Search results for: post WWII period
8182 Socialist Ideology in Africa: A Comparative Study of Pre and Post Socialism
Authors: Haymanot Gebre-Amlak, Selamawit Gebre-Amlak
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Since its original declaration in the 18th century, Karl Marx and Friedrich Engels's Communist Manifesto has become one of the most influential political tracts. Socialism is a political path that leads towards communism by fostering a cooperative economy through the creation of cooperative enterprises, common ownership, state ownership, or shared equity. The ultimate objective of communism is to bring everyone working toward the same collective goal of a healthy, happy, and free society. The European establishment of 19-century colonial rule over the continent of Africa reinforced inflows of European investment and forced a profound change in the operation of labor and land markets. The colonial era and forced labor schemes in Africa lasted for several decades. When exiting from colonialism, these African countries were attracted to socialism’s ideology to bridge the social gap and freedom to their society. In this paper, we compare a pre and post socialist ideology and the impact in various African countries. We analyse the different aspects, which led to inconsistent outcomes. Our finding indicates that while they have some facets in common, each African country had a unique interpretation and influence from the socialist ideology.Keywords: African politics, socialism in Africa, African history, Africa
Procedia PDF Downloads 1668181 Assesing Spatio-Temporal Growth of Kochi City Using Remote Sensing Data
Authors: Navya Saira George, Patroba Achola Odera
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This study aims to determine spatio-temporal expansion of Kochi City, situated on the west coast of Kerala State in India. Remote sensing and GIS techniques have been used to determine land use/cover and urban expansion of the City. Classification of Landsat images of the years 1973, 1988, 2002 and 2018 have been used to reproduce a visual story of the growth of the City over a period of 45 years. Accuracy range of 0.79 ~ 0.86 is achieved with kappa coefficient range of 0.69 ~ 0.80. Results show that the areas covered by vegetation and water bodies decreased progressively from 53.0 ~ 30.1% and 34.1 ~ 26.2% respectively, while built-up areas increased steadily from 12.5 to 42.2% over the entire study period (1973 ~ 2018). The shift in land use from agriculture to non-agriculture may be attributed to the land reforms since 1980s.Keywords: Geographical Information Systems, Kochi City, Land use/cover, Remote Sensing, Urban Sprawl
Procedia PDF Downloads 1298180 Application of Metaverse Service to Construct Nursing Education Theory and Platform in the Post-pandemic Era
Authors: Chen-Jung Chen, Yi-Chang Chen
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While traditional virtual reality and augmented reality only allow for small movement learning and cannot provide a truly immersive teaching experience to give it the illusion of movement, the new technology of both content creation and immersive interactive simulation of the metaverse can just reach infinite close to the natural teaching situation. However, the mixed reality virtual classroom of metaverse has not yet explored its theory, and it is rarely implemented in the situational simulation teaching of nursing education. Therefore, in the first year, the study will intend to use grounded theory and case study methods and in-depth interviews with nursing education and information experts. Analyze the interview data to investigate the uniqueness of metaverse development. The proposed analysis will lead to alternative theories and methods for the development of nursing education. In the second year, it will plan to integrate the metaverse virtual situation simulation technology into the alternate teaching strategy in the pediatric nursing technology course and explore the nursing students' use of this teaching method as the construction of personal technology and experience. By leveraging the unique features of distinct teaching platforms and developing processes to deliver alternative teaching strategies in a nursing technology teaching environment. The aim is to increase learning achievements without compromising teaching quality and teacher-student relationships in the post-pandemic era. A descriptive and convergent mixed methods design will be employed. Sixty third-grade nursing students will be recruited to participate in the research and complete the pre-test. The students in the experimental group (N=30) agreed to participate in 4 real-time mixed virtual situation simulation courses in self-practice after class and conducted qualitative interviews after each 2 virtual situation courses; the control group (N=30) adopted traditional practice methods of self-learning after class. Both groups of students took a post-test after the course. Data analysis will adopt descriptive statistics, paired t-tests, one-way analysis of variance, and qualitative content analysis. This study addresses key issues in the virtual reality environment for teaching and learning within the metaverse, providing valuable lessons and insights for enhancing the quality of education. The findings of this study are expected to contribute useful information for the future development of digital teaching and learning in nursing and other practice-based disciplines.Keywords: metaverse, post-pandemic era, online virtual classroom, immersive teaching
Procedia PDF Downloads 688179 Environmental Degradation in Niger-Delta and Sustainable Development in Nigeria: Issues for Consideration
Authors: Peter Okpamen
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The issue of environmental degradation in Nigeria is of serious concern. The colonial period brought a major change in environmental awareness and relationship with the environment. This period introduced a model of development, the major thrust of which was the exploration and transformation of natural and human resources for the benefit of the colonial masters. There is abundant evidence in the literature that there are various manifestations of environmental degradation in Nigeria, which have resulted in the various problems found throughout the Nigeria national space. The idea of the environment acting as a constraint to the growth of human activity has given way to the contrary. Environmental education, going by the literature, exists at the primary, secondary and tertiary institutions. In short, the 1st National conference on environmental education gave several suggestions on how it could be realised. Thus, to realise sustainable environmental development we need to accelerate the process of providing basic education for both the old and young. Environmental education should cover the whole federation, and resources should be made available for the training of environmental education teachers and research into environmental education for the development of appropriate learning resources.Keywords: degradation, development, education, environment, sustainable
Procedia PDF Downloads 4148178 The Effectiveness of Sexual Cognitive Behavioral Therapy on Strategic Thinking and Communication Patterns of Couples in Colostomy Patients
Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Seyedeh Somayeh Amiri, Mozhgan Shakhseniaei, Amin Asadi Hieh
