, interactive exercises and short courses. Moreover, teachers are offered free web-based material with full instructions to be developed in class. Since year 2013, the project has been developed and improved according to a comprehensive study about the realistic scenario of ICTs infrastructure in Brazilian schools and in full compliance with the best e-learning national and international recommendations.

Keywords: information and communication technologies, nuclear technology, science communication, society and education

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457 Improving Efficiency and Effectiveness of FMEA Studies

Authors: Joshua Loiselle

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This paper discusses the challenges engineering teams face in conducting Failure Modes and Effects Analysis (FMEA) studies. This paper focuses on the specific topic of improving the efficiency and effectiveness of FMEA studies. Modern economic needs and increased business competition require engineers to constantly develop newer and better solutions within shorter timeframes and tighter margins. In addition, documentation requirements for meeting standards/regulatory compliance and customer needs are becoming increasingly complex and verbose. Managing open actions and continuous improvement activities across all projects, product variations, and processes in addition to daily engineering tasks is cumbersome, time consuming, and is susceptible to errors, omissions, and non-conformances. FMEA studies are proven methods for improving products and processes while subsequently reducing engineering workload and improving machine and resource availability through a pre-emptive, systematic approach of identifying, analyzing, and improving high-risk components. If implemented correctly, FMEA studies significantly reduce costs and improve productivity. However, the value of an effective FMEA is often shrouded by a lack of clarity and structure, misconceptions, and previous experiences and, as such, FMEA studies are frequently grouped with the other required information and documented retrospectively in preparation of customer requirements or audits. Performing studies in this way only adds cost to a project and perpetuates the misnomer that FMEA studies are not value-added activities. This paper discusses the benefits of effective FMEA studies, the challenges related to conducting FMEA studies, best practices for efficiently overcoming challenges via structure and automation, and the benefits of implementing those practices.

Keywords: FMEA, quality, APQP, PPAP

Procedia PDF Downloads 287
456 Pattern the Location and Area of Earth-Dumping Stations from Vehicle GPS Data in Taiwan

Authors: Chun-Yuan Chen, Ming-Chang Li, Xiu-Hui Wen, Yi-Ching Tu

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The objective of this study explores GPS (Global Positioning System) applied to trace construction vehicles such as trucks or cranes, help to pattern the earth-dumping stations of traffic construction in Taiwan. Traffic construction in this research is defined as the engineering of high-speed railways, expressways, and which that distance more than kilometers. Audit the location and check the compliance with regulations of earth-dumping stations is one of important tasks in Taiwan EPA. Basically, the earth-dumping station was known as one source of particulate matter from air pollution during construction process. Due to GPS data can be analyzed quickly and be used conveniently, this study tried to find out dumping stations by modeling vehicles tracks from GPS data during work cycle of construction. The GPS data updated from 13 vehicles related to an expressway construction in central Taiwan. The GPS footprints were retrieved to Keyhole Markup Language (KML) files so that can pattern the tracks of trucks by computer applications, the data was collected about eight months- from Feb. to Oct. in 2017. The results of GPS footprints identified dumping station and outlined the areas of earthwork had been passed to the Taiwan EPA for on-site inspection. Taiwan EPA had issued advice comments to the agency which was in charge of the construction to prevent the air pollution. According to the result of this study compared to the commonly methods in inspecting environment by manual collection, the GPS with KML patterning and modeling method can consumes less time. On the other hand, through monitoring the GPS data from construction vehicles could be useful for administration to development and implementation of strategies in environmental management.

Keywords: automatic management, earth-dumping station, environmental management, Global Positioning System (GPS), particulate matter, traffic construction

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455 Factors Associated with Non-Adherence to Antiretroviral Treatment among HIV Infected Patients in Ukraine

Authors: Larissa Burruano, Sergey Grabovyj, Irina Nguen

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The study aimed to assess the level of adherence to anti retroviral therapy (ART) and to examine the relationship between adherence and risk behavior factor (drug use) among patients infected with HIV. The patients with newly diagnosed or established HIV infection under follow-up at the Sumskij Regional Centre for AIDS Prevention in Ukraine were eligible for this study. Medical records were used to measure the patient’s adherence to medication. Measurements were obtained at month 6 and at month 12 to calculate the number of medication omission during the past 30 days: (on a 2-point scale – once until three in a month – were considered adherent, three and more in a month – were considered non-adherent). Of the 50 study participants, 27 (54.0%) were men and 23 (46.0%) women. The mean age is 35.2 years (SD= 5.1). A majority of the patients (82.0%) is in the age group of 25-30 years. The main level of adherence was 74.0% and 66.0% at 6 and 12 months, respectively. The main routes of HIV transmission were drug injection among men 12 (44.4%) and sexual contact among women 11 (47.8%). Univariate analyses indicated that patients who had lower level of education were more likely to have been non-adherent at month 6- (X2 =5.1, n=50, p < .05) and at month 12 (X2 = 4.34, n=50, p < .05). Multivariate tests showed that only age (OR= 1.163 [95% CI 0.98–1.370]) was significant independent predictor of treatment adherence, while gender, education, employment status were not predictive for the risk of developing non-compliance. There was not a significant interaction between non-adherence and intravenous drug use. Consistent with these findings, younger people were more likely to have missed a dose of their medication because they had a greater sense of invulnerability than older patients. The study indicates that the socio demographic characteristic should be taken into an account in the future research regarding adherence in the case of HIV infection. If the patient anti retroviral adherence can be improved by qualitatively better medical care in all regions of the Ukraine, behavioral changes in the population can to be expected in the long term.

