Search results for: sustainable solid waste management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16252

Search results for: sustainable solid waste management

3022 Potential for Massive Use of Biodiesel for Automotive in Italy

Authors: Domenico Carmelo Mongelli

Abstract:

The context of this research is that of the Italian reality, which, in order to adapt to the EU Directives that prohibit the production of internal combustion engines in favor of electric mobility from 2035, is extremely concerned about the significant loss of jobs resulting from the difficulty of the automotive industry in converting in such a short time and due to the reticence of potential buyers in the face of such an epochal change. The aim of the research is to evaluate for Italy the potential of the most valid alternative to this transition to electric: leaving the current production of diesel engines unchanged, no longer powered by gasoil, imported and responsible for greenhouse gas emissions, but powered entirely by a nationally produced and eco-sustainable fuel such as biodiesel. Today in Italy, the percentage of biodiesel mixed with gasoil for diesel engines is too low (around 10%); for this reason, this research aims to evaluate the functioning of current diesel engines powered 100% by biodiesel and the ability of the Italian production system to cope to this hypothesis. The research geographically identifies those abandoned lands in Italy, now out of the food market, which is best suited to an energy crop for the final production of biodiesel. The cultivation of oilseeds is identified, which for the Italian agro-industrial reality allows maximizing the agricultural and industrial yields of the transformation of the agricultural product into a final energy product and minimizing the production costs of the entire agro-industrial chain. To achieve this objective, specific databases are used, and energy and economic balances are prepared for the different agricultural product alternatives. Solutions are proposed and tested that allow the optimization of all production phases in both the agronomic and industrial phases. The biodiesel obtained from the most feasible of the alternatives examined is analyzed, and its compatibility with current diesel engines is identified, and from the evaluation of its thermo-fluid-dynamic properties, the engineering measures that allow the perfect functioning of current internal combustion engines are examined. The results deriving from experimental tests on the engine bench are evaluated to evaluate the performance of different engines fueled with biodiesel alone in terms of power, torque, specific consumption and useful thermal efficiency and compared with the performance of engines fueled with the current mixture of fuel on the market. The results deriving from experimental tests on the engine bench are evaluated to evaluate the polluting emissions of engines powered only by biodiesel and compared with current emissions. At this point, we proceed with the simulation of the total replacement of gasoil with biodiesel as a fuel for the current fleet of diesel vehicles in Italy, drawing the necessary conclusions in technological, energy, economic, and environmental terms and in terms of social and employment implications. The results allow us to evaluate the potential advantage of a total replacement of diesel fuel with biodiesel for powering road vehicles with diesel cycle internal combustion engines without significant changes to the current vehicle fleet and without requiring future changes to the automotive industry.

Keywords: biodiesel, economy, engines, environment

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3021 Online Social Network Vital to Hospitality and Tourism Marketing and Management

Authors: Nureni Asafe Yekini, Olawale Nasiru Lawal, Bola Dada, Gabriel Adeyemi Okunlola

Abstract:

This study is focused on the strengths and challenges associated with using the online social network as a rapidly evolving medium in marketing tourism services and businesses among the youths in Nigeria. The paper examines the Nigerian tourists’ attitude, mainly towards three aspects: application of Internet for travel and tourism; usage of online social networks in sharing travel and tourism experiences; and trust in electronic-media for marketing tourism businesses and services. The aim of this research is to determine the level of application of internet tools in marketing tourism businesses and services in Nigeria. This study reports an empirical analysis based on data obtained from a survey among 1004 Nigerian tourists. The outcome confirms the research hypothesis and points to crucial importance of introducing online social network site for marketing tourism businesses and services in Nigeria, and increasing the awareness for Nigeria as a tourist destination. Moreover, the paper strongly recommends the use of online social network as a tool for marketing tourism businesses and services, and the need for identifying effective framework for application of ICT tools in marketing tourism businesses and services in Nigeria at large.

Keywords: tourism business, internet, online social networks, tourism services, ICT

Procedia PDF Downloads 356
3020 Combination of Artificial Neural Network Model and Geographic Information System for Prediction Water Quality

Authors: Sirilak Areerachakul

Abstract:

Water quality has initiated serious management efforts in many countries. Artificial Neural Network (ANN) models are developed as forecasting tools in predicting water quality trend based on historical data. This study endeavors to automatically classify water quality. The water quality classes are evaluated using 6 factor indices. These factors are pH value (pH), Dissolved Oxygen (DO), Biochemical Oxygen Demand (BOD), Nitrate Nitrogen (NO3N), Ammonia Nitrogen (NH3N) and Total Coliform (T-Coliform). The methodology involves applying data mining techniques using multilayer perceptron (MLP) neural network models. The data consisted of 11 sites of Saen Saep canal in Bangkok, Thailand. The data is obtained from the Department of Drainage and Sewerage Bangkok Metropolitan Administration during 2007-2011. The results of multilayer perceptron neural network exhibit a high accuracy multilayer perception rate at 94.23% in classifying the water quality of Saen Saep canal in Bangkok. Subsequently, this encouraging result could be combined with GIS data improves the classification accuracy significantly.

Keywords: artificial neural network, geographic information system, water quality, computer science

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3019 A Multivariate 4/2 Stochastic Covariance Model: Properties and Applications to Portfolio Decisions

Authors: Yuyang Cheng, Marcos Escobar-Anel

Abstract:

This paper introduces a multivariate 4/2 stochastic covariance process generalizing the one-dimensional counterparts presented in Grasselli (2017). Our construction permits stochastic correlation not only among stocks but also among volatilities, also known as co-volatility movements, both driven by more convenient 4/2 stochastic structures. The parametrization is flexible enough to separate these types of correlation, permitting their individual study. Conditions for proper changes of measure and closed-form characteristic functions under risk-neutral and historical measures are provided, allowing for applications of the model to risk management and derivative pricing. We apply the model to an expected utility theory problem in incomplete markets. Our analysis leads to closed-form solutions for the optimal allocation and value function. Conditions are provided for well-defined solutions together with a verification theorem. Our numerical analysis highlights and separates the impact of key statistics on equity portfolio decisions, in particular, volatility, correlation, and co-volatility movements, with the latter being the least important in an incomplete market.

