Search results for: total quality environmental management (TQEM)

Authors: Septiany Trisnaningtyas

Abstract:

Purpose: This research aims to examine the factors affecting the profitability of pharmaceutical company during the Covid-19 Pandemic in Indonesia. A sharp decline in the number of patients coming to the hospital for treatment during the pandemic has an impact on the growth of the pharmaceutical sector and brought major changes in financial position and business performance. Pharmaceutical companies that provide products related to the Covid-19 pandemic can survive and continue to grow. This study investigates the factors affecting the profitability of pharmaceutical company during the Covid-19 Pandemic in Indonesia associated with the number of Covid-19 cases. Design/methodology/approach: This study uses panel-data regression models to evaluate the influence of the number of Covid-19 confirmed cases on profitability of ninelisted pharmaceuticalcompanies in Indonesia. This research is based on four independent variables that were empirically examined for their relationship with profitability. These variables are liquidity (current ratio), growth rate (sales growth), firm size (total sales), and market power (the Lerner index). Covid-19 case is used as moderating variable. Data of nine pharmaceutical companies listed on the Indonesia Stock Exchange covering the period of 2018–2021 were extracted from companies’ quarterly annual reports. Findings: In the period during Covid-19, company growth (sales growth) and market power (lerner index) have a positive and significant relationship to ROA and ROE. Total of confirmed Covid-19 cases has a positive and significant relationship to ROA and is proven to have a moderating effect between company’s growth (sales growth) to ROA and ROE and market power (Lerner index) to ROA. Research limitations/implications: Due to data availability, this study only includes data from nine listed pharmaceutical companies in Indonesian Stock exchange and quarterly annual reportscovering the period of 2018-2021. Originality/value: This study focuses onpharmaceutical companies in Indonesia during Covid-19 pandemic. Previous study analyzes the data from pharmaceutical companies’ annual reports since 2014 and focus on universal health coverage (national health insurance) implementation from the Indonesian government. This study analyzes the data using fixed effect panel-data regression models to evaluate the influence of Covid-19 confirmed cases on profitability. Pooled ordinary least squares regression and fixed effects were used to analyze the data in previous study. This study also investigate the moderating effect of Covid-19 confirmed cases to profitability in relevant with the pandemic situation.

Keywords: profitability, indonesia, pharmaceutical, Covid-19

Procedia PDF Downloads 108

Authors: M. J. Rodríguez, F. M. Sánchez, B. Velardo, P. Calvo, M. J. Serradilla, J. Delgado, J. M. López

Abstract:

The main problems in storage and later transport of fruits, are the decays developed that reduce the quality on destination’s markets. Nowadays, there is an increasing interest in the use of compounds to avoid decays in post-harvest. Triazole fungicides are agrochemicals widely used in the agricultural industry due to their wide spectrum of actions, and in some case, they are used in citrus fruit post-harvest. Moreover, its use is not authorized in plum post-harvest, but in order to a future possible authorization, the evolutions of propiconazole and tebuconazole residues are studied after its post-harvest application in ‘Angeleno’ plum.

Keywords: maximum residue limit (MRL), triazole fungicides, decay, Prunus salicina

Procedia PDF Downloads 299

Authors: Laura Canagueral-Pellice, Antonio Munar-Frau, Adaia Valls-Ontanon, Joao Carames, Federico Hernandez-Alfaro, Jordi Caballe-Serrano

Abstract:

Objective: Guided bone regeneration (GBR) aims to replace the missing bone with a new structure to achieve long-term stability of rehabilitations. The aim of the present systematic review and meta-analysis is to determine the effect of barrier membranes on histological outcomes after GBR procedures. Moreover, the effect of the grafting material and tissue gain were analyzed. Materials & methods: Two independent reviewers performed an electronic search in Pubmed and Scopus, identifying all eligible publications up to March 2020. Only randomized controlled trials (RCTs) assessing a histological analysis of augmented areas were included. Results: A total of 6 publications were included for the present systematic review. A total of 110 biopsied sites were analysed; 10 corresponded to vertical bone augmentation procedures, whereas 100 analysed horizontal regeneration procedures. A mean tissue gain of 3 ± 1.48mm was obtained for horizontal defects. Histological assessment of new bone formation, residual particle and sub-epithelial connective tissue (SCT) was reported. The four main barrier membranes used were natural collagen membranes, e-PTFE, polylactic resorbable membranes and acellular dermal matrix membranes (AMDG). The analysis demonstrated that resorbable membranes result in higher values of new bone formation and lower values of residual particles and SCT. Xenograft resulted in lower new bone formation compared to allograft; however, no statistically significant differences were observed regarding residual particle and SCT. Overall, regeneration procedures adding autogenous bone, plasma derivate or growth factors achieved in general greater new bone formation and tissue gain. Conclusions: There is limited evidence favoring the effect of a certain type of barrier membrane in GBR. Data needs to be evaluated carefully; however, resorbable membranes are correlated with greater new bone formation values, especially when combined with allograft materials and/or the addition of autogenous bone, platelet reach plasma (PRP) or growth factors in the regeneration area. More studies assessing the histological outcomes of different GBR protocols and procedures testing different biomaterials are needed to maximize the clinical and histological outcomes in bone regeneration science.

Keywords: barrier membrane, graft material, guided bone regeneration, implant surgery, histology

Procedia PDF Downloads 138

Authors: Åse Nygren, Linda du Plessis

Abstract:

Academic leadership has traditionally been associated with collegiality, consensus and a limitation in time. These factors alone have resulted in a complex and fuzzy leadership culture in academia, combined with a strong sense of autonomy among researchers and teachers. A more competitive educational market have resulted in increased audit as well as recent autonomy reforms with higher demands on effectiveness, cost awareness and accountability in higher education. In recent years, with the introduction of new public management, academic leadership has been in a state of transition moving from collegiality towards manergerialism. University reforms and changes, which have gradually taken place in most western countries in the past decade, including Sweden and South-Africa, have contributed to the notion that collegial academic leadership is questioned. Academic leadership is traditionally associated with vice-chancellors, deans and heads of departments. This paper will focus on “outer circle” of academic leaders, consisting of, for example, program directors, directors of disciplines, course coordinators and research leaders. We investigate the meaning of collegiality for these groups of academic leaders in Sweden and South-Africa. The paper rests on a comparative study made on universities both in Sweden and in South-Africa. The aim of the comparison is to achieve a wider scope and to investigate perspectives from both inside and outside of Bologna.

