Search results for: human resources management (HRM)

Authors: Ayalkibet Mekonnen, Adane Abebe

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In hydrological cycle there are many water-related human interventions that modify the natural systems. Rainwater harvesting is one such intervention that involves harnessing of water in the upstream. Water harvesting used in upstream prevents water runoff on downstream mainly disturbance on biodiversity and ecosystems. The main objectives of the study are to assess the effects of water harvesting technologies on downstream water availability in the Woreda. To address the above problem, SWAT model, cost-benefit ratio and optimal control approach was used to analyse the hydrological and socioeconomic impact and tradeoffs on water availability of the community, respectively. The downstream impacts of increasing water consumption in the upstream rain-fed areas of the Bilate and Shala Catchment are simulated using the semi-distributed SWAT model. The two land use scenarios tested at sub basin levels (1) conventional land use represents the current land use practice (Agri-CON) and (2) in-field rainwater harvesting (IRWH), improving soil water availability through rainwater harvesting land use scenario. The simulated water balance results showed that the highest peak mean monthly direct flow obtained from Agri-CON land use (127.1 m3/ha), followed by Agri-IRWH land use (11.5 mm) and LULC 2005 (90.1 m3/ha). The Agri-IRWH scenario reduced direct flow by 10% compared to Agri-CON and more groundwater flow contributed by Agri-IRWH (190 m3/ha) than Agri-CON (125 m3/ha). The overall result suggests that the water yield of the Woreda may not be negatively affected by the Agri-IRWH land use scenario. The technology in the Woreda benefited positively having an average benefit cost ratio of 4.2. Water harvesting for domestic use was not optimal that the value of the water per demand harvested was less than the amount of water needed. Storage tanks, series of check dams, gravel filled dams are an alternative solutions for water harvesting.

Keywords: water harvesting, SWAT model, land use scenario, Agri-CON, Agri-IRWH, trade off, benefit cost ratio

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Authors: Y. Zhang, J. Perez, S. Marnier

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To date, no study on goaltending butterfly motion has been completed in real conditions, during an ice hockey game or training practice, to the author's best knowledge. This motion, performed to save score, is unnatural, intense, and repeated. The target of this research activity is to identify representative biomechanical criteria for this goaltender-specific movement pattern. Determining specific physical parameters may allow to will identify the risk of hip and groin injuries sustained by goaltenders. Four professional or academic goalies were instrumented during ice hockey training practices with five inertial measurement units. These devices were inserted in dedicated pockets located on each thigh and shank, and the fifth on the lumbar spine. A camera was also installed close to the ice to observe and record the goaltenders' activities, especially the butterfly motions, in order to synchronize the captured data and the behavior of the goaltender. Each data recorded began with a calibration of the inertial units and a calibration of the fully equipped goaltender on the ice. Three butterfly motions were recorded out of the training practice to define referential individual butterfly motions. Then, a data processing algorithm based on the Madgwick filter computed hip and knee joints joint range of motion as well as angular specific angular velocities. The developed algorithm software automatically identified and analyzed all the butterfly motions executed by the four different goaltenders. To date, it is still too early to show that the analyzed criteria are representative of the trauma generated by the butterfly motion as the research is only at its beginning. However, this descriptive research activity is promising in its ecological assessment, and once the criteria are found, the tools and protocols defined will allow the prevention of as many injuries as possible. It will thus be possible to build a specific training program for each goalie.

Keywords: biomechanics, butterfly motion, human motion analysis, ice hockey, inertial measurement unit

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Authors: Shirin jalili, Hadi Shirzad, Mahasti Modarresi, Samaneh Nabavi, Somayeh Khanjani

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Identifying the source tissue of biological material found at crime scenes can be very informative in a number of cases. Despite their usefulness, current visual, catalytic, enzymatic, and immunologic tests for presumptive and confirmatory tissue identification are applicable only to a subset of samples, might suffer limitations such as low specificity, lack of sensitivity, and are substantially impacted by environmental insults. In addition their results are operator-dependent. Recently the possibility of discriminating body fluids using mRNA expression differences in tissues has been described but lack of long term stability of that Molecule and the need to normalize samples for each individual are limiting factors. The use of DNA should solve these issues because of its long term stability and specificity to each body fluid. Cells in the human body have a unique epigenome, which includes differences in DNA methylation in the promoter of genes. DNA methylation, which occurs at the 5′-position of the cytosine in CpG dinucleotides, has great potential for forensic identification of body fluids, because tissue-specific patterns of DNA methylation have been demonstrated, and DNA is less prone to degradation than proteins or RNA. Previous studies have reported several body fluid-specific DNA methylation markers.The presence or absence of a methyl group on the 5’ carbon of the cytosine pyridine ring in CpG dinucleotide regions called ‘CpG islands’ dictates whether the gene is expressed or silenced in the particular body fluid. Were described methylation patterns at tissue specific differentially methylated regions (tDMRs) to be stable and specific, making them excellent markers for tissue identification. The results demonstrate that methylation-based tissue identification is more than a proof-of-concept. The methodology holds promise as another viable forensic DNA analysis tool for characterization of biological materials.

Keywords: DNA methylation, forensic science, epigenome, tDMRs

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Authors: Chloé Kernaléguen, Laura Kundun, Tessie Lery, Ryan Laleg, Zhangyun Tan

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This study explores global disparities in respiratory syncytial virus (RSV) bronchiolitis incidence among children aged 0-2 years, focusing on the human development index (HDI) as a key determinant. RSV bronchiolitis poses a significant health risk to young children, influenced by factors, including socio-economic conditions captured by the HDI. Through a comprehensive systematic review and dataset selection (Switzerland, Brazil, United States of America), we formulated an HDI-SEIRS numerical model within the SEIRS framework. Results show variations in RSV bronchiolitis dynamics across countries, emphasizing the influence of HDI. Modelling reveals a correlation between higher HDI and increased bronchiolitis spread, notably in the USA and Switzerland. The ratios HDIcountry over HDImax strengthen this association, while climate disparities contribute to variations, especially in colder climates like the USA and Switzerland. The study raises the hypothesis of an indirect link between higher HDI and more frequent bronchiolitis, underlining the need for nuanced understanding. Factors like improved healthcare access, population density, mobility, and social behaviors in higher HDI countries might contribute to unexpected trends. Limitations include dataset quality and restricted RSV bronchiolitis data. Future research should encompass diverse HDI datasets to refine HDI's role in bronchiolitis dynamics. In conclusion, HDI-SEIRS models offer insights into factors influencing RSV bronchiolitis spread. While HDI is a significant indicator, its impact is indirect, necessitating a holistic approach to effective public health policies. This analysis sets the stage for further investigations into multifaceted interactions shaping bronchiolitis dynamics in diverse socio-economic contexts.

