Search results for: global surgery

Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

Abstract:

Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

Procedia PDF Downloads 238

Authors: M. Ndeley

Abstract:

The performance of global manufacturing supply chains depends on the interaction of production and transport processes. Currently, the scheduling of these processes is done separately without considering mutual requirements, which leads to no optimal solutions. An integrated scheduling of both processes enables the improvement of supply chain performance. The integrated production and transport scheduling problem (PTSP) is NP-hard, so that heuristic methods are necessary to efficiently solve large problem instances as in the case of global manufacturing supply chains. This paper presents a heuristic scheduling approach which handles the integration of flexible production processes with intermodal transport, incorporating flexible land transport. The method is based on a graph that allows a reformulation of the PTSP as a shortest path problem for each job, which can be solved in polynomial time. The proposed method is applied to a supply chain scenario with a manufacturing facility in South Africa and shipments of finished product to customers within the Country. The obtained results show that the approach is suitable for the scheduling of large-scale problems and can be flexibly adapted to different scenarios.

Keywords: production and transport scheduling problem, graph based scheduling, integrated scheduling

Procedia PDF Downloads 469

Authors: Rajesh Kondareddy, Prakash Kumar Nayak, Maunash Das, Vrinatri Velentina Boro

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Today, there is a huge global concern for sustainable development which would include minimizing the consumption of non-renewable energies without affecting the basic global economy. Solar drying is one of the important processes used for extending the shelf life of agricultural products. The performance of a low cost automated solar dryer fitted with cascade control scheme and modified PI controller for drying chilli was investigated. The dryer was composed of designed solar collector (air heater) fitted with cylindrical pipes to improve the air velocity and a solar drying chamber containing rack of two cheese cloth (net) trays both being integrated together. The air allowed in through air inlet is heated up in the solar collector and channelled through the drying chamber where it is utilized in drying (removing the moisture content from the food substance or agricultural produce loaded). Here, to maintain the temperature in the heating chambers and to improve performance, a modified PI (Proportional–Integral) controller was used due its simplicity and robustness. Drying time for drying chilli from the initial moisture content of 88.5% (wb) to 7.3% (wb) was estimated to be 14 hours in solar dryer whereas 32 h was observed in the open sun drying.

Keywords: cascade control, chilli, PI controller, solar dryer

Procedia PDF Downloads 285

Authors: Ebru Thwaites Diken

Abstract:

This article analyzes the works of certain directors in Danish cinema, namely Susanne Bier and Lone Sherfig, in the context of transnationalisation of Danish cinema. It looks at how the films' narratives negotiate and reconstruct the local / national / regional and the global. Scholars such as Nestingen & Elkington (2005), Hjort (2010), Higbee and Lim (2010), Bondebjerg and Redvall (2011) address transnationalism of Danish cinema in terms of production and distribution processes and how film making trascends national boundaries. This paper employs a particular understanding of transnationalism - in terms of how ideas and characters travel - to analyze how the storytelling and style has evolved to connect the national, the regional and the global on the basis of the works of these two directors. Strategies such as Hollywoodization - i.e. focus on stardom and classical narration, adhering to conventional European genre formulas, producing Danish films in English language have been identifiable strategies in Danish cinema in the period after the 2000s. Susanne Bier and Lone Scherfig are significant for employing some of these strategies simultaneously. For this reason, this article will look at how these two directors have employed these strategies and negotiated the cultural boundaries and exchanges.

Keywords: transnational cinema, danish cinema, susanne bier, lone scherfig

Procedia PDF Downloads 67

Authors: Baffoe Kingsley

Abstract:

The consequence of the migration of young people from rural farming communities in the global south to the global north is a well-known phenomenon. While climate change and its accompanying socio-economic structures continue to be the driver, what is not really known is how left behinds are compelled to convert lands meant for the production of traditional staples such as cereals, vegetables, and tubers to the production of export-driven cashew plantations due to youth migration. The consequence of such migration on the development of Ghana and its food security is multidimensional. Using an ethnographic research design, the study revealed that the majority of farmers in the area are now aged, and farm labor has become scarce, which has impeded the cultivation of traditional staples for the population. It has also been established that in the absence of farm labor, most farmers have reduced farm sizes for the production of staples and increased the production of cashews. The practice has, in tend, resulted in a scarcity of land for the cultivation of staples. The study recommends further inquiry into how the effects of migration and cashew production as diversification in agriculture influence national development in Ghana.

