Search results for: risk management failure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16129

Search results for: risk management failure

2089 Monitoring Urban Green Space Cover Change Using GIS and Remote Sensing in Two Rapidly Urbanizing Cities, Debre Berhan and Debre Markos, Ethiopia

Authors: Alemaw Kefale, Aramde Fetene, Hayal Desta

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Monitoring the amount of green space in urban areas is important for ensuring sustainable development and proper management. The study analyzed changes in urban green space coverage over the past 20 years in two rapidly urbanizing cities in Ethiopia, Debre Berhan and Debre Markos, using GIS and remote sensing. The researchers used Landsat 5 and 8 data with a spatial resolution of 30 m to determine different land use and land cover classes, including urban green spaces, barren and croplands, built-up areas, and water bodies. The classification accuracy ranged between 90% and 91.4%, with a Kappa Statistic of 0.85 to 0.88. The results showed that both cities experienced significant decreases in vegetation cover in their urban cores between 2000 and 2020, with radical changes observed from green spaces and croplands to built-up areas. In Debre Berhan, barren and croplands decreased by 32.96%, while built-up and green spaces increased by 357.9% and 37.4%, respectively, in 2020. In Debre Markos, built-up areas increased by 224.2%, while green spaces and barren and croplands decreased by 41% and 5.71%, respectively. The spatial structure of cities and planning policies were noticed as the major factors for big green cover change. Thus it has an implication for other rapidly urbanized cities in Africa and Asia. Overall, rapid urbanization threatens green spaces and agricultural areas, highlighting the need for ecological-based spatial planning in rapidly urbanizing cities.

Keywords: green space coverage, GIS and remote sensing, Landsat, LULC, Ethiopia

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2088 Project Knowledge Harvesting: The Case of Improving Project Performance through Project Knowledge Sharing Framework

Authors: Eng Rima Al-Awadhi, Abdul Jaleel Tharayil

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In a project-centric organization like KOC, managing the knowledge of the project is of critical importance to the success of the project and the organization. However, due to the very nature and complexity involved, each project engagement generates a lot of 'learnings' that need to be factored into while new projects are initiated and thus avoid repeating the same mistake. But, many a time these learnings are localized and remains as ‘tacit knowledge’ leading to scope re-work, schedule overrun, adjustment orders, concession requests and claims. While KOC follows an asset based organization structure, with a multi-cultural and multi-ethnic workforce and larger chunk of the work is carried out through complex, long term project engagement, diffusion of ‘learnings’ across assets while dealing with the natural entropy of the organization is of great significance. Considering the relatively higher number of mega projects, it's important that the issues raised during the project life cycle are centrally harvested, analyzed and the ‘learnings’ from these issues are shared, absorbed and are in-turn utilized to enhance and refine the existing process and practices, leading to improve the project performance. One of the many factors contributing to the successful completion of a project on time is the reduction in the number of variations or concessions triggered during the project life cycle. The project process integrated knowledge sharing framework discusses the knowledge harvesting methodology adopted, the challenges faced, learnings acquired and its impact on project performance. The framework facilitates the proactive identification of issues that may have an impact on the overall quality of the project and improve performance.

Keywords: knowledge harvesting, project integrated knowledge sharing, performance improvement, knowledge management, lessons learn

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2087 Participatory Testing of Precision Fertilizer Management Technologies in Mid-Hills of Nepal

Authors: Kedar Nath Nepal, Dyutiman Choudhary, Naba Raj Pandit, Yam Gahire

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Crop fertilizer recommendations are outdated as these are based on the response trails conducted over half a century ago. Further, these recommendations were based on the response trials conducted over large geographical area ignoring the large spatial variability in indigenous nutrient supplying capacity of soils typical of most smallholder systems. Application of fertilizer following such blanket recommendation in fields with varying native nutrient supply capacity leads to under application in some places and over application in others leading to reduced nutrient-use-efficiency (NUE), loss of profitability, and increased environmental risks associated with loss of unutilized nutrient through emissions or leaching. Opportunities exist to further increase yield and profitability through a significant gain in fertilizer use efficiency with commercialization of affordable and precise application technologies. We conducted participatory trails in Maize (Zea Mays), Cauliflower (Brassica oleracea var. botrytis) and Tomato (Solanum lycopersicum) in Mid Hills of Nepal to evaluate the efficacy of Urea Deep Placement (UDP and Polymer Coated Urea (PCU);. UDP contains 46% of N having individual briquette size 2.7 gm each and PCU contains 44% of N . Both PCU and urea briquette applied at reduced amount (100 kg N/ha) during planting produced similar yields (p>0.05) compared with regular urea (200 Kg N/ha). . These fertilizers also reduced N fertilizer by 35 - 50% over government blanket recommendations. Further, PCU and urea briquette increased farmer’s net income by USD 60 to 80.

Keywords: high efficiency fertilizers, urea deep placement, briquette polymer coated urea, zea mays, brassica, lycopersicum, Nepal

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2086 How Envisioning Process Is Constructed: An Exploratory Research Comparing Three International Public Televisions

Authors: Alexandre Bedard, Johane Brunet, Wendellyn Reid

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Public Television is constantly trying to maintain and develop its audience. And to achieve those goals, it needs a strong and clear vision. Vision or envision is a multidimensional process; it is simultaneously a conduit that orients and fixes the future, an idea that comes before the strategy and a mean by which action is accomplished, from a business perspective. Also, vision is often studied from a prescriptive and instrumental manner. Based on our understanding of the literature, we were able to explain how envisioning, as a process, is a creative one; it takes place in the mind and uses wisdom and intelligence through a process of evaluation, analysis and creation. Through an aggregation of the literature, we build a model of the envisioning process, based on past experiences, perceptions and knowledge and influenced by the context, being the individual, the organization and the environment. With exploratory research in which vision was deciphered through the discourse, through a qualitative and abductive approach and a grounded theory perspective, we explored three extreme cases, with eighteen interviews with experts, leaders, politicians, actors of the industry, etc. and more than twenty hours of interviews in three different countries. We compared the strategy, the business model, and the political and legal forces. We also looked at the history of each industry from an inertial point of view. Our analysis of the data revealed that a legitimacy effect due to the audience, the innovation and the creativity of the institutions was at the cornerstone of what would influence the envisioning process. This allowed us to identify how different the process was for Canadian, French and UK public broadcasters, although we concluded that the three of them had a socially constructed vision for their future, based on stakeholder management and an emerging role for the managers: ideas brokers.