Keywords: stochastic covariance process, 4/2 stochastic volatility model, stochastic co-volatility movements, characteristic function, expected utility theory, veri cation theorem

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3018 Implementation-Oriented Discussion for Historical and Cultural Villages’ Conservation Planning

Authors: Xing Zhang

Abstract:

Since the State Council of China issued the Regulations on the Conservation of Historical Cultural Towns and Villages in 2008, formulation of conservation planning has been carried out in national, provincial and municipal historical and cultural villages for protection needs, which provides a legal basis for inheritance of historical culture and protection of historical resources. Although the quantity and content of the conservation planning are continually increasing, the implementation and application are still ambiguous. To solve the aforementioned problems, this paper explores methods to enhance the implementation of conservation planning from the perspective of planning formulation. Specifically, the technical framework of "overall objectives planning - sub-objectives planning - zoning guidelines - implementation by stages" is proposed to implement the planning objectives in different classifications and stages. Then combined with details of the Qiqiao historical and cultural village conservation planning project in Ningbo, five sub-objectives are set, which are implemented through the village zoning guidelines. At the same time, the key points and specific projects in the near-term, medium-term and long-term work are clarified, and the spatial planning is transformed into the action plan with time scale. The proposed framework and method provide a reference for the implementation and management of the conservation planning of historical and cultural villages in the future.

Keywords: conservation planning, planning by stages, planning implementation, zoning guidelines

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3017 Distributed Leadership: An Alternative at Higher Education Institutions in Turkey

Authors: Sakine Sincer

Abstract:

In today’s world, which takes further steps towards globalization each and every day, societies and cultures are re-shaped while the demands of the changing world are described once more. In this atmosphere, where the speed of change sometimes reaches a terrifying point, it is possible to state that effective leaders are needed more than ever in order to meet the above-stated needs and demands. The question of what effective leadership is keeping its importance on the agenda. Most of the answers to this question has mostly focused on the approach of distributed leadership recently. This study aims at analyzing the applicability of distributed leadership, which is accepted to be an example of effective leadership that can meet the needs of global world, which is changing more and more rapidly nowadays, at higher education institutions in Turkey. Within the framework of this study, first of all, the historical development of distributed leadership is addressed, and then a theoretical framework is drawn for this approach by means of underlying what distributed leadership is and is not. After that, different points of view about the approach are laid out within the borders of opinions expressed by Gronn and Spillane, who are accepted to be the most famous advocators of distributed leadership. Then, exemplar practices of distributed leadership are included in the study before drawing attention to the strengths and weaknesses of this approach. Lastly, the applicability of distributed leadership at higher education institutions in Turkey is analyzed. This study is carried out with the method of literature review by resorting to first- and second-hand sources on distributed leadership.

Keywords: globalization, school leadership, distributed leadership, higher education, management

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3016 A Fuzzy TOPSIS Based Model for Safety Risk Assessment of Operational Flight Data

Authors: N. Borjalilu, P. Rabiei, A. Enjoo

Abstract:

Flight Data Monitoring (FDM) program assists an operator in aviation industries to identify, quantify, assess and address operational safety risks, in order to improve safety of flight operations. FDM is a powerful tool for an aircraft operator integrated into the operator’s Safety Management System (SMS), allowing to detect, confirm, and assess safety issues and to check the effectiveness of corrective actions, associated with human errors. This article proposes a model for safety risk assessment level of flight data in a different aspect of event focus based on fuzzy set values. It permits to evaluate the operational safety level from the point of view of flight activities. The main advantages of this method are proposed qualitative safety analysis of flight data. This research applies the opinions of the aviation experts through a number of questionnaires Related to flight data in four categories of occurrence that can take place during an accident or an incident such as: Runway Excursions (RE), Controlled Flight Into Terrain (CFIT), Mid-Air Collision (MAC), Loss of Control in Flight (LOC-I). By weighting each one (by F-TOPSIS) and applying it to the number of risks of the event, the safety risk of each related events can be obtained.

Keywords: F-topsis, fuzzy set, flight data monitoring (FDM), flight safety

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3015 The Descriptions of vBloggers with Type 1 Diabetes about Overcoming Diabetes Burnout

Authors: Samereh Abdoli, Amit Vora, Anusha Vora

Abstract:

Background: Diabetes burnout is one of the most common contributors to decreased quality of life, poor psychosocial well-being, and increased morbidity, mortality and diabetes cost. While the term diabetes burnout is widely accepted particularly in type 1 diabetes (T1D), the state of the science on diabetes burnout is lacking a systematic approach to overcome diabetes burnout. Objective: The study aimed to explore the strategies to overcome burnout by integrating the voices of individuals with T1D. Methods: In this study, we applied a descriptive qualitative design using YouTube videos produced by individuals with T1D. Seven YouTube videos (Austria= 1, U.S=6) with the highest rate of views which met the inclusion criteria were analyzed using a qualitative content analysis approach. Results: Participants verbalized overcoming diabetes burnout as a 'difficult hole to climb out of' which make them empowered. Themes that describes their strategies to overcome burnout in T1D, in general, include; 'make plan and take action', 'start with small steps', 'ask for help', 'get engage in diabetes community' and 'do not be perfect'. Future Work: These findings can begin the examination of different strategies to overcome diabetes burnout, which may change the course of action for diabetes care and management to improve quality of diabetes care and quality of life.

Keywords: diabetes burnout, type 1 diabetes, qualitative research, YouTube videos

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3014 The Ecological Role of Loligo forbesii in the Moray Firth Ecosystem, Northeast Scotland

Authors: Godwin A. Otogo, Sansanee Wangvoralak, Graham J. Pierce, Lee C. Hastie, Beth Scott

Abstract:

The squid Loligo forbesii is suspected to be an important species in marine food webs, as it can strongly impact its prey and be impacted upon by predation, competition, fishing and/or climate variability. To quantify these impacts in the food web, the measurement of its trophic position and ecological role within well-studied ecosystems is essential. An Ecopath model was balanced and run for the Moray Firth ecosystem and was used to investigate the significance of this squid’s trophic roles. The network analysis routine included in Ecopath with Ecosim (EwE) was used to estimate trophic interaction, system indicators (health condition and developmental stage) and food web features. Results indicated that within the Moray Firth squid occupy a top trophic position in the food web and also a major prey item for many other species. Results from Omnivory Index (OI) showed that squid is a generalized feeder transferring energy across wide trophic levels and is more important as a predator than that as a prey in the Moray Firth ecosystem. The results highlight the importance of taking squid into account in the management of Europe’s living marine resources.