Keywords: staple food crops, cashew plantations, climate change, migration

Procedia PDF Downloads 47

Authors: Todd Jackson

Abstract:

In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

Procedia PDF Downloads 61

Authors: K. A.Veselova, N. V.Gromova, I. N.Antonova, I. N. Kalakutskii

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There are many diseases and incidents that may result facial defects and deformities: cancer, trauma, burns, congenital anomalies, and autoimmune diseases. In some cases, patient may acquire atypically extensive facial defect, including more than one anatomical region or, by contrast, atypically small defect (e.g. partial auricular defect). The anaplastology gives us opportunity to help patient with facial disfigurement in cases when plastic surgery is contraindicated. Using of implant retention for facial prosthesis is strongly recommended because improves both aesthetic and functional results and makes using of the prosthesis more comfortable. Prostheticly oriented fixture position is extremely important for aesthetic and functional long-term result; however, the optimal site for fixture placement is not clear in cases with atypical configuration of facial defect. The objective of this report is to demonstrate challenges in fixture position determination we have faced with and offer the solution. In this report, four cases of implant-supported facial prosthesis are described. Extra-oral implants with four millimeter length were used in all cases. The decision regarding the quantity of surgical stages was based on anamnesis of disease. Facial prostheses were manufactured according to conventional technique. Clinical and technological difficulties and mistakes are described, and prostheticly oriented approach for determination of fixture position is demonstrated. The case with atypically large combined orbital and nasal defect resulting after arteriovenous malformation is described: the correct positioning of artificial eye was impossible due to wrong position of the fixture (with suprastructure) located in medial aspect of supraorbital rim. The suprastructure was unfixed and this fixture wasn`t used for retention in order to achieve appropriate artificial eye placement and better aesthetic result. In other case with small partial auricular defect (only helix and antihelix were absent) caused by squamoized cell carcinoma T1N0M0 surgical template was used to avoid the difficulties. To achieve the prostheticly oriented fixture position in case of extremely small defect the template was made on preliminary cast using vacuum thermoforming method. Two radiopaque markers were incorporated into template in preferable for fixture placement positions taking into account future prosthesis configuration. The template was put on remaining ear and cone-beam CT was performed to insure, that the amount of bone is enough for implant insertion in preferable position. Before the surgery radiopaque markers were extracted and template was holed for guide drill. Fabrication of implant-retained facial prostheses gives us opportunity to improve aesthetics, retention and patients’ quality of life. But every inaccuracy in planning leads to challenges on surgery and prosthetic stages. Moreover, in cases with atypically small or extended facial defects prostheticly oriented approach for determination of fixture position is strongly required. The approach including surgical template fabrication is effective, easy and cheap way to avoid mistakes and unpredictable result.

Keywords: anaplastology, facial prosthesis, implant-retained facial prosthesis., maxillofacil prosthese

Procedia PDF Downloads 106

Authors: Debora Gottardello, Mireia Valverde Aparicio, Juan Llopis Taverner

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Globalization has given rise to a great diversity in the composition of people in organizations. Diversity management is therefore key to create growth in today’s competitive global marketplace. This work develops a literature review related to the existing models for managing diversity covering the period from 1980 until 2014. Furthermore, it identifies limitations in previous models. More specifically, the literature review reveals that there is a lack of information about how these models can be adapted from the headquarters to the subsidiaries. Therefore, the contribution of this paper is to suggest how the models should be adapted when they are directed to host countries. Our aim is to highlight the limitations of the developed models with regards to the translation of the diversity management practices to the subsidiaries. Accordingly, a model that will enable MNCs to ensure a global strategy is suggested. Taking advantage of the potential incorporated in a culturally diverse work team should be at the top of every international company’s aims. Executives from headquarters need to use different attitudes when transferring diversity practices towards their subsidiaries. Further studies should reassess local practices of diversity management to find out how this universal management model is translated.

Keywords: culture diversity, diversity management, human resources management, MNCs, subsidiaries, workforce diversity

Procedia PDF Downloads 250

Authors: Trevor G. Gates

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In global communities, volunteering is an important yet rapidly changing mechanism of civic engagement. However, the volunteer rate in the US significantly declined by as much as five percent during the last two decades, resulting in increased interest in what it takes to attract and recruit volunteers. Volunteers are utilized across a number of sectors, including working within the social welfare sector either with disadvantaged individuals and communities or indirectly through advocacy As with many mainstream community groups, lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) organizations actively rely on the contributions of volunteers. Consequently, community organizations must adopt strategies to attract and retain volunteers to continue to deliver their services and remain competitive. For LGBTQ+ organizations, this means an increased understanding of volunteers’ motivations and, in particular, LGBTQ+ volunteers, as they have historically been more involved due to ongoing stigmatization. In this paper, I reviewed existing literature in order to provide insights for non-profits who are managing volunteer resources for LGBTQ+ people by identifying important characteristics of LGBTQ+ volunteers and discussing what volunteering entails. Motivational factors are outlined, and the role of volunteerism in the LGBTQ+ community is explored. The benefits of volunteering and the needs of volunteers are discussed.

Keywords: volunteer, lesbian, gay, bisexual, transgender

Procedia PDF Downloads 92

Authors: Astha Sinha, Anjali Kanagali

Abstract:

The United Kingdom’s withdrawal from the European Union, also termed as “Brexit,” took place on June 23, 2016 and immediately had global repercussions on the stock markets of the world. It is however expected to have a greater impact on the Banking sector in the UK. There is a two-fold effect on the earnings of banks which is being expected. First is of the trading activity and investment banking businesses being hit due to global weakness in financial markets. Second is that the banks having a large presence in the European Union will have to restructure their operations in order to cover other European countries as well increase their operating costs. As per the analysis, banks are expected to face rate cuts, bad loans, and tight liquidity. The directives in the Brexit negotiations on the Markets in Financial Instruments Directive (MiFID) will be a major decision to be taken for the Banking sector. New regulations will be required since most of the regulations governing the financial services industry allowing for the cross-border transactions were at the EU level. This paper aims to analyze the effect of Brexit on the UK Banking sector and changes in regulations that are expected due to the same. It shall also lay down the lessons learnt from the 2008 financial crisis and draw a parallel in terms of potential areas to be focused on for revival of the financial sector of Britain.