Keywords: HIV, antiretroviral therapy, adherence, Ukraine, Eastern Europe

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454 Improving English by Reading Local Literature: The Case for Thai Primary Children

Authors: Wipada Prasansaph

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The aim of this research is twofold: to develop a local literature (simplified English translation version) reading booklet for Thai primary school children (the fourth graders) and to encourage the love of reading in English by reading local literature. An excerpt from Thai literature namely Phra-apaimani, the reading requirement for Primary 4 was selected to be translated into English in simplified language with cartoon pictures to illustrate the key happenings of the story. After the first draft of the booklet development, the samples of the booklets were distributed to 3 educator experts to call for validity and comments on 1) the appropriateness of the English language, 2) the organization of the booklet, 3) the comprehension of the story, and 4) the relevance to the core curriculum of Basic Education of Thailand (B.E.2551). The IOC (Index of Item – Objective Congruence) was 0.9 indicated that the material is applicable (with some comments and suggestions). After the first amendment, the booklets were distributed to 30 fourth graders (in 3 schools – 10 in each school), 10 English teachers of Primary 4, and 10 educational supervisors for English subjects (in primary level) to call for comments on 1) the comprehension of the story 2) the organization of the booklet, and 3) the encouragement for the love of reading in English. The English reading booklet on Phra-apaimani for Thai primary children, the IOC questionnaire (with the open-ended questions) for the educator experts, and the rating scales for the students, the teachers, and the educational supervisors were used as the instruments of the research. The findings revealed that most students rated ‘positive’ level for the comprehension of the story, while the teachers and the educational supervisors rated ‘highly positive’. The 3 groups rated ‘highly positive’ for both the organization of the booklet and for the encouragement for the love of reading in English. It is recommended that there should be more production of English reading texts for children, especially the texts that children already have some background knowledge. Moreover, illustration is the most crucial part for the children’s reading texts.

Keywords: English language, reading skill, primary children, Thai literature

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453 Experimental Pain Study Investigating the Distinction between Pain and Relief Reports

Authors: Abeer F. Almarzouki, Christopher A. Brown, Richard J. Brown, Anthony K. P. Jones

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Although relief is commonly assumed to be a direct reflection of pain reduction, it seems to be driven by complex emotional interactions in which pain reduction is only one component. For example, termination of a painful/aversive event may be relieving and rewarding. Accordingly, in this study, whether terminating an aversive negative prediction of pain would be reflected in a greater relief experience was investigated, with a view to separating apart the effects of the manipulation on pain and relief. We use aversive conditioning paradigm to investigate the perception of relief in an aversive (threat) vs. positive context. Participants received positive predictors of a non-painful outcome which were presented within either a congruent positive (non-painful) context or an incongruent threat (painful) context that had been previously conditioned; trials followed by identical laser stimuli on both conditions. Participants were asked to rate the perceived intensity of pain as well as their perception of relief in response to the cue predicting the outcome. Results demonstrated that participants reported more pain in the aversive context compared to the positive context. Conversely, participants reported more relief in the aversive context compares to the neutral context. The rating of relief in the threat context was not correlated with pain reports. The results suggest that relief is not dependant on pain intensity. Consistent with this, relief in the threat context was greater than that in the positive expectancy condition, while the opposite pattern was obtained for the pain ratings. The value of relief in this study is better appreciated in the context of an impending negative threat, which is apparent in the higher pain ratings in the prior negative expectancy compared to the positive expectancy condition. Moreover, the more threatening the context (as manifested by higher unpleasantness/higher state anxiety scores), the more the relief is appreciated. The importance of the study highlights the importance of exploring relief and pain intensity in monitoring separately or evaluating pain-related suffering. The results also illustrate that the perception of painful input may largely be shaped by the context and not necessarily stimulus-related.

Keywords: aversive context, pain, predictions, relief

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452 Development of Competitive Advantage for the Apparel Manufacturing Industry of South Africa

Authors: Sipho Mbatha, Anne Mastament-Mason

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The Multi-Fibre Arrangement (MFA) which regulated all trade in the Apparel Manufacturing Industries (AMI) for four decades was dissolved in 2005. Since 2005, the Apparel Manufacturing Industry of South Africa (AMISA) has been battling to adjust to an environment of liberalised trade, mainly due to strategic, infrastructural and skills factors. In developing competitive advantage strategy for the AMISA, the study aimed to do the following (1) to apply Porter’s diamond model’s determinant “Factor Condition” as framework to develop competitive advantage strategies. (2) Examine the effectiveness of government policy Industrial Policy Action Plan (IPAP 2007) in supporting AMISA. (3) Examine chance events that could be used as bases for competitive advantage strategies for the AMISA. This study found that the lack of advanced skills and poor infrastructure are affecting the competitive advantage of AMISA. The then Clothing, Textiles, Leather and Footwear Sector Education and Training Authority (CTLF-SETA) has also fallen short of addressing the skills gap within the apparel manufacturing industries. The only time that AMISA have shown signs of competitive advantage was when they made use of government grants and incentives available to only compliant AMISA. The findings have shown that the apparel retail groups have shown support for the AMISA by shouldering raw material costs, making it easier to manufacture the required apparel at acceptable lead times. AMISA can compete in low end apparel, provided quick response is intensified, the development of local textiles and raw materials is expedited.

