Search results for: social general condition
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 17102

Search results for: social general condition

5222 The Development of an Anaesthetic Crisis Manual for Acute Critical Events: A Pilot Study

Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

Abstract:

Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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5221 Perceived Barriers and Benefits of Technology-Based Progress Monitoring for Non-Academic Individual Education Program Goals

Authors: A. Drelick, T. Sondergeld, M. Decarlo-Tecce, K. McGinley

Abstract:

In 1975, a free, appropriate public education (FAPE) was granted for all students in the United States regardless of their disabilities. As a result, the special education landscape has been reshaped through new policies and legislation. Progress monitoring, a specific component of an Individual Education Program (IEP) calls, for the use of data collection to determine the appropriateness of services provided to students with disabilities. The recent US Supreme Court ruling in Endrew F. v. Douglas County warrants giving increased attention to student progress, specifically pertaining to improving functional, or non-academic, skills that are addressed outside the general education curriculum. While using technology to enhance data collection has become a common practice for measuring academic growth, its application for non-academic IEP goals is uncertain. A mixed-methods study examined current practices and rationales for implementing technology-based progress monitoring focused on non-academic IEP goals. Fifty-seven participants responded to an online survey regarding their progress monitoring programs for non-academic goals. After isolated analysis and interpretation of quantitative and qualitative results, data were synthesized to produce meta-inferences that drew broader conclusions on the topic. For the purpose of this paper, specific focus will be placed on the perceived barriers and benefits of implementing technology-based progress monitoring protocols for non-academic IEP goals. The findings of this study highlight facts impacting the use of technology-based progress monitoring. Perceived barriers to implementation include: (1) lack of training, (2) access to technology, (3) outdated or inoperable technology, (4) reluctance to change, (5) cost, (6) lack of individualization within technology-based programs, and (7) legal issues in special education; while perceived benefits include: (1) overall ease of use, (2) accessibility, (3) organization, (4) potential for improved presentation of data, (5) streamlining the progress-monitoring process, and (6) legal issues in special education. Based on these conclusions, recommendations are made to IEP teams, school districts, and software developers to improve the progress-monitoring process for functional skills.

Keywords: special education, progress monitoring, functional skills, technology

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5220 Leaders Behaving Badly in Higher Education: Constructing Toxic Leadership from Followers

Authors: Aishah Tamby Omar, Zolkifle Ahmad

Abstract:

The aim of this research was to explore academician perception of toxic leadership in higher education organizations. The data consisted of 17 semi-structured interviews with academicians’ grade 45 above. According to them, toxicity in higher education organizations can be categorized as dysfunctional command, employee anti-social, less trust and commitment, abusive supervision, tyranny, unethical, hierarchical structures, and permissive environment. While they believed that culture, climate, and situational factors may form a toxic development and have the greatest influence on toxicity determination in higher education organizations. Respondents acknowledged that the future studies should involve the person who had held positions to get their opinions. These results emphasized the need for the leaders to learn about leadership in order to avoid a negative performance of the higher education organizations in the near future.

Keywords: academician perception, higher education organizations, leadership, toxic leadership

Procedia PDF Downloads 447
5219 A Digital Health Approach: Using Electronic Health Records to Evaluate the Cost Benefit of Early Diagnosis of Alpha-1 Antitrypsin Deficiency in the UK

Authors: Sneha Shankar, Orlando Buendia, Will Evans

Abstract:

Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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5218 Change of Taste Preference after Bariatric Surgery

Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

Abstract:

Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

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5217 Comparative Coverage Analysis of Football and Other Sports by the Leading English Newspapers of India during FIFA World Cup 2014

Authors: Rajender Lal, Seema Kaushik

Abstract:

The FIFA World Cup, often simply called the World Cup, is an international association football competition contested by the senior men's national teams of the members of Fédération Internationale de Football Association (FIFA), the sport's global governing body. The championship has been awarded every four years since the inaugural tournament in 1930, except in 1942 and 1946 when it was not held because of the Second World War. Its 20th edition took place in Brazil from 12 June to 13 July 2014, which was won by Germany. The World Cup is the most widely viewed and followed sporting event in the world, exceeding even the Olympic Games; the cumulative audience of all matches of the 2006 FIFA World Cup was estimated to be 26.29 billion with an estimated 715.1 million people watching the final match, a ninth of the entire population of the planet. General-interest newspapers typically publish news articles and feature articles on national and international news as well as local news. The news includes political events and personalities, business and finance, crime, severe weather, and natural disasters; health and medicine, science, and technology; sports; and entertainment, society, food and cooking, clothing and home fashion, and the arts. It became curiosity to investigate that how much coverage is given to this most widely viewed international event as compared to other sports in India. Hence, the present study was conducted with the aim of examining the comparative coverage of FIFA World Cup 2014 and other sports in the four leading Newspapers of India including Hindustan Times, The Hindu, The Times of India, and The Tribune. Specific objectives were to measure the source of news, type of news items and the placement of news related to FIFA World Cup and other sports. Representative sample of ten editions each of the four English dailies was chosen for the purpose of the study. The analysis was based on the actual scanning of data from the representative sample of the dailies for the period of the competition. It can be concluded from the analysis that this event was given maximum coverage by the Hindustan Times while other sports were equally covered by The Hindu.