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The purpose of this research was to determine the effectiveness of sexual cognitive behavioral therapy on strategic thinking and communication patterns of couples in colostomy patients. In this study, experimental research was conducted with a pre-test and post-test design with a control group and a follow-up period. The statistical population studied were married female colostomy patients referring to the Iranian Ostomy Association. 30 qualified people were selected by voluntary sampling and randomly divided into two experimental and control groups (15 people in each group). Both groups responded to Goleman's strategic thinking (2007) and the communication patterns of Christensen and Sulawai questionnaires (1984). The results of covariance analysis showed that sexual cognitive behavioral therapy has an effect on improving strategic thinking. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving the strategic thinking of colostomy patients until the follow-up stage. Also, sexual cognitive behavioral therapy has an effect on improving the communication patterns of couples in colostomy patients. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving communication patterns of couples in patients with colostomy until the follow-up stage. Based on the results of this research, sexual cognitive behavioral therapy can be used to improve strategic thinking and communication patterns of couples of colostomy patients.Keywords: sexual cognitive behavioral therapy, strategic thinking, communication patterns of couples, colostomy
Procedia PDF Downloads 838177 Evaluation of Social Media Customer Engagement: A Content Analysis of Automobile Brand Pages
Authors: Adithya Jaikumar, Sudarsan Jayasingh
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The dramatic technology led changes that continue to take place at the market place has led to the emergence and implication of online brand pages on social media networks. The Facebook brand page has become extremely popular among different brands. The primary aim of this study was to identify the impact of post formats and content type on customer engagement in Facebook brand pages. Methodology used for this study was to analyze and categorize 9037 content messages posted by 20 automobile brands in India during April 2014 to March 2015 and the customer activity it generated in return. The data was obtained from Fanpage karma- an online tool used for social media analytics. The statistical technique used to analyze the count data was negative binomial regression. The study indicates that there is a statistically significant relationship between the type of post and the customer engagement. The study shows that photos are the most posted format and highest engagement is found to be related to videos. The finding also reveals that social events and entertainment related content increases engagement with the message.Keywords: content analysis, customer engagement, digital engagement, facebook brand pages, social media
Procedia PDF Downloads 3228176 Dynamic Model of Heterogeneous Markets with Imperfect Information for the Optimization of Company's Long-Time Strategy
Authors: Oleg Oborin
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This paper is dedicated to the development of the model, which can be used to evaluate the effectiveness of long-term corporate strategies and identify the best strategies. The theoretical model of the relatively homogenous product market (such as iron and steel industry, mobile services or road transport) has been developed. In the model, the market consists of a large number of companies with different internal characteristics and objectives. The companies can perform mergers and acquisitions in order to increase their market share. The model allows the simulation of long-time dynamics of the market (for a period longer than 20 years). Therefore, a large number of simulations on random input data was conducted in the framework of the model. After that, the results of the model were compared with the dynamics of real markets, such as the US steel industry from the beginning of the XX century to the present day, and the market of mobile services in Germany for the period between 1990 and 2015.Keywords: Economic Modelling, Long-Time Strategy, Mergers and Acquisitions, Simulation
Procedia PDF Downloads 3678175 Impact of Chimerism on Y-STR DNA Determination: Sex Mismatch Analysis
Authors: Anupuma Raina, Ajay P. Balayan, Prateek Pandya, Pankaj Shrivastava, Uma Kanga, Tulika Seth
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DNA fingerprinting analysis aids in personal identification for forensic purposes and has always been a driving motivation for law enforcement agencies in almost all countries since its inception. The introduction of DNA markers (Y-STR) has allowed for greater precision and higher discriminatory power in forensic testing. A criminal/ person committing crime after bone marrow transplantation is a rare situation but not an impossible one. Keeping such a situation in mind, a study was carried out to find out the best biological sample to be used for personal identification, especially in forensic situation. We choose a female patient (recipient) and a male donor. The pre transplant sample (blood) and post transplant samples (blood, buccal swab, hair roots) were collected from the recipient (patient). The same were compared with the blood sample of the donor using DNA FP technique. Post transplant samples were collected at different interval of time (15, 30, 60, and 90 days). The study was carried out using Y-STR kit at 23 loci. The results determined discusses the phenomenon of chimerism and its impact on Y-STR. Hair sample was found the most suitable sample which had no donor DNA profiling up to 90 days.Keywords: bone marrow transplantation, chimerism, DNA profiling, Y-STR
Procedia PDF Downloads 1458174 Post Occupancy Evaluation of Thermal Comfort and User Satisfaction in a Green IT Commercial Building
Authors: Shraddha Jadhav
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We are entering a new age in the built environment where we expect our buildings to deliver far more than just a place to work or live. It is widely believed that sustainable building design strategies create improved occupants’ comfort & satisfaction with respect to thermal comfort & indoor environmental quality. Yet this belief remains a hypothesis with little empirical support. IT buildings cater to more than 3000 users at a time. Nowadays people spend 90% of the time inside offices. These sustainable IT office buildings should provide the occupants with maximum comfort for better work productivity. Such green rated buildings fulfill all the criteria at the designing stage, but do they really work as expected at the occupancy stage. The aim of this paper is to evaluate whether green IT buildings provide the required comfort level as expected at the design stage. Building Occupants are a rich source of information for evaluating their comfort level in the building and to find out the solutions for their discomfort. This can be achieved by carrying out Post Occupancy Evaluation after the building has been occupied for more than a year or two. The technique consists of qualitative methods like questionnaire surveys & observations and quantitative methods like field measurements, photographs. Post Occupancy Evaluation was carried out in a Green (Platinum rated) IT building in Pune. 30 samples per floor were identified for the questionnaire survey. The core questions access occupant satisfaction with thermal comfort in the work area and measures adopted for making it comfortable were identified. The Mean Radiant Temperature of the same samples was taken to compare the quantitative and qualitative results. The survey was used to evaluate the occupant thermal comfort in a green office building and identify areas needing improvement. The survey has been designed in reference to ASHRAE standard 55-2010 & ISHRAE 10001:2017 IEQ and was further refined to suit the user of the building.Keywords: green office building, building occupant, thermal comfort, POE, user satisfaction, survey
