Search results for: food quality

Authors: Raymond Treacy, Paul Humphreys, Ronan McIvor, Trevor Cadden, Alan McKittrick

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This study employed event study methodology to examine the role of institutions, resources and dynamic capabilities in the relationship between the Environmental Management System ISO 14001 adoption and firm performance. Utilising financial data from 140 ISO 14001 certified firms and 320 non-certified firms, the results of the study suggested that the UK and Irish manufacturers were not implementing ISO 14001 solely to gain legitimacy. In contrast, the results demonstrated that firms were fully integrating the ISO 14001 standard within their operations as certified firms were able to improve both financial and operating performance when compared to non-certified firms. However, while there were significant and long lasting improvements for employee productivity, manufacturing cost efficiency, return on assets and sales turnover, the sample firms operating cycle and fixed asset efficiency displayed evidence of diminishing returns in the long-run, underlying the observation that no operating advantage based on incremental improvements can be everlasting. Hence, there is an argument for investing in dynamic capabilities which help renew and refresh the resource base and help the firm adapt to changing environments. Indeed, the results of the regression analysis suggest that dynamic capabilities for innovation acted as a moderator in the relationship between ISO 14001 certification and firm performance. This, in turn, will have a significant and symbiotic influence on sustainability practices within the participating organisations. The study not only provides new and original insights, but demonstrates pragmatically how firms can take advantage of environmental management systems as a moderator to significantly enhance firm performance. However, while it was shown that firm innovation aided both short term and long term ROA performance, adaptive market capabilities only aided firms in the short-term at the marketing strategy deployment stage. Finally, the results have important implications for firms operating in an economic recession as the results suggest that firms should scale back investment in R&D while operating in an economic downturn. Conversely, under normal trading conditions, consistent and long term investments in R&D was found to moderate the relationship between ISO 14001 certification and firm performance. Hence, the results of the study have important implications for academics and management alike.

Keywords: supply chain management, environmental management systems, quality management, sustainability, firm performance

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Authors: Noor Ismael, Somaya Malkawi, Sherin Al Awady, Taleb Ismael

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Background/Significance: Cancer is a serious health condition that affects individuals’ quality of life during and after the course of this condition. Children who have survived cancer and their caregivers may deal with residual physical, cognitive or social disabilities. There is little research on caregivers’ health and wellbeing after cancer. To the authors’ best knowledge; there is no specific research about how caregivers cope with everyday stressors after cancer. Therefore, this study aimed to explore the coping strategies that caregivers of children who have survived cancer utilize to overcome everyday stressors. Methods: This study utilized a descriptive survey design. The sample consisted of 103 caregivers, who visited the health and wellness clinic at a national cancer center (additional demographics are presented in the results). The sample included caregivers of children who were off cancer treatments for at least two years from the beginning of data collection. The institution’s internal review board approved this study. Caregivers who agreed to participate completed the survey. The survey collected caregiver reported demographic information and the Brief COPE which measures caregivers' frequency of engaging in certain coping strategies. The Brief COPE consisted of 14 coping sub-scales, which are self-distraction, active coping, denial, substance use, use of emotional support, use of instrumental support, behavioral disengagement, venting, positive reframing, planning, humor, acceptance, religion, and self-blame. Data analyses included calculating sub-scales’ scores for the fourteen coping strategies and analysis of frequencies of demographics and coping strategies. Results: The 103 caregivers who participated in this study were 62% mothers, 80% married, 45% finished high school, 50% do not work outside the house, and 60% have low family income. Result showed that religious coping (66%) and acceptance (60%) were the most utilized coping strategies, followed by positive reframing (45%), active coping (44%) and planning (43%). The least utilized coping strategies in our sample were humor (5%), behavioral disengagement (8%), and substance-use (10%). Conclusions: Caregivers of children who have survived cancer mostly utilize religious coping and acceptance in dealing with everyday stressors. Because these coping strategies do not directly solve stressors like active coping and planning coping strategies, it is important to support caregivers in choosing and implementing effective coping strategies. Knowing from our results that some caregivers may utilize substance use as a coping strategy, which has negative health effects on caregivers and their children, there must be direct interventions that target these caregivers and their families.

Keywords: caregivers, cancer, stress, coping

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Authors: Arlan S. Freitas, Leila M. Carvalho, Adriana L. Soares, Arnoud Neto, Marta S. Madruga, Elza I. Ida, Massami Shimokomaki

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The objective of this work was to evaluate the influence of microclimatic profile of broiler transport trucks under commercial conditions over the breast meat quality and DOA (Death On Arrival) in a tropical Brazilian regions as the North East where routinely the season is divided into dry and wet seasons. The temperature remains fairly constant and obviously the relative humidity changes accordingly. Three loads of 4,100 forty seven days old broiler were monitored from farm to slaughterhouse in a distance of 4.3 km, morning period of October 2015 rainy days. The profile of the environmental variables inside the container truck throughout the journey was obtained by the installation of thermo anemometers in 6 different locations by monitoring the heat index (HI), air velocity (AV), temperature (T), and relative humidity (RH). Meat qualities were evaluated by determining the occurrence of PSE (pale, soft, exudative) meat and DFD (dark, firm dry) meat. The percentage of birds DOA per loaded truck was determined by counting the dead broiler during the hanging step at the slaughtering plant. The analysis of variance was performed using statistical software (Statistica 8 for windows, Statsoft 2007, Tulsa, OK, USA). The Tukey significance test (P<0.05) was applied to compare means from microenvironmental data, PSE, DFD and DOA. Fillet samples were collected at 24h post mortem for pH e color (L*, a* e b*) determination through the CIELAB system. Results showed the occurrence of 2.98% of PSE and 0.66% de DFD and only 0.016% of DOA and overall the most uncomfortable container location was at the truck frontal inferior presenting 6.25% of PSE. DFD of 2.0% were obtained from birds located at central and inferior rear locations. These values were unexpected in comparison to other results obtained in our laboratories in previous experiments carried out within the country south state. The results reported herein were lower in every aspect. Reasonable explanation would be the shorter distance, wet conditions throughout around 15-20 min journeys and lower T and RH values as observed in samples taken from the rear location as higher DFD values were obtained. These facts mean the animals were not under heat stressful condition but in fact under cold stress conditions as the result of DFD suggested in association to the lower number of DOA.