Keywords: Squid, Loligo forbesii, Ecopath, Moray Firth, Trophic level

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3013 Diversity and Equality in Four Finnish and Italian Energy Companies' Open Access Material

Authors: Elisa Bertagna

Abstract:

A frame analysis of the work done by various energy multinational companies concerning diversity issues and gender equality is presented. Documents of four multinational companies - two from Finland and two from Italy - have been studied. The array of companies’ documents includes data from their websites, policies and so on. The Finnish and Italian contexts have been chosen as a sample of North and South Europe, of 'advanced' and 'less advanced'. The aim of the analysis is to understand if and how human resource and diversity management in Finnish and Italian multinational energy companies communicate their activity towards the employees. Attention is given on how employees are reacting in their role and on the consequences of its social positioning. The findings of this essay are crucially important. They show how the companies in object tend to focus on the HR and DM positive actions towards female employees’ struggles since the industry is characterized by multinationals with male-dominated employees. In this way, other categories, which are also depicted as sensitive such as young and elderly people or foreigners, do not receive the same amount of attention. Consequently, power hierarchies can be found: 'women' as a social category are given more importance and space in the companies’ data than others. Consequently, the present work analysis reflects on possible struggles that such companies might be facing concerning gender biases and further diverse issues.

Keywords: energy, diversity, gender, multinationals, power hierarchies

Procedia PDF Downloads 143
3012 Digital Mapping of First-Order Drainages and Springs of the Guajiru River, Northeast of Brazil, Based on Satellite and Drone Images

Authors: Sebastião Milton Pinheiro da Silva, Michele Barbosa da Rocha, Ana Lúcia Fernandes Campos, Miquéias Rildo de Souza Silva

Abstract:

Water is an essential natural resource for life on Earth. Rivers, lakes, lagoons and dams are the main sources of water storage for human consumption. The costs of extracting and using these water sources are lower than those of exploiting groundwater on transition zones to semi-arid terrains. However, the volume of surface water has decreased over time, with the depletion of first-order drainage and the disappearance of springs, phenomena which are easily observed in the field. Climate change worsens water scarcity, compromising supply and hydric security for rural populations. To minimize the expected impacts, producing and storing water through watershed management planning requires detailed cartographic information on the relief and topography, and updated data on the stage and intensity of catchment basin environmental degradation problems. The cartography available of the Brazilian northeastern territory dates to the 70s, with topographic maps, printed, at a scale of 1:100,000 which does not meet the requirements to execute this project. Exceptionally, there are topographic maps at scales of 1:50,000 and 1:25,000 of some coastal regions in northeastern Brazil. Still, due to scale limitations and outdatedness, they are products of little utility for mapping low-order watersheds drainage and springs. Remote sensing data and geographic information systems can contribute to guiding the process of mapping and environmental recovery by integrating detailed relief and topographic data besides social and other environmental information in the Guajiru River Basin, located on the east coast of Rio Grande do Norte, on the Northeast region of Brazil. This study aimed to recognize and map catchment basin, springs and low-order drainage features along estimating morphometric parameters. Alos PALSAR and Copernicus DEM digital elevation models were evaluated and provided regional drainage features and the watersheds limits extracted with Terraview/Terrahidro 5.0 software. CBERS 4A satellite images with 2 m spatial resolution, processed with ESA SNAP Toolbox, allowed generating land use land cover map of Guajiru River. A Mappir Survey 3 multiespectral camera onboard of a DJI Phantom 4, a Mavic 2 Pro PPK Drone and an X91 GNSS receiver to collect the precised position of selected points were employed to detail mapping. Satellite images enabled a first knowledge approach of watershed areas on a more regional scale, yet very current, and drone images were essential in mapping details of catchment basins. The drone multispectral image mosaics, the digital elevation model, the contour lines and geomorphometric parameters were generated using OpenDroneMap/ODM and QGis softwares. The drone images generated facilitated the location, understanding and mapping of watersheds, recharge areas and first-order ephemeral watercourses on an adequate scale and will be used in the following project’s phases: watershed management planning, recovery and environmental protection of Rio's springs Guajiru. Environmental degradation is being analyzed from the perspective of the availability and quality of surface water supply.

Keywords: imaging, relief, UAV, water

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3011 TeleEmergency Medicine: Transforming Acute Care through Virtual Technology

Authors: Ashley L. Freeman, Jessica D. Watkins

Abstract:

TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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3010 A Comparative Evaluation of Cognitive Load Management: Case Study of Postgraduate Business Students

Authors: Kavita Goel, Donald Winchester

Abstract:

In a world of information overload and work complexities, academics often struggle to create an online instructional environment enabling efficient and effective student learning. Research has established that students’ learning styles are different, some learn faster when taught using audio and visual methods. Attributes like prior knowledge and mental effort affect their learning. ‘Cognitive load theory’, opines learners have limited processing capacity. Cognitive load depends on the learner’s prior knowledge, the complexity of content and tasks, and instructional environment. Hence, the proper allocation of cognitive resources is critical for students’ learning. Consequently, a lecturer needs to understand the limits and strengths of the human learning processes, various learning styles of students, and accommodate these requirements while designing online assessments. As acknowledged in the cognitive load theory literature, visual and auditory explanations of worked examples potentially lead to a reduction of cognitive load (effort) and increased facilitation of learning when compared to conventional sequential text problem solving. This will help learner to utilize both subcomponents of their working memory. Instructional design changes were introduced at the case site for the delivery of the postgraduate business subjects. To make effective use of auditory and visual modalities, video recorded lectures, and key concept webinars were delivered to students. Videos were prepared to free up student limited working memory from irrelevant mental effort as all elements in a visual screening can be viewed simultaneously, processed quickly, and facilitates greater psychological processing efficiency. Most case study students in the postgraduate programs are adults, working full-time at higher management levels, and studying part-time. Their learning style and needs are different from other tertiary students. The purpose of the audio and visual interventions was to lower the students cognitive load and provide an online environment supportive to their efficient learning. These changes were expected to impact the student’s learning experience, their academic performance and retention favourably. This paper posits that these changes to instruction design facilitates students to integrate new knowledge into their long-term memory. A mixed methods case study methodology was used in this investigation. Primary data were collected from interviews and survey(s) of students and academics. Secondary data were collected from the organisation’s databases and reports. Some evidence was found that the academic performance of students does improve when new instructional design changes are introduced although not statistically significant. However, the overall grade distribution of student’s academic performance has changed and skewed higher which shows deeper understanding of the content. It was identified from feedback received from students that recorded webinars served as better learning aids than material with text alone, especially with more complex content. The recorded webinars on the subject content and assessments provides flexibility to students to access this material any time from repositories, many times, and this enhances students learning style. Visual and audio information enters student’s working memory more effectively. Also as each assessment included the application of the concepts, conceptual knowledge interacted with the pre-existing schema in the long-term memory and lowered student’s cognitive load.