Procedia PDF Downloads 738173 Crop Losses, Produce Storage and Food Security, the Nexus: Attaining Sustainable Maize Production in Nigeria
Authors: Charles Iledun Oyewole, Harira Shuaib
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While fulfilling the food security of an increasing population like Nigeria remains a major global concern, more than one-third of crop harvested is lost or wasted during harvesting or in postharvest operations. Reducing the harvest and postharvest losses, especially in developing countries, could be a sustainable solution to increase food availability, eliminate hunger and improve farmers’ livelihoods. Nigeria is one of the countries in sub-Saharan Africa with insufficient food production and high food import bill, which has had debilitating effects on the country’s economy. One of the goals of Nigeria’s agricultural development policy is to ensure that, the nation produces enough food and be less dependent on importation so as to ensure adequate and affordable food for all. Maize could fill the food gap in Nigeria’s effort to beat hunger and food insecurity. Maize is the most important cereal after rice and its production contributes immensely to food availability on the tables of many Nigerians. Maize grains constitute primary source of food for large percentage of the Nigerian populace, thus a considerable waste of this valuable food pre and post-harvest constitutes such a major agricultural bottleneck; that the reduction of pre and post-harvest losses is now a common food security strategy. In surveys conducted, as much as 60% maize outputs can be lost on the field and during the storage stage due to technical inefficiency. Field losses due to rodent damage alone can account for between 10% - 60% grain losses depending on the location. While the use of scientific storage methods can reduce losses below 2% in storage, timely harvesting of crop can check losses on the fields resulting from rodent damage or pest infestation. A push for increased crop production must be complemented by available and affordable post-harvest technologies that will reduce losses on farmers’ fields as well as in storage.Keywords: government policy, maize, population increase, storage, sustainable food production, yield, yield losses
Procedia PDF Downloads 1368172 Solar Power Forecasting for the Bidding Zones of the Italian Electricity Market with an Analog Ensemble Approach
Authors: Elena Collino, Dario A. Ronzio, Goffredo Decimi, Maurizio Riva
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The rapid increase of renewable energy in Italy is led by wind and solar installations. The 2017 Italian energy strategy foresees a further development of these sustainable technologies, especially solar. This fact has resulted in new opportunities, challenges, and different problems to deal with. The growth of renewables allows to meet the European requirements regarding energy and environmental policy, but these types of sources are difficult to manage because they are intermittent and non-programmable. Operationally, these characteristics can lead to instability on the voltage profile and increasing uncertainty on energy reserve scheduling. The increasing renewable production must be considered with more and more attention especially by the Transmission System Operator (TSO). The TSO, in fact, every day provides orders on energy dispatch, once the market outcome has been determined, on extended areas, defined mainly on the basis of power transmission limitations. In Italy, six market zone are defined: Northern-Italy, Central-Northern Italy, Central-Southern Italy, Southern Italy, Sardinia, and Sicily. An accurate hourly renewable power forecasting for the day-ahead on these extended areas brings an improvement both in terms of dispatching and reserve management. In this study, an operational forecasting tool of the hourly solar output for the six Italian market zones is presented, and the performance is analysed. The implementation is carried out by means of a numerical weather prediction model, coupled with a statistical post-processing in order to derive the power forecast on the basis of the meteorological projection. The weather forecast is obtained from the limited area model RAMS on the Italian territory, initialized with IFS-ECMWF boundary conditions. The post-processing calculates the solar power production with the Analog Ensemble technique (AN). This statistical approach forecasts the production using a probability distribution of the measured production registered in the past when the weather scenario looked very similar to the forecasted one. The similarity is evaluated for the components of the solar radiation: global (GHI), diffuse (DIF) and direct normal (DNI) irradiation, together with the corresponding azimuth and zenith solar angles. These are, in fact, the main factors that affect the solar production. Considering that the AN performance is strictly related to the length and quality of the historical data a training period of more than one year has been used. The training set is made by historical Numerical Weather Prediction (NWP) forecasts at 12 UTC for the GHI, DIF and DNI variables over the Italian territory together with corresponding hourly measured production for each of the six zones. The AN technique makes it possible to estimate the aggregate solar production in the area, without information about the technologic characteristics of the all solar parks present in each area. Besides, this information is often only partially available. Every day, the hourly solar power forecast for the six Italian market zones is made publicly available through a website.Keywords: analog ensemble, electricity market, PV forecast, solar energy
Procedia PDF Downloads 1588171 The Robotic Factor in Left Atrial Myxoma
Authors: Abraham J. Rizkalla, Tristan D. Yan
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Atrial myxoma is the most common primary cardiac tumor, and can result in cardiac failure secondary to obstruction, or systemic embolism due to fragmentation. Traditionally, excision of atrial an myxoma has been performed through median sternotomy, however the robotic approach offers several advantages including less pain, improved cosmesis, and faster recovery. Here, we highlight the less well recognized advantages and technical aspects to robotic myxoma resection. This video-presentation demonstrates the resection of a papillary subtype left atrial myxoma using the DaVinci© Xi surgical robot. The 10x magnification and 3D vision allows for the interface between the tumor and the interatrial septum to be accurately dissected, without the need to patch the interatrial septum. Several techniques to avoid tumor fragmentation and embolization are demonstrated throughout the procedure. The tumor was completely excised with clear margins. There was no atrial septal defect or mitral valve injury on post operative transesophageal echocardiography. The patient was discharged home on the fourth post-operative day. This video-presentation highlights the advantages of the robotic approach in atrial myxoma resection compared with sternotomy, as well as emphasizing several technical considerations to avoid potential complications.Keywords: cardiac surgery, left atrial myxoma, cardiac tumour, robotic resection