Keywords: bronchiolitis propagation, HDI influence, respiratory syncytial virus, SEIRS model

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Authors: Ahmed Chetouani

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Corrosion is a natural occurring process where it can be defined as the deterioration of materials properties due to its interaction with its environment. Corrosion can lead to failures in plant infrastructure and machines which are usually costly to repair. In terms of loss of contaminated products which will cause environmental damage and possibly costly in terms of human health. The driving force that causes metals to corrode is due to the natural consequence of their temporary existence in metallic form. There is a growing trend in utilizing plant extracts and pharmaceutical compounds as corrosion inhibitors. Exquisite identification of the essential oil of aerial parts of Pelargonium was obtained using hydrodistillation and identification using GC (gas chromatography) and GC/MS (gas chromatography-mass spectrometry). The oil was predominated by Citronellol (22.8%). The inhibitory effect of essential oil and extract of Pelargonium was estimated on the corrosion of mild steel in 1M hydrochloric acid (HCl) using weight loss, Electrochemical Impedance Spectroscopy (EIS) and Tafel polarization curves. Inhibition was found to increase with increasing concentration of the essential oil and extract of Pelargonium. The effect of temperature on the corrosion behaviour of mild steel in 1M HCl with addition of essential oil and extract was also studied and the thermodynamic parameters were determined and discussed. Values of inhibition efficiency were calculated from weight loss, Tafel polarization curves, and EIS. All results are in good agreement. Polarization curves showed that essential oil and extract of Pelargonium behave as mixed type inhibitors in hydrochloric acid. The results obtained showed that the essential oil and extract of Pelargonium could serve as an effective inhibitor of the corrosion of mild steel in Hydrochloric acid solution. To avoid any surprise of toxicity, the majority compounds have been studied by using POM analyses.

Keywords: corrosion inhibition, mild steel, pelargonium oil, extract, electrochemical system, hydrodistillation, side effects, POM Analyses

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Authors: Mark Andrew

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Geopolitical tensions are at a thirty-year high, and the pace of technological innovation is driving asymmetry in force capabilities between nation states and between non-state actors. Technology futures are a vital component of defence capability growth, and investments in technology futures need to be informed by accurate and reliable forecasts of the options for ‘systems of systems’ innovation, development, and deployment. This paper describes a method for forecasting technology futures developed through an analysis of four key systems’ development stages, namely: technology domain categorisation, scanning results examining novel systems’ signals and signs, potential system-of systems’ implications in warfare theatres, and political ramifications in terms of funding and development priorities. The method has been applied to several technology domains, including physical systems (e.g., nano weapons, loitering munitions, inflight charging, and hypersonic missiles), biological systems (e.g., molecular virus weaponry, genetic engineering, brain-computer interfaces, and trans-human augmentation), and information systems (e.g., sensor technologies supporting situation awareness, cyber-driven social attacks, and goal-specification challenges to proliferation and alliance testing). Although the current application of the method has been team-centred using paper-based rapid prototyping and iteration, the application of autonomous language models (such as GPT-3) is anticipated as a next-stage operating platform. The importance of forecasting accuracy and reliability is considered a vital element in guiding technology development to afford stronger contingencies as ideological changes are forecast to expand threats to ecology and earth systems, possibly eclipsing the traditional vulnerabilities of nation states. The early results from the method will be subjected to ground truthing using longitudinal investigation.

Keywords: forecasting, technology futures, uncertainty, complexity

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Authors: Mahsa Pishdar

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Food traceability through the supply chain is facing increased demand. IoT and blockchain are among the tools under consideration in the Industry 4.0 era that could be integrated to help implementation of the Circular Economy (CE) principles while enhancing food traceability solutions. However, such tools need intellectual system, and infrastructureto be settled as guidance through the way, helping overcoming obstacles. That is why the critical success factors for implementing Industry 4.0 and circular economy principles in food traceability concept are analyzed in this paper by combination of interval type 2 fuzzy Worst Best Method and Measurement Alternatives and Ranking according to Compromise Solution (Interval Type 2 fuzzy WBM-MARCOS). Results indicate that “Knowledge of Industry 4.0 obligations and CE principle” is the most important factor that is the basis of success following by “Management commitment and support”. This will assist decision makers to seize success in gaining a competitive advantage while reducing costs through the supply chain.

Keywords: food traceability, industry 4.0, internet of things, block chain, best worst method, marcos

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Authors: Laura Cochrane

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The United States Centers for Disease Control and Prevention has established three categories of biological agents based on their ease of spread and the severity of the disease they cause. Category A biological agents are the highest priority because of their high degree of morbidity and mortality, ease of dissemination, the potential to cause social disruption and panic, special requirements for public health preparedness, and past use as a biological weapon. Despite the threat of Category A biological agents, opportunities for medical intervention exist. This work summarizes public information, consolidated and reviewed across the situational usefulness and disease awareness to offer discussion to three specific Category A agents: anthrax (Bacillus anthracis), botulism (Clostridium botulinum toxin), and smallpox (variola major), and provides an overview on the management of medical countermeasures available to treat these three (3) different types of pathogens. The medical countermeasures are discussed in the setting of pre-exposure prophylaxis, post-exposure prophylaxis, and therapeutic treatments to provide a framework for requirements in public health preparedness.