Keywords: envisioning process, international comparison, television, vision

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2085 Local Ordinances with Sharia Nuances in Pluralism Society of Indonesia: Convergence or Divergence

Authors: Farida Prihatini

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As a largest Muslim country in the world with around 215 Muslim inhabitants, Indonesia interestingly is not an Islamic country. Yet, Indonesia is not a secular country as well. The country has committed to be a unity in diversity country where people from various socio-political background may be coexistent live in this archipelago country. However, many provinces and Muslim groups are disposed of special regulation for Muslim people, namely local ordinances with sharia nuances, applied specifically in provinces, cities or regions where Muslim inhabitants are the majority. For the last two decades, particularly since Indonesia reform movement of 1998, a lot of local ordinances (Peraturan Daerah) with Sharia nuance have been enacted and applied in several provinces, cities and regions in Indonesia. The local ordinances are mostly deal with restriction of alcohol, prohibition of prostitution, Al Qur'an literacy, obligation to wear Muslim attire and zakat or alms management. Some of local ordinances have been warmly welcomed by society, while other ordinances have created tension. Those who oppose the ordinances believe that such things regulated by the ordinances are in violation of human rights and democracy, part of privacy rights of the people and must not be regulated by the State or local government. This paper describes the dynamic of local Ordinances with sharia nuances in Indonesia, in this research is limited to three ordinances: on the restriction of alcohol, prohibition of prostitution and obligation to wear Muslim attire. The researcher employs a normative method by studying secondary data and local ordinances in selected areas in Indonesia. The findings of the paper are that local ordinances with sharia nuances are indeed part of the needs of society, yet, in their implementation must take the pluralism of Indonesia and the state basic foundation, which is Pancasila (five pillars) into account.

Keywords: local, ordinances, sharia, rights

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2084 Markov Random Field-Based Segmentation Algorithm for Detection of Land Cover Changes Using Uninhabited Aerial Vehicle Synthetic Aperture Radar Polarimetric Images

Authors: Mehrnoosh Omati, Mahmod Reza Sahebi

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The information on land use/land cover changing plays an essential role for environmental assessment, planning and management in regional development. Remotely sensed imagery is widely used for providing information in many change detection applications. Polarimetric Synthetic aperture radar (PolSAR) image, with the discrimination capability between different scattering mechanisms, is a powerful tool for environmental monitoring applications. This paper proposes a new boundary-based segmentation algorithm as a fundamental step for land cover change detection. In this method, first, two PolSAR images are segmented using integration of marker-controlled watershed algorithm and coupled Markov random field (MRF). Then, object-based classification is performed to determine changed/no changed image objects. Compared with pixel-based support vector machine (SVM) classifier, this novel segmentation algorithm significantly reduces the speckle effect in PolSAR images and improves the accuracy of binary classification in object-based level. The experimental results on Uninhabited Aerial Vehicle Synthetic Aperture Radar (UAVSAR) polarimetric images show a 3% and 6% improvement in overall accuracy and kappa coefficient, respectively. Also, the proposed method can correctly distinguish homogeneous image parcels.

Keywords: coupled Markov random field (MRF), environment, object-based analysis, polarimetric SAR (PolSAR) images

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2083 Hydrological Modelling of Geological Behaviours in Environmental Planning for Urban Areas

Authors: Sheetal Sharma

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Runoff,decreasing water levels and recharge in urban areas have been a complex issue now a days pointing defective urban design and increasing demography as cause. Very less has been discussed or analysed for water sensitive Urban Master Plans or local area plans. Land use planning deals with land transformation from natural areas into developed ones, which lead to changes in natural environment. Elaborated knowledge of relationship between the existing patterns of land use-land cover and recharge with respect to prevailing soil below is less as compared to speed of development. The parameters of incompatibility between urban functions and the functions of the natural environment are becoming various. Changes in land patterns due to built up, pavements, roads and similar land cover affects surface water flow seriously. It also changes permeability and absorption characteristics of the soil. Urban planners need to know natural processes along with modern means and best technologies available,as there is a huge gap between basic knowledge of natural processes and its requirement for balanced development planning leading to minimum impact on water recharge. The present paper analyzes the variations in land use land cover and their impacts on surface flows and sub-surface recharge in study area. The methodology adopted was to analyse the changes in land use and land cover using GIS and Civil 3d auto cad. The variations were used in  computer modeling using Storm-water Management Model to find out the runoff for various soil groups and resulting recharge observing water levels in POW data for last 40 years of the study area. Results were anlayzed again to find best correlations for sustainable recharge in urban areas.