Keywords: compliance rule, apparel manufacturing idustry, factor conditions, advance skills, industrial policy action plan of South Africa

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451 Patients' Understanding of Their Treatment Plans and Diagnosis during Discharge in Emergency Ward at B. P. Koirala Institute of Health Sciences

Authors: Ajay Kumar Yadav, Masum Paudel, Ritesh Chaudhary

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Background: Understanding the diagnosis and the treatment plan is very important for the patient which reflects the effectiveness of the patient care as well as counseling. Large groups of patients do not understand their emergency care plan or their discharge instructions. With only a little more than 2/3ʳᵈ of the adult population is literate and poorly distributed health service institutions in Nepal, exploring the current status of patient understanding of their diagnosis and treatment would help identify interventions to improve patient compliance with the provided care and the treatment outcomes. Objectives: This study was conducted to identify and describe the areas of patients’ understanding and confusion regarding emergency care and discharge instructions at the Emergency ward of B. P. Koirala Institute of Health Sciences teaching hospital, Dharan, Nepal. Methods: A cross-sectional study was conducted among 426 patients discharged from the emergency unit of BPKIHS. Cases who are leaving against medical advice absconded cases and those patients who came just for vaccination are excluded from the study. Patients’ understanding of the treatment plan and diagnosis was measured. Results: There were 60% men in this study. More than half of the participants reported not being able to read English. More than 90% of the respondents reported they could not read their prescription at all. While patient could point out their understanding of their diagnosis at discharge, most of them could not tell the names and the dosage of all the drugs prescribed to them at discharge. More than 95% of the patients could not tell the most common side effects of the drugs that they are prescribed. Conclusions: There is a need to further explore the factors influencing the understanding of the patients regarding their treatment plan. Interventions to understand the health literacy needs and ways to improve the health literacy of the patients are needed.

Keywords: discharge instruction, emergency ward, health literacy, treatment plan

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450 Statistical Modeling and by Artificial Neural Networks of Suspended Sediment Mina River Watershed at Wadi El-Abtal Gauging Station (Northern Algeria)

Authors: Redhouane Ghernaout, Amira Fredj, Boualem Remini

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Suspended sediment transport is a serious problem worldwide, but it is much more worrying in certain regions of the world, as is the case in the Maghreb and more particularly in Algeria. It continues to take disturbing proportions in Northern Algeria due to the variability of rains in time and in space and constant deterioration of vegetation. Its prediction is essential in order to identify its intensity and define the necessary actions for its reduction. The purpose of this study is to analyze the concentration data of suspended sediment measured at Wadi El-Abtal Hydrometric Station. It also aims to find and highlight regressive power relationships, which can explain the suspended solid flow by the measured liquid flow. The study strives to find models of artificial neural networks linking the flow, month and precipitation parameters with solid flow. The obtained results show that the power function of the solid transport rating curve and the models of artificial neural networks are appropriate methods for analysing and estimating suspended sediment transport in Wadi Mina at Wadi El-Abtal Hydrometric Station. They made it possible to identify in a fairly conclusive manner the model of neural networks with four input parameters: the liquid flow Q, the month and the daily precipitation measured at the representative stations (Frenda 013002 and Ain El-Hadid 013004 ) of the watershed. The model thus obtained makes it possible to estimate the daily solid flows (interpolate and extrapolate) even beyond the period of observation of solid flows (1985/86 to 1999/00), given the availability of the average daily liquid flows and daily precipitation since 1953/1954.

Keywords: suspended sediment, concentration, regression, liquid flow, solid flow, artificial neural network, modeling, mina, algeria

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449 Integrated Mass Rapid Transit System for Smart City Project in Western India

Authors: Debasis Sarkar, Jatan Talati

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This paper is an attempt to develop an Integrated Mass Rapid Transit System (MRTS) for a smart city project in Western India. Integrated transportation is one of the enablers of smart transportation for providing a seamless intercity as well as regional level transportation experience. The success of a smart city project at the city level for transportation is providing proper integration to different mass rapid transit modes by way of integrating information, physical, network of routes fares, etc. The methodology adopted for this study was primary data research through questionnaire survey. The respondents of the questionnaire survey have responded on the issues about their perceptions on the ways and means to improve public transport services in urban cities. The respondents were also required to identify the factors and attributes which might motivate more people to shift towards the public mode. Also, the respondents were questioned about the factors which they feel might restrain the integration of various modes of MRTS. Furthermore, this study also focuses on developing a utility equation for respondents with the help of multiple linear regression analysis and its probability to shift to public transport for certain factors listed in the questionnaire. It has been observed that for shifting to public transport, the most important factors that need to be considered were travel time saving and comfort rating. Also, an Integrated MRTS can be obtained by combining metro rail with BRTS, metro rail with monorail, monorail with BRTS and metro rail with Indian railways. Providing a common smart card to transport users for accessing all the different available modes would be a pragmatic solution towards integration of the available modes of MRTS.

Keywords: mass rapid transit systems, smart city, metro rail, bus rapid transit system, multiple linear regression, smart card, automated fare collection system

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448 Evaluating the Effect of Spatial Qualities, Openness and Complexity, on Human Cognitive Performance within Virtual Reality

Authors: Pierre F. Gerard, Frederic F. Leymarie, William Latham

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Architects have developed a series of objective evaluations, using spatial analysis tools such as Isovist, that show how certain spatial qualities are beneficial to specific human activities hosted in the built environments. In return, they can build more adapted environments by tuning those spatial qualities in their design. In parallel, virtual reality technologies have been developed by engineers with the dream of creating a system that immerses users in a new form of spatial experiences. They already have demonstrated a useful range of benefits not only in simulating critical events to assist people in acquiring new skills, but also to enhance memory retention, to name just a few. This paper investigates the effects of two spatial qualities, openness, and complexity, on cognitive performance within immersive virtual environments. Isovist measure is used to design a series of room settings with different levels of each spatial qualities. In an empirical study, each room was then used by every participant to solve a navigational puzzle game and give a rating of their spatial experience. They were then asked to fill in a questionnaire before solving the visual-spatial memory quiz, which addressed how well they remembered the different rooms. Findings suggest that those spatial qualities have an effect on some of the measures, including navigation performance and memory retention. In particular, there is an order effect for the navigation puzzle game. Participants tended to spend a longer time in the complex room settings. Moreover, there is an interaction effect while with more open settings, participants tended to perform better when in a simple setting; however, with more closed settings, participants tended to perform better in a more complex setting. For the visual-spatial memory quiz, participants performed significantly better within the more open rooms. We believe this is a first step in using virtual environments to enhance participant cognitive performances through better use of specific spatial qualities.