Keywords: anthrax, botulism, smallpox, medical countermeasures

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Authors: Younus Mohammad, Anita B. Fallah, Ben J. Boyd, Shakila B. Rizwan

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N-acylethanolamines (NAEs) are endogenous lipids, which have neuromodulatory properties. NAEs have shown neuroprotective properties in various neurodegenerative diseases including Alzheimer's disease, Parkinson's disease and ischemic stroke. However, NAEs are eliminated rapidly in vivo by enzymatic hydrolysis. We propose to encapsulate NAEs in liquid crystalline nanoparticles (cubosomes) to increase their biological half-life and explore their therapeutic potential. Recently, we have reported the co-formulation and nanostructural characterization of cubosomes containing the NAE, oleoylethanolamide and a synthetic cubosome forming lipid phytantriol. Here, we report on the formulation of cubosomes with the NAE, linoleoylethanolamide (LEA) as the core cubosome forming lipid. LEA-cubosomes were formulated in the presence of three different steric stabilisers: two brain targeting ligands, Tween 80 and Pluronic P188 and a control, Pluronic F127. Size, morphology and internal structure of formulations were characterized by dynamic light scattering (DLS), cryogenic transmission electron microscopy (Cryo–TEM) and small angle X–ray scattering (SAXS), respectively. Chemical stability of LEA in formulations was investigated using high-performance liquid chromatography (HPLC). Cytotoxicity of formulations towards human cerebral microvascular endothelial cell line (hCMEC/D3) was also investigated using an MTT (3-[4, 5- dimethylthiazol-2-yl]-2, 5-diphenyl tetrazolium bromide) assay. All cubosome formulations had mean particle size of less than 250 nm and were uniformly distributed with polydispersity indices less than 0.2. Cubosomes produced had a bicontinuous cubic internal structure with an Im3m space group but different lattice parameters, indicating the different modes of interaction between the stabilisers and LEA. LEA in formulations was found to be chemically stable. At concentrations of up to 20 µg/mL LEA in the presence of all the stabilisers, greater than 80% cell viability was observed.

Keywords: blood-brain barrier, cubosomes, linoleoyl ethanolamide, N-acylethanolamines (NAEs)

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Authors: David Parmenter, Brian Millar

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Obstructive sleep apnoea is a common condition which is generally under-diagnosed. Poorly managed obstructive sleep apnoea carries serious health risks and can greatly impact on the sufferer's quality of life. This publication covers the aetiology, symptoms, and treatment of sleep apnoea. The treatment of Obstructive Sleep Apnoea is an emerging field, and the useful role of the Dental Team is relatively unknown, therefor this paper will highlight the role of the dental team in its treatment. The concept of mandibular advancement appliances, along with the clinical and laboratory stages for constructing them, are documented. It is the hope of the author that this publication will educate healthcare professionals on the role of dental practitioners in the multidisciplinary team for treating sleep apnoea. Objective: Individuals should be more aware of the demographic of patients at risk of sleep apnoea, how it is diagnosed and which group of sleep apnoea patients are suitable to refer for mandibular appliance therapy. Individuals should also be aware of what a mandibular advancement appliance is and how it helps treat obstructive sleep apnoea.

Keywords: sleep apnoea, snoring, sleep appliances, mandibular advancement appliance

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Authors: Mudassar Mohiuddin, Zahid Iqbal

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Introduction: Clostridium perfringens is an important pathogen responsible for causing enteric diseases in both human and animals. The bacteria produce several toxins. These toxins play vital role in the pathogenesis of various fatal enteric diseases and are classified into five types, on the basis of the differential production of Alpha, Beta, Epsilon and Iota toxins. In addition to the so-called major toxins, there are other toxins like beta2 toxin, produced by some strains of C. perfringens which may play a role in the pathogenesis of disease. Aim of the study: In this study a multiplex PCR assay was developed and used for detection of cpb2 gene to identify the Beta2 harboring isolates among different types of C. perfringens. Objectives: The primary objective of this study was to identify the prevalence of β2-toxin gene in local isolates of Clostridium perfringens. Methodology: This was an experimental study. Random sampling technique was used. A total of 97 sheep and goats were included in this study. All were Pakistani local breeds. The samples were collected during the period from Sep, 2014 to Mar, 2015 from selected districts of Punjab province (Pakistan). Faecal samples were cultured in cooked meat media. The identification of Clostridium perfringens was made on the basis of biochemical tests. Multiplex PCR was performed to identify the toxin genes. Results: A total of 43 C. perfringens isolates were genotyped using multiplex PCR assay. The gene encoding C. perfringens β2-toxin (cpb2) was present in more than 50% of the isolates genotyped. However, the prevalence of this gene varied between sheep and goat isolates. Conclusion: The present study suggests the high occurrence of C. perfringens b2-toxin (cpb2) in the local isolates of Pakistan. As β2-toxin is present in both healthy and diseased animals, so further studies are suggested to establish the role of β2-toxin in pathogenesis of the clostridial enteric diseases.

Keywords: beta 2 toxin gene, clostridium perfringens, enteric diseases, goats, multiplex PCR, sheep

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Authors: José Carlos Bronze, Carlinda Leite, Angélica Monteiro

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The creation of the Erasmus Program in 1987 represented a milestone in promoting and funding international mobility in higher education in Europe. Its effects were so significant that they influenced the creation of the European Higher Education Area through the Bologna Process and ensured the program’s continuation and maintenance. Over the last decades, the escalating figures of participants and funds instigated significant scientific studies on the program's effects on higher education. More recently, in 2014, the program was renamed “Erasmus+” when it expanded into other fields of education, namely Vocational Education and Training (VET). Despite being now running in this field of education for a decade (2014-2024), its effects on VET remain less studied and less known, while the higher education field keeps attracting researchers’ attention. Given this gap, it becomes relevant to study the effects of E+ on VET, particularly in the priority domains of the Program: “Inclusion and Diversity,” “Participation in Democratic Life, Common Values and Civic Engagement,” “Environment and Fight Against Climate Change,” and “Digital Transformation.” This latter has been recently emphasized due to the COVID-19 pandemic that forced the so-called emergency remote teaching, leading schools to quickly transform and adapt to a new reality regardless of the preparedness levels of teachers and students. Together with the remaining E+ priorities, they directly relate to an emancipatory perspective of education sustained in soft skills such as critical thinking, intercultural awareness, autonomy, active citizenship, teamwork, and problem-solving, among others. Based on this situation, it is relevant to know the effects of E+ on the VET field, namely questioning how international mobility instigates digitalization processes and supports emancipatory queries therein. As an education field that more directly connects to hard skills and an instrumental approach oriented to the labor market’s needs, a study was conducted to determine the effects of international mobility on developing digital literacy and soft skills in the VET field. In methodological terms, the study used semi-structured interviews with teaching and non-teaching staff from three VET schools who are strongly active in the E+ Program. The interviewees were three headmasters, four mobility project managers, and eight teachers experienced in international mobility. The data was subjected to qualitative content analysis using the NVivo 14 application. The results show that E+ international mobility promotes and facilitates the use of digital technologies as a pedagogical resource at VET schools and enhances and generates students’ soft skills. In conclusion, E+ mobility in the VET field supports adopting the program’s priorities by increasing the teachers’ knowledge and use of digital resources and amplifying and generating participants’ soft skills.