Keywords: cold stress, DFD, microclimatic profile, PSE

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Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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Authors: Shau-Ping Shiu, Shu-Ling Lin

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Pregnancy lead a process of changing in the endocrine system. Either pregnancy itself or the surrounding affect such as the attitude of family to the pregnant lady can bring lots of stress. Sever stress may lead pregnant women display serious mental problem such as mood swings, impulsivity, and abnormal behavior. A method of self management of stress(SMS) has been proved that help patient of cancer in release their stress. This study were going to use SMS to help pregnant women. Methods: In this study, 42 ladies in the first to third months of pregnancy process applied to join SMS of program have divided into 21 participants in both control and experimental group by draw. 24 sessions of Yoga program were conducted once a week for 6 months for experimental group. Verbatim used to gather more feedbacks from the interview followed by each Yoga sessions. Brief symptom Rating scale also conducted pre and post experiment for 42 participations. Results: Overall score of Brief Symptom Rating Scale reduced 17.82 points and suicide drop 9 points in experimental group, compared to the control group increasing 10.24 point of overall score and suicide add 7 points. Feedback from interviews showed participations improved in emotion, physical health and stress management. They indicated having more positive emotion daily, having better gastrointestinal peristalsis movement, releasing back tention, well weight control, reducing stress and changing the quality of interpersonal relationships. Conclusion: SMS of Yoga program in this study included four key training directions which were stimulation, relaxation, awareness and pranayama lead a great improvment of stress management for pregnant lady. Throughout this Yoga program, women learned to ignite eustress, remove distress, create calmness and breath slows down. As the result, Yoga program has helped women in experiment group lower their tension, and bring the extra benifits in emotion and relationships. It support women to overcome their pregnancy. Suggestion: An unexpected result of this study showed all participants had no morning sickness since they engaged in SMS program, and no one absent from course due to the benefits of it. We strongly suggest that SMS of Yoga program can be a add of medication for women in pregnancy, however, the position of Forward in the SMS sequence has been point out pressing participant’s stomach, which can be replace to Bridge position to comfort participants.

Keywords: self-management of stress(SMS), yoga program, pregnant women, early pregnancy

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Authors: Seval Kizildag, Ozge Can Aran

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The effective intervention of counselors’ in conflict between spouses may be effective in increasing the quality of marital relationship. At this point, it is necessary for counselors to consider their own value systems at first and then reflect this correctly to the counseling process. For this reason, it is primarily important to determine the needs of counselors. Starting from this point of view, in this study, it is aimed to reveal the perspective of counselor candidates about the universal values in marriage relation. The study group of the survey was formed by sampling, which is one of the prospective sampling methods. As a criterion being a candidate for counseling area and having knowledge of the concepts of the Marriage and Family Counseling course is based, because, that candidate students have a comprehensive knowledge of the field and that students have mastered the concepts of marriage and family counseling will strengthen the findings of this study. For this reason, 61 counselor candidates, 32 (52%) female and 29 (48%) male counselor candidates, who were about to graduate from a university in south-east Turkey and who took a Marriage and Family Counseling course, voluntarily participated in the study. The average age of counselor candidates’ is 23. At the same time, 70 % of the parents of these candidates brought about their marriage through arranged marriage, 13% through flirting, 8% by relative marriage, 7% through friend circles and 2% by custom. The data were collected through Demographic Information Form and a form titled ‘Universal Values Form in Marriage’ which consists of six questions prepared by researchers. After the data were transferred to the computer, necessary statistical evaluations were made on the data. The qualitative data analysis was used on the data which was obtained in the study. The universal values which include six basic values covering trustworthiness, respect, responsibility, fairness, caring, citizenship, determined under the name as ‘six pillar of character’ are used as base and frequency values of the data were calculated trough content analysis. According to the findings of the study, while the value which most students find the most important value in marriage relation is being reliable, the value which they find the least important is to have citizenship consciousness. Also in this study, it is found out that counselor candidates associate the value of being trustworthiness ‘loyalty’ with (33%) as the highest in terms of frequency, the value of being respect ‘No violence’ with (23%), the value of responsibility ‘in the context of gender roles and spouses doing their owns’ with (35%) the value of being fairness ‘impartiality’ with (25%), the value of being caring ‘ being helpful’ with (25%) and finally as to the value of citizenship ‘love of country’ with (14%) and’ respect for the laws ‘ with (14%). It is believed that these results of the study will contribute to the arrangements for the development of counseling skills for counselor candidates regarding value in marriage and family counseling curricula.

Keywords: caring, citizenship, counselor candidate, fairness, marriage relationship, respect, responsibility, trustworthiness, value system

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Authors: Suat Erel, Gozde Gur

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Background: Recently a supramalleolar type of dynamic ankle foot orthosis (DAFO) has been increasingly used to support all of the dynamic arches of the foot and redistribute the pressure under the plantar surface of the foot to reduce the muscle tone. DAFO helps to maintain balance and postural control by providing stability and proprioceptive feedback in children with disease like Cerebral Palsy, Muscular Dystrophies, Down syndrome, and congenital hypotonia. Aim: The aim of this study was to investigate the role of Dynamic ankle foot orthosis (DAFO) on temporo-spatial parameters of gait and balance in three children with hereditary spastic paraparesis (HSP). Material Method: 13, 14, and 8 years old three children with HSP were included in the study. To provide correction on weight bearing and to improve gait, DAFO was made. Lower extremity spasticity (including gastocnemius, hamstrings and hip adductor muscles) using modified Ashworth Scale (MAS) (0-5), The temporo-spatial gait parameters (walking speed, cadence, base of support, step length) and Timed Up & Go test (TUG) were evaluated. All of the assessments about gait were compared with (with DAFO and shoes) and without DAFO (with shoes only) situations. Also after six months follow up period, assessments were repeated by the same physical therapist. Results: MAS scores for lower extremity were between “2-3” for the first child, “0-2” for the second child and “1-2” for the third child. TUG scores (sec) decreased from 20.2 to 18 for case one, from 9.4 to 9 for case two and from 12,4 to 12 for case three in the condition with shoes only and also from 15,2 to 14 for case one, from 7,2 to 7,1 for case two and from 10 to 7,3 for case three in the condition with DAFO and shoes. Gait speed (m/sec) while wearing shoes only was similar but while wearing DAFO and shoes increased from 0,4 to 0,5 for case one, from 1,5 to 1,6 for case two and from 1,0 to 1,2 for case three. Base of support scores (cm) wearing shoes only decreased from 18,5 to 14 for case one, from 13 to 12 for case three and were similar as 11 for case two. While wearing DAFO and shoes, base of support decreased from 10 to 9 for case one, from 11,5 to 10 for case three and was similar as 8 for case two. Conclusion: The use of a DAFO in a patient with HSP normalized the temporo-spatial gait parameters and improved balance. Walking speed is a gold standard for evaluating gait quality. With the use of DAFO, walking speed increased in this three children with HSP. With DAFO, better TUG scores shows that functional ambulation improved. Reduction in base of support and more symmetrical step lengths with DAFO indicated better balance. These encouraging results warrant further study on wider series.