Keywords: geology, runoff, urban planning, land use-land cover

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2082 Classical Improvisation Facilitating Enhanced Performer-Audience Engagement and a Mutually Developing Impulse Exchange with Concert Audiences

Authors: Pauliina Haustein

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Improvisation was part of Western classical concert culture and performers’ skill sets until early 20th century. Historical accounts, as well as recent studies, indicate that improvisatory elements in the programme may contribute specifically towards the audiences’ experience of enhanced emotional engagement during the concert. This paper presents findings from the author’s artistic practice research, which explored re-introducing improvisation to Western classical performance practice as a musician (cellist and ensemble partner/leader). In an investigation of four concert cycles, the performer-researcher sought to gain solo and chamber music improvisation techniques (both related to and independent of repertoire), conduct ensemble improvisation rehearsals, design concerts with an improvisatory approach, and reflect on interactions with audiences after each concert. Data was collected through use of reflective diary, video recordings, measurement of sound parameters, questionnaires, a focus group, and interviews. The performer’s empirical experiences and findings from audience research components were juxtaposed and interrogated to better understand the (1) rehearsal and planning processes that enable improvisatory elements to return to Western classical concert experience and (2) the emotional experience and type of engagement that occur throughout the concert experience for both performer and audience members. This informed the development of a concert model, in which a programme of solo and chamber music repertoire and improvisations were combined according to historically evidenced performance practice (including free formal solo and ensemble improvisations based on audience suggestions). Inspired by historical concert culture, where elements of risk-taking, spontaneity, and audience involvement (such as proposing themes for fantasies) were customary, this concert model invited musicians to contribute to the process personally and creatively at all stages, from programme planning, and throughout the live concert. The type of democratic, personal, creative, and empathetic collaboration that emerged, as a result, appears unique in Western classical contexts, rather finding resonance in jazz ensemble, drama, or interdisciplinary settings. The research identified features of ensemble improvisation, such as empathy, emergence, mutual engagement, and collaborative creativity, that became mirrored in audience’s responses, generating higher levels of emotional engagement, empathy, inclusivity, and a participatory, co-creative experience. It appears that duringimprovisatory moments in the concert programme, audience members started feeling more like active participants in za\\a creative, collaborative exchange and became stakeholders in a deeper phenomenon of meaning-making and narrativization. Examining interactions between all involved during the concert revealed that performer-audience impulse exchange occurred on multiple levels of awareness and seemed to build upon each other, resulting in particularly strong experiences of both performer and audience’s engagement. This impact appeared especially meaningful for audience members who were seldom concertgoers and reported little familiarity with classical music. The study found that re-introducing improvisatory elements to Western classical concert programmes has strong potential in increasing audience’s emotional engagement with the musical performance, enabling audience members to connect more personally with the individual performers, and in reaching new-to-classical-music audiences.

Keywords: artistic research, audience engagement, audience experience, classical improvisation, ensemble improvisation, emotional engagement, improvisation, improvisatory approach, musical performance, practice research

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2081 Surgical Outcomes of Lung Cancer Surgery in Tasmania

Authors: Ayeshmanthe Rathnayake, Ashutosh Hardikar

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Introduction: Lung cancer is the most common cause of cancer death in Australia, with more than 13000 cases per year. Until now, there has been a major deficiency of national comprehensive thoracic surgery data. The thoracic workload for surgeons as well as caseload per unit, is highly variable, with some centres performing less than 15 cases per annum, thus raising concerns about optimal care at low-volume sites. This is an attempt to review the outcomes of lung cancer surgery in Tasmania. Method: The objective of this study is to determine the surgical outcomes of lung cancer surgery at Royal Hobart Hospital (RHH) with the primary outcome of surgical mortality. Four hundred fifty-one cases were analysed retrospectively from 2010 to May 2022. Results: A total of 451 patients underwent thoracic surgery with a primary diagnosis of lung cancer. The primary outcome of 30-day mortality was <0.5%. The mean age was 65.3 years, with male predominance and a 4.2% prevalence of Indigenous Australians. The mean LOS was 7.5 days. The surgical approach was either VATS (50.3%) or Thoracotomy (49.7%), with a trend towards the former in recent years with an increase in the proportion of VATS from 18.2% to 51% (p<0.05) in complex resections since 2019. A corresponding reduction in conversion rate to open was observed (18% vs. 5.5%), and there were no deaths within this subgroup. Lung resections were divided into lobectomy (55.4%), wedge resection (36.8%), segmentectomy (2.9%) and pneumonectomy (4.9%). The RHH demonstrates good surgical outcomes for lung cancer and provides a sustainable service for Tasmania. Conclusion: This retrospective study reports the surgical outcomes of lung cancer surgery at the Royal Hobart Hospital, thereby providing insight into the surgical management of lung cancer in the state thus far. The state has been slow to catch up on the minimally invasive program, but the overall results have been comparable to most peers.

Keywords: lung cancer, thoracic surgery, lung resection, surgical outcomes

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2080 Contact Toxicity Effects of Different Formulations of Artemisia Absinthium Extracts on Rose Aphid

Authors: Maryam Atapour

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Chemical pesticides, which are widely used in agriculture, cause problems such as soil and water pollution, reducing biodiversity and creating pest resistance. These problems have led to increased attention to alternative and more sustainable methods such as natural-based pesticides. Herbal pesticides have been developed based on essential oils or extracts from different parts of plants, such as leaves, roots, and flowers. Herbal pesticides are compatible with the environment and can be used in integrated pest management programs. Despite the many benefits, herbal pesticides, especially essential oil-based compounds, have low durability in the environment, and their production costs are high, so the use of herbal extracts with appropriate formulations is more justified in all aspects. In the current study and based on the results of previous studies, aqueous and 70% ethanolic extract of Artemisia absinthium L. was prepared by the percolation method and formulated as an emulsion and water-soluble powder. To produce powder formulation, 20% maltodextrin was used with the spray-dryer method. Different concentrations of these compounds were sprayed on bushes infected with rose aphid Macrosiphum rosae (L.). Sampling was done randomly and the percentage of aphids’ mortality was checked. The results showed that the use of different concentrations of ethanolic extracts created a significant difference in the mortality rate of aphids, while water-soluble powder formulation caused less mortality. The current results showed that the extract of this plant has practical usability to control aphids, and with the appropriate formulation, it can be used as a good alternative to chemical pesticides.

Keywords: contact toxicity, formulation, extract, aphid, Artemisia absinthium.