Keywords: architecture, navigation, spatial cognition, virtual reality

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447 Passive Voice in SLA: Armenian Learners’ Case Study

Authors: Emma Nemishalyan

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It is believed that learners’ mother tongue (L1 hereafter) has a huge impact on their second language acquisition (L2 hereafter). This hypothesis has been exposed to both positive and negative criticism. Based on research results of a wide range of learners’ corpora (Chinese, Japanese, Spanish among others) the hypothesis has either been proved or disproved. However, no such study has been conducted on the Armenian learners. The aim of this paper is to understand the implication of the hypothesis on the Armenian learners’ corpus in terms of the use of the passive voice. To this end, the method of Contrastive Interlanguage Analysis (hereafter CIA) has been used on native speakers’ corpus (Louvain Corpus of Native English Essays (LOCNESS)) and Armenian learners’ corpus which has been compiled by me in compliance with International Corpus of Learner English (ICLE) guidelines. CIA compares the interlanguage (the language produced by learners) with the one produced by native speakers. With the help of this method, it is possible not only to highlight the mistakes that learners make, but also to underline the under or overuses. The choice of the grammar issue (passive voice) is conditioned by the fact that typologically Armenian and English are drastically different as they belong to different branches. Moreover, the passive voice is considered to be one of the most problematic grammar topics to be acquired by learners of the English language. Based on this difference, we hypothesized that Armenian learners would either overuse or underuse some types of the passive voice. With the help of Lancsbox software, we have identified the frequency rates of passive voice usage in LOCNESS and Armenian learners’ corpus to understand whether the latter have the same usage pattern of the passive voice as the native speakers. Secondly, we have identified the types of the passive voice used by the Armenian leaners trying to track down the reasons in their mother tongue. The results of the study showed that Armenian learners underused the passive voices in contrast to native speakers. Furthermore, the hypothesis that learners’ L1 has an impact on learners’ L2 acquisition and production was proved.

Keywords: corpus linguistics, applied linguistics, second language acquisition, corpus compilation

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446 Assessment of Heavy Metal Bioaccumulation by Tissues of Ipomoea Batatas and Manihot Esculenta Irrigated with Water from Muhammad Ayuba Dam, Kazaure, Jigawa State, Nigeria

Authors: Sa’idu A. Abdullah, Jafar Lawan, A. U. Adamu, Fowotade, S. A., Hamisu Abdu

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Scarcity of quality water in many communities compels inhabitants to use any available water resources for domestic, recreational, industrial and agricultural purposes. Global concern on the potential health hazards of anthropogenic inputs into our ecosystems imposes the need for constant monitoring of levels of pollutants in order to ensure compliance with internationally acceptable criteria. In this research, assessment of bioaccumulation of Cd, Co, Cu, Pb and Zn was carried out using tissues of Ipomoea batatas (sweet potato) and Manihot esculenta (cassava) irrigated with water from Muhammad Ayuba Dam in Kazaure, Jigawa State. The metal concentrations were determined using Flame Atomic Absorption Spectrophotometer (FAAS). The result of the analysis revealed the presence of the metals in varying concentrations. Cd and Co showed higher concentrations in the tubers of Manihot esculenta but all the other investigated metals were more concentrated in the leaves of the plant. Cd and Cu on the other hand showed higher concentration in the root of Ipomoea batatas while the remaining investigated metals were concentrated more in the leaves of the plant. The result of analysis of water samples from five sampling stations in the Dam showed the presence of the metals as follows: Cd, (0.063±0.02 mg/L), Co (0.086±0.03 mg/L), Cu (0.167±0.08 mg/L), Pb (0.22±0.01 mg/L) and Zn (0.047±0.01 mg/L) respectively. The results of bioaccumulation studies using the Bioaccumulation Factors (BAF) index indicated Ipomoea batatas to have higher bioaccumulation potential for Cd, Co and Cu while Pb and Zn were more accumulated in Manihot esculenta. The levels of the metals in both the water samples and plant tissues were all below the WHO permissible limit. This is indicative that the inhabitants of the community under investigation are not at any health risk.

Keywords: agriculture, bioaccumulation, heavy metal, plant tissues

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445 The Role of Fluid Catalytic Cracking in Process Optimisation for Petroleum Refineries

Authors: Chinwendu R. Nnabalu, Gioia Falcone, Imma Bortone

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Petroleum refining is a chemical process in which the raw material (crude oil) is converted to finished commercial products for end users. The fluid catalytic cracking (FCC) unit is a key asset in refineries, requiring optimised processes in the context of engineering design. Following the first stage of separation of crude oil in a distillation tower, an additional 40 per cent quantity is attainable in the gasoline pool with further conversion of the downgraded product of crude oil (residue from the distillation tower) using a catalyst in the FCC process. Effective removal of sulphur oxides, nitrogen oxides, carbon and heavy metals from FCC gasoline requires greater separation efficiency and involves an enormous environmental significance. The FCC unit is primarily a reactor and regeneration system which employs cyclone systems for separation.  Catalyst losses in FCC cyclones lead to high particulate matter emission on the regenerator side and fines carryover into the product on the reactor side. This paper aims at demonstrating the importance of FCC unit design criteria in terms of technical performance and compliance with environmental legislation. A systematic review of state-of-the-art FCC technology was carried out, identifying its key technical challenges and sources of emissions.  Case studies of petroleum refineries in Nigeria were assessed against selected global case studies. The review highlights the need for further modelling investigations to help improve FCC design to more effectively meet product specification requirements while complying with stricter environmental legislation.