Keywords: dynamic ankle foot orthosis, gait, hereditary spastic paraparesis, balance in patient

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Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

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Diabetes mellitus is the most common etiology of end-stage renal disease (ESRD). Also, diabetic nephropathy is the etiology of ESRD in approximately 23% of kidney transplant recipients. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients. However, patients require close follow-up after transplantation due to medical complications. Diabetes mellitus can affect patient morbidity and mortality due to possible effects of immunosuppressive therapy on glucose metabolism. We compared the frequency of medical complications and the outcomes in diabetic and non-diabetic kidney transplant recipients. Materials and Methods: This retrospective study conducted in 498 patients who underwent kidney transplant surgery at our center in 10-year periods. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). The medical complications, graft functions, causes of graft loss and death were obtained from medical records. Results: There was no significant difference between recipient age, duration of dialysis, body mass index, gender, donor type, donor age, dialysis type, histories of HBV, HCV and coronary artery disease between two groups. The history of hypertension in diabetics was higher (69% vs. 36%, p < 0.001). The ratios of hypertension (50.1% vs. 57.1%), pneumonia (21.9% vs. 20%), urinary infection (16.9% vs. 20%), transaminase elevation (11.5% vs. 20%), hyperpotasemia (14.7% vs. 17.1%), hyponatremia (9.7% vs. 20%), hypotension (7.1% vs. 7.9%), hypocalcemia (1.4% vs. 0%), thrombocytopenia (8.6% vs. 8.6%), hypoglycemia (0.7% vs. 0%) and neutropenia (1.8% vs. 0%) were comparable in non-diabetic and diabetic groups, respectively. The frequency of hyperglycaemia in diabetics was higher (8.6% vs. 54.3%, p < 0.001). After transplantation, primary non-function (3.4% vs. 2.6%), delayed graft function (25.1% vs. 34.2%) and acute rejection (7.3% vs. 10.5%) ratios of in non-diabetic and diabetic groups were similar, respectively. Hospitalization durations in non-diabetics and diabetics were 22.5 ± 17.5 and 18.7 ± 13 day (p=0.094). Mean serum creatinine levels in non-diabetics and diabetics were 1.54 ± 0.74 and 1.52 ± 0.62 mg/dL at 6th month. Forty patients had graft loss. The ratios of graft loss and death in non-diabetic and diabetic groups were 8.2% vs. 7.1% and 7.1% vs. 2.6% (p > 0.05). There was no significant relationship between graft and patient survivals with the development of medical complication. Conclusion: As a result, medical complications are common in the early period. Hyperglycaemia was frequently seen following transplantation due to the effects of immunosuppressant regimens. However, the frequency of other medical complications in diabetic patients did not differ from non-diabetic one. The most important cause of death is still infections. The development of medical complications during the first 6 months did not significantly affect transplant outcomes.

Keywords: kidney transplantation, diabetes mellitus, complication, graft function

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Authors: Juliet Sorensen, Anna Maitland

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Introduction: Characterized by lack of water and sanitation, food insecurity, and low access to hospitals and clinics, informal urban settlements in Lagos, Nigeria have very poor health outcomes. With little education and a general inability to demand basic rights, these communities are often disempowered and isolated from understanding, claiming, or owning their health needs. Utilizing community-based participatory research characterized by interdisciplinary, cross-cultural partnerships, evidence-based assessments, and both primary and secondary source research, a holistic health education and advocacy program was developed in Lagos to address health barriers for targeted communities. This includes a first of its kind guide formulated to teach community-based health educators how to transmit health information to low-literacy Nigerian audiences while supporting behavior change models and social support mechanisms. This paper discusses the interdisciplinary contributions to developing a health education program while also looking at the need for greater beneficiary ownership and implementation of health justice and access. Methods: In March 2016, an interdisciplinary group of medical, legal, and business graduate students and faculty from Northwestern University conduced a Health Needs Assessment (HNA) in Lagos with a partner and a local non-governmental organization. The HNA revealed that members of informal urban communities in Lagos were lacking basic health literacy, but desired to remedy this lacuna. Further, the HNA revealed that even where the government mandates specific services, many vulnerable populations are unable to access these services. The HNA concluded that a program focused on education, advocacy, and organizing around anatomy, maternal and sexual health, infectious disease and malaria, HIV/AIDS, emergency care, and water and sanitation would respond to stated needs while also building capacity in communities to address health barriers. Results: Based on the HNA, including both primary and secondary source research on integrated health education approaches and behavior change models and responsive, adaptive material development, a holistic program was developed for the Lagos partners and first implemented in November 2016. This program trained community-nominated health educators in adult, low-literacy, knowledge exchange approaches, utilizing information identified by communities as a priority. After a second training in March 2017, these educators will teach community-based groups and will support and facilitate behavior change models and peer-support methods around basic issues like hand washing and disease transmission. They will be supported by community paralegals who will help ensure that newly trained community groups can act on education around access, such as receiving free vaccinations, maternal health care, and HIV/AIDS medicines. Materials will continue to be updated as needs and issues arise, with a focus on identifying best practices around health improvements that can be shared across these partner communities. Conclusion: These materials are the first of their kind, and address a void of health information and understanding pervasive in informal-urban Lagos communities. Initial feedback indicates high levels of commitment and interest, as well as investment by communities in these materials, largely because they are responsive, targeted, and build community capacity. This methodology is an important step in dignity-based health justice solutions, albeit in the process of refinement.

Keywords: community health educators, interdisciplinary and cross cultural partnerships, health justice and access, Nigeria

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Authors: Tsepiso Mofolo, Luna Bergh

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The Lesotho construction industry fails to embrace environmental practices, which has then lead to excessive consumption of resources, land degradation, air and water pollution, loss of habitats, and high energy usage. The industry is highly inefficient, and this undermines its capability to yield the optimum contribution to social, economic and environmental developments. Sustainable construction is, therefore, imperative to ensure the cultivation of benefits from all these intrinsic themes of sustainable development. The development of a sustainable construction industry requires a holistic approach that takes into consideration the interaction between Lean Construction principles, socio-economic and environmental policies, technological advancement and the principles of construction or project management. Sustainable construction is a cutting-edge phenomenon, forming a component of a subjectively defined concept called sustainable development. Sustainable development can be defined in terms of attitudes and judgments to assist in ensuring long-term environmental, social and economic growth in society. The key concept of sustainable construction is Lean Construction. Lean Construction emanates from the principles of the Toyota Production System (TPS), namely the application and adaptation of the fundamental concepts and principles that focus on waste reduction, the increase in value to the customer, and continuous improvement. The focus is on the reduction of socio-economic waste, and protestation of environmental degradation by reducing carbon dioxide emission footprint. Lean principles require a fundamental change in the behaviour and attitudes of the parties involved in order to overcome barriers to cooperation. Prevalent barriers to adoption of Lean Construction in Lesotho are mainly structural - such as unavailability of financing, corruption, operational inefficiency or wastage, lack of skills and training and inefficient construction legislation and political interferences. The consequential effects of these problems trigger down to quality, cost and time of the project - which then result in an escalation of operational costs due to the cost of rework or material wastage. Factor and correlation analysis of these barriers indicate that they are highly correlated, which then poses a detrimental potential to the country’s welfare, environment and construction safety. It is, therefore, critical for Lesotho’s construction industry to develop a robust governance through bureaucracy reforms and stringent law enforcement.