Keywords: academic leadership, new public management, collegiality, consensus

Procedia PDF Downloads 398

Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

Abstract:

Computer navigation has been introduced in total knee arthroplasty to improve the accuracy of the procedure. Computer navigation improves the accuracy of bone resection in the coronal and sagittal planes. It was also noted that it normalizes the rotational alignment of the femoral component and fully assesses and balances the deformation of soft tissues in the coronal plane. The work is devoted to the advantages of using computer navigation technology in total knee arthroplasty in 62 patients (11 men and 51 women) suffering from gonarthrosis, aged 51 to 83 years, operated using a computer navigation system, followed up to 3 years from the moment of surgery. During the examination, the deformity variant was determined, and radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion. After surgery, improvement was observed in all scales; firstly, the WOMAC values decreased by 5.90 times, and the median value to 11 points (p < 0.001), secondly KSS increased by 3.91 times and reached 86 points (p < 0.001), and the third one is that FKSS data increased by 2.08 times and reached 94 points (p < 0.001). After TKA, the axis deviation of the lower limbs of more than 3 degrees was observed in 4 patients at 6.5% and frontal instability of the knee joint just in 2 cases at 3.2%., The lower incidence of sagittal instability of the knee joint after the operation was 9.6%. The range of motion increased by 1.25 times; the volume of movement averaged 125 degrees (p < 0.001). Computer navigation increases the accuracy of the spatial orientation of the endoprosthesis components in all planes, reduces the variability of the axis of the lower limbs within ± 3 °, allows you to achieve the best results of surgical interventions, and can be used to solve most basic tasks, allowing you to achieve excellent and good outcomes of operations in 100% of cases according to the WOMAC scale. With diaphyseal deformities of the femur and/or tibia, as well as with obstruction of their medullary canal, the use of computer navigation is the method of choice. The use of computer navigation prevents the occurrence of flexion contracture and hyperextension of the knee joint during the distal sawing of the femur. Using the navigation system achieves high-precision implantation for the endoprosthesis; in addition, it achieves an adequate balance of the ligaments, which contributes to the stability of the joint, reduces pain, and allows for the achievement of a good functional result of the treatment.

Keywords: knee joint, arthroplasty, computer navigation, advantages

Procedia PDF Downloads 71

Authors: Sean T. S. Wei, Joy D. Van Nostrand, Annapoorna Maitrayee Ganeshram, Stephen B. Pointing

Abstract:

McMurdo Dry Valleys are a largely ice-free polar desert protected by international treaty as an Antarctic special managed area. The terrestrial landscape is dominated by oligotrophic mineral soil with extensive rocky outcrops. Several environmental stresses: low temperature, lack of liquid water, UV exposure and oligotrophic substrates, restrict the major biotic component to microorganisms. The bacterial diversity and the putative physiological capacity of microbial communities of quartz rocks (hypoliths) and soil of a maritime-influenced Dry Valleys were interrogated by two metagenomic approaches: 454 pyro-sequencing and Geochp DNA microarray. The most abundant phylum in hypoliths was Cyanobacteria (46%), whereas in solils Actinobacteria (31%) were most abundant. The Proteobacteria and Bacteriodetes were the only other phyla to comprise >10% of both communities. Carbon fixation was indicated by photoautotrophic and chemoautotrophic pathways for both hypolith and soil communities. The fungi accounted for polymer carbon transformations, particularly for aromatic compounds. The complete nitrogen cycling was observed in both communities. The fungi in particular displayed pathways related to ammonification. Environmental stress response pathways were common among bacteria, whereas the nutrient stress response pathways were more widely present in bacteria, archaea and fungi. The diversity of bacterialphage was also surveyed by Geochip. Data suggested that different substrates supported different viral families: Leviviridae, Myoviridae, Podoviridae and Siphoviridiae were ubiquitous. However, Corticoviridae and Microviridae only occurred in wetter soils.

Keywords: Antarctica, hypolith, soil, dry valleys, geochip, functional diversity, stress response

Procedia PDF Downloads 436

Authors: Kristina Amaleviciute, Ieva Jokubauskaite, Alvyra Slepetiene, Jonas Volungevicius, Inga Liaudanskiene

Abstract:

The main task of this research was to investigate the chemical composition of the differently used soil in profiles. To identify the differences in the soil were investigated organic carbon (SOC) and its fractional composition: dissolved organic carbon (DOC), mobile humic acids (MHA) and C to N ratio of natural and anthropogenically affected Luvisols. Research object: natural and anthropogenically affected Luvisol, Akademija, Kedainiai, distr. Lithuania. Chemical analyses were carried out at the Chemical Research Laboratory of Institute of Agriculture, LAMMC. Soil samples for chemical analyses were taken from the genetics soil horizons. SOC was determined by the Tyurin method modified by Nikitin, measuring with spectrometer Cary 50 (VARIAN) in 590 nm wavelength using glucose standards. For mobile humic acids (MHA) determination the extraction procedure was carried out using 0.1 M NaOH solution. Dissolved organic carbon (DOC) was analyzed using an ion chromatograph SKALAR. pH was measured in 1M H2O. N total was determined by Kjeldahl method. Results: Based on the obtained results, it can be stated that transformation of chemical composition is going through the genetic soil horizons. Morphology of the upper layers of soil profile which is formed under natural conditions was changed by anthropomorphic (agrogenic, urbogenic, technogenic and others) structure. Anthropogenic activities, mechanical and biochemical disturbances destroy the natural characteristics of soil formation and complicates the interpretation of soil development. Due to the intensive cultivation, the pH values of the curve equals (disappears acidification characteristic for E horizon) with natural Luvisol. Luvisols affected by agricultural activities was characterized by a decrease in the absolute amount of humic substances in separate horizons. But there was observed more sustainable, higher carbon sequestration and thicker storage of humic horizon compared with forest Luvisol. However, the average content of humic substances in the soil profile was lower. Soil organic carbon content in anthropogenic Luvisols was lower compared with the natural forest soil, but there was more evenly spread over in the wider thickness of accumulative horizon. These data suggest that the organization of geo-ecological declines and agroecological increases in Luvisols. Acknowledgement: This work was supported by the National Science Program ‘The effect of long-term, different-intensity management of resources on the soils of different genesis and on other components of the agro-ecosystems’ [grant number SIT-9/2015] funded by the Research Council of Lithuania.