Keywords: cognitive load theory, learning style, instructional environment, working memory

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3009 Risk Indicators of Massive Removal Phenomena According to the Mora - Vahrson Method, Applied in Pitalito and Campoalegre Municipalities

Authors: Laura Fernanda Pedreros Araque, Sebastian Rivera Pardo

Abstract:

The massive removal phenomena have been one of the most frequent natural disasters in the world, causing thousands of deaths, victims, damage to homes and diseases. In Pitalito, and Campoalegre department of Huila municipalities - Colombia, disasters have occurred due to various events such as high rainfall, earthquakes; it has caused landslides, floods, among others, affected the economy, the community, and transportation. For this reason, a study was carried out on the area’s most prone to suffer these phenomena to take preventive measures in favor of the protection of the population, the resources of management, and the planning of civil works. For the proposed object, the Mora-Varshon method was used, which allows classifying the degree of susceptibility to landslides in which the areas are found. Also, various factors or parameters were evaluated such as the soil moisture, lithology, slope, seismicity, and rain, each of these indicators were obtained using information from IDEAM, Servicio Geologico Colombiano (SGC) and using geographic information for geoprocessing in the Arcgis software to realize a mapping to indicate the susceptibility to landslides, classifying the areas of the municipalities such as very low, low, medium, moderate, high or very high.

Keywords: geographic information system, landslide, mass removal phenomena, Mora-Varshon method

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3008 Mitigating the Cost of Empty Container Repositioning through the Virtual Container Yard: An Appraisal of Carriers’ Perceptions

Authors: L. Edirisinghe, Z. Jin, A. W. Wijeratne, R. Mudunkotuwa

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Empty container repositioning is a fundamental problem faced by the shipping industry. The virtual container yard is a novel strategy underpinning the container interchange between carriers that could substantially reduce this ever-increasing shipping cost. This paper evaluates the shipping industry perception of the virtual container yard using chi-square tests. It examines if the carriers perceive that the selected independent variables, namely culture, organization, decision, marketing, attitudes, legal, independent, complexity, and stakeholders of carriers, impact the efficiency and benefits of the virtual container yard. There are two major findings of the research. Firstly, carriers view that complexity, attitudes, and stakeholders may impact the effectiveness of container interchange and may influence the perceived benefits of the virtual container yard. Secondly, the three factors of legal, organization, and decision influence only the perceived benefits of the virtual container yard. Accordingly, the implementation of the virtual container yard will be influenced by six key factors, namely complexity, attitudes, stakeholders, legal, organization and decision. Since the virtual container yard could reduce overall shipping costs, it is vital to examine the carriers’ perception of this concept.

Keywords: virtual container yard, imbalance, management, inventory

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3007 Epidemiological, Clinical, Histopathological Profile and Management of Breast Cancer at Kinshasa University Clinics

Authors: Eddy K. Mukadi

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This work is a documentary and descriptive study devoted to the epidemiological, clinical, histopathological and therapeutic profile of breast cancer deals with the department of gynecology and obstetrics of the university clinics of Kinshasa during the period from 1 January 2014 to 31 December 2014. We have identified 56 cases of breast cancer. These cancers accounted for 45.2% of gynecological mammary cancers. The youngest in our series was 18 years old while the oldest was 74 years old; And the mean age of these patients was 43.4 years and mostly multiparous (35.7%). Brides (60.7%) and bachelors (26.8%) were the most affected by breast cancer. The reasons for consultation were dominated by nodules in the breast (48.2%) followed by pain (35.7%) and nipple discharge (14.3%). In 89.2% of the cases, it was the advanced clinical stage (stage 3 and 4) and the infiltrating ductal carcinoma was the most frequent histological type (75%) The malignant tumor was mainly in the left breast (55.3%), and chemotherapy with hormone therapy and patey was the most convenient treatment (42.8%), while patey mastectomy was performed in 12.5% of patients. Because of the high incidence of breast cancer identified in our study, some preventive measures must be taken into account to address this public health problem, including breast autopalpation once a month, Early detection system development of a national breast cancer policy and the implementation of a national breast cancer control program.

Keywords: breast cancer, histopathological profile, epidemiological profile, Kinshasa

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3006 Energy Policy of India: An Assessment of Its Impacts and Way Forward

Authors: Mrinal Saurabh Bhaskar, Rahul E Ravindranathan, Priyangana Borah

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Energy plays a key role and as a driving force for economic and social growth for any country. To manage the energy sources and its efficient utilization in different economic sectors, energy policy of a country is critical. The energy performance of a country is measured in Energy Intensity and India’s Energy Intensity due to several policies interventions has reduced from 0.53 toe/1000USD (2010) in the year 2000 to 0.38 toe/1000USD (2010) in the year 2014, which is about 28 per cent reduction. The Government of India has taken several initiates to manage their increasing energy demand and meet the climate change goals defined by them. The major policy milestones in India related to energy are (i) Enactment of Energy Conservation (EC) Act 2001 (ii) Establishment of Bureau of Energy Efficiency 2001 (iii) National Action Plan on Climate Change (iv) Launch of Demand Side Management schemes (v) Amendment of EC Act 2010 (vi) Launch of Perform Achieve and Trade scheme 2012. Through a critical review, this paper highlights the key energy policy interventions by India, its benefits and impact, challenges faced and efforts of the Government to overcome such challenges. Such take away would be helpful for other countries who are proposing to prepare or amend their energy policy for their different economic sectors.