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2079 Frenotomy for Tongue Tie: The Unlikely Benefit of Massage

Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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2078 An Interactive Institutional Framework for Evolution of Enterprise Technological Innovation Capabilities System: A Complex Adaptive Systems Approach

Authors: Sohail Ahmed, Ke Xing

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This research theoretically explored the evolution mechanism of enterprise technological innovation capability system (ETICS) from the perspective of complex adaptive systems (CAS). This research proposed an analytical framework for ETICS, its concepts, and theory by integrating CAS methodology into the management of the technological innovation capability of enterprises and discusses how to use the principles of complexity to analyze the composition, evolution, and realization of the technological innovation capabilities in complex dynamic environments. This paper introduces the concept and interaction of multi-agent, the theoretical background of CAS, and summarizes the sources of technological innovation, the elements of each subject, and the main clusters of adaptive interactions and innovation activities. The concept of multi-agents is applied through the linkages of enterprises, research institutions, and government agencies with the leading enterprises in industrial settings. The study was exploratory and based on CAS theory. Theoretical model is built by considering technological and innovation literature from foundational to state of the art projects of technological enterprises. On this basis, the theoretical model is developed to measure the evolution mechanism of the enterprise's technological innovation capability system. This paper concludes that the main characteristics for evolution in technological systems are based on the enterprise’s research and development personnel, investments in technological processes, and innovation resources are responsible for the evolution of enterprise technological innovation performance. The research specifically enriched the application process of technological innovation in institutional networks related to enterprises.

Keywords: complex adaptive system, echo model, enterprise technological innovation capability system, research institutions, multi-agents

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2077 Robotic Assisted vs Traditional Laparoscopic Partial Nephrectomy Peri-Operative Outcomes: A Comparative Single Surgeon Study

Authors: Gerard Bray, Derek Mao, Arya Bahadori, Sachinka Ranasinghe

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The EAU currently recommends partial nephrectomy as the preferred management for localised cT1 renal tumours, irrespective of surgical approach. With the advent of robotic assisted partial nephrectomy, there is growing evidence that warm ischaemia time may be reduced compared to the traditional laparoscopic approach. There is still no clear differences between the two approaches with regards to other peri-operative and oncological outcomes. Current limitations in the field denote the lack of single surgeon series to compare the two approaches as other studies often include multiple operators of different experience levels. To the best of our knowledge, this study is the first single surgeon series comparing peri-operative outcomes of robotic assisted and laparoscopic PN. The current study aims to reduce intra-operator bias while maintaining an adequate sample size to assess the differences in outcomes between the two approaches. We retrospectively compared patient demographics, peri-operative outcomes, and renal function derangements of all partial nephrectomies undertaken by a single surgeon with experience in both laparoscopic and robotic surgery. Warm ischaemia time, length of stay, and acute renal function deterioration were all significantly reduced with robotic partial nephrectomy, compared to laparoscopic nephrectomy. This study highlights the benefits of robotic partial nephrectomy. Further prospective studies with larger sample sizes would be valuable additions to the current literature.

Keywords: partial nephrectomy, robotic assisted partial nephrectomy, warm ischaemia time, peri-operative outcomes

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2076 Studies on Efficacy of Some Acaricidal Molecules against Mites in Polyhouse Capsicum

Authors: P. N. Guru, C. S. Patil

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The experiment was conducted during Kharif 2016 at Hingoni, Ahmednagar (dist.), Maharashtra (India) to evaluate the novel molecules of acaricides against mites in polyhouse capsicum. The study was planned with randomized block design (RBD) and included nine treatments replicated thrice with 30 m² each plot size. The crop (var. Bachata) was raised according to the standard package of practices except plant protection measures. The molecules viz., spiromesifen 22.9SC (95 gm a.i. ha⁻¹), fenpyroximate 5EC (15 gm a.i. ha⁻¹), hexythiazox 5.45EC (15 gm a.i. ha⁻¹), diafenthiuron 50WP (300 gm a.i. ha⁻¹), chlorfenapyr 10SC (75 gm a.i. ha⁻¹) were compared with a standard acaricide, dicofol 18.5EC (500 gm a.i. ha⁻¹) and biopesticides like Verticillium lecanii (2 g/l), Metarhizium anisopliae (2 g/l) and Neem oil 10,000ppm (2ml/l). In total three sprays were given after 30, 50 and 70 days after transplanting (DAT) at an interval of 20 days. The insecticidal solutions were prepared in water by diluting required concentration of chemical and applied using knapsack sprayer with hollow cone nozzle @ 500L of solution per hectare. The mites were counted per 4 cm² in three leaves from randomly selected five plants in each plot at 1 day before treatment (precount) and 1, 3, 5, 7, 10 and 15 days after treatment. The results revealed that fenpyroximate 5EC found best by recording significantly least mite population (2.72/4 cm² leaf area) followed by hexythiazox 5.45EC and spiromesifen 22.9SC (3.78 and 3.82 per 4 cm² leaf area, respectively) and followed by remaining treatments chlorfenapyr 10SC (4.13/4 cm² leaf area), diafenthiuron 50WP (4.32/4 cm² leaf area), and dicofol 18.5EC (4.48/4 cm² leaf area). Among the biopesticides tested Neem oil and Verticillium lecanii were found to be superior to Metarhizium anisopliae. Overall, newer molecules like fenpyroximate, hexythiazox, spiromesifen, diafenthiuron, and Chlorfenapyr can be used for the effective management of mites under polyhouse capsicum.