Keywords: agrogenization, dissolved organic carbon, luvisol, mobile humic acids, soil organic carbon

Procedia PDF Downloads 220

Authors: Antonio Boggia, Luisa Paolotti, Gianluca Massei, Lucia Rocchi, Elaine Pace, Maria Attard

Abstract:

The aim of this paper is to present a methodology and a computer model for sustainability assessment based on the integration of Multi-criteria Decision Analysis (MCDA) with a Geographic Information System (GIS). It presents the result of a study for the implementation of a model for measuring sustainability to address the policy actions for the improvement of sustainability at territory level. The aim is to rank areas in order to understand the specific technical and/or financial support that is required to develop sustainable growth. Assessing sustainable development is a multidimensional problem: economic, social and environmental aspects have to be taken into account at the same time. The tool for a multidimensional representation is a proper set of indicators. The set of indicators must be integrated into a model, that is an assessment methodology, to be used for measuring sustainability. The model, developed by the Environmental Laboratory of the University of Perugia, is called GeoUmbriaSUIT. It is a calculation procedure developed as a plugin working in the open-source GIS software QuantumGIS. The multi-criteria method used within GeoUmbriaSUIT is the algorithm TOPSIS (Technique for Order Preference by Similarity to Ideal Design), which defines a ranking based on the distance from the worst point and the closeness to an ideal point, for each of the criteria used. For the sustainability assessment procedure, GeoUmbriaSUIT uses a geographic vector file where the graphic data represent the study area and the single evaluation units within it (the alternatives, e.g. the regions of a country, or the municipalities of a region), while the alphanumeric data (attribute table), describe the environmental, economic and social aspects related to the evaluation units by means of a set of indicators (criteria). The use of the algorithm available in the plugin allows to treat individually the indicators representing the three dimensions of sustainability, and to compute three different indices: environmental index, economic index and social index. The graphic output of the model allows for an integrated assessment of the three dimensions, avoiding aggregation. The presence of separate indices and graphic output make GeoUmbriaSUIT a readable and transparent tool, since it doesn’t produce an aggregate index of sustainability as final result of the calculations, which is often cryptic and difficult to interpret. In addition, it is possible to develop a “back analysis”, able to explain the positions obtained by the alternatives in the ranking, based on the criteria used. The case study presented is an assessment of the level of sustainability in the six regions of Malta, an island state in the middle of the Mediterranean Sea and the southernmost member of the European Union. The results show that the integration of MCDA-GIS is an adequate approach for sustainability assessment. In particular, the implemented model is able to provide easy to understand results. This is a very important condition for a sound decision support tool, since most of the time decision makers are not experts and need understandable output. In addition, the evaluation path is traceable and transparent.

Keywords: GIS, multi-criteria analysis, sustainability assessment, sustainable development

Procedia PDF Downloads 268

Authors: Kyohei Yoshino, Masahiko Matsumiya, Yuji Sasaki

Abstract:

Recently, studies have been conducted on Au(III) extraction using ionic liquids (ILs) as extractants or diluents. ILs such as piperidinium, pyrrolidinium, and pyridinium have been studied as extractants for noble metal extractions. Furthermore, the polarity, hydrophobicity, and solvent miscibility of these ILs can be adjusted depending on their intended use. Therefore, the unique properties of ILs make them functional extraction media. The extraction mechanism of Au(III) using phosphonium-based ILs and relevant thermodynamic studies are yet to be reported. In the present work, we focused on the mechanism of Au(III) extraction and related thermodynamic analyses using phosphonium-based ILs. Triethyl-n-pentyl, triethyl-n-octyl, and triethyl-n-dodecyl phosphonium bis(trifluoromethyl-sulfonyl)amide, [P₂₂₂ₓ][NTf₂], (X = 5, 8, and 12) were investigated for Au(III) extraction. The IL–Au complex was identified as [P₂₂₂₅][AuCl₄] using UV–Vis–NIR and Raman spectroscopic analyses. The extraction behavior of Au(III) was investigated with a change in the [P₂₂₂ₓ][NTf₂]IL concentration from 1.0 × 10–4 to 1.0 × 10–1 mol dm−3. The results indicate that Au(III) can be easily extracted by the anion-exchange reaction in the [P₂₂₂ₓ][NTf₂]IL. The slope range 0.96–1.01 on the plot of log D vs log[P₂₂₂ₓ][NTf2]IL indicates the association of one mole of IL with one mole of [AuCl4−] during extraction. Consequently, [P₂₂₂ₓ][NTf₂] is an anion-exchange extractant for the extraction of Au(III) in the form of anions from chloride media. Thus, this type of phosphonium-based IL proceeds via an anion exchange reaction with Au(III). In order to evaluate the thermodynamic parameters on the Au(III) extraction, the equilibrium constant (logKₑₓ’) was determined from the temperature dependence. The plot of the natural logarithm of Kₑₓ’ vs the inverse of the absolute temperature (T–1) yields a slope proportional to the enthalpy (ΔH). By plotting T–1 vs lnKₑₓ’, a line with a slope range 1.129–1.421 was obtained. Thus, the result indicated that the extraction reaction of Au(III) using the [P₂₂₂ₓ][NTf₂]IL (X=5, 8, and 12) was exothermic (ΔH=-9.39〜-11.81 kJ mol-1). The negative value of TΔS (-4.20〜-5.27 kJ mol-1) indicates that microscopic randomness is preferred in the [P₂₂₂₅][NTf₂]IL extraction system over [P₂₂₂₁₂][NTf₂]IL. The total negative alternation in Gibbs energy (-5.19〜-6.55 kJ mol-1) for the extraction reaction would thus be relatively influenced by the TΔS value on the number of carbon atoms in the alkyl side length, even if the efficiency of ΔH is significantly influenced by the total negative alternations in Gibbs energy. Electrochemical analysis revealed that extracted Au(III) can be reduced in two steps: (i) Au(III)/Au(I) and (ii) Au(I)/Au(0). The diffusion coefficients of the extracted Au(III) species in [P₂₂₂ₓ][NTf₂] (X = 5, 8, and 12) were evaluated from 323 to 373 K using semi-integral and semi-differential analyses. Because of the viscosity of the IL medium, the diffusion coefficient of the extracted Au(III) increases with increasing alkyl chain length. The 4f7/2 spectrum based on X-ray photoelectron spectroscopy revealed that the Au electrodeposits obtained after 10 cycles of continuous extraction and electrodeposition were in the metallic state.