Keywords: Brexit, Brexit impact on UK, impact of Brexit on banking, impact of Brexit on financial services

Procedia PDF Downloads 398

Authors: Y. Lacroix, J.-F. Malbranque

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We present a chronological evolution for naval telecommunication networks. We distinguish periods: with or without multiplexers, with switch systems, with federative systems, with medium switching, and with medium switching with wireless networks. This highlights the introduction of new layers and technology in the architecture. These architectures are presented using layer models of transmission, in a unified way, which enables us to integrate pre-existing models. A ship of a naval fleet has internal communications (i.e. applications' networks of the edge) and external communications (i.e. the use of the means of transmission between edges). We propose architectures, deduced from the layer model, which are the point of convergence between the networks on board and the HF, UHF radio, and satellite resources. This modelling allows to consider end-to-end naval communications, and in a more global way, that is from the user on board towards the user on shore, including transmission and networks on the shore side. The new architectures need take care of quality of services for end-to-end communications, the more remote control develops a lot and will do so in the future. Naval telecommunications will be more and more complex and will use more and more advanced technologies, it will thus be necessary to establish clear global communication schemes to grant consistency of the architectures. Our latest model has been implemented in a military naval situation, and serves as the basic architecture for the RIFAN2 network.

Keywords: equilibrium beach profile, eastern tombolo of Giens, potential function, erosion

Procedia PDF Downloads 287

Authors: Keunhong Chae, Seokho Yoon

Abstract:

Recently, the global navigation satellite system (GNSS) such as Galileo and GPS is employing more satellites to provide a higher degree of accuracy for the location service, thus calling for a more efficient signaling scheme among the satellites used in the overall GNSS network. In that the network throughput is improved, the spatial diversity can be one of the efficient signaling schemes; however, it requires multiple antenna that could cause a significant increase in the complexity of the GNSS. Thus, a diversity scheme called the cooperative signaling was proposed, where the virtual multiple-input multiple-output (MIMO) signaling is realized with using only a single antenna in the transmit satellite of interest and with modeling the neighboring satellites as relay nodes. The main drawback of the cooperative signaling is that the relay nodes receive the transmitted signal at different time instants, i.e., they operate in an asynchronous way, and thus, the overall performance of the GNSS network could degrade severely. To tackle the problem, several modified cooperative signaling schemes were proposed; however, all of them are difficult to implement due to a signal decoding at the relay nodes. Although the implementation at the relay nodes could be simpler to some degree by employing the time-reversal and conjugation operations instead of the signal decoding, it would be more efficient if we could implement the operations of the relay nodes at the source node having more resources than the relay nodes. So, in this paper, we propose a novel cooperative signaling scheme, where the data signals are combined in a unique way at the source node, thus obviating the need of the complex operations such as signal decoding, time-reversal and conjugation at the relay nodes. The numerical results confirm that the proposed scheme provides the same performance in the cooperative diversity and the bit error rate (BER) as the conventional scheme, while reducing the complexity at the relay nodes significantly. Acknowledgment: This work was supported by the National GNSS Research Center program of Defense Acquisition Program Administration and Agency for Defense Development.

Keywords: global navigation satellite network, cooperative signaling, data combining, nodes

Procedia PDF Downloads 277

Authors: M. F. Wu, F. T. Cheng

Abstract:

Leather industry is the most important traditional industry to provide the leather products in the world for thousand years. The fierce global competitive environment and common awareness of global carbon reduction make livestock supply quantities falling, salt and wet blue leather material reduces and the price skyrockets significantly. Exchange rate fluctuation led sales revenue decreasing which due to the differences of export exchanges and compresses the overall profitability of leather industry. This paper applies activity-based benefit assessment approach to build up fitness fur input mixed model, fur is Wet Blue, which concerned with four key factors: the output rate of wet blue, unit cost of wet blue, yield rate and grade level of Wet Blue to achieve the low cost strategy under given unit price of leather product condition of the company. The research findings indicate that applying this model may improve the input cost structure, decrease numbers of leather product inventories and to raise the competitive advantages of the enterprise in the future.

Keywords: activity-based benefit assessment approach, input mixed, output rate, wet blue

Procedia PDF Downloads 371

Authors: Nwachukwu M. A., Nwachukwu J. I., Anyanwu J., Emeka U., Okorondu J., Acholonu C.