Keywords: acaricides, capsicum, mites, spiromesifen

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2075 Randomized, Controlled Blind Study Comparing Sacroiliac Intra-Articular Steroid Injection to Radiofrequency Denervation for Management of Sacroiliac Joint Pain

Authors: Ossama Salman

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Background and objective: Sacroiliac joint pain is a common cause for chronic axial low back pain, with up to 20% prevalence rate. To date, no effective long-term treatment intervention has been embarked on yet. The aim of our study was to compare steroid block to radiofrequency ablation for SIJ pain conditions. Methods: A randomized, blind, study was conducted in 30 patients with sacroiliac joint pain. Fifteen patients received radiofrequency denervation of L4-5 primary dorsal rami and S1-3 lateral sacral branch, and 15 patients received steroid under fluoroscopy. Those in the steroid group who did not respond to steroid injections were offered to cross over to get radiofrequency ablation. Results: At 1-, 3- and 6-months post-intervention, 73%, 60% and 53% of patients, respectively, gained ≥ 50 % pain relief in the radiofrequency (RF) ablation group. In the steroid group, at one month post intervention follow up, only 20% gained ≥ 50 % pain relief, but failed to show any improvement at 3 months and 6 months follow up. Conclusions: Radiofrequency ablation at L4 and L5 primary dorsal rami and S1-3 lateral sacral branch may provide effective and longer pain relief compared to the classic intra-articular steroid injection, in properly selected patients with suspected sacroiliac joint pain. Larger studies are called for to confirm our results and lay out the optimal patient selection and treatment parameters for this poorly comprehended disorder.

Keywords: lateral branch denervation, LBD, radio frequency, RF, sacroiliac joint, SIJ, visual analogue scale, VAS

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2074 Improving the Health of Communities: Students as Leaders in a Community Clinical Health Promotion and Disease Prevention Immersion

Authors: Samawi Zepure, Beck Christine, Gallagher Peg

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This community immersion employs the NLN Excellence Model which challenges nursing programs to create student-centered, interactive, and innovative experiences to prepare students for roles in providing high quality care, effective teaching, and leadership in the delivery of nursing services to individuals, families, and communities (NLN, 2006). Senior nursing students collaborate with ethnically and linguistically diverse participants at community-based sites and develop leadership roles of coordination of care linkage within the larger healthcare system, adherence, and self-care management. The immersion encourages students to develop competencies of the NLN Nursing Education Competencies Model (NLN, 2012), proposed to address fast changes in health care delivery, which include values of caring, diversity, and holism; and integrating concepts of context and environment, relationship, and teamwork. Students engage in critical thinking and leadership as they: 1) assess health/illness beliefs, values, attitudes, and practices, explore community resources, interview key informants, and collaborate with community participants to identify learning goals, 2) develop and implement appropriate holistic health promotion and disease prevention teaching interventions promoting continuity, sustainability, and innovation, 3) evaluate interventions through participant feedback and focus groups and, 4) reflect on the immersion experience and future professional role as advocate and citizen.

Keywords: quality of care, health of communities, students as leaders, health promotion

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2073 Integrating Music on Construction Sites: Key Benefits and Cautions: A Literature Perspective

Authors: Oluwatayomi Daniel Fadumo, Chinyere Celestina Esimone

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The construction industry, as a massive human capital-related sector, requires an always motivated workforce. The inability to maintain this state has been found to hamper productivity which ultimately leads to poor project delivery, infrastructural development decline, and low morale among citizens. The need to develop an approach to keep this set of people inspired before, during, and after work becomes a necessity; this paper aims to evaluate the key benefits and cautions in integrating music on construction sites in Nigeria to improve effective project delivery. In attaining this, the study identified the advantages of music on construction sites, evaluated the key considerations in introducing music on construction sites, and recommended measures for the effective integration of music on construction sites in Nigeria. The study is a descriptive research through the use of secondary data gleaned from relevant literature, journals, and research sites. The study concluded that different forms of music genres can be implemented ranging from Pop music, rock, metal, and classical music. Introducing music has the advantage of industrial branding, improving workers` morale, setting the pace for working, helping in information retention, and improving mental health and happiness. The key consideration, however, is to provide the right volume and music that doesn’t pose health and safety challenges. The study finally recommended that for effective integration of music on construction sites in Nigeria, policies should be drafted regulating its use, specific radio customized for the site be introduced and that research-based music, proven to have previously helped, should be given to a group of workers.

Keywords: music, construction sites, workers, construction industry, construction management practice

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2072 An Investigation of the Relationship between Organizational Culture and Innovation Type: A Mixed Method Study Using the OCAI in a Telecommunication Company in Saudi Arabia

Authors: A. Almubrad, R. Clouse, A. Aljlaoud

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Organizational culture (OC) is recognized to have an influence on the propensity of organizations to innovate. It is also presumed that it may impede the innovation process from thriving within the organization. Investigating the role organizational culture plays in enabling or inhibiting innovation merits exploration to investigate organizational cultural attributes necessary to reach innovation goals. This study aims to investigate a preliminary matching heuristic of OC attributes to the type of innovation that has the potential to thrive within those attributes. A mixed methods research approach was adopted to achieve the research aims. Accordingly, participants from a national telecom company in Saudi Arabia took the Organizational Culture Assessment Instrument (OCAI). A further sample selected from the respondents’ pool holding the role of managing directors was interviewed in the qualitative phase. Our study findings reveal that the market culture type has a tendency to adopt radical innovations to disrupt the market and to preserve its market position. In contrast, we find that the adhocracy culture type tends to adopt the incremental innovation type and found this tends to be more convenient for employees due to its low levels of uncertainty. Our results are an encouraging indication that matching organizational culture attributes to the type of innovation aids in innovation management. This study carries limitations while drawing its findings from a limited sample of OC attributes that identify with the adhocracy and market culture types. An extended investigation is merited to explore other types of organizational cultures and their optimal innovation types.