Keywords: energy, efficiency, climate, policy

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3005 Intellectual Capital Disclosure: Profiles of Spanish Public Universities

Authors: Yolanda Ramírez, Ángel Tejada, Agustín Baidez

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In the higher education setting, there is a current trend in society toward greater openness and transparency. The economic, social and political changes that have occurred in recent years in public sector universities (particularly the New Public Management, the Bologna Process and the emergence of the “third mission”) call for a wider disclosure of value created by universities to support fundraising activities, to ensure accountability in the use of public funds and the outcomes of research and teaching, as well as close relationships with industries and territories. The paper has two purposes: 1) to explore the intellectual capital (IC) disclosure in Spanish universities through their websites, and 2) to identify university profiles. This study applies a content analysis to analyze the institutional websites of Spanish public universities and a cluster analysis. The analysis reveals that Spanish universities’ website content usually relates to human capital, while structural and relational capitals are less widely disclosed. Our research identifies three behavioral profiles of Spanish universities with regard to the online disclosure of IC (universities more proactive, universities less proactive and universities adopt a middle position in this regard. The results can serve as encouragement to university managers to enhance online IC disclosure to meet the information needs of university stakeholders.

Keywords: universities, intellectual capital, disclosure, internet

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3004 Valuing Social Sustainability in Agriculture: An Approach Based on Social Outputs’ Shadow Prices

Authors: Amer Ait Sidhoum

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Interest in sustainability has gained ground among practitioners, academics and policy-makers due to growing stakeholders’ awareness of environmental and social concerns. This is particularly true for agriculture. However, relatively little research has been conducted on the quantification of social sustainability and the contribution of social issues to the agricultural production efficiency. This research's main objective is to propose a method for evaluating prices of social outputs, more precisely shadow prices, by allowing for the stochastic nature of agricultural production that is to say for production uncertainty. In this article, the assessment of social outputs’ shadow prices is conducted within the methodological framework of nonparametric Data Envelopment Analysis (DEA). An output-oriented directional distance function (DDF) is implemented to represent the technology of a sample of Catalan arable crop farms and derive the efficiency scores the overall production technology of our sample is assumed to be the intersection of two different sub-technologies. The first sub-technology models the production of random desirable agricultural outputs, while the second sub-technology reflects the social outcomes from agricultural activities. Once a nonparametric production technology has been represented, the DDF primal approach can be used for efficiency measurement, while shadow prices are drawn from the dual representation of the DDF. Computing shadow prices is a method to assign an economic value to non-marketed social outcomes. Our research uses cross sectional, farm-level data collected in 2015 from a sample of 180 Catalan arable crop farms specialized in the production of cereals, oilseeds and protein (COP) crops. Our results suggest that our sample farms show high performance scores, from 85% for the bad state of nature to 88% for the normal and ideal crop growing conditions. This suggests that farm performance is increasing with an improvement in crop growth conditions. Results also show that average shadow prices of desirable state-contingent output and social outcomes for efficient and inefficient farms are positive, suggesting that the production of desirable marketable outputs and of non-marketable outputs makes a positive contribution to the farm production efficiency. Results also indicate that social outputs’ shadow prices are contingent upon the growing conditions. The shadow prices follow an upward trend as crop-growing conditions improve. This finding suggests that these efficient farms prefer to allocate more resources in the production of desirable outputs than of social outcomes. To our knowledge, this study represents the first attempt to compute shadow prices of social outcomes while accounting for the stochastic nature of the production technology. Our findings suggest that the decision-making process of the efficient farms in dealing with social issues are stochastic and strongly dependent on the growth conditions. This implies that policy-makers should adjust their instruments according to the stochastic environmental conditions. An optimal redistribution of rural development support, by increasing the public payment with the improvement in crop growth conditions, would likely enhance the effectiveness of public policies.

Keywords: data envelopment analysis, shadow prices, social sustainability, sustainable farming

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3003 Discursively Examination of 8th Grade Students’ Geometric Thinking Levels

Authors: Ferdağ Çulhan, Emine Gaye Çontay

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Geometric thinking levels created by Van Hiele are used to determine students' progress in geometric thinking. Many studies have been conducted on geometric thinking levels and they have taken their place in teaching curricula over time. It is thought that geometric thinking levels, which have become so important in teaching, can be examined in depth. In order to make an in-depth analysis, it was decided that the most appropriate management was discourse analysis. In this study, the focus is on examining the geometric thinking levels of 8th grade students from a discursive point of view. Sfard (2008)'s "Commognitive" theory will be used to conduct discursive analysis. The "Global Van Hiele Questionnaire" created by Patkin (2014) and translated into Turkish for this research will be used in the research. The "Global Van Hiele Questionnaire" contains questions from the sub-learning domain of triangles and quadrilaterals, circles and geometric objects. It has a wider scope than many "Van Hiele Questionnaires". “Global Van Hiele Questionnaire” will be applied to 8th grade students. Then, the geometric thinking levels of the students will be determined and interviews will be held with two students from each of the 1st, 2nd and 3rd levels. The interviews will be recorded and the students' discourses will be examined. By evaluating the relations between the students' geometric thinking levels and their discourses, it will be examined how much their discourse reflects their level of thinking. In this way, it is thought that students' geometric thinking processes can be better understood.