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Actualization of the 17 sustainable development goals (SDGs) conceived by the United Nations in 2015 is a global challenge that may not be feasible in sub-Saharan Africa by the year 2030, except universities play a committed role. This is because; there is a need to educate the people about the concepts of sustainability and sustainable development in the region to make the desired change. Here is a sensitization paper with a model of intervention and curricular planning to allow advancement in understanding and knowledge of SDGs. This Model Center for Sustainability Studies (MCSS) will enable partnerships with institutions in Africa and in advanced nations, thereby creating a global network for sustainability studies not found in sub-Saharan Africa. MCSS will train and certify public servants, government agencies, policymakers, entrepreneurs and personnel from organizations, and students on aspects of the SDGs and sustainability science. There is a need to add sustainability knowledge into environmental education and make environmental education a compulsory course in higher institutions and a secondary school certificate exam subject in sub-Saharan Africa. MCSS has 11 training modules that can be replicated anywhere in the world.

Keywords: sustainability, higher institutions, training, SDGs, collaboration, sub-Saharan Africa

Procedia PDF Downloads 91

Authors: Mohamed Salah El-Din Mahmoud, Heba Radi Atta Allah

Abstract:

Background: Our study assesses the safety profile and efficacy of toric Implantable Collamer Lens (T-ICL) and toric implantable phakic contact lens (IPCL) for the correction of high myopia with astigmatism. Methods: A prospective interventional randomized comparative study included 60 myopic eyes divided into 2 groups, group A including 30 eyes that were implanted with T-ICL, and group B including 30 eyes that were implanted with toric IPCL. The refractive results, visual acuity, corneal endothelial cell count, and intraocular pressure (IOP) were evaluated at baseline and at 1, 6, and 9 months post-surgery. Any complications either during or after surgery were assessed. Results: A significant reduction in both spherical and cylindrical refractive errors with good predictability was reported in both groups compared with preoperative values. Regarding the predictability, In T-ICL group (A), the median spherical and cylindrical errors were significantly improved from (-10 D & -4.5 D) pre-operatively to (-0.25 D & - 0.3 D) at the end of 9 months follow up period. Similarly, in the toric IPCL group (B), the median spherical and cylindrical errors were significantly improved from (-11 D & -4.5 D) pre-operatively to (-0.25 D & - 0.3 D) at the end of 9 months follow up period. A statistically significant improvement of UCDVA at 9 months postoperatively was found in both groups, as median preoperative Log Mar UCDVA was 1.1 and 1.3 in groups A and B respectively, which was significantly improved to 0.2 in both groups at the end of follow-up period. Regarding IOP, no significant difference was found between both groups, either pre-operatively or during the postoperative period. Regarding the endothelial count, no significant differences were found during the pre-operative and postoperative follow-up periods between the two groups. Fortunately, no intra or postoperative complications as cataract, keratitis or lens decentration had occurred. Conclusions: Toric IPCL is a suitable alternative to T-ICL for the management of high myopia with astigmatism, especially in developing countries, as it is cheaper and easier for implantation than T-ICL. However, data over longer follow-up periods are needed to confirm its safety and stability.

Keywords: T-ICL, Toric IPCL, IOP, corneal endothelium

Procedia PDF Downloads 145

Authors: Godiya Atsiya Pius

Abstract:

The recent dimension of terrorist attacks and violence in West Africa and Nigeria in particular has attracted both academic and global concerns. Children, young girls and women are now victims of violent attacks and insurgency in their own country. Today, we have a reverse situation where women and children were spared during violence in the past. Empirical evidence shows that millions of children, young girls and women are caught up in violent attacks in which they are not merely spectatorial, but victims of circumstance. Some fall victims of a general onslaught against civilians by the drivers of such conflicts. Others die as part of a calculated genocide. Still others are taken as hostages as part of a deliberate attack on them. With particular reference to over 200 Chibok school girls that were abducted by the Boko Haram Islamic sect in Maiduguri, Borno state, Nigeria, this study shall attempt a theoretical exploration of the circumstances surrounding the insurgency attacks on these categories of vulnerable groups in Nigeria. This paper also intends to examine the nature, dimensions, causes, effects as well as implications of these attacks on women and children in West Africa. The paper shall sum up with conclusion and possible recommendations that could help the region in the 21st century and beyond.

Keywords: insurgency, gender, violence, security, vulnerable groups

Procedia PDF Downloads 465

Authors: Ebru Thwaites Diken

Abstract:

This article analyzes the works of certain directors in Danish cinema, namely Susanne Bier and Lone Sherfig, in the context of transnationalisation of Danish cinema. It looks at how the films' narratives negotiate and reconstruct the local / national / regional and the global. Scholars such as Nestingen & Elkington (2005), Hjort (2010), Higbee and Lim (2010), Bondebjerg and Redvall (2011) address transnationalism of Danish cinema in terms of production and distribution processes and how film making trascends national boundaries. This paper employs a particular understanding of transnationalism - in terms of how ideas and characters travel - to analyze how the storytelling and style has evolved to connect the national, the regional and the global on the basis of the works of these two directors. Strategies such as Hollywoodization - i.e. focus on stardom and classical narration, adhering to conventional European genre formulas, producing Danish films in English language have been identifiable strategies in Danish cinema in the period after the 2000s. Susanne Bier and Lone Scherfig are significant for employing some of these strategies simultaneously. For this reason, this article will look at how these two directors have employed these strategies and negotiated the cultural boundaries and exchanges.