Keywords: au(III), electrodeposition, phosphonium-based ionic liquids, solvent extraction

Procedia PDF Downloads 83

Authors: Nursultan Turdakyn, Alisher Medeubayev, Didar Meiramov, Zhibek Bekezhankyzy, Desmond Adair, Gulnur Kalimuldina

Abstract:

In recent years the development of sustainable energy sources is getting extensive research interest due to the ever-growing demand for energy. As an alternative energy source to power small electronic devices, ambient energy harvesting from vibration or human body motion is considered a potential candidate. Despite the enormous progress in the field of battery research in terms of safety, lifecycle and energy density in about three decades, it has not reached the level to conveniently power wearable electronic devices such as smartwatches, bands, hearing aids, etc. For this reason, the development of self-charging power units with excellent flexibility and integrated energy harvesting and storage is crucial. Self-powering is a key idea that makes it possible for the system to operate sustainably, which is now getting more acceptance in many fields in the area of sensor networks, the internet of things (IoT) and implantable in-vivo medical devices. For solving this energy harvesting issue, the self-powering nanogenerators (NGS) were proposed and proved their high effectiveness. Usually, sustainable power is delivered through energy harvesting and storage devices by connecting them to the power management circuit; as for energy storage, the Li-ion battery (LIB) is one of the most effective technologies. Through the movement of Li ions under the driving of an externally applied voltage source, the electrochemical reactions generate the anode and cathode, storing the electrical energy as the chemical energy. In this paper, we present a simultaneous process of converting the mechanical energy into chemical energy in a way that NG and LIB are combined as an all-in-one power system. The electrospinning method was used as an initial step for the development of such a system with a β-PVDF separator. The obtained film showed promising voltage output at different stress frequencies. X-ray diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FT-IR) analysis showed a high percentage of β phase of PVDF polymer material. Moreover, it was found that the addition of 1 wt.% of BTO (Barium Titanate) results in higher quality fibers. When comparing pure PVDF solution with 20 wt.% content and the one with BTO added the latter was more viscous. Hence, the sample was electrospun uniformly without any beads. Lastly, to test the sensor application of such film, a particular testing device has been developed. With this device, the force of a finger tap can be applied at different frequencies so that electrical signal generation is validated.

Keywords: electrospinning, nanogenerators, piezoelectric PVDF, self-charging li-ion batteries

Procedia PDF Downloads 148

Authors: Rino Gubiani, Gianfranco Pergher

Abstract:

The work focused on the statistical analysis of accidents in the forestry sector (2000-2020) in Friuli-Venezia Giulia region, located in the North-East of Italy. The aim of the work was to analyse the evolution of the casualties throughout time and to evaluate possible improvements in the sector. It was shown that even nowadays the rate of accidents in forestry work is higher compared with all the other sectors, including agriculture; moreover, it was highlighted that some accidents remained present throughout the whole analysed range, such as slipping on the soil, being hit by trees and falling down from the plants. The results showed that an increase in forestry exploitation could even increase the total number of accidents, if advanced technological machines, such as cable cranes, would not implemented, given the fact that there is also a significant number of old people (above 50 years old) working in the sector.

Keywords: safety, forestry work, accidents, risk analysis, casualties, statistical analysis

Procedia PDF Downloads 121

Authors: Singara Singh Kasana, Pankaj Garg

Abstract:

In this paper, a blind data hiding technique based on interpolation of sub sampled versions of a cover image is proposed. Sub sampled image is taken as a reference image and an interpolated image is generated from this reference image. Then difference between original cover image and interpolated image is used to embed secret data. Comparisons with the existing interpolation based techniques show that proposed technique provides higher embedding capacity and better visual quality marked images. Moreover, the performance of the proposed technique is more stable for different images.

Keywords: interpolation, image subsampling, PSNR, SIM

Procedia PDF Downloads 566

Authors: Onur Elma, Giray E. Kıral, Ugur S. Selamoğuları, Mehmet Uzunoğlu, Bulent Vural

Abstract:

Electrical energy has become indispensable for people's lives and with rapidly developing technology and continuously changing living standards the need for the electrical energy has been on the rise. Therefore, both energy generation and efficient use of energy are very important topics. Smart grid concept has been introduced to provide monitoring, energy efficiency, reliability and energy quality. Under smart grid concept, smart homes, which can be considered as key component in smart grid operation, have appeared as another research area. In this study, first, smart grid research in the world will be reviewed. Then, overview of smart grid applications in Turkey will be given.

Keywords: energy efficiency, smart grids, smart home, applications

Procedia PDF Downloads 484

Authors: Ivan Todorović, Stefan Komazec, Jelena Anđelković-Labrović, Ondrej Jaško, Miha Marič

Abstract:

Micro, small and medium enterprises (MSME) are important factors of the economy in each country. Recent years have brought increased number and higher sophistication of scientific research related to numerous aspects of entrepreneurship. Various authors try to find the positive correlation between entrepreneur's personal characteristics, skills and knowledge on one hand, and company growth and success of small business on the other hand. Different models recognize staff as one of the key elements in every organizational system. Human resource (HR) function is present in almost all large companies, despite the geographical location or industry. Small and medium enterprises also often have separate positions or even departments for HR administration. However, in early stages of organizational life cycle human resources are usually managed by the founder, entrepreneur. In this paper we want to question whether the companies where founder, entrepreneur, recognizes the significance of human capital in the organization and understands the importance of HR management have higher growth rate and better business results. The findings of this research can be implemented in practice, but also in the academia, for improving the curricula related to the MSME and entrepreneurship.