Keywords: design, emission, fluid catalytic cracking, petroleum refineries

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444 Study of the Composition of Lipids in Different Kinds of Packaged Food Products

Authors: Zineb Taidirt, Fathia Sebahi, Mohamed Karim Guarchani, Anissa Berkane, Noureddine Smail, Ouahiba Hadjoudj

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Cardiovascular diseases are one of the most important causes of death in Algeria. Several risk factors are responsible for this, including the consumption of foods containing saturated fat and trans fatty acids TFAs. This brief presents the results of a descriptive study of the lipid composition of 251 food products marketed in Algeria. The objective of the study is to describe the nature and composition of lipids and to verify the compliance of saturated and trans fatty acids intakes with the regulations. The study is based on data from the nutrition labelling of marketed food products. The results showed that the lipids in foodstuffs are diverse in nature and of varying amounts, but their nature is not specified on all products. In addition, the required content of saturated fatty acids is mentioned only in 29.48% of the products; 21.62% of them do not comply with the standard. Hydrogenation of fats, which produced Trans fatty acids, is common: 19.92% of products contain hydrogenated fats, and 74.89% may contain them according to the aspect of the lipid (solid fat). However, the trans fatty acid content is only mentioned in 5.18% of the products. The latter is above the limits set by Algerian regulations in 50% of the butter samples studied. The composition of lipids in mono- and polyunsaturated fatty acids essential for the body is insufficient: only 13.94% of the products inform their contents on their labels. It is necessary to adopt mandatory restriction of trans fatty acids, to ban the use of partially-hydrogenated oils, and to require required mandatory labeling of the TFAs and the other fatty acids on packaged foods, and to conduct more studies in order to appreciate the intake of TFAs and saturated fat and appreciate their effects on the Algerian population and to get more informed about the composition of the lipid in packaged foods.

Keywords: cardiovascular diseases, lipids, nutrition labelling, lipids, trans fatty acids

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443 Psychiatric Risk Assessment in the Emergency Department: The Impact of NEAT on the Management of Mental Health Patients

Authors: Euan Donley

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Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.

Keywords: assessment, emergency, risk, psychiatric

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442 Externalised Migration Controls and the Deportation of Minors and Potential Refugees from Mexico

Authors: Vickie Knox

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Since the ‘urgent humanitarian crisis’ of the arrival of tens of thousands of Central American minors at the Mexico-US border in early 2014, the USA has increasingly externalised migration controls to Mexico. Although the resulting policy ‘Plan Frontera Sur’ claimed to protect migrants’ human rights, it has manifested as harshly delivered in-country controls and an alarming increase in deportations, particularly of minors. This is of particular concern given the ongoing situation of forced migration caused by criminal violence in Central America because these deportations do not all comply with Mexico’s international obligations and with its own legal framework for international protection that allows inter alia verbal asylum claims and grants minors additional protection against deportation. Notably, the volume of deportations, the speed with which they are carried out and the lack of adequate screening indicate non-compliance with the principle of non-refoulement and the right to claim asylum or other forms of protection. Based on qualitative data gathered in fieldwork in 2015 and quantitative data covering the period 2014-2016, this research details three types of adverse outcome resulting from these externalised controls: human rights violations perpetrated in order to deliver the policy–namely, deportations that may not comply with the principle of non-refoulement or the protection of minors; human rights violations perpetrated in the execution of policy–such as violations by state actors during apprehension and detention; and adverse consequences of the policy – such as increased risk during transit. This research has particular resonance as the Trump era brings tighter enforcement in the region, and has broader relevance for the study of externalisation tools on a global level.

Keywords: deportation, externalisation, forced migration, non-refoulement

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441 Optimizing Fire Tube Boiler Design for Efficient Saturated Steam Production: A Cost-Minimization Approach

Authors: Yoftahe Nigussie Worku

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This report unveils a meticulous project focused on the design intricacies of a Fire Tube Boiler tailored for the efficient generation of saturated steam. The overarching objective is to produce 2000kg/h of saturated steam at 12-bar design pressure, achieved through the development of an advanced fire tube boiler. This design is meticulously crafted to harmonize cost-effectiveness and parameter refinement, with a keen emphasis on material selection for component parts, construction materials, and production methods throughout the analytical phases. The analytical process involves iterative calculations, utilizing pertinent formulas to optimize design parameters, including the selection of tube diameters and overall heat transfer coefficients. The boiler configuration incorporates two passes, a strategic choice influenced by tube and shell size considerations. The utilization of heavy oil fuel no. 6, with a higher heating value of 44000kJ/kg and a lower heating value of 41300kJ/kg, results in a fuel consumption of 140.37kg/hr. The boiler achieves an impressive heat output of 1610kW with an efficiency rating of 85.25%. The fluid flow pattern within the boiler adopts a cross-flow arrangement strategically chosen for inherent advantages. Internally, the welding of the tube sheet to the shell, secured by gaskets and welds, ensures structural integrity. The shell design adheres to European Standard code sections for pressure vessels, encompassing considerations for weight, supplementary accessories (lifting lugs, openings, ends, manhole), and detailed assembly drawings. This research represents a significant stride in optimizing fire tube boiler technology, balancing efficiency and safety considerations in the pursuit of enhanced saturated steam production.