Keywords: danish cinema, transnational cinema, susanne bier, lone scherfig, national cinema

Procedia PDF Downloads 66

Authors: Nazli Akhlaghinia, Ali Rajabzadeh Ghatari

Abstract:

In today's world, with increasing environmental awareness, firms are facing severe pressure from various stakeholders, including the government and customers, to reduce their harmful effects on the environment. Over the past few decades, the increasing effects of global warming, climate change, waste, and air pollution have increased the global attention of experts to the issue of the green supply chain and led them to the optimal solution for greenery. Green supply chain management (GSCM) plays an important role in motivating the sustainability of the organization. With increasing environmental concerns, the main objective of the research is to use system thinking methodology and Vensim software for designing a dynamic system model for green supply chain and observing behaviors. Using this methodology, we look for the effects of a green supply chain structure on the behavioral dynamics of output variables. We try to simulate the complexity of GSCM in a period of 30 months and observe the complexity of behaviors of variables including sustainability, providing green products, and reducing energy consumption, and consequently reducing sample pollution.

Keywords: supply chain management, green supply chain management, system dynamics, energy consumption

Procedia PDF Downloads 135

Authors: Michael Bellas, George Voulgaridis

Abstract:

This paper refers to the world known mega - landslide induced at the community of Ropoto, belonging to the Municipality of Trikala, in the Central part of Greece. The landslide affected the debris as well as the colluvium mantle of the flysch, and makes up a special case of study in engineering geology and geotechnical engineering not only because of the size of the domain affected by the landslide (approximately 750m long), but also because of the geostructure’s global behavior. Due to the landslide, the whole community’s infrastructure massively collapsed and human lives were put in danger. After the complete simulation of the coupled Seepage - Deformation phenomenon due to the extreme rainfall, and by closely examining the slope’s global behavior, both the mitigation of the landslide, as well as, an advanced surveillance method (Fiber Bragg Grating) using fiber optics were further studied, in order both to retain the geostructure and to monitor its health by creating an early warning system, which would serve as a complete safety net for saving both the community’s infrastructure as well as the lives of its habitats.

Keywords: landslide, remediation measures, the finite element method (FEM), Fiber Bragg Grating (FBG) sensing method

Procedia PDF Downloads 323

Authors: Anupam Sibal

Abstract:

Apollo Quality Program(AQP) was launched across the Apollo Group of Hospitals to address the four patient safety areas; Safety during Clinical Handovers, Medication Safety, Surgical Safety and the six International Patient Safety Goals(IPSGs) of JCI. A measurable, online, quality dashboard covering 20 process and outcome parameters was devised for monthly monitoring. The expected outcomes were also defined and categorized into green, yellow and red ranges. An audit methodology was also devised to check the processes for the measurable dashboard. Documented clinical handovers were introduced for the first time at many locations for in-house patient transfer, nursing-handover, and physician-handover. Prototype forms using the SBAR format were made. Patient-identifiers, read-back for verbal orders, safety of high-alert medications, site marking and time-outs and falls risk-assessment were introduced for all hospitals irrespective of accreditation status. Measurement of Surgical-Site-Infection (SSI) for 30 days postoperatively, was done. All hospitals now tracked the time of administration of antimicrobial prophylaxis before surgery. Situations with high risk of retention of foreign body were delineated and precautionary measures instituted. Audit of medications prescribed in the discharge summaries was made uniform. Formularies, prescription-audits and other means for reduction of medication errors were implemented. There is a marked increase in the compliance to processes and patient safety outcomes. Compliance to read-back for verbal orders rose from 86.83% in April’11 to 96.95% in June’15, to policy for high alert medications from 87.83% to 98.82%, to use of measures to prevent wrong-site, wrong-patient, wrong procedure surgery from 85.75% to 97.66%, to hand-washing from 69.18% to 92.54%, to antimicrobial prophylaxis within one hour before incision from 79.43% to 93.46%. Percentage of patients excluded from SSI calculation due to lack of follow-up for the requisite time frame decreased from 21.25% to 10.25%. The average AQP scores for all Apollo Hospitals improved from 62 in April’11 to 87.7 in Jun’15.

Keywords: clinical handovers, international patient safety goals, medication safety, surgical safety

Procedia PDF Downloads 254

Authors: Frederick Johnson

Abstract:

Product management has a long and well-established history within the consumer goods industry, despite being one of the most obscure aspects of brand management. Many global manufacturing organizations are now opting for external cloud-based Manufacturing Execution Systems (MES) to replace costly and outdated monolithic MES solutions. Other global manufacturing leaders are restructuring their organizations to support human-centered values, agile methodologies, and fluid operating principles. Still, industry-leading organizations struggle to apply the appropriate framework for managing evolving external MES solutions as internal "digital products." Product management complements these current trends in technology and philosophical thinking in the market. This paper discusses the central problems associated with adopting product management processes by analyzing its traditional theories and characteristics. Considering these ideas, the article then constructs a translated internal digital product management framework by combining new and existing approaches and principles. The report concludes by demonstrating the framework's capabilities and potential effectiveness in achieving digital maturity and business agility within a manufacturing environment.