Keywords: entrepreneurship, MSME, micro small and medium enterprises, company growth, human resources, HR management

Procedia PDF Downloads 341

Authors: Murtaza Hassan Sheikh, Ahmed A. A. AlSaleh, Naser H. N. Jasem

Abstract:

Kuwait has not yet made its mark in the world of technology and research. Therefore, advancements have been made to fill in this gap. Since Robotics covers a wide variety of fields and helps innovation, efforts have been made to promote its education. Despite of the efforts made in Kuwait, robotics education is still on hold. The paper discusses the issues and obstacles in the implementation of robotics education in Kuwait and how a robotics kit “E-Robot” is making an impact in the Kuwait’s future education and innovation. Problems such as robotics competitions rather than education, complexity of robot programming and lack of organized open source platform are being addressed by the introduction of the E-Robot Kit in Kuwait. Due to its success since 2012 a total of 15 schools have accepted the Kit as a core subject, with 200 teaching it as an extracurricular activity.

Keywords: robotics education, Kuwait's education, e-robot kit, research and development, innovation and creativity

Procedia PDF Downloads 399

Authors: Sundaresan Soundararajan, Chor Ngee Tan

Abstract:

Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

Procedia PDF Downloads 164

Authors: Timmis W., Simms M., Thomas C.

Abstract:

This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.

Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco

Procedia PDF Downloads 97

Authors: Shiva Ebrahimian Dehaghani, Afsaneh Doosti, Morteza Zare

Abstract:

Background: There is no consensus regarding the association between dysphagia and cognition. Purpose: The aim of this study was to quantitatively and qualitatively analyze the available evidence on the direction and strength of association between dysphagia and cognition. Methodology: PubMed, Scopus, Embase and Web of Science were searched about the association between dysphagia and cognition. A random-effects model was used to determine weighted odds ratios (OR) and 95% confidence intervals (CI). Sensitivity analysis was performed to determine the impact of each individual study on the pooled results. Results: A total of 1427 participants showed that some cognitive disorders were significantly associated with dysphagia (OR = 3.23; 95% CI, 2.33–4.48). Conclusion: The association between cognition and swallowing disorders suggests that multiple neuroanatomical systems are involved in these two functions.

Keywords: adult, association, cognitive impairment, dysphagia, systematic review

Procedia PDF Downloads 144

Authors: Blessings Masuku

Abstract:

Background: Considering that Africa is urbanizing faster than any other region globally, managing cities in the global South has become the centerpiece for the New Urban Agenda (i.e., a shared vision of how we rethink, rebuild, and manage our cities for a better and more sustainable future). This study is centered on governance and planning of urban informality practices with particular reference to the relationship between the state, informal actors (e.g., informal traders and informal dwellers), and other city stakeholders who are public space users (commuters, businesses, and environmental activists), and how informal actors organize themselves to lobby the state and claim for their rights in the city, and how they navigate their everyday livelihood strategies. Aim: The purpose of this study is to examine and interrogate contemporary approaches, policy and regulatory frameworks to urban spatial planning and management of informality in one of South Africa’s busiest and major cities, Johannesburg. Setting: The study uses the metropolitan region of the city of Johannesburg, South Africa to understand how this contemporary industrial city manages urban informality practices, including the use of public space, land zoning and street life, and paying a closer look at what progress has been made and gaps in their inclusive urban policy frameworks. Methods: This study utilized a qualitative approach that includes surveys (open-ended questions), archival research (i., e policy and other key document reviews), and key interviews mainly with city officials, and informality actors. A thematic analysis was used to analyze the data collected. Contribution: This study contributes to large urban informality scholarship in the global South cities by exploring how major cities particularly in Africa regulate and manage informality patterns and practices in their quest to build “utopian” smart cities. This study also brings a different perspective on the hacking ways used by the informal actors to resist harsh regulations and remain invisible in the city, which is something that previous literature has barely delved in-depth.

Keywords: inclusive planning and governance, infrastructure systems, livelihood strategies urban informality, urban space

Procedia PDF Downloads 57

Authors: Werner Bernatik, Pavel Adamek

Abstract:

The Societas Europaea is the legal form of company which plays its role within European Union since 2004. Since that it has settled in particular EU's member according to conditions. There is several hundreds of Societas Europaea found in EU and the article pays attention to historical background of conditions which formed the European Entrepreneurial Environment. Also, the differences of particular details of Societas Europaea are mentioned. Furthermore, the case of Czech Republic Business Environment is subject of interest where, surprisingly, the total amount of registered Societas Europaea was identified as the highest. The possible reasons of such situation are subject of research and results are to be presented in the article.

Keywords: Societas Europaea, business environment, legal form of company, entrepreneurial environment, European Union, competitivness

Procedia PDF Downloads 407

Authors: Arta Jashari, Enver Kutllovci

Abstract:

Abstract— The purpose of this study is to examine the relationship of recruitment and selection practice and performance in medium service enterprises in Kosovo. A total of 110 managers from public and private sector was analyzed. Our empirical results show that enterprises in Kosovo use recruitment and selection practice and they know how important is to have the right people with skills and knowledge accordingly with the job requirements. The outcome of Pearson correlation analysis provides evidence that recruitment and selection practice, positively and significantly influence the financial performance. Also, our results show a significant relationship between the education of managers and the use of the recruitment and selection practice. From our results we can conclude and suggest that with a good recruiting and selection, the organization will fill with a group of potentially qualified candidates who will be able to fulfill the enterprises objective.