Keywords: fire tube, saturated steam, material selection, efficiency

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440 Software Development for Both Small Wind Performance Optimization and Structural Compliance Analysis with International Safety Regulations

Authors: K. M. Yoo, M. H. Kang

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Conventional commercial wind turbine design software is limited to large wind turbines due to not incorporating with low Reynold’s Number aerodynamic characteristics typically for small wind turbines. To extract maximum annual energy product from an intermediately designed small wind turbine associated with measured wind data, numerous simulation is highly recommended to have a best fitting planform design with proper airfoil configuration. Since depending upon wind distribution with average wind speed, an optimal wind turbine planform design changes accordingly. It is theoretically not difficult, though, it is very inconveniently time-consuming design procedure to finalize conceptual layout of a desired small wind turbine. Thus, to help simulations easier and faster, a GUI software is developed to conveniently iterate and change airfoil types, wind data, and geometric blade data as well. With magnetic generator torque curve, peak power tracking simulation is also available to better match with the magnetic generator. Small wind turbine often lacks starting torque due to blade optimization. Thus this simulation is also embedded along with yaw design. This software provides various blade cross section details at user’s design convenience such as skin thickness control with fiber direction option, spar shape, and their material properties. Since small wind turbine is under international safety regulations with fatigue damage during normal operations and safety load analyses with ultimate excessive loads, load analyses are provided with each category mandated in the safety regulations.

Keywords: GUI software, Low Reynold’s number aerodynamics, peak power tracking, safety regulations, wind turbine performance optimization

Procedia PDF Downloads 286
439 Evaluating the Implementation of a Quality Management System in the COVID-19 Diagnostic Laboratory of a Tertiary Care Hospital in Delhi

Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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438 A Review of the Handling and Disposal of Botulinum Toxin in a Maxillofacial Unit

Authors: Ashana Gupta

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Aim: In the UK, Botulinum Toxin (botox) is authorised for treating chronic myofascial pain secondary to masseter muscle hypertrophy (Fedorowicz et al. 2013). This audit aimed to ensure the Maxillofacial Unit is meeting the trust guidelines for the safe storage and disposal of botox. Method: The trust upholds a strict policy for botox handling. The audit was designed to optimise several elements including Staff awareness of regulations around botox handling A questionnaire was designed to test knowledge of advised storage temperatures, reporting of adverse events, disposal procedures and regulatory authorities. Steps taken to safely delivertoxin and eliminate unused toxin. A checklist was completed. These include marks for storagetemperature, identification checks, disposal of sharps, deactivation of toxin, and disposal. Results: All staff correctly stated storage requirements for toxin. 75% staff (n=8) were unsure about reporting and regulations. Whilst all staff knew how to dispose of vials, 0% staff showed awareness for the crucial step of deactivating toxin. All checklists (n=20) scored 100% for adequate storage, ID checks, and toxin disposal. However, there were no steps taken to deactivate toxin in any cases. Staff training took place with revision to clinical protocols. In line with Trust guidelines, an additional clinical step has been introduced including use of 0.5% sodium hypochlorite to deactivate botox. Conclusion: Deactivation is crucial to ensure residual toxin is not misused. There are cases of stolen botox within South-Tees Hospital (Woodcock, 2014). This audit was successful in increasing compliance to safe handling and disposal of botox by 100% and ensured our hospitalmeets Trust guidance.

Keywords: botulinum toxin, aesthetics, handling, disposal

Procedia PDF Downloads 186
437 Reducing Ambulance Offload Delay: A Quality Improvement Project at Princess Royal University Hospital

Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

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436 Role of Micro-Patterning on Stem Cell-Material Interaction Modulation and Cell Fate

Authors: Lay Poh Tan, Chor Yong Tay, Haiyang Yu

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Micro-contact printing is a form of soft lithography that uses the relief patterns on a master polydimethylsiloxane (PDMS) stamp to form patterns of self-assembled monolayers (SAMs) of ink on the surface of a substrate through conformal contact technique. Here, we adopt this method to print proteins of different dimensions on our biodegradable polymer substrates. We started off with printing 20-500 μm scale lanes of fibronectin to engineer the shape of bone marrow derived human mesenchymal stem cell (hMSCs). After 8 hours of culture, the hMSCs adopted elongated shapes, and upon analysis of the gene expressions, genes commonly associated with myogenesis (GATA-4, MyoD1, cTnT and β-MHC) and neurogenesis (NeuroD, Nestin, GFAP, and MAP2) were up-regulated but gene expression associated to osteogenesis (ALPL, RUNX2, and SPARC) were either down modulated or remained at the nominal level. This is the first evidence that cellular morphology control via micropatterning could be used to modulate stem cell fate without external biochemical stimuli. We further our studies to modulate the focal adhesion (FA) instead of the macro shape of cells. Micro-contact printed islands of different smaller dimensions were investigated. We successfully regulated the FAs into dense FAs and elongated FAs by micropatterning. Additionally, the combined effects of hard (40.4 kPa), and intermediate (10.6 kPa) PA gel and FAs patterning on hMSCs differentiation were studied. Results showed that FA and matrix compliance plays an important role in hMSCs differentiation, and there is a cross-talk between different physical stimulants and the significance of these stimuli can only be realized if they are combined at the optimum level.