Keywords: mathematical discourses, commognitive framework, geometric thinking levels, van hiele

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3002 Research on the Spatial Evolution of Tourism-Oriented Rural Settlements: Take the Xiaochanfangyu Village, Dongshuichang Village, Maojiayu Village in Jixian County, Tianjin City as Examples

Authors: Yu Zhang, Jie Wu, Li Dong

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Rural tourism is the service industry which regards the agricultural production, rural life, rural nature and cultural landscape as the tourist attraction. It aims to meet the needs of the city tourists such as country sightseeing, vacation, and leisure. According to the difference of the tourist resources, the rural settlements can be divided into different types: The type of tourism resources, scenic spot, and peri-urban. In the past ten years, the rural tourism has promoted the industrial transformation and economic growth in rural areas of China. And it is conducive to the coordinated development of urban and rural areas and has greatly improved the ecological environment and the standard of living for farmers in rural areas. At the same time, a large number of buildings and sites are built in the countryside in order to enhance the tourist attraction and the ability of tourist reception and also to increase the travel comfort and convenience, which has significant influence on the spatial evolution of the village settlement. This article takes the XiangYing Subdistrict, which is in JinPu District of Dalian in China as the exemplification and uses the technology of Remote Sensing (RS), Geographic Information System (GIS) and the technology of Landscape Spatial Analysis to study the influence of the rural tourism development in the rural settlement spaces in four steps. First, acquiring the remote sensing image data at different times of 8 administrative villages in the XiangYing Subdistrict, by using the remote sensing application EDRAS8.6; second, vectoring basic maps of XiangYing Subdistrict including its land-use map with the application of ArcGIS 9.3, associating with social and economic attribute data of rural settlements and analyzing on the rural evolution visually; third, quantifying the comparison of these patches in rural settlements by using the landscape spatial calculation application Fragstats 3.3 and analyzing on the evolution of the spatial structure of settlement in macro and medium scale; finally, summarizing the evolution characteristics and internal reasons of tourism-oriented rural settlements. The main findings of this article include: first of all, there is difference in the evolution of the spatial structure between the developing rural settlements and undeveloped rural settlements among the eight administrative villages; secondly, the villages relying on the surrounding tourist attractions, the villages developing agricultural ecological garden and the villages with natural or historical and cultural resources have different laws of development; then, the rural settlements whose tourism development in germination period, development period and mature period have different characteristics of spatial evolution; finally, the different evolution modes of the tourism-oriented rural settlement space have different influences on the protection and inheritance of the village scene. The development of tourism has a significant impact on the spatial evolution of rural settlement. The intensive use of rural land and natural resources is the fundamental principle to protect the rural cultural landscape and ecological environment as well as the critical way to improve the attraction of rural tourism and promote the sustainable development of countryside.

Keywords: landscape pattern, rural settlement, spatial evolution, tourism-oriented, Xiangying Subdistrict

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3001 Regional Flood-Duration-Frequency Models for Norway

Authors: Danielle M. Barna, Kolbjørn Engeland, Thordis Thorarinsdottir, Chong-Yu Xu

Abstract:

Design flood values give estimates of flood magnitude within a given return period and are essential to making adaptive decisions around land use planning, infrastructure design, and disaster mitigation. Often design flood values are needed at locations with insufficient data. Additionally, in hydrologic applications where flood retention is important (e.g., floodplain management and reservoir design), design flood values are required at different flood durations. A statistical approach to this problem is a development of a regression model for extremes where some of the parameters are dependent on flood duration in addition to being covariate-dependent. In hydrology, this is called a regional flood-duration-frequency (regional-QDF) model. Typically, the underlying statistical distribution is chosen to be the Generalized Extreme Value (GEV) distribution. However, as the support of the GEV distribution depends on both its parameters and the range of the data, special care must be taken with the development of the regional model. In particular, we find that the GEV is problematic when developing a GAMLSS-type analysis due to the difficulty of proposing a link function that is independent of the unknown parameters and the observed data. We discuss these challenges in the context of developing a regional QDF model for Norway.

Keywords: design flood values, bayesian statistics, regression modeling of extremes, extreme value analysis, GEV

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3000 Enquiry into Psychological and Psychosocial Aspects in Cancer Care: Cancer Diseases Hospital, Zambia

Authors: Mubita Namuyamba

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Despite an increase in the number of cancer programs and partnerships in cancer care provision, the burden of cancer in Zambia is increasingly having a significant impact on morbidity and mortality rates. The increase in cancer morbidity and mortality rates has given rise to psychological and psycho social implications (PPsI) in cancer care. Cancer patients, care givers and health care providers are faced with a multitude of PPsIs in cancer care that mainly impact negatively on the management of cancer patients. The study adopted a case study design and was purposively conducted at the Cancer Diseases Hospital in Lusaka (Zambia) after obtaining ethical clearance from the Ethics committee. The sample for this study included 70 cancer patients, 20 care givers and 5 hospital staff (4 nurses and 1 doctor). Data was collected using interviews guides, focus group discussion guides and questionnaires respectively. The qualitative data was analysed thematically. The various psychological and psychosocial challenges that conspire to deter the provision of effective cancer care nursing and improved methods of minimizing the psychological and psychosocial implications in cancer care are the products of this study.

Keywords: case study, enquiry, psychological and psycho social aspects, Zambia

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2999 Safety Culture Implementation Based on Occupational Health and Safety Assessment

Authors: Nyambayar Davaadorj, Ichiro Koshijima

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Safety or the state of being safe can be described as a condition of being not dangerous or not harmful. It is necessary for an individual to avoid dangerous situations every day. Also, an organization is subject to legal requirements for the health and safety of persons inside and around the immediate workplace, or who are exposed to the workplace activities. Although it might be difficult to keep a situation where complete safety is ensured, efforts must nonetheless be made to consider ways of removing any potential danger within an organization. In order to ensure a safe working environment, the capability of responding (i.e., resilience) to signals (i.e., information concerning events that could pose future problems that must be taken into account) that occur in and around corporations is necessary. The ability to evaluate this essential point is thus one way in which safety and security can be managed. This study focuses on OHSAS18001, an internationally applied standard for the construction and operation of occupational health and safety management systems, by using IDEF0 for Function Modeling (IDEF0) and the Resilience Matrix originally made by Bracco. Further, this study discusses a method for evaluating a manner in which Occupational Health and Safety Assessment Series (OHSAS) systematically functions within corporations. Based on the findings, this study clarifies the potential structural objection for corporations when implementing and operating the OHSAS standard.