Procedia PDF Downloads 728170 Including All Citizens Pathway (IACP): Transforming Post-Secondary Education Using Inclusion and Accessibility as Foundation
Authors: Fiona Whittington-Walsh
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Including All Citizens Pathway (IACP) is addressing the systems wide discrimination that students with disabilities experience throughout the education system. IACP offers a wide, institutional support structure so that all students, including students with intellectual/developmental disabilities, are included and can succeed. The entire process from admissions, course selection, course instruction, graduation is designed to address systemic discrimination while supporting learners and faculty. The inclusive and accessible pedagogical model that is the foundation of IACP opens the doors of post-secondary education by making existing academic courses environments where all students can participate and succeed. IACP is about transforming teaching, not modifying, or adapting the curriculum or essential knowledge and skill sets that are required learning outcomes. Universal Design for Learning (UDL) principles are applied to instructional teaching strategies such as lectures, presentations, and assessment tools. Created in 2016 as a research pilot, IACP is one of the first fully inclusive for credit post-secondary options available. The pilot received numerous external and internal grants to support its initiative to investigate and assess the teaching strategies and techniques that support student learning of essential knowledge and skill sets. IACP pilot goals included: (1) provide a successful pilot as a model of inclusive and accessible pedagogy; (2) create a teacher’s guide to assist other instructors in transforming their teaching to reach a wide range of learners; (3) identify policy barriers located within the educational system; and (4) provide leadership and encouraging innovative and inclusive pedagogical practices. The pilot was a success and in 2020 the first cohort of students graduated with an exit credential that pre-exists IACP and consists of ten academic courses. The University has committed to continue IACP and has developed a sustainable model. Each new academic year a new cohort of IACP students starts their post-secondary educational journey, while two additional instructors are mentored with the pedagogy. The pedagogical foundation of IACP has far-reaching potential including, but not limited to, programs that offer services for international students whose first language is not English as well as influencing pedagogical reform in secondary and post-secondary education. IACP also supports universities in satisfying educational standards that are or will be included in accessibility/disability legislation. This session will present information about IACP, share examples of systems transformation, hear from students and instructors, and provide participatory experiential activities that demonstrate the transformative techniques. We will be drawing from the experiences of a recent course that explored research documenting the lived experiences of students with disabilities in post-secondary institutes in B.C (Whittington-Walsh). Students created theatrical scenes out of the data and presented it using Forum Theatre method. Forum Theatre was used to create conversations, challenge stereotypes, and build connections between ableism, disability justice, Indigeneity, and social policy.Keywords: disability justice, inclusive education, pedagogical transformation, systems transformation
Procedia PDF Downloads 88169 Retrospective Assessment of the Safety and Efficacy of Percutaneous Microwave Ablation in the Management of Hepatic Lesions
Authors: Suang K. Lau, Ismail Goolam, Rafid Al-Asady
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Background: The majority of patients with hepatocellular carcinoma (HCC) are not suitable for curative treatment, in the form of surgical resection or transplantation, due to tumour extent and underlying liver dysfunction. In these non-resectable cases, a variety of non-surgical therapies are available, including microwave ablation (MWA), which has shown increasing popularity due to its low morbidity, low reported complication rate, and the ability to perform multiple ablations simultaneously. Objective: The aim of this study was to evaluate the validity of MWA as a viable treatment option in the management of HCC and hepatic metastatic disease, by assessing its efficacy and complication rate at a tertiary hospital situated in Westmead (Australia). Methods: A retrospective observational study was performed evaluating patients that underwent MWA between 1/1/2017–31/12/2018 at Westmead Hospital, NSW, Australia. Outcome measures, including residual disease, recurrence rates, as well as major and minor complication rates, were retrospectively analysed over a 12-months period following MWA treatment. Excluded patients included those whose lesions were treated on the basis of residual or recurrent disease from previous treatment, which occurred prior to the study window (11 patients) and those who were lost to follow up (2 patients). Results: Following treatment of 106 new hepatic lesions, the complete response rate (CR) was 86% (91/106) at 12 months follow up. 10 patients had the residual disease at post-treatment follow up imaging, corresponding to an incomplete response (ICR) rate of 9.4% (10/106). The local recurrence rate (LRR) was 4.6% (5/106) with follow-up period up to 12 months. The minor complication rate was 9.4% (10/106) including asymptomatic pneumothorax (n=2), asymptomatic pleural effusions (n=2), right lower lobe pneumonia (n=3), pain requiring admission (n=1), hypotension (n=1), cellulitis (n=1) and intraparenchymal hematoma (n=1). There was 1 major complication reported, with pleuro-peritoneal fistula causing recurrent large pleural effusion necessitating repeated thoracocentesis (n=1). There was no statistically significant association between tumour size, location or ablation factors, and risk of recurrence or residual disease. A subset analysis identified 6 segment VIII lesions, which were treated via a trans-pleural approach. This cohort demonstrated an overall complication rate of 33% (2/6), including 1 minor complication of asymptomatic pneumothorax and 1 major complication of pleuro-peritoneal fistula. Conclusions: Microwave ablation therapy is an effective and safe treatment option in cases of non-resectable hepatocellular carcinoma and liver metastases, with good local tumour control and low complication rates. A trans-pleural approach for high segment VIII lesions is associated with a higher complication rate and warrants greater caution.Keywords: hepatocellular carcinoma, liver metastases, microwave ablation, trans-pleural approach
Procedia PDF Downloads 1358168 Rapid Monitoring of Earthquake Damages Using Optical and SAR Data
Authors: Saeid Gharechelou, Ryutaro Tateishi