Keywords: internal product management, digital transformation, manufacturing information technology, manufacturing execution systems

Procedia PDF Downloads 128

Authors: Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Lawal Abdurraheem Maidoki, Nnodimele Onuigbo Atulomah

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Background: Hepatitis B virus infection remains a significant global public health challenge with infectivity as well as the potential for transmission more than 50 to 100 times that of HIV. Annually, global HBV-related mortality is linked primarily to cirrhosis and liver carcinoma. The ever-increasing endemicity of HBV among children under-5-years, owing to vertical transmission and its lingering chronicity in developing countries, will hamper the global efforts concertedly endorsed towards eliminating viral hepatitis as a global public health threat by 2030. Objective: This study assessed information motivation behavioral skills model constructs as predictors of HBV infection prevention practices among consenting expectant mothers attending antenatal care in Central Uganda as a focal point of intervention towards breaking materno-foetal transmission of HBV. Methods: A cross-sectional study with a quantitative data collection approach based on the constructs of the IMB model was used to capture data on the study variables among 385 randomly selected pregnant women between September and October 2020. Data derived from the quantitative instrument were transformed into weighted aggregate scores using SPSS version 26. ANOVA and regression analysis were done to ascertain the study hypotheses with a significance level set as (p ≤ 0.05). Results: Relatively 60% of the respondents were aged between 18 and 28. Expectant mothers with secondary education (42.3%) were predominant. Furthermore, an average but inadequate knowledge (X ̅=5.97±6.61; B=0.57; p<.001), incorrect perception (X ̅=17.10±18.31; B=0.97; p=.014), and good behavioral skills (X ̅=12.39±13.37; B=0.56; p<.001) for adopting prevention practices all statistically predicted the unsatisfactory level of prevention practices (X ̅=15.03±16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. Conclusion: Evidence from this study corroborates the imperativeness of IMB constructs in reducing the burden of HBV infection in developing countries. Therefore, the inadequate HBV knowledge and misperception among obstetric populations necessitate personalized health education during antenatal visits and subsequent health campaigns in order to inform better prevention practices and, in turn, reduce the lingering chronicity of HBV infection in developing countries.

Keywords: behavioral skills, HBV infection, knowledge, perception, pregnant women, prevention practices

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Authors: Luiz Antonio Da Costa Rodrigues, Mara Aparecida De Castilho Lopes, Alexandre Santos Alencar

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Teaching of science must transcend simple transmission of fundamental concepts and allow scientific literacy, as a process for understanding the human being as an integral part of a complex and interdependent whole. In this context, approaching the theme ‘Antarctica’ in deaf education is an important advance for teaching, considering that that continent has direct interactions with the climatic and environmental system of the planet. Therefore, textbooks can be important tools to enable the Deaf Community to access the discussion about the natural environment. A specific script was used to analyze textbooks adopted by schools in the Rio de Janeiro Metropolitan Region. Results show that none of the 14 analyzed books have a specific chapter on the theme, some presents images of the continent without reference to their environmental importance, and the complementary texts present in the analyzed material do not address the theme either. It is concluded that the study on Antarctica and global changes in elementary education is still incipient and the material used by most Brazilian public schools does not contemplate that subject in an accessible way for the deaf person. This fact represents the distance between deaf students and their environment, denoting the need for actions to promote that and other neglected themes in Science teaching.

Keywords: Antarctica, deaf education, science teaching, textbook

Procedia PDF Downloads 273

Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

Abstract:

Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Tarek Duzan, Walid Eddib

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The marine shallow carbonate reservoir (G- Eocene) is one of the biggest mature water drive reservoir of Waha Oil Company. The cumulative oil produced up to date is about to eighty percent of the booked original oil in place at ninety five percent of Water cut. However, the company believes that there is a good amount of remaining oil left need to be recovered. Many laboratory studies have been conducted to see the possibility drain the commercial oil left behind using two types of gases, namely, carbone dioxide and enriched hydrocarbon gas injection. The conclusions of those cases were inconclusive Technically and Economically. Therefore, the company has decided to verify another Tertiary Recovery (EOR) technique that may be applied to the interested reservoir. A global screening criteria and quick Laboratory chemical tests have been conducted by using many types of chemical injection into real rock samples. The outcomes were unique economically and provide a significant increase in the commercial oil left. Finally, the company has started conducting a sector pilot plan before proceeding with a full plan. There are many wellbores available to use in a potential field Enhanced Oil Recovery.

Keywords: chemical lab. test, ASP, rock types, oil samples, and global screening criteria

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Authors: Billel Kenidra, Mohamed Benmohammed

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Data mining technique used in the field of clustering is a subject of active research and assists in biological pattern recognition and extraction of new knowledge from raw data. Clustering means the act of partitioning an unlabeled dataset into groups of similar objects. Each group, called a cluster, consists of objects that are similar between themselves and dissimilar to objects of other groups. Several clustering methods are based on partitional clustering. This category attempts to directly decompose the dataset into a set of disjoint clusters leading to an integer number of clusters that optimizes a given criterion function. The criterion function may emphasize a local or a global structure of the data, and its optimization is an iterative relocation procedure. The K-Means algorithm is one of the most widely used partitional clustering techniques. Since K-Means is extremely sensitive to the initial choice of centers and a poor choice of centers may lead to a local optimum that is quite inferior to the global optimum, we propose a strategy to initiate K-Means centers. The improved K-Means algorithm is compared with the original K-Means, and the results prove how the efficiency has been significantly improved.