Keywords: OHSAS18001, IDEF0, resilience engineering, safety culture

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2998 Sonication as a Versatile Tool for Photocatalysts’ Synthesis and Intensification of Flow Photocatalytic Processes Within the Lignocellulose Valorization Concept

Authors: J. C. Colmenares, M. Paszkiewicz-Gawron, D. Lomot, S. R. Pradhan, A. Qayyum

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This work is a report of recent selected experiments of photocatalysis intensification using flow microphotoreactors (fabricated by an ultrasound-based technique) for photocatalytic selective oxidation of benzyl alcohol (BnOH) to benzaldehyde (PhCHO) (in the frame of the concept of lignin valorization), and the proof of concept of intensifying a flow selective photocatalytic oxidation process by acoustic cavitation. The synthesized photocatalysts were characterized by using different techniques such as UV-Vis diffuse reflectance spectroscopy, X-ray diffraction, nitrogen sorption, thermal gravimetric analysis, and transmission electron microscopy. More specifically, the work will be on: a Design and development of metal-containing TiO₂ coated microflow reactor for photocatalytic partial oxidation of benzyl alcohol: The current work introduces an efficient ultrasound-based metal (Fe, Cu, Co)-containing TiO₂ deposition on the inner walls of a perfluoroalkoxy alkanes (PFA) microtube under mild conditions. The experiments were carried out using commercial TiO₂ and sol-gel synthesized TiO₂. The rough surface formed during sonication is the site for the deposition of these nanoparticles in the inner walls of the microtube. The photocatalytic activities of these semiconductor coated fluoropolymer based microreactors were evaluated for the selective oxidation of BnOH to PhCHO in the liquid flow phase. The analysis of the results showed that various features/parameters are crucial, and by tuning them, it is feasible to improve the conversion of benzyl alcohol and benzaldehyde selectivity. Among all the metal-containing TiO₂ samples, the 0.5 at% Fe/TiO₂ (both, iron and titanium, as cheap, safe, and abundant metals) photocatalyst exhibited the highest BnOH conversion under visible light (515 nm) in a microflow system. This could be explained by the higher crystallite size, high porosity, and flake-like morphology. b. Designing/fabricating photocatalysts by a sonochemical approach and testing them in the appropriate flow sonophotoreactor towards sustainable selective oxidation of key organic model compounds of lignin: Ultrasonication (US)-assitedprecipitaion and US-assitedhydrosolvothermal methods were used for the synthesis of metal-oxide-based and metal-free-carbon-based photocatalysts, respectively. Additionally, we report selected experiments of intensification of a flow photocatalytic selective oxidation through the use of ultrasonic waves. The effort of our research is focused on the utilization of flow sonophotocatalysis for the selective transformation of lignin-based model molecules by nanostructured metal oxides (e.g., TiO₂), and metal-free carbocatalysts. A plethora of parameters that affects the acoustic cavitation phenomena, and as a result the potential of sonication were investigated (e.g. ultrasound frequency and power). Various important photocatalytic parameters such as the wavelength and intensity of the irradiated light, photocatalyst loading, type of solvent, mixture of solvents, and solution pH were also optimized.

Keywords: heterogeneous photo-catalysis, metal-free carbonaceous materials, selective redox flow sonophotocatalysis, titanium dioxide

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2997 Understanding Informal Settlements: The Role of Geo-Information Tools

Authors: Musyimi Mbathi

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Information regarding social, political, demographic, economic and other attributes of human settlement is important for decision makers at all levels of planning, as they have to grapple with dynamic environments often associated with settlements. At the local level, it is particularly important for both communities and urban managers to have accurate and reliable information regarding all planning attributes. Settlement mapping, in particular, informal settlements mapping in Kenya, has over the past few years been carried out using modern tools like Geographic information systems (GIS) and remote sensing for spatial data analysis and planning. GIS tools offer a platform for integration of spatial and non-spatial data as well as visualisation of the settlements. The capabilities offered by these tools have enabled communities to participate especially in the planning and management of new infrastructure as well as settlement upgrading. Land tenure based projects within informal settlements have also relied on GIS and related tools with considerable success. Additionally, the adoption of participatory approaches and use of geo-information tools helped to provide a basis for all inclusive planning thus promoting accountability, transparency, legitimacy, and other dimensions of governance within human settlement planning. The paper examines the context and application of geo-information tools for planning within low-income settlements of Kenya. A case study of Kiambiu settlement will be used to demonstrate how the tools have been applied for planning and decision-making purposes.

Keywords: informal settlements, GIS, governance, modern tools

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2996 Assessing the Risk of Socio-economic Drought: A Case Study of Chuxiong Yi Autonomous Prefecture, China

Authors: Mengdan Guo, Zongmin Wang, Haibo Yang

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Drought is one of the most complex and destructive natural disasters, with a huge impact on both nature and society. In recent years, adverse climate conditions and uncontrolled human activities have exacerbated the occurrence of global droughts, among which socio-economic droughts are closely related to human survival. The study of socio-economic drought risk assessment is crucial for sustainable social development. Therefore, this study comprehensively considered the risk of disaster causing factors, the exposure level of the disaster-prone environment, and the vulnerability of the disaster bearing body to construct a socio-economic drought risk assessment model for Chuxiong Prefecture in Yunnan Province. Firstly, a threedimensional frequency analysis of intensity area duration drought was conducted, followed by a statistical analysis of the drought risk of the socio-economic system. Secondly, a grid analysis model was constructed to assess the exposure levels of different agents and study the effects of drought on regional crop growth, industrial economic growth, and human consumption thresholds. Thirdly, an agricultural vulnerability model for different irrigation levels was established by using the DSSAT crop model. Industrial economic vulnerability and domestic water vulnerability under the impact of drought were investigated by constructing a standardized socio-economic drought index and coupling water loss. Finally, the socio-economic drought risk was assessed by combining hazard, exposure, and vulnerability. The results show that the frequency of drought occurrence in Chuxiong Prefecture, Yunnan Province is relatively high, with high population and economic exposure concentrated in urban areas of various counties and districts, and high agricultural exposure concentrated in mountainous and rural areas. Irrigation can effectively reduce agricultural vulnerability in Chuxiong, and the yield loss rate under the 20mm winter irrigation scenario decreased by 10.7% compared to the rain fed scenario. From the perspective of comprehensive risk, the distribution of long-term socio-economic drought risk in Chuxiong Prefecture is relatively consistent, with the more severe areas mainly concentrated in Chuxiong City and Lufeng County, followed by counties such as Yao'an, Mouding and Yuanmou. Shuangbai County has the lowest socio-economic drought risk, which is basically consistent with the economic distribution trend of Chuxiong Prefecture. And in June, July, and August, the drought risk in Chuxiong Prefecture is generally high. These results can provide constructive suggestions for the allocation of water resources and the construction of water conservancy facilities in Chuxiong Prefecture, and provide scientific basis for more effective drought prevention and control. Future research is in the areas of data quality and availability, climate change impacts, human activity impacts, and countermeasures for a more comprehensive understanding and effective response to drought risk in Chuxiong Prefecture.