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Earthquake is an inevitable catastrophic natural disaster. The damages of buildings and man-made structures, where most of the human activities occur are the major cause of casualties from earthquakes. A comparison of optical and SAR data is presented in the case of Kathmandu valley which was hardly shaken by 2015-Nepal Earthquake. Though many existing researchers have conducted optical data based estimated or suggested combined use of optical and SAR data for improved accuracy, however finding cloud-free optical images when urgently needed are not assured. Therefore, this research is specializd in developing SAR based technique with the target of rapid and accurate geospatial reporting. Should considers that limited time available in post-disaster situation offering quick computation exclusively based on two pairs of pre-seismic and co-seismic single look complex (SLC) images. The InSAR coherence pre-seismic, co-seismic and post-seismic was used to detect the change in damaged area. In addition, the ground truth data from field applied to optical data by random forest classification for detection of damaged area. The ground truth data collected in the field were used to assess the accuracy of supervised classification approach. Though a higher accuracy obtained from the optical data then integration by optical-SAR data. Limitation of cloud-free images when urgently needed for earthquak evevent are and is not assured, thus further research on improving the SAR based damage detection is suggested. Availability of very accurate damage information is expected for channelling the rescue and emergency operations. It is expected that the quick reporting of the post-disaster damage situation quantified by the rapid earthquake assessment should assist in channeling the rescue and emergency operations, and in informing the public about the scale of damage.Keywords: Sentinel-1A data, Landsat-8, earthquake damage, InSAR, rapid damage monitoring, 2015-Nepal earthquake
Procedia PDF Downloads 1728167 Fault Tree Analysis (FTA) of CNC Turning Center
Authors: R. B. Patil, B. S. Kothavale, L. Y. Waghmode
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Today, the CNC turning center becomes an important machine tool for manufacturing industry worldwide. However, as the breakdown of a single CNC turning center may result in the production of an entire plant being halted. For this reason, operations and preventive maintenance have to be minimized to ensure availability of the system. Indeed, improving the availability of the CNC turning center as a whole, objectively leads to a substantial reduction in production loss, operating, maintenance and support cost. In this paper, fault tree analysis (FTA) method is used for reliability analysis of CNC turning center. The major faults associated with the system and the causes for the faults are presented graphically. Boolean algebra is used for evaluating fault tree (FT) diagram and for deriving governing reliability model for CNC turning center. Failure data over a period of six years has been collected and used for evaluating the model. Qualitative and quantitative analysis is also carried out to identify critical sub-systems and components of CNC turning center. It is found that, at the end of the warranty period (one year), the reliability of the CNC turning center as a whole is around 0.61628.Keywords: fault tree analysis (FTA), reliability analysis, risk assessment, hazard analysis
Procedia PDF Downloads 4148166 Effectiveness of Imagery Compared with Exercise Training on Hip Abductor Strength and EMG Production in Healthy Adults
Authors: Majid Manawer Alenezi, Gavin Lawrence, Hans-Peter Kubis
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Imagery training could be an important treatment for muscle function improvements in patients who are facing limitations in exercise training by pain or other adverse symptoms. However, recent studies are mostly limited to small muscle groups and are often contradictory. Moreover, a possible bilateral transfer effect of imagery training has not been examined. We, therefore, investigated the effectiveness of unilateral imagery training in comparison with exercise training on hip abductor muscle strength and EMG. Additionally, both limbs were assessed to investigate bilateral transfer effects. Healthy individuals took part in an imagery or exercise training intervention for two weeks and were assesses pre and post training. Participants (n=30), after randomization into an imagery and an exercise group, trained 5 times a week under supervision with additional self-performed training on the weekends. The training consisted of performing, or to imagine, 5 maximal isometric hip abductor contractions (= one set), repeating the set 7 times. All measurements and trainings were performed laying on the side on a dynamometer table. The imagery script combined kinesthetic and visual imagery with internal perspective for producing imagined maximal hip abduction contractions. The exercise group performed the same number of tasks but performing the maximal hip abductor contractions. Maximal hip abduction strength and EMG amplitudes were measured of right and left limbs pre- and post-training period. Additionally, handgrip strength and right shoulder abduction (Strength and EMG) were measured. Using mixed model ANOVA (strength measures) and Wilcoxen-tests (EMGs), data revealed a significant increase in hip abductor strength production in the imagery group on the trained right limb (~6%). However, this was not reported for the exercise group. Additionally, the left hip abduction strength (not used for training) did not show a main effect in strength, however, there was a significant interaction of group and time revealing that the strength increased in the imagery group while it remained constant in the exercise group. EMG recordings supported the strength findings showing significant elevation of EMG amplitudes after imagery training on right and left side, while the exercise training group did not show any changes. Moreover, measures of handgrip strength and shoulder abduction showed no effects over time and no interactions in both groups. Experiments showed that imagery training is a suitable method for effectively increasing functional parameters of larger limb muscles (strength and EMG) which were enhanced on both sides (trained and untrained) confirming a bilateral transfer effect. Indeed, exercise training did not reveal any increases in the parameters above omitting functional improvements. The healthy individuals tested might not easily achieve benefits from exercise training within the time tested. However, it is evident that imagery training is effective in increasing the central motor command towards the muscles and that the effect seems to be segmental (no increase in handgrip strength and shoulder abduction parameters) and affects both sides (trained and untrained). In conclusion, imagery training was effective in functional improvements in limb muscles and produced a bilateral transfer on strength and EMG measures.Keywords: imagery, exercise, physiotherapy, motor imagery
Procedia PDF Downloads 2348165 Elucidation of Mechanism of Action of Antidepressant-Like Effect of Valeriana wallichii Maaliol Chemotype in Mice
Authors: Sangeeta Pilkhwal Sah, C. S. Mathela, Kanwaljit Chopra