Keywords: Erasmus international mobility, digital literacy, soft skills, vocational education and training

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Authors: M. Lu

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The paper presents part of the results of EU-funded projects: SoCool@EU (Sustainable Organisation between Clusters Of Optimized Logistics @ Europe), DG-RTD (Research and Innovation), Regions of Knowledge Programme (FP7-REGIONS-2011-1). It will provide an in-depth review of emerging technologies for further improving urban mobility and freight transport systems, such as (information and physical) infrastructure, ICT-based Intelligent Transport Systems (ITS), vehicles, advanced logistics, and services. Furthermore, the paper will provide an analysis of the barriers and will review business models for the market uptake of innovations. From a perspective of science and technology, the challenges of urbanization could be mainly handled through adequate (human-oriented) solutions for urban planning, sustainable energy, the water system, building design and construction, the urban transport system (both physical and information aspects), and advanced logistics and services. Implementation of solutions for these domains should be follow a highly integrated and balanced approach, a silo approach should be avoided. To develop a sustainable urban transport system (for people and goods), including inter-hubs and intra-hubs, a holistic view is needed. To achieve a sustainable transport system for people and goods (in terms of cost-effectiveness, efficiency, environment-friendliness and fulfillment of the mobility, transport and logistics needs of the society), a proper network and information infrastructure, advanced transport systems and operations, as well as ad hoc and seamless services are required. In addition, a road map for an enhanced urban transport system until 2050 will be presented. This road map aims to address the challenges of urban transport, and to provide best practices in inter-city and intra-city environments from various perspectives, including policy, traveler behaviour, economy, liability, business models, and technology.

Keywords: synchromodality, multimodal transport, logistics, Intelligent Transport Systems (ITS)

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Authors: Omogoriola Hannah Omoloye

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Fish is a key ingredient on the global menu, a vital factor in the global environment and an important basis for livelihood worldwide1. The length – weight relationships (LWRs) is of great importance in fishery assessment2,3. Its importance is pronounced in estimated the average weight at a given length group4 and in assessing the relative well being of a fish population5. Length and weight measurement in conjunction with age data can give information on the stock composition, age at maturity, life span, mortality, growth and production4,5,6,7. In addition, the data on length and weight can also provides important clues to climatic and environmental changes and the change in human consumption practices8,9. However, the size attained by the individual fish may also vary because of variation in food supply, and these in turn may reflect variation in climatic parameters and in the supply of nutrient or in the degree of competition for food. Environment deterioration, for example, may reduce growth rates and will cause a decrease in the average age of the fish. The condition factor and the relative condition factor10 are the quantitative parameters of the well being state of the fish and reflect recent feeding condition of the fish. It is based on the hypothesis that heavier fish of a given length are in better condition11. This factor varies according to influences of physiological factors, fluctuating according to different stages of the development. Condition factor has been used as an index of growth and feeding intensity12. Condition factor decrease with increase in length 12,13 and also influences the reproductive cycle in fish14. The objective here is to determine the length-weight relationships and condition factor for direct use in fishery assessment and for future comparisons between populations of the same species at different locations. To provide quantitative information on the biology of marine fish species trawl from Nigeria coastal water.

Keywords: condition factor, growth pattern, marine fish species, Nigerian Coastal water

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Authors: Ravinder Kaur

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Introduction Global cerebrovascular reactivity (CVR) mapping is a promising clinical assessment for stress-testing the brain using physiological challenges, such as CO₂, to elicit changes in perfusion. It enables real-time assessment of cerebrovascular integrity and health. Conventional imaging approaches solely use steady-state parameters, like cerebral blood flow (CBF), to evaluate the integrity of the resting parenchyma and can erroneously show a healthy brain at rest, despite the underlying pathogenesis in the presence of cerebrovascular disease. Conversely, coupling CO₂ inhalation with phase-contrast MRI neuroimaging interrogates the capacity of the vasculature to respond to changes under stress. It shows promise in providing prognostic value as a novel health marker to measure neurovascular function in disease and to detect early brain vasculature dysfunction. Objective This exploratory study was established to:(a) quantify the CBF response to CO₂ in hypocapnia and hypercapnia,(b) evaluate disparities in CVR between internal carotid (ICA) and vertebral artery (VA), and (c) assess sex-specific variation in CVR. Methodology Phase-contrast MRI was employed to measure the cerebrovascular reactivity to CO₂ (±10 mmHg). The respiratory interventions were presented using the prospectively end-tidal targeting RespirActTM Gen3 system. Post-processing and statistical analysis were conducted. Results In 9 young, healthy subjects, the CBF increased from hypocapnia to hypercapnia in all vessels (4.21±0.76 to 7.20±1.83 mL/sec in ICA, 1.36±0.55 to 2.33±1.31 mL/sec in VA, p < 0.05). The CVR was quantitatively higher in ICA than VA (slope of linear regression: 0.23 vs. 0.07 mL/sec/mmHg, p < 0.05). No statistically significant effect was observed in CVR between male and female (0.25 vs 0.20 mL/sec/mmHg in ICA, 0.09 vs 0.11 mL/sec/mmHg in VA, p > 0.05). Conclusions The principal finding in this investigation validated the modulation of CBF by CO₂. Moreover, it has indicated that regional heterogeneity in hemodynamic response exists in the brain. This study provides scope to standardize the quantification of CVR prior to its clinical translation.