Keywords: Human Resource, Kosovo, Recruitment and Selection, Performance

Procedia PDF Downloads 145

Authors: James M. Wakiru, Liliane Pintelon, Peter Muchiri, Peter Chemweno

Abstract:

The fast-changing business and operational environment are forcing organizations to adopt asset performance management strategies, not only to reduce costs but also maintain operational and production policies while addressing demand. To attain optimal asset performance management, a framework that ensures a continuous and systematic approach to analyzing an organization’s current maturity level and expected improvement regarding asset maintenance processes, strategies, technologies, capabilities, and systems is essential. Moreover, this framework while addressing maintenance-intensive organizations should consider the diverse business, operational and technical context (often dynamic) an organization is in and realistically prescribe or relate to the appropriate tools and systems the organization can potentially employ in the respective level, to improve and attain their maturity goals. This paper proposes an asset maintenance maturity model to assess the current capabilities, strength and weaknesses of maintenance processes an organization is using and analyze gaps for improvement via structuring set levels of achievement. At the epicentre of the proposed framework is the utilization of maintenance objective selected by an organization for various maintenance optimization programs. The framework adapts the Capability Maturity Model of assessing the maintenance process maturity levels in the organization.

Keywords: asset maintenance, maturity models, maintenance objectives, optimization

Procedia PDF Downloads 205

Authors: D. Kurt, İ. F. Barut, Z. Ü. Yümün, E. Kam

Abstract:

After development of the industrial revolution, industrial plants and settlements have spread widely on the sea coasts. This concentration also brings environmental pollution in the sea. This study focuses on the Gulf of İzmir where is located in West of Turkey and it is a fascinating natural gulf of the Eastern Aegean Sea. Investigating marine current sediment is extremely important to detect pollution. Natural radionuclides’ pollution of the marine environment which is also known as a significant environmental anxiety. Ground drilling cores (the depth of each sediment is variant) were collected from the Gulf of İzmir’s four different locations which were Karşıyaka, İnciraltı, Çeşmealtı and Bayraklı. These sediment cores were put in preserving bags with weight around 1 kg, and they were dried at room temperature in a week for moisture removal. Then, they were sieved with 1 mm sieve holes, and finally these powdered samples were relocation to polyethylene Marinelli beakers of 100 ml versions. Each prepared sediment was waited to reach radioactive equilibrium between uranium and thorium for 40 days. Gamma spectrometry measurements were settled using a HPG (High- Purity Germanium) semiconductor detector. Semiconductor detectors are very good at separating power of the energy, they are easily able to differentiate peaks that are pretty close to each other. That is why, gamma spectroscopy’s usage is common for the determination of the activities of U - 238, Th - 232, Ra - 226, Cr - 137 and K - 40 in Bq kg⁻¹. In this study, the results display that the average concentrations of activities’ values are in respectively; 2.2 ± 1.5 Bq/ kg⁻¹, 0.98 ± 0.02 Bq/ kg⁻¹, 8 ± 0.96 Bq/ kg⁻¹, 0.93 ± 0.14 Bq/ kg⁻¹, and 76.05 ± 0.93 Bq/ kg⁻¹. The outcomes of the study are able to be used as a criterion for forthcoming research and the obtained data would be pragmatic for radiological mapping of the precise areas.

Keywords: gamma, Gulf of İzmir (Eastern Aegean Sea-Turkey), natural radionuclides, pollution

Procedia PDF Downloads 247

Authors: Inbal Zuriely, Yonit Weiss, Hilla Zaharoni, Hadas Lewkowicz, Tatiana Vander, Tarif Bader

Abstract:

early active movement, along with adjusting optimal nutrition, prevents aggravation of muscle degeneracy and functional decline. Eating is a basic activity of daily life, which reflects the patient's independence. When eating and feeding are experienced successfully, they lead to a sense of pleasure and satisfaction. However, when they are experienced as a difficulty, they might evoke feelings of helplessness and frustration. This stresses the essential process of gradual weaning off the enteral feeding tube. the work describes the collaboration of a dietitian, determining the nutritional needs of patients undergoing enteral tube weaning as part of the rehabilitation process, with the suited treatment of an occupational therapist. Occupational therapy intervention regarding eating capabilities focuses on improving the required motor and cognitive components, along with environmental adjustments and aids, imparting eating strategies and training to patients and their families. The project was conducted in the long-term, ventilated patients’ department at the Herzfeld Rehabilitation Geriatric Medical Center on patients undergoing enteral tube weaning with the staff’s assistance. Establishing continuous collaboration between the dietician and the occupational therapist, starting from the beginning of the feeding-tube weaning process: 1.The dietician updates the occupational therapist about the start of the process and the approved diet. 2.The occupational therapist performs cognitive, motor, and functional assessments and treatments regarding the patient’s eating capabilities and recommends the required adjustments for independent eating according to the FIM (Functional Independence Measure) scale. 3.The occupational therapist closely follows up on the patient’s degree of independence in eating and provides a repeated update to the dietician. 4.The dietician accordingly guides the ward staff on whether and how to feed the patient or allow independent eating. The project aimed to promote patients toward independent feeding, which leads to a sense of empowerment, enjoyment of the eating experience, and progress of functional ability, along with performing active movements that will motivate mobilization. From the beginning of 2022, 26 patients participated in the project. 79% of all patients who started the weaning process from tube feeding achieved different levels of independence in feeding (independence levels ranged from supervision (FIM-5) to complete independence (FIM-7). The integration of occupational therapy and dietary treatment is based on a patient-centered approach while considering the patient’s personal needs, preferences, and goals. This interdisciplinary partnership is essential for meeting the complex needs of prolonged mechanically ventilated patients and promotes independent functioning and quality of life.