Keywords: incremental innovation, radical innovation, organization culture, market culture, adhocracy culture, OACI

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2071 Legal Pluralism and Land Administration in West Sumatra: The Implementation of the Regulations of Both Local and Nagari Governments on Communal Land Tenure

Authors: Hilaire Tegnan

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Land administration has always been a delicate issue in the history of nations, and Indonesia, a country where a significant number of the population lives a pastoral life is not exempt from this reality. This paper discusses land tenure issues in West Sumatra, an Indonesian province which is home to the Minangkabau people with their long existing village management system known as Nagari, established to settle disputes based on adat (custom) principles as well as to protect the rights of the community members. These rights include communal land (referred to as tanahulayat hereafter). Long before the Dutch occupation of Indonesian archipelago, the nagari government was vested with powers to regulate communal land in West Sumatra. However, this authority was constantly overlooked by the then Dutch colonial administration as well as the post-independence governments (both central and regional). To reinforce the Nagari government as the guardian of the customary law (hukumadat) and to specify its jurisdiction, the Regional Government of West Sumatra enacted two laws between 2000 and 2008: Law No. 9/2000 repealed by Law No. 2/2007 and Law No. 6/2008 on communal land tenure. Although these two laws provide legal grounds to address land issues across the region, land conflicts still prevail among West Sumatran populations due to unsynchronized and contradictory regulations. The protests against the army (Korem) in Nagari Kapalo Hilalang, against the oil palm company in Nagari Kinali, and against a cement factory in Nagari Lubuk Kilangan are cited in this paper as case references.

Keywords: local government, Nagari government, Tanah Ulayat, legal pluralism, land administration

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2070 Blockchain Technology Applications in Patient Tracking Systems Regarding Privacy-Preserving Concerns and COVID-19 Pandemic

Authors: Farbod Behnaminia, Saeed Samet

Abstract:

The COVID-19 pandemic has paralyzed many lives until a vaccine was available, which caused the so-called “new normal.” According to the World Health Organization (WHO), COVID-19 is an infectious disease. It can cause significant illness or death in anyone. Governments and health officials tried to impose rules and regulations to avoid and slow down transmission. Therefore, software engineers worldwide developed applications to trace and track patients’ movements and notify others, mainly using Bluetooth. In this way, everyone could be informed whether they come in close contact with someone who has COVID-19 and takes proper safety precautions. Because most of the applications use technologies that can potentially reveal the user’s identity and location, researchers have debated privacy preservation and how to improve user privacy during such pandemics. Thanks to Distributed Ledger Technology (DLT), there have been some proposed methods to develop privacy-preserving Patient Tracking Systems in the last two years. As an instance of the DLT, Blockchain is like a decentralized peer-to-peer database that maintains a record of transactions. Transactions are immutable, transparent, and anonymous in this system. We conducted a comprehensive evaluation of the literature by looking for papers in the relevant field and dividing them into pre- and post-pandemic systems. Additionally, we discussed the many uses of blockchain technology in pandemic control. We found that two major obstacles facing blockchain implementation across many healthcare systems are scalability and privacy. The Polkadot platform is presented, along with a review of its efficacy in tackling current concerns. A more scalable healthcare system is achievable in the near future using Polkadot as well as a much more privacy-preserving environment.

Keywords: blockchain, electronic record management, EHR, privacy-preserving, patient tracking, COVID-19, trust and confidence, Polkadot

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2069 Consultation Liasion Psychiatry in a Tertiary Care Hospital

Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

Abstract:

Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

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2068 Current Zonal Isolation Regulation and Standards: A Compare and Contrast Review in Plug and Abandonment

Authors: Z. A. Al Marhoon, H. S. Al Ramis, C. Teodoriu

Abstract:

Well-integrity is one of the major elements considered for drilling geothermal, oil, and gas wells. Well-integrity is minimizing the risk of unplanned fluid flow in the well bore throughout the well lifetime. Well integrity is maximized by applying technical concepts along with practical practices and strategic planning. These practices are usually governed by standardization and regulation entities. Practices during well construction can affect the integrity of the seal at the time of abandonment. On the other hand, achieving a perfect barrier system is impracticable due to the needed cost. This results in a needed balance between regulations requirements and practical applications. The guidelines are only effective when they are attainable in practical applications. Various governmental regulations and international standards have different guidelines on what constitutes high-quality isolation from unwanted flow. Each regulating or standardization body differ in requirements based on the abandonment objective. Some regulation account more for the environmental impact, water table contamination, and possible leaks. Other regulation might lean towards driving more economical benefits while achieving an acceptable isolation criteria. The research methodology used in this topic is derived from a literature review method combined with a compare and contrast analysis. The literature review on various zonal isolation regulations and standards has been conducted. A review includes guidelines from NORSOK (Norwegian governing entity), BSEE (USA offshore governing entity), API (American Petroleum Institute) combined with ISO (International Standardization Organization). The compare and contrast analysis is conducted by assessing the objective of each abandonment regulations and standardization. The current state of well barrier regulation is in balancing action. From one side of this balance, the environmental impact and complete zonal isolation is considered. The other side of the scale is practical application and associated cost. Some standards provide a fair amount of details concerning technical requirements and are often flexible with the needed associated cost. These guidelines cover environmental impact with laws that prevent major or disastrous environmental effects of improper sealing of wells. Usually these regulations are concerned with the near future of sealing rather than long-term. Consequently, applying these guidelines become more feasible from a cost point of view to the required plugging entities. On the other hand, other regulation have well integrity procedures and regulations that lean toward more restrictions environmentally with an increased associated cost requirements. The environmental impact is detailed and covered with its entirety, including medium to small environmental impact in barrier installing operations. Clear and precise attention to long-term leakage prevention is present in these regulations. The result of the compare and contrast analysis of the literature showed that there are various objectives that might tip the scale from one side of the balance (cost) to the other (sealing quality) especially in reference to zonal isolation. Furthermore, investing in initial well construction is a crucial part of ensuring safe final well abandonment. The safety and the cost saving at the end of the well life cycle is dependent upon a well-constructed isolation systems at the beginning of the life cycle. Long term studies on zonal isolation using various hydraulic or mechanical materials need to take place to further assess permanently abandoned wells to achieve the desired balance. Well drilling and isolation techniques will be more effective when they are operationally feasible and have reasonable associated cost to aid the local economy.