Keywords: cerebrovascular disease, neuroimaging, phase contrast MRI, cerebrovascular reactivity, carbon dioxide

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Authors: Viktoriia Burkina, Vladimir Zlabek, Galia Zamaratskaia

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Cytochromes P450 (CYP) are important family of enzymes in Phase I metabolism. Environmental pollutants often act as inducers of the gene expression and activities CYP1A1 and CYP3A-like isoforms in fish. The activities are generally measured in the fish liver or gills, and less is known about tissue distribution of expression. In present study, the CYP1A1 and CYP3A-like activities were measured in rainbow trout liver, gill, intestine, heart, brain and gonads. The activities of CYP1A1 and CYP3A-like proteins were estimated as the rates of 7-ethoxyresorufin-O-deethylation (EROD) and benzyloxy-4-trifluoromethylcoumarin-O-debenzyloxylation (BFCOD), respectively. The CYP1A1 and CYP3A-like activities were detectable in all investigated fish tissues, with the highest activity in hepatic tissue followed by heart > brain > gill > intestine > gonads. To confirm the presence of CYP1A1 in different tissues, EROD activity was measured in presence of the selective inhibitors ellipticine (CYP1A1), ketoconazole (CYP3A), 8-methoxypsoralen (human CYP2A) and diallyl sulphide (CYP2E1). It was found that ellipticine, ketoconazole and 8-methoxypsoralen inhibited hepatic EROD activity by 88-98%. Ellipticine inhibited gill, intestine, and gonad EROD activity by 50%. In conclusion, EROD and BFCOD activities were detected in rainbow trout liver, gill, intestine, heart, brain and gonads. Further studies are needed to fully identify all CYP450 isoforms responsible for these activities. Acknowledgement: The study was financially supported by the Ministry of Education, Youth and Sports of the Czech Republic - projects „CENAKVA “(No. CZ.1.05/2.1.00/01.0024), “CENAKVA Center Development “(No. CZ.1.05/2.1.00/19.0380), “CENAKVA II “(No. LO1205 under the NPU I program), and "Development of USB - International mobility (No. CZ.02.2.69/0.0/0.0/16_027/0008364).

Keywords: BFCOD, EROD, fish, phase I metabolism, selective inhibitors

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Authors: L. M. Chinh

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Vam Cong Bridge beside Can Tho Bridge is the next cable-stayed bridge spanning the Hau River, connecting Lap Vo district with Thot Not district. After construction by the end of 2018, the Vam Cong Bridge with Cao Lanh Bridge will help to improve the road network in this region of Mekong Delta. For this bridge, the SHM system also had designed for two stages – construction stage and exploitation stage. At the moment over 65% of the bridge construction had completed, and the bridge will be completed at the end of 2018. During the construction stage, the SHM system had been install to monitor behaviors of the bridge. Based on the study of the design documentation of the SHM system of the Vam Cong Bridge and site visit during construction work, many designs and installation errors have been detected. In this paper author thoroughly analyzed the pros and cons of this SHM system, simultaneously make conclusions and recommendations for this system. Specially concentrated on the possibility of implementing the acoustic emission method (AE) into this SHM system, which is an alternative to the further development of the system, enabling a full and cost-effective solution for the bridge management, which is of utmost importance for the service life and safe operation of the bridge.

Keywords: SHM system, design and installation, Vam Cong bridge, construction stage, acoustic emission method (AE)

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Authors: O. E. Eberechi, G. P. Stevens

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Legal theory has been referred to as the explanation of why things do or do not happen. It also describes situations and why they ensue. It provides a normative framework by which things are regulated and a foundation for the establishment of legal mechanisms/institutions that can bring about a desired change in a society. Furthermore, it offers recommendations in resolving practical problems and describes what the law is, what the law ought to be and defines the legal landscape generally. Some legal theories provide a universal standard, e.g. human rights, while others are capable of organizing and streamlining the collective use, and, by extension, bring order to society. Legal theory is used to explain how the world works and how it does not work. This paper will argue for the application of the principles of legal theory in the achievement of access to justice for female victims of sexual violence in refugee camps in Africa through the analysis of legal theories underpinning the access to justice for these women. It is a known fact that female refugees in camps in Africa often experience some form of sexual violation. The perpetrators of these incidents may never be apprehended, prosecuted, convicted or sentenced. Where prosecution does occur, the perpetrators are either acquitted as a result of poor investigation, inept prosecution, a lack of evidence, or the case may be dismissed owing to tardiness on the part of the prosecutor, which accounts for the culture of impunity in refugee camps. In other words, victims do not have access to the justice that could ameliorate the plight of the victims. There is, thus, a need for a legal framework that will facilitate access to justice for these victims. This paper will start with an introduction, and be followed by the definition of legal theory, its functions and its application in law. Secondly, it will provide a brief explanation of the problems faced by female refugees who are victims of sexual violence in refugee camps in Africa. Thirdly, it will embark on an analysis of theories which will be a help to an understanding of the precarious situation of female refugees, why they are violated, the need for access to justice for these victims, and the principles of legal theory in its usefulness in resolving access to justice for these victims.

Keywords: access to justice, underpinning legal theory, refugee, sexual violence

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Authors: Eugene C. Lim

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This paper seeks to examine the extent to which ‘forum shopping’ is available to patent filers seeking protection of GMO (genetically modified organisms)-based inventions in Hong Kong. Under Hong Kong’s current re-registration system for standard patents, an inventor must first seek patent protection from one of three Designated Patent Offices (DPO) – those of the People’s Republic of China (PRC), the Europe Union (EU) (designating the UK), or the United Kingdom (UK). The ‘designated patent’ can then be re-registered by the successful patentee in Hong Kong. Interestingly, however, the EU and the PRC do not adopt a harmonized approach toward the patenting of GMOs, and there are discrepancies in their interpretation of the phrase ‘animal or plant variety’. In view of these divergences, the ability to effectively manage ‘conflict of law’ issues is an important priority for multinational biotechnology firms with a patent portfolio in the Greater China region. Generally speaking, both the EU and the PRC exclude ‘animal and plant varieties’ from the scope of patentable subject matter. However, in the EU, Article 4(2) of the Biotechnology Directive allows a genetically modified plant or animal to be patented if its ‘technical feasibility is not limited to a specific variety’. This principle has allowed for certain ‘transgenic’ mammals, such as the ‘Harvard Oncomouse’, to be the subject of a successful patent grant in the EU. There is no corresponding provision on ‘technical feasibility’ in the patent legislation of the PRC. Although the PRC has a sui generis system for protecting plant varieties, its patent legislation allows the patenting of non-biological methods for producing transgenic organisms, not the ‘organisms’ themselves. This might lead to a situation where an inventor can obtain patent protection in Hong Kong over transgenic life forms through the re-registration of a patent from a more ‘biotech-friendly’ DPO, even though the subject matter in question might not be patentable per se in the PRC. Through a comparative doctrinal analysis of legislative provisions, cases and court interpretations, this paper argues that differences in the protection afforded to GMOs do not generally prejudice the ability of global MNCs to obtain patent protection in Hong Kong. Corporations which are able to first obtain patents for GMO-based inventions in Europe can generally use their European patent as the basis for re-registration in Hong Kong, even if such protection might not be available in the PRC itself. However, the more restrictive approach to GMO-based patents adopted in the PRC would be more acutely felt by enterprises and inventors based in mainland China. The broader scope of protection offered to GMO-based patents in Europe might not be available in Hong Kong to mainland Chinese patentees under the current re-registration model for standard patents, unless they have the resources to apply for patent protection as well from another (European) DPO as the basis for re-registration.