Keywords: micro-contact printing, polymer substrate, cell-material interaction, stem cell differentiation

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435 Transdermal Medicated- Layered Extended-Release Patches for Co-delivery of Carbamazepine and Pyridoxine

Authors: Sarah K. Amer, Walaa Alaa

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Epilepsy is an important cause of mortality and morbidity, according to WHO statistics. It is characterized by the presence of frequent seizures occurring more than 24 hours apart. Carbamazepine (CBZ) is considered first-line treatment for epilepsy. However, reports have shown that CBZ oral formulations failed to achieve optimum systemic delivery, minimize side effects, and enhance patient compliance. Besides, the literature has signified the lack of therapeutically efficient CBZ transdermal formulation and the urge for its existence owing to its ease and convenient method of application and highlighted capability to attain higher bioavailability and more extended-release profiles compared to conventional oral CBZ tablets. This work aims to prepare CBZ microspheres (MS) that are embedded in a transdermal gel containing Vitamin B to be co-delivered. MS were prepared by emulsion-solvent diffusion method using Eudragit S as core forming polymer and hydroxypropyl methylcellulose (HPMC) polymer. The MS appeared to be spherical and porous in nature, offering a large surface area and high entrapment efficiency of CBZ. The transdermal gel was prepared by solvent-evaporation technique using HPMC that, offered high entrapment efficiency and Eudragit S that provided an extended-release profile. Polyethylene glycol, Span 80 and Pyridoxine were also added. Data indicated that combinations of CBZ with pyridoxine can reduce epileptic seizures without affecting motor coordination. Extended-release profiles were evident for this system. The patches were furthermore tested for thickness, moisture content, folding endurance, spreadability and viscosity measurements. This novel pharmaceutical formulation would be of great influence on seizure control, offering better therapeutic effects.

Keywords: epilepsy, carbamazepine, pyridoxine, transdermal

Procedia PDF Downloads 38
434 Comparing the Effects of Systemic Family Intervention on End Stage Renal Disease: Families of Different Modalities

Authors: Fenni Sim

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Background: The application of systemic family therapy approaches to community health cases have not gathered traction. In National Kidney Foundation, Singapore, the belief is that community support has great potential in helping End Stage Renal Failure (ESRF) patients manage the demands of their treatment regime, whether Hemodialysis (HD) or Peritoneal Dialysis(PD) and sustain them on the treatment. However, the current community support does not include family interventions and is largely nursing based. Although nursing support is well provided to patients, and their family members in issues related to treatment and compliance, complex family issues and dynamics arising from caregiver strain or pre-dialysis relationship strain might deter efforts in managing the challenges of the treatment. Objective: The objective of the study is to understand the potential scope of work provided by a social worker who is trained in systemic family therapy and the effects of these interventions. Methodology: 3 families on HD and 3 families on PD who have been receiving family intervention for the past 6 months would be chosen for the study. A qualitative interview would be conducted to review the effectiveness for the family. Scales such as SCORE-15, PHQ-9, and Zarit Burden were used to measure family functioning, depression, and caregiver’s burden for the families. Results: The research is still in preliminary phase. Conclusion: The study highlights the importance of family intervention for families with multiple stressors on different treatment modalities who might have different needs and challenges. Nursing support needs to be complemented with family-based support to manage complex family issues in order to achieve better health outcomes and improved family coping.

Keywords: complementing nursing support, end stage renal failure, healthcare, systemic approaches

Procedia PDF Downloads 187
433 Fuzzy Logic-Based Approach to Predict Fault in Transformer Oil Based on Health Index Using Dissolved Gas Analysis

Authors: Kharisma Utomo Mulyodinoto, Suwarno, Ahmed Abu-Siada

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Transformer insulating oil is a key component that can be utilized to detect incipient faults within operating transformers without taking them out of service. Dissolved gas-in-oil analysis has been widely accepted as a powerful technique to detect such incipient faults. While the measurement of dissolved gases within transformer oil samples has been standardized over the past two decades, analysis of the results is not always straightforward as it depends on personnel expertise more than mathematical formulas. In analyzing such data, the generation rate of each dissolved gas is of more concern than the absolute value of the gas. As such, history of dissolved gases within a particular transformer should be archived for future comparison. Lack of such history may lead to misinterpretation of the obtained results. IEEE C57.104-2008 standards have classified the health condition of the transformer based on the absolute value of individual dissolved gases along with the total dissolved combustible gas (TDCG) within transformer oil into 4 conditions. While the technique is easy to implement, it is considered as a very conservative technique and is not widely accepted as a reliable interpretation tool. Moreover, measured gases for the same oil sample can be within various conditions limits and hence, misinterpretation of the data is expected. To overcome this limitation, this paper introduces a fuzzy logic approach to predict the health condition of the transformer oil based on IEEE C57.104-2008 standards along with Roger ratio and IEC ratio-based methods. DGA results of 31 chosen oil samples from 469 transformer oil samples of normal transformers and pre-known fault-type transformers that were collected from Indonesia Electrical Utility Company, PT. PLN (Persero), from different voltage rating: 500/150 kV, 150/20 kV, and 70/20 kV; different capacity: 500 MVA, 60 MVA, 50 MVA, 30 MVA, 20 MVA, 15 MVA, and 10 MVA; and different lifespan, are used to test and establish the fuzzy logic model. Results show that the proposed approach is of good accuracy and can be considered as a platform toward the standardization of the dissolved gas interpretation process.