Keywords: plug and abandon, P&A regulation, P&A standards, international guidelines, gap analysis

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2067 Isolation and Characterization of Bacteriophages Against Aeromonas Spp. Mediated Diseases in Indian Aquaculture

Authors: Mrunalini Sonne

Abstract:

Aquaculture uses a variety of broad spectrum antibiotics to manage and prevent a variety of diseases without understanding their mechanisms of action. This has led to water pollution in the modern world. The necessity for alternate control measures against bacterial illnesses in the aquaculture sector is highlighted by issues brought on by antibiotic-resistant bacteria and the dearth of effective control strategies. Bacteriophages (phages) have shown promise as therapeutic agents for the efficient management of bacterial infections in aquaculture. In the current study, a variety of investigations were conducted to determine if utilizing lytic phages to reduce Aeromonas spp. infection in fish aquaculture was appropriate. Motile Aeromonas septicaemia is a fish disease that has caused financial harm to the aquaculture sector. Currently, the production of aquaculture depends significantly on antibiotics, which adds to the worldwide problem of the rise of bacteria that are resistant to medicines and resistance genes. To decrease the usage of antibiotics in aquaculture systems, it is crucial to create efficient antibiotic substitutes. Bacteriophages are capable of acting as a natural antagonist, mostly because of their great specificity, capacity for self-replication, and ability to quickly eradicate dangerous bacteria. There is a need for research that goes beyond just isolating and characterising lytic bacteriophages to examine their morphology, stability, and efficacy in various environmental conditions. Bacteriophage (or phage) therapy is a promising technique to control dangerous microbes in farmed fish. More phage therapy research in aquaculture is required in order to effectively employ phage treatment to lessen infection in fish brought on by Aeromonas.

Keywords: aquaculture, bacteriophages, fish, freshwater

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2066 Effectiveness of Enhancing Positive Emotion Program of Patients with Lung Cancer

Authors: Pei-Fan Mu

Abstract:

Background: Lung cancer is the most common cancer with the highest mortality rate. Patients with lung cancer under chemotherapy treatment experience life-threatening uncertainty. This study was based on the broaden-and-build theory using intentionality reflection of the body and internalization of positive prioritization strategies to enhance positive emotions of patients with lung cancer. Purpose: The purpose of this study was to use a quasi-experimental research design to examine the effectiveness of the enhancing positive emotion program. Method: Data were collected from a medical center in Taiwan. Fifty-four participants with lung cancer were recruited. Thirty participants were in the experiential group receiving the two weeks program. The content of the program includes awareness and understanding of the symptom experience, co-existing with illness and establishing self-identity, cognitive-emotion adjustment and establishing a new body schema, and symptom management to reach spiritual well-being. Twenty-four participants were in the control group receiving regular nursing care. Baseline, one month later and two months later, programmed measurements of symptoms of distress, positive emotion, and psychological well-being. Results: These two weeks of enhancing the positive emotion program resulted in a significantly improved positive emotion score for the experimental group compared to the control group. The findings of this study indicated that the positive emotion had significant differences between the two groups. There were no differences in symptom distress between the two groups. Discussion: The findings indicated that the enhancing positive emotion program could help patients enhance their life-threatening facing conditions.

Keywords: positive emotion, lung cancer, experimental design, symptom distress

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2065 Sports Business Services Model: A Research Model Study in Reginal Sport Authority of Thailand

Authors: Siriraks Khawchaimaha, Sangwian Boonto

Abstract:

Sport Authority of Thailand (SAT) is the state enterprise, promotes and supports all sports kind both professional and athletes for competitions, and administer under government policy and government officers and therefore, all financial supports whether cash inflows and cash outflows are strictly committed to government budget and limited to the planned projects at least 12 to 16 months ahead of reality, as results of ineffective in sport events, administration and competitions. In order to retain in the sports challenges around the world, SAT need to has its own sports business services model by each stadium, region and athletes’ competencies. Based on the HMK model of Khawchaimaha, S. (2007), this research study is formalized into each 10 regional stadiums to details into the characteristics root of fans, athletes, coaches, equipments and facilities, and stadiums. The research designed is firstly the evaluation of external factors: hardware whereby competition or practice of stadiums, playground, facilities, and equipments. Secondly, to understand the software of the organization structure, staffs and management, administrative model, rules and practices. In addition, budget allocation and budget administration with operating plan and expenditure plan. As results for the third step, issues and limitations which require action plan for further development and support, or to cease that unskilled sports kind. The final step, based on the HMK model and modeling canvas by Alexander O and Yves P (2010) are those of template generating Sports Business Services Model for each 10 SAT’s regional stadiums.

Keywords: HMK model, not for profit organization, sport business model, sport services model

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2064 Contribution of Different Farming Systems to Soil and Ecological Health in Trans Nzoia County, Kenya

Authors: Janeth Chepkemoi, Richard Onwonga, Noel Templer, Elkana Kipkoech, Angela Gitau

Abstract:

Conventional agriculture is one of the leading causes of land degradation, threatening the sustainability of food production. Organic farming promotes practices that have the potential of feeding the world while also promoting ecological health. A study was therefore carried out with the aim of conceptualizing how such farming systems are contributing to ecological health in Trans Nzoia County. 71 farmers were interviewed and data was collected on parameters such as land preparation, agroforestry, soil fertility management, soil and water conservation, and pests and diseases. A soil sample was also collected from each farm for laboratory analysis. Data collected were analyzed using Microsoft Excel and SPSS version 21. Results showed that 66% of the respondents practiced organic farming whereas 34% practiced conventional farming. Intercropping and crop rotations were the most common cropping systems and the most preferred land preparation tools among both organic and conventional farmers were tractors and hand hoes. Organic farms fared better in agroforestry, organic soil amendments, land and water conservation, and soil chemical properties. Pests and disease, however, affected organic farms more than conventional. The average nitrogen (%), K (Cmol/ kg and P (ppm) of organic soils were 0.26, 0.7 and 26.18 respectively, conventional soils were 0.21, 0.66 and 22.85. Soil organic carbon content of organic farms averaged a higher percentage of 2.07% as compared to 1.91 for the conventional. In conclusion, most farmers in Trans Nzoia County had transitioned into ecologically friendly farming practices that improved the quality and health of the soil and therefore promoted its sustainability.