Keywords: biotechnology, forum shopping, genetically modified organisms (GMOs), greater China region, patent portfolio

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Authors: Camila Dazzi, Crisitiane Passos de Mattos, Thiago Leite

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The paper discusses the cultural identity of the communities located in Environmental Protection Area (APAs), in the mountainous region of Rio de Janeiro, constituted almost entirely by descendants of Swiss immigrants who arrived in Brazil in the nineteenth century. The communication is the result of an extension project named "Cultural Identity in Environmental Protection Areas of Nova Friburgo." The objectives of this project were framed in the identification of local history, cultural demonstrations, crafts, religious events, festivals, the "know-how" and traditions. While an extension project, developed by students and teachers of a Bachelor of Tourism Management program, the work provided a more practical action: awareness the communities that inhabit the APAs on the possible implementation of the cultural community-based tourism, a sustainable alternative for economic development, involving local people as propagators of local culture, and tourism as a way of valuing and safeguarding of Intangible Heritage.

Keywords: tourism and cultural heritage, tourism and cultural impacts, tourism and cultural change, cultural identity

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Authors: Gabriele Ciasca, Tanya E. Sassun, Eleonora Minelli, Manila Antonelli, Massimiliano Papi, Antonio Santoro, Felice Giangaspero, Roberto Delfini, Marco De Spirito

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Glioblastoma multiforme (GBM) is an extremely aggressive brain tumor, characterized by a diffuse infiltration of neoplastic cells into the brain parenchyma. Although rarely considered, mechanical cues play a key role in the infiltration process that is extensively mediated by the tumor microenvironment stiffness and, more in general, by the occurrence of aberrant interactions between neoplastic cells and the extracellular matrix (ECM). Here we provide a nano-mechanical characterization of the viscoelastic response of human GBM tissues by indentation-type atomic force microscopy. High-resolution elasticity maps show a large difference between the biomechanics of GBM tissues and the healthy peritumoral regions, opening possibilities to optimize the tumor resection area. Moreover, we unveil the nanomechanical signature of necrotic regions and anomalous vasculature, that are two major hallmarks useful for glioma staging. Actually, the morphological grading of GBM relies mainly on histopathological findings that make extensive use of qualitative parameters. Our findings have the potential to positively impact on the development of novel quantitative methods to assess the tumor grade, which can be used in combination with conventional histopathological examinations. In order to provide a more in-depth description of the role of mechanical cues in tumor progression, we compared the nano-mechanical fingerprint of GBM tissues with that of grade-I (WHO) meningioma, a benign lesion characterized by a completely different growth pathway with the respect to GBM, that, in turn hints at a completely different role of the biomechanical interactions.

Keywords: AFM, nano-mechanics, nanomedicine, brain tumors, glioblastoma

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Authors: V. Vsevolozhskaia

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Since 1990, energy-efficient development concepts have constituted both a turning point in civil engineering and a challenge for an environmentally friendly future. Energy and water currently play an essential role in the sustainable economic growth of the world in general and Russia in particular: the efficiency of the water supply system is the second most important parameter for energy consumption according to the British assessment method, while the water-energy nexus has been identified as a focus for accelerating sustainable growth and developing effective, innovative solutions. The activities considered in this study were aimed at organizing and executing the renovation of the property in residential buildings located in St. Petersburg, specifically buildings with local or federal historical heritage status under the control of the St. Petersburg Committee for the State Inspection and Protection of Historic and Cultural Monuments (KGIOP) and UNESCO. Even after reconstruction, these buildings still fall into energy efficiency class D. Russian Government Resolution No. 87 on the structure and required content of project documentation contains a section entitled ‘Measures to ensure compliance with energy efficiency and equipment requirements for buildings, structures, and constructions with energy metering devices’. Mention is made of the need to install collectors and meters, which only calculate energy, neglecting the main purpose: to make buildings more energy-efficient, potentially even energy efficiency class A. The least-explored aspects of energy-efficient technology in the Russian Federation remain the water balance and the possibility of implementing rain and meltwater collection systems. These modern technologies are used exclusively for new buildings due to a lack of government directive to create project documentation during the planning of major renovations and reconstruction that would include the collection and reuse of rainwater. Energy-efficient technology for rain and meltwater collection is currently applied only to new buildings, even though research has proved that using rainwater is safe and offers a huge step forward in terms of eco-efficiency analysis and water innovation. Where conservation is mandatory, making changes to protected sites is prohibited. In most cases, the protected site is the cultural heritage building itself, including the main walls and roof. However, the installation of a second water supply system and collection of rainwater would not affect the protected building itself. Water efficiency in St. Petersburg is currently considered only from the point of view of the installation that regulates the flow of the pipeline shutoff valves. The development of technical guidelines for the use of grey- and/or rainwater to meet the needs of residential buildings during reconstruction or renovation is not yet complete. The ideas for water treatment, collection and distribution systems presented in this study should be taken into consideration during the reconstruction or renovation of residential cultural heritage buildings under the protection of KGIOP and UNESCO. The methodology applied also has the potential to be extended to other cultural heritage sites in northern countries and lands with an average annual rainfall of over 600 mm to cover average toilet-flush needs.