Keywords: dissolved gas analysis, fuzzy logic, health index, IEEE C57.104-2008, IEC ratio method, Roger ratio method

Procedia PDF Downloads 139
432 The Comparative Electroencephalogram Study: Children with Autistic Spectrum Disorder and Healthy Children Evaluate Classical Music in Different Ways

Authors: Galina Portnova, Kseniya Gladun

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In our EEG experiment participated 27 children with ASD with the average age of 6.13 years and the average score for CARS 32.41 and 25 healthy children (of 6.35 years). Six types of musical stimulation were presented, included Gluck, Javier-Naida, Kenny G, Chopin and other classic musical compositions. Children with autism showed orientation reaction to the music and give behavioral responses to different types of music, some of them might assess stimulation by scales. The participants were instructed to remain calm. Brain electrical activity was recorded using a 19-channel EEG recording device, 'Encephalan' (Russia, Taganrog). EEG epochs lasting 150 s were analyzed using EEGLab plugin for MatLab (Mathwork Inc.). For EEG analysis we used Fast Fourier Transform (FFT), analyzed Peak alpha frequency (PAF), correlation dimension D2 and Stability of rhythms. To express the dynamics of desynchronizing of different rhythms we've calculated the envelope of the EEG signal, using the whole frequency range and a set of small narrowband filters using Hilbert transformation. Our data showed that healthy children showed similar EEG spectral changes during musical stimulation as well as described the feelings induced by musical fragments. The exception was the ‘Chopin. Prelude’ fragment (no.6). This musical fragment induced different subjective feeling, behavioral reactions and EEG spectral changes in children with ASD and healthy children. The correlation dimension D2 was significantly lower in autists compared to healthy children during musical stimulation. Hilbert envelope frequency was reduced in all group of subjects during musical compositions 1,3,5,6 compositions compared to the background. During musical fragments 2 and 4 (terrible) lower Hilbert envelope frequency was observed only in children with ASD and correlated with the severity of the disease. Alfa peak frequency was lower compared to the background during this musical composition in healthy children and conversely higher in children with ASD.

Keywords: electroencephalogram (EEG), emotional perception, ASD, musical perception, childhood Autism rating scale (CARS)

Procedia PDF Downloads 264
431 Corporate Governance Development in Mongolia: The Role of Professional Accountants

Authors: Ernest Nweke

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The work of Professional Accountants and Corporate governance are synonymous and cannot be divorced from each other. Organizations, profit and non-profit alike cannot implement sound corporate practices without inputs from Professional Accountants. In today’s dynamic corporate world, good corporate governance practice is a sine qua non. More so, following the corporate failures of the past decades like Enron and WorldCom, governments around the world, including Mongolia are becoming more proactive in ensuring sound corporate governance mechanisms. In the past fifteen years, the Mongolian government has taken several measures to establish and strengthen internal corporate governance structures in firms. This paper highlights the role of professional accountants and auditors play in ensuring that good corporate governance mechanisms are entrenched in listed companies in Mongolia. Both primary and secondary data are utilized in this research. In collection of primary data, Delphi method was used, securing responses from only knowledgeable senior employees, top managers, and some CEOs. Using this method, a total of 107 top-level company employees and executives randomly selected from 22 companies were surveyed; maximum of 5 and minimum of 4 from each company. These companies cut across several sectors. It was concluded that Professional Accountants play key roles in setting and maintaining firm governance. They do this by ensuring full compliance with all the requirements of good and sound corporate governance, establishing reporting, monitoring and evaluating standards, assisting in the setting up of proper controls, efficient and effective audit systems, sound fraud risk management and putting in place an overall vision for the enterprise. Companies with effective corporate governance mechanisms are usually strong and fraud-resilient. It was also discovered that companies with big 4 audit firms tend to have better governance structures in Mongolia.

Keywords: accountants, corporate disclosure, corporate failure, corporate governance

Procedia PDF Downloads 255
430 Technical Sustainable Management: An Instrument to Increase Energy Efficiency in Wastewater Treatment Plants, a Case Study in Jordan

Authors: Dirk Winkler, Leon Koevener, Lamees AlHayary

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This paper contributes to the improvement of the municipal wastewater systems in Jordan. An important goal is increased energy efficiency in wastewater treatment plants and therefore lower expenses due to reduced electricity consumption. The chosen way to achieve this goal is through the implementation of Technical Sustainable Management adapted to the Jordanian context. Three wastewater treatment plants in Jordan have been chosen as a case study for the investigation. These choices were supported by the fact that the three treatment plants are suitable for average performance and size. Beyond that, an energy assessment has been recently conducted in those facilities. The project succeeded in proving the following hypothesis: Energy efficiency in wastewater treatment plants can be improved by implementing principles of Technical Sustainable Management adapted to the Jordanian context. With this case study, a significant increase in energy efficiency can be achieved by optimization of operational performance, identifying and eliminating shortcomings and appropriate plant management. Implementing Technical Sustainable Management as a low-cost tool with a comparable little workload, provides several additional benefits supplementing increased energy efficiency, including compliance with all legal and technical requirements, process optimization, but also increased work safety and convenient working conditions. The research in the chosen field continues because there are indications for possible integration of the adapted tool into other regions and sectors. The concept of Technical Sustainable Management adapted to the Jordanian context could be extended to other wastewater treatment plants in all regions of Jordan but also into other sectors including water treatment, water distribution, wastewater network, desalination, or chemical industry.

Keywords: energy efficiency, quality management system, technical sustainable management, wastewater treatment

Procedia PDF Downloads 143
429 Effect of Rehabilitative Nursing Program on Pain Intensity and Functional Status among Patients with Discectomy

Authors: Amal Shehata

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Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

Procedia PDF Downloads 125