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Valeriana wallichii DC, an ayurvedic traditional medicine, popularly named as Indian valerian exist as three chemotypes. GC-MS analysis of V. wallichii essential oil in present study showed maaliol as the major constituent followed by the presence of β-gurjunene, acoradiene, guaiol and α-santalene. The results thus confirmed it to be a maaliol chemotype. Further, the antidepressant-like effect of root essential oil (10, 20 and 40 mg/kg p.o.) was investigated in both acute and chronic treatment study using forced swim test in mice. Single administration of different doses produced an inverted U shaped curve and significantly inhibited the immobility period (39.7% and 58%) at doses 10 and 40 mg/kg respectively. Standard drug imipramine significantly decreased immobility period (59.8%). None of the doses altered locomotor activity except a significant decrease of 44.9% was observed with 40 mg/kg (p < 0.05). Similarly, daily administration of essential oil for 14 days produced a dose dependent effect with significantly reduced immobility period (70.9%) at 40 mg/kg dose only whereas imipramine produced 86% decrease (p < 0.05). The neurotransmitter levels in mouse brain were estimated on day 14 after the behavioral study. Significant increase in the level of norepinephrine (10%) and dopamine (23%) (p < 0.05) was found at 40 mg/kg dose, while no change was observed at 10 and 20 mg/kg doses. The antidepressant-like effect of essential oil (40 mg/kg) was prevented by pretreatment of mice with L-arginine (750 mg/kg i.p.) and sildenafil (5 mg/kg i.p). On the contrary, pretreatment of mice with L-NAME (10 mg/kg i.p.) or methylene blue (10 mg/kg i.p.) potentiated the antidepressant action of essential oil (20 mg/kg). The findings thus demonstrated that nitric oxide pathway is involved in mediating antidepressant like effect of essential oil from this chemotype.Keywords: Valeriana wallichii DC chemotype, essential oil, forced swim test, nitric oxide modulators, neurotransmitters
Procedia PDF Downloads 2978164 Clinical, Demographic and Molecular Characterization of Dengue, Chikungunya and Zika Viruses Causing Hemorrhagic Fever in North India
Authors: Suruchi Shukla, Shantanu Prakash, Amita Jain
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Introduction: Arboviral diseases are one of the most common causes of viral hemorrhagic fever (VHF). Of which, Dengue and Chikungunya pose a significant health problem in India. Arbovirus has a tendency to cross the territories and emerge in the new region. Considering the above issues, in the current study active surveillance was conducted among viral hemorrhagic fever (VHF) cases reported from Uttar Pradesh (UP), India. We studied the arboviral etiology of VHF; mainly Dengue, Chikungunya, and ZIKA. Methods: Clinical samples of 465 suspected VHF cases referred to tertiary care referral center of UP, India were enrolled in the study during a period from 15th May 2016 to 9th March 2018. Serum specimens were collected and analyzed for the presence of Dengue, Chikungunya, and ZIKA either by serology and/or by molecular assays. Results: Of all tested, 165 (35.4%) cases were positive for either Dengue or Chikungunya. Dengue (21.2%) was found to be the most prevalent, followed by Chikungunya, (6.6%). None of the cases tested positive for ZIKA virus. Serum samples of 35 (7.5%) cases were positive for both Dengue and Chikungunya. DEN-2 serotype was the most predominant serotype. Phylogenetic and sequence analysis of DEN-2 strains showed 100% clustering with the Cosmopolitan genotype strain. Bleeding from several sites, jaundice, abdominal pain, arthralgia, haemoconcentration, and thrombocytopenia were significantly higher in dengue hemorrhagic cases. However, the rash was significantly more common in Chikungunya patients. Most of the Dengue and Chikungunya positive cases (Age group 6-40 years) were seen in post monsoon season (September to November). Conclusion: Only one-third of total VHF cases are positive for either Dengue/Chikungunya or both. This necessitates the screening of other etiologies capable of causing hemorrhagic manifestations.Keywords: viral hemorrhagic fever, dengue, chikungunya, zika, India
Procedia PDF Downloads 1558163 Behavioral Finance in Hundred Keywords
Authors: Ramon Hernán, Maria Teresa Corzo
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This study examines the impact and contribution of the main journals in the discipline of behavioral finance to determine the state of the art of the discipline and the growth lines and concepts studied to date. This is a unique and novel study given that a review of the discipline has not been carried out through the keywords of the articles that allows visualizing through this component of the research, which are the main topics of discussion and the relationships that arise between the concepts discussed. To carry out this study, 3,876 articles have been taken as a reference, which includes 15,859 keywords from the main journals responsible for the growth of the discipline.; Journal of Behavioral Finance, Review of Behavioral Finance, Journal of Behavioral and Experimental Economics, Journal of Behavioral and Experimental Economics and Review of Behavioral Finance. The results indicate which are the topics most covered in the discipline throughout the period from 2000 to 2020, how these concepts have been dealt with on a recurring basis along with others throughout the aforementioned period and how the different concepts have been grouped based on the keywords established by the authors for the classification of their articles with a network diagram to complete the analysis.Keywords: behavioral finance, keywords, co-words, top journals, data visualization
Procedia PDF Downloads 1918162 Bi-Criteria Objective Network Design Model for Multi Period Multi Product Green Supply Chain
Authors: Shahul Hamid Khan, S. Santhosh, Abhinav Kumar Sharma
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Environmental performance along with social performance is becoming vital factors for industries to achieve global standards. With a good environmental policy global industries are differentiating them from their competitors. This paper concentrates on multi stage, multi product and multi period manufacturing network. Bi-objective mathematical models for total cost and total emission for the entire forward supply chain are considered. Here five different problems are considered by varying the number of suppliers, manufacturers, and environmental levels, for illustrating the taken mathematical model. GA, and Random search are used for finding the optimal solution. The input parameters of the optimal solution are used to find the tradeoff between the initial investment by the industry and the long term benefit of the environment.Keywords: closed loop supply chain, genetic algorithm, random search, green supply chain
Procedia PDF Downloads 5498161 Energy Absorption of Circular Thin-Walled Tube with Curved-Crease Patterns under Axial Crushing
Authors: Grzegorz Dolzyk, Sungmoon Jung
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Thin-walled tubes are commonly used as energy absorption devices for their excellent mechanical properties and high manufacturability. Techniques such as grooving and pre-folded origami shapes were introduced to circular and polygonal tubes to improve its energy absorption efficiency. This paper examines the energy absorption characteristics of circular tubes with pre-embedded curved-crease pattern. Set of numerical analyzes were conducted with different grooving patterns for tubes with various diameter (D) to thickness (t) ratio. It has been found that even very shallow grooving can positively affect thin wall tubes, leading to increased energy absorption and higher crushing load efficiency. The phenomenon is associated with nonsymmetric deformation that is usually observed for tubes with a high D/t ratio ( > 90). Grooving can redirect a natural mode of post-buckling deformation to a one with a higher number of lobes such that its beneficial and more stable. Also, the opposite effect can be achieved, and highly disrupted deformation can be a cause of reduced energy absorption capabilities. Curved-crease engraved patterns can be used to stabilize and change a form of hazardous post-buckling deformation.Keywords: axial crushing, energy absorption, grooving, thin-wall structures