Keywords: cultural heritage, energy efficiency, renovation, rainwater collection, reconstruction, water management, water supply

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Authors: Lin Feng, Ling-Ling E., Hong-Chen Liu

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The development of chemoresistance in patients represents a major challenge in cancer treatment. Lactate dehydrogenase‑A (LDHA) is one of the principle isoforms of LDH that is expressed in breast tissue, controlling the conversion of pyruvate to lactate and also playing a significant role in the metabolism of glucose. The aim of this study was to identify whether LDHA was involved in oral cancer cell resistance to Taxol and whether the downregulation of LDHA, as a result of cisplatin treatment, may overcome Taxol resistance in human oral squamous cells. The OECM‑1 oral epidermal carcinoma cell line was used, which has been widely used as a model of oral cancer in previous studies. The role of LDHA in Taxol and cisplatin resistance was investigated and the synergistic cytotoxicity of cisplatin and/or Taxol in oral squamous cells was analyzed. Cell viability was analyzed by MTT assay, LDHA expression was analyzed by western blot analysis and siRNA transfection was performed to knock down LDHA expression. The present study results showed that decreased levels of LDHA were responsible for the resistance of oral cancer cells to cisplatin (CDDP). CDDP treatments downregulated LDHA expression and lower levels of LDHA were detected in the CDDP‑resistant oral cancer cells compared with the CDDP‑sensitive cells. By contrast, the Taxol‑resistant cancer cells showed elevated LDHA expression levels. In addition, small interfering RNA‑knockdown of LDHA sensitized the cells to Taxol but desensitized them to CDDP treatment while exogenous expression of LDHA sensitized the cells to CDDP, but desensitized them to Taxol. The present study also revealed the synergistic cytotoxicity of CDDP and Taxol for killing oral cancer cells through the inhibition of LDHA. This study highlights LDHA as a novel therapeutic target for overcoming Taxol resistance in oral cancer patients using the combined treatments of Taxol and CDDP.

Keywords: cisplatin, Taxol, carcinoma, oral squamous cells

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Authors: Anahita Suri

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Craft -an integral part of the conduit to create something beautiful- is a visual representation of the human imagination given life through the hand. The Mirgan tribe in the Naxalite infested forests of Koraput, Odisha are not exempt from this craving for beauty. These skilled craftsmen dye and weave the simple yet sophisticated Kotpad textiles. The women undertake the time-consuming task of dyeing the cotton and silk yarns with the root of the aul tree. The men then weave these yarns into beautiful sarees and dupattas. The root of the aul tree lends the textile its maroon to brown color, which is offset against the unbleached cotton to create a minimalist and distinctive look. The motifs, incorporated through the extra weft technique, reflect the rich tribal heritage of the community. This is an eco-friendly, non-toxic textile. Kotpad fabrics were on the verge of extinction due to various factors like poor infrastructure, no innovation in traditional designs/products, customer ignorance leading to low demand. With livelihood opportunities through craft slowly dwindling, artisans were moving to alternative sources of income generation, like agriculture and daily wage labor. There was an urgent need for intervention to revive the craft, spread awareness about them in urban spaces, and strengthen the artisan’s ability to innovate and create. Recent efforts by government bodies and local designers have given Kotpad handloom a contemporary look without diluting its essence. This research explores the possibilities to leverage Kotpad handloom to find a place in the dynamic culture of the world by its promotion among different target groups and incorporating self-sustaining practices for the artisans. This could further encourage a space for handmade and handcrafted art, rich with stories about India, with a contemporary visual sensibility. This will strengthen environmental and ethical sustainability.

Keywords: craft, contemporary, handloom, natural dye, tribal

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Authors: Syed Hadi Hasan, Devendra Kumar Singh, Viyaj Kumar

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Cr (VI) is a known toxic heavy metal and has been considered as a priority pollutant in water. The effluent of various industries including electroplating, anodizing baths, leather tanning, steel industries and chromium based catalyst are the major source of Cr (VI) contamination in the aquatic environment. Cr (VI) show high mobility in the environment and can easily penetrate cell membrane of the living tissues to exert noxious effects. The Cr (VI) contamination in drinking water causes various hazardous health effects to the human health such as cancer, skin and stomach irritation or ulceration, dermatitis, damage to liver, kidney circulation and nerve tissue damage. Herein, an attempt has been done to develop an efficient adsorbent for the removal of Cr (VI) from water. For this purpose nanosorbent composed of polyvinyl alcohol functionalized graphene oxide (GO/PVA) was prepared. Thus, obtained GO/PVA was characterized through FTIR, XRD, SEM, and Raman Spectroscopy. As prepared nanosorbent of GO/PVA was utilized for the removal Cr (VI) in batch mode experiment. The process variables such as contact time, initial Cr (VI) concentration, pH, and temperature were optimized. The maximum 99.8 % removal of Cr (VI) was achieved at initial Cr (VI) concentration 60 mg/L, pH 2, temperature 35 °C and equilibrium was achieved within 50 min. The two widely used isotherm models viz. Langmuir and Freundlich were analyzed using linear correlation coefficient (R2) and it was found that Langmuir model gives best fit with high value of R2 for the data of present adsorption system which indicate the monolayer adsorption of Cr (VI) on the GO/PVA. Kinetic studies were also conducted using pseudo-first order and pseudo-second order models and it was observed that chemosorptive pseudo-second order model described the kinetics of current adsorption system in better way with high value of correlation coefficient. Thermodynamic studies were also conducted and results showed that the adsorption was spontaneous and endothermic in nature.

Keywords: adsorption, GO/PVA, isotherm, kinetics, nanosorbent, thermodynamics

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Authors: Youcef Lakhdar Hamina

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In order to tame the ecological damage specificity, it is imperative to assert the procedural and objective liability aspect, which leads us to analyse current trends based on the development of preventive civil liability based on the precautionary principle. Our research focuses on the instruments of the environment protection in urban areas based on two complementary aspects appearing contradictory and refer directly to the institutional dimensions: - The preventive aspect: considered as a main objective of the environmental policy which highlights the different legal mechanisms for the environment protection by highlighting the role of administration in its implementation (environmental planning, tax incentives, modes of participation of all actors, etc.). - The healing-repressive aspect: considered as an approach for the identification of ecological damage and the forms of reparation (spatial and temporal-responsibility) to the impossibility of predicting with rigor and precision, the appearance of ecological damage, which cannot be avoided.