Keywords: coverage analysis, FIFA World Cup 2014, Hindustan Times, the Hindu, The Times of India, The Tribune

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5216 Impact of Preoperative Physiotherapy Care in Total Hip Arthroplasty in Slovakia and Austria

Authors: Peter Kutis, Vladimir Littva

Abstract:

Nowadays, it is necessary to ensure that this reduction in costs is not at the expense of the quality of health care and future medical success. In general, physiotherapy for total hip joint arthroplasty is considered to be a routine matter that deals mainly with mobility training, increased muscular strength, and basic day-to-day activities such as bed-to-chair transition, standing, and walking. Within the KEGA project no. 003KU-4-2021, we decided to investigate preoperative physiotherapy care in Slovakia and Austria in total hip arthroplasty patients to shortened overall recovery. Research Sample and Methods: The sample comprised 498 respondents –patients who were indicated to total hip arthroplasty on the territory of Slovakia and Austria. There were 130 women in Slovakia and 135 women in Austria. The numbers of men were 120 in Slovakia and 113 men in Austria. The age of respondents was between 40 and 85 years of age. As a method of our research, we chose a non-standardized questionnaire, which consisted of three parts. The first part for the initial examination of the patient contained the identification of the patient according to the assigned number and subsequently 19 questions conditioned by the physical examination and evaluation of the patients. The second part of our questionnaire was completed after the patient's hospitalization and contained 10 questions that were conditioned by the patient's examination. The last third part for the overall assessment of the patient's state of health consisted of 12 questions conditioned by the patient's examination. This part was performed at the last meeting with the patient at the end of the treatment. All data were statistically processed by SPSS 25. Results: All data were evaluated at a significance level of p = 0.05. From the comparison of patients who underwent preoperative preparation, we can clearly state that the total duration of treatment is significantly shorter. A t-test of two mean values with uneven variance was used to verify the validity of the assumption. The total duration of treatment in patients with preoperative preparation was on average 92,635 days and without preoperative preparation was on average 135,884 days (t-Stat = 44,52784, t Critical one-tail = 1,648187415, t Critical two-tail = 1,965157). Conclusion: The results obtained during the research show the importance of adequate preoperative physiotherapeutic preparation of the patient. The results of total hip joint arthroplasty studies showed a significant reduction in a hospital stay as well as shortened total treatment time.

Keywords: THA, physiotherapy, recovery, preoperative physiotherapy care

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5215 Measuring the Level of Knowledge of Construction Contracts Procedures: A Case Study of Botswana

Authors: Babulayi B. Wilson

Abstract:

Unsatisfactory performance of construction projects in both the industrialised and developing countries indicate that there could be several defects in construction projects phases. Notwithstanding the fact that some project defects are often conceived at the initiation phase of construction projects, insufficient knowledge of contract procedures has been identified as one of the major sources of construction disputes. Contract procedures are a set of rules that outlines the primary obligations and liabilities of parties involved in the implementation of a construction project. Engineering professional bodies often codify contract procedures into standard forms of contract such as the Institution of Civil Engineers (ICE, UK) and Association of Consulting Engineers (ACE, UK) and keep them under constant review by updating any clause to reflect any change in case law or relevant piece of legislation. Even so, it is the responsibility of a professional body or conditions of contract draftsperson to introduce contract-specific clauses that may be necessary for business efficacy but not covered in the chosen standard conditions of contract. In Botswana, the use of clients’ drafted and/or un-adapted for environment of use international forms of contract in conjunction with client-drafted pricing schedules is common. The product of the latter often impact negatively upon contractors’ claims and payments, in that, tender rates and prices can only be deemed to be sufficient if the chosen conditions of contract compliment the pricing schedule (use of standardised procurement documents). In addition, client drafted and the use of borrowed forms of contract such as FIDIC often conflict with domicile law resulting in costly disputes on the part of the client. It is upon the preceding text that the object of the research is to measure the level of knowledge of contract procedures amongst key stakeholders in the Botswana construction industry by requesting a representative sample from the industry and academia to respond to tutorial questions prepared from two commonly used forms of contract for civil works, that is, FIDIC (International Form of Contract) and ICE (UK). The questions were prepared under the following captions: (a) preparation of tender documents (b) obligations of the parties (c) contract administration; and (d) claims, variations, and valuation of variations. After ascertaining that the level of knowledge of contract procedures is insufficient among most practitioners in the Botswana construction industry, major procurement entities, and engineering institutions of learning; a guide to drafting a condition of a construction contract was developed and then validated through seminars and workshops. In the present, the effectiveness of the guide is not yet measured but feedback from seminars and workshops conducted indicates an appreciation of the guide by the majority of major construction industry stakeholders.

Keywords: contract procedures, conditions of contract, professional practice, construction law, forms of contract

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5214 Investigation of Elastic Properties of 3D Full Five Directional (f5d) Braided Composite Materials

Authors: Apeng Dong, Shu Li, Wenguo Zhu, Ming Qi, Qiuyi Xu

Abstract:

The primary objective of this paper is to focus on the elasticity properties of three-dimensional full five directional (3Df5d) braided composite. A large body of research has been focused on the 3D four directional (4d) and 3D five directional (5d) structure but not much research on the 3Df5d material. Generally, the influence of the yarn shape on mechanical properties of braided materials tends to be ignored, which makes results too ideal. Besides, with the improvement of the computational ability, people are accustomed to using computers to predict the material parameters, which fails to give an explicit and concise result facilitating production and application. Based on the traditional mechanics, this paper firstly deduced the functional relation between elasticity properties and braiding parameters. In addition, considering the actual shape of yarns after consolidation, the longitudinal modulus is modified and defined practically. Firstly, the analytic model is established based on the certain assumptions for the sake of clarity, this paper assumes that: A: the cross section of axial yarns is square; B: The cross section of braiding yarns is hexagonal; C: the characters of braiding yarns and axial yarns are the same; D: The angle between the structure boundary and the projection of braiding yarns in transverse plane is 45°; E: The filling factor ε of composite yarns is π/4; F: The deformation of unit cell is under constant strain condition. Then, the functional relation between material constants and braiding parameters is systematically deduced aimed at the yarn deformation mode. Finally, considering the actual shape of axial yarns after consolidation, the concept of technology factor is proposed and the longitudinal modulus of the material is modified based on the energy theory. In this paper, the analytic solution of material parameters is given for the first time, which provides a good reference for further research and application for 3Df5d materials. Although the analysis model is established based on certain assumptions, the analysis method is also applicable for other braided structures. Meanwhile, it is crucial that the cross section shape and straightness of axial yarns play dominant roles in the longitudinal elastic property. So in the braiding and solidifying process, the stability of the axial yarns should be guaranteed to increase the technology factor to reduce the dispersion of material parameters. Overall, the elastic properties of this materials are closely related to the braiding parameters and can be strongly designable, and although the longitudinal modulus of the material is greatly influenced by the technology factors, it can be defined to certain extent.