Keywords: microarray data mining, biological pattern recognition, partitional clustering, k-means algorithm, centroid initialization

Procedia PDF Downloads 187

Authors: K. Rhea Devaiah, B. S. Premalatha

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Background: Tonsillar Lingual sulcus is the area between the tonsils and the base of the tongue. The surgical resection of the lesions in the head and neck results in changes in speech and swallowing functions. The severity of the speech and swallowing problem depends upon the site and extent of the lesion, types and extent of surgery and also the flexibility of the remaining structures. Need of the study: This paper focuses on the importance of speech and swallowing rehabilitation in an individual with the lesion in the Tonsillar Lingual Sulcus and post-operative functions. Aim: Evaluating the speech and swallow functions post-intensive speech and swallowing rehabilitation. The objectives are to evaluate the speech intelligibility and swallowing functions after intensive therapy and assess the quality of life. Method: The present study describes a report of an individual aged 47years male, with the diagnosis of basaloid squamous cell carcinoma, left tonsillar lingual sulcus (pT2n2M0) and underwent wide local excision with left radical neck dissection with PMMC flap reconstruction. Post-surgery the patient came with a complaint of reduced speech intelligibility, and difficulty in opening the mouth and swallowing. Detailed evaluation of the speech and swallowing functions were carried out such as OPME, articulation test, speech intelligibility, different phases of swallowing and trismus evaluation. Self-reported questionnaires such as SHI-E(Speech handicap Index- Indian English), DHI (Dysphagia handicap Index) and SESEQ -K (Self Evaluation of Swallowing Efficiency in Kannada) were also administered to know what the patient feels about his problem. Based on the evaluation, the patient was diagnosed with pharyngeal phase dysphagia associated with trismus and reduced speech intelligibility. Intensive speech and swallowing therapy was advised weekly twice for the duration of 1 hour. Results: Totally the patient attended 10 intensive speech and swallowing therapy sessions. Results indicated misarticulation of speech sounds such as lingua-palatal sounds. Mouth opening was restricted to one finger width with difficulty chewing, masticating, and swallowing the bolus. Intervention strategies included Oro motor exercise, Indirect swallowing therapy, usage of a trismus device to facilitate mouth opening, and change in the food consistency to help to swallow. A practice session was held with articulation drills to improve the production of speech sounds and also improve speech intelligibility. Significant changes in articulatory production and speech intelligibility and swallowing abilities were observed. The self-rated quality of life measures such as DHI, SHI and SESE Q-K revealed no speech handicap and near-normal swallowing ability indicating the improved QOL after the intensive speech and swallowing therapy. Conclusion: Speech and swallowing therapy post carcinoma in the tonsillar lingual sulcus is crucial as the tongue plays an important role in both speech and swallowing. The role of Speech-language and swallowing therapists in oral cancer should be highlighted in treating these patients and improving the overall quality of life. With intensive speech-language and swallowing therapy post-surgery for oral cancer, there can be a significant change in the speech outcome and swallowing functions depending on the site and extent of lesions which will thereby improve the individual’s QOL.

Keywords: oral cancer, speech and swallowing therapy, speech intelligibility, trismus, quality of life

Procedia PDF Downloads 104

Authors: Zeynep Aksoy

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Since global mobility of capital, information and people increase more and more, intercultural communication and management become a growing study field of investigating various aspects of the interaction between people from different cultural backgrounds. Human mobility, caused by several intentions from tourism to forced migration, often put people in facing communication barriers, issues or sometimes conflicts. This reality naturally enforces education institutions to develop international policies and programs for students in order to improve their intercultural experiences along with the educative objectives. Study-abroad programs, particularly the student exchanges in higher education provide an environment for participants to encounter with cultural differences. Therefore, international exchange programs (i.e. Erasmus Student Mobility, Global Exchange Program) are accepted to bring opportunities for intergroup contact, which may lead students to obtain new perspectives about the host culture, either in positive or negative ways, and new intercultural communication skills. This study aims to explore the role of short-term study abroad experience on intercultural communication competence with a qualitative approach. It attempts to reveal a comparative analysis, which is derived from two field studies conducted in Izmir (Turkey) and in Amsterdam (the Netherlands) in 2015 and 2016. They were both organized in two phases as pre-and-posttest to gain an insight into the changes (if any) in students’ attitudes and knowledge regarding the host culture, and their further motivations towards cross-cultural interactions. With this aim, focus group sessions and in-depth interviews have been taken place with participants at the beginning of their stay and at the end of the semester. The sample covers students mainly from Erasmus program (20 students in Izmir and 14 students in Amsterdam), and few from Global Exchange Program (5 students in Amsterdam). Data obtained from both studies were thematically analyzed and essential themes were identified within the framework of intercultural communication competence.