Keywords: DSSAT model, risk assessment, socio-economic drought, standardized socio-economic drought index

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2995 The Historical Perspectives of Peace Education as a Vehicle of Unity and Technological Developments in Nigeria

Authors: Oluwole Enoch Adeniran

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Peace studies and conflict resolution; though a relatively new discipline had attracted scholars from far and near. It had enhanced a purposeful training of mind of young adult among other categories of learners. It provides a platform through which university under-graduates and post-graduates students are exposed to the rudiments of peace building, peacemaking and peace keeping towards a successful conflict resolution. The paper historicizes peace education as most desirable in any human society that desired development. It aims at educating children and young adults in the dynamics of peaceful conflicts resolution at home, in school and communities (states) throughout the world for a purposeful technological development. It also aims at exposing students to the nature of conflict and how to manage and resolve conflicts in order to promote national unity for meaningful development. The paper argues that, for a state to record any meaningful socio-economic, political and technological development; a conducive and peaceful atmosphere must be put in place. This theoretical paper emerged in the context of historical specificities of conflict resolution from a general conceptual framework. It then concludes with suggestions on the modes of conflict prevention, conflict management and conflict resolution for an ideal technologically advanced society.

Keywords: history, education, peace, unity, technology and development

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2994 Hydrogen Purity: Developing Low-Level Sulphur Speciation Measurement Capability

Authors: Sam Bartlett, Thomas Bacquart, Arul Murugan, Abigail Morris

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Fuel cell electric vehicles provide the potential to decarbonise road transport, create new economic opportunities, diversify national energy supply, and significantly reduce the environmental impacts of road transport. A potential issue, however, is that the catalyst used at the fuel cell cathode is susceptible to degradation by impurities, especially sulphur-containing compounds. A recent European Directive (2014/94/EU) stipulates that, from November 2017, all hydrogen provided to fuel cell vehicles in Europe must comply with the hydrogen purity specifications listed in ISO 14687-2; this includes reactive and toxic chemicals such as ammonia and total sulphur-containing compounds. This requirement poses great analytical challenges due to the instability of some of these compounds in calibration gas standards at relatively low amount fractions and the difficulty associated with undertaking measurements of groups of compounds rather than individual compounds. Without the available reference materials and analytical infrastructure, hydrogen refuelling stations will not be able to demonstrate compliance to the ISO 14687 specifications. The hydrogen purity laboratory at NPL provides world leading, accredited purity measurements to allow hydrogen refuelling stations to evidence compliance to ISO 14687. Utilising state-of-the-art methods that have been developed by NPL’s hydrogen purity laboratory, including a novel method for measuring total sulphur compounds at 4 nmol/mol and a hydrogen impurity enrichment device, we provide the capabilities necessary to achieve these goals. An overview of these capabilities will be given in this paper. As part of the EMPIR Hydrogen co-normative project ‘Metrology for sustainable hydrogen energy applications’, NPL are developing a validated analytical methodology for the measurement of speciated sulphur-containing compounds in hydrogen at low amount fractions pmol/mol to nmol/mol) to allow identification and measurement of individual sulphur-containing impurities in real samples of hydrogen (opposed to a ‘total sulphur’ measurement). This is achieved by producing a suite of stable gravimetrically-prepared primary reference gas standards containing low amount fractions of sulphur-containing compounds (hydrogen sulphide, carbonyl sulphide, carbon disulphide, 2-methyl-2-propanethiol and tetrahydrothiophene have been selected for use in this study) to be used in conjunction with novel dynamic dilution facilities to enable generation of pmol/mol to nmol/mol level gas mixtures (a dynamic method is required as compounds at these levels would be unstable in gas cylinder mixtures). Method development and optimisation are performed using gas chromatographic techniques assisted by cryo-trapping technologies and coupled with sulphur chemiluminescence detection to allow improved qualitative and quantitative analyses of sulphur-containing impurities in hydrogen. The paper will review the state-of-the art gas standard preparation techniques, including the use and testing of dynamic dilution technologies for reactive chemical components in hydrogen. Method development will also be presented highlighting the advances in the measurement of speciated sulphur compounds in hydrogen at low amount fractions.

Keywords: gas chromatography, hydrogen purity, ISO 14687, sulphur chemiluminescence detector

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2993 Total Knee Arthroplasty in a Haemophilia: A Patient with High Titre of Inhibitor Using Recombinant Factor VIIa

Authors: Mohammad J. Mortazavi, Arvin Najafi, Pejman Mansouri

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Hemophilia A is simply described as deficiency of factor VIII(FVIII) and patients with this disorder have bleeding complications in different organs. By using the recombinant factor VIII in these patients, elective orthopedic surgeries have been done approximately in 40 last years. About 10-30 % of these patients have bleeding complications in their surgeries even by using recombinant factor VIII because of their inhibitor against FVIII molecule. Preoperative haemostatic management in these patients is challenging. We treated a 28-year-old male patient with hemophilia A with FVIII inhibitor which had been detected when he was14 years old (with the titer 54 Bethesda unit(BU)) scheduled for total knee arthroplasty (TKA). We use 90 µg/kg rFVIIa just before the surgery and every 2 hours during surgery. The patient did not have any significant hemorrhage during the surgery and after that. For the 2 days after surgery, the rFVIIa repeated every 2 hours as the same as preoperative dosage(90 µg/kg) and for another 2 days of postoperative admission it continued every 4 hours. After 4th day, the rFVIIa continued every 6 hours with the same dosage until the sixth day from the surgery, and finally the patient were discharged about two weeks after surgery. Seven days after the discharge, he came back for the follow up visit. On the follow up examination, the site of the surgery had neither infection hemarthroses signs.

Keywords: hemophilia, factor VIII inhibitor, total knee replacement, rFVIIa

Procedia PDF Downloads 440