Keywords: analytic solution, braided composites, elasticity properties, technology factor

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5213 Sustainable Solutions for Urban Problems: Industrial Container Housing for Endangered Communities in Maranhao, Brazil

Authors: Helida Thays Gomes Soares, Conceicao De Maria Pinheiro Correia, Fabiano Maciel Soares, Kleymer Silva

Abstract:

There is great discussion around populational increase in urban areas of the global south, and, consequently, the growth of inappropriate housing and the different ways humans have found to solve housing problems around the world. Sao Luís, the capital of the state of Maranhao is a good example. The 1.6 million inhabitant metropole is a colonial tropical city that shelters 22% of the population of Maranhão, brazilian state that still carries the scars of slavery in past centuries. In 2016, Brazilian Institute of Geography and Statistic found that 20% of Maranhão’s inhabitants were living in houses with external walls made of non-durable materials, like recycled wood, cardboard or soil. Out of this problematic, this study aims to propose interventions not only in the physical structure of irregular housing, but also to serve as a guide to intervene in the way eco-friendly, communitarian housing is seen by extreme poor zones inside metropolitan regions around big cities in the global south. The adaptation and reuse of industrial containers from the Harbor of Itaqui for housing is also an aim of the project. The great volume of discarded industrial containers may be an opportunity to solve housing deficit in the city. That way, through field research in São Luís’ neighborhoods mostly occupied by inappropriate housing, the study intends to raise ethnographical and physical values that help to shape new uses of industrial containers and recycled building materials, bringing the community into the process of shaping new-housing for local housing programs, changing the mindset of a concrete/brick model of building. The study used a general feasibility analysis of local engineers regarding strength of the locally used container for construction purposes, and also researched in-loco the current impressions of risky areas inhabitants of housing, traditional housing and the role they played as city shapers, evaluating their perceptions of what means to live and how their houses represent their personality.

Keywords: container housing, civil construction, housing deficit, participatory design, sustainability

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5212 Study on Network-Based Technology for Detecting Potentially Malicious Websites

Authors: Byung-Ik Kim, Hong-Koo Kang, Tae-Jin Lee, Hae-Ryong Park

Abstract:

Cyber terrors against specific enterprises or countries have been increasing recently. Such attacks against specific targets are called advanced persistent threat (APT), and they are giving rise to serious social problems. The malicious behaviors of APT attacks mostly affect websites and penetrate enterprise networks to perform malevolent acts. Although many enterprises invest heavily in security to defend against such APT threats, they recognize the APT attacks only after the latter are already in action. This paper discusses the characteristics of APT attacks at each step as well as the strengths and weaknesses of existing malicious code detection technologies to check their suitability for detecting APT attacks. It then proposes a network-based malicious behavior detection algorithm to protect the enterprise or national networks.

Keywords: Advanced Persistent Threat (APT), malware, network security, network packet, exploit kits

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5211 Translating Creativity to an Educational Context: A Method to Augment the Professional Training of Newly Qualified Secondary School Teachers

Authors: Julianne Mullen-Williams

Abstract:

This paper will provide an overview of a three year mixed methods research project that explores if methods from the supervision of dramatherapy can augment the occupational psychology of newly qualified secondary school teachers. It will consider how creativity and the use of metaphor, as applied in the supervision of dramatherapists, can be translated to an educational context in order to explore the explicit / implicit dynamics between the teacher trainee/ newly qualified teacher and the organisation in order to support the super objective in training for teaching; how to ‘be a teacher.’ There is growing evidence that attrition rates among teachers are rising after only five years of service owing to too many national initiatives, an unmanageable curriculum and deteriorating student discipline. The fieldwork conducted entailed facilitating a reflective space for Newly Qualified Teachers from all subject areas, using methods from the supervision of dramatherapy, to explore the social and emotional aspects of teaching and learning with the ultimate aim of improving the occupational psychology of teachers. Clinical supervision is a formal process of professional support and learning which permits individual practitioners in frontline service jobs; counsellors, psychologists, dramatherapists, social workers and nurses to expand their knowledge and proficiency, take responsibility for their own practice, and improve client protection and safety of care in complex clinical situations. It is deemed integral to continued professional practice to safeguard vulnerable people and to reduce practitioner burnout. Dramatherapy supervision incorporates all of the above but utilises creative methods as a tool to gain insight and a deeper understanding of the situation. Creativity and the use of metaphor enable the supervisee to gain an aerial view of the situation they are exploring. The word metaphor in Greek means to ‘carry across’ indicating a transfer of meaning form one frame of reference to another. The supervision support was incorporated into each group’s induction training programme. The first year group attended fortnightly one hour sessions, the second group received two one hour sessions every term. The existing literature on the supervision and mentoring of secondary school teacher trainees calls for changes in pre-service teacher education and in the induction period. There is a particular emphasis on the need to include reflective and experiential learning, within training programmes and within the induction period, in order to help teachers manage the interpersonal dynamics and emotional impact within a high pressurised environment

Keywords: dramatherapy supervision, newly qualified secondary school teachers, professional development, teacher education

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5210 The Impact of Artificial Intelligence on Marketing Principles and Targets

Authors: Felib Ayman Shawky Salem

Abstract:

Experiential marketing means an unforgettable experience that remains deeply anchored in the customer's memory. Furthermore, customer satisfaction is defined as the emotional response to the experiences provided that relate to specific products or services purchased. Therefore, experiential marketing activities can influence the level of customer satisfaction and loyalty. In this context, the study aims to examine the relationship between experiential marketing, customer satisfaction and loyalty of beauty products in Konya. The results of this study showed that experiential marketing is an important indicator of customer satisfaction and loyalty and that experiential marketing has a significant positive impact on customer satisfaction and loyalty.