Keywords: construction industry, sustainable development, sustainable construction industry, lean construction, barriers to sustainable construction

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Authors: Maria Jędrzejczak, Patryk Pieniążek

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The European legal reality is on the eve of significant change. In European Union law, there is talk of a “fourth industrial revolution”, which is driven by massive data resources linked to powerful algorithms and powerful computing capacity. The above is closely linked to technological developments in the area of artificial intelligence, which has prompted an analysis covering both the legal environment as well as the economic and social impact, also from an ethical perspective. The discussion on the regulation of artificial intelligence is one of the most serious yet widely held at both European Union and Member State level. The literature expects legal solutions to guarantee security for fundamental rights, including privacy, in artificial intelligence systems. There is no doubt that personal data have been increasingly processed in recent years. It would be impossible for artificial intelligence to function without processing large amounts of data (both personal and non-personal). The main driving force behind the current development of artificial intelligence is advances in computing, but also the increasing availability of data. High-quality data are crucial to the effectiveness of many artificial intelligence systems, particularly when using techniques involving model training. The use of computers and artificial intelligence technology allows for an increase in the speed and efficiency of the actions taken, but also creates security risks for the data processed of an unprecedented magnitude. The proposed regulation in the field of artificial intelligence requires analysis in terms of its impact on the regulation on personal data protection. It is necessary to determine what the mutual relationship between these regulations is and what areas are particularly important in the personal data protection regulation for processing personal data in artificial intelligence systems. The adopted axis of considerations is a preliminary assessment of two issues: 1) what principles of data protection should be applied in particular during processing personal data in artificial intelligence systems, 2) what regulation on liability for personal data breaches is in such systems. The need to change the regulations regarding the rights and obligations of data subjects and entities processing personal data cannot be excluded. It is possible that changes will be required in the provisions regarding the assignment of liability for a breach of personal data protection processed in artificial intelligence systems. The research process in this case concerns the identification of areas in the field of personal data protection that are particularly important (and may require re-regulation) due to the introduction of the proposed legal regulation regarding artificial intelligence. The main question that the authors want to answer is how the European Union regulation against data protection breaches in artificial intelligence systems is shaping up. The answer to this question will include examples to illustrate the practical implications of these legal regulations.

Keywords: data protection law, personal data, AI law, personal data breach

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Authors: Alberto Abello Moreno-Cid

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Mummification was the process through which immortality was granted to the deceased, so it was of extreme importance to the Egyptians. The techniques of embalming had evolved over the centuries, and specialists created increasingly sophisticated tools. However, due to its eminently religious nature, knowledge about everything related to this practice was jealously preserved, and the testimonies that have survived to our time are scarce. For this reason, embalming instruments found in archaeological excavations are uncommon. The tomb of the Vizier Amenhotep Huy (AT No. -28-), located in the el-Assasif necropolis that is being excavated since 2009 by the team of the Institute of Ancient Egyptian Studies, has been the scene of some discoveries of this type that evidences the existence of mummification practices in this place after the New Kingdom. The clysters or enemas are the fundamental tools in the second type of mummification described by the historian Herodotus to introduce caustic solutions inside the body of the deceased. Nevertheless, such objects only have been found in three locations: the tomb of Ankh-Hor in Luxor, where a copper enema belonged to the prophet of Ammon Uah-ib-Ra came to light; the excavation of the tomb of Menekh-ib-Nekau in Abusir, where was also found one made of copper; and the excavations in the Bucheum, where two more artifacts were discovered, also made of copper but in different shapes and sizes. Both of them were used for the mummification of sacred animals and this is the reason they vary significantly. Therefore, the object found in the tomb No. -28-, is the first known made of faience of all these peculiar tools and the oldest known until now, dated in the Third Intermediate Period (circa 1070-650 B.C.). This paper bases its investigation on the study of those parallelisms, the material, the current archaeological context and the full analysis and reconstruction of the object in question. The key point is the use of faience in the production of this item: creating a device intended to be in constant use seems to be a first illogical compared to other samples made of copper. Faience around the area of Deir el-Bahari had a strong religious component, associated with solar myths and principles of the resurrection, connected to the Osirian that characterises the mummification procedure. The study allows to refute some of the premises which are held unalterable in Egyptology, verifying the utilization of these sort of pieces, understanding its way of use and showing that this type of mummification was also applied to the highest social stratum, in which case the tools were thought out of an exceptional quality and religious symbolism.

Keywords: clyster, el-Assasif, embalming, faience enema mummification, Theban necropolis

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Authors: Vidya Nimkar Tayade

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Introduction: Intellectual capital of an organization is a key factor to success. Many companies invest a huge amount in their Research and development activities. Any innovation is helpful not only to that particular company but also to many other companies, industry and mankind as a whole. Companies undertake innovative changes for increasing their capital profitability and indirectly increase in pay packages of their employees. The quality of human capital can also improve due to such positive changes. Employees become more skilled and experienced due to such innovations and inventions. For increasing intangible capital, the author has referred to a couple of books and referred case studies to come to a conclusion. Different charts and tables are also referred to by the author. Case studies are more important because they are proven and established techniques. They enable students to apply theoretical concepts in real-world situations. It gives solutions to an open-ended problem with multiple potential solutions. There are three different strategies for undertaking intellectual capital increase. They are: Research push strategy/ Technology pushed approach, Market pull strategy/ approach and Open innovation strategy/approach. Research push strategy, In this strategy, research is undertaken and innovation is achieved on its own. After invention inventor company protects such invention and finds buyers for such invention. In this way, the invention is pushed into the market. In this method, research and development are undertaken first and the outcome of this research is commercialized. Market pull strategy, In this strategy, commercial opportunities are identified first and our research is concentrated in that particular area. For solving a particular problem, research is undertaken. It becomes easier to commercialize this type of invention. Because what is the problem is identified first and in that direction, research and development activities are carried on. Open invention strategy, In this type of research, more than one company enters into an agreement of research. The benefits of the outcome of this research will be shared by both companies. Internal and external ideas and technologies are involved. These ideas are coordinated and then they are commercialized. Due to globalization, people from the outside company are also invited to undertake research and development activities. Remuneration of employees of both the companies can increase and the benefit of commercialization of such invention is also shared by both the companies. Conclusion: In modern days, not only can tangible assets be commercialized, but also intangible assets can also be commercialized. The benefits of such an invention can be shared by more than one company. Competition can become more meaningful. Pay packages of employees can improve. It Is a need for time to adopt such strategies to benefit employees, competitors, stakeholders.