Keywords: Erasmus student mobility, intercultural communication competence, student exchange, short-term study abroad

Procedia PDF Downloads 256

Authors: Sugam Kale, Arif Uzair Bin Mohammed Roslan, Cindy Lee, Syed Beevee Mohammed Ismail

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Preemptive analgesia is an established concept in the modern practice of anaesthesia. To be most effective, it is best instituted earlier than the surgical stimulus and should last beyond the offset of surgically induced pain till healing is complete. Whereas the start of afferent pain blockade with regional anaesthesia is common, its effect often falls short to cover the entire period of pain impulses making their way to CNS in the post-operative period. We tried to use a combination of two regional anaesthetic techniques used sequentially to overcome this handicap. Madam S., a 56 year old lady, was scheduled for elective surgery for pancreatic cancer. She underwent laparotomy and distal pancreatectomy, splenectomy, bilateral salpingo oophorectomy, and sigmoid colectomy. Surgery was expected to be extensive, and it was presumed that the standard pain relief with PCA with opiates and oral analgesics would not be adequate. After counselling the patient pre-operative about the technique of regional anaesthesia techniques, including epidural catheterization and rectus sheath catheter placement, their benefits, and potential complications, informed consent was obtained. Epidural catheter was placed awake, and general anaesthesia was then induced. Epidural infusion of local anaesthetics was started prior to surgical incision and was continued till 60 hours into the postoperative period. Before skin closure, the surgeons inserted commercially available rectus sheath catheters bilaterally along the midline incision used for laparotomy. After 46 hours post-op, local anaesthetic infusion via these was started as bridging while the epidural infusion rate was tapered off. The epidural catheter was removed at 75 hours. Elastomeric pumps were used to provide local anaesthetic infusion with the ability to vary infusion rates. Acute pain service followed up the patient’s vital signs and effectiveness of pain relief twice daily or more frequently as required. Rectus sheath catheters were removed 137 hours post-op. The patient had good post-op analgesia with the minimal additional analgesic requirement. For the most part, the visual analog score (VAS) for pain remained at 1-3 on a scale of 1 to 10. Haemodynamics remained stable, and surgical recovery was as expected. Minimal opiate requirement after an extensive laparotomy also translates to the early return of intestinal motility. Our experience was encouraging, and we are hoping to extend this combination of two regional anaesthetic techniques to patients undergoing similar surgeries. Epidural analgesia is denser and offers excellent pain relief for both visceral and somatic pain in the first few days after surgery. As the pain intensity grows weaker, rectus sheath block and oral analgesics provide almost the same degree of pain relief after the epidural catheter is removed. We discovered that the background infusion of local anaesthetic down the rectus sheath catherter largely reduced the requirement for other classes of analgesics. We aim to study this further with a larger patient cohort and hope that it may become an established clinical practice that benefits patients everywhere.

Keywords: rectus sheath, epidural infusion, post operative analgesia, elastomeric

Procedia PDF Downloads 127

Authors: R. W. Walker, J. M. Lynch, K. Anderson, R. G. Middleton

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Hip and knee arthritis are two of the commonest conditions that result in elective orthopaedic outpatient referral. At clinic appointments advice given regarding lifestyle modifications or treatment options may not be fully understood by patients. The majority of patients now use the internet to research their condition and use this to inform their decision about treatments. This study assessed the quality of patient information regarding hip and knee arthritis. To assess the quality of patient information regarding knee and hip arthritis available on the internet. Two internet searches were carried out one month apart using the search terms “knee arthritis” and “hip arthritis” on Google, a search engine that accounts for over 90% or internet searches in the UK. Sites were evaluated using the DISCERN instrument, a validated tool for measuring the quality of consumer health information. The first 50 results for each search were analysed by two different observers and discrepancies in scores were reviewed by both observers together and a score was agreed upon. In total 200 search result websites were assessed, of which 84 fulfilled the inclusion criteria. 53% (n=44) were funded directly by commercial healthcare businesses and of these, 70% (n=31) were funded by a surgeon/hospital promoting end-user purchase of surgical intervention. Overall 35% (n=29) websites were “for-profit” information websites where funding was from advertising revenues from pharmaceutical and prosthesis companies. 81% (n=67) offered information about surgical treatments however only 43% (n=36) mentioned the risk of complications of surgery. 67% (n=56) did not have any reference to sources for the information they detailed and 57% (n=47) had no apparent date for the production of the information they offered. Overall 17% (n=14) of websites were judged as being of high quality, with 29% (n=24) being of moderate quality and 54% (n=45) being of low quality. The quality of health information regarding hip and knee arthritis on the internet is highly variable and the majority of websites assessed were of poor quality. A preponderance of websites were funded by a commercial surgical service offering athroplasty at consumer cost, with a further third being funded indirectly via advertising revenues from commercial businesses. The vast majority of websites only mentioned surgery as a treatment and nearly half of all websites did not mention the risks or complications of surgical intervention at all. This has implications for the consent process. As such, Clinicians should be aware of the heterogeneous nature of patient information on the internet and be prepared to advise their patients about good quality websites where further reliable information can be sought.

Keywords: hip osteoarthritis, informed consent, knee osteoarthritis, patient information

Procedia PDF Downloads 90