Keywords: sponsorship, marketing communication theories, marketing communication tools internet, marketing, tourism, tourism management corporate responsibility, employee organizational performance, internal marketing, internal customer experiential marketing, customer satisfaction, customer loyalty, social sciences.

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5209 Features Valuation of Intellectual Capital in the Organization

Authors: H. M. Avanesyan

Abstract:

Economists have been discussing the importance of intangible assets for the success of organization for many years. The term intellectual capital was popularized in the 1990s by Thomas Stewart. “Intellectual capital is the knowledge, applied experience, enterprise processes and technology customer relationship and professional skills which are valuable assets to an organization.” Human capital – includes employee brainpower, competence, skills, experience and knowledge. Customer capital – includes relations and networks with partners, suppliers, distributors, and customers. The objective of the article is to assess one of the key components of organizational culture – organizational values. The focus of the survey was on assessing how intellectual capital presented in these values of the organization. In the conclusion section the article refers to underestimation of intellectual capital by the organization management and the various possible negative effects of the latter.

Keywords: human capital, intellectual capital, organizational culture, management, social identity, organization

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5208 Thermal and Visual Comfort Assessment in Office Buildings in Relation to Space Depth

Authors: Elham Soltani Dehnavi

Abstract:

In today’s compact cities, bringing daylighting and fresh air to buildings is a significant challenge, but it also presents opportunities to reduce energy consumption in buildings by reducing the need for artificial lighting and mechanical systems. Simple adjustments to building form can contribute to their efficiency. This paper examines how the relationship between the width and depth of the rooms in office buildings affects visual and thermal comfort, and consequently energy savings. Based on these evaluations, we can determine the best location for sedentary areas in a room. We can also propose improvements to occupant experience and minimize the difference between the predicted and measured performance in buildings by changing other design parameters, such as natural ventilation strategies, glazing properties, and shading. This study investigates the condition of spatial daylighting and thermal comfort for a range of room configurations using computer simulations, then it suggests the best depth for optimizing both daylighting and thermal comfort, and consequently energy performance in each room type. The Window-to-Wall Ratio (WWR) is 40% with 0.8m window sill and 0.4m window head. Also, there are some fixed parameters chosen according to building codes and standards, and the simulations are done in Seattle, USA. The simulation results are presented as evaluation grids using the thresholds for different metrics such as Daylight Autonomy (DA), spatial Daylight Autonomy (sDA), Annual Sunlight Exposure (ASE), and Daylight Glare Probability (DGP) for visual comfort, and Predicted Mean Vote (PMV), Predicted Percentage of Dissatisfied (PPD), occupied Thermal Comfort Percentage (occTCP), over-heated percent, under-heated percent, and Standard Effective Temperature (SET) for thermal comfort that are extracted from Grasshopper scripts. The simulation tools are Grasshopper plugins such as Ladybug, Honeybee, and EnergyPlus. According to the results, some metrics do not change much along the room depth and some of them change significantly. So, we can overlap these grids in order to determine the comfort zone. The overlapped grids contain 8 metrics, and the pixels that meet all 8 mentioned metrics’ thresholds define the comfort zone. With these overlapped maps, we can determine the comfort zones inside rooms and locate sedentary areas there. Other parts can be used for other tasks that are not used permanently or need lower or higher amounts of daylight and thermal comfort is less critical to user experience. The results can be reflected in a table to be used as a guideline by designers in the early stages of the design process.

Keywords: occupant experience, office buildings, space depth, thermal comfort, visual comfort

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5207 The Wellness Wheel: A Tool to Reimagine Schooling

Authors: Jennifer F. Moore

Abstract:

The wellness wheel as a tool for school growth and change is currently being piloted by a startup school in Chicago, IL. In this case study, members of the school community engaged in the appreciative inquiry process to plan their organizational development around the wellness wheel. The wellness wheel (comprised of physical, emotional, social, spiritual, environmental, cognitive, and financial wellness) is used as a planning tool by teachers, students, parents, and administrators. Through the appreciative inquiry method of change, the community is reflecting on their individual level of wellness and developing organizational structures to ensure the well being of children and adults. The goal of the case study is to test the appropriateness of the use of appreciative inquiry (as a method) and the wellness wheel (as a tool) for school growth and development. Findings of the case study will be realized by the conference. The research is in process now.

Keywords: education, schools, well being, wellness

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5206 Directors’ Compensation: Analyzing the Multilevel Factors That Exert the Greatest Influence

Authors: Isabel Acero, Nuria Alcalde

Abstract:

The economic crisis and notorious corporate scandals have caused social indignation and sparked the debate concerning the underlying rationality of the compensation that directors receive. In this context, this study examines the determinants of the remuneration of directors in listed Spanish companies using individualized data. A multilevel methodology appropriate for this type of data has been used that allows us to differentiate between inter-company variations and intra-company variations. The results show that company size is the variable (at the company level) that exerts the greatest influence on the level of director´s compensation. One surprising finding is that the presence of independent directors on the board has a positive influence on remuneration. At the individual level, tenure and experience have a significant influence on the level of compensation, while the director´s level of education does not appear to have an effect on it.

Keywords: board of directors, compensation, experience, multilevel, tenure

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5205 Estimation of Biomedical Waste Generated in a Tertiary Care Hospital in New Delhi

Authors: Priyanka Sharma, Manoj Jais, Poonam Gupta, Suraiya K. Ansari, Ravinder Kaur

Abstract:

Introduction: As much as the Health Care is necessary for the population, so is the management of the Biomedical waste produced. Biomedical waste is a wide terminology used for the waste material produced during the diagnosis, treatment or immunization of human beings and animals, in research or in the production or testing of biological products. Biomedical waste management is a chain of processes from the point of generation of Biomedical waste to its final disposal in the correct and proper way, assigned for that particular type of waste. Any deviation from the said processes leads to improper disposal of Biomedical waste which itself is a major health hazard. Proper segregation of Biomedical waste is the key for Biomedical Waste management. Improper disposal of BMW can cause sharp injuries which may lead to HIV, Hepatitis-B virus, Hepatitis-C virus infections. Therefore, proper disposal of BMW is of upmost importance. Health care establishments segregate the Biomedical waste and dispose it as per the Biomedical waste management rules in India. Objectives: This study was done to observe the current trends of Biomedical waste generated in a tertiary care Hospital in Delhi. Methodology: Biomedical waste management rounds were conducted in the hospital wards. Relevant details were collected and analysed and sites with maximum Biomedical waste generation were identified. All the data was cross checked with the commons collection site. Results: The total amount of waste generated in the hospital during January 2014 till December 2014 was 6,39,547 kg, of which 70.5% was General (non-hazardous) waste and the rest 29.5% was BMW which consisted highly infectious waste (12.2%), disposable plastic waste (16.3%) and sharps (1%). The maximum quantity of Biomedical waste producing sites were Obstetrics and Gynaecology wards with a total Biomedical waste production of 45.8%, followed by Paediatrics, Surgery and Medicine wards with 21.2 %, 4.6% and 4.3% respectively. The maximum average Biomedical waste generated was by Obstetrics and Gynaecology ward with 0.7 kg/bed/day, followed by Paediatrics, Surgery and Medicine wards with 0.29, 0.28 and 0.18 kg/bed/day respectively. Conclusions: Hospitals should pay attention to the sites which produce a large amount of BMW to avoid improper segregation of Biomedical waste. Also, induction and refresher training Program of Biomedical waste management should be conducted to avoid improper management of Biomedical waste. Healthcare workers should be made aware of risks of poor Biomedical waste management.

Keywords: biomedical waste, biomedical waste management, hospital-tertiary care, New Delhi

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5204 Development and Effects of Transtheoretical Model Exercise Program for Elderly Women with Chronic Back Pain

Authors: Hyun-Ju Oh, Soon-Rim Suh, Mihan Kim

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The steady and rapid increase of the older population is a global phenomenon. Chronic diseases and disabilities are increased due to aging. In general, exercise has been known to be most effective in preventing and managing chronic back pain. However, it is hard for the older women to initiate and maintain the exercise. Transtheoretical model (TTM) is one of the theories explain behavioral changes such as exercise. The application of the program considering the stage of behavior change is effective for the elderly woman to start and maintain the exercise. The purpose of this study was to develop TTM based exercise program and to examine its effect for elderly women with chronic back-pain. For the program evaluation, the non-equivalent control pre-posttest design was applied. The independent variable of this study is exercise intervention program. The contents of the program were constructed considering the characteristics of the elderly women with chronic low back pain, focusing on the process of change, the stage of change by the previous studies. The developed exercise program was applied to the elderly women with chronic low back pain in the planning stage and the preparation stage. The subjects were 50 older women over 65 years of age with chronic back-pain who did not practice regular exercise. The experimental group (n=25) received the 8weeks TTM based exercise program. The control group received the book which named low back pain management. Data were collected at three times: before the exercise intervention, right after the intervention, and 4weeks after the intervention. The dependent variables were the processes of change, decisional balance, exercise self-efficacy, back-pain, depression and muscle strength. The results of this study were as follows. Processes of change (<.001), pros of decisional balance (<.001), exercise self-efficacy (<.001), back pain (<.001), depression (<.001), muscle strength (<.001) were higher in the experimental group than in the control group right after the program and 4weeks after the programs. The results of this study show that applying the TTM based exercise program increases the use of the change process, increases the exercise self-efficacy, increases the stage of changing the exercise behavior and strengthens the muscular strength by lowering the degree of pain and depression Respectively. The significance of the study was to confirm the effect of continuous exercise by maintaining regular exercise habits by applying exercise program of the transtheoretical model to the chronic low back pain elderly with exercise intention.

Keywords: chronic back pain, elderly, exercise, women

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5203 Madame Bovary in Transit: from Novel to Graphic Novel

Authors: Hania Pasandi

Abstract:

Since its publication in 1856, Madame Bovary has established itself as one of the most adapted texts of French literature. Some eighteen film adaptations and twenty-seven rewritings of Madame Bovary in fiction to date shows a great enthusiasm for recreating Flaubert’s masterpiece in a variety of mediums. Posy Simmonds’ 1999 graphic novel, Gemma Bovery stands out among these adaptations as the graphic novel with its visual and narrative structure offers a new reading experience of Madame Bovary, while combining Emma Bovary’s elements with contemporary social, cultural, and artistic discourses. This paper studies the transposition of Flaubert’s Madame Bovary (1857) to late twentieth-century Britain in Posy Simmonds’ 1999 graphic novel, Gemma Bovery by exploring how it borrows the essential flaubertian themes, from its source text to incorporate it with contemporary cultural trends.

Keywords: graphic novel, Gemma Bovery, Madame Bovary, transposition

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5202 Support for Refugee Entrepreneurs Through International Aid

Authors: Julien Benomar

Abstract:

The World Bank report published in April 2023 called “Migrants, Refugees and Society” allows us to first distinguish migrants in search of economic opportunities and refugees that flee a situation of danger and choose their destination based on their immediate need for safety. Amongst those two categories, the report distinguished people having professional skills adapted to the labor market of the host country and those who have not. Out of that distinction of four categories, we choose to focus our research on refugees that do not have professional skills adapted to the labor market of the host country. Given that refugees generally have no recourse to public assistance schemes and cannot count on the support of their entourage or support network, we propose to examine the extent to which external assistance, such as international humanitarian action, is likely to accompany refugees' transition to financial empowerment through entrepreneurship. To this end, we propose to carry out a case study structured in three stages: (i) an exchange with a Non-Governmental Organisation (NGO) active in supporting refugee populations from Congo and Burundi to Rwanda, enabling us to (i.i) define together a financial empowerment income, and (i. ii) learn about the content of the support measures taken for the beneficiaries of the humanitarian project; (ii) monitor the population of 118 beneficiaries, including 73 refugees and 45 Rwandans (reference population); (iii) conduct a participatory analysis to identify the level of performance of the project and areas for improvement. The case study thus involved the staff of an international NGO active in helping refugees from Rwanda since 2015 and the staff of a Luxembourg NGO that has been funding this economic aid project through entrepreneurship since 2021. The case study thus involved the staff of an international NGO active in helping refugees from Rwanda since 2015 and the staff of a Luxembourg NGO, which has been funding this economic aid through an entrepreneurship project since 2021, and took place over a 48-day period between April and May 2023. The main results are of two types: (i) the need to associate indicators for monitoring the impact of the project on the indirect beneficiaries of the project (refugee community) and (ii) the identification of success factors making it possible to bring concrete and relevant responses to the constraints encountered. The first result thus made it possible to identify the following indicators: Indicator of community potential ((jobs, training or mentoring) promoted by the activity of the entrepreneur), Indicator of social contribution (tax paid by the entrepreneur), Indicator of resilience (savings and loan capacity generated, and finally impact on social cohesion. The second result made it possible to identify that among the 7 success factors tested, the sector of activity chosen and the level of experience in the sector of the future activity are those that stand out the most clearly.

Keywords: entrepreuneurship, refugees, financial empowerment, international aid

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5201 Developing a Theory for Study of Transformation of Historic Cities

Authors: Sana Ahrar

Abstract:

Cities are undergoing rapid transformation with the change in lifestyle and technological advancements. These transformations may be experienced or physically visible in the built form. This paper focuses on the relationship between the social, physical environment, change in lifestyle and the interrelated factors influencing the transformation of any historic city. Shahjahanabad as a city has undergone transformation under the various political powers as well as the various policy implementations after independence. These visible traces of transformation diffused throughout the city may be due to socio-economic, historic, political factors and due to the globalization process. This study shall enable evolving a theory for the study of transformation of Historic cities such as Shahjahanabad: which has been plundered, rebuilt, and which still thrives as a ‘living heritage city’. The theory developed will be the process of studying the transformation and can be used by planners, policy makers and researchers in different urban contexts.

Keywords: heritage, historic cities, Shahjahanabad, transformation

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5200 Impact of Cultural Intelligence on Decision Making Styles of Managers: A Turkish Case

Authors: Fusun Akdag

Abstract:

Today, as business becomes increasingly global, managers/leaders of multinational companies or local companies work with employees or customers from a variety of cultural backgrounds. To do this effectively, they need to develop cultural competence. Therefore, cultural intelligence (CQ) becomes a vitally important aptitude and skill, especially for leaders. The organizational success or failure depends upon the way, the kind of leadership which has been provided to its members. The culture we are born into deeply effects our values, beliefs, and behavior. Cultural intelligence (CQ) focuses on how well individuals can relate and work across cultures. CQ helps minimize conflict and maximize performance of a diverse workforce. The term 'decision,' refers to a commitment to a course of action that is intended to serve the interests and values of particular people. One dimension of culture that has received attention is individualism-collectivism or, independence-interdependence. These dimensions are associated with different conceptualizations of the 'self.' Individualistic cultures tend to value personal goal pursuit as opposed to pursuit of others’ goals. Collectivistic cultures, by contrast, view the 'self' as part of a whole. Each person is expected to work with his or her in-group toward goals, generally pursue group harmony. These differences underlie cross-cultural variation in decision-making, such as the decision modes people use, their preferences, negotiation styles, creativity, and more. The aim of this study is determining the effect of CQ on decision making styles of male and female managers in Turkey, an emergent economy framework. The survey is distributed to gather data from managers at various companies. The questionnaire consists of three parts: demographics, The Cultural Intelligence Scale (CQS) to measure the four dimensions of cultural intelligence and General Decision Making Style (GMDS) Inventory to measure the five subscales of decision making. The results will indicate the Turkish managers’ score at metacognitive, cognitive, motivational and behavioral aspects of cultural intelligence and to what extent these scores affect their rational, avoidant, dependent, intuitive and spontaneous decision making styles since business leaders make dozens of decisions every day that influence the success of the company and also having an impact on employees, customers, shareholders and the market.

Keywords: cultural intelligence, decision making, gender differences, management styles,

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5199 University Students' Perceptions of Effective Teaching

Authors: Christine K. Ormsbee, Jeremy S. Robinson

Abstract:

Teacher quality is important for United States universities. It impacts student achievement, program and degree progress, and even retention. While course instructors are still the primary designers and deliverers of instruction in U.S. higher education classrooms, students have become better and more vocal consumers of instruction. They are capable of identifying what instructors do that facilitates their learning or, conversely, what instructors do that makes learning more difficult. Instructors can use students as resources as they design and implement their courses. Students have become more aware of their own learning preferences and processes and can articulate those. While it is not necessarily possible or likely that an instructor can address the widely varying differences in learning preferences represented by a large class of students, it is possible for them to employ general instructional supports that help students understand clearly the instructor's study expectations, identify critical content, efficiently commit content to memory, and develop new skills. Those learning supports include reading guides, test study guides, and other instructor-developed tasks that organize learning for students, hold them accountable for the content, and prepare them to use that material in simulated and real situations. When U.S. university teaching and learning support staff work with instructors to help them identify areas of their teaching to improve, a key part of that assistance includes talking to the instructor member's students. Students are asked to explain what the instructor does that helps them learn, what the instructor does that impedes their learning, and what they wish the instructor would do. Not surprisingly, students are very specific in what they see as helpful learning supports for them. Moreover, they also identify impediments to their success, viewing those as the instructor creating unnecessary barriers to learning. A qualitative survey was developed to provide undergraduate students the opportunity to identify instructor behaviors and/or practices that they thought helped students learn and those behaviors and practices that were perceived as hindrances to student success. That information is used to help instructors implement more student-focused learning supports that facilitate student achievement. In this session, data shared from the survey will focus on supportive instructor behaviors identified by undergraduate students in an institution located in the southwest United States and those behaviors that students perceive as creating unnecessary barriers to their academic success.

Keywords: effective teaching, pedagogy, student engagement, instructional design

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5198 Evaluating the Role of Cinema in the Formation of Cultural Schemas of Iranian Families by Studying the Opinions of Critics at the Venice Film Festival

Authors: Elahe Zavareian

Abstract:

Cinema is a powerful medium that can depict and critique sociological and cultural issues, contributing to the expansion of important societal issues and raising awareness. Family crises and challenges are significant concerns faced by societies worldwide. The family serves as the central core for societal formation, and the challenges experienced within this small social group have implications not only for individuals within a country but also for the wider culture. The concept of the family represents the entire society in relation to other countries, shaping ideas and prejudices regarding interpersonal culture and relationships. The representation of society's problems through cinema influences the formation of cultural schemas within the country producing the films and among the societies that view them.

Keywords: interpersonal culture, representation, society, family, cultural schemas

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5197 Analysis of Reduced Mechanisms for Premixed Combustion of Methane/Hydrogen/Propane/Air Flames in Geometrically Modified Combustor and Its Effects on Flame Properties

Authors: E. Salem

Abstract:

Combustion has been used for a long time as a means of energy extraction. However, in recent years, there has been a further increase in air pollution, through pollutants such as nitrogen oxides, acid etc. In order to solve this problem, there is a need to reduce carbon and nitrogen oxides through learn burning modifying combustors and fuel dilution. A numerical investigation has been done to investigate the effectiveness of several reduced mechanisms in terms of computational time and accuracy, for the combustion of the hydrocarbons/air or diluted with hydrogen in a micro combustor. The simulations were carried out using the ANSYS Fluent 19.1. To validate the results “PREMIX and CHEMKIN” codes were used to calculate 1D premixed flame based on the temperature, composition of burned and unburned gas mixtures. Numerical calculations were carried for several hydrocarbons by changing the equivalence ratios and adding small amounts of hydrogen into the fuel blends then analyzing the flammable limit, the reduction in NOx and CO emissions, then comparing it to experimental data. By solving the conservations equations, several global reduced mechanisms (2-9-12) were obtained. These reduced mechanisms were simulated on a 2D cylindrical tube with dimensions of 40 cm in length and 2.5 cm diameter. The mesh of the model included a proper fine quad mesh, within the first 7 cm of the tube and around the walls. By developing a proper boundary layer, several simulations were performed on hydrocarbon/air blends to visualize the flame characteristics than were compared with experimental data. Once the results were within acceptable range, the geometry of the combustor was modified through changing the length, diameter, adding hydrogen by volume, and changing the equivalence ratios from lean to rich in the fuel blends, the results on flame temperature, shape, velocity and concentrations of radicals and emissions were observed. It was determined that the reduced mechanisms provided results within an acceptable range. The variation of the inlet velocity and geometry of the tube lead to an increase of the temperature and CO2 emissions, highest temperatures were obtained in lean conditions (0.5-0.9) equivalence ratio. Addition of hydrogen blends into combustor fuel blends resulted in; reduction in CO and NOx emissions, expansion of the flammable limit, under the condition of having same laminar flow, and varying equivalence ratio with hydrogen additions. The production of NO is reduced because the combustion happens in a leaner state and helps in solving environmental problems.

Keywords: combustor, equivalence-ratio, hydrogenation, premixed flames

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5196 Variation in Wood Anatomical Properties of Acacia seyal var. seyal Tree Species Growing in Different Zones in Sudan

Authors: Hanadi Mohamed Shawgi Gamal, Ashraf Mohamed Ahmed Abdalla

Abstract:

Sudan is endowed by a great diversity of tree species; nevertheless, the utilization of wood resources has traditionally concentrated on a few number of species. With the great variation in the climatic zones of Sudan, great variations are expected in the anatomical properties between and within species. This variation needs to be fully explored in order to suggest the best uses for the species. Modern research on wood has substantiated that the climatic condition where the species grow has significant effect on wood properties. Understanding the extent of variability of wood is important because the uses for each kind of wood are related to its characteristics; furthermore, the suitability or quality of wood for a particular purpose is determined by the variability of one or more of these characteristics. The present study demonstrates the effect of rainfall zones in some anatomical properties of Acacia seyal var. seyal growing in Sudan. For this purpose, twenty healthy trees were collected randomly from two zones (ten trees per zone). One zone with relatively low rainfall (273mm annually) which represented by North Kordofan state and White Nile state and the second with relatively high rainfall (701 mm annually) represented by Blue Nile state and South Kordofan state. From each sampled tree, a stem disc (3 cm thick) was cut at 10% from stem height. One radius was obtained in central stem dices. Two representative samples were taken from each disc, one at 10% distance from pith to bark, the second at 90% in order to represent the juvenile and mature wood. The investigated anatomical properties were fibers length, fibers and vessels diameter, lumen diameter, and wall thickness as well as cell proportions. The result of the current study reveals significant differences between zones in mature wood vessels diameter and wall thickness, as well as juvenile wood vessels, wall thickness. The higher values were detected in the drier zone. Significant differences were also observed in juvenile wood fiber length, diameter as well as wall thickness. Contrary to vessels diameter and wall thickness, the fiber length, diameter as well as wall thickness were decreased in the drier zone. No significant differences have been detected in cell proportions of juvenile and mature wood. The significant differences in some fiber and vessels dimension lead to expect significant differences in wood density. From these results, Acacia seyal var. seyal seems to be well adapted with the change in rainfall and may survive in any rainfall zone.

Keywords: Acacia seyal var. seyal, anatomical properties, rainfall zones, variation

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5195 The Relationship between Organizational Climate with Job Burnout and Job Satisfaction in Employees of Tehran Electric Company

Authors: Zeinab Amini Moghaddam, Alireza Dehkhodania

Abstract:

Nowadays, organizations have found a high status in the cultural and social structures of societies. The purpose of current study is to investigate the relationship between organizational climate with job burnout as well as job satisfaction. The research method is descriptive and correlational. The population of the study includes all employees in Tehran Electric Company, which equals 1984 people in 2018. The sampling was performed in the form of a consensus, and all employees were regarded as samples. The data gathering tools consist of three questionnaires of Smith’s Job Satisfaction Questionnaire, Halpin and Craft's Occupational climate, and Maslach and Jackson's Job burnout. The results showed that there was a direct and positive relationship between organizational climate and job burnout, as well as job satisfaction. The organizational climate variable could successfully predict job satisfaction. It was also able to predict job burnout.

Keywords: organizational climate, job burnout, job satisfaction, descriptive, correlational

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5194 A Framework for Incorporating Non-Linear Degradation of Conductive Adhesive in Environmental Testing

Authors: Kedar Hardikar, Joe Varghese

Abstract:

Conductive adhesives have found wide-ranging applications in electronics industry ranging from fixing a defective conductor on printed circuit board (PCB) attaching an electronic component in an assembly to protecting electronics components by the formation of “Faraday Cage.” The reliability requirements for the conductive adhesive vary widely depending on the application and expected product lifetime. While the conductive adhesive is required to maintain the structural integrity, the electrical performance of the associated sub-assembly can be affected by the degradation of conductive adhesive. The degradation of the adhesive is dependent upon the highly varied use case. The conventional approach to assess the reliability of the sub-assembly involves subjecting it to the standard environmental test conditions such as high-temperature high humidity, thermal cycling, high-temperature exposure to name a few. In order to enable projection of test data and observed failures to predict field performance, systematic development of an acceleration factor between the test conditions and field conditions is crucial. Common acceleration factor models such as Arrhenius model are based on rate kinetics and typically rely on an assumption of linear degradation in time for a given condition and test duration. The application of interest in this work involves conductive adhesive used in an electronic circuit of a capacitive sensor. The degradation of conductive adhesive in high temperature and humidity environment is quantified by the capacitance values. Under such conditions, the use of established models such as Hallberg-Peck model or Eyring Model to predict time to failure in the field typically relies on linear degradation rate. In this particular case, it is seen that the degradation is nonlinear in time and exhibits a square root t dependence. It is also shown that for the mechanism of interest, the presence of moisture is essential, and the dominant mechanism driving the degradation is the diffusion of moisture. In this work, a framework is developed to incorporate nonlinear degradation of the conductive adhesive for the development of an acceleration factor. This method can be extended to applications where nonlinearity in degradation rate can be adequately characterized in tests. It is shown that depending on the expected product lifetime, the use of conventional linear degradation approach can overestimate or underestimate the field performance. This work provides guidelines for suitability of linear degradation approximation for such varied applications

Keywords: conductive adhesives, nonlinear degradation, physics of failure, acceleration factor model.

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5193 Predictors of Pericardial Effusion Requiring Drainage Following Coronary Artery Bypass Graft Surgery: A Retrospective Analysis

Authors: Nicholas McNamara, John Brookes, Michael Williams, Manish Mathew, Elizabeth Brookes, Tristan Yan, Paul Bannon

Abstract:

Objective: Pericardial effusions are an uncommon but potentially fatal complication after cardiac surgery. The goal of this study was to describe the incidence and risk factors associated with the development of pericardial effusion requiring drainage after coronary artery bypass graft surgery (CABG). Methods: A retrospective analysis was undertaken using prospectively collected data. All adult patients who underwent CABG at our institution between 1st January 2017 and 31st December 2018 were included. Pericardial effusion was diagnosed using transthoracic echocardiography (TTE) performed for clinical suspicion of pre-tamponade or tamponade. Drainage was undertaken if considered clinically necessary and performed via a sub-xiphoid incision, pericardiocentesis, or via re-sternotomy at the discretion of the treating surgeon. Patient demographics, operative characteristics, anticoagulant exposure, and postoperative outcomes were examined to identify those variables associated with the development of pericardial effusion requiring drainage. Tests of association were performed using the Fischer exact test for dichotomous variables and the Student t-test for continuous variables. Logistic regression models were used to determine univariate predictors of pericardial effusion requiring drainage. Results: Between January 1st, 2017, and December 31st, 2018, a total of 408 patients underwent CABG at our institution, and eight (1.9%) required drainage of pericardial effusion. There was no difference in age, gender, or the proportion of patients on preoperative therapeutic heparin between the study and control groups. Univariate analysis identified preoperative atrial arrhythmia (37.5% vs 8.8%, p = 0.03), reduced left ventricular ejection fraction (47% vs 56%, p = 0.04), longer cardiopulmonary bypass (130 vs 84 min, p < 0.01) and cross-clamp (107 vs 62 min, p < 0.01) times, higher drain output in the first four postoperative hours (420 vs 213 mL, p <0.01), postoperative atrial fibrillation (100% vs 32%, p < 0.01), and pleural effusion requiring drainage (87.5% vs 12.5%, p < 0.01) to be associated with development of pericardial effusion requiring drainage. Conclusion: In this study, the incidence of pericardial effusion requiring drainage was 1.9%. Several factors, mainly related to preoperative or postoperative arrhythmia, length of surgery, and pleural effusion requiring drainage, were identified to be associated with developing clinically significant pericardial effusions. High clinical suspicion and low threshold for transthoracic echo are pertinent to ensure this potentially lethal condition is not missed.

Keywords: coronary artery bypass, pericardial effusion, pericardiocentesis, tamponade, sub-xiphoid drainage

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