Keywords: dietary, mechanical ventilation, occupational therapy, tube feeding weaning

Procedia PDF Downloads 63

Authors: Dennis Kreutzer, Sarah Müller-Abdelrazeq, Ingrid Isenhardt

Abstract:

Resource scarcity, energy transition and the planned climate neutrality pose enormous challenges for manufacturing companies. In order to achieve these goals and a holistic sustainable development, the European Union has listed the circular economy as part of the Circular Economy Action Plan. In addition to a reduction in resource consumption, reduced emissions of greenhouse gases and a reduced volume of waste, the principles of the circular economy also offer enormous economic potential for companies, such as the generation of new circular business models. However, many manufacturing companies, especially small and medium-sized enterprises, do not have the necessary capacity to plan their transformation. They need support and strategies on the path to circular transformation, because this change affects not only production but also the entire company. Maturity models offer an approach, as they enable companies to determine the current status of their transformation processes. In addition, companies can use the models to identify transformation strategies and thus promote the transformation process. While maturity models are established in other areas, e.g. IT or project management, only a few circular economy maturity models can be found in the scientific literature. The aim of this paper is to analyse the identified maturity models of the circular economy through a systematic literature review (SLR) and, besides other aspects, to check their completeness as well as their quality. Since the terms "maturity model" and "readiness model" are often used to assess the transformation process, this paper considers both types of models to provide a more comprehensive result. For this purpose, circular economy maturity models at the company (micro) level were identified from the literature, compared, and analysed with regard to their theoretical and methodological structure. A specific focus was placed, on the one hand, on the analysis of the business units considered in the respective models and, on the other hand, on the underlying metrics and indicators in order to determine the individual maturity level of the entire company. The results of the literature review show, for instance, a significant difference in the holism of their assessment framework. Only a few models include the entire company with supporting areas outside the value-creating core process, e.g. strategy and vision. Additionally, there are large differences in the number and type of indicators as well as their metrics. For example, most models often use subjective indicators and very few objective indicators in their surveys. It was also found that there are rarely well-founded thresholds between the levels. Based on the generated results, concrete ideas and proposals for a research agenda in the field of circular economy maturity models are made.

Keywords: maturity model, circular economy, transformation, metric, assessment

Procedia PDF Downloads 96

Authors: Hannah Evangeline Sangeetha

Abstract:

Ageing is an inevitable change in the life span of an individual. India’s old age population has increased from 19 million in 1947 to 100 million in the 21st century. The United Nations World Population ageing reports that the grey population has immensely increased from 9.2% in 1990 to 11.7 % in 2013, and it’s expected to triple by the year 2050 growing from 737 million to over 2 billion persons 60 years of age and older. Ageing is a period of physical, mental and social decline which brings a host of challenges to the individual and the family. Hence it requires attention at the micro, mezzo and the macro levels of the society. The concepts of healthy and successful aging are being used to help people to change their negative attitude towards aging. This perspective is important to make people realize their potentialities to bring about a change in the minds of senior citizens as well as the society. The objective of this study was to understand the level of active ageing among the rural elderly women and its impact on the quality of life. 330 elderly women from 12 villages of Sriperumbudur associated with the Mobile medical care of Help age India were interviewed using census method. The study revealed the following findings; most respondents in this study were young old between the age group of 60 to 75 years. All the three major religious groups were represented, 85.5percent were Hindus. Majority of the respondents 73.3percent had no education. It was interesting to know that majority of the respondents were self reliant (83.94 percent) and 82.73 percent of them very independent and took care of them by themselves (activities of daily living) without any support from their families. 76.9 percent of the senior women worked based on their competencies, 75.5 percent of them were involved in plenty of activities everyday including their occupation and household chores, which enabled them to be physically active. The chi square values that there is a significant association between the overall active ageing score, religion &number of members in the family. The other demographic variables like age, occupation, income marital status, age at marriage, number of children in the family and Socio –Economic Status were not significantly associated with the overall active aging score. The p-value 0.032 showed Social network and being self-reliant are significantly associated. The study surprisingly shows that most women enjoyed freedom and Independence in their family which is a positive indicator of active ageing.

Keywords: active ageing, quality of life, independence, self reliance

Procedia PDF Downloads 139

Authors: Maria Reznakova, Michala Strnadova, Lukas Reznak

Abstract:

The global financial crisis that erupted in 2008 is associated mainly with the debt crisis. It quickly spread globally through financial markets, international banks and trade links, and affected many economic sectors. Measured by the index of the year-on-year change in GDP and industrial production, the consequences of the global financial crisis manifested themselves with some delay also in the Czech economy. This can be considered a result of the overwhelming export orientation of Czech industrial enterprises. These events offer an important opportunity to study how financial and macroeconomic instability affects corporate performance. Corporate performance factors have long been given considerable attention. It is therefore reasonable to ask whether the findings published in the past are also valid in the times of economic instability and subsequent recession. The decisive factor in effective corporate performance measurement is the existence of an appropriate system of indicators that are able to assess progress in achieving corporate goals. Performance measures may be based on non-financial as well as on financial information. In this paper, financial indicators are used in combination with other characteristics, such as the firm size and ownership structure. Financial performance is evaluated based on traditional performance indicators, namely, return on equity and return on assets, supplemented with indebtedness and current liquidity indices. As investments are a very important factor in corporate performance, their trends and importance were also investigated by looking at the ratio of investments to previous year’s sales and the rate of reinvested earnings. In addition to traditional financial performance indicators, the Economic Value Added was also used. Data used in the research were obtained from a questionnaire survey administered in industrial enterprises in the Czech Republic and from AMADEUS (Analyse Major Database from European Sources), from which accounting data of companies were obtained. Respondents were members of the companies’ senior management. Research results unequivocally confirmed that corporate performance dropped significantly in the 2010-2012 period, which can be considered a result of the global financial crisis and a subsequent economic recession. It was reflected mainly in the decreasing values of profitability indicators and the Economic Value Added. Although the total year-on-year indebtedness declined, intercompany indebtedness increased. This can be considered a result of impeded access of companies to bank loans due to the credit crunch. Comparison of the results obtained with the conclusions of previous research on a similar topic showed that the assumption that firms under foreign control achieved higher performance during the period investigated was not confirmed.