Keywords: innovation, protection, management, commercialization

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Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

Procedia PDF Downloads 123

Authors: Naif Mohsen Alharbi

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This paper present failure occurred on flexible coupling installed at oil anf gas operation. Also it presents maintenance ideas implemented on the flexible coupling installed to transmit high torque from gearbox to pump. Basically, the machine train is including steam turbine which drives the pump and there is gearbox located in between for speed reduction. investigation are identifying the root causes, solving and developing the technology designs or bad actor. This report provides the study intentionally for continues operation optimization, utilize the advanced opportunity and implement a improvement. Objective: The main objectives of the investigation are identifying the root causes, solving and developing the technology designs or bad actor. Ultimately, fulfilling the operation productivity, also ensuring better technology, quality and design by solutions. This report provides the study intentionally for continues operation optimization, utilize the advanced opportunity and implemet improvement. Method: The method used in this project was a very focused root cause analysis procedure that incorporated engineering analysis and measurements. The analysis method extensively covers the measuring of the complete coupling dimensions. Including the membranes thickness, hubs, bore diameter and total length, dismantle flexible coupling to diagnose how deep the coupling has been affected. Also, defining failure modes, so that the causes could be identified and verified. Moreover, Vibration analysis and metallurgy test. Lastly applying several solutions by advanced tools (will be mentioned in detail). Results and observation: Design capacity: Coupling capacity is an inadequate to fulfil 100% of operating conditions. Therefore, design modification of service factor to be at least 2.07 is crucial to address this issue and prevent recurrence of similar scenario, especially for the new upgrading project. Discharge fluctuation: High torque flexible coupling encountered during the operation. Therefore, discharge valve behaviour, tuning, set point and general conditions revaluated and modified subsequently, it can be used as baseline for upcoming Coupling design project. Metallurgy test: Material of flexible coupling membrane (discs) tested at the lab, for a detailed metallurgical investigation, better material grade has been selected for our operating conditions,

Keywords: high speed machine, reliabilty, flexible coupling, rotating equipment

Procedia PDF Downloads 69

Authors: Benedictus Asriparusa, Lathifah Al Hakimi, Aulia Husada

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A large amount of energy is being wasted by the release of natural gas associated with the oil industry. This release interrupts the environment particularly atmosphere layer condition globally which contributes to global warming impact. This research presents an overview of the methods employed by researchers in PT. Chevron Pacific Indonesia in the Minas area to determine a new prediction method of measuring and reducing gas flaring and its emission. The method emphasizes advanced research which involved analytical studies, numerical studies, modeling, and computer simulations, amongst other techniques. A flaring system is the controlled burning of natural gas in the course of routine oil and gas production operations. This burning occurs at the end of a flare stack or boom. The combustion process releases emissions of greenhouse gases such as NO2, CO2, SO2, etc. This condition will affect the chemical composition of air and environment around the boundary layer mainly during transition season. Transition season in Indonesia is absolutely very difficult condition to predict its pattern caused by the difference of two air mass conditions. This paper research focused on transition season in 2013. A simulation to create the new pattern of the pollutants distribution is needed. This paper has outlines trends in gas flaring modeling and current developments to predict the dominant variables in the pollutants distribution. A Fluent model is used to simulate the distribution of pollutants gas coming out of the stack, whereas WRF model output is used to overcome the limitations of the analysis of meteorological data and atmospheric conditions in the study area. Based on the running model, the most influence factor was wind speed. The goal of the simulation is to predict the new pattern based on the time of fastest wind and slowest wind occurs for pollutants distribution. According to the simulation results, it can be seen that the fastest wind (last of March) moves pollutants in a horizontal direction and the slowest wind (middle of May) moves pollutants vertically. Besides, the design of flare stack in compliance according to EPA Oil and Gas Facility Stack Parameters likely shows pollutants concentration remains on the under threshold NAAQS (National Ambient Air Quality Standards).

Keywords: flare motion, new prediction, pollutants distribution, transition season, WRF model

Procedia PDF Downloads 556

Authors: Tendü H. Göktuğ, Gönül T. İçemer, Bülent Deniz

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National parks, which are rich in natural and cultural resources values are protected in the context of the idea to develop sustainability, are among the most important recreated areas demanding with each passing day. Increasing recreational use or unplanned use forms negatively affect the resource values and visitor satisfaction. The intent of national parks management is to protect the natural and cultural resource values and to provide the visitors with a quality of recreational experience, as well. In this context, the current studies to improve the appropriate tourism and recreation planning and visitor management, approach have focused on recreational carrying capacity analysis. The aim of this study is to analyze recreational carrying capacity of Çıralı Coast in the Bey Mountains Coastal National Park to compare the analyze results with the current usage format and to develop alternative management strategies. In the first phase of the study, the annual and daily visitations, geographic, bio-physical, and managerial characteristics of the park and the type of recreational usage and the recreational areas were analyzed. In addition to these, ecological observations were carried out in order to determine recreational-based pressures on the ecosystems. On-site questionnaires were administrated to a sample of 284 respondents in the August 2015 - 2016 to collect data concerning the demographics and visit characteristics. The second phase of the study, the coastal area separated into four different usage zones and the methodology proposed by Cifuentes (1992) was used for capacity analyses. This method supplies the calculation of physical, real and effective carrying capacities by using environmental, ecological, climatic and managerial parameters in a formulation. Expected numbers which estimated three levels of carrying capacities were compared to current numbers of national parks’ visitors. In the study, it was determined that the current recreational uses in the north of the beach were caused by ecological pressures, and the current numbers in the south of beach much more than estimated numbers of visitors. Based on these results management strategies were defined and the appropriate management tools were developed in accordance with these strategies. The authors are grateful for the financial support of this project by The Scientific and Technological Research Council of Turkey (No: 114O344)

Keywords: Çıralı Coast, national parks, recreational carrying capacity, visitor management

Procedia PDF Downloads 275

Authors: Elena Listo Ubeda, Miguel Marchamalo Sacristan

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The demand for water doubles every twenty years, at a rate which is twice as fast as the world´s population growth. Despite it´s great importance, water is one of the most degraded natural resources in the world, mainly because of the reduction of natural vegetation coverage, population growth, contamination and changes in the soil use which reduces its capacity to collect water. This situation is especially serious in Central America, as reflected in the Human Development reports. The objective of this project is to assist in the improvement of water production and quality in Central America. In order to do these two watersheds in Costa Rica were selected as experiments: that of the Virilla-Durazno River, located in the extreme north east of the central valley which has an Atlantic influence; and that of the Jabillo River, which flows directly into the Pacific. The Virilla river watershed is located over andisols, and that of the Jabillo River is over alfisols, and both are of great importance for water supply to the Greater Metropolitan Area and the future tourist resorts respectively, as well as for the production of agriculture, livestock and hydroelectricity. The hydrological reaction in different soil-cover complexes, varying from the secondary forest to natural vegetation and degraded pasture, was analyzed according to the evaluation of the properties of the soil, infiltration, soil compaction, as well as the effects of the soil cover complex on erosion, calculated by the C factor of the Revised Universal Soil Loss Equation (RUSLE). A water balance was defined for each watershed, in which the volume of water that enters and leaves were estimated, as well as the evapotranspiration, runoff, and infiltration. Two future scenarios, representing the implementation of reforestation and deforestation plans, were proposed, and were analyzed for the effects of the soil cover complex on the water balance in each case. The results obtained show an increase of the ground water recharge in the humid forest areas, and an extension of the study of the dry areas is proposed since the ground water recharge here is diminishing. These results are of great significance for the planning, design of Payment Schemes for Environmental Services and the improvement of the existing water supply systems. In Central America spatial planning is a priority, as are the watersheds, in order to assess the water resource socially and economically, and securing its availability for the future.