Keywords: organic farming, conventional farming, ecological health, soil health

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2063 Integration of GIS with Remote Sensing and GPS for Disaster Mitigation

Authors: Sikander Nawaz Khan

Abstract:

Natural disasters like flood, earthquake, cyclone, volcanic eruption and others are causing immense losses to the property and lives every year. Current status and actual loss information of natural hazards can be determined and also prediction for next probable disasters can be made using different remote sensing and mapping technologies. Global Positioning System (GPS) calculates the exact position of damage. It can also communicate with wireless sensor nodes embedded in potentially dangerous places. GPS provide precise and accurate locations and other related information like speed, track, direction and distance of target object to emergency responders. Remote Sensing facilitates to map damages without having physical contact with target area. Now with the addition of more remote sensing satellites and other advancements, early warning system is used very efficiently. Remote sensing is being used both at local and global scale. High Resolution Satellite Imagery (HRSI), airborne remote sensing and space-borne remote sensing is playing vital role in disaster management. Early on Geographic Information System (GIS) was used to collect, arrange, and map the spatial information but now it has capability to analyze spatial data. This analytical ability of GIS is the main cause of its adaption by different emergency services providers like police and ambulance service. Full potential of these so called 3S technologies cannot be used in alone. Integration of GPS and other remote sensing techniques with GIS has pointed new horizons in modeling of earth science activities. Many remote sensing cases including Asian Ocean Tsunami in 2004, Mount Mangart landslides and Pakistan-India earthquake in 2005 are described in this paper.

Keywords: disaster mitigation, GIS, GPS, remote sensing

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2062 Remittances and Water Access: A Cross-Sectional Study of Sub Saharan Africa Countries

Authors: Narges Ebadi, Davod Ahmadi, Hiliary Monteith, Hugo Melgar-Quinonez

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Migration cannot necessarily relieve pressure on water resources in origin communities, and male out-migration can increase the water management burden of women. However, inflows of financial remittances seem to offer possibilities of investing in improving drinking-water access. Therefore, remittances may be an important pathway for migrants to support water security. This paper explores the association between water access and the receipt of remittances in households in sub-Saharan Africa. Data from round 6 of the 'Afrobarometer' surveys in 2016 were used (n= 49,137). Descriptive, bivariate and multivariate statistical analyses were carried out in this study. Regardless of country, findings from descriptive analyses showed that approximately 80% of the respondents never received remittance, and 52% had enough clean water. Only one-fifth of the respondents had piped water supply inside the house (19.9%), and approximately 25% had access to a toilet inside the house. Bivariate analyses revealed that even though receiving remittances was significantly associated with water supply, the strength of association was very weak. However, other factors such as the area of residence (rural vs. urban), cash income frequencies, electricity access, and asset ownership were strongly associated with water access. Results from unadjusted multinomial logistic regression revealed that the probability of having no access to piped water increased among remittance recipients who received financial support at least once a month (OR=1.324) (p < 0.001). In contrast, those not receiving remittances were more likely to regularly have a water access concern (OR=1.294) (p < 0.001), and not have access to a latrine (OR=1.665) (p < 0.001). In conclusion, receiving remittances is significantly related to water access as the strength of odds ratios for socio-demographic factors was stronger.

Keywords: remittances, water access, SSA, migration

Procedia PDF Downloads 179
2061 Integrated Design in Additive Manufacturing Based on Design for Manufacturing

Authors: E. Asadollahi-Yazdi, J. Gardan, P. Lafon

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Nowadays, manufactures are encountered with production of different version of products due to quality, cost and time constraints. On the other hand, Additive Manufacturing (AM) as a production method based on CAD model disrupts the design and manufacturing cycle with new parameters. To consider these issues, the researchers utilized Design For Manufacturing (DFM) approach for AM but until now there is no integrated approach for design and manufacturing of product through the AM. So, this paper aims to provide a general methodology for managing the different production issues, as well as, support the interoperability with AM process and different Product Life Cycle Management tools. The problem is that the models of System Engineering which is used for managing complex systems cannot support the product evolution and its impact on the product life cycle. Therefore, it seems necessary to provide a general methodology for managing the product’s diversities which is created by using AM. This methodology must consider manufacture and assembly during product design as early as possible in the design stage. The latest approach of DFM, as a methodology to analyze the system comprehensively, integrates manufacturing constraints in the numerical model in upstream. So, DFM for AM is used to import the characteristics of AM into the design and manufacturing process of a hybrid product to manage the criteria coming from AM. Also, the research presents an integrated design method in order to take into account the knowledge of layers manufacturing technologies. For this purpose, the interface model based on the skin and skeleton concepts is provided, the usage and manufacturing skins are used to show the functional surface of the product. Also, the material flow and link between the skins are demonstrated by usage and manufacturing skeletons. Therefore, this integrated approach is a helpful methodology for designer and manufacturer in different decisions like material and process selection as well as, evaluation of product manufacturability.

Keywords: additive manufacturing, 3D printing, design for manufacturing, integrated design, interoperability

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2060 Early versus Late Percutaneous Tracheostomy in Critically Ill Adult Mechanically Ventilated Patients

Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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