Procedia PDF Downloads 1448160 Changing Colours and Odours: Exploring Cues Used by Insect Pollinators in Two Brassicaceous Plants
Authors: Katherine Y. Barragan-Fonseca, Joop J. A. Van Loon, Marcel Dicke, Dani Lucas-Barbosa
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Flowering plants use different traits to attract pollinators, which indicate flower location and reward quality. Visual and olfactory cues are among the most important floral traits exploited by pollinating insects. Pollination can alter physical and chemical cues of flowers, which can subsequently influence the behaviour of flower visitors. We investigated the main cues exploited by the syrphid fly Episyrphus balteatus and the butterfly Pieris brassicae when visiting flowers of Brassica nigra and Raphanus sativus plants. We studied post-pollination changes and their effects on the behaviour of flower visitors and flower volatile emission. Preference of pollinators was investigated by offering visual and olfactory cues simultaneously as well as separately in two-choice bioassays. We also assessed whether pollen is used as a cue by pollinating insects. In addition, we studied whether behavioural responses could be correlated with changes in plant volatile emission, by collecting volatiles from flower headspace. P. brassicae and E. balteatus did not use pollen as a cue in either of the two plant species studied. Interestingly, pollinators showed a strong bias for visual cues over olfactory cues when exposed to B. nigra plants. Flower visits by pollinators were influenced by post-pollination changes in B. nigra. In contrast, plant responses to pollination did not influence pollinator preference for R. sativus flowers. These results correlate well with floral volatile emission of B. nigra and R. sativus; pollination influenced the volatile profile of B. nigra flowers but not that of R. sativus. Collectively, our data show that different pollinators exploit different visual and olfactory traits when searching for nectar or pollen of flowers of two close related plant species. Although the syrphid fly consumes mostly pollen from brassicaceous flowers, it cannot detect pollen from a distance and likely associates other flower traits with quantity and quality of pollen.Keywords: plant volatiles, pollinators, post-pollination changes, visual and odour cues
Procedia PDF Downloads 1618159 Formal Stress Management Teaching Incorporated into the First Year of a Doctor's Practice: A Career Transition Study of British Foundation Year 1 Doctors
Authors: Edward Ridyard, Vinary Varadarajan
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Background and Aims: The first year as a doctor in any country represents a major career transition in any physician's life. During this period, many physicians concentrate on obtaining clinical skills but may not obtain the important skills necessary to cope with stress. In this study we elucidate stress levels amongst FY1 doctors regarding the transitioning into specialty career choices, working in the NHS and anxiety about future career success. Methods: A prospective single blinded analysis of Foundation Year one (FY1) trainees using a non-mandatory online questionnaire was distributed. No exclusion criteria were applied. The only inclusion criteria was the doctor was in a full-time FY1 post and this was their first job in the UK. A total of n= 22 doctors were included in the study. After data collection, statistical analysis using chi-squared testing was applied. Results: The large majority of FY1 doctors (72.7%) already knew what specialty they wished to pursue (p=0.0001). With regards to their future careers 45.5% of FY1 doctors stated "above average" stress levels. The majority of FY1 doctors (64.3%) stated their stress levels working in the NHS were either "above average" or "high". Finally, 81.8% of respondents know colleagues who have been put off from pursuing specialties due to the stress of competition. Conclusions: A large majority of FY1 doctors already know at this early stage what area they would like to specialise in. With this in mind, a large proportion have above "average" levels of stress with regards to securing this future career path. The most worrying finding is that 64.3% of FY1s stated they had "above average" or "high" stress levels working in the NHS. We therefore recommend formal stress management education to be incorporated into the foundation programme curriculum.Keywords: stress, anxiety, junior doctor, education
Procedia PDF Downloads 3708158 Analysis of Vibration and Shock Levels during Transport and Handling of Bananas within the Post-Harvest Supply Chain in Australia
Authors: Indika Fernando, Jiangang Fei, Roger Stanley, Hossein Enshaei
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Delicate produce such as fresh fruits are increasingly susceptible to physiological damage during the essential post-harvest operations such as transport and handling. Vibration and shock during the distribution are identified factors for produce damage within post-harvest supply chains. Mechanical damages caused during transit may significantly diminish the quality of fresh produce which may also result in a substantial wastage. Bananas are one of the staple fruit crops and the most sold supermarket produce in Australia. It is also the largest horticultural industry in the state of Queensland where 95% of the total production of bananas are cultivated. This results in significantly lengthy interstate supply chains where fruits are exposed to prolonged vibration and shocks. This paper is focused on determining the shock and vibration levels experienced by packaged bananas during transit from the farm gate to the retail market. Tri-axis acceleration data were captured by custom made accelerometer based data loggers which were set to a predetermined sampling rate of 400 Hz. The devices recorded data continuously for 96 Hours in the interstate journey of nearly 3000 Km from the growing fields in far north Queensland to the central distribution centre in Melbourne in Victoria. After the bananas were ripened at the ripening facility in Melbourne, the data loggers were used to capture the transport and handling conditions from the central distribution centre to three retail outlets within the outskirts of Melbourne. The quality of bananas were assessed before and after transport at each location along the supply chain. Time series vibration and shock data were used to determine the frequency and the severity of the transient shocks experienced by the packages. Frequency spectrogram was generated to determine the dominant frequencies within each segment of the post-harvest supply chain. Root Mean Square (RMS) acceleration levels were calculated to characterise the vibration intensity during transport. Data were further analysed by Fast Fourier Transform (FFT) and the Power Spectral Density (PSD) profiles were generated to determine the critical frequency ranges. It revealed the frequency range in which the escalated energy levels were transferred to the packages. It was found that the vertical vibration was the highest and the acceleration levels mostly oscillated between ± 1g during transport. Several shock responses were recorded exceeding this range which were mostly attributed to package handling. These detrimental high impact shocks may eventually lead to mechanical damages in bananas such as impact bruising, compression bruising and neck injuries which affect their freshness and visual quality. It was revealed that the frequency range between 0-5 Hz and 15-20 Hz exert an escalated level of vibration energy to the packaged bananas which may result in abrasion damages such as scuffing, fruit rub and blackened rub. Further research is indicated specially in the identified critical frequency ranges to minimise exposure of fruits to the harmful effects of vibration. Improving the handling conditions and also further study on package failure mechanisms when exposed to transient shock excitation will be crucial to improve the visual quality of bananas within the post-harvest supply chain in Australia.Keywords: bananas, handling, post-harvest, supply chain, shocks, transport, vibration