Keywords: Costa Rica, infiltration, soil, water

Procedia PDF Downloads 384

Authors: Daniel Bülz, Franziska Lüttich, Sreetama Banerjee, Georgeta Salvan, Dietrich R. T. Zahn

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For the development of electronics, organic semiconductors are of great interest due to their adjustable optical and electrical properties. Especially for spintronic applications they are interesting because of their weak spin scattering, which leads to longer spin life times compared to inorganic semiconductors. It was shown that some organic materials change their resistance if an external magnetic field is applied. Pentacene is one of the materials which exhibit the so called photoinduced magnetoresistance which results in a modulation of photocurrent when varying the external magnetic field. Also the soluble derivate of pentacene, the 6,13-bis (triisopropylsilylethynyl)-pentacene (TIPS-pentacene) exhibits the same negative magnetoresistance. Aiming for simpler fabrication processes, in this work, we compare TIPS-pentacene organic field effect transistors (OFETs) made from solution with those fabricated by thermal evaporation. Because of the different processing, the TIPS-pentacene thin films exhibit different morphologies in terms of crystal size and homogeneity of the substrate coverage. On the other hand, the interface treatment is known to have a high influence on the threshold voltage, eliminating trap states of silicon oxide at the gate electrode and thereby changing the electrical switching response of the transistors. Therefore, we investigate the influence of interface treatment using octadecyltrichlorosilane (OTS) or using a simple cleaning procedure with acetone, ethanol, and deionized water. The transistors consist of a prestructured OFET substrates including gate, source, and drain electrodes, on top of which TIPS-pentacene dissolved in a mixture of tetralin and toluene is deposited by drop-, spray-, and spin-coating. Thereafter we keep the sample for one hour at a temperature of 60 °C. For the transistor fabrication by thermal evaporation the prestructured OFET substrates are also kept at a temperature of 60 °C during deposition with a rate of 0.3 nm/min and at a pressure below 10-6 mbar. The OFETs are characterized by means of optical microscopy in order to determine the overall quality of the sample, i.e. crystal size and coverage of the channel region. The output and transfer characteristics are measured in the dark and under illumination provided by a white light LED in the spectral range from 450 nm to 650 nm with a power density of (8±2) mW/cm2.

Keywords: organic field effect transistors, solution processed, surface treatment, TIPS-pentacene

Procedia PDF Downloads 447

Authors: M. Turmanauli, T. Todua, O. Gvaberidze, R. Javakhadze, N. Chkhaidze, N. Khatiashvili

Abstract:

Background: Mining process has the significant influence on human health and quality of life. In recent years the events in Georgia were reflected on the industry working process, especially minimal requirements of labor safety, hygiene standards of workplace and the regime of work and rest are not observed. This situation is often caused by the lack of responsibility, awareness, and knowledge both of workers and employers. The control of working conditions and its protection has been worsened in many of industries. Materials and Methods: For evaluation of the current situation the prospective epidemiological study by face to face interview method was conducted at Georgian “Manganese Zestafoni Ferroalloy Plant” in 2011-2013. 65.7% of employees (1428 bulletin) were surveyed and the incidence rates of temporary disability days were studied. Results: The average length of a temporary disability single accident was studied taking into consideration as sex groups as well as the whole cohort. According to the classes of harmfulness the following results were received: Class 2.0-10.3%; 3.1-12.4%; 3.2-35.1%; 3.3-12.1%; 3.4-17.6%; 4.0-12.5%. Among the employees 47.5% and 83.1% were tobacco and alcohol consumers respectively. According to the age groups and years of work on the base of previous experience ≥50 ages and ≥21 years of work data prevalence respectively. The obtained data revealed increased morbidity rate according to age and years of work. It was found that the bone and articulate system and connective tissue diseases, aggravation of chronic respiratory diseases, ischemic heart diseases, hypertension and cerebral blood discirculation were the leading among the other diseases. High prevalence of morbidity observed in the workplace with not satisfactory labor conditions from the hygienic point of view. Conclusion: According to received data the causes of morbidity are the followings: unsafety labor conditions; incomplete of preventive medical examinations (preliminary and periodic); lack of access to appropriate health care services; derangement of gathering, recording, and analysis of morbidity data. This epidemiological study was conducted at the JSC “Manganese Ferro Alloy Plant” according to State program “ Prevention of Occupational Diseases” (Program code is 35 03 02 05).

Keywords: occupational health, mining process, morbidity level, cerebral blood discirculation

Procedia PDF Downloads 428

Authors: Calister Wingang Makebe, Wilson Ambindei Agwanande, Emmanuel Jong Nso, P. Nisha

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Traditional liquid-state fermentation processes of Annona muricata L. juice can result in fluctuating product quality and quantity due to difficulties in control and scale up. This work describes a laboratory-scale batch fermentation process to produce a probiotic Annona muricata L. enzymatically extracted juice, which was modeled using the Doehlert design with independent extraction factors being incubation time, temperature, and enzyme concentration. It aimed at a better understanding of the traditional process as an initial step for future optimization. Annona muricata L. juice was fermented with L. acidophilus (NCDC 291) (LA), L. casei (NCDC 17) (LC), and a blend of LA and LC (LCA) for 72 h at 37 °C. Experimental data were fitted into mathematical models (Monod, Logistic and Luedeking and Piret models) using MATLAB software, to describe biomass growth, sugar utilization, and organic acid production. The optimal fermentation time was obtained based on cell viability, which was 24 h for LC and 36 h for LA and LCA. The model was particularly effective in estimating biomass growth, reducing sugar consumption, and lactic acid production. The values of the determination coefficient, R2, were 0.9946, 0.9913 and 0.9946, while the residual sum of square error, SSE, was 0.2876, 0.1738 and 0.1589 for LC, LA and LCA, respectively. The growth kinetic parameters included the maximum specific growth rate, µm, which was 0.2876 h-1, 0.1738 h-1 and 0.1589 h-1 as well as the substrate saturation, Ks, with 9.0680 g/L, 9.9337 g/L and 9.0709 g/L respectively for LC, LA and LCA. For the stoichiometric parameters, the yield of biomass based on utilized substrate (YXS) was 50.7932, 3.3940 and 61.0202, and the yield of product based on utilized substrate (YPS) was 2.4524, 0.2307 and 0.7415 for LC, LA, and LCA, respectively. In addition, the maintenance energy parameter (ms) was 0.0128, 0.0001 and 0.0004 with respect to LC, LA and LCA. With the kinetic model proposed by Luedeking and Piret for lactic acid production rate, the growth associated, and non-growth associated coefficients were determined as 1.0028 and 0.0109, respectively. The model was demonstrated for batch growth of LA, LC, and LCA in Annona muricata L. juice. The present investigation validates the potential of Annona muricata L. based medium for heightened economical production of a probiotic medium.