Keywords: corporate performance, foreign control, intercompany indebtedness, ratio of investment

Procedia PDF Downloads 317

Authors: Abderrahman Hassi, Omar Bacadi, Khaoula Zitouni

Abstract:

Abdelkader El Mouaziz is a Moroccan long-distance runner with a career-best time of 2:06:46 in the Chicago Marathon. El Mouaziz is a winner of the Madrid Marathon in 1994, the London Marathon in 1999 and 2001, as well as the New York Marathon in 2001. While he was playing for the Moroccan national team, he used to train in the Ifrane-Azrou region owing to its altitude, fresh forests, non-polluted air and quietness. After winning so many international competitions and retiring, he left his native Casablanca and went back to the Ifrane-Azrou region and started a business that employs ten people. In March 2010, El Mouaziz opened a bed and breakfast called Tourtite with a nice view on the mountain near the city of Ifrane in the way to Azrou. He wanted to give back to the region that helped him become a sport legend. His management style is not different than his sport style: performance and competitiveness combined with fair play. The objective of the present case study is to further enhance the understanding of the dynamics of transferring athletic championship-winning principles to entrepreneurial activities. The case study is a real-life situation and experience designed to provoke and stimulate reflections about a particular approach of management, especially for start-up businesses.

Keywords: sport, winning principles, entrepreneurship, Abdelkader El Mouaziz

Procedia PDF Downloads 260

Authors: Tak Mau Simon Chan, Ying Chuen Lance Chan

Abstract:

Homelessness has been a popular and controversial debate in Hong Kong, a city which is densely populated and well-known for very expensive housing. The constitution of the homeless as threats to the community and environmental hygiene is ambiguous and debatable in the Hong Kong context. The lack of an intervention model is the critical research gap thus far, aside from the tangible services delivered. The life story approach (LSA), with its unique humanistic orientation, has been well applied in recent decades to depict the needs of various target groups, but not the homeless. It is argued that the life story approach (LSA), which has been employed by health professionals in the landscape of dementia, and health and social care settings, can be used as a reference in the local Chinese context through indigenization. This study, therefore, captures the viewpoints of service providers and users by constructing an indigenous intervention model that refers to the LSA in serving the chronically homeless. By informing 13 social workers and 27 homeless individuals in 8 focus groups whilst 12 homeless individuals have participated in individual in-depth interviews, a framework of LSA in homeless people is proposed. Through thematic analysis, three main themes of their life stories was generated, namely, the family, negative experiences and identity transformation. The three domains solidified framework that not only can be applied to the homeless, but also other disadvantaged groups in the Chinese context. Based on the three domains of family, negative experiences and identity transformation, the model is applied in the daily practices of social workers who help the homeless. The domain of family encompasses familial relationships from the past to the present to the speculated future with ten sub-themes. The domain of negative experiences includes seven sub-themes, with reference to the deviant behavior committed. The last domain, identity transformation, incorporates the awareness and redefining of one’s identity and there are a total of seven sub-themes. The first two domains are important components of personal histories while the third is more of an unknown, exploratory and yet to-be-redefined territory which has a more positive and constructive orientation towards developing one’s identity and life meaning. The longitudinal temporal dimension of moving from the past – present - future enriches the meaning making process, facilitates the integration of life experiences and maintains a more hopeful dialogue. The model is tested and its effectiveness is measured by using qualitative and quantitative methods to affirm the extent that it is relevant to the local context. First, it contributes to providing a clear guideline for social workers who can use the approach as a reference source. Secondly, the framework acts as a new intervention means to address problem saturated stories and the intangible needs of the homeless. Thirdly, the model extends the application to beyond health related issues. Last but not least, the model is highly relevant to the local indigenous context.

Keywords: homeless, indigenous intervention, life story approach, social work practice

Procedia PDF Downloads 279

Authors: Rebecca Pryce, Nijole Bernaitis, Andrew K. Davey, Shailendra Anoopkumar-Dukie

Abstract:

Background: Warfarin is an oral anticoagulant widely used in the prevention of strokes in patients with atrial fibrillation (AF) and in the treatment and prevention of deep vein thrombosis (DVT). Regular monitoring of Internationalised Normalised Ratio (INR) is required to ensure therapeutic benefit with time in therapeutic range (TTR) used to measure warfarin control. A number of factors influence TTR including diet, concurrent illness, and drug interactions. Extensive literature exists regarding the effect of conventional medicines on warfarin control, but documented interactions relating to complementary medicines are limited. It has been postulated that fish oil and krill oil supplementation may affect warfarin due to their association with bleeding events. However, to date little is known as to whether fish and krill oil significantly alter the incidence of bleeding with warfarin or impact on warfarin control. Aim:To assess the influence of fish oil and krill oil supplementation on warfarin control in AF and DVT patients by determining the influence of these supplements on TTR and bleeding events. Methods:A retrospective cohort analysis was conducted utilising patient information from a large private pathology practice in Queensland. AF and DVT patients receiving warfarin management by the pathology practice were identified and their TTR calculated using the Rosendaal method. Concurrent medications were analysed and patients taking no other interacting medicines were identified and divided according to users of fish oil and krill oil supplements and those taking no supplements. Study variables included TTR and the incidence of bleeding with exclusion criteria being less than 30 days of treatment with warfarin. Subject characteristics were reported as the mean and standard deviation for continuous data and number and percentages for nominal or categorical data. Data was analysed using GraphPad InStat Version 3 with a p value of <0.05 considered to be statistically significant. Results:Of the 2081 patients assessed for inclusion into this study, a total of 573 warfarin users met the inclusion criteria. Of these, 416 (72.6%) patients were AF patients and 157 (27.4%) DVT patients and overall there were 316 (55.1%) male and 257 (44.9%) female patients. 145 patients were included in the fish oil/krill oil group (supplement) and 428 were included in the control group. The mean TTR of supplement users was 86.9% and for the control group 84.7% with no significant difference between these groups. Control patients experienced 1.6 times the number of minor bleeds per person compared to supplement patients and 1.2 times the number of major bleeds per person. However, this was not statistically significant nor was the comparison between thrombotic events. Conclusion: No significant difference was found between supplement and control patients in terms of mean TTR, the number of bleeds and thrombotic events. Fish oil and krill oil supplements when used concurrently with warfarin do not significantly affect warfarin control as measured by TTR and bleeding incidence.

Keywords: atrial fibrillation, deep vein thormbosis, fish oil, krill oil, warfarin

Procedia PDF Downloads 285