Keywords: environmental law, environmental taxes, environmental damage, eco responsibility, precautionary principle, environmental management

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Authors: Olanrewaju Aladeitan, Obiageli Phina Anaghara-Uzor

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Despite the abundance of natural gas deposits in Nigeria and the immense potential, this presents both for the domestic and export oriented revenue, there exists an imbalance in the preference for export as against the development and optimal utilization of natural gas for the domestic industry. Considerable amounts of gas are still being wasted by flaring in the country to this day. Although the government has set in place initiatives to harness gas at the flare and thereby reduce volumes flared, the gas producers would rather direct the gas produced to the export market whereas gas apportioned to the domestic market is often marred by the low domestic gas price which is often discouraging to the gas producers. The exported fraction of gas production no doubt yields healthy revenues for the government and an encouraging return on investment for the gas producers and for this reason export sales remain enticing and preferable to the domestic sale of gas. This export pull impacts negatively if left unchecked, on the domestic market which is in no position to match the price at the international markets. The issue of gas price remains critical to the optimal development of the domestic gas industry, in that it comprises the basis for investment decisions of the producers on the allocation of their scarce resources and to what project to channel their output in order to maximize profit. In order then to rebalance the domestic industry and streamline the market for gas, the Gas Aggregation Company of Nigeria, also known as the Strategic Aggregator was proposed under the Nigerian Gas Master Plan of 2008 and then established pursuant to the National Gas Supply and Pricing Regulations of 2008 to implement the domestic gas supply obligation which focuses on ramping-up gas volumes for domestic utilization by mandatorily requiring each gas producer to dedicate a portion of its gas production for domestic utilization before having recourse to the export market. The 2008 Regulations further stipulate penalties in the event of non-compliance. This study, in the main, assesses the adequacy of the legal framework for the Nigerian Gas Industry, given that the operational laws are structured more for oil than its gas counterpart; examine the legal basis for the Strategic Aggregator in the light of the Domestic Gas Supply and Pricing Policy 2008 and the National Domestic Gas Supply and Pricing Regulations 2008 and makes a case for a review of the pivotal role of the Aggregator in the Nigerian Gas market. In undertaking this assessment, the doctrinal research methodology was adopted. Findings from research conducted reveal the reawakening of the Federal Government to the immense potential of its gas industry as a critical sector of its economy and the need for a sustainable domestic natural gas market. A case for the review of the ownership structure of the Aggregator to comprise a balanced mix of the Federal Government, gas producers and other key stakeholders in order to ensure the effective implementation of the domestic supply obligations becomes all the more imperative.

Keywords: domestic supply obligations, natural gas, Nigerian gas sector, strategic gas aggregator

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Authors: Liliane Ventura, Mauro Masili

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Ultraviolet (UV) protection is critical for sunglasses, and mydriasis, as well as miosis, are relevant parameters to consider. The literature reports that for sunglasses, ultraviolet protection is critical because sunglasses can cause the opposite effect if the lenses do not provide adequate UV protection due to the greater dilation of the pupil when wearing sunglasses. However, the scientific literature does not properly quantify to support this rationale. The reasoning may be misleading by ignoring not only the inherent absorption of UV by the sunglass lens materials but also by ignoring the absorption of the anterior structures of the eye, i.e., the cornea and aqueous humor. Therefore, we estimate the pupil diameter and calculate the solar ultraviolet influx through the pupil of the human eye for two situations of an individual wearing and not wearing sunglasses. We quantify the dilation of the pupil as a function of the luminance of the surrounding. Therefore, we calculate the influx of solar UV through the pupil of the eye for two situations for an individual wearing sunglass and for the eyes free of shade. A typical boundary condition for the calculation is an individual in an upright position wearing sunglasses, staring at the horizon as if the sun is in the zenith. The calculation was done for the latitude of the geographic center of the state of São Paulo (-22º04'11.8'' S) from sunrise to sunset. A model from the literature is used for determining the sky luminance. The initial approach is to obtain pupil diameter as a function of luminance. Therefore, as a preliminary result, we calculate the pupil diameter as a function of the time of day, as the sun moves, for a particular day of the year. The working range for luminance is daylight (10⁻⁴ – 10⁵ cd/m²). We are able to show how the pupil adjusts to brightness change (~2 - ~7.8 mm). At noon, with the sun higher, the direct incidence of light on the pupil is lower if compared to mid-morning or mid-afternoon, when the sun strikes more directly into the eye. Thus, the pupil is larger at midday. As expected, the two situations have opposite behaviors since higher luminance implies a smaller pupil. With these results, we can progress in the short term to obtain the transmittance spectra of sunglasses samples and quantify how light attenuation provided by the spectacles affects pupil diameter.

Keywords: sunglasses, UV protection, pupil diameter, solar irradiance, luminance

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Authors: B. Shahzamanian, S. Varga, D. C. Alarcón-Padilla

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Desalination is considered the primary alternative to increase water supply for domestic, agricultural and industrial use. Sustainable desalination is only possible in places where renewable energy resources are available. Solar energy is the most relevant type of renewable energy to driving desalination systems since most of the areas suffering from water scarcity are characterized by a high amount of available solar radiation during the year. Multi-Effect Desalination (MED) technology integrated with solar thermal concentrators is a suitable combination for heat-driven desalination. It can also be coupled with thermal vapour compressors or absorption heat pumps to boost overall system performance. The most interesting advantage of MED is the suitability to be used with a transient source of energy like solar. An experimental study was carried out to assess the performance of the most important life-size multi-effect desalination plant driven by solar energy located in the Plataforma Solar de Almería (PSA). The MED plant is used as a reference in many studies regarding multi-effect distillation. The system consists of a 14-effect MED plant coupled with a double-effect absorption heat pump. The required thermal energy to run the desalination system is supplied by means of hot water generated from 60 static flat-plate solar collectors with a total aperture area of 606 m2. In order to compensate for the solar energy variation, a thermal storage system with two interconnected tanks and an overall volume of 40 m3 is coupled to the MED unit. The multi-effect distillation unit is built in a forward feed configuration, and the last effect is connected to a double-effect LiBr-H2O absorption heat pump. The heat pump requires steam at 180 ºC (10 bar a) that is supplied by a small-aperture parabolic trough solar field with a total aperture area of 230 m2. When needed, a gas boiler is used as an auxiliary heat source for operating the heat pump and the MED plant when solar energy is not available. A set of experiments was carried out for evaluating the impact of the heating water temperature (Th), top brine temperature (TBT) and temperature difference between effects (ΔT) on the performance ratio of the MED plant. The considered range for variation of Th, TBT and ΔT was 60-70°C, 54-63°C and 1.1-1.6°C, respectively. The performance ratio (PR), defined as kg of distillate produced for every 2326 kJ of thermal energy supplied to the MED system, was almost independent of the applied variables with a variation of less than 5% for all the cases. The maximum recorded PR was 12.4. The results indicated that the system demonstrated robustness for the whole range of operating conditions considered. Author gratitude is expressed to the PSA for providing access to its installations, the support of its scientific and technical staff, and the financial support of the SFERA-III project (Grant Agreement No 823802). Special thanks to the access provider staff members who ensured the access support.

Keywords: multi-effect distillation, performance ratio, robustness, solar energy

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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