Keywords: L. acidophilus, L. casei, fermentation, modelling, kinetics

Procedia PDF Downloads 82

Authors: Torsten Hermanns, Thoufik Al Khawli, Wolfgang Schulz

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In laser cutting as well as in long pulsed laser drilling of metals, it can be demonstrated that the ablation shape (the shape of cut faces respectively the hole shape) that is formed approaches a so-called asymptotic shape such that it changes only slightly or not at all with further irradiation. These findings are already known from the ultrashort pulse (USP) ablation of dielectric and semiconducting materials. The explanation for the occurrence of an asymptotic shape in laser cutting and long pulse drilling of metals is identified, its underlying mechanism numerically implemented, tested and clearly confirmed by comparison with experimental data. In detail, there now is a model that allows the simulation of the temporal (pulse-resolved) evolution of the hole shape in laser drilling as well as the final (asymptotic) shape of the cut faces in laser cutting. This simulation especially requires much less in the way of resources, such that it can even run on common desktop PCs or laptops. Individual parameters can be adjusted using sliders – the simulation result appears in an adjacent window and changes in real time. This is made possible by an application-specific reduction of the underlying ablation model. Because this reduction dramatically decreases the complexity of calculation, it produces a result much more quickly. This means that the simulation can be carried out directly at the laser machine. Time-intensive experiments can be reduced and set-up processes can be completed much faster. The high speed of simulation also opens up a range of entirely different options, such as metamodeling. Suitable for complex applications with many parameters, metamodeling involves generating high-dimensional data sets with the parameters and several evaluation criteria for process and product quality. These sets can then be used to create individual process maps that show the dependency of individual parameter pairs. This advanced simulation makes it possible to find global and local extreme values through mathematical manipulation. Such simultaneous optimization of multiple parameters is scarcely possible by experimental means. This means that new methods in manufacturing such as self-optimization can be executed much faster. However, the software’s potential does not stop there; time-intensive calculations exist in many areas of industry. In laser welding or laser additive manufacturing, for example, the simulation of thermal induced residual stresses still uses up considerable computing capacity or is even not possible. Transferring the principle of reduced models promises substantial savings there, too.

Keywords: asymptotic ablation shape, interactive process simulation, laser drilling, laser cutting, metamodeling, reduced modeling

Procedia PDF Downloads 215

Authors: Freya Willicks

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The society of the 21st century is characterized by dynamic and complexity, developments that also shape universities and university life. The Bologna reform, for example, has led to restructuring at many European universities. Today's university teachers, therefore, have to meet many expectations: Their tasks include not only teaching but also the general improvement of the quality of teaching, good research, the management of various projects or the development of their own personal skills. This requires a high degree of flexibility and openness to change. The resulting pressure can often lead to exhaustion. Coaching can be a way for university teachers to cope with these pressures because it gives them the opportunity to discuss stressful situations with a coach and self-reflect on them. As a result, more and more universities in Europe offer to coach to their teachers. An analysis of the services provided at universities in Germany, however, quickly reveals an immense disagreement with regard to the understanding of ‘coaching’. A variety of terms is used, such as coaching, counselling or supervision. In addition, each university defines its offer individually, from process-oriented consulting to expert consulting, from group training to individual coaching. The biographic backgrounds of those who coach are also very divergent, both external and internal coaches can be suitable. These findings lead to the following questions: Which structural characteristics for coaching at universities have been proven successful? What competencies should a good coach for university lecturers have? In order to answer these questions, a qualitative study was carried out. In a first step, qualitative semi-structured interviews (N = 14) were conducted, on the one hand with coaches for university teachers and on the other hand with university teachers who have been coached. In a second step, the interviews were transcribed and analyzed using Mayring's qualitative content analysis. The study shows how great the potential of coaching can be for university teachers, who otherwise have little opportunity to talk about their teaching in a private setting. According to the study, the coach should neither be a colleague nor a superior of the coachee but should take an independent perspective, as this is the only way for the coachee to openly reflect on himself/herself. In addition, the coach should be familiar with the university system, i.e., be an academic himself/herself. Otherwise, he/she cannot fully understand the complexity of the teaching situation and the role expectations. However, internal coaches do not necessarily have much coaching experience or explicit coaching competencies. They often come from the university's own didactics department, are experts in didactics, but do not necessarily have a certified coaching education. Therefore, it is important to develop structures and guidelines for internal coaches to support their coaching. In further analysis, such guidelines will be developed on the basis of these interviews.

Keywords: coaching, university coaching, university didactics, qualitative interviews

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Authors: Aarti Agarwal, Ajmal Khan

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Background and Objective: Breathing difficulty is most distressing symptom for the patient and their caregivers providing palliative care to individuals with advanced malignancy. It needs to be tackled effectively and sometimes preemptively to provide relief from respiratory obstruction. Interventional procedures like tracheal stenting are becoming increasingly popular as a part of palliation for respiratory symptoms. We present a case of esophageal tumor earlier stented by Gastroenterologist to maintain esophageal patency, but the tumor outgrew to produce tracheal infiltration and thereby causing airway obstruction. Method and Result: 62-year-old man presented with unresectable Carcinoma oesophagus with inability to swallow. A metallic stent was placed by the gastroenterologist, to maintain esophageal patency and enable patient to swallow. Two months later, the patient returned to hospital in emergency with respiratory distress. CT neck and thorax revealed tumor infiltration through posterior tracheal wall. Lower extent of the tumor was till 1 cm above the carina. Airway stenting with Tracheo bronchial stent with Y configuration was planned under general anaesthesia with airway blocks. Superior Laryngeal Nerve Block, Glossopharyngeal block and Trans tracheal infiltration of local anaesthetics were performed. The patient was sedated with Fentanyl, Midazolam and propofol infusion but was breathing spontaneously. Once the rigid bronchoscope was placed inside trachea, breathing was supported with oxygen and sevoflurane. Initially, the trachea was cleared of tumor by coring. After creating space, tracheal stent was positioned and deployed. After stent placement patient was awakened, suctioned and nebulized. His respiratory stridor relieved instantaneously and was shifted to recovery. Conclusion: Airway blocks help in decreasing the incidence and severity of coughing during airway instrumentation thereby help in proper stent placement. They also reduce the requirement of general anaesthetics and hasten the post stenting recovery. Airway stent provided immediate relief to patient from symptoms of respiratory difficulty. Decision for early tracheal stenting may be taken for a select group of patients with high propensity for local spread, thereby avoiding respiratory complications and providing better quality of life in patients with inoperable malignancy.

Keywords: tracheal stent, respiratory difficulty, esophageal tumor, anaesthetic management

Procedia PDF Downloads 227

Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan

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Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.

Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents

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Authors: Siti Noor Syahirah Mohd Sabri

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The oil and gas industry is committed to net zero carbon emissions because the consequences of climate change could be catastrophic unless responded to very soon. One way of reducing CO₂ emissions is to inject it into a depleted reservoir buried underground. This greenhouse gas reduction technique significantly reduces CO₂ released into the atmosphere. In general, depleted oil and gas reservoirs provide readily available sites for the storage of CO₂ in offshore areas. This is mainly due to the hydrocarbons have been optimally produced and the existence of voids for effective CO₂ storage. Hence, make it a good candidate for a CO₂ well injector location. Geological storage sites are often evaluated in terms of capacity, injectivity and containment. Leakage through the cap rock or existing well is the main concern in the depleted fields. In order to develop these fields as CO₂ storage sites, the long-term integrity of wells drilled in these oil & gas fields must be ascertained to ensure good CO₂ containment. Well, integrity is often defined as the ability to contain fluids without significant leakage through the project lifecycle. Most plugged and abandoned (P & A) wells in Peninsular Malaysia have drilled 20 – 30 years ago and were not designed to withstand downhole conditions having >50%vol CO₂ and CO₂/H₂O mixture. In addition, Corrosive-Resistant Alloy (CRA) tubular and CO₂-resistant cement was not used during good construction. The reservoir pressure and temperature conditions may have further degraded the material strength and elevated the corrosion rate. Understanding all the uncertainties that may have affected cement-casing bonds, such as the quality of cement behind the casing, subsidence effect, corrosion rate, etc., is the first step toward well integrity evaluation. Secondly, proper quantification of all the uncertainties involved needs to be done to ensure long-term underground storage objectives of CO₂ are achieved. This paper will discuss challenges associated with estimating the performance of well barrier elements in existing P&A wells. Risk ranking of the existing P&A wells is to be carried out in order to ensure the integrity of the storage site is maintained for long-term CO₂ storage. High-risk existing P&A wells are to be re-entered to restore good integrity and to reduce future leakage that may happen. In addition, the requirement to design a fit-for-purpose monitoring and mitigation technology package for potential CO₂ leakage/seepage in the marine environment will be discussed accordingly. The holistic approach will ensure that the integrity is maintained, and CO₂ is contained underground for years to come.

Keywords: CCUS, well integrity, co₂ storage, offshore

Procedia PDF Downloads 90

Authors: Gianmaria Califano, Júlio Augusto Lucena Maciel, Olfa Zarrouk, Miguel Damasio, Jose Silvestre, Ana Margarida Fortes

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Global warming, with rapid and sudden changes in meteorological conditions, is one of the major constraints to ensuring agricultural and crop resilience in the Mediterranean regions. Several strategies are being adopted to reduce the pressure of drought stress on grapevines at regional and local scales: improvements in the irrigation systems, adoption of interline cover crops, and adaptation of pruning techniques. However, still, more can be achieved if also microbial compartments associated with plants are considered in crop management. It is known that the microbial community change according to several factors such as latitude, plant variety, age, rootstock, soil composition and agricultural management system. Considering the increasing pressure of the biotic and abiotic stresses, it is of utmost necessity to also evaluate the effects of drought on the microbiome associated with the grapevine, which is a commercially important crop worldwide. In this study, we characterize the diversity and the structure of the microbial community under three long-term irrigation levels (100% ETc, 50% ETc and rain-fed) in a drought-tolerant grapevine cultivar present worldwide, Syrah. To avoid the limitations of culture-dependent methods, amplicon sequencing with target primers for bacteria and fungi was applied to the same soil samples. The use of the DNeasy PowerSoil (Qiagen) extraction kit required further optimization with the use of lytic enzymes and heating steps to improve DNA yield and quality systematically across biological treatments. Target regions (16S rRNA and ITS genes) of our samples are being sequenced with Illumina technology. With bioinformatic pipelines, it will be possible to obtain a characterization of the bacterial and fungal diversity, structure and composition. Further, the microbial communities will be assessed for their functional activity, which remains an important metric considering the strong inter-kingdom interactions existing between plants and their associated microbiome. The results of this study will lay the basis for biotechnological applications: in combination with the establishment of a bacterial library, it will be possible to explore the possibility of testing synthetic microbial communities to support plant resistance to water scarcity.

Keywords: microbiome, metabarcoding, soil, vinegrape, syrah, global warming, crop sustainability

Procedia PDF Downloads 123

Authors: Maria Klitgaard Christensen, Carmen Lim, Sukanta Saha, Danielle Cannon, Finley Prentis, Oleguer Plana-Ripoll, Natalie Momen, Kim Moesgaard Iburg, John J. McGrath

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Introduction: About a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders. Methods: Systematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses, (2) diagnosis of at least one mental disorder, (3) samples based on the general population, and (4) outcome in monetary units. 13,640 publications were screened by their title/abstract and 439 articles were full-text screened by at least two independent reviewers. 112 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 143 included articles. Results: Information about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The vast majority of the included studies were from Western countries and only a few from Africa and South America. The disorder group most often investigated was mood disorders, followed by schizophrenia and neurotic disorders. The disorder group least examined was intellectual disabilities, followed by eating disorders. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies. An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality. Discussion: This is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policymaking.

Keywords: cost-of-illness, health economics, mental disorders, systematic review

Procedia PDF Downloads 131

Authors: Norah Alosayl

Abstract:

English is considered the most important foreign language in the Kingdom of Saudi Arabia (KSA) because of the usefulness of English as a global language compared to Arabic. As students’ desire to improve their English language skills has grown, English writing has been identified as the most difficult problem for Saudi students in their language learning. Although the English language in Saudi Arabia is taught beginning in the seventh grade, many students have problems at the university level, especially in writing, due to a gap between what is taught in secondary and high schools and university expectations- pupils generally study English at school, based on one book with few exercises in vocabulary and grammar exercises, and there are no specific writing lessons. Moreover, from personal teaching experience at King Saud bin Abdulaziz University, students face real problems with their writing. This paper revolves around the blackboard-based collaborative writing to help the undergraduate Saudi EFL students, in their first year enrolled in two sections of ENGL 101 in the first semester of 2021 at King Saud bin Abdulaziz University, practice the most difficult skill they found in their writing through a small group. Therefore, a sequential mixed methods design will be suited. The first phase of the study aims to highlight the most difficult skill experienced by students from an official writing exam that is evaluated by their teachers through an official rubric used in King Saud bin Abdulaziz University. In the second phase, this study will intend to investigate the benefits of social interaction on the process of learning writing. Students will be provided with five collaborative writing tasks via discussion feature on Blackboard to practice a skill that they found difficult in writing. the tasks will be formed based on social constructivist theory and pedagogic frameworks. The interaction will take place between peers and their teachers. The frequencies of students’ participation and the quality of their interaction will be observed through manual counting, screenshotting. This will help the researcher understand how students actively work on the task through the amount of their participation and will also distinguish the type of interaction (on task, about task, or off-task). Semi-structured interviews will be conducted with students to understand their perceptions about the blackboard-based collaborative writing tasks, and questionnaires will be distributed to identify students’ attitudes with the tasks.

Keywords: writing difficulties, blackboard-based collaborative writing, process of learning writing, interaction, participations

Procedia PDF Downloads 192

Authors: Michael Adebayo, Saheed Lawal

Abstract:

The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

Procedia PDF Downloads 85