Procedia PDF Downloads 1908157 Nazi Propaganda and the 1930 Berlin Film Premiere of “All Quiet on the Western Front”
Authors: Edward C. Smith
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Historical narration in literature and film is an act that necessarily develops and deforms history, whether consciously or unconsciously. Such “translation” suffers or thrives depending on its historical context and on the ability of the artist/artists to make choices that enhance or diminish social and political reality. This “translation” and its challenges is examined from within the historical and political context of the 1930 Berlin film premiere of “All Quiet on the Western Front,” a film based on Erich Maria Remarque’s 1928 best-selling novel. Both the film and the novel appeared during a period in which the “aestheticization” of reality predominated. This was an era in early 20th-century European society in which life was conceived of as innately artistic and structured like an art form. The emergence of this modern consciousness, one in which memory and history surrendered their former authority, enabled conservative propaganda of the period to denounce all art that did not adhere conceptually to its political tenets, with “All Quiet” becoming yet another of its “victims.”Keywords: documentary and propaganda film, film and TV audiences, international literature in film studies, popular culture and film
Procedia PDF Downloads 4058156 Ion Beam Polishing of Si in W/Si Multilayer X-Ray Analyzers
Authors: Roman Medvedev, Andrey Yakshin, Konstantin Nikolaev, Sergey Yakunin, Fred Bijkerk
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Multilayer structures are used as spectroscopic elements in fluorescence analysis. These serve the purpose of analyzing soft x-ray emission spectra of materials upon excitation by x-rays or electrons. The analysis then allows quantitative determination of the x-ray emitting elements in the materials. Shorter wavelength range for this application, below 2.5nm, can be covered by using short period multilayers, with a period of 2.5 nm and lower. Thus the detrimental effect on the reflectivity of morphological roughness between materials of the multilayers becomes increasingly pronounced. Ion beam polishing was previously shown to be effective in reducing roughness in some multilayer systems with Si. In this work, we explored W/Si multilayers with the period of 2.5 nm. Si layers were polishing by Ar ions, employing low energy ions, 100 and 80 eV, with the etched Si thickness being in the range 0.1 to 0.5 nm. CuK X-ray diffuse scattering measurements revealed a significant reduction in the diffused scattering in the polished multilayers. However, Grazing Incidence CuK X-ray showed only a marginal reduction of the overall roughness of the systems. Still, measurements of the structures with Grazing Incidence Small Angle X-ray scattering indicated that the vertical correlation length of roughness was strongly reduced in the polished multilayers. These results together suggest that polishing results in the reduction of the vertical propagation of roughness from layer to layer, while only slightly affecting the overall roughness. This phenomenon can be explained by ion-induced surface roughening inherently present in the ion polishing methods. Alternatively, ion-induced densification of thin Si films should also be considered. Finally, the reflectivity of 40% at 0.84 nm at grazing incidence of 9 degrees has been obtained in this work for W/Si multilayers. Analysis of the obtained results is expected to lead to further progress in reflectance.Keywords: interface roughness, ion polishing, multilayer structures, W/Si
Procedia PDF Downloads 1348155 User Satisfaction Survey Based Facility Performance Evaluation
Authors: Gopikrishnan Seshadhri, V. M. Topkar
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Facility management post occupation is a facet that has gained tremendous ground in the recent times. While the efficiency of expenditure and utilization of all types of resources are monitored to ensure timely completion with minimum cost and acceptable quality during construction phase, value for money comes out only when the facility performs satisfactorily post occupation, meeting aspirations and expectations of users of the facility. It is more so for the public facilities. Due to the paradigm shift in focus to outcome based performance evaluation, user satisfaction obtained mainly through questionnaires has become the single important criterion in performance evaluation. Questionnaires presently being used to gauge user satisfaction being subjective, the feedback obtained do not necessarily reflect actual performance. Hence, there is a requirement of developing a survey instrument that can gauge user satisfaction as objectively as possible and truly reflects the ground reality. A near correct picture of actual performance of the built facility from the user point of view will enable facility managers to address pertinent issues. This paper brings out the need for an effective survey instrument that will elicit more objective user response. It also lists steps involved in formulation of such an instrument.Keywords: facility performance evaluation, attributes, attribute descriptors, user satisfaction surveys, statistical methods, performance indicators
Procedia PDF Downloads 2898154 The Effectiveness of Group Counseling of Mindfulness-Based Cognitive Therapy on Cognitive Emotion Regulation in High School Students
Authors: Hossein Ilanloo, Sedigheh Ahmadi, Kianoosh Zahrakar
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The present study aims at investigating the effectiveness of group counseling of mindfulness-based cognitive therapy on cognitive emotion regulation in high school students. The research design was quasi-experimental and pre-test-post-test type and a two-month follow-up with a control group. The statistical population of the study consisted of all-male high school students in Takestan city in the Academic Year 2020-2021. The sample comprised 30 high school male students selected through the convenience sampling method and randomly assigned to experimental (n=15) and control (n=15) groups. The experimental group then received ten sessions of 90-minute group counseling of mindfulness-based cognitive therapy, and the control group did not receive any intervention. In order to collect data, the author used the Cognitive Emotion Regulation Questionnaire (CERQ). The researcher also used multivariate analysis of covariance, repeated measures, LSD post hoc test, and SPSS-26 software for data analysis.Keywords: mindfulness-based cognitive therapy, cognitive emotion regulation, students, high schools
Procedia PDF Downloads 1238153 Reducing the Risk of Alcohol Relapse after Liver-Transplantation
Authors: Rebeca V. Tholen, Elaine Bundy
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Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.Keywords: alcoholism, liver transplant, quality improvement